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SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST DATE <br /> CERTIFICATE OF INSURANCE ENDORSEMENT 10/10/2025 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, <br /> EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE ENDORSEMENT DOES NOT CONSTITUTE A CONTRACT <br /> BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> PRODUCER: SPECIAL EVENT INSURANCE DEPARTMENT CONTACT INFORMATION: <br /> HUB International Insurance Services Inc. PHONE 9256096547 F <br /> AX 9256096550 <br /> 3000 Executive Parkway,Suite 300 EMAIL sDecialevent(a)hubinternational com <br /> San Ramon,CA 94583 INSURER(S)AFFORDING COVERAGE NAIC# <br /> CA License#0757776 INSURER A: Colony Insurance Company 39993 <br /> NAMED INSURED: <br /> Gabriela Pineault <br /> 616 Cantor <br /> Irvine,CA 92618 <br /> COVERAGES <br /> This is to certify that the policies of insurance listed below have been issued to the insured named above for the event date(s)indicated below. Notwithstanding any requirement,term o <br /> condition of any contract or other document with respect to which this certificate may be issued or may pertain,the insurance afforded by the policies described herein is subject to all the <br /> terms,exclusions and conditions of such policies. <br /> INSURED MEMBER <br /> INSR TYPE OF INSURANCE ENDORSEMENT COVERAGE EFFECTIVE 1 LIMITS <br /> LFR NUMBER EXPIRATION DATE <br /> A GENERAL LIABILITY EACHOCCURRENCE <br /> $2,000,000 <br /> X COMMERCIAL GENERAL LIABILITY 51616 10/25/2025 DAMAGE TO RENTED PREMISES $1,000,000 <br /> (Ea acwrsencey <br /> CLAIMS-MADE OCCURRENCE MEDEXP(Anynneper ) $5,000 <br /> PERSONAL B ADV INJURY $2,000,000 <br /> GENERAL AGGREGATE $4,000,000 <br /> PRODUCTS-COMKOP AGG $4,000,000 <br /> LIQUOR LIABILITY PER <br /> OCCURRENCE(AGGREGATE <br /> I NCLLJCED IN GENERAL LIABILITY NIA <br /> AGGREGATE) <br /> MASTER POLICY#103 GL 0021111 -EFFECTIVE DATE 11112025;EXPIRATION 1/1/2026 <br /> DESCRIPTION OF OPERATIONS!LOCATIONS <br /> City of Santa Ana,its City Council,its officers,officials,employees,agents and volunteers,20 Civic Center Plaza,Santa Ana,CA 92701 <br /> Ware included as an additional insuredis)per attached endorsement T5409.0118,Policy is Primary and Non-contributing per attached endorsement T1095-0108;Waiver of <br /> Subrogation applies per attached endorsement CG 24 04 05 09. <br /> Event Type: Performer <br /> Event date(s): 1 012 5/2 0 2 5 <br /> CERTIFICATE HOLDER APPROVED CANCELLATION <br /> By Tu Tran Nguyen at 1:18 pm,Oct 96,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City of Santa Ana RMD approval only due to ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attention:Library Services,Dylan Dario Director's decision to waive AUTHORIZED REPRESENTATIVE <br /> 20 Civic Center Plaza,M-42 certain requirements <br /> Santa Ana,CA 92701 <br /> Dig y TitallyuT r a <br /> signedn <br /> Tu Tran b <br /> Nguyen <br /> I127:07-07'00' <br />