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<br /> AC"RE►® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODfYYYY}
<br /> `-� 01/26/2026
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS j
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I
<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 endorsements, f}
<br /> PRODUCER CONTACT
<br /> Number? Insurance Marketing Services PHONE Shannon Balo FAX
<br /> 17111 Beach Blvd Ste 103 c 714 848.4400 WC,No):(714)848-3500
<br /> Huntington Beach, CA 92647 ED DRESS' Shannon@numberlins.com
<br /> License#: OC 17917 INSURER 5 AFFORDING COVERAGE NAIC#
<br /> INSURERA: Associated Industries Insurance Company1
<br /> INSURED INSURERS: California Automobile Ins 38342
<br /> A 2 Z CONSTRUCT INC INSURERa Nautlus Insurance Company
<br /> 63 VIA GATILLO INSURER D: State Compensation Insurance Fund I
<br /> RANCHO SANTA MARGAR,CA 92688-3160 INSURER : Colony Insurance Company
<br /> INSURER F•
<br /> COVERAGES CERTIFICATE NUMBER: 00004613.0 REVISION NUMBER: 55
<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. i
<br /> IN
<br /> R TYPE OF INSURANCE ADDI.$VBR POLICY EFF POLICY EXP i
<br /> POLICY NUMBER MMIODIYYW M IDDIYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y AES1268943 00 1112312025 1112312026 EACH OCCURRENCE $ 11000,000
<br /> '
<br /> CLAIMS-MADE N OCCUR DAMAG Ea accu enee $ 100,000
<br /> MED EXP(Any one arson) $ 2,500 !
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> i
<br /> GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2 000 000
<br /> �( POLICY❑JECT ELOG PRODUCTS•COMPIOP AGG $ 2,000,000
<br /> OTHER, $
<br /> B AUTOMOBILE LIABILITY Y Y BA040000086557 0211512025 0211612026 ea agoNen i SINGLE LIMIT $ 1 000 000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per $
<br /> AUTOS ONLY AUTOS { 1
<br /> X AUTOS ONLY X AUTOS ON� AerOaxRden DAMAGE $
<br /> $
<br /> e UMBRELLA LIAR X OCCUR AN 1367841 1112312025 11123/2026 EACH OCCURRENCE $ 4,000,000
<br /> X I EXCESS LIAR CLAIMS-MADE AGGREGATE S 4,000,000
<br /> DEM RETENTION$ 0 $
<br /> D WORKERS COMPENSATION Y 9392821 12/3112025 12131/2026 X sEATUTE ERH
<br /> AND EMPLOYERS'LlA81LITY
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE Y 1 N E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICERIMEM3EREXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE•EA EMPLOYEE $ 1,000,000
<br /> If qes.describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000 000
<br /> E Pollution CSIP4245644 07110/2025 07/1012026 General Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
<br /> City of Santa Ana,Its City Council,officers,officials,employees,agents,and volunteers are named additional insured with
<br /> regards to CGL and commercial Auto per policy when required by written contract with the Insured.Primary and non
<br /> contributory wording shall be afforded by the policy to the additional insured.Waiver of subrogation shall be afforded by the
<br /> CGL,commercial Auto and WC policy In favor of the additional insured.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Trap Nguyen at 7;54 am,Jari 27, 2026
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> PWA—Park Services ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 220 S Daisy Ave
<br /> SANTA ANA, CA 92703 AUTH RIZED REPRESENTATIVE
<br /> SSB
<br /> ©1988-2015 ACORD CORPORATION, All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by SSB on 01126/2026 at C4:39PM
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