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<br /> CERTIFICATE OF LIABILITY INSURANCE °ATE`"9/2026
<br /> AtL't�aRra. 3/ /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 pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certaln policies may require an endorsement, A statement on
<br /> this certificate does not confer rights to the certificate holder In lieu of such andorsemen s,
<br /> PRODUCER Phone: (707)996-2912 CONTAOT Jen'lee Cetpenter
<br /> Fax: (107)996-7912 IIAM AX
<br /> Apolto Gemral Insurance Agency,Inc.(1) PIAHIGL Nob
<br /> P.O.Box 1508 �es • jerileec�apgen,00nt
<br /> Sonoma,California 95476 INSURER AFFORDINGCOWPIA06 NA1Ct
<br /> INSURER A: Everest Indemnity Insurance Company 10851.
<br /> MORE$ INSURER 8, Everest National Insurance Company 10120
<br /> American Wrecking,Inc. INSURER C. State Compensation Insurance,Fund Of California 35076
<br /> 2459 Leo Avenue MURER D t Tokio Marine Specialty Insurance Company 23850
<br /> South Ei Monte,CA 91733
<br /> URER E
<br /> 1. URER P.
<br /> COVERAGES CERTIFICATE NUMBER:1519 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 ANO CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> MR ADDTYPE OF INSURANCE E sues P ICYNUMBSR POLIGYEFP POLICYEXP lJMIiS
<br /> t/ COMMERCIAL GENERAL CF40LO1371-251 4/28/2025 4/28/2026 EAcHOCCURRENCE $ 1,000,000
<br /> A CLAIM-MADE ✓ OCCUR E nee $ 300,000
<br /> an
<br /> __._._ _ _._ ✓ MEO EXP(Any one person S ,
<br /> 000
<br /> PERSONAL&ACV INJURY S L,000,00(I i
<br /> GENt AGGREGATE LIMIT APPLIES PER GGNMALAGGREGATE g 2,000,000
<br /> POLICY Q JEPCT LOC PRODUCTS-OOMMP AGG S 2,000,000
<br /> I
<br /> THER: $ }
<br /> B AUTOMOBlLELIABILITY CFACA01390-251 9/112625 9JIi2026 C H ot81 GLEL S L,000,OOQ 1
<br /> ✓ ANY ALITO BODILY INJURY(Per paman) i I
<br /> OWNED SCHEDULED BODLYINJUttYtParacddord) $
<br /> AUTOSONLY AUTOS ✓
<br /> HIRED 1/ NON-OWNED PROPERTYDAMAGE S
<br /> AUTOS ONLY AUTOS ONLY feer amwArd
<br /> S t
<br /> UMBRELLA LIAB ✓ OCCUR XW5EX00092-251 4/2812025 4/28/2026 EAcHoccuRRENCE s 5,000,000
<br /> A ✓ I P-XCEsSLtAB CLAIMS•MAOE AGGREGATE $ 5,000,000
<br /> DED I lrimwws $
<br /> WORKERSCOMPENSATION 9161b94-2J 10/I 2025 ]011J20211 gY T �R
<br /> C AND VMPLOYEPWLIABIWTY I,dDD,QeO
<br /> OANY EORIPMRIETQ" RTNE t WUrtVt YIN
<br /> N to E.L.EACH ACCIDENT $
<br /> (Mandatory in NH) E.E.DISEASE•EA EMPLOYEE S 1,00OA00
<br /> 9
<br /> yyeBa adascd6a under [i
<br /> DESGIRIPTIOMOFOPERATIONSbelaw E.L.DISEASE•POLIG1rLIMIT S 1+ ,
<br /> l
<br /> Pollution Liability ✓ PPK2657314-002 2/18/2026 2/18/2027 5,000,000
<br /> Per Amrmtm 5,600,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACOND 1014 Additional Remarks Schedu4e,rn4y tie*N"tC ad If Info epees IS 04utre4)
<br /> Re: Contract A-2022-065-04. Operations of the Named Insured. City of Santa Ana, its officers, employees, agents, and
<br /> volunteers are hereby named as Additional insured, if required by written contract, per endorsement hereto. Waiver of
<br /> uhragation is provided, as required by written contract with the insured as respects coverage evidenced herein.
<br /> overage evidenced herein is primary and non-contributory, A 30-day written notice shall be mailed to the certificate
<br /> older at the address provided herein, should a described policy(s) be cancelled before the expiration date thereof;
<br /> 10-day notice for non-payment of premium,
<br /> CERTIFICATE HOLDER CANCELLATION .ByT.u-Tran.Nguyen.at3:03,pm,.,Mar09,.2026-
<br /> Holder's Nature of Interest:Additional Insured
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELWO BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POUCYPROV[StONS.
<br /> Attention: Public Works Agency
<br /> CIP/Design Engineering AUTHORREDREPRESENT�
<br /> 20 Civic Center Plaza,M-36 f�#/._ /�,
<br /> Santa Ana,CA 92702 417
<br /> 0 1988-201 5 ACORD CORPORATION, All rights reserved.
<br /> ACORD 25(2DI6103) The ACORD name and logo are registered marks of ACORD
<br />
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