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DATE(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE
<br /> 11/17/2025
<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(ies)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 CONTACT Certificate Dept.
<br /> NAME:
<br /> Assured Partners of California A/cNN. Ext: (949)261-5335 a/c,No): (949)261-1911
<br /> 1300 Dove Street,Suite 300 E-MAIL certificates.nb@assuredpartners.com
<br /> ADDRESS:
<br /> Lic#OM07762 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Newport Beach CA 92660 INSURERA: Nationwide General Insurance Company 23760
<br /> INSURED INSURER B: Oak River Insurance Company 34630
<br /> Williams and Maher,Inc. INSURER C:
<br /> 1406-E S.Ritchey Street INSURER D:
<br /> INSURER E:
<br /> Santa Ana CA 92705-4735 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 25/26 GL,Auto,Umb,WC REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT 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 TYPE OF INSURANCE POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 100'000
<br /> MED EXP(Any one person) $ 10,000
<br /> A Y Y ACP3007878695 11/01/2025 11/01/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> MOTHER
<br /> LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> JECT: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> X ANYAUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED Y Y ACP3007878695 11/01/2025 11/01/2026 BODILY INJURY(Pe r accide nt) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> Underinsured motorist $ 1,000,000
<br /> UMBRELLA LIAB X 2,000,000
<br /> OCCUR EACH OCCURRENCE $
<br /> A EXCESS LAB CLAIMS-MADE ACP3007878695 11/01/2025 11/01/2026 AGGREGATE $ 2,000,000
<br /> DED I I RETENTION $ $
<br /> WORKERS COMPENSATION X1
<br /> SPTER
<br /> EORH
<br /> AND EMPLOYERS'LIABI LI TY YIN 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> B OFFICER/MEMBER EXCLUDED? N/A Y WIWC621385 01/01/2025 01/01/2026
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:All Operations
<br /> Digitally igned
<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 TU Tran byTuTr
<br /> A/I with Waiver of Sub.&Per Pro'.Aggregate Endt.-NCG7471 1216.GL Primary and Non-Contributor Endt.-CG2001 04/13.Auto A/I with Prima and Nguyen
<br /> 1Y Y Y Nguyen Date:zo .11.n
<br /> Waiver applies per NCA7005 0118.(WC)Blanket Waiver of Sub.Endt.included-WC99041 OC 01/19. i 1:1a:a5 oa'oo
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> By Tu Tran Nguyen at 11:18 am,Nov 17,2025
<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 /> AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza
<br /> Santa Ana CA 92701
<br /> @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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