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AC" CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDfYYYY)
<br /> 09/2512025
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
<br /> PRODUCER NAME CT certificate dept.
<br /> Assured Partners of California PHONE (949)261-5335 FAX (949)261-1911
<br /> (AIG,No Ext: Al.No;
<br /> 1300 Dove Street,Suite 300 EMAIL certificates.nb@assuredpartners.com
<br /> ADDRESS:
<br /> LIc#UM07762 INSURER(S)AFFORDING COVERAGE NAIL N
<br /> Newport Beach CA 92661) INSURER A: Nationwide General Insurance Company 2376D
<br /> INSURED INSURER B: California Automobile Insurance Company 38342
<br /> Williams and Maher,Inc. INSURER C: Oak River Insurance Company 34630
<br /> 1406-E S,Ritchey Street INSURER D:
<br /> INSURER E:
<br /> Santa Ana CA 92705-4735 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 24125 LlablAutolXS1WC REVISION NUMBER:
<br /> THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br /> INSR P LICYEFF POLICYEXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS
<br /> X COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ 1,00D,000
<br /> NO ECLAIMS-MADE 19 OCCUR PREMISES Ea occu ence $ 100,000
<br /> MED EXP(Any one person) $ 10,000
<br /> A Y Y ACP3007878695 11/01/2024 11/01/2025 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMITAPPLIES PER; GENERAL AGGREGATE $ 2.000,000
<br /> POLICY PRO ❑ 2,000,000
<br /> PRO-
<br /> JECT LOC PRODUCTS-COMPIOPAGG $
<br /> OTHER: $
<br /> AUTOMOBII.ELIABILITY COMBINED SINGLE LIWT $ 1,000,000
<br /> Ea accident
<br /> X ANYAUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED Y Y BA040000091159 11/01/2024 11/01/2025 BODILYINJURY{Per accident
<br /> AUTOS ONLY AUTOS ) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Par accident $
<br /> Underinsured motorist 1,000,000
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> A EXCESS LIAB CLAIMS-MADE ACP3007878695 11/01/2024 11/01/2025 AGGREGATE $ 2,000,000
<br /> DED I I RETENTION$ $
<br /> WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y I N
<br /> C OPFICERIMEMBEREXCLUDED?ANY ECUTIVE � NIA Y WIWC621385 01/01/2025 01/01/2026 E.L.EACHACCIDENT $ 1,000,000
<br /> (Mandatory In NH) E.L.DISEASE
<br /> D -EA EMPLOYEE $ 110{)D,000
<br /> yes,dIP r*a under E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS below 11000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS[VEHICLES (ACORD 01,Additional Remarks Schedule,may be attached If more space Is required)
<br /> RE:All Operations
<br /> City of Santa Ana,its City Council,its officers,officials,employees,agents,and volunteers are to be covered as additional insureds per attached GL Blanket
<br /> All with Waiver of Sub.&Per Proj.Aggregate Endt.-NGG7471 1216.GL Primary and Nan-Contributory End(.-CG2001 04113.Blanket Auto Al with PNOC
<br /> Endt,-MCACABE 0823.Blanket Auto WOS Endt.-MCA0444 0913. (WC)Blanket Waiver of Sub.End(,Included-WC99041OC 01119.
<br /> Tu Tra n Y by
<br /> To TralnNguyen Date:205.10.0
<br /> Nguyen 07:25:39i0700$ APPROVED
<br /> -�__
<br /> CERTIFICATE HOLDER CANCELLATION 8y Tu Trap Nguyen at 7.25 ani,.O a 08 2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> ATTN:PWA PFFR
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701r rvi
<br /> ©19BB-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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