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"1 ENVIPLA-02 TAKAPUK
<br /> .4►CO�� CERTIFICATE OF LIABILITY INSURANCE DATE
<br /> 1 5
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<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 License#OE67768 CONTaCT katalina takapu
<br /> t�AIOA Insurance Services PHONE FAX
<br /> 3875 Hopyard Road (Arc,No,Ext):(925)416-7$62 IruC,NoF(925)416-7869
<br /> Suite 200 E-MAIL
<br /> Pleasanton,CA 94588
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Continental Casualty Company 20443
<br /> INSURED INSURER B:Hartford Casualty Insurance Company 29424
<br /> Environment Planning Development Solutions Inc dba EPD INSURER C:
<br /> Solutions Inc
<br /> 3333 Michelson Dr.,Suite 500 INSURER D:
<br /> Irvine,CA 92612 INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 2
<br /> THIS IS TO CFRTIFY 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 NUMBER POLICY EFF POLICY EXPLTR LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE FA]OCCUR X X B6025654530 913012025 9/3012026 DAMAPREMOETORENf ED rence� $ 1,000,000
<br /> MED EXP(Any one erson $ 10,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> hFN'LAGGREGATFUMTAPPLIESPER GENERAL AGGREGATE $ 4,000,000
<br /> POLICY FX_1 PE') LOC PRODUCTS-COMPIOPAGG $ 4,000,TOO
<br /> —
<br /> OTHER $
<br /> A AUTOMOBILE LIABILITY COMBrINED SINGLE LIMIT 11000,000
<br /> ANY AUTO X X B6025654530 913012025 9/3012026 BODILY INJURY Perperson) S
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Peraccidenl 5
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident 5
<br /> I
<br /> S
<br /> A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 4,000,000
<br /> EXCESS LIAB CLAIMS-MADE X X B6025663132 9/3012025 913012026 AGGREGATE 4,000,000
<br /> DED I X I RETENTION$ 10,000 S
<br /> B WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITYATUTF
<br /> iN
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE Y� N/A
<br /> X 57WEGAC208W 9/30/2025 9/30/2026 E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFIGERIMEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 1,000,000
<br /> If yes,describe urder 9,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Professional Liab. X EEH591923312 913012025 913012026 Per Claim 4,000,000
<br /> A Professional Liab. X EEH591923312 9/3012025 9130/2026 Aggregate 5,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:On-Call Agreement-Agreement No.A-2023-194-03
<br /> As required by Certificate Holder written contract or agreement,in-addition to(if applicable)the governing written contract or agreement:(1)Commercial
<br /> General Liability policy shall include(a)additional insured coverage and contain(b)primary&non-contributory and(c)waiver of subrogation provisions for
<br /> any additional insured;(2)to the extent applicable,Automobile Liability policy shall include(a)additional insured coverage and contain(b)primary&non-
<br /> contributory and(c)waiver of subrogation provisions for any additional insured;(3)to the extent applicable,Commercial Excess Liability policy shall apply
<br /> on a follow-form basis,excess of commercial general liability,automobile liability and employers'liability policy(ies)with such coverage being concurrent
<br /> with underlying insurance;(4)to the extent applicable,Workers Compensation and Employers'Liability policy shall include a waiver of subrogation provision;
<br /> SEE ATTACHED ACORD 101
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Tran Nguyen at 11:18 am,Oct 22,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Tu Tra n ligita11yslgnedby ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Tu T—Nguyen
<br /> Wte.2025 10 22
<br /> Nguyen]F'15:57-07'00'
<br /> AUTHORIZED REPRESENTATIVE
<br /> City of Santa Ana,Planning and Building Agency
<br /> 20 Civic Center Plaza ��y"�
<br /> ASanta Ana,CA 92701 "`JJJJ
<br /> ACORD 25(2016103) (D 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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