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ACC)R130 CERTIFICATE OF LIABILITY INSURANCE DArE{MM1oDlYYYYp
<br /> 2/l/2026 2/13/2025
<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(les)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 /> CONTACT
<br /> PRODUCER LOckton Companies,LLC NAME:
<br /> DBA Lockton Insurance Brokers,LLC in CA PHONE FAX
<br /> C a ExII; (A!C No):
<br /> CA license#OF15767 E-MAIL
<br /> 81 l0 E Union Ave.,Ste. 100 ADDRESS:
<br /> Denver CO 80237 INSURER 5 AFFORDING COVERAGE NAIC#
<br /> denver- INSURER A:Crum&Forster Specialty Insurance Co 44520
<br /> INSURED Rincon Consultants,Inc. INSURER S:Hartford Fire Insurance Company 19682
<br /> 1462719 180 N Ashwood Ave. INSURER C:Crum and Forster Insurance Company 42471
<br /> Ventura CA 93003 INSURER D:Palomar Excess and Surplus Insurance Co. 16754
<br /> INSURER E:Starstonc National Insurance Company 25496
<br /> _ INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 16059509 REVISION NUMBER: XXXXXXX
<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 ADDLTYPE OF INSURANCE INM SUER POLICY NUMBER MMIDPOLIDY LTR IYYYY MM ODIYYYY LIMITS
<br /> COMMERCIAL GENERAL LIABILITY
<br /> A X Y Y EPK-15091I 2/1/2025 2.r112026 EACH OCCURRENCE s 4,000,000
<br /> DAMAGE TO RENT ED
<br /> CLAIMS-MADE U OCCUR PREMISES Ea occurrence $ 100 000
<br /> X SiR:S50,040 MED EXP(Any one person( $ 10,000
<br /> X P&T PERSONAL&ADV INJURY_ $ 4,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY JE O- LOG PRODUCTS-COMP/OP AGG $ 4 000 000
<br /> OTHER: $
<br /> 72UENOL5481 2/I/2025 2/1/2026 COMBINED SINGLE LIMIT $
<br /> g AUTOMOBILE LIABILITY �� Y ? Ea accident 1 000 000
<br /> X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX
<br /> OWNED SCHEDULED BODILY INJURY(Per $
<br /> AUTOS ONLY AUTOS racc XXXXXXX
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $ XXvXXX
<br /> AUTOS ONLY AUTOS ONLY Per accident XXr
<br /> om ./Coll.Ded $ 1,000
<br /> UMBRELLA LIAR X OCCUR N N EFX-127832 2/1/2025 2/t/2026 EACH OCCURRENCE $ 10.000.000
<br /> D X EXCESS LFAB CLAIMS-MADE CEEXP-25-0000094-00 2/l/2025 2/l/2026 AGGREGATE $ 10,000,000
<br /> DEE) I X I RETENTION$ 10,000 S XXXXXXX
<br /> WORKERS COMPENSATION PER OTH-
<br /> E AND EMPLOYERS'LIABILITY Y T10250329 AOS) 2/1/2025 21/2026 X. STATUTE ER
<br /> E ANY PROPRIETORIPARTNERIEXEGUTIVE YIN T10251427�FL) 2/l/2025 2/l/2026 E,L,EACH ACCIDENT $ 1,000 000
<br /> OFFICERIMEMBER EXCLUDED? FN—] N I A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,dascdbe under
<br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> A ContractorsPollutioDLiab N N EPK-150911 2/1/2025 2/1/2026 54,000,000/$4,000,000
<br /> E&O Liab. $4,000,000 ea.oce./$4,000,000 agg,
<br /> Retro Date: 12/9/1994
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER.APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S)REFERENCED.
<br /> Effective 2/l/2024-8/l/2025,Cyber Liability$5M Limit,525k Retention,Carver:HCC;Policy#H24NGP224923-01,$5M x$5M Limit,Carrier:Catvus,Policy 4CXS-I07946155-00.The City of
<br /> Santa Ana and Community Development Agency and their officers,employees,agents and volunteers are an Additional Insured to the extent provided by the policy language or endorsement issued or
<br /> approved by the insurance carrier.Waiver of Subrogation applies per attached endorsement(s)or policy language.Insurance provided to Additional Insured(s)is primary and non-contributory as per the
<br /> attached endorsement or policy language.Excess policy follows General Liability,Auto Liability and Employers Liability form.Notice of Cancellation applies per the applicable policy language or
<br /> endorsements.
<br /> Ng.y
<br /> Tu Tran Digiran Nguygned6yTu APPROVED
<br /> Ten
<br /> Nguyen Date:2o15n2.13
<br /> 0:51:42-08'00 By Tu Tran Nguyen of 10:51 am, Feb 13, 20251
<br /> 0ERTIFICATE HOLDER CANCELLATION See Attachments
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 16059509 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attention: Planning and Building Department
<br /> 20 Civic Center Plaza,M-20 AUTHORIZED REPRESENTATIVE Santa Ana CA 9270I1988-20 ' All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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