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Ac�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDDlYYYY) <br /> 3/10/2025 <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 Annette Romero <br /> Acrisure Southwest Partners Insurance Services, LLC PHONE 949-486-7904 Fnc No <br /> 18952 MacArthur Blvd., Suite#300 -MAIL <br /> Irvine, CA 92612 ADDRESS: aromero,@patrisk.com <br /> INSURER 3 AFFORDING COVERAGE NAIC# <br /> www.patrisk.com OK07568 INSURERA: AIX Specialty Insurance Company A+XV 12833 <br /> INSURED INSURER B: Travelers Indemnity Co of Connecticut A++XV 25682 <br /> Pacific Plumbing ton Avenue Company of Santa Ana <br /> 615 E.Washing INsuRERc: Travelers Property Casualty Co of Amer A++XV 25674 <br /> Santa Ana CA 92701 INSURER D: Arch Specialty Insurance Company A+ XV 21199 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 84296662 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE 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 ADDLTYPE OF INSURANCE m5n SUER POLICY NUMBER MML�D�YY MML�DfYYYY LIMITS <br /> LTR <br /> A COMMERCIAL GENERAL LIABILITY ✓ L14-J658006-01 3/1/2025 3/1/2026 EACH OCCURRENCE $1 000000 <br /> DAMAGE TO CLAIMS-MADE OCCUR RENTED <br /> ✓ PREMISES Ea occurrence $100 000 <br /> MED EXP(Any oneperson) $5 000 <br /> PERSONAL&ADV INJURY $1 000 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> POLICY�JEGT LOG PRODUCTS-COMPIOPAGG $2000 000 <br /> OTHER: Employee Benfits $1 000 000 <br /> S AUTOMOBILE LIABILITY ✓ 810A8559123 3/1/2025 3/1/2026 EOa aBI;NEid.D-91NGLE LIMIT $1 000 000 <br /> ✓ ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NOWOWNED PROPERTY DAMAGE $ <br /> ✓ AUTOS ONLY ✓ AUTOS ONLY Per accldent <br /> $ <br /> A �/ UMBRELLALIAB �/ OCCUR L14-J658005-01 3/1/2025 311/2026 EACH OCCURRENCE $5000000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5 000 000 <br /> ✓ DED RETENTION$() $ <br /> C WORKERS COMPENSATION ✓ UBA8559424 3/1/2025 311/2026 �/ STATUTE HR" <br /> AND EMPLOYERS'LIABILITY YIN - <br /> ANYPROPRIE=TOR/PARTNERIEXECUTIVE N f A E.L.EACH ACCIDENT $1,000 000 <br /> OFFICERlMEMBJ=REXCLUDE67 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1 00 <br /> oE8CRIPTION OFOPE=RATIONS below E.L.DISEASE-POLICY LIMIT 1$1 000 000 <br /> Q Pollution Liability PDCPPOO19908 3/1/2025 3/1/2026 Limit:$2,000,000 <br /> Deductible/Ea Poll Condition:$10,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> City of Santa Ana,its officers,employees,agents,volunteers and representatives are named as additional Insured as their Interest TU Tran .TUTralayNg n- <br /> may app ear,coverage includes Primary and Non-contributory as respects to General Liability and Auto Liability oate:202s,on.D7 <br /> per endorsement attached where required by written contract.Waiver of Subrogation applies to WC and in favor Nguyen 07:47s3-07'00' <br /> of the additional insured per attached endorsement.*30-day notice of cancellation 1 10-days for non-payment of premium. <br /> APPR4VfD _ <br /> CERTIFICATE HOLDER CANCELLATION 8y Tu 4aNguye i af.7 47 am:Apr0T_2U25 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 20 Civic Center Plaza M-21 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Santa Ana CA 92701 <br /> AUTHORVED REPRESENTATIVE <br /> Dave Jacobson <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> 84296662 1 25/26 GL/AU/UM13/WC/P0LL I Annette Romero ( 3/10/2025 12:42:D7 PM (PDT) I Page 1 of 12 <br />