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ACC>R" CERTIFICATE OF LIABILITY INSURANCE P09/09/2025 ATE(MMIODIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER CONTACT EZ Insurance Services, Inc NAME: Alan Starc 2960 Harbor Blvd Suite b PH : (714)754-9037 FAX No: (714)754-9035 COSTA MESA, CA 92626 ADDRESS: Alan@ezlnsurance923.com License#- OEB6632 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Gotham insurance Company 25569 INSURED INSURERB: Nautilus Insurance Company 17370 CABIFORNIA INC. INSURER C: 26611 NACCOME DR INSURER D: MISSION VIEJO, CA 92691 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00029446.0 REVISION NUMBER: 22 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS: INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY) (MMiDDffYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y GL202500023595 07130/2025 07130/2026 EACH OCCURRENCE $ 1 0OO 000 CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence) $ 300,000 MED EXP(An one arson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JE'CT ❑ LOC PRODUCTS-COMPIOPAGO $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMDINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY per accident B X UMBRELLA LIAB OCCUR Y Y AN1356530 0713012025 0713012026 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1 000,000 DED I I RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- ANbEMPLOYERS'LIABILITY YIN STATUTE ER ANY PRO PRIETORIPARTNERIEXECUTIVE E,L,EACH ACCIDENT $ OFFICERIMEMBEREXCLUOE1 NIA (Mandatory in NH) EX,DISFASE-EA EMPLOYE $ If yyes,describe under OESGRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Tu T an %Digiruuysru�dby D.t ra2 Ngu APPROVED �a�e:xazs,l 13 - Ngu en n,:41:19-07' � -. ray T.Tran Nguyen at 7;40 am,Oct 43,2075. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) GENERAL LIABILITY POLICY HAS BLANKET Al, BLANKET WOS&BLANKET PNC ENDORSEMENTS.See Attached. City of Santa, its officers,empolyees, agents and representative are Additional Insureds with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non-Contributory. 30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of premium in accordance with policy provisions, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN RISK MANAGEMENT DIVISION ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA AUTI1Q2QD REPRESENTATIVE - 5ANTAANA, CA 92702 AAS ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by AAS on 0 9109/2 0 2 5 at 08:38AM