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acoRbr CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMro DNYYY) <br />11/1812025 <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 />CONTACT Mike Brown <br />A r <br />SfafeFarm Mike Brown <br />PONAHC No Ext : 515-264-2626 Fn c No): <br />'E-MAILSS mike. brown.eyyk@statefarm.com <br />• = 1356 E Hickman Road <br />INSURER(S) AFFORDING COVERAGE <br />NAIC 4 <br />INSURER A: State Farm Fire and Casualty Company <br />25143 <br />Waukee IA 502638137 <br />INSURED <br />INSURER e <br />NATHAN T WRIGHT ILLUSTRATION LLC <br />INSURER C . <br />1709 BUFFALO RD <br />INSURER D: <br />INSURER E: <br />WDM IA 502651 fi30 <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 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 <br />LTR <br />TYPE OF INSURANCE <br />ADD <br />INSD <br />SUB <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD1YYYY <br />POLICY EXP <br />MMIDD <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F\/1 OCCUR - <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTS❑ <br />PREMISES Ea occurrence <br />$ 300,000 <br />MED EXP (Any are person) <br />$ 5,000 <br />PERSONAL BADVINJURY <br />$ 1,000,000 <br />A <br />Y <br />Y <br />95-CP-L410-0 <br />10/31/2025 <br />10/31/2026 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRO- �l <br />POLICY "I'll);/� LOC <br />PRODUCTS-COMPIOP AGG <br />$ 2,000.000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea ac ident <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />BODILY INJURY (Per accident) <br />$ <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />Per accident <br />$ <br />AUTOS ONLY AUTOS ONLY <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE Y f N <br />OFFICER]MEMBER EXCLUDED? <br />NIA <br />PER OTH- <br />E.L, EACH ACCIDENT <br />$ <br />E.L. DISEASE- EA EMPLOYE <br />S <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISFASE - POLICY LIMIT <br />g <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached 1f more space is required) <br />City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers are listed as blanket and scheduled additional insureds with waiver of <br />subrogation on policy 95-CP-L410-0 <br />TU Tran Di,ita"Ysi9ned by <br />Tu Tran Nguyen <br />Nguyen084359-08'009 APPROVED <br />By Tu Tran Nguyen at 8:43 am, Nov 19, 2025 <br />I.CK I11- 6A I C MULLJtK UANGI=LLA I IUN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Attn: PWA-Water Resources <br />220 S Daisy Ave AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92703 This farm was system -generated on 1111812025 <br />O 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />1001486 2005 155279 205 01-19-2°23 <br />