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® DATE(MM/DD/YYYY)
<br /> ACC OR"
<br /> � CERTIFICATE OF LIABILITY INSURANCE 5/27/2026
<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 /> NAME: Rachel Garciano
<br /> Chrysalis Insurance Agency(Incorporated) PHONE ,A/C,No,Ext: 714 464-8080 (A/C No) (714)464-8070
<br /> 3001 Red Hill Ave,Ste.2-226 ADDRESS: service@insuredwell.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Costa Mesa CA 92626 INSURER A: ADMIRAL INS CO 24856
<br /> INSURED INSURER B: CALIFORNIA AUTOMOBILE INS CO 38342
<br /> Sunny Hills Associates Inc.d/b/a SUNNY HILLS RESTORATION INSURER C: MIDWEST EMPLOYERS CAS CO 23612
<br /> 1999 RITCHEY ST INSURER D: OHIO CAS INS CO 24074
<br /> INSURER E:
<br /> SANTA ANA CA 92705-5100 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 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 /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 100,000
<br /> X POLLUTION LIABILITY MED EXP(Any one person) $ 5,000
<br /> A X PROFESSIONAL LIABILITY Y FEI-ECC-35209-04 05/15/2026 05/15/2027 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY ❑ECT ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> B OWNED AUTOS ONLY X AUTOSULED Y BA040000099937 04/10/2026 04/10/2027 BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED HF<UHEK I Y DAMAGE $
<br /> X AUTOS ONLY X AUTOS ONLY (Per accident)
<br /> UMBRELLA LAB M
<br /> OCCUR EACH OCCURRENCE $ 1,000,000
<br /> A X EXCESS LAB CLAIMS-MADE Y FEI-EXS-45093-04 05/15/2026 05/15/2027 AGGREGATE $ 1,000,000
<br /> DED I I RETENTION$ PRODUCTS/COMPLETI $ 1,000,000
<br /> WORKERS COMPENSATION X STATUTE ER
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000
<br /> COFFICER/MEMBER EXCLUDED? Fy] N/A Y BNET729611432 11/14/2025 11/14/2026
<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 /> Misc Equipment $55,000
<br /> D Commercial Property&Inland Marine BK061278353 4/7/2026 4/7/2027 Property of Others $319,489
<br /> Systems Breakdown $319,489
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana and Santa Ana Police Department,Its Officers,Agents and Employees,Vendors are named as additional insured.30 days notice of cancellation.
<br /> Waiver of Subrogation applies.Above coverage is primary and any insurance or self-insurance maintained by the Entity,its officers,officials,employees,or
<br /> volunteers shall be excess of the Contractor's insurance and shall not contribute with it.
<br /> APPROVED
<br /> By Tu Tran Nguyen at 11:36 am,May 27,2026
<br /> L]
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> Attention:Santa Ana Police Department AUTHORIZED REPRESENTATIVE
<br /> 60 Civic Center Plaza,M-97
<br /> Santa Ana CA 92701
<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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