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a DATE(MMlDD1YYYY)AC�
<br /> CERTIFICATE OF LIABILITY INSURANCE 121212025
<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 /> NAME: Bonnie Me for
<br /> SHIS-Colossus-Alkeme Insurance PHONE 619 908 6351 FArAXX
<br /> 1204 E Yorba Linda Blvd (A No):
<br /> Placentia CA 92870 ADDRESS: bme for alkemeins.com
<br /> INSURERS AFFORDING COVERAGE NAIC 1f
<br /> INSURER A:National Fire&Marine Insurance Company 20079
<br /> INSURED BRUCAND-03 INSURER B:State Compensation Insurance Fund of California 35076
<br /> Bruce Anderson Enterprises, Inc, dba A's Construction 1662 West McFadden Ave msuRERc:Associated Industries Insurance Company, Inc. 23140
<br /> Santa Ana CA 92704 INSURER D:Ategrity Specialty Insurance Cornpanv 16427
<br /> INSURER E:Scottsdale Insurance Company 41297
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1149131948 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 /> ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MW�bmYY MMIDDIYYYY LIMITS
<br /> C X COMMERCIALGENERALLIABILITY AES125773501 11/1812025 11/18/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADEFRI OCCUR DAMAGETORENTEO
<br /> PREMISES Ea occurrence $100,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000
<br /> POLICY ]JEOT LOG PRODUCTS-COMP/CPAGG $2,000,000
<br /> OTHER: 1 $
<br /> A AUTOMOBILE LIABILITY 72APS123295 1/10/2025 1/10/2026 COMI INRDSINGLELIMIT $1,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED Ix
<br /> SCHEDULED BODILY INJURY(Per sccldent) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> E UMBRELLA LIAR X OCCUR CXS4067120 10/21/2025 11/18/2026 EAGH OCCURRENCE $2,000,000
<br /> X EXCESSLIAB CLAIMS-MADE AGGREGATE $2,000,000
<br /> ❑EO I X I RETENTION $
<br /> B WORKERSCOMPENSATION 9352130 1/1012025 1/10/2026 X STATUTE OTRH
<br /> AND EMPLOYERS'LIABILITY Y/N
<br /> ANYPROPRIETORIPARTNEPJEXECUTIVE TI NIA R.L.EACH ACCIDENT $1,000,000
<br /> OFFICE RIMEMBEREXCLUDED?
<br /> (Mandatory In NH) R.L.DISEASE-RA EMPLOYEE $1,000,000
<br /> If as,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> O Pollution Llabilty G48784586 001 10/612025 10/6/2026 Each Condition 1,000,000
<br /> Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> The City of Santa Ana,its officers,Officials,employees and volunteers are named as Additional Insureds applies per CG 2033 0413&CG 2037 0704 On a
<br /> Primary and Non-Contributory basis per attached form NXGL009 0809 and waiver of subrogation applies per attached form CG 2404 0509 as respects to
<br /> General Liability coverage per attached forms and are required by written contract with the named insured prior to an occurrence and subject to policy terms
<br /> and conditions as respects to insureds operations.
<br /> The City of Santa Ana,its officers,officials,employees and volunteers are named as Additional Insureds applies per attached form M58870817 and waiver of
<br /> subrogation applies per attached form M5144a0607as respects to business auto liabillty coverage and are required by written contract with the named insured
<br /> prior to an occurrence and subject to policy terms and conditions as respects to insureds operations.
<br /> See Attached...
<br /> CERTIFICATE HOLDER CANCELLATION APPROVED J
<br /> Fran Nguyen.af 9 94•am�.Dec-03,2025
<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 PROVISIONS.
<br /> Public Works Agency-Parks, Fleet, &Facilities S Digitally signed
<br /> 20 Civic Centre Plaza M-11 AUTHORIZED REPRESENTATIVE p� Nguyen
<br /> Santa Ana CA 92701 �Q I V g t lyel l 09 to 24-090'
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and-logo are registered marks of ACORD
<br /> THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE
<br />
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