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DATE(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE 3/30/2026
<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 /> IMA, Inc. -Pasadena PHONE IMA Certs Team FAX
<br /> 3475 E. Foothill Boulevard A/c No EXt: .JC,No:
<br /> E-MSuite 100 ADDRESS: certificates@imacorp.com
<br /> Pasadena CA 91107 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:0008309 INSURERA: Hartford Casualty Insurance Company 29424
<br /> INSURED LIEBCAS-Cl INSURERB: Federal Insurance Company 20281
<br /> Liebert Cassidy Whitmore, A Professional Corporation INSURERC: QBE Insurance Corporation 39217
<br /> 6033 W. Century Blvd 5th Floor
<br /> Los Angeles CA 90045 INSURERD: QBE Specialty Insurance Company 11515
<br /> INSURER E: Harco National Insurance Company 26433
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:600526245 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICY NUMBER MM/DD MM/DD
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 72SBABL8FM5 12/14/2025 12/14/2026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE � OCCUR PREMISES DAMAGE TO
<br /> PREMISES Ea occurrence)
<br /> ccurrence $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY D PRO
<br /> JECT LOC PRODUCTS-COMP/OP AGG $4,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY 72SBABL8FM5 12/14/2025 12/14/2026 COMBINED SINGLE LIMIT $2,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED FIR ERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> A X UMBRELLA LIAB X OCCUR 72SBABL8FM5 12/14/2025 12/14/2026 EACH OCCURRENCE $4,000,000
<br /> EXCESS LAB CLAIMS-MADE AGGREGATE $4,000,000
<br /> DED X RETENTION$1 n nnn $
<br /> B WORKERS COMPENSATION Y 2771750595 4/1/2026 4/1/2027 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE FN] N/A E.L.EACH ACCIDENT $1,000,000
<br /> OFFICE R/M EMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> C Professional Liability LAW2163903 12/14/2025 12/14/2026 Each Claim/Aggregate: $10,000,000
<br /> D Cyber Liability CELP001193501377801 12/14/2025 12/14/2026 Each Occ/Aggregate: $3,000,000
<br /> E D&O PML000345401 12/14/2025 12/14/2026 Aggregate: $2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> General Liability forms apply to Automobile as written on the policy.
<br /> RE: Legal Services Agreement A-2021-138 Certificate Holder Includes: City of Santa Ana, its officers,officials,employees and agents Certificate Holder and all
<br /> other parties required by the contract are included as Additional Insured on the General Liability Policy, if required by written contract or agreement,subject to
<br /> the policy terms and conditions.This Insurance is Primary& Non-Contributory on the General Liability Policy, if required by written contract or agreement,
<br /> subject to the policy terms and conditions.A Waiver of Subrogation is provided in favor of the Certificate Holder and all other parties required by the contract on
<br /> the General Liability and Workers Compensation Policies, if required by written contract or agreement,subject to the policy terms and conditions.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 10:47 am,Apr 30, 2026
<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 /> Risk Management Division
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702
<br /> USA
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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