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AC o> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODlYYYY) <br /> �' 11mAt2025 <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 <br /> Edgewood Partners Ins Center PHONE Jer ND ola FAX <br /> 3780 Mansell Rd. Suite 370 -770.552.4225 Arc No <br /> Alpharetta GA 30022 A2DRess: greylingceits@greyling.com <br /> INSURERS AFFORDING COVERAGE NAIC If <br /> INSURER A:National Union Fire Ins CO Of Pittsburg19445 <br /> INSURED KIMLASS INSURER B:Allied World Assurance CO U.S. Inc. 19489 <br /> K 1 Fayetteville Street, Suite 600 <br /> Horn and Associates, <br /> 421 Fa INSURER C:New Hampshire Insurance Company 23841 <br /> Raleigh, NC 27601 INSURER D:Lloyd's of London 85202 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1 551 0961 74 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 DOCUMLNT 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 ADDL SUER POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER MMfDDIYYYY) (MMIDDfYYYYt LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY GL5268169 4/1/2025 4/112026 EACH OCCURRENCE $2,000,G44 <br /> CLAIMS-MADE F�J OCCUR DAMAGE TO RENTED <br /> PREMISES Ea occurrence $1,04D,000 <br /> X Contractual Liab MED EXP(Any one person) $25,000 <br /> PERSONAL&ADV INJURY $2.000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4.000,000 <br /> POLICY® PE O LOC <br /> PRODUCTS-COMPIOP AGG $4,000,004 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY CA4489663(AOS) 411/2025 4/112026 COMBINED SINGLE LIMIT $2,000,000 <br /> q Ea accident <br /> X ANY AUTO CA2970071 (MA) 4/112025 4/112026 BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY Per accident $ <br /> AUTOS ONLY .AUTOS ( ) <br /> X HIRED X NON-OWNED PROPERFY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> S <br /> B X UMBRELLA LIAB X OCCUR 03127930 4/1/2025 4/112026 EACH OCCURRENCE $5,000.000 <br /> X EXCESS LIAB CLAIMS-MADE <br /> AGGREGATE $5,000,400 <br /> DIED I X I RETENTION$ $ <br /> C WORKERS COMPENSATION WC067961230(AOS) 4/112025 411/2026 X PER OTH- <br /> C AND EMPLOYERS'LIABILITY STATUTE ER <br /> YIN WC013711685(CA) 411I2025 4/1/2426 <br /> ANYPROPRIETOPJPAR7NER!EXECUTIVE E.L.EACH ACCIDENT $2,000,000 <br /> OFFICERlMEM6ER EXCLUDE07 [_N] N I A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $2,400,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2.000.000 <br /> D Professional Liability B0146LDUSA2504949 4/1/2025 4/1/2026 Per Claim $2,000,000 <br /> Aggregate $2,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Re: On-Call Engineering Services;RFP 22-002.The City of Santa Ana,its officers,employees,agents&representatives are named as Additional Insureds on <br /> the above referenced liability policies with the exception of workers compensation&professional liability where required by written contract.The above <br /> referenced liability policies with the exception of professional liability are primary&non-contributory where required by written contract.Separation of Insureds <br /> applies to the General Liability Policy.Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof,30 <br /> days'written notice(except 10 days for nonpayment of premium)will be provided to the Certificate Holder.Waiver of Subrogation in favor of Additional <br /> Insured(s)With respects to Workers Compensation,General&Professional Liability where required by written contract&allowed by law. <br /> APPROVED <br /> CERTIFICATE HOLDER By Tu Tran Nguyen at 4:40 pm,Nov 06 2025 CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Digitally signed THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City of Santa Ana Tu Tra n byuuTrran ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Planning and Building Agency Nguyen Date:2025.11.0 <br /> 20 Civic Center Plaza 16:4119-0900' AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92701 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE <br />