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ENVIPLA-02 TAKAPUK
<br /> A�C7R� CERTIFICATE OF LIABILITY INSURANCE DATE 10 2112 25
<br /> 1are112a25
<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 License#OE67768 CONTACT katalina takapu
<br /> MAMIOA Insurance Services PHONE EAx
<br /> 3875 Hopyard Road Alc,No,Ext):(925)416-7862 A c,NQI:(925)416-7869
<br /> Suite 200 E-MAIL
<br /> ESS
<br /> Pleasanton,CA 94588
<br /> INSURERS AFFORDING COVERAGE NAIC ff
<br /> INSURERA:Continental Casualty Company 20443
<br /> INSURED INSURER B:Hartford Casualty Insurance Com an 29424
<br /> Environment Planning Development Solutions Inc dba EPD INSURER
<br /> Solutions Inc
<br /> 3333 Michelson Dr.,Suite 500 INSURERD:
<br /> Irvine,CA 92612 INSURERE:
<br /> INSURER F;
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 2
<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 ISSULD OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVL BLEN REDUCED BY PAID CLAIMS,
<br /> ILTR NSR ADDLTYPE OF INSURANCE INSD WVD POLICY NUMBER ZMJDDPOLICY EFF POLICY EXP LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000
<br /> CLAIMS-MADE X OCCUR DAMAGE TO RFNTE❑
<br /> X X Bfi025654530 9I3012O25 9/3012026 P a occ S 1,00O,60o
<br /> MEO EXP(Any one ersun $ 10,000
<br /> PERSONAL&ADV INJURY g 2,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 4,000,000
<br /> POLICY®JECT LOG PRODUCTS-COMPfOPAGG 5 4,000,000
<br /> OTHER
<br /> A s
<br /> AUTOMOBILE LIABILITY COJE.aMBINED SINGLE LIMIT $ 1,000,000
<br /> ANY AUTO X X B6025654530 913012025 9130/2026 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident) 5
<br /> )( HIRED �( NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> S
<br /> A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 4,000,000
<br /> EXCESS LIAR CLAIMS-MADE X X B6025663132 9/30/2025 9130/2026 AGGREGATE s 4,000,000
<br /> DED I X I RETENTION 5 10,000
<br /> 5
<br /> S WORKERS COMPENSATION X PER OTH-
<br /> ANDEMPLOYERS'LIABILITY
<br /> ANY PROPRIETORIPARTNERIEXECUT€VE YIN® NIA X 57WEGAC20BW 91301202$ 913012026 E.L.EACH ACCIDENT g 1,000,000
<br /> OFFICERIMEMHER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE 5 1,000,000
<br /> If yes,descdbe under
<br /> DESCRIPTION OF OPERATIONS below I EL.DISEASE-POLICY LIMIT 5 1,000,000
<br /> A Professional Liab, X EEH591923312 9/30/2025 9/3012026 Per Claim 4,000,000
<br /> A Professional Liab. X EEH591923312 9/30/2025 9/3012026 Aggregate 5,000,000
<br /> DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES IACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:On-Call Agreement-Agreement No,A-2023-194-03
<br /> As required by Certificate Holder written contract or agreement,in-addition to(if applicable)the governing written contract or agreement:(1)Commercial
<br /> General Liability policy shall include(a)additional insured coverage and contain(b)primary&non-contributory and(c)waiver of subrogation provisions for
<br /> any additional insured; (2)to the extent applicable,Automobile Liability policy shall include(a)additional insured coverage and contain(b)primary&non-
<br /> contributory and(c)waiver of subrogation provisions for any additional insured;(3)to the extent applicable,Commercial Excess Liability policy shall apply
<br /> on a follow-form basis,excess of commercial general liability,automobile liability and employers' liability policy(ies)with such coverage being concurrent
<br /> with underlying insurance;(4)to the extent applicable,Workers Compensation and Employers'Liability policy shall include a waiver of subrogation provision;
<br /> SEE ATTACHED ACORD 101
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Trarr Nguyen at 1 f:18 am,Oct 22,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Tu Tra n °1gi,Wfl s'goedby ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Tu Tr Nguyen
<br /> Nguy�r,oate.zoz5.,q.2=
<br /> ,,.,esy-0Too�
<br /> AUTHORIZED REPRESENTATIVE
<br /> City of Santa Ana, Planning and Building Agency
<br /> 20 Civic Center Plaza
<br /> Ana,CA 92701 t�-Q_h —�
<br /> ACORD 25(2016/03) O 1988-2015 ACORD CORPORATION, All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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