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A� o® CERTIFICATE OF LIABILITY INSURANCE
<br />ATE(MMi025YY)
<br />P
<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
<br />AssuredPartners Design Professionals Insurance Services, LLC
<br />3697 Mt. Diablo Blvd Suite 230
<br />CONTACT
<br />NAME: AnnlOWens
<br />NAME:
<br />FAX
<br />Arc No Ezt: 510-272-1465 IC,No:
<br />Lafayette CA 94549
<br />ADDRRss: GertsDesignPro@AssuredPartners.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: BERKLEY INSURANCE COMPANY
<br />32603
<br />License#:6003745
<br />INSURED MIGINGO-01
<br />MIG, Inc.
<br />Moore lacofano Goftsman, Inc.
<br />INSURER B : Travelers Property Casualty Company of America
<br />25674
<br />INSURER The Travelers Indemnity Company of Connecticut
<br />25682
<br />-..
<br />INSURERD:NationalIndemnity Company
<br />800Hearst Ave
<br />20087
<br />Berkeley CA 94710
<br />29459
<br />INSURERE: Twin City Fire Insurance Company
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:287007949 REVISION NIIMRFR-
<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 />ILTR
<br />TPEOFINSURANCE
<br />jSVD
<br />W
<br />POLICYNUMBER
<br />MUL, MWDDYICY YY
<br />LIMITS
<br />B
<br />X COMMERCIAL. GENERAL LIABILITY
<br />CLAIMS -MADE rx] OCCUR
<br />Y
<br />Y
<br />680JH899998
<br />8131/2025
<br />': 8/31/2026
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />X Contractual Liab
<br />MED EXP (Any one person)
<br />$ 10,ODD
<br />Included
<br />PERSONAL & ADV INJURY
<br />31,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY [�K] PRO-JECT fJ LOG
<br />GENERALAGGREGATE
<br />$2,000,000
<br />PRODUCTS -COMPIOPAGG
<br />52,000,000
<br />S
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />Y
<br />Y
<br />BAOS579947
<br />8/31/2025
<br />8/31[2026
<br />ObMSINED SINGLE LIMIT
<br />Ea accident
<br />S 1,000,0o0
<br />BODILY INJURY (Per person)
<br />$
<br />DOWNED
<br />SCHEDULED
<br />. AUTOS ONLY AUTOS
<br />5
<br />BODILY INJURY (Per accident)
<br />X
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTYDAMAGE
<br />Per accident
<br />S
<br />$
<br />B
<br />X
<br />UMBRELLAUAB
<br />X OCCUR
<br />Y
<br />Y
<br />CUPOH758762
<br />8/31/2025
<br />8/31/2026
<br />EACH OCCURRENCE
<br />310,000,000
<br />EXCESS LIAB
<br />CLAIMS -MARE
<br />AGGREGATE
<br />$ 10,000,000
<br />j DED X I RETENTIONS n
<br />$
<br />e
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LlABILITY YIN
<br />ANYPROPRIETORlPARTNERIEXECUTIVE a
<br />OFFICERIMEM$EREXCLUE
<br />NIA
<br />Y
<br />UB2L553909
<br />8/3112025
<br />8/31/2026
<br />XPER OTH-
<br />STATUTE I ER
<br />E.L. EACH ACCIDENT
<br />$ 1.000.000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1.000.000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />A
<br />D
<br />E
<br />Professional Liab & Contr.Poll
<br />Drone Liability
<br />Cybar Liability
<br />AEC909023107
<br />9C041014
<br />57MB035552025
<br />8/31/2025 8131/2026
<br />8131/2025 8/31l2026
<br />8131/2025 8/31/2026
<br />Per ClainV$5 000,000
<br />Limit
<br />Limit
<br />$5,000,0001Aggr
<br />$1,OOD,D00
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS r LOCATIONS r VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached R more space Is required)
<br />The following policies are included in the underlying schedule of insurance for umbrellalexoess liability: General LiabilitylAuto Liabi lityl Employers
<br />LiabilitylEmployee Benefits Liability.
<br />Project #5619.00- Santa Ana Dog Park Design Services
<br />City of Santa Ana Public Works, its officers, officials, employees, and volunteers are named as additional insureds as respects general liability as required per
<br />written contract. General Liability is Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of subrogation per the attached
<br />endorsement(s).
<br />CANCELLATIONS 30 day notice will be sent to the certificate holder.
<br />11
<br />CERTIFICATE HOLDER APPROVED CANCELLATION 30 Day Notice of Cancellation
<br />By Tv Tran Nguyen at 7:35 am, Oct 13, 2025
<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 Public Works ni'T"' lys+g,ea
<br />Ngu,yeny,.
<br />20 Civic Center Plaza, M-36 Tu Tran byAUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 Nguyen073551-0TU3
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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