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Ac"® CERTIFICATE OF LIABILITY INSURANCE pATEIMMIDDIYYYYj
<br /> 12/09/2025
<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 bolder is an ADDITIONAL INSURED,the policy(tes)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 Paul LUCCI
<br /> NAME;
<br /> Brown&Brown Insurance Services,Inc. PHONE (445)201-1625 FAX
<br /> WC.No Ext: FAX
<br /> NO:
<br /> 107Audubon Rd E-MAIL aul.lucci bbrown,com
<br /> ADDRESS: P
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Wakefield MA 018BO INSURER A: Travelers Property Casualty Company of America 25674
<br /> INSURED INSURER B: The Charter Oak Fire Insurance Company 25615
<br /> CLR Design,Inc INSURER C: The Standard Fire Insurance Company 19070
<br /> 833 Chestnut St INSURER D: XL Specialty Insurance Company 37885
<br /> Suite 909 INSURER E:
<br /> Philadelphia PA 19107 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 25-26 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br /> ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM,DDmYY MMJDDNY POLICY Y1 LIMITS
<br /> X COMMERCIALGENERALLIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO RENTED-
<br /> CLAIMS-MADE FX—I OCCUR PREMISES Eaoccuence $ 9,000,000
<br /> MED EXP fAny one person) $ 10,000
<br /> A Y Y 6802J979064 07/11/2025 07/1112026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000
<br /> POLICY 19 JECT LJ LOG PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED Y Y BA9R272273 07/11/2025 07/11/2026 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED Ix
<br /> NON-OWNED PROPERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> X UMBRELLA LIAB X OCCUR $ 5,000,000
<br /> EACH OCCURRENCE
<br /> A EXCESS LIAB CLAIMS-MADE CUP6736Y412 07/11/2025 07/11/2026 AGGREGATE $ 5,000,000
<br /> DIED X RETENTION $ 10,000 $
<br /> WORKERS COMPENSATION X STATUTE ORH
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNERIEXECUTIVE Y!N E.L,EACH ACCIDENT $ 1,000.000
<br /> C OFFICER/MEMBER EXCLUDED? FR
<br /> NIA Y UB7K189676 07/11l2025 07l1112026
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,OD0,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Professional Liability Each Claim $4,000,000
<br /> D DPR5045978 07/11/2025 07/11/2026 Aggregate $4,000,000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required)
<br /> RE:City of Santa Ana Agreement#A-2D21-060. DIgiullysl ed
<br /> City of Santa Ana,its officers,employees,agents and representatives are named as additional insured as respects general liability and auto liability for TU Tran hyTuTran
<br /> Nguyen
<br /> services provided by the named insured. Coverage is primary and non-contributory.30 days notice of cancellation applies. Additional Insured Nguyen D te:2025 2.09
<br /> endorsements attached.(CG T8 02 07 22&CG T8 03 07 22). Waiver of Subrogation applies to the General Liability(See endorsements CG T1 00 02 19, 14:570-0'00'
<br /> Page 16,Paragraph a and CG D3 79 01 16,Page 5,Paragraph Q.),Sulo Liability and Workers Compensation.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION 8y Tu?°ran Nguyen at 2.37 p 2025
<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 PROVIStONS.
<br /> Attention: PWA
<br /> 20 Civic Center Plaza,M-11 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701 °_
<br /> O 1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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