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(MMIDWYYY
<br /> ACC>RL> CERTIFICATE OF LIABILITY INSURANCE DAT911612025 Y)
<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 NAME;CT Brandon Full!
<br /> CaiNonpr Insurance Services PHONE .831-824-5020 a°�xc No):831-462-8529
<br /> 1500 500 41 st Avenue, Suite 228 E-MAIL
<br /> Capitola CA 95010 ADDRESS: brand on cal-insurance.o
<br /> INSURERS AFFORDING COVERAGE HAIL#
<br /> INSURERA:Philadelphia Indemnity Insurance Company 18058
<br /> INSURED OCHUMAN-01 INSURERB:Hartford Casualty Insurance Company 29424
<br /> We Are Groundswell
<br /> 1801 E Edinger Ave, Ste. 115 INSURER c:Underwriters at Lloyds,London
<br /> Santa Ana CA 92705 INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:247693578 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR POLICYNUMBER MMIDDNYYY MMlDDIYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y PHPK2664706-020 4/26/2025 4/26/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE �OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrence $100,000
<br /> MED EXP Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY1:1 ECT LOC PRODUCTS-COMPIOPAGG $1,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY PHPK2664706-020 4I2612025 4/26/2026 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> X HIRED Ix
<br /> NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> A X UMBRELLALIAB X OCCUR PHUB903790-002 4/26/2025 412612D26 EACH OCCURRENCE $2.000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000
<br /> DEO I X I RETENTION$i n nnn $
<br /> B WORKERS COMPENSATION Y 57WECANIML1 10/1/2025 10/1/2026 X STATUTE ERH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANYPROPRIETORIPARTNERIEXECUIIVE ❑ NIA
<br /> E.L.EACH ACCIDENT $1,000.000
<br /> OFFICERlMEMBEREXCLUDED7
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000.000
<br /> if
<br /> yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E,L,DISEASE-POLICY LIMIT $1.000.000
<br /> C CyberLlabllity ESN0240143583 12/15/2024 12/15/2025 Policy Aggregate $1,000,000
<br /> A Professienal Liability PHPK2664706-020 4/26/2025 4/26/2026 EachOcc.lAggregate $1M/$2M
<br /> A Improper Sexual Conduct&Abuse PHPK2664706-020 4/26/2025 4126,2026 Each Occ.Mggregate $I M/$2M
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,maybe anached it more space is required)
<br /> Accident(Philadelphia Indemnity Insurance Company,NAIC#18058,Policy#PHPA157428-006,5/10/2025-511012026,Maximum Benefit:$100,000)
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as Additional Insured with respect to General Liability as
<br /> required by written contract per Endorsement Form(s)CG 20 26 04 13 and PI-GL-005(07/12)attached.General Liability coverage is Primary&
<br /> Nan-Contributory and Waiver of Subrogation applies as required by written contract per Endorsement Form(s)PI-GL-005(07/12)&PI-GLD-HS(10/11)
<br /> attached.Worker's Compensation Waiver of Subrogation applies as required by written contract per Endorsement Form(s)WC 00 03 13 attached.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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