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ACE h® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br /> 5/11/2026
<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: Cameron Schuh
<br /> Brown & Brown RS Insurance Services, LLC PHONE FAX
<br /> 6 Concourse Pkw , Ste 2300 lac.No.Extl: 470-456-4375 INC.No):
<br /> Atlanta, GA 30328 ADDRESS: Cameron.Schuh(c,bbrown.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> www.bbinsurance.com INSURER A: Great Northern Insurance Company 20303
<br /> INSURED INSURER B: Chubb National Insurance Company 10052
<br /> The Howard E. Nyhart Company, Inc.
<br /> 5750 Castle Creek Parkway Suite 245 INSURER C.
<br /> Indianapolis IN 46250 INSURER D: Chubb Indemnity Insurance Company 12777
<br /> INSURER E: XL Specialty Insurance Company 37885
<br /> INSURER F: _
<br /> COVERAGES CERTIFICATE NUMBER: 90507748 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 ADDTYPE OF INSURANCE NSI SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> UNSO,tYVD JMMlDDlYYYY) (MM/DD/YYW)
<br /> A ✓ COMMERCIAL GENERAL LIABILITY / ✓ 3952-18-14 7/1/2025 7/1/2026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE ✓ OCCUR DAMAGE TO RENTED
<br /> PREMISES(Ea occurrence) $2,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY JET / LOC PRODUCTS-COMP/OPAGG $INCLUDED _
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY 73593601 7/1/2025 7/1/2026 COMBINED NGLE LIMIT $
<br /> ✓ ✓ (EaaccdenqSI 1,000,000
<br /> ✓ ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY _ AUTOS ONLY (Per accident)
<br /> $
<br /> UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE S
<br /> DED RETENTION$ _ S
<br /> B WORKERS COMPENSATION 7174-63-26 7/1/2025 7/1/2026 ,/ STATUTE OTH-
<br /> ER
<br /> AND EMPLOYERS'LIABILITY Y/N *see attached
<br /> ANYPROPRIETORJPARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1,000,000
<br /> OFFICER/MEMBEREXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1.000.000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> D Workers'Compensation ✓ 7177-08-19 7/1/2025 7/1/2026 EL Each Accident $1,000,000
<br /> **see attached EL Disease-Ea Emp $1,000,000
<br /> EL Disease-Policy Limit $1,000,000
<br /> E Professional Liab.-E&0(Ret.$1M) _ ELU204918-25 7/1/2025 7/1/2026 Per claim/Aggregate $10,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required)
<br /> The City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are covered as additional insureds
<br /> on the Commercial General Liability and Auto Liability policies,with respect to liability arising out of work or operations performed by
<br /> or on behalf of Contractor including materials,parts,equipment,and personnel furnished in connection with such work or operations.
<br /> Waiver of Subrogation applies,where required by written contract.
<br /> APPROVED
<br /> By Tu Tran Nguyen at 7:39arn,May 12,2026
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> Attn: Finance & Management Services ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana, CA 92701
<br /> AUTHORIZED REPRESENTATIVE Brown&Brown RS Insurance Services,LLC
<br /> 1 Brown&Brown RS Insurance Services,LLC
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> 90507748 1 XX 7/1/25 Ascensus Only+Prof Liability 25-26 ** 1 EXc1:XS 1 Judith Boich 1 5/11/2026 2:02:14 PM (EDT) 1 Page 1 of 8
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