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r <br /> i <br /> R� DATE <br /> CERTIFICATE OF LIABILITY INSURANCE <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOZES 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 be endorsed. If SUBROGATION IS WAIVED,subject to the <br /> terms and conditions of the policy,certain policles may require an endorsement. A statement on this Certificate does not confer rights to the <br /> certificate holder In lieu of such endorsement(s). <br /> PRODUCER CONTANAME; YENY CANALES <br /> AUTO INTERNATIONAL INSURANCE COMPANY PHON1xt)�CCANALES uI ,SEGLIRF NIT Fax No): _ <br /> 946 S,ATLANTIC BLVD,LOS ANGELES CA 90022 E-MAIL <br /> ADDRESS: _ <br /> INSURER 9 AFFORDING COVERAGE mm� NAM# <br /> INSURER A: NEXT INSURANCE US COMPANY _ 16285 <br /> INSURED _ - -~ INSURER B <br /> PACIFIC COAST SHUTTLE LLC INsuRSRc: <br /> 1000 E SANTA ANA BLVD,STE#105 INSURER D: �--- -- - — <br /> SANTA ANA CA 92701 INSURER E: <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 DESCR16ED 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 TYPE OF INSURANCE D L SU8R POLICY NUMEI_R POLICY EYY MMIO�� LIMITS <br /> LTR <br /> GENERAL LIABILITY EACH OCCURRENCE $2,000,000,00 <br /> DAMAGE RENTED <br /> X COMMERCIAL GENERAL LIABILITY PREMISESEa Occurence $ 100,000.00 <br /> CLAIMS-MADE OCCUR LIED EXP(Any one person) $ 5,000.00 <br /> A _ NXT3V7VHD4-00-GL 10/01/2025 10/01/2026 PERSONAL&ADV INJURY $2,000,000,00 <br /> GBNERALAGGREGATE_ $4,000,000,00 <br /> GENT AGGREGATE LIMIT APPLIES PER; PRODUCTS,COMPIOPAGO $4 D ()000.00 <br /> POLICY PRO- LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident <br /> ANYAUTO BODILY INJURY(Par parson) $ <br /> ALLOWNEO SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $WON-OW _ <br /> _ <br /> HIRED AUTOS AUTO$ Nk:D pea c d nIDAMAGE $ -- <br /> UMBRELLA L1AB OCCUR F 1 �r EACH OCCURRENCE $ <br /> --- - <br /> EXCESS LIAB CLAIMS-MADEAGGREGATE $ - <br /> DED RETENTIONS --------- .$ - <br /> ¢!!WORKERS COMPENSATION 7WOC SL'TUS ;OTH <br /> f AND EMPLOYERS'LIABILITY Y N <br /> IIII ANY PROPRIETORMARTNER&XF.CUTIVE E.L.EACH ACCIDENT $ <br /> IOFFICF.IMEMBEREXCLUDED? NIAI - - <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> i If yes,deaMbe under $ <br /> I&SCRIFflON OF OPQWIQNS below E.L.DISEASE-POLICY LIMIT <br /> i I <br /> I <br /> DESCRIPTION OF OPERATIONS/LOCATIONS IVEHICLES (Attach ACORD 101,A(Idlltonat Romarks Schedule,If more space is required) <br /> COVERAGE: <br /> APPROVED <br /> ENDORSEMENT WAIVER OF SUBROGATION FORM Sy Tu Tran Nguyen at 3.36 pm,Nov 13,2025-. <br /> INCLUDED ADDITIONAL INSURED ENDORSEMENT. Tu TranIuIranNg ye°Y <br /> Nguyen°5':3 o250-8lbo3 <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF SANTA ANA,ITS CITY COUNCIL,OFFIERS, SHOULD ANY OF THE ABOVE DE5CRISE0 POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> OFFICIALS,EMPLOYEES,AGENTS,AND VOLUNTEERS ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PWAFACILITIES-SARTO <br /> AUT RfzED REPRESENTATIVE <br /> 1000 E SANTA ANA BLVD,SANTA ANA CA 92701 fdJ <br /> }'YENY CANALES-AGENT-AUTO INTERNATIONAL <br /> vF O 1988.2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010106) The ACORD name and logo are registered marks of ACORD <br />