The URL can be used to link to this page

Home My WebLink AboutItem 15 - Renew Citywide Insurance Program and Policies Procured through Independent Cities Risk Management Authority and Arthur J. Gallagher � Human Resources Department www.santa-ana.org/HR Item # 15 r City of Santa Ana 20 Civic Center Plaza, Santa Ana, CA 92701 Staff Report August 5, 2025 TOPIC: Renew Citywide Insurance Program and Policies Procured through Independent Cities Risk Management Authority and Arthur J. Gallagher AGENDA TITLE Approve Renewal of Citywide Insurance Program and Policies Through Independent Cities Risk Management Authority (ICRMA) and Arthur J. Gallagher, an Appropriation Adjustment of$1,345,359, Associated Insurance Premiums, Costs, Programs, and Regulatory Fees for Total Payments Not to Exceed $13,521,649 (Non-General Fund) RECOMMENDED ACTION 1. Authorize the City Manager to approve payment of insurance premiums and associated programs to ICRMA in an amount not to exceed $9,501,254 for the protection of City assets from July 1, 2025 through June 30, 2026 including but not limited to: a. Excess Liability Program b. Excess Workers' Compensation Program c. Auto Physical Damage Program d. Property and Equipment Program e. Crime Program f. Cyber Program g. Associated Programs 2. Authorize the City Manager to approve payment of insurance premiums to Arthur J. Gallagher, Broker, in an amount not to exceed $3,520,395 for ancillary coverages of City's assets from July 1, 2025 to June 30, 2026 including but not limited to: a. General Liability Buffer Program b. Workers' Compensation Buffer Program c. Earth Movement & Flood and Difference in Coverage (DIC) Program d. Terrorism Insurance Program e. Underground Storage Tank and Environmental Program 3. Authorize the City Manager to approve the City's obligation to pay the State of California Department of Industrial Relations (DIR) estimated assessment in the amount not to exceed $500,000. Renew Citywide Insurance Program and Policies Procured through Independent Cities Risk Management Authority and Arthur J. Gallagher August 5, 2025 Page 2 4. Approve an Appropriation Adjustment of$1,345,359 in Liability and Property Insurance Revenue to utilize the fund balance through the Prior Year Carryforward revenue account (No. 08009002-50001) and appropriate spending of the original adopted budget in the same amount from the Liability & Property insurance account (No. 08009051-64010). (Requires five affirmative votes) GOVERNMENT CODE 484308 APPLIES: No DISCUSSION Staff is recommending renewal with ICRMA, a joint powers authority formed in 1980 in accordance with California Government Code Section 6500. ICRMA's purpose is to provide: 1) excess and re-insurance to protect member cities from extensive financial debt due to large claims, settlements, and judgments; 2) group insurance purchasing power that can offer broader coverage at a lower cost; 3) rate stability; and 4) protect individual member cities through pooling of losses and self-insurance. ICRMA also offers to its members actuarial services, appraisal services, loss control assessments and recommendations, safety trainings, claims audits, contract risk transfer consultation, and other services and resources. Currently comprised of 14 California cities, Santa Ana joined ICRMA in July 2019. For this renewal period: • The City's Workers' Compensation coverage experienced a decrease of approximately one-half percent (-0.5%). • The City's Liability and Property premiums increased approximately twelve percent (12%). • The City's Property & Equipment Program premium increased approximately one percent (1%). • Overall, the City's insurance coverages remain the same with the exception of an increase in earthquake insurance coverage from $25,000,000 to $40,000,000. The increase to the cost of insurance is primarily due to the following ongoing reasons: 1. An insurance market with continually decreasing excess carriers willing to quote municipal government entities in California, especially those with Police departments; 2. High dollar jury awards of litigated matters against public entities; 3. High dollar settlements of litigated and non-litigated matters; 4. Rising cost of repairs and replacement of damaged vehicles, property, and equipment; 5. Increased number of claims filed against the City resulting from aging infrastructure including sidewalks and streets; and 6. Increased number of claims filed against the City resulting from damage caused by City owned trees. Renew Citywide Insurance Program and Policies Procured through Independent Cities Risk Management Authority and Arthur J. Gallagher August 5, 2025 Page 3 WORKERS' COMPENSATION FY 2023/24 FY 2024/25 FY 2025/26 COVERAGES Excess Pool Workers' Compensation Program $ 415,464 $ 459,770 $ 428,629 Excess Workers' Compensation Buffer $ 264,085 $ 300,027 $ 327,547 Sub-Total $ 679,549 $ 759,797 $ 756,176 Percent Change 13% 12% -0.5% LIABILITY AND PROPERTY COVERAGES FY 2023/24 FY 2024125 FY 2025/26 Excess Pool Liability Program $ 6,070,925 $ 6,927,723 $ 8,202,559 Auto Physical Damage Program $ 145,108 $ 185,294 $ 188,102 Property & Equipment Program $ 593,557 $ 534,757 $ 538,928 Crime Program $ 15,394 $ 17,563 $ 18,518 Cyber Program $ 100,445 $ 118,787 $ 119,518 Associated Programs $ 5,000 Excess Liability Buffer $ 1,743,398 $ 1,805,650 $ 1,676,675 DIC Earth Movement & Flood $ 1,283,147 $ 1,353,245 $ 1,492,474 Terrorism $ 13,723 $ 14,652 $ 14,460 Underground Storage Tanks- Environmental $ 12,539 $ 15,314 $ 9,239 Sub-Total $ 9,978,236 $ 10,972,985 $ 12,265,473 Percent Change 21% 10% 12% FY 2023/24 FY 2024125 FY 2025/26 City Special Events Insurance $ 300,000 $ 350,000 $ 0* State of California DIR $ 500,000 $ 500,000 $ 500,000 Total $ 11,457,785 $ 12,582,782 $ 13,521,649 *City Special Events Insurance is still being researched to best meet the needs of the City and may be brought before Council at a later date. ENVIRONMENTAL IMPACT There is no environmental impact associated with this action. FISCAL IMPACT The recommended action includes appropriating $1.3 million from the General Liability Fund balance. The table below compares the most recent actuarial valuations of claims liabilities and the City's target reserve policy with the estimated spendable fund balances for both the Workers' Compensation and General Liability Funds. Current actuarial Renew Citywide Insurance Program and Policies Procured through Independent Cities Risk Management Authority and Arthur J. Gallagher August 5, 2025 Page 4 estimates indicate that liabilities exceed available fund balances. However, the City's target reserve levels—set at 80% of actuarially determined liabilities, as determined biennially—are $35.8 million for Workers' Compensation and $14.9 million for General Liability. To address this target reserve shortfall, staff has gradually increased overhead charges during the annual budget process, with the goal of restoring fund balances to target levels over time. Workers' Compensation General Liability Actuarial valuation as of June 30, 2026 $44,757,982 $18,646,692 Present Value Target Reserve 80% of liability) $35,806,386 $14,917,354 Estimated ending fund balance as of June $19,801,925 $13,170,324 30, 2026 Estimated Target Reserve Shortfall $ 16,004,461 $ 1,747,030 After appropriation adjustment, the following table summarizes the funds budgeted and available for estimated premium and administrative costs. Fiscal Accounting Unit Accounting Unit Account Description Amount Year -Account Description 2025-26 08209054-64010 Workers Workers Compensation, $ 1,300,000 Compensation Insurance Payment Liability & Liability & Property $ 10,876,290 2025-26 08009051-64010 Property Insurance, Insurance Insurance Payment APPROPRIATION ADJUSTMENT 2025-26 08009051-64010 Liability & Liability & Property $ 1,345,359 Property Insurance, Insurance Insurance -Payment Total: $ 13,521,649 EXHIBIT(S) 1. Agreement with Arthur J. Gallagher Insurance Brokers of California, Inc. For Insurance Broker Services, Client Service Agreement 2. ICRMA Member Contribution Invoice - Santa Ana Submitted By: Lori Schnaider, Executive Director of Human Resources Approved By: Alvaro Nunez, City Manager kWau dry s h i uuuu� �� „„ „�� II mn I11�111111�11 III IIIIIIIIIII�II IIIIIIIII@II IIIII�IIIIIII�III IIIIIIIII IIIIII�II III III Vigo � ,,,,,;��,iuu,� , �� IIIIIII� II iil City of Santa Ana /% CORE 360' err IIL II I' of C o r"t errts YourGallagher Team..................................................................................................................................................3 ProgramStructure.......................................................................................................................................................4 NamedInsured.............................................................................................................................................................5 MarketReview..............................................................................................................................................................6 Year Over Year Comparison.......................................................................................................................................9 FullProgram Details..................................................................................................................................................10 Excess Liability Buffer-$1 M xs$2M SIR-General Star Indemnity Company.....................................................10 Excess Liability Buffer-$1 M xs$2M SIR- Princeton Excess&Surplus Lines Ins Cc......................................... 13 Excess Workers' Compensation- Response Indemnity Company of California................................................... 16 DIC-$5M Part of$10M- Endurance American Specialty Ins Co........................................................................18 DIC-$2.5M Part of$10M- Palms Insurance Company, Limited.........................................................................21 DIC-$2.5M Part of$10M- Landmark American Insurance Company................................................................23 Excess DIC-$5M xs$10M- Mt Hawley Insurance Company, (More).................................................................25 Excess DIC-$10M Excess$15M- Palomar Excess and Surplus Insurance Company, (More)..........................27 Terrorism-Lloyd's Syndicate 3623(Beazley Furlonge Limited) ..........................................................................30 Terrorism-Texas Insurance Company................................................................................................................33 PremiumSummary....................................................................................................................................................33 LocationSchedule................................................................................................................................................35 PaymentPlans.....................................................................................................................................................36 CoinsuranceIllustration ...........................................................................................................................................37 ProposalDisclosures................................................................................................................................................38 ProposalDisclosures............................................................................................................................................39 Client Signature Requirements................................................................................................................................42 Surplus Lines Notice- California..........................................................................................................................43 Client Authorization to Bind Coverage..................................................................................................................45 Appendix....................................................................................................................................................................48 Compensation Disclosure Schedule.....................................................................................................................49 BindingRequirements..........................................................................................................................................51 ClaimsReporting By Policy..................................................................................................................................53 GallagherSTEP Flyer..........................................................................................................................................56 Attachments City of Santa Ana-2025 Schedule of Values f �� JJil�llJlIIl111�D��1�11111��1�1��JJ��Il _ _ ,,,,,,,,,,,��««��«�««��«��«��«��«iiiiiiii��o��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�II�I�II��IIIIIIIIII�IIOII�IIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII /%e City of Santa Ana rr CORE 360' Yu,i,r Your Gallagher team is a true partner. We have the expertise to understand your business and we're here to service and stay alongside you, every step of the way. ��uii�>rk��N��Na��n��>1�ryr;�� R R " " ��gf IIV�Vi11,1111J� r ii�ui�i k � �fyiili�klllllllllllllllllllll �"' 7 NN�Rh�N Susan Blankenburg Client Service Executive Susan—Blankenburg@ajg.com (415)536-8417(p) Area Executive Vice President — Natalie Bates Client Service Manager Natalie_Bates@ajg.com (949)349-9856(p) Client Service Manager III Kaylee Langron Client Service Associate Kaylee_Langron@ajg.com (925)310-1032 (p) Client Service Manager Ron Green Certificate Specialist Ron_Green@ajg.com (415)536-8432 (p) Client Service Associate Senior Ryan Asuncion Dedicated Claims Advocate Ryan_Asuncion@ajg.com (415)536-4051 (p) Claims Advocate Julie Frisbey Dedicated Loss Control Julie Frisbey@ajg.com (303)889-2505(p) Senior Loss Control Specialist Representative — f ��>� JJil�llJlIIl111�D��1�11111�11�1>�>I��JJ��Il _ _ ,,,,,,,,,,, «««�««��«��«��«�o��liillllilii��l��lo��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�II�I�II��IIIIIIIIII�IIOII�IIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII /%e City of Santa Ana rr IlCORE 360' ,,,1g II`a rr,,,,Ii S1 II°°u ctu II e �� J�il�llJlIIl111�D��1�11111��1�1��JJ��Il _ _ ,,,,,,,,,,,��««��«�««��«��«��«��«iiii�iii��o��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�II�I�II��IIIIIIIIII�IIOII�IIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII /%e City of Santa Ana rr ��U 9,rri orrm I�hiD�'m�u��r�ipJ�iriD�i�fp�r�&��iiro�l��ni�p�imiirnrul� I r � �riip�ru��mlglnu��imrn��/N�.ii irp�ii i�ii�p��pf�rm�l�RI IU�»y CORE 360' All Lines of Coverage included in this proposal City of Santa Ana Santa Ana Financing Authority Santa Ana Police Athletic and Activity League Excess Liability Buffer The Friends of Santa Ana Parks and Recreation Community Services The Housing Authority of the City of Santa Ana Note: Any entity not named in this proposal may not be an insured entity. This may include affiliates, subsidiaries, LLCs, partnerships, and joint ventures. f �� JJil�llJlIIl111�D��1�11111��1�1��JJ��Il _ _ ,,,,,,,,,,,��««��«�««��«��«��«��«iiiiiiii��o��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�II�I�II��IIIIIIIIII�IIOII�IIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII City of Santa Ana /% CORE 360' err r`°°.A(aIdk,/,e t ,?!,;e v Il ew We approached the following carriers in an effort to provide the most comprehensive and cost effective insurance program. ill��' Ill�r' I�IIIIIIIIl11DUIIIIIIIUIIIII V�ii�»1,��y >r��n41011DDlIillUuliUN�� lii�"' Ilii�' . J u �n n u iri ILII n I I I� 1 I11�I�IJIJIJII�I�IIIIIIII�IIIIIII�IIJI�IlI1111111 �� rr��Il�lr��IllYlr�,��r�IVil,��lll�l��1�r��lrll��l�rr��l,�rl�(!�>�>�alll��>��J�J�� ,r��II1f1111��IIIIIJIII�III�I�IIIJIII�I�II��llllllll�� >li��i>'��I�I�I Quoted Rate reduction of 9% over expiring. This rate reduction is equivalent to a$105K in premium General Star Indemnity savings. Company(A++XV); Non- $1,702,470 Admitted They maintained the$2M aggregate and confirmed they are unable to match the$3M aggregate proposed by Princeton. Princeton Excess&Surplus Recommended Quote: A 11% rate reduction in Excess Liability addition to increasing the aggregate from$2M to Lines Ins Co(A+XV); Non- . $1,676,675 Buffer-$1 M xs$2M Admitted $3M The rate reduction is equivalent to over q SIR $130K in premium savings. Chubb Group of Insurance Declined—outside of underwriting appetite Companies (A XV);Admitted Gemini Insurance Company Declined—not able to improve on the pricing or (A+XV) ); Non-Admitted terms of the incumbent Recommended Ouote: at a rate increase of 5% over expiring for the expiring $500K xs$1.5M Excess Workers' Response Indemnity retention. Compensation Company of California (A-X); $327,547 Admitted The$750K and$1 M limit options were found not to be competitive with rate increases of 53%and 137%, respectively. DIC-$5M Part of Endurance American Recommended Quote: Rate reduction of 10%, Specialty Ins Co(A+XV); ); $349,881.32 $10M Non-Admitted a premium savings of nearly$32,000 DIC-$2.5M Part of Palms Insurance Company, Recommended Quote: Rate reduction of 10%, Limited (A IX) ); Non- $176,488.36 $10M Admitted a premium savings of nearly$16,000 DIC-$2.5M Part of Landmark American Recommended Quote: Rate reduction of 9%, a $10M Insurance Company(A++X); premium savings of over$14,000 $174,940.66 Non-Admitted Mt Hawley Insurance Excess DIC-$5M xs Company(A+XIV); (l Recommended uote: Rate reduction of 10%, a $10M Lloyd's Synd 1458 premium savings of nearly$20,000 $217,193.90 (RenaissanceRe Synd)(A XV); Non-Admitted 111fllll�� _...,,,,,, «,« ��«�oioiolli��ll�lllllllllllloll��ll�oiilo��lloi�illll011lllllllllllllllllllll �� III�IIIIIIIIIIIII��IIIIIIIII�I� IOIIIIIII�IIIIIIIII�IIIIII�O011llllllllll�lll�lllllllll�lli�lllll(III�I I�I(011llf llll��lllllll City of Santa Ana /% CORE 360' err III "" �" i�IIIIIDDU�I'i1 iIID1111 ViiIiUIIIIIIIIIIIII11UD111111iluINN NN��N II��" Ilil� Ills'"'Illi�"' Ili��" IIl,lllll 1 l� �N�>��V�II ,�II,III�1D 11�111�1� y,��( II I� ��IIIII„ II �IIIIII I I �I�4��4��i��I�I�II�I�I��II�IiI��I4��I� i it iI4NNi�il4dNd�14N>'IS�iNoal4'Nillf�ii�l4'd>��4�Ni�i14NRd�14NNi�14N1ii�14NNiil4'Nlidil i4��il i �i'!i'�14'Nlii�l4'Ni'1��14iI��I��I��i'lI��14��I�4��4�t1 i4� it t i i i t i i i t i i i t �I4��'N1iI�I��II I�I�� i �a tl Palomar Excess and Surplus Insurance Company(A X); Excess DIC-$10M Recommended Lluote: Rate reduction of 10%, a Excess$15M Princeton Excess&Surplus premium savings of nearly$30,000 $320,559.62 Lines Ins Co (A+XV); Non- Admitted Palomar Excess and Surplus New Option: Excess Insurance Company(A X); DIC-$5M Excess Non-Admitted Quoted additional$5M in limits to bring the total $92 862.00 $25M Princeton Excess&Surplus DIC coverage the$30M Lines Ins Co (A+XV); Non- Admitted Palomar Excess and Surplus New Option: Excess Insurance Company(A X); DIC-$10M Excess Princeton Excess&Surplus Quoted additional$10M in limits to bring the total $170,247.00 $25M Lines Ins Co (A+XV); Non- DIC coverage the$35M Admitted Palomar Excess and Surplus New Option: Excess Insurance Company(A X); DIC-$15M Excess Princeton Excess&Surplus Quoted additional$15M in limits to bring the total $252,791.00 $25M Lines Ins Co (A+XV); Non- DIC coverage the$40M Admitted Recommended Quote:for$14,919.83 for the Lloyd's Syndicate 3623 expiring$10M Combined Property/Liability Limit (Beazley Furlonge Limited)(A $14,919.83 XV); Non-Admitted Also provided options for a$1 M or$5M combined limit Texas Insurance Company Terrorism (A-XII); Non-Admitted; Non- Quoted-$1 for the$10M Combined Admitted Property/Liabbilityility Limit. Quoted—Not competitive Indian Harbor Insurance Company(A XV); Non- To secure a$10M Property Damage Limit would Admitted be$20,000. To secure a separate$1 M Liability Limit would be$10,000. *If shown as an indication,the actual premium and acceptance of the coverage requested will be determined by the market after a thorough review of the completed application. **Gallagher companies use AM Best rated insurers and the rating listed above was verified on the date the proposal document was created. Best's Credit RatingsTm reproduced herein appear under license from AM Best and do not constitute, either expressly or impliedly, an endorsement of Gallagher's service or its recommendations.AM Best is not responsible for transcription errors made in presenting Best's Credit RatingsTM. Best's Credit RatingsTm are proprietary and may not be reproduced or distributed without the express written permission of AM Best. A Best's Financial Strength Rating is an independent opinion of an insurer's financial strength and ability to meet its ongoing insurance policy and contract obligations. It is not a warranty of a company's financial strength and ability to meet its obligations to policyholders. Best's Credit RatingsTm are under continuous review and subject to change and/or affirmation. For the latest Best's Credit RatingsTm and Guide to Best's Credit Ratings,visit the AM Best website at http-//www.ambest.com/ratings. �>�>� JJil�llJlIIl111�D��1�11111�11�1>'�>I��JJ��Il _ _ :::,:,,,,,, «««�««��«��II«I��I«lo��illillllliillll��lo��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�II�I�II��IIIIIIIIII�IIOII�IIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII /%e City of Santa Ana rr CORE 360' ***If coverage placed with a non-admitted carrier, it is doing business in the state as a surplus lines or non-admitted carrier, and is neither subject to the same regulations as an admitted carrier nor do they participate in any state insurance guarantee fund. Gallagher companies make no representations and warranties concerning the solvency of any carrier, nor does it make any representation or warranty concerning the rating of the carrier which may change. f �� JJil�llJlIIl111�D��1�11111��1�1��JJ��Il _ _ ,,,,,,,,,,,��««��«�««��«��«��«��«iiiiiiii��o��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�II�I�II��IIIIIIIIII�IIOII�IIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII fgpl/ City of Santa Ana G a I I a g h e r CORE 360' rr Year Over Year EXPOSURES Liability- DE9 Payroll $137,686,727 $142,743,924 4% Worker's Compensation- paVroll $137,686,727 $142,743,924 4% Earth Movement&Flood (DIC) -TIV $763,954,380 $777,575,467 2% Standalone Terrorism -TIV $763,954,3791 $777,685,4671 2% RATES Liability- Budget 1.3129 1.1746 -11% Worker's Compensation - payroll 0.2179 0.2295 5% $25M Earth Movement& Flood (DIC) 0.1769 0.1593 -10% Excess Earth Movement&Flood (DIC):$5M xs$25M 0.0133 0.0119 -10% Excess Earth Movement&Flood (DIC):$10M xs$25M 0.0246 0.0219 -11% Excess Earth Movement&Flood (DIC):$15M xs$25M 0.0339 0.0325 -4% Standalone Terrorism 0.0019 0.0019 0% PREMIUMS Liability:$1M/$3M xs$2M SIR $1,807,650.00 $1,676,675.00 -7% Workers Compensation:$500K xs$1.5M SIR $300,027.00 $327,547.0 9% $25M Earth Movement&Flood (DIC) $1,351,649.51 $1,239,063.87 -8% Excess Earth Movement& Flood (DIC): $5M xs$25M $103,489.54 $92,862.00 -10% Excess Earth Movement& Flood (DIC): $10M xs$25M $191,192.54 $170,247.00 -11% Excess Earth Movement& Flood (DIC): $15M xs$25M $263,418.54 $252,791.00 -4% Standalone Terrorism $14,651.56 $14,919.83 2% TOTAL PREMIUM/$25M DIC: $3,473,978.07 $3,258,205.70 -6% TOTAL PREMIUM/$30M DIC: $3,577,467.61 $3,351,067.70 -6% TOTAL PREMIUM/$35M DIC: $3,768,660.15 $3,521,314.70 -7% TOTAL PREMIUM/$40M DIC: $4,032,078.69 $3,774,105.70 -6% 9 g/pl/ City of Santa Ana G a I I a g h e r CORE 360' rr II UdH Excess Liability Buffer - $1 M xs $21VI SIR Carrier General Star Indemnity Company A.M. Rating A++XV Admitted/Non-Admitted Non-Admitted Payment Plan Full annual premium payment is due at inception Payment Method Agency Bill 1�111111)101 lj/'l FpSERY)NE 5, Premium $1,650,000.00 State Tax: $49,500.00 Stamping Fee: $2,970.00 TRIA $31,187.19 Minimum Type Minimum Earned Premium Minimum Amount Description 25% Estimated Cost $1,702,470.00 JJ Coverage Part A: Each i Occurrence Limit $1,000,000 Coverage Part A: Coverage Part Aggregate $2,000,000(Does not apply to Auto) Coverage Part B: Each Claim Limit $1,000,000 Coverage Part B: Coverage Part Aggregate $1,000,000 Overall Aggregate Will Apply to Coverage Parts A and B Combined rrl@ I:1. E: 1JIMMEN Retention-Coverage Pa $2,000,000-Each Occurrence Retention-Coverage Part B $2,000,000-Each Claim Coverage Part A Claim expenses will erode both the retained limit and the limit of insurance Coverage Part B Claim expenses will erode both the retained limit and the limit of insurance ) AIII I lllllllllllllll 0 l F) 111 )A I 1 I I II I II 1 1 11I II 11 1 : l IP0I I I I I Il I I I I I I I Il 1 1 1 1 l 1IIII I 1 1 1111 II, II I I ,I 1I I I I I I I I III l I II I I I I II l 1 1 1 11 1 Form Type-Coverage Part A: Genesis Public Occurrence Entity Liability Policy Form Type-Coverage Part B: Genesis Public Occurrence Official Liability Policy Form Type-Medical Incident Liability Claims Made Retroactive Date-Medical Incident Liability 7/1/2023 10 /%e City of Santa Ana rr I I 1 I r III 17 771 Ii rrrrr rl,,,llii „rrr � ll�rrlrr r r+r r, rr 1 1 r J „ 1 >< , � r , J111111111111111� 11111� 1>� � 11� 11111� �1111� 11111� 11 � � 1� 11 �Il»,»�»�II»,1,><i11„t,I»�f,,,�1»l>�11111��1I111111��1111>��11111111I11>�11>��11111111>�1111>��1�1111��1111��1��11�11111�1111�111f1�1��1r��11111�1111��1111��1�11�11111�11�11�1��11��1�11�1111�1111��1111��11�11�11111�1111�1111��1�11��I�1I1�1111��1111��1�,Refer to attached policy form rl r I r 7 I rr rr»rr, ,r r II II II II III�rr.r ri 11»Ir Ir r I 11 rr 11 ,III rr r1 rrr rr I I , l , J � r r, r 1 >J , JJ „ , J , Irr , 1 � 111 � 1 � � � 1 � 1 � 111 � 11111 � 1 � 111 � 11111111111 � 11111 � 1 � 111 � 1 I1J»»»�1I�,,I�IIJ>>»J1i,>;11 �»r„1111111�111111111111111�111111I11111��11111111111111111111111111111�111111111111111111111111111111�111111111111111�111111111111111111111111111111111111111111111�111111111111111111111111111111�111111111111111�1�11111Jrr1»1�,1�Ilfrll,��II1r)ll�fll�rl/111111J��>>>r11�111��1�11111�1��111��11�1�111111/�1111��1�111�111�1�111��111111�1��111�>r11�111�11�11111��1�l��ll��ll��lll>r��11111�1��111��11�111�11�1111111��1�11111�111��11111111�1��1�l�rrll�111�11�11111��111�111�1�111>?��11111�1��111��11�1111 Refer to attached policy form 1 r+ I r 1 r IIII Irr Ilrrrr� I illu �r,,r»r.rrrlrrrl 1»rrrrrrl»1�lrrrrlr III r I I II I ��, 11 r r r i r � J r i, , , J � „ >< lr , , , , , J , , , , lllll11111111111111111111111111111111111111111 Ill1��,�1,111Jr,1,tlrJ»»I1J11�111»f»I1,Irflfrr„J„JI,J„�,�,�1,,,�„lllllllllllllllllllll111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111�11111 lljllrrrl'1»IIII) ,lali»>rll�lil»I11.1ai11»l,r<r1��1,r1r�,,JJJJ1>>,,,rya,�„h�r�1,�111111111�1111111111111�11111111111111�/1111111�1111111111111111111�111111111111111111111111111111�/1111111�1111111111111111111111111111�/111111111111111111�11111111�111111111111111111�11111111111111111111�111111111�/11111� Refer to attached policy form r I r I r r rr 1 r I1 r!7 r7il » rr r 7 1 rr rr err rrr r 71 Irr» r rr,r rrr 7rrll rr .rrrrr! r rrlr rr rrr 1 ,1 1 1 I a r CORE 360' 1111111.1,»>>II,1»1»Jl»��ll��llll»III,III'»1»Il11,111»„1I111»»rr»1»>,r,»�rllr„r111111I1I1111IIIII11I1111I1I1111I11111111I111I11I1111III111J1111111I111111IIllIlII11111111I111111111111IIllllllllllllllllllllll111111J1111111I111111IIlllII11111111I11111J111I1I111111111J1I11111111111111J1111111Illllllllllllll11111111I11111J111111II11111I111I1I1111111I1I11111J1111111111111111111111111 Should you elect to change carriers (if a new retroactive date is provided)or non-renew this policy, a supplemental extended reporting endorsement may be available subject to policy terms and conditions.You must request the extended reporting period in writing to the carrier within (60)days of the expiration date. The cost of this extended reporting period is 100%%of the annual premium and is fully earned. The extended reporting period extends only to those claims made during the extended reporting period for wrongful acts that occurred prior to the expiration date and would have been covered by the policy. Claims must be reported to the carrier within (3 Years)days of the end of the policy period. The extended reporting period does not increase the limits of liability and is subject to all policy terms, conditions and exclusions. r I , ,r r r I I I r I 7 1 7 r 1 rJrllr Ill.III III I11111III 1 7!7 111 111 Il. Ir1l7l II lrlr Jl Illlll rll,, I !r 1 rrr all rl l Iilrl,lr l,i111 I n111 rrr+ l7 IIIIII r rr rrl i 111711 lr r r rr r 1 111 1, r r, I r 111 r rrr i r i >rrr r,r irr r i I 1 1,1 r 1 I I.l I I I r 1 IJi , f ) , J , � rrr � llfrrrJrrr111 � 11111 � 1 � 111r111111111111 � 11111 >11 >� 111 >1 �, Ill!.l!»II,IJlr�111,1,11�,1�rr»I 1„r,,,,)flltl,�r„�,r,1r,J,JJ„�rrr�1,,,»,,,,JJJ„�,,,f��1��rlrl��>J1J�11��r11��lJ��'��1J111111111��1J��>JIJ��11J��rl��>11J�11��11111�1111111�11111111111��111111J11111111111�rJ11111��1J��1 The Public Policy—Retained Limit Form—Declarations Page-GPE 10 0002 03 25 Coverage Part A—Public Liability-GPE 00 0001 10 21 Coverage Part B—Public Officials Liability—Occurrence-GPE 00 0003 07 21 Common Policy Conditions-GPE 00 0004 07 21 Schedule of Forms and Endorsements-GPE 07 0001 07 21 Personal Injustices-GPE 00 0006 07 21 Medical Incident Liability Coverage-GPE 04 0003 10 21 Employee Benefits Liability-GPE 04 0011 07 23 Claim Expenses Erode Retained Limit and Limit(s)of Insurance-GPE 24 0012 07 12 Service of Suit Clause- IC 24 0002 01 25 Additional Policy Conditions—Trade Sanctions and Specially Designated Nationals(OFAC)- IL 11 0001 07 22 Signature Page-SGN 90 0001 08 22 TRIA(if accepted): Cap on Losses from Certified Acts of Terrorism-IL 09 0021 01 15 TRIA(if accepted): Disclosure Pursuant to Terrorism Risk Insurance Act-IL 09 85 01 15 r I 1 rIllIll„»alIrfi r1r1 ir,I ,IIIlIi,rJ I,l1,I Ii,>1'1�i»11I„I1I�1 r1 1 J»I1,I,>I I�r Ilr1�1�III,1J lI1l r11,11 I 1 rJ,I1,,,rr",, r%%. , J ,1 1J J1J��111J��r11J�1J111J 1111J11Jr11J1111J1J1J1J1 111J111J��11111J1J�1J1l1)�1J��J111111J>)lJ��1J�1�IJ��11J��111J��1J�1J111J 1111J11J�1J11111J1 J1J1J�1�1J��J11J��11111J1J�11J 11J11 1J1Jl JJ11J 111J1 1J1111111J 11JJ1 1J1Jl JJ1lJ 1lJlJ 11JJJ Jl 111J111J1Jr1r)11111J111J1111J111JJ�r)��r1J�111J111J1J�111111J11��1J111J11J1J11J111JJJ1J111J111J1J11��11J111J1111J111J��r1�r1J��1JJJJ�I��r1J>11111>11J1J11>)�rl Nuclear Energy Liability Exclusion-GPE 00 0005 07 21 Exclusion—Unmanned Aircraft System-GPE 21 0018 07 21 Total PFAS Exclusion-GPE 21 0044 12 21 Exclusion—Cyber Privacy Event, Cyber Security Event, Data-Related Liability and Interruption or Failure of Services-GPE 21 0055 06 22 Exclusion—Recording and Distribution of Material or Information in Violation of Law-GPE 21 0056 04 23 Exclusion—Human Trafficking- IL 24 0005 01 25 TRIA(if accepted): Exclusion—Nuclear, Biological, Chemical or Radiological Acts of Terrorism-IC 21 0006 01 25 TRIA(if accepted): Exclusion of Punitive Damages Related to a Certified Act of Terrorism-IL 09 0026 01 15 TRIA(if rejected): Exclusion—Nuclear, Biological, Chemical or Radiological Acts of Terrorism- IC 21 0006 01 25 11 r �� U�u1111�i�� IIIIIIIIII .,,.,,,,,,,,«< ««<«n,,,IIIIIIIIIIIIIIIIIIIiiiillillilliol��IIIIIIIfIIIf01111I011111011111�011IIII��I�� I��IOIIII�li��ll�l��III �IIIIIIIIOI� ��f�llll��lll ��lllll '' /%e City of Santa Ana rr r r rrI II I r r r rrr»rrr lr llrr�r.III II rl�� rrr�r rr rrrr rr.rrrrrrrrrrrr rr rr rr ri r»r rri r Ilrrr I r rrrrr rr 1 r rr J �JJ1 r� rrrJ �J Jr� tr. l J 1 1 i CORE 360' TRIA(if rejected): Exclusion of Certified Acts of Terrorism-IL 09 0022 01 15 Binding Requirements: u lm u k . kr u 1 Ju h k N IIIIIIII ��rII�Iir�� Il ��l�lllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll. Subject To: D-1 (Effective January 1, 2020) Signed TRIA Form. Confirmation of Binding Coverage must be signed at Binding Copy of signed E&S due diligence affidavit from retail agent must accompany any request to bind coverage. Other Significant Terms and Conditions/Restrictions: �11°"'khNf ryf U JUIIIJJIIIU9JU11,pIlU'JIIU IIIIIIIIIII� 11I�JI�f��k�rlr��lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll Type of Insurance: Coverage Part A: Genesis Public Entity Liability on an Occurrence Basis excess of a Retained Limit on the Genesis Public Entity Policy Form. Coverage Part B: Genesis Public Entity Liability on an Occurrence Basis excess of a Retained Limit on the Genesis Public Officials Liability Form TRIA Premium includes additional taxes of$961.19 12 ��>� JJil�llJlIIl111�D��1�11111��1�1>�>I�I�JJ�III _ _ ,,,,,,,,,,,��««��«�««��II�IIIIIIIIIIIIIII�iiiiiiiiii��o��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�IIII�II��IIIIIIIIII�IIOII IIIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII /%e City of Santa Ana rr CORE 360' Excess Liability Buffer - $1 M xs $21VI SIR i iirriurrrr»» �urii,rin iiirirJuir ,nn »�ai ii r i ii r rrrr,r1" rr ,rrmiiir r x�mirr r,,,r�lr Ip rr�uii iiir 1 �r J !r 1 1 rl 1 Carrier Princeton Excess&Surplus Lines Ins Co A.M. Best Rating A+XV Admitted/Non-Admitted Non-Admitted Payment Plan Premium is payable within 60 days of binding Payment Method Agency Bill r r rrrrrrrrrrrrrrrrrrrrrrrrr rrriarrrirnrrrirrrrrrrri »r»»r»r»»rrrrr:r r rr rrrrr r r r err r r r rrr»r r �r J r J J 1 ,l J I l 1 l 1 � r 1 I , , , , , , 11� 11111� �� ,11�11�1,r1�J»�,�1,1I„f>;r,r�,,,,,,r,�„�,J,,,,,11�11111��111111�1111111��111��l J 11, ,r, ,f,�)11111)J 1)11)1111111 J1111J 1111)1 I)11)11111I11I11)11111)11)11)1)11111 �1J1�J1.rJJr,rrJrlJrJ1i111r��Il�»�Jr�lrlrr>!�,,�„�r,�,,,,�J�r�,,,1�1�111��>r�1111�1�11�1��11��>r�l��/11J��1�11�,�,,,11�,1��»Ilt�»,�)1)))11�)JJJ11)))1J1)11))1)1)111)11�)J1J1J)J)))1�))1)1)1)))11�)JJJ1.11))I)1)111)I)1)111)II1)1111)I11)11)D1))II1)11)1)1)1)))11�)JJJ111))1J1)11))1)1)111).1�)J1J1J)J Premium $1,625,000.00 State Tax: $48,750.00 Stamping Fee: $2,925.00 TRIA $33,533.50 Minimum Type Minimum Earned Premium Minimum Amount/Description 25% Estimated Cost $1,676,675.00 , r ,r , ,, , ,� r rrr � ��rrrrr rrrr�,r»r err r� r rr rrrrrrr ri rrrrr rr r» »rrrrr rrr rrrr rrr rrr,.rrr rrrr rr � rr � r rr rr ,r rrrrr rrr rr rrr! r l l ll 1 r 1!l I JJ 1 J J l 1 , 1 l J J I 1 „ l 1 .J. r , l I 1 �� 1JJ11��l�l��l��l��l�l��l�/��11J�,11�t1�„1„ll,�f�»,r�.Irr,,,�1)))11�)JJJ11)))1)1)11))1)1�11))11�)J1J1J)J)))1�))1)1�1)))11�)JJJ1.11))I)1)111)I)1�11))II111111I111)111D1))II1111)1)1�1)))11�)JJJ111))1)1)11))1)1�11)).1�)J1J1J)J Auto Liability: Specific Limit $1,000,000 General Liability: Specific Limit $1,000,000 General Liability: Policy Aggregate Limit **$3,000,000 *Law Enforcement Liability: -Specific Limit $1,000,000 - Policy Aggregate Limit **$3,000,000 *Sexual Abuse -Specific Limit $1,000,000 - Policy Aggregate Limit **$3,000,000 Professional Liability: -Specific Limit $1,000,000 - Policy Aggregate Limit **$3,000,000 *EPLI: -Specific Limit $1,000,000 - Policy Aggregate Limit **$3,000,000 *Sexual Harassment: -Specific Limit $1,000,000 - Policy Aggregate Limit **$3,000,000 rig r, r rrrrr rrr rrrr»rrr rrr rr rrr rr ri ri ra r i rr r rr.r rrrr rnri r , rrrrr r rrr rrrr rrrrr r rrrr rr rrr. r r r r rr r r r » rr r, r rr r rr � rrr i 1 I f 1 l 1 >I 1,�11,f1,, ))II)I)))))�))II)II�II)I))II)II�II��I�II)II�II ��111J �� „ Annual Aggregate $3M applies to I'll Lines except Auto Liability Retention:Auto Liability-Underlying Retention 2 000 000 Y 9 $ , Retention: General Liability-Underlying $2,000,000 Retention 13 _ .,,,,.,, ,«« « « u««<i« «II�I��II��iioiilliii��oIII�IIIIIIIIIIIIIIIl011111111 � II f IIIIIIIIIIIIIIII�01111111��0111(I��I�II��I�r�I�II��II OI��IIIIOI��l�l�l�l�llll��ll�lll�lll��llll��ll IIII��IIIIIII(�I�IIIII� City of Santa Ana /% CORE 360' err I r ,r ,,r rrrl rrr. rr hill Ili „r,i»I rl r»» r r rrr irr r rrrlrr r rr l 1 J 1 J J rJ 1 11»»„»1,r»,,,,�,,),!»rl„r1,,1111111111111111�11111�1��11�11111111111�1111>)1�>)11>)1�>)r�>)1�>)11>)>ilJ �1, ,�, ,Jr,)1)111)J1)11)1)11111J1111J)111)1I)11)11111)11I11)1)111)11)11)1)11)11 �1J1„,,,r<„r�„�rrrl�,f,r,,»��,r,�»1,.11�1�11�1�111111�1�11�1��11��1�111�11��11�1��111��1��1��11�11J�r11�t1�l,r,,,Jlrrf»r�.J»„�1)))11�)JJJ11)))1)1)11))1)1�111)11�)J1J1J)J)))1�))1)1�1)))11�)JJJ1.11))I)1)111)I)1�111)II1)1111)l11)11)D1))II1)11)1)1�1)))11�)JJJ111))1)1)11))1)1�111).1�)J1)1))) Retention: *Law Enforcement Liability- Underlying Retention $2,000,000 Retention: *Sexual Abuse-Underlying $2,000,000 Retention Retention: Professional Liability-Underlying $2,000,000 Retention Retention: *EPLI-Underlying Retention $2,000,000 Retention: *Sexual Harassment-Underlying $2,000,000 Retention r r r I r rr r r r r rrr rrr r Inl r !!!l rr r l r»r,r rrrr»r r r r,rr rrr .rrr»r ,» I II rlrl rrrrrrrrrri r rr rr� r rr rr rr rr r r r f u IIIII . Excess Liability Defense cost Inside the Limit r r I rrr Illlllillli ni�nl,n, rr»i�raorlr��rrar Ir I» 1 ll�� r rrr 1 I l I I ! !!!!!I 1 1 l l / C� P C J � 1 f / / ll / II1ll / / I / III / I / ,' r , 11111111�>1,r»�I�l,l�lllll»>»»a,,�,1,1»»JJIIJJJIIJJ��IJJJJ��1J111J1JJJJIJJIJJJJJJ�JJIIJJJ��1�J�J��JJJIIJJJJ�JJJJJJJJ�J��111J1JJJIJJIJJJJ11f�fll�IGl��»r,Cllr»»»r»I»r»r,»»�>I///III/CC>r>ll>IC�C>l>lIC>I�CIC�>l/C>1I01�/CC>r�C>ICC�/�C/>I/C/>lC�>I///10��/C�/01�/ICl/O//IC��/C�IOI�/CCI�CCCC�/�C/�/C/>lC�>l///I////I/I/01//I///D/I///ll//I//0/IIIII////I//II/Dl/%III/IIIII%//////ICE Excess Liability: Occurrence; General Liability: Occurrence; *Law Form Type Enforcement Liability: Occurrence; *Sexual Abuse: Occurrence; Professional Liability: Occurrence; *EPLI: Occurrence; *Sexual Harassment: Occurrence lJl 11 II l 111 III I I IIII lrl lJll 111 II II !r!r! 7r 11111 Illlll »!, Ill I»r Illrl I Illll lill,a ll�i Illr,l,l, rrrlrlr rrrrrr rr rlr i.I rrlrlr. »ll r r I r r r r rr rrr I r r r i� I � 7� it � � i 1 r 1 . 1 I..l L l r 1 ,1 „ � , ) , 1 , 1r , / , , , , JllJllJll / lllllJJlJlllllJllJJlJll1111111J1 111111»»>>,11»I»»r,»,r»1»r»�flll,lllr�»I»„I>',�f»»r»r ,1J,JI11,,�,,,I1,��,,,�,J1,rJ,,,�,�,r�Ir,,,,JJJ,,,I,,,��1��Irl��I1J�11��r11��1/IIJ��I1J1111111r1��/1J��IlJ�1��11��11J��IrJ��I1J�11��11��/11111111111111�11111111111��111111J11111111111/1J1111111�I1J�I��, Automobile Liability Coverage Part-RL 1000 AU Retained Limit Policy-Common Policy Declarations- RL 1000 CDEC General Liability Coverage Part-OCC- RL 1000 GLOC Retained Limit Policy-Liability Coverage Parts Declarations- RL 1000 LDEC Misc Professional Liability Coverage Part-OCC- RL 1000 MPOC Retained Limits Policy Conditions- RL 1000 PC Schedule of Forms and Endorsements- RL 1000 S WROC Wrongful Acts Liability Coverage Part-OCC- RL 1000 Ultimate Net Loss Amendment-RL 2028 Service of SUIT_ PESLIC-RL 2050 Sexual Abuse Occurrence GL-RL 2097 Law Enforcement Endorsement-RL 2191 Cap on Losses from Certified Acts of Terrorism (if TRIA is accepted)-RL VLTERR01 Violation of Economic or Trade Sanctions-VL ES 21 01 U.S. Treasury Department's Office of Foreign Assets Control ("OFAC")Advisory Notice of Policyholders- IL P 001 r r , I I � I r rr r r I I I I I rr. I I r I J.r ri lri ri,lllri ri I,i� lri I ,»r,r rr In r Ir rlrlr,rrr r rl lrrrr r rrrr rr I In�l�ll.rrrrrrr �Ir Ili I r r11 Irr rr r I r r rrr, r r i l +�, I I �� I, 1� � J 1 I l 1 , )NE" r�, >'rr / Ir�Ir,rI>��>��>��,�� l��»��r��1 rlr�J,,,,1 ,,,,,r�,'�,�rlrr»r)a„r)rlrr�r,Jr,,,,�„)J„�,�1��1�11�11111�1111111111��1llll�llllllllll11�11111111�111111111��1��11111�1111111111��1lllllllllllll111�11111111�111111111111�1111111111111111111111111111�1111111111��1111��111111111111�11111111�11111111.111�11111111111111111�1111111111111111111111>�111�111. Exclusions(in addition to those contained in agreed policy form)- Liability Claim Administration, Exclusions, Conditions and Definitions-RL 1000 LC Mold/Fungal Pathogens Exclusion-RL 2034 Silica and Silica-Related Dust Exclusion- RL 2090 Watercraft Exclusion-RL 2095 Communicable Disease Exclusion-RL 2177 PFAS Chemicals Exclusion-RL 2193 Exclusion of Certified Acts of Terrorism and Other Acts of Terrorism (if TRIA is rejected)- RL 2203 II 14 plllllllll�ll)>l , liiliii��lllll�llll��l»Nt a„ � _ . ,,.,,,,,«,,, ««,,IlllllIllIIIII««iiiiii«�iilollllllol�liii�lolllllll�«�IIIIIIIOIIOIIII � �� IIIII(IIIII��IIIIIIIIIIIOII�llllil��IIIIIIIIII ItIIIIIIIIIIIIIIII�IIIIl0llll�llllllll�flll��lllll(�Illl�llf llrl�llllll City of Santa Ana /% CORE 360' err Binding Requirements: v I I JII II 11)I..II IIJ A,IU V J II . IIIIIIIIIr�IIII�IIoIIrIIo�II�YK�n��r�l�rl(�t��llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll. Subject To: D-1 (Effective January 1, 2020) Signed TRIA Form Prior to binding,the Insurer requires a completed, signed, and dated UM/UIM acceptance/rejection form. Confirmation of Binding Coverage must be signed at Binding Other Significant Terms and Conditions/Restrictions: Y I I N III IIIIJ 1D NJ NN I I 1 I I � N LI II�II III� �a.��r'nil�n �RRkkkNNNttN�f��IIIIIIIIfIIIIIIIIfin�IIIIIIIIIIIIii�rl(�i'�N��I��I��II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII *Sub-limits/Sub-lines are included and not in addition to the major line of business covered above. **$3M Aggregate is a Policy Aggregate and applies to all Lines of Business except Auto Liability Limits Structure: Combined Single Limit Minimum and deposit annual premium Cancellation: (60)Days for Cancellation and Non-Renewal (10)Days for Non-Payment of Premium Share: 100% TRIA Premium includes additional tax of$1,033.50 15 i �,�,� JJ it I�111<,<II1111�D��1�llll lUl�ll�>I�JJ'III _ _ ,,,,,,,,,,,��««��IIIIIII��II�IIIIIIIIIIIIIIIII�II��ii�oiii�illfIIIIIIIff0111111IIIIl011llllll��l�ll�l � �� II III011lllf I��I��I�I��I�IIIIII�(O�I��I��IIIIIII�II��II�III��IIIIIIIIIIIIII IIII��I�I��I�IIIIII�III��IIIII Il��l��f I��IIIII City of Santa Ana /% CORE 360' err Excess Workers' Compensation i »rriurrrru» �urii,rin iiirirJuir ,nn »�ai ii r i ii �»rr,»� r� ,mmiirr� x»mire r,,,r��r Iprr�uiiiiir 1 �r 1 �r 1 f rl 1 Carrier Response Indemnity Company of California A.M. Best Rating A-X Admitted/Non-Admitted Admitted Payment Plan In Full Payment Method Agency Bill r rr, r , ,�� r r++ rrrr. rrr r r i r r rrrrrr » r r r r rrrrrrrrrrrrrrrrrrrrrrrrr rrriarrrirnrrrirrrrrrrri »r»»»»rrr»rrrrr:r r rr rrrrr r r err r 1 r rrr»r i r r �r r ,l I l, J 1 l 1 � r t � , 1 I , , , , , , 11� 11111� 1� � 1r 11;II;1,r1;I»rr»I,1I„f>;r,rr,,,,,,r,�„�,Ir,,,,1111111111�1111111111111111111111�11111�1��11�111�1J 11, ,r, ,f,�)11111)J1)11)1111111J1111J1111)1I)11)11111I11I11)11111)11)11)1)11111 I1J1�ff.rJ�rrrrrJrl JrJ1r111r�rll�»rl�rrlrrt�,,�,rrr,�,,,,��rr�,,,1�1�111��1111�1�11�1��11��1��111J�r�1�11�»�,»ll�r1��»rlt�»,�)1)))11�)JJJ11)))1J1)11))1)1)111)11�)J1J1J)J)))1�))1)1)1)))11�)JJJ1.11))I)1)111)I)1)111)II1)1111)I11)11)D1))II1)11)1)1)1)))11�)JJJ111))1J1)11))1)1)111).1�)J1J1J)J Premium $327,547.00 Exposure/TIV $142,743,924-Total Payroll Rate 0.2295 TRIA Included Minimum Type Minimum And Deposit Premium Minimum Amount/Description $327,547 Estimated Cost $327,547.00 rr rrrrr.rrrr rar r r l J J l 1��1��11�1��1��1>�1��1�111�1��1�1�1��1��1111��1�111�1��1��1��1��1��111��1�111��1��11�1111�1��11�1��1��1��1�111�1��1��1��1�111��1��>1�1��1��1��11�1��1��1>�1��1�111�1��1��1��1��rJ States Covered: CA States Excluded: OH, ND, WA, WY Extraterritorial Jurisdictions: !rr „r r r r rrrr rrr ririir»r,rrrrrrr r rrrrr�rrrrrrrr»rrr rr »r rrrr rrrr rr rr rr, rrr r rr»rrrrrrr r„rrrrrrrr rrrr.iir rrr r r rrr r r I I I 1 1 I 1 Jrl , , , , , rr . , 11111111111111, 1 „ 1 l ) 1 ) ) 1 1 ) 1 1 ) 1 1 ) 1 )11r„�,,»�,,»r;,1�r11r,1,,,�,1„rl»,,,,,�„1111111111�11111111111�11��1�11111�1>111111111>111>111>11�i,1 J 11, ,r, ,t, �)11111)J 1)11)1111111J1111J 1111)1I)11)11111I11I11)11111)11)11)1)11111 Coverage A-Workers'Compensation Statutory Per Occurrence, Each Accident: Per Person, Each Occupational Disease or Cumulative $500,000 Trauma rr r rr !!r r » !r!r r rr iirrrr ii imrrrri »r » rr rrr,ir nr rr rririnn rrrr rirrrrri » r»r »» rr rr ri ir, ri i i rrrr r r I,I rl r , l 1 11 , � , J1 , 11r , 11111111111111, 1 , , , , ) ) 1 ) ) 11 ) 11 ) 1 ) ) 1 ) ) 1J11 ) ) ) ) ) 1 ) ) 1J11 ) ��,��,,,,��r,��1��11��Ill ll»��I�1r��i»r��„�1»»�»�r�,��»�11)J)11)1)J111)J)1JIJJJJJ�J1111)1)1�111)I)1I)I)III1)I)11)1)11I11))1)11)1)111)�)1�111)J)11)1)1111)J JIJJJJJ�J111J)1)1�111JJ�JIJ�JJJ111JJJ�JIIJ)1)1�J11)J)11)1)111J)1)1JIJJJJJ�J1111)J)1�111JJ�JIJ�JJJJIIJJ» $750,000 xs$1,250,000 Premium : $475,721 $1,000,000 xs$1,000,000 Premium :.$735,719 nn r»ri nr it rrr r rar,!r +r+r n n r ,,rrr ,,r n q, r r r r rr, r rr rr r � r rrrr r� rr rrr raar�rrai r ii r,r , rrrr.,",,rr rrr r rrr rrrr rr rr r rr r �r�r�r .rrr ,, r r r'1., ,, ,, l l l 1 1 l »r1,rl,ll�»»1�1111�1�11111��1��111��1�111��11111�111��1�111�1��1�1111�1�11111��11�„I��ll;;�,»r»,Irr�fr�»�»r»��>lllllll>11�11>1I1��1��I��>ll1>1101>11�11��1��1��l�l�l>l��IIIl01��I1�IDl�l��lllll��>ll1>1101�I�1��1��I��I�I�I��IIIII�III111011/��IIIII11�111/1II�IIIIlllll Retention-Workers Compensation-Limit& Retention per occurrence, each Accident: per person, each Occupational Disease or $1,500,000 Cumulative Trauma rrr r ,r r r r»rrr rrr rrrrrrrr rr rrrrrrr»rrrrrrrrrrrrr rrri raa rrrrr rr.rrrrrrrrrrr r rrr rr rr r»rrrrr»rr rrrrrrr r rrrrrrr rrrrr r rrrrr rrr. r r r , rr rr rr rrr rrrr, r r rr rrrr rr r rr r r r r11 r r r 1 (l r ( 1 , , r , , , , r „ ; ., , , , , , , � , 1 , 11111111111111111111111111111111111111111 Policy form-FSIR 000 Subject to Audit: At Expiration 16 �� W IIIIII) f /%e City of Santa Ana rr CORE 360' Auditable Exposures: III I ' I�IIIII� IIIIIiIr r�ioi�llU)'NN$,u,lin7,UI�IIIIII IIII11�� I�IIIii�, !'"'�f��"'I " I�IIIii�, IIIIIIrIIIIii�, 1 I 1 1 1 I 1,1 ff 1 1 1 f Workers Compensation & Employers CA Liability: Class Codes: 7520, 7720, $0.2179 $137,686,727 $0.229465 $142,743,924 7721, 8810, 9033, 9410, 9420 17 �� JJil�llJlIIl111�D��1�IIIIII�I�1��>I�I�JJ�III _ _ ,,,,,,,,,,,��««��«�««��«ouollillllllllllllll�ll��i�ll��l�llllollllll�l�llllll«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�II�I�II��IIIIIIIIII�IIOII IIIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII /%e City of Santa Ana rr CORE 360' DIC - $5M Part of $10M I lir»»r»u» »»»In IIilirrull ,nn »�al III r I li 1 �r 1 Jr J 1 1 I rl 1 Carrier Endurance American Specialty Ins Co A.M. Best Rating A+XV Admitted/Non-Admitted Non-Admitted Payment Plan In Full Payment Method Agency Bill „ r r Ilrrlr rrJ rl »rrrlrrrl Irlllrl /rlrrrrlrlJrlrl»»rr»rJ irl»irr»»rr»r»»ri Irlr»Irr»»»rr»:r rr Jrirr � � J IJJ �I J rrJ»�r J r J J 1 ,l J I J 1 l 1 � r 1 I , , , , , , 11� 11111� �� r 11�IIJ1»1JI»»�I»1I»11»r»,»»»�»�,IJ,»»11>�11111>��>�11>�111�1111111>��111��l J 11, ,r, ,»,�)1111 I)J 1)1 I)1111111 J11 I1J 111 I)1 I)11)11111I11I11)11111)11)11)1)11111 �1J1�II»�JJ»»�J1�J1»11J�JI1»J1�J»rl>!�,,�„�»�»»�JJr�»,1�1�111��1111�1�11�1��11��>r��>r�l��/11J�»I�11�III�,11111J1�»Ill1J»,J)1)))11�)JJJ11)))1J1)11))1)1)111)11�)J1J1J)J)))1�))1)1)1)))11�)JJJ1.11))I)1)111)I)1)111)II1)1111)I11)11)D1))II1)11)1)1)1)))11�)JJJ111))1J1)11))1)1)111).1�)J1J1J)J Premium $339,098.00 Surplus Lines Tax $10,172.94 Stamping Office Fee $610.38 Exposure/TIV $777,575,468 Rate 0.0436 TRIA $34,988.33 Minimum Type Minimum Earned Premium Minimum Amount/Description 25 Estimated Cost $349,881.32 i i n ,ri r r nm rn r r r r 1 I l,l I II 11»11 IIII I II I Jl J J ,»Ill JlJJ JI JI »/I Ill/J l Il,I � I I� I I III„r,»„»j»1,II,�»11J»»»�r„II»»»»»»��il,fJ,l��,1»�»»III�II�IIII�I11�111�III�III�111111�I111rIII�III�II1�11�111I�110111DIIIIII10111D1III111IIIID1l0II1011II1110IIII111DII101IIIII Dllllllll �111»»»»JI,flJlll ,1,1»I�J»1J�11» Limit of Llity- Earth Movement and Flood $5,000,000 part of$10,000,000 Per Occurrence and Annual Aggregate , r i J 1 l l J I II 1 f , , , l , � l , , ��i � „ � „ IIIIIIIIIIIIIIIIIIIIIIIIIII / l / / l / / Extra Expense Extra Expense $2,500,000 Ordinance or Law-Coverage A, B &C. Included Combined , r I 1 � l J J J . u , l l � I 1 ��1��1��1��1��1�11��1 J 1><I ,r, ,1,�)1111 I)J 1)1 I)1111111 J1111J 111 I)1 I)11)11111I11I11)11111)11)11)1)11111 1�1��11��1�11�1�11�1��11��1�,��,��1�11J�»I�1,1�IIII,IIJl1Jl�»II��J»,J>?1))>1111�>1JJ11))>)1)1)11)>11)1�111>1111�J1J1J�JII�111)1)1l1)))111�JJJ1.11))I)1)111)I)1�111)II1)1111)I11)11)D1))II1)11)1)1l1)))111�JJJ111))1)1)11)>'11)1�111>!?.11)J1J1J)J Deductible-Flood 2% Per Unit of Insurance Per Occurrence Deductible-Flood -Subject to$100,000 Minimum Deductible-Earth Movement 5% Per Unit of Insurance Per Occurrence Deductible-Earth Movement -Subject to$100,000 Minimum III I Irlrl rlrlrlrlr r I II IIr Irlrl Irlr/�»r rlrl r 1 .l 1 11 L J I I 1 111,�,»»»,�»»,I,1,11111�rJl�ll�11�11111111�11111�11111��11�'1111111111�1111�1��1�1��1��11��1 J i I, ,r, ,�,,)1)111)J 1)11)1)11111 J1111J)111)1 I)11)11111)11I11)1)111)11)11)1)11111 �1Ji»�,»1J1,»1,»,I»��»IIJ11��1��11�1�11�1�111111�1�11�1�1�11��1�111�11��11111��111�;J�1;J�1;J�11�11J�JJI�11�,Ililllf»ll»Ill.�»JI1)))111)JJJ11)))1)1)11))1)1�111)111)J1J1J)J)))11))1)1l1)))111)JJJ1.11))I)1)111)I)1�111)II1)1111)l11)11)D1))II1)11)1)1l1)))111)JJJ111))1)1)11))1)1�111).11)J1J1J)J Replacement Cost Property Actual Loss Sustained Business Income rr r � �I J y J r JJ I Irr I I »JIJIJ rlrlr rrl Irlr�.»»rJ JrrJ I»�JI�J» r , rl I I �»»/ » J� >"1 � 1,J J t J � J r 1 l J �,» ,l�,�, », Ill,l,l�ill�l,llll ,1»1,,,,,,1»,�,J ,,,,�„I,1,�,1��,,,��,»,,,,l,,,rl��,»»�,»„I,,,,��1�111111111��11111��1�1111111�111�11111111�111111111��1�11��1�111��1��11111��111��11��1��ll��11111�11��1�1111��11��1�1��1��ll��l��>!�11��1�111�11111�11111111��1. SN-California-SN 9005 0120 CA Office Of Foreign Assets Control ("Ofac")- PN 0001 0721 Property Declarations-ECP 0001 0616 Forms And Endorsements Schedule-ECP 0101 0508 Disclosure Pursuant To The Terrorism Risk Insurance Act-IL 1214 1220 Cap On Losses From Certified Acts Of Terrorism- IL 1204 0115 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... ... .. IIII 18 ,,,,,,,,,,, ««««««IIIIIIIllllllliii��ii�oiiiliilllllll��Ilo�IIIIIIIIIl011111101111101 � �� IIIIIOIIIIIflll�flIIIIIIIIII�III��IIOII�II�III�III�I�IIIIIIIIIIOIIIIII�IIIIIIIIIIIII Illllllllllllllllllllfll�llllfllll /%e City of Santa Ana rr r / r I /rrJr J II Ir�rri r JI Ir»/»r J»Jr I/I/I Irrrl Ilr r/rl r,.»rrirri rl/rlr r�rrrr�irrr+r .///1r.///rrrr r��/JJ r Ir r JrJr r rr r , t l r r J J J �r J, ,! r J J I ! I l� I l 1l � , ! ! , l � , , , , , lJ „ 11l � , , , llIIII// 111ll/ lllllll/lll/ lllllll/ll�ll/l, CORE 360' Easic Specified Perils Policy-ECP 0224 1018 Business Income Endorsement Gross Earnings Form Including Extra Expense-ECP 0628 0416 Occurrence Limit Of Liability Endorsement- ECP 1324A 1220 Flood Coverage Limitation- ECP 0508 0516 Flood Percentage Deductible- ECP 1346 0417 Earth Movement And Optional Earth Movement And Sprinkler Leakage Percentage Deductible- ECP 1348 0417 Sub-Limits Of Liability Endorsement-ECP 0102 0216 Ordinance Or Law Coverage Endorsement With Time Element Coverage-ECP 0611 0716 Loss Adjustment Endorsement-ECP 1301 0616 Notice Of Loss-ECP 1302 0214 Service Of Suit Endorsement- ECP 1307 0316 Actual Total Or Constructive Loss Earned Premium Condition-ECP 0684 0123 Signature Page- IL 1008 0114 Mandatory Policyholder Disclosure RE:Terrorism Insurance Coverage-TRIA TRIB 0115 California Fraud Statement-IL N 018 01 22 Privacy Notice for Insurance Applicants and Policyholders- PN 0017 1120 r rrrr ri rl rrl rrl /rr rrr r+ //r/r Ir /�r� Irlrl /r� rl r rrrrr rrlrlr.1/rl r r .»rr r rlrrl J////r/ Irlr/rr r1r rrr .11 r r/�1� Irl r l .,l r. l I l 0�Ill1l��1��ll��l1�111��111��ll��ll��11111��ll��ll��l1��111��11��11��ll��ll�>�1��111��lll��ll��lll��11��ll��ll��l1� Equipment Breakdown Exclusion-ECP 0510b 0508 Absolute Pollution Exclusion-ECP 0501 0606 Asbestos Exclusion-ECP 0502 0606 Absolute Mold Exclusion- ECP 0505 0606 Exclusion For Certain Computer Related Losses- ECP 0509 0416 War And Military Action, Terrorism, And Nuclear, Biological Or Chemical Exclusion-ECP 0507 0606 Communicable Disease Exclusion- ECP 0519 0817 Post-Loss Assignment Exclusion-ECP 0676 1021 Binding Requirements: �p°ullllOjl,p J,'Nry/ITC'OIUU�rUnl�l PI �i i �I��kuN��lllllllll�ll(II��III�III�Ii�I�II�N��l�l�l�l��(�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�I Signed Terrorism Disclosure Form prior to binding D-1 (Effective January 1, 2020) Other Significant Terms and Conditions/Restrictions: ilu'C�N�flfi�UIIII�IIIIViI DD��i�JNNN NNJ TRIA Premium Includes Additional Taxes: $1,078.33 Peril(s)Insured: Risk of Direct Physical Loss or Damage caused by the peril(s)of Earth Movement and Flood only as per Policy Form, Endorsements and Exclusions attached. Coverage(s): Real Property, Business Personal Property, Business Income including Extra Expense and Rental Value as per Policy Form, Endorsements and Exclusions attached Cancellation: Cancellation term is 60 days. Term is 10 days for reasons of nonpayment. Occurrence Definition Must Include an Hourly Limit not to Exceed 96 Hours for Named Windstorm and up to 168 Hours for Flood and Earthquake/Earth Movement Excluding Flood Zones A&V-501 N. Newhope St., 2501 N. Flower St., 2615 N. Valencia St.,4812 W. Camile St., 706 N. Newhope St., 751 Memory Ln., 122 N. Newhope St., 3006 Centennial Way, 2401 N. Bristol St.,4404 W. 1st St., 730 E iI 19 /%e City of Santa Ana rr CORE 360' Other Significant Terms and Conditions/Restrictions: u i J 1 1 1 JII 1' . ulnaINN Ii 17 NNI7N'II U ID II . �K�nIiM��r��ll�� '�i Memory Ln., 207 S. Mountain View, 2315 N. Bristol St., 2410 N. Bristol St.or any area designated as a 100 year flood plain are excluded (FS C 505). See Appendix 20 �>�>� JJil�llJlIIl111�D��1�11111��1�1>'�>I�I�JJ��III _ _ ,,,,,,,,,,,��««��«�««��«��IIIII��IIIIII��iiiiiiiiii��o��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�II�I�II��IIIIIIIIII�IIOII�IIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII /%e City of Santa Ana rr CORE 360' DIC - $2.5M Part of $10M i iirriurrrru» urii,rin iiirirJuir ,nn »�ai ii r i ii r11r1,r� r ,rrmiirl x�mJri r,,,r�Jllprr�uiiiiir 1 �r J lr 1 1 rl 1 Carrier Palms Insurance Company, Limited A.M. Best Rating A IX Admitted/Non-Admitted Non-Admitted Payment Plan Payments Terms: 30 Days from Date of Inception Payment Method Agency Bill rrrr rrr r r r++ rrrr. rrr r r r r r rrrrrr rr r r r r rrrrrrrrrrrrrrrrrrrrrrrrr rrriarrrirnrrrirrrrrrrri rrrrrrrrrrrr»rrrrr:r r rr lrirr r r r err r 1 1 rrr»r i �1 �1 J J 1 ,l J I l 1 l 1 � r t , 1 I llllllllllllr 1lrllrlrlrl»rr»Ir1lr»r,rr,,,r„r,�„�,Ir,,,,111111111111111111111111111111111111�11111111111��1J 11 ,r, ,fr�)11111)J1)11)1111111J1111J1111)1I)11)11111I11I11)11111)11)11)1)11111 �1J1�II.rJJrrrrJrl JrJ1i111r�rll»rl�rrlrr>!�,,�„�r,�,,,,�Jrr�,,,1�1�11J��1�1111�1�11�1��11��1��>r�l��111J��1�11rtr�,,rllrrl��»r1.11»,�)1)))11�)JJJ11)))1J1)11))1)1)111)11�)J1J1J)J)))1�))1)1)1)))1111)JJJ1.11))I)1)111)I)1)111)II1)1111)I11)11)D1))II1)11)1)1)1)))11�)JJJ111))1J1)11))1)1)111).1�)J1J1J)J Premium $169,549.00 Surplus Lines Tax $5,131.47 Stamping Office Fee $307.89 , Carrier Fees-Carrier Policy Fee/Modeling Fee $1,500.00 Exposure/TIV $777,575,468 Rate 0.0218 TRIA $87,470.84 Minimum Type Minimum Earned Premium Minimum Amount/Description 35 Estimated Cost $176,488.36 r r r r r> > r r rrr , i i i rrr r rrrrrrr rrr rr rrr rrr�a��r,r�rrrrr,iiri»r, rrrrr rrrrr rrrrr »rrr�rrrrrr r rrr r r r1 / rrrl 1r r J JJ rr JJJJ 1 J I . „ rJ , 1r , r „ ll/1�11��1�111111, , , , II11111111111111I11111111111111I11 JJ1J1�»»�r»»rrrrrlrl>rrrl»r»rrr>>1r»,rrI11»»»»r��f,�1»�11r,»,,,,,,1,r,�,r„��I11��1��1>i/,�»�,1�„/�,r�„�,,,�r,,,,,,,r,IIIIIOIIII�111�1��I1�101�1�11�II1�I11111II01��I�I1I�1��I1�10/�I11�I11�1��IIIIOIIO/111�II1�I111�11I01��1�II1�I�11111I01�1I�I11�1��I1�101�I�110IIOIIIIII�OIIII 25.00% being$2,500,000 Per Occurrence and Annual Aggregate as Limit of Liability respects Earth Movement and Flood Part of$10,000,000 Excess of Underlying Deductibles , r rrr, , r , i rrr. r rrrr » rr rrrrrrrirr i trrrrrrrr r»r»»rrr»arrrrrrr rrrrrirr rrraror r r rr r rrr i r r r r r rr rr+ + r 1 J rr I 1 Jr Il i r r i/ r C , .,IIIII,rf�Jlir„rrrll„»r1 rr1rrrf l,rI1„,1�r�l»„r»1I111r»»rf1�»,rrr�rrrr�1r»�l,f1lrr,rr1„,„�1r,,,rr,,r��>1J111111J1111111 111111111�111111111J1111111�1>11J�1111�11�11 1�1111��1�111�111�1111�111�1�11�i r�1��1,1»I„f>�r,,�,,�rrfr,,rr,r1fr,�Jr,rrllllllIllll1l1I1lllllllIlllllllIIl1 11l1l1Il1l1l1lI111111l1Il1l111�Il1 11l1l1Il1l1l1lIl1l1l1l1Il1l1l1lII11 111111I1111111I11111111I111111I111 1111111111/1111111/1l1l11l1l1l1I11l 1l1/1II1/1111111111111/11I1/11I111 1/1I1II1///IIIIIIIIIIII1IIIIIIII1I1 I1I1I11I1I/I1I1111I1IIIIIIII1IIIII/I/1II1/IIIlIIJr 11' 1�1�,11�111111JII1111111111�11�1111111�1111/1111111111111111111111111111111, Sub-limits As Per Sompo Quote Dated 4/28/2025 rrrrr it inrir rrr �I�II 1 1 I �r ro ri,riri +r+r+ rrr, r„ r r it r� i a I rrr r rrrr rirrarrrr»rrrrrrii i rrrrrrr r l rirrrrrrrirrrr r r r rrrr r i r , rrr rr r r fir 1 r, 1, , , 11111111111111111 � , r1 , 1111111111111111111111111111111I11,rr,rr„�„r,1111111111111111111111111111111111111111111111111111111111111111111f1i1lr,r,»r1Jr„IIIIIIIIIIIII111111111111IIIII1111111111�IIIIIIIIIIIII111III1111111111/IIIII111IIIII1111/1111/II//I/IIIIIIIIIII11111111111111IIIIII�»�,J,r/,f,»rr111111111111111111111111111111111111111111111111111111111/1111//IIII111/111111I/111//I////IIIII/I11/1111111/11111/1111r IIII>><rl»rrrr»l rf,f�»1»,»rr rr�,111�rr�1r111111J111�1�111111I11111�1�1�1�111111�1�111�11111111�1111111J111�1�1111,11�11�11,�1�111111111111111111111111111111�1111/11/1111111111111111111111111111, Deductible: Deductibles As Per Sompo Quote Dated 4/28/2025 r, r r r ,r r i rr r ri n �r r r rr rr rrrr rrrr rrrrrr rr»o rr rrarrrrrr,i r rr1 rr r1r r 1r 1 1 � rJrrr i rJ rr r r r >r / I l I I l 1J,1,rrf,>>„>>,t�r�,�11>�1/>�11>�111�111111��>�11111111'11��1111�11��11�1/�11�1111�1111111�>�1/11i�1,11,/,1,1 »f»r„IIIIIIIIICIIICICIICCI�CIIIICIIIIICIIIC/ll/lull/lllllll/lull//ll/l/II/IICIIIIIIIIICl/11/lulllllllll//ll/l//l//I/II//III//////l//lr 1111 rr�r�rlrr rlr�rrr1�,i»rrr'��>�1��111�1��'�'��1�11�1�111��'�11�1��1��111�1��'�'1��11��Jr lllrl�„��rrf»�rrrrlr�rrr�//ICIICIICIICCIICCIICCICCCl//ICIIIIICIIC>IIIC/C//CC/IIC//ICIICII�ICl/I//C//C%/III//ICIIIIIC/lC>IIIC/C//CC/IIC//ICIICC////C////l/l/////l/ll/l///l///ll///C///r) OtherAs Per Sompo Quote Dated 4/28/2025 r r rr rrr rr rr rrrrr rrr rrr rrr a»r r rrarrrr,rirrrrrrrrrrrrrrrrrrlrr r11 rrrr»i/�i/� r r �,l 1 , J , l i 1 , „ Ir „ 1111111111111111111 Jrr , llllllllllllllllllllllllllllll / lll Il,r�,rrl,�,>»r�, lrf»r,111111111111111111111111111111111111111111111111111111111111111111111111,11,1„�,,1,»J�rf,rlllllllllllll�lllll�l��llllllllllllll�llllllllllllll111/lllllllllllllllllllllllllll(Illllllllllllllll/Illlllllllllll/Il/Illll/Illllr 1111 r,�lr�r»rrrrrrr»I�r11rr frr1111�111�111�111�111111�1111111111111111�111�111111111111111�1111111�111�111111�111�/�lUrllr/,rrf»1rr1J�r�rr��lllllllllllllll�lllll>(I��I�lll111111111111�1111�11111�11111111�111111111/l�lllll�lllllllllll1111�111/�IIIII�III�II/1///111/111/lllllll/l1�/llll/1///lll/l Coinsurance As Per Sompo Quote Dated 4/28/2025 rr , r r , rr r rr r ,r r r r rr r r r rr>" rr rrrr rrr rr rrrr rrr rrrr rrr rr r rr rrr » r n» rrrrrr. rrr, rrr.r rrr rrrrrrr rrrrr rrrrrrr .rrrr,rrrrr rrrrr rrrrrr rr rrr r r rrrrrr, rrrr 1 1 r r r r� 11r r r r 1 rJr 1 1 J r r 1J r J 1 J / i ,1 , , 1 � , II , I ,� . r l > r l J I J I 1 1 r„ ,l�,1> >, ,J1 r 1�rr�1„ ,ll/lll/l/lllllllllll/ll/ll/11111/ll/ll/l/lll/lull/l/ll/lllllll/lll/ll/ll/llllllll Ill,»rJr11,,ui»r,,l>>I»,f»Ire»lrrlrrr�»l�ra» �„rrlrlr,J,,,.,,1„�,rr„I,,,�„),,1r,�rr�r�rr�lrrlJl�rl�r�rrrr�»J»1�rrr»1r�r»Irl�llrr�rrlri��1�11//�1��11/1/��1//��1��1/�111��1��11/1/1��1�1/��1�11/��1��11/1/��1//��l��l��1��11111r11/��1�11/1��1��1�1��1��1��1��1�1/��1�11/��1�1111111111��11� California Surplus Lines Notice-CA SL Notice Spectrum Declaration Page-Spectrum Dec 08 22 Schedule Of Forms And Endorsements-Spectrum Forms 08 22 Policy Endorsement Page-Change End Page Spectrum Participation Follow Form Endorsement-Spectrum PFF Spectrum Service Of Suit Clause-Spectrum SOS 08 21 21 nirrrnnioirrrrri00OfVf011llillliill�oll�li«��I��illoiiiol�IIIIIl0111101111111111111111 �� IItIIIIl0lllll�lll�lllllllll�I�(�I(IIIII01111II��IIIII�OOIIIIIIIIIIII�I�I�IIIIIIIIIIII��IIII�IIIIIIIIIIIIIIfIl�lfl�IfIIII /%e City of Santa Ana rr I r»rr r �I I»rri r rr Ir»r»r r»rr Irlrl .rrrrr rrr rrrr r.rr�lr�Ir rl rrlr r�rrrr�rrrr Ir .rrllr+.»irrrr rlrrrr r rr r Ir r rrrr r rr r , 1 r I r rrr rrr r, r.. .r r r I l„ 1 >' � , , , � , , , ) , C � l � � , � � , Illllllllllllll/ lllllll/lll/ lllllll/ll�ll/l CORE 360' Communicable Disease Endorsement- LMA5393 25Mar2020 Ofac Advisory Notice To Policyholders- IL P 001 01 04 Several Liability Notice-LSW1001INS 08//94 Spectrum Chemical, Biological, Nuclear And Radioactive Explosion, Pollution-Spectrum NCBR 08 21 Spectrum Asbestos Endorsement-Spectrum Asbestos 08 21 Spectrum Claims Reporting And Adjustment-Spectrum Claim 08 22 Property Cyber And Data Endorsement-LMA5400 11 Nov2019 Spectrum Occurrence Limit Of Liability-Spectrum OLLE 08 22 U.S. Terrorism Risk Insurance Act Of 2002 As Amended- Not Purchased-LMA5390 09Jan2020 Minimum Earned Premium Endorsement-Spectrum MEP 08 22 Spectrum Assignment-Spectrum Assignment 06 22 ,I�111»»��IJrIf1»rr» J,,1 rrr1 rrr rrr„1n,1rrrrrrr rrr rIrIrIrl11r lrr�rr ri r��»�<,rri � �� ,„�r1f „ 1r111 All Buildings with Outstanding Damage are Excluded, Contact Underwriter if Waiver Needed Coverage Excludes all Loss or Damage Directly or Indirectly Caused by any Named Storm in Existence at Time of Written Request to Bind or Inception of any New or Additional Exposure Excluding Flood Zones A&V-or any Area Designated as a 100 Year Flood Plain are Excluded (Per Sompo) Sanction Limitation And Exclusion Clause- LMA3100 15Sept2010 War And Terrorism Exclusion Endorsement- NMA2918 Exclusion Of Certified Acts Of Terrorism-Spectrum TRIA EXCL 08 21 Binding Requirements: u I � �U�k'kN♦'�fltl'('(i� Illllllllll�tlf��(III(��IIIIIIIIIIIIIIIIII�I�I�I�I�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Subject to -requested information is received within 30 days, automatic NOC must be sent contingent upon receipt of information D-1 (Effective January 1, 2020) Signed TRIA Disclosure Notice(s)(required at binding) The complete Named Insured listing (if any) is per schedule on file with the Program Manager Other Significant Terms and Conditions/Restrictions: Nf rig u r I � 1 U II , ,r , r 1 Illlllllllllllll��lllll�llllll�llllll�f�l�»�mllr'I�i�l�l��lllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll. Total TRIA Premium Includes Additional Tax of$2,695.84 Covered Perils: Risk of Direct Physical Loss or Damage caused by the peril(s)of Earth Movement and Flood only. Final Binder to be reviewed prior to binding Final wording to be reviewed prior to binding Subject to no deterioration in loss record or terms to be reviewed This quote is subject to acceptance on both sides with No Cover Given See Appendix 22 �� JJil�llJlIIl111�D��1�11111��1�1>�>I�I�JJ�III _ _ ,,,,,,,,,,,��««��«�««��II�IIIIIIIIIII«IOIIII��illiiiiiiii��o��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III�IIII�II��IIIIIIIIII�IIOII IIIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII City of Santa Ana /% CORE 360' err DIC - $2.5M Part of $10M I »rrlurrrru» ulil,Jin IIIlilirJulJ ,nn »�a11111 I II li J 1JI J,»� 11 ,rani l 11 x»mlrl r,,,r�/J Ip lull ii111 1 �r 1 �r J 1 ,I rl 1 Carrier Landmark American Insurance Company A.M. Best Rating A++XV Admitted/Non-Admitted Non-Admitted Payment Plan In Full Payment Method Agency Bill rl , „ �� r r++ rrJr rrJ r l l l r rJrrrJ »I I J r J J rJrrrrJrJJrrrJrJrJrrJJJrJ JrliarlrlJ�llrlirJrrJrrri »Ir»»r»r»»rrrrJ:r r rr JIiII J ! J IJJ !1 J rrJ»r I / J r 1 ,l J I J 1 J 1 J r 1 I , , , , , , 1111111111111J 1lrllrl,JJrJ»J,»1,1I„f>;f,rr,,,,,,r,�„�,1J,,,,11>�11111>��>�11>�111�1111111>��111��1 J 11, ,r, ,f,!)11111)J 1)11)1111111J1111J 1111)1I)11)11111I11I11)11111)11)11)1)11111 �1J1II.JJ�JJJJJJJI JJJ1i111rJIl(1JJr�J(Jf(>!�,,�„�1,�,,,,��1(�,,,1�1�111��1111�1�11�1��11��1��111J�JJI�11�I»I�,»1JIJJ�»rl.1J»JJ)1)))11�)JJJ11)))1J1)11))1)1)111)11�)J1J1J)J)))1�))1)1)1)))11�)JJJ1.11))I)1)111)I)1)111)II1)1111)I11)11)D1))II1)11)1)1)1)))11�)JJJ111))1J1)11))1)1)111).1�)J1J1J)J Premium $169,549.00 Surplus Lines Tax $5,086.47 Stamping Office Fee $305.19 Exposure/TIV $777,575,467 Rate 0.0218 TRIA Minimum Type Minimum Earned Premium Minimum Amount/Description 25 Estimated Cost $174,940.66 nJJ1J1»»�nr1»r f II»1»1J1 1»1(I(I„1 111J1�J rJ1 r1r1J,,1 JIJr�I II,Ir Jr>II>JIIIJ»I 11l J1/J»i»l l,lI,lJI,,Il1J J,IJ�r1/I,I Jl�.J IJ�Jl�� 1 1� (�/�//11 JJ r/r r//�r� IIIIOIIIIIIIIIllll111lI1II1�lIlI1Il1� 11�II1�1111I1ID1�lI1lII11I1111IIIIIIIIlI1Il1�lI1lIOIlI11lI1Il1�lIIIIOIlI11111II11I1111I1II1�lIIIIIIIIIIIIII�IIIIf Property Limits $2,500,000 P/O: $10,000,000 per occurrence and annual aggregate earth movement and flood Sub-limits: Extra Expense per occurrence $625,000 P/O: $2,500,000 r r r r r r J J J III II II I U r r J1J 111 I!! I!I(rr!rJJ,I 11 JI 7111 /ll!!ll r!!!L!I(� IrJJ , ! lr�r J I J r, J u , , 1111111»»�»,f»»»J»»III»J,J»)rl,lJ1J»f»,�,1»»rfJllltr»»1�111�1��1��111�111��1�111��1��111�1�111�1��1�111�1��1��l1CJ,l�1,)rJJ,»r»II,fJJ»�J»�J,»»�ICCCOOIIJC�>lIC>l�C>r>IICCC�C>(CC�ICCC>IICI�C�>lIC>I�CIC��IC�l01�ICC10011C��CC�ICI�C��I/IIII�ICCI>IICI>l>C��IC��CIC��IC�IOI�ICCI00%CCl/I/IIIIIIDII%IIIIIIIII01111100111111111111111111/llllllll/lllll Deductible : Flood 2.00%*, subject to a minimum of$100,000 per occurrence(Property Damage&Time Element) Deductible : Earth Movement 5.00%*, subject to a minimum of$100,000 per occurrence(Property Damage&Time Element) , r r r ,I »rl rJrJr Jrt I.J rlr rl1J rJr »I»r rrrr Jrrr Jrrr rrr J�J r+! IrrrJJ rJJIJr» J! 1 J r J r Jl» I 1 J � . I I I 1 I �1Ji>>�»JrrJ,Jl,rrJ,rlr,11J1J1J��1�1��11�1�11�1�111111�1�11�1�111��1�111�11�1�11111�1�1111�1>��1�111�11J�JJI�1,1�»III,I(JJIJJ�»(r,.lJ»JJ�1)))11��JJJ11)))1)1)11))1)1J111)11��J1J1J�J��J1��)1)1J1)))11��JJJ1.11))I)1)111)I)1J111)II1)1111)I11)11)D1))II1)11)1)1J1)))11��JJJ111)>'11)1)11))1)1J111).1�)J1J1J)J Replacement Cost Applies Actual Loss Business Income II r ( r I rrr»r lu lil IIIIIII In III »r . I»»I In »rJ i Jrrr Jr JrJrJr I»li JrJ J rJJ a l I Ii1 a l ri l I n111 rrJJJrJ IIIIII r JJ rr» rr ,11i 11 rJr r.Ir 11111 J J I r1 i J, r r I J J r +l 1 ,Ii r..I I � I ! l I J I ) , , , 1 , / , , , 1 , J , I , 11J „ JI11l111111111111111111111111111111�1111111 Warranty Coverage Form r r r ,r , ,I r r r»r »Illu»rlrr Julilillrlli»Ili I IrlJrJrrlrlr rlJlrrJ JrrlrJ rrlJJr .111(I.JrJrJJ, IIII JI J 1 1J I 11 I l 1 I 1 I I 1 I J,, J 1 J r I , I � 1 1 ) , � 1 1 J 1 1 1 1 l l 1 1 1 1 1 1 J 1 1 1 1 1 J 1 l J I„ I!f�„ ,,, ,I!�,, ,,, ,1, 1,,„I,,,�,,,,,�,J,,,11J11111111111111J11J11J11J11111111J1111111111J11JJ1111111J11111111J11J1lJJ1J1lJJ11JJJl Illlll»llfJ»»Ilf J»�»�fr�J�1J»>�J��1J»J11,J,,,,1,�I(�,,,�J)»III,J,.11�,,,,,,J1J„�„�,1,,,�1„�,,,r)„J,J„J,�,�1„�,,,,,J�,,,�11J111�11r1�r1Jr1111J111J11�111J1J1J1��1111J111111111J1J�1�>)1��J1111J��J��1��111�11��r11�111J111J11�1111J1J1J1�>)1��J11111111J1J�111J111J1Jr1�11111J111J1111J111JJ11��r1J�111J111J11�111111J11��1J111J11J1J111111JJJ1J111J111J1J11��11J111J1111J111J11��r1�r)J��IJJJJ�l�r1��J�111111J>JJ��>�� Asbestos Exclusion Cyber, Electronic Data and Systems Exclusion Exclusion-Marijuana Exclusion of Pathogenic or Poisonous Biological or Chemical Materials r' 23 QQ . .,,,,, „ «<««IIIIII««IIIIIIII«ii��«oiiill�llllllllllllllllllllllllllllllll �� III IIII�IIIIII IIIIIIIIIIIIIIIIII�I ��II�IIIII�II��I��IIIII�IIIII(IIIIIIII��IIIIII�I�IIIIII��I��IIIIII0111111(IIII /%e City of Santa Ana rr CORE 360' Binding Requirements: 0 I n li i X n l I.I IN U ID 1 t �URkNNN�Ntl�ll�llll((IIIC�II�ttf'NNIIIP�IIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIII�I��IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII D-1 (Effective January 1, 2020) Other Significant Terms and Conditions/Restrictions: P°°uNNNn�1il��l,IIN u!puuylrll�l, , I,F�,,,,,, „ � 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 1. Coverages: Building, Personal Property, Rental Value, Extra Expense, Ordinance or Law-Coverage A, B&C (Combined) Perils: Earth Movement and Flood • Excluding Terrorism • Excluding Mechanical Breakdown • Excluding Flood Zones A&V(501 N. Newhope St, 2501 N. Flower St.,2615 N.Valencia St., 4812 W. Camille St., 706 N. Newhope St., 751 Memory Ln., 122 N. Newhope St., 3006 Centennial Way, 2401 N. Bristol St,4404 W. 1st St., 730 E. Memory Ln., 207 S. Mountain View, 2315 N. Bristol St, 2410 N. Bristol St., or any area designated as a 100 year flood plain (FS C 505)) If the Deductible is expressed as a percentage(unless otherwise stated), the Deductible is calculated separately for and applies separately to each building that sustains loss or damage,the personal property at each building at which there is loss or damage to personal property, Personal property in the open, Business Income and Extra Expense. If there is damage to both a building and personal property in that building, separate deductibles apply to the building and to the personal property. In the event that multiple minimum deductibles apply in any one occurrence, no more than the largest minimum deductible shall apply. Appraisal Clause Amendment Loss Reporting Conditions See Appendix 24 i ��,� JJ it I�111<,<II1111�D��1�llll lUl�ll�>I�JJ��Il _ _ ,,,,,,,,,,,��««��«�««III«IIIIII«II�IIIIII��ii��i��ii�oiii�illfIIIIIIIff0111111IIIIl011IIIIII��I�101 � �� II III011lllf I��I��I�I��I�IIIIII�(O�I��I��IIIIIII��I��II�III��IIIIIIIIIIOII IIII��I�I��I�IIIIII�III��IIIII Il��l��f I��IIIII City of Santa Ana /% CORE 360' err Excess DIC - $5M xs $10M I lir�lulr»u» �ulii,lin iiilirruil ,nn u>»ai ail r I ii J11r1,»1" r� ,rrmlilrl x»ml11 r,,,r�ll 1pJr�uiliiir + 1 �r l J 1 1 r I , .��,�,lalaaralala�al�aala��ialaial�� iallla��f� iaiaialliai��iaiaaial�((��li��aaalaa�aa��alallllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll �. a Carrier/A.M. Best Rating/Admitted/Non- Mt Hawley Insurance Company(A+XIV, Non-Admitted) Admitted Lloyd's Synd 1458 (RenaissanceRe Synd)(A XV, Non-Admitted) Payment Plan In Full Payment Method Agency Bill. r r r+rrr r1 rl » rr»rr11 1r11 » rlrl rlr1rr11r»1J�JrJJrrJ 1ri»lrrr»rJr��rl»r» lrl rrlr 111rr111 rJ r! I JJ 1 � rrll7r +r J r 1 I r 1, 1 l J J l 1 I J1J „ 1 , , , , , , , lllllllllllllJ ! „ 1 l J 1 J J 1 1 J 1 1 J 1 1 J 1 J 11�11�11»1��»1r»>,11„1f,r1,,,�„J,�„1�1,,,,��>��1��>✓1��>��1��1��>��1��1��1��11��11��,1 J 11, ,1� ,r, �J11111JJ 1J11J1111111 J1111J 1111J1 IJ11J11I11I11I11J11111J11J11J1)11111 �1J1�11.J��JIIJJ�J»J11111»J111»J�11Jf11,,,,�„1,�,�,,,,�1,111��>�>��>�>��>�>��I 11J�JJ1>'11�11Ir,»��1JJ1�»1J 1J1J1�)1)J)11�)JJJ11)J)1J1J11))1)1)111)11�)J1J1J)J)))1�))1)1)1)J)11�)JJJ1.11J)IJ1J111)I)1)111)II1J1111JI11JI1JDIJ)II1J11)1)1)1)J)11�)JJJ111J)1J1J11))1)1)111).1�)J1J1J)J Premium $210,000.00 Surplus Lines Tax $6,315.00 Stamping Office Fee $378.90 Carrier Fees-Catastrophe Analysis Fee $500.00 Exposure/TIV $777,575,467 Rate 0.0270 Minimum Type Minimum Earned Premium Minimum Amount/Description 35 Estimated Cost $217,193.90 rNTT) 1 r 1r 1 1J 1 1 1 111»»r» , 1 JJJ J��JJJ��J�J 1r�r r�!r ir11r 1��r1 �J 1 1,1» 1J1 1lIJJll llll 1I,1J11JJ 1!.1 lll. J IJI 1 11!!! J l 1J !IIJ rl , J 1. l 1., ! l 1 I � J 1 J r � l��1 �� 1.�1�1J�i1��11�Ji1l11aiiJ1�1i1 ��r��r�1�� All Coverages Combined $5,000,000 Excess of$10,000,000 per occurrence -Subject to an Annual Aggregate of for the Perils of Earth Movement and Flood,Applied $5,000,000 Separately r i 1 11r r Sri ri» rl rrr1,11r1�11�� r irr»r lrl»r�r11,1rniirl,1 I 1 r � 1 11! I � J rl J J 1 1 11 .1 1 >+ 1 1 I � � � r1 �� r � , , , r , � , llllllllllllll111 ! J J J J J J J J J 1 J J J J J J J 11�,1J�1»1»»rJ»>„J,»,�I�,f,1,1,1111111111111111111111111111111111111111111111111111111111111111r�1J 11, ,Jr ,r, �JJJIJJJJJJJJJJJ1JJ11J1JJ1JJIJJJJJJJJJJ1J11JJJJJJJJJIJJJJJJJJJJJ11J11 �1J1»>.»J�JJJJJ�IJJ1�1�»1J1111»>'�Ill>»>1,.11�1�11111�111111�11111>�1��11>%1l1>�111�11�1�11111��>�1111��1��>%1��11�11J�JJ1�1,1�11Ir,»JI1JJ11»1,.�»J1��1)J)11��JJJ11)J)1J1J11))1)1�111)11��J1J1J�J��1��)1)1�1)J)11��JJJ1.11J)IJ1J111)I)1�111)II1J1111JI11JI1JDIJ)II1J11)1)1�1)J)11��JJJ111J)1J1J11))1)1�111).1�)J1J1J)J1 Deductible-Earth Movement 5.00%of the TIV Per Unit(Including Time Element if Applicable)at the Time of Loss or Damage Deductible-Earth Movement -Subject to a Minimum of$100,000 Per Occurrence Deductible-Flood 2.00%of the TIV Per Unit(Including Time Element if Applicable)at the Time of Loss or Damage Deductible-Flood -Subject to a Minimum of$100,000 Per Occurrence „1 7 I1 I 1»»»r1rr+»1 .1rrrllrrrlrlr rrlrrrlrll»r»»r�r1�!I I r + IJ1J 1 r 11 rr 1 1 r ! r l 1 1 ,1 I „ l 1 I J � , l „ lllllllllllllllll 11 r ! J J J J J J J J J 1 J J J J J J J 111,�,,,»,,,,�,1,»1,I,1111��rJl�ll�11�11111111�11111>J11111��1�11,J11111111111rJ1111�11�11111�r)1�11�11>J��l J 11, ,r, ,f, ,J1)111JJ 1J11J1)11111 J1111J)111J1 IJ11J11111J11I11J1)111J11J11J1)11111 �1Ji�,>J,,,111,r,1»J,11��„11,11��11�1�11�1��11111�1�11>�1��11��1>�111�11��11�1��111��1��11111J�J11>'11�»r,»fJ1JJ�»11,.111„�1)J)11�)JJJ11)J)1J1J11))1)1�111)11�)J1J1J)J)))1�))1)1�1)J)11�)JJJ1.11J)IJ1J111)I)1�111)II1J1111J111J11JD1J)II1J11)1)1�1)J)11�)JJJ111J)1J1J11))1)1�111).1�)J1J1J)J Replacement Cost Physical Damage Actual Loss Sustained Time Element r 1 rr rr 11 r r»r iirl liri r,�,rJril l»rr 1r�1r1 »J�1�1��r�l r�r�Jr�r�1r�JJ 1111 1J 11,1 1 , 1J JJll, ! I 1 J J � � � � � � � � 1 , , J J � J J,r, 11111111111111111111111111111111111111,f11,1,1„11111111111111111J111111111111111111))�)�1))�1)1))�)�1)J�)�1))�)�1) 11�1J�1��1��1�J��11�11�11111��1��11�1J�1��111J11��»,1�,�,»ff»`1111frJ,�,1111111J�11111111!1>�11111�1J1111�1111111>11�1�111>�11111>)11!11111111111�1111111)1�11�1�1J„JIJJJJIJJJJ)JJJJJJJJJI�JJJIJJJJIJJJJ)JJIJJJ)JJJ�JJJJJJIJJJJIJJJJ)JJJJJI Coinsurance N/A for Physical Damage Coinsurance N/A for Time Element rrrrr, rr»oJ»J�J�J»»r>tI� rrrr rr ttrr .Jo>» rrraru�rrJ»r .Io�L I��Ir Jrrrr III 111 III II 11 1 II 1! IIII II III 1t l 1 1 l l l f I I I J„ � , r „ ffl , , , � I , I , � , � , lllllll111lllllllllllllllllllllllllllllll I�Ill�lal»1,ai11�1�111�11�1>,»1��1a1��i�11�/ Earthquake Coverage Form (2025 Version) Definition of Occurrence j Earth Movement Coverage Endorsement 25 <«<«<«aao«««rrll�IIIffIIIIIIIIIIIfo111�0«I��«��«�OI��IOI��I�I��IO��IIIIII�� I��I�III�I�IIIIII�IIIII�I�II��III��IIIIII�II��I�IIO�Illlll�lllllll��lllfl�III�IIIII��II�II��I�IIII��III�I(�I�Illll�ll��llll��l�l��f�IIIII /%e City of Santa Ana rr I / I rrrr r II Ir�rri r rl Ir»I»r r»rr ulrl .rrllr Irl rlrl r.rr»rr Ir rl Irlr r�rrrr�rrrr Ir .rrllr+.»Irrrr rlrlrl I�r I lr r rrrr I rr I , I r I r r r� Irr i, r.. .r r r I /, � 1 >' I „ � � , , , ) , C > >� 1 � , � � , Illllllllllllll/ lllllll/lll/ lllllll/ll�ll/l CORE 360' Flood Coverage Endorsement Actual Cash Value(ACV) Definition Appraisal Cyber and Data Endorsement Legal Action Conditions Endorsement Service of Suit Clause(U.S.A) Several Liability Clause Additional Interest Notification Conditions Fully Earned Premium for Actual Total Loss or Constructive Total Loss Business Income(and Extra Expense) Coverage Endorsement I r r I� rr r r r n l Iriri� rr�rrrrrrl Irrirrrir.I Iri Irilrlra 11r11>11 rralrl,rrlrtalr rlrllrr r iiri�� .rlrlll�rrltr�rr, Irrlrrl� I i I r , l i. I I 1,1,,,r1lllllllll111111111111111111/ll�llllll1111llllll%llllllllllll�lllllll%11111/ll�llllll1111lllll%llllll111111111111111111111111/ll�llllll1111llllll%lllllllll�llllll%11111/l1�11111111111�1��lll�llll�lll%lll%llll/ll�llllll1111llll11%llllllllllll�lllll11%11111/ll�llllll11llll11%lllllllllllllllll1111111111111/ll�llllllllllllllll%lllllllllll Asbestos Exclusion Communicable Disease Exclusion Nuclear, Biological, Chemical or Radioactive Exclusion Sanction Limitation and Exclusion Clause Total Pollution Exclusion Multi-Carrier Schedule: 1 N 1 ND 11,I N� , G, Mt Hawley Insurance Company 85% Lloyd's Synd 1458(RenaissanceRe Synd) 15% Perils Covered: , us ur I I �oolrllilLuu Nl I 1 1 I l°1 , I , �IIII�p�p�� 1 II pf�pppppuuNN IIIIIuNIrlf ool(Illiiil�lllllllllllllll�llllllllllllllll�l�l�l�l�l IIIIiiiiiii(flliiilllliillYlml�Y�iiIIIr�IjiilulllliillPiilf i��ll�llllllllllllllllllllllll��lllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll Special Form Earth Movement; Flood- Flood excluded for locations located in Federal Zones A prefix and/or V prefix Perils and/or any 100 year Flood Plain area. Binding Requirements: (i'i ipJl,U1JJCII(�II111�11rI�!o/YIU�II,Ji9�I Subject to D-1 (Effective January 1, 2020) Please include up-to-date additional interest information such as Additional Named Insureds,Additional Insureds, Mortgagees and Loss Payees with the bind request, if applicable. Conditional binding subject to receipt and review of primary binder within 5 days.Any changes or discrepancies may invalidate this binder Subject to receipt of the primary policy within 45 days of binding. Other Significant Terms and Conditions/Restrictions: I111°UJJIIIl�11IIIJIII X!�NCI��",�lrl I l r"' IIUUIIuuh��I(��n��mII�If��N��l�l�llllllllll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll�lll Coverages: Building; Business Personal Property; Business Income/Extra Expenses 30 Day Notice of Cancellation, Except 10 Days for Non-Payment of Premium Based on 100%Values all Coverages Representation(s):There is no Loss or Damage from Covered Perils in the Last Five Years See Appendix 26 .,,,,��«<��«�IIIIIIIIIIIIIIIIIIIII((II(Iiioiilou�lo��I��IIIIIIII�011III101101111111��llllllll�� I I�I II�IIIIIIIIIII 1I�I�IIIIIIIIII111I�III��IIO�III I I��IIII��II�IIIIIIIIIIII��IIII�II�I I��IIIIIII�I��IIIIIIIIIIf�f I�I��IIIII /%e City of Santa Ana rr CORE 360' Excess DIC - $10M Excess $15M i lirr lu�r»»» �uli I,rin I�IIi li rJu I I ,nn »�ail Ali r �i li l�l� �a�a�aia�a�ra%a�ala�a�lr��r��a�a�aia�a��a�a��la�a�llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll �. a Carrier/A.M. Best Rating/Admitted/Non- Palomar Excess and Surplus Insurance Company(A X, Non-Admitted) Admitted Princeton Excess&Surplus Lines Ins Co(A+XV, Non-Admitted) Payment Plan In Full Payment Method Agency Bill. r+rrr rr rr » rrnrrrr rrr� » r � r �»rrr»rr»lrrrrrrrrr irirr irrr»rir��rirr rrr »�r»r��»»��rr 11 I � I � ri �IIr r r � r J 1, J J J J l 1 I J J � , ,11�IJ��r»1��»��»>,11„1r,r�,,,�„�,�„l�r,,,, �1J1�II.>>J��»��>»�1r111»�111»>�rrlrrt,,,,�„1,r,�,,,,�J,rl1��1��111J��1�1�1��r,1,��11�»�J 1»>1�)1)))11�)JJJ11)))1J1)11))1)1)111)11�)J1J1J)J)))1�))1)1)1)))11�)JJJ1.11))I)1)111)I)1)111)II1)11111I11111)D1))II1)11)1)1)1)))11�)JJJ111))1J1)11))1)1)111).1�)J1J1J)J Premium $310,080.00 Surplus Lines Tax $9,320.40 Stamping Office Fee $559.22 , -Catastrophe Analysis Fee-Fully Earned $600.00 Exposure/TIV $777,575,467 Rate 0.0399 TRIA $159,970.28 Minimum Type Minimum Earned Premium Minimum Amount/Description 25 Estimated Cost $320,559.62 ,u, r r ,� , r r r i� r r > rrr r r� r r i it r it irir r r rr r ri it ri rir rri„rrl»II, inalrirrl��ril�� 1 �rr r� r i >>r r r r , r 1 � �r r r� I L 1 J 1 , J 1 I 1JJ,11r ��l��1��1��J��l��l��l��1��111��llJ 1»1I�»l�r �l��11��/11J��1�1,1��,�r,,,f�rr�r»��,1»„��1)))11��JJJ11)))1)1)11))1)1�111)11��J1J1J�J��1��)1)1�1)))11��JJJ1.11))I)1)111)I)1�111)II1)11111I11111)D1))II1)11)1)1�1)))11��JJJ111))1)1)11))1)1�111).1�)J1J1J)J Palomar Excess and Surplus Insurance $7,500,000 Company Princeton Excess&Surplus Lines Insurance $2,500,000 Company Layer 1 - Limits Apply Per Occurrence and in the Aggregate for the Following: Earth- $10,000,000(100.00%) part of$10,000,000 excess of$15,000,000 Movement r i i r rr r rr, r i �r �r r rrr ,�� rrr��rrr � ,rrr,rrrr��r arrr,rrrr»rrr,,irli rr ��. �I 1 1 I i 1 I 1 J I 1, I n , 1 I J � , , , 1 J , � , , , , l�� l�ll�� l� 11, I , , 1 l ) 1 J ) 1 1 1 1 1 ) 1 1 ) 1 )11r�»„�,��»1r»��»,1�„Jr,irl,Jr�r„1„�, ,1 J 1><� ,r� ,r,�)11111)J 1)11)1111111J1111J 1111)1I)11)11111I11I11)11111)11)11)1)11111 �1J�11�»>1J»�J�l,>>�rJ��»��J1�,r>',rl�»��.»l�r»J,,,,,�,�, 11J��1�1�1��I�,,,flrrl��»r��.�»r,��1)))11��JJJ11)))1)1)11))1)1�111)11��J1J1J�J��1��)1)1�1)))11��JJJ1.11))I)1)111)I)1�111)II1)11111I11111)D1))II1)11)1)1�1)))11��JJJ111))1)1)11))1)1�111).1�)J1J1J)J Building Ordinance Coverage A Included. ICC/Demo: Sub-limit $10,000,000 The following program sub-limits is covered in the primary layer and is allowed to erode primary aggregate: Extra Expense, part of and not in addition to the $2,500,000 above business interruption limit(s) r r, 111r J J J 1Jl JJ , 1 1 J J J J 1 1 l I,Jr,rf,, r)rr„ �rll,,,��1r1Jf,f1,,�,11111111111111111J1111111111111111111)11111)�1)1111111111J111)�1111 Ill,�,rl„�,�r��»r»f»I»�»�,1J11`1rl�l»rl�r��r�l��»�„�,�,,�,�1��11��1��11��111111�1��1�,1�JJJr+11`��r�,�,»f,�,11�1,��1��11111111�1�1�1�1�11�1�1J1111�1111111�1�1�1111111�1J1J1�11111111�1�1�1)1�11�1�1J„11111J11111JJ1J11JJJJ1�JJ11111111111JJJ1111JJJ1111JJJ11111J1J111JJ1J111 $5,000,000 Part of$5,000,000 Excess of Option 1 : $90,000(Premium) + $900 (Carrier Fee)+$2,727 (CA Surplus $25,000,000 Lines Tax)+$163.62 (CA Stamping Fee)=$93,790.62 $10,000,000 Part of $10,000,000 Excess of Option 2 : $90,000(Premium) + $900 (Carrier Fee)+$2,727 (CA Surplus $25,000,000 Lines Tax)+$163.62 (CA Stamping Fee)=$93,790.62 $15,000,000 Part of$15,000,000 Excess of Option 3 : $245,000 (Premium)+$900 (Carrier Fee)+$7,377(CA e $25,000,000 Surplus Lines Tax)+$442.62 (CA Stamping Fee)_$253,719.62 27 « «<«��Il��1��l�lll�l�lil��iii«oIIIIIIIIIIIIIIIIIIIl0111111111 �� OIII��II� �� Iftlllllllllllf IIIIIIIIIIIIIIIIIII��IIOIIIIII�IIII I�IIIIII(llllll�lf IIIIIII i�IIIIIIIIIOIIIIIIIIIII01(IIIIIII /%e City of Santa Ana rr � r r� CORE 360' r ririr it irrir n»n ,nnr nn rn, r r, r ,i r r I i r r .I I r r rrrr.r»I»r r rir rl in nI r Irlirr � Ir i rir r»r rrrrr I rIl 1 11 1, 1 1!!1 , ! I , u l , illlllllllllllllllll , 1 , I � � � � � l � � � l � l � lllll � � � l � l � lllllllll »�1�111�1��1��>��1��1��1�111��1��1��1�1��1�111�1��1��l,r��i�1�,�r„»��r�rf»r1»»r�»>»>(��>1��>l>1��>1��>(��>(��r(��rl��rl��rl��>(��>1��>1��». Deductible : CA- EM -Including Time Element, ° Business Income 5 /°-per Unit Deductible : -Minimum.EM Deductible: $100,000 inn in r�,r n r ,rirr.i t r r r.rr r» rrrri r I lri ri l iu.r l rrlr r»»r ! » r rrrr r I r I 1 11 Ill I ..1 ll11111111111111111 � , � r , ll � � � � l � � � l � lllllll � >r � l >rl111111111 1111111 �111111111�11111�111111111�1111111��1�1J11111�11�1111��111111111111�11111111�111111�111111111�1111111��11/�„��1„��,,,�,»rf»»��1�»»��>lllllll>11�11�11��1��1��>1I1�101>11�11��1��1��1>II�I��IIIIO��I1�ID��1��111/I��I1>1101�I�1��1��I��1�I�I��IIIII�00I1110�1/��11III1/�1�1/1II�IIIIII/l Replacement Cost Property Damage Actual Loss Sustained Time Element including Extra Expense rT�N �r ��r �r rrr, r„ r r , r!. r 1 1 1 r 1 rrrr nrrirrirrrilnriirrrrr»rra»r I iinnmi� niln.rrl»r!lr+l rrrrrrrrrrrrrlr! .rrrrrrrr.rrrrrrrra rrrri r rlrrr r r Irl Ii r r r r r,� rl r rr _r r err rrr r r! r »r r r r >" r� i 1 r 1 1 ., r . 1 ! I , >r f � , r l �., l l l l l l l l l l 1 , , � „ I „ � , , , , lllllllllulllllllllllllllllllllllllllllll ,J,,,,,)„lr��,,,,��,,,,,,�lll, „Ill„1,1�,�„�,�,�,�,,,Il,,,,��ll��1111111111��l11lll11111��11111��111111111��llllllllll111lllllll11111111111��1111111111��lhilllllll��11111��111111111111��11��111��ll��1111111111��l11lllll111��11111��11111111��lhilllllllllllllllllllllllllll��llllllllll��llllllllll1111111 Company Excess Follow Form (subject to review and approval of form we are to follow) Debris Removal clause(Company Form) Excess Limit of Liability and Participation Clause(Company Form) rrrr� �r ,rr r»r, r, ,i r i r r I r!!»»»�ri rir»ir Ilri,Iri rrrr ar�rrrrrrr rlr rr+�rrrrrr rrrrr.I»rrrrr r rrlrr��r rlrlrlrrr r»rrrrrrr I»r!r� r I r r r r �� r r ! r i � � r � I , l I. i IJ1 , � lrrlrr � l � , llllllllllllllllllllllllllllllllllllllllllll J,1 � J1,,,,��1��r)��>1��11��1��rJ111111111��rll��1��>l�>111��111��rl�� Pollution (Company Form) Asbestos/Contamination (Company Form) Mold (Company Form) Flood EQSL Theft Boiler and Machinery Communicable Disease,Virus or Bacteria Cyber Exclusion Endorsement Underlying Sublimited Coverages Exclusion All Risk Perils(Including Windstorm) Ensuing Loss Existing Damage War Exclusion Nuclear/Radioactive/Biological and Chemical Exclusion All perils except the peril of Earth Movement Multi-Carrier Schedule: , „ r u»,�ilum�rn ri»u l »I„ru !_iii iiiu rrrr I �M Al N 11 1 !U I� 1 ,r N ��k»»�»»n��r��f��lllll�l�lll�lll�l�llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll Ull��rl��n��1��v»'»��i��1f��f�i��i��l��l��lll�lll�lll�lll�ll Palomar Excess and Surplus Insurance Company 75.00% Princeton Excess&Surplus Lines Ins Co 25.00% Binding Requirements: pr�r�„»l�Iiliiiluip Ir�s»�»�N»r IIUUII»»»�u»�'��f��1��IY��"��I�III�IIIIIIIIIIIII�IIIIIII�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III�III Subject to D-1 (Effective January 1, 2020) Signed Insurance Applications and Acknowledgement of State Fraud Warnings. Notice Regarding Surplus Lines Filing Confirmation and TRIPRA Rejection Forms 28 l�r fir,,.�III II �rn1 ffl III y P�I _ . .....rrrr„r��,,,,,,,�,,,,,r,,,,,,��III�IIfI�IIIIIII«Iiill�iii�li«<�Ilu�«��II�fII�fI011�0�IIIIIIl011110IIllllllll � � �� IIIIII��IIII�IIIl��101�lll II��OIOIIII�IIIIIIOIIIIIIIIIIII�III�IIIII�IIII�IIIII III�IIIIIOIII��IIIIIIIIIIIIIIOIII�IIII City of Santa Ana /% CORE 360' err Other Significant Terms and Conditions/Restrictions: v ��Ippp I I V U 1 U U Total TRIA Premium includes Additional Taxes: $4,930.28 Perils: Earth Movement only Excluding Flood, Excluding Earthquake Sprinkler Leakage Property Covered: Real Property, Business Income, Business Personal Property Conditions: Warrant All Risk Underlyer Statement of Values form '(collectively for Demo and ICC, not individually) Catastrophe Analysis Fee Breakdown Palomar Excess and Surplus Insurance Company-Treaty 1 -$300.00 Princeton Excess&Surplus Lines Insurance Company-$300.00 See Appendix 29 �� JJil�llJlIIl111�D��1�11111��1�1��1��JJ��Il _ _ ,,,,,,,,,,,��««��«�««III«IIIIII«III((((I��iiiiiiiiii��o��l��f��1�«OIIIIIIIIIIIOIIIIIIOIIIII01 � �� II III011lllf III�IIIIIIIIIII��(OII�II�III III�I�II��IIIIIIIIII�IIOII�IIII�IIIIIII��IIIIIIIIIIIIII Illllllllf II��IIIII City of Santa Ana /% CORE 360' err Terrorism » ,»� ,�miirr x»mirr r,,,r�� Ipruiiii»r 1 �r 1 �r 1 1 rl 1 Carrier Lloyd's Syndicate 3623(Beazley Furlonge Limited) A.M. Best Rating AXV Admitted/Non-Admitted Non-Admitted Payment Plan Full Pay Payment Method Agency Bill , r rrrrri rrr it iiir»ir rrrrrrr,ariirrirr»rrrrr » » i»»»n»irr rrrrrrirrriirr,.irr rr r , r i rrr r rrr i r i r r rr 1 1 l 7 l l r r 1 � �1 � I, J � ll >t , , � , r , 11 �111 � 1 �� 111 , rl , lull ( llllllllllllllllllllllllllll 111111111�11Ilrr»r»�»�irirrr»»1111r»»rl»»rrr»»,»rr,»�r��»rr�rrr»»,1r,��1��1��1�111��1��1��1��1��1��1�111�1��1��l��I��C�/„�,,rrf,��1»i»»�I�CIIIIIIC�>ll>C��CI�IC>(ICI(C(I�I�CI�ICI�C�>IIC��CI��IC�IDI�I�CIIIII��/��I�I�I��IIIIII�I�CI�ICI�C��IC��CI��IC�IDI�I�CIIIICII////Illl/Illl/Illlllllll///D//I/ID/I////IIII/r�� Premium $14,460.00 Exposure/TIV Total Insured Value- $777,685,467 Minimum Type Minimum Earned Premium Minimum Amount/Description 75% Estimated Cost.... $14,460.00 r , r rrrrr rrr ii rrir it rrrr� rr rrrrr rrr rrr ar rrrr rrr�rr r rr rrr rrr rr r r.r � rrr � llr rr r , I r� r �rr � r l I„ � llt , r „ 111 �� 1 >� 1 �� 111 , , , lllll � llllllllllllllllllllllllllll . ll„r„„>>,J,„�, 1»�r„,,r�r ,,,,%,11111��111111�11111�1I1��ll�l>rll>r1��11111111�11111��11C,1,1»f,,t„»f,,lllllllllllllllllllll(Illllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll/Illllllllllllr I111,,1»»,r,»r,,,r»� 1�rrr»�rf�1r,,,1r,,,,1„�,,,1��1�111�11r11�11��1�1��1�1��>r1�1�11�1�11��1�11111>»�fl�„f,rrfrlr11>>>,rIIICIIIIICIICCIICIIIIC ICIC(IIIICIIIIICIICCIICIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIICIIIIIIIIIIIIIIIIIIIIICIIII�lll11lllllllllllllllllllllllll�lll Limit �$10,000,000-Each Occurrence/,Claim/,Aggregate Limit rr rr rrr r„.r r.r rr irrrir rir rirrn ri rirairi an it iri rr �� rr I l 1 I I p� I I rr „ „>t„� ,t r„ ,,, ,,,�J��JJ�JIJJJ�J�JJ�JJ�JJJ�J�i1,f�f f>',,,,1111111111111111111111111111111111111J111111JI111111111111111JJ1111 Ill»l»,ra»1»»,a»I»,»�11,»r11Jf»»t,»t»rlr,�rl»,»,,.1,�,,,,��1J��J�1JJ�1J1J1�11111J1J1J�1JJ��J��J1��1J1J1'1J��i�r�`„�r,�,»frr,`rr1,f>>,,1111111JJII11II1�I1�1JIJ1D11JII111D1JII11D11�I1�1J1J1111111111J1111111�11�1J1J„11111J1J11J111J1J1JJJ1J11lJIlJ11l)111111J1J11J111J1J1J1J111111JJ1111111J11111J1J11J111J1J1JJJ111J1J�. Demolition and Increased Cost of Construction Sublimit: $25,000,000 Extension EXTENSIONS OF COVERAGE-If the Policy provides business income coverage and/or additional coverage(s)(hereinafter, collectively referred to as Additional Coverages), the Company will only cover such Additional Coverages if they are directly caused by an Act of Terrorism.With respect to the Additional Coverages shown in the attached policy,the Sublimits of Insurance shown below replace and are not in addition to the same or similar Sublimits of Insurance shown in the Policy. If no sublimit is shown below, then the sublimit shown in the Policy applies. Service Interruption $50,000,000 any one occurrence and in the aggregate for direct suppliers Service Interruption $25,000,000 any one occurrence and in the aggregate for indirect suppliers Contingent time element $25,000,000 any one occurrence and in the aggregate for direct suppliers only. Indirect coverage excluded. Civil and Military authority This coverage is sub $50,000,000. 5 mile distance limitation to apply outside of metropolitan limited regions. 1 mile distance limitation to apply in metropolitan regions Ingress/Egress-This coverage is sub limited $50,000,000. 5 mile distance limitation to apply outside of metropolitan regions. 1 mile distance limitation to apply in metropolitan regions. Transportation $5,000,000 any one occurrence and in the aggregate (inland only) 30 y, ( �� I,I°l�lp�!l]"JN��IIIIIIIIIJII�Ii�Vlllll ,,Ji . r . «< «« ««<« iiiu«��I«Illlllllllllllllllllo�olll�oll�lllllllllllll � � � �� I�� IOII��II��II��IIIII��(0��I�llllllll��(II�I��IIIIIIIIIII�II�I��IOI��IIIi��I��l(�III��II��IIIfOII�f��l�lll� /%e City of Santa Ana rr I r rrr Irr . rrr»» r»Jrr IIIr , I �r 1 r 1111 1 ! l 1 1 1 J 1 J J 1 CORE 360' Deductible-PD/BI and Liability Combined $0 Deductible-Each Occurrence/Claim $0 Deductible: Deductible-Terrorism-Each Occurrence/ $0 Claim I r I 1 r rrr , rr.r r ,I l III III II IU»r »r,r,�1 rr rrr rrr err »�ar rrr r» rU , Irli » rf rrr ��a»ir��rl 1, »r» r rr, 1rr»1 i t JrJ r 1,1 1 I .I , l , ,r��11��,�� 1��>�� , , Ir , IIIII ( 1111111111111111111111111111,��111111��1111��l��l��111�1��1��/�I�>r„»rIl»!r»»1111II(11111111111111(11111111III11111111111II1111IIIIIIII111III111II1111111IIIIIIIIIII1111II1111II(1111111III111IIIIIIIIIIIIIIIIII, I111,,�,f»»111,�„J,�>r»,��»Ills,�»,,II�»»��1 �1��1�11�1�111��1��111��1��11�,111,1�„�»rfllf��»,�„�IIIIIIIII111I>III11II111111(11II11I1II11II>11111�11111111111111111111111111�111111111111111111111>lllll�l11111111111111111111111111111111111%IIIIIIIIIII�II/ LiabilityDefense expenses.erode the limit Irmlr» rr�»rrr �»ii»»r»rrrr rI U»I»r1, J� lI»r irl�irl%a/rr/ �1I�"Forrn,11»»,1,111,III,I 111r, �ll�ii,�r»„��111�111��1�11�, .... .... .... .... .... .... .... .... .... Type-Terrorism Occurrence r ,r r , I 1 r 1 I 1 I r Il 11 Il J J l/ r rr » 1 I rrrrrinlnrrUUli»r»»r»ralk .r»rrrrrrr,rrrr»rrrr ,rrrrrrrll rrrrrrr»rrrrr,, rrra r I Ir rrr rrrrr r rr rr r r» II rr r r _r rr . .rrr r rrr 1 1 r r r»rI r r 1 � 1 �� 1 r r , l I 1 If I ! I . , !, » J 1 l 1 1 1 1 1 l 1 1 llllrl , l , J , , , , l „ / „ 1 , , , , 11111111I11111111111111111111111Illlllllll JI,�l„llIJJ,,,,�„I„I„I„�,J„�,�,,,,%„11,,,,��1111111111111111111111111111111111111111111111111111111111111111111/l��llllllllllllllllllll111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111��111111111111111111��/IIIIlIl111111111111111111111111111111Illllll��lllllllll111111IlllllllllllllDll��llllllllll��llllllllll11111�1 California Surplus Lines Notice 1 (Post Bind)-A01861 CA 012024 ed. (Re)lnsurers Liability Clause-E17206 122024 ed. Capon Losses Arising Out of Certified Act of Terrorism- E10177 062017 ed. Policyholder Disclosure Notice of Terrorism Insurance Coverage-E06680 082020 ed. Premium Payment Clause-E17208 122024 ed. Sanction Limitation Clause-E16415 012024 ed. Service of Suit Clause(U.S.A.)-El7209 122024 ed. Participation Clause-E17212 122024 ed. Demolition and Increased Cost of Construction Extension- E17207 122024 ed. I I ,r r r r r r r r r r r rrrrr rrr Ir U U r»»r»rrr »rr rr rrrr r.rrrr»r Ir rr rl ri ri �r .»r»r.r rr r »Irl r r » rr, r» r rr» r rrr , rrr, r,r rrr ! r r !r 11 J 1 r I � Nuclear, Radioactive War Chemical or Biological Auditable Exposures: I AM J I UJJ. A I»I U IIIII IUI,»UD 1 k f II111 N II N N N I Ul r �UUbuuu�N»»hn»Film(uIffn�oli�iY�uill(ulbi��lllllllllllllll��ll��l�l�l�l�l�l�l�l�l�l�l�l�l�l� U�knritihri»I(ra�N»Nilllful(ill srlfN�riNmifuulliu�uu(((��Ill�lll�lll�lllllllllllllll�llluuuilulmlffr�(u(I�iir�drrll(khn»U(illui�rr�oliulluuu�Umu(f�uIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII�IIIll011fiuiulluiliiull��l�l�l�l�l�l�l�lll��luuiufullu�rrir`�nrIIfIIIIlfliuoiYllllluull�ll�llllllllllllllllll��l�l� Total Insured Values $777,685,467 Binding Requirements: ,r u k III U 7N N kJ ,l A N !IN I �19 1 IIIIIIIIIIIII��IIIIII��»r✓nn��l�"i�71�'��IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Subject to The Return of a Completed and Signed Surplus Lines Verification Form Must be Received in our Office Within Twenty(20) Days of Binding/California Surplus Lines Disclosure Statement(Pre Bind) Other Significant Terms and Conditions/Restrictions: , IOIra m u 1, 1 J �IUUUuukrrr'NriH»ri�mldmV�iiYl(+ri��oiY�ullffllff illllllllllll��llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll�l Subject to: No material changes; No previous incidents Choice of Law: New York VALUES Deleted and replaced by USD 20,000,000 errors and omissions sublimit Significant Restrictions or Exclusions:As detailed in the attached policy wording We have determined an allocation of the premium for TRIA coverage.The allocation we have made in respect of US exposures to Acts of Terrorism, as defined under TRIA, is 80%of your current premium. 31 _ «,««��«<I�IfIIIIIIIIIIIIIIIIIIIIIIIOIIIiiII�oII�I��II�IIIIIIIffflllff�011011111111111��11��1��1� � �� IIIII(IIIII�IIIIIIII�IIII�III��i��III�IIIIIIIIItI�IIIIIII�IIIII�II��1011111I�tIII��I��lllllllllll�l�lllll�111111�� /%e City of Santa Ana rr i �� JJ it I�11�III1111�D��1�llll lUl�ll��JJ��Il City of Santa Ana /% CORE 360' err II °re ii II,II iI U,ii II II ``,;1 u.11,ii I°II ii Inary The estimated program cost for the options are outlined in the following table: r 1 II II III I( fffffff ff N fffff if 1! ( ( f I 1, f 1 I 1 ! � II J<IIIJ I ,III fJJ il., ti>tl�f IIIII!»J�/< II II III , IIII I /,JJ�1f,II JJJJJ�J D l N 11� 1 I A11J1� JJ 0 J' 0 >'1 ( n� 0 !� J Ill .�. r NN.o ., m I ,I « r , ,. 1 f (I II I. I.1 I I , � � I J � I I I I f. I I � I I I � I I ii r I/ J r, I I I I I » /i f J I i Excess Liability Buffer— Estimated Cost* $1,807,650.00 $1,702,470.00 $1,676,675.00 I $1 M xs$2M SIR r r r rr r / rr rr I I r I I I I r , c„ Ik�l I II II II0 I I I I I II AID 1/ I I I I I ID N I1) I 1 I 11DJJJJ/IU, ��IN��I III U ll >l ,I I,�, �J � N�i 1 , /11�11 llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll 1�>>��I��,,,,,,��J„��,IIINNNNHiNINi�i�i�i�i�i�l��ll�llllllllll�lll(Ill�lllll�la�llllllllllllll��lllll�lllllll�lrll�rll�l��lll�llllllllllll��"��"��I��I�I�II ��l�lllllll Excess Workers' Estimated Cost* $300,027.00 $327,547.00 $327,547.00 Compensation 1 l it r r r, r „ 1 I I r I Il f U I 1 1 ll� >f ,J'� 11 IL, , IIII III ,III D �I o� J / r , / / I DIC-$5M Part of$10M Estimated Cost* $381,766.00 $349,881.32 $349,881.32 ri r rr r i, / I I � IIIIIII � 1I I 1 I � IIIII II11 II[<�� IIII IIIII Ir .IIIII.III��, � � � II IIII�I I IY 1r II J f � I II/ / / r� l I DIC-$2.5M Part of$10M Estimated Cost* $192,383.00 $176,488.36 $176,488.36 i / / I I � II II 1 IU I I � ��I J��II IIIJ,I U .II IIII I DJ11111 II III� I I / � I J 1 , r / I��IIIIIII�I��II�IIIIIII�II��IIIII�II��»»�/l1111/�»»>��1/�////��////��/ IIII IIIII III�IIIIIIY�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1�1111111PIIII IIIIIII1111P�1111111 IIIIIIIIIIIIII��IIIII��III II IIIII IIII(III��IIIIII�� DIC-$2.5M Part of$10M Estimated Cost* $190,883.00 � $174,940.66 $174,940.66 r iaioo,oiffo«rriiiioiiiiiiiiiaioioi aiiiiiiia�in�anii ,v loi,oi oil,rcr ou uu i i u»rc,i�m,,, �rrcrcu,m m » ,rr rii � ri rr � r rcfr I i 1/ I rI, l ll I I I I I I I V I I f I / I I 1/ I I 1/ � I / / I 1 / 1 I / / I I l f I Excess DIC-$5M xs Estimated Cost* $236,901.28 $217,193.90 $217,193.90 $10M I I I„ I I I / I� I I I f I I f r 1 f I I I 1 I I / I I / / I, r i I / I � I I J r / I� I f r / Excess DIC $10M Estimated Cost $349,716.23 $320,559.62 $320,559.62 Excess$15M r r irr ,r rr r 1, I 01f � li IIIIII I I U/ � I I III � NI IL I ail I11 I L J I I�I 1J IU N I r 1 N / 11 II J J J I ��'II��r r//��i��f//////�JrJrJrr////////��r%��NN��NN�NIIIIII��II�IIIIII��IIIIIIIII�IIIIIIIIIIIIIIIOIIIIIIIIIIIIIIIIIIIII��IIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIII�IIIII�IIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII�I IIIIIIIIIIIIOIIII�IIIIIIIIII�I�I�IIIIII�IIIIIIIIIII U Terrorism Estimated Cost* $14,651.56 I $14,919.83 $14,919.83 Total Program Cost l $3 473 978 07 $3,284 000 70 $3 258 205 70 1, 1 .. 1, °/0 Change ................ ............. .. $Change..� ..... ....................................... .. ..... ... ......... ....�$189,977.37..................................... � ($215,772.37)„.I I 33 i �>�>� )J II I�111<,<IIlIl1�D�1�l�llll llll�ll�>I�JJ IIII I _ _ ,,,,,,,,,,, «««�««IIIIII�uIIIIIUIIIIIIIIII��IIIIIIIIIIIIIIIIIIIOIIIIIIIIIIIII�IIIo�IIIIIIIIIl0111111111111101 I �� II III011lllflll�IIIIIIIIIIIIIIIII�(OII�II�IIIIIIIII�I�IIII�IIIIIIIIIIIIIIIOIIIIIII�IIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIfII��IIIII /%e City of Santa Ana rr CORE 360' "Estimated Cost includes all taxes,fees,surcharges and TRIA premium(if applicable) Premiums are due and payable as billed and Quote from General Star Indemnity Company(Berkshire Hathaway Insurance Group)is valid until may be financed,subject to acceptance by an 7/1/2025 approved finance company.Following acceptance,completion(and signature)of a Quote from Response Indemnity Company of California is valid until 7/1/2025 premium finance agreement with the specified Quote from Endurance American Specialty Ins Co(Sompo Japan US Group)is valid until 7/1/2025 down payment is required. Note:Unless Quote from Palms Insurance Company,Limited is valid until 6/8/2025 prohibited by law,Gallagher may earn compensation for this optional value-added Quote from Landmark American Insurance Company(Allegheny Corporation)is valid until 7/1/2025 service. Quote from Mt Hawley Insurance Company(RLI Group),etc...is valid until 7/1/2025 Quote from Palomar Excess and Surplus Insurance Company(Palomar Insurance Corporation), Gallagher is responsible for the placement of etc...is valid until 7/1/2025 the following lines of coverage: Quote from Lloyd's Syndicate 3623(Beazley Furlonge Limited)(Lloyd's Syndicate 3623(Beazley Excess Liability Buffer-$1M xs$2M SIR Furlonge Limited))is valid until 6/412025 Quote from Princeton Excess&Surplus Lines Ins Co(Munich-American Holding Corporation)is Excess Workers'Compensation valid until 7/1/2025 DIC-$5M Part of$10M Quote from Texas Insurance Company is valid until 7/1/2025 DIC-$2.5M Part of$10M DIC-$2.5M Part of$10M Excess DIC-$5M xs$10M Excess DIC-$10M Excess$15M Terrorism Other Casualty-Underground Storage Tank Liability It is understood that any other type of exposure/coverage is either self-insured or placed by another brokerage firm other than Gallagher.If you need help in placing other lines of coverage or covering other types of exposures,please contact your Gallagher representative. This proposal of insurance features insurance policies which contain cancellation provisions to refund premium other than on a pro-rata basis for such occurrences including but not limited to non-payment of premium (short rate penalty provisions). At your request,we can detail the terms of such cancellation provisions. 34 i �� JJ it I�11�III1111�D��1�llll lUl�ll��JJ jell _ _ ,,,,,,,,,,, ««��«�««��«��ii��i««iiiii��ii��i��ii�oiii�illfIIIIIIIff0111111IIIIl011IIIIII��I�IOI � �� II III011lllf I��I��I�I��I�IIIIII�(O�I��I��IIIIIII��I��II�III��IIIIIIIIIIOII IIII��I�I��I�IIIIII�III��IIIII Il��l��f I��IIIII /%e City of Santa Ana rr III � CORE 360' ocad i a,-°ti ' d Ied dU I� pllU U l IIIpIU U!�,11GlUl UU N Nn� Il01 I�,��>�> >��>t> >,��,�1��lllllllllllllllllllllllllllllllllllllllllll,�„��,�j�,��f> >,��,�,��„�1 i�llllllllllllllllllllllllllllllllll Difference in Conditions Per Schedule on File 35 i �� JJ it I�11�III1111�D��1�llll lUl�ll��JJ��Il err City of Santa Ana a I I a g h e r CORE 360' IIllllpll (Berkshire Star Indemnity Company Excess Liability Buffer Full annual premium payment is due at Agency i hire Hathaway Insurance Group) -$11VI xs$21VI SIR inception Bill Princeton Excess&Surplus Lines Ins Excess Liability Buffer Premium is payable within 60 days of Agency Co(Munich-American Holding -$1 M xs$21VI SIR binding Bill Corporation) Response Indemnity Company of Excess Workers' In Full Agency California Compensation Bill Endurance American Specialty Ins Co DIC-$51VI Part of In Full Agency (Sompo Japan US Group) $1 om Bill Palms Insurance Company, Limited DIC-$2.51VI Part of Payments Terms: 30 Days from Date of Agency $1 om Inception Bill Landmark American Insurance DIC-$2.51VI Part of In Full Agency Company(Allegheny Corporation) $1 om Bill Mt Hawley Insurance Company(RLI Group) Excess DIC-$51VI xs In Full Agency Lloyd's Synd 1458(RenaissanceRe $1 om Bill Synd) Palomar Excess and Surplus Insurance Company(Palomar Insurance Corporation) Excess DIC-$1 OM In Full Agency Princeton Excess&Surplus Lines Ins Excess$15M Bill Co(Munich-American Holding Corporation) Lloyd's Syndicate 3623(Beazley Agency Furlonge Limited) (Lloyd's Syndicate Terrorism Full Pay Bill 3623(Beazley Furlonge Limited)) Texas Insurance Company Terrorism Agency Bill 36 jj /%e City of Santa Ana rr CORE 360' C o s u lira tc e I II II us+ ii a[J ai, Coinsurance Formula: Insurance Carried = Insurance Required x Loss- Deductible =Settlement Example of Coinsurance formula applied to a hypothetical loss situation: Property Value = $1,000,000 Coinsurance Amount = 80% Deductible = $500 Insurance Required = $800,000(80% of$1,000,000) Insurance Carried = $400,000 Loss Incurred = $200,000 Settlement determined by applying the coinsurance formula: $400,000 (Insurance Carried) x$200,000 (Loss)-$500(Deductible)=$99,500 Settlement $800,000 (Insurance Required) Note: If the property in the above example is insured for the full insurance required ($800,000),the insured will recover $199,500. In the above example,the insured will suffer a$100,000 penalty for not being insured to the proper limit. 37 i �� JJ it I�11�III1111�D��1�llll lUl�ll��JJ��Il /%e City of Santa Ana rr I' i �� JJ it I�11�III1111�D��1�llll lUl�ll��JJ��Il City of Santa Ana /% CORE 360' err qli//o s Gamer The following disclosures are hereby made a part of this proposal. Please review these disclosures prior to signing the Client Authorization to Bind or e-mail confirmation. Proposal Disclaimer IMPORTANT:The proposal and/or any executive summaries outline certain terms and conditions of the insurance proposed by the insurers, based on the information provided by your company. The insurance policies themselves must be read to fully understand the terms,coverages, exclusions,limitations and/or conditions of the actual policy contract of insurance. Policy forms will be made available upon request. We make no warranties with respect to policy limits or coverage considerations of the carrier. Compensation Disclosure 1. Gallagher Companies are primarily compensated from the usual and customary commissions,fees or,where permitted,a combination of both,for brokerage and servicing of insurance policies,annuity contracts,guarantee contracts and surety bonds(collectively"insurance coverages")handled for a client's account,which may vary based on market conditions and the insurance product placed for the client. 2. In placing,renewing,consulting on or servicing your insurance coverages,Gallagher companies may participate in contingent and supplemental commission arrangements with intermediaries and insurance companies that provide for additional compensation if certain underwriting,profitability,volume or retention goals are achieved.Such goals are typically based on the total amount of certain insurance coverages placed by Gallagher with the insurance company,not on an individual policy basis. As a result,Gallagher may be considered to have an incentive to place your insurance coverages with a particular insurance company.If you do not wish to have your commercial insurance placement included in consideration for additional compensation,contact your producer or service team for an Opt-out form. 3. Gallagher Companies may receive investment income on fiduciary funds temporarily held by them, or from obtaining or generating premium finance quotes,unless prohibited by law. 4. Gallagher Companies may also access or have an ownership interest in other facilities, including wholesalers,reinsurance intermediaries, captive managers, underwriting managers and others that act as intermediaries for both Gallagher and other brokers in the insurance marketplace some of which may earn and retain customary brokerage commission and fees for their work. If you have specific questions about any compensation received by Gallagher and its affiliates in relation to your insurance placements, please contact your Gallagher representative for more details. TRIA/TR/PRA Disclaimer If this proposal contains options to purchase TRIA/TRIPRA coverage,the proposed TRIA/TRIPRA program may not cover all terrorism losses. While the amendments to TRIA eliminated the distinction between foreign and domestic acts of terrorism,a number of lines of coverage excluded under the amendments passed in 2005 remain excluded including commercial automobile, burglary and theft insurance;surety insurance,farm owners multiple perils and professional liability(although directors and officers liability is specifically included). If such excluded coverages are required,we recommend that you consider purchasing a separate terrorism policy.Please note that a separate terrorism policy for these excluded coverages may be necessary to satisfy loan covenants or other contractual obligations.TRIPRA includes a$100 billion cap on insurers'aggregate liability. TRIPRA is set to expire on December 31,2027.There is no certainty of extension,thus the coverage provided by your insurers may or may not extend beyond December 31,2027. In the event you have loan covenants or other contractual obligations requiring that TRIA/TRIPRA be maintained throughout the duration of your policy period,we recommend that a separate""Stand Alone""terrorism policy be purchased to satisfy those obligations. 39 i �� JJ it I�11III1111�D��1llll lUlll� JJ��Il _ _ ,,,,,,,,,,,I�Illlllllllllllll��«��«��«Il�iiii��illi��ii�oiii�illfIIIIIIIff0111111IIIIl011IIIIII��I�IOI � �� II III011lllf I��I��I�I��I�IIIIII�(O�I��I��IIIIIII��I��II�III��IIIIIIIIIIOII IIII��I�I��I�IIIIII�III��IIIII Il��l��f I��IIIII City of Santa Ana /% CORE 360' err Property Estimator Disclaimer These property values were obtained using a desktop Property Estimator software operated by non-appraisal professionals.These property values represent general estimates which are not to be considered a certified appraisal.These property values include generalities and assumptions that may produce inaccurate values for specific structures. Terms and Conditions It is important that we clearly outline the nature of our mutual relationship.The following terms and conditions(these"Terms")govern your relationship with Gallagher unless you have separately entered into a written services agreement with Gallagher relative to the policies and services outlined in this Proposal,in which case that services agreement will govern and control with respect to any conflicts with these Terms. These Terms will become effective upon your execution of the Client Authorization to Bind Coverage(the"CAB")included in this Proposal and shall survive for the duration of your relationship with Gallagher relative to the policies placed pursuant to the CAB or otherwise at your request. Services Gallagher will represent and assist you in all discussions and transactions with insurance companies relating to the lines of insurance coverage set forth in the CAB and any other lines of insurance coverage with which you request Gallagher's assistance. Gallagher will consult with you regarding any matters involving these or other coverages for which you have engaged Gallagher.You have the sole discretion for approving any insurance policies placed,as well as all other material decisions involving your risk management,risk transfer and/or loss prevention needs. Although you are responsible for notifying applicable insurance companies directly in connection with any claims,demands,suits,notices of potential claims or any other matters as required by the terms and conditions of your policies,Gallagher will assist you in determining applicable claim reporting requirements. Treatment of Information Gallagher understands the need to protect the confidentiality and security of your confidential and sensitive information and strives to comply with applicable data privacy and security laws. Your confidential and sensitive information will be protected by Gallagher and only used to perform services for you;provided that Gallagher may disclose and transfer your information to our affiliates,agents or vendors that have a need to know such information in connection with the provision of such services(including insurance markets,as necessary,for marketing,quoting, placing and/or servicing insurance coverages). We may also disclose such information as required by applicable data protection laws or the order of any court or tribunal,subject to our providing you with prior notice as permitted by law. We will (i)implement appropriate administrative,physical and technical safeguards to protect personal information;(ii)timely report security incidents involving personal information to affected parties and/or regulatory bodies;(iii)create and maintain required policies and procedures; and(iv)comply with data subjects'rights,as applicable. To the extent applicable under associated data protection laws,you are a"business"or "controller"and Gallagher is a"service provider"or"data processor."You will ensure that any information provided to Gallagher has been provided with any required notices and that you have obtained all required consents, if any and where required,or are otherwise authorized to transfer all information to Gallagher and enable Gallagher to process the information for the purposes described in this Proposal and as set forth in Gallaher's Privacy Policy located at https-///www.a1g.com/ rp ivacy policy/.Gallagher may update its Privacy Policy from time to time and any updates will be posted to such site. Dispute Resolution Gallagher does not expect that it will ever have a formal dispute with any of its clients. However, in the event that one should arise,we should each strive to achieve a fair,expedient and efficient resolution and we'd like to clearly outline the resolution process. A.If the parties have a dispute regarding Gallagher's services or the relationship governed by this Proposal ("Dispute"),each party agrees to resolve that Dispute by mediation.If mediation fails to resolve the Dispute,you and Gallagher agree to binding arbitration. Each party waives all rights to commence litigation in court to resolve a Dispute,and specifically waives all rights to pursue relief by class action or mass action in court or through arbitration. However,the parties do not waive the ability to seek a court order of injunction in aid of the mediation and arbitration required by these Terms. B.The party asserting a Dispute must provide a written notice("Notice")of the claim to the other party and to the American Arbitration Association("AAA")in accordance with its Commercial Arbitration Rules and Mediation Procedures.All Dispute resolutions will take place in Chicago,IL,unless you and Gallagher agree to another location.The parties will equally divide all costs of the mediation and arbitration proceedings and will each pay their own attorneys'fees. All matters will be before a neutral,impartial and disinterested mediator or arbitrator(s) that have at least 20 years'experience in commercial and insurance coverage disputes. C. Mediation will occur within sixty(60)days of filing the Notice with the AAA.Mediation results will be reduced to a memorandum of understanding signed by you,Gallagher and the mediator. A Dispute that is not resolved in mediation will commence to binding arbitration. For Disputes in excess of$500,000,either party may elect to have the Dispute heard by a panel of three(3)arbitrators.The award of the arbitrator(s)must be accompanied by a reasoned opinion prepared and signed by the arbitrator(s). Except as may be required by law,neit40 her i �� JJ i1111111�III1111�D��l�llll ll»��Il��JJ jell _ _ ,,,,,,,,,,, «««�««��«��«��«ioiiiiuilli��f��illlllllfolllflllflllllll«OIIIIII�III�OIIIIIIIIIIIII01 � �� II�I�OI�I��III��III��I�I��I�IIIIII�(O�IIII�III�IIIIIII��III��IIIIIII��IIII�IIII�O�I IIII�III�I��I�IIIIII�III��II�II II��I��III�IIII IIII� /%e City of Santa Ana rr CORE 360' you,Gallagher, nor a mediator or arbitrator may disclose the existence,content or results of any Dispute or its dispute resolution proceeding without the prior written consent of both you and Gallagher. Electronic Delivery In lieu of receiving documents in paper format,you agree,to the fullest extent permitted by law,to accept electronic delivery of any documents that Gallagher may be required to deliver to you(including,but not limited to,insurance policies and endorsements,account statements and all other agreements,forms and communications)in connection with services provided by Gallagher. Electronic delivery of a document to you may be made via electronic mail or by other electronic means, including posting documents to a secure website. Miscellaneous Terms Gallagher is engaged to perform services as an independent contractor and not as your employee or agent,and Gallagher will not be operating in a fiduciary capacity. Where applicable,insurance coverage placements and other services may require the payment of federal excise taxes,surplus lines taxes, stamping or other fees to the Internal Revenue Service,various State(s)departments of revenue,state regulators, boards or associations. In such cases,you will be responsible for the payment of the taxes and/or fees,which Gallagher will separately identify on related invoices. The Proposal and these Terms are governed by the laws of the State of Illinois,without regard to its conflict of law rules. If an arbitrator/court of competent jurisdiction determines that any provision of these Terms is void or unenforceable,that provision will be severed,and the arbitrator/court will replace it with a valid and enforceable provision that most closely approximates the original intent,and the remainder of these Terms will remain in effect. Except to the extent in conflict with a services agreement that you may enter into with Gallagher,these Terms and the remainder of the Proposal constitute the entire agreement between you and Gallagher with respect to the subject matter of the Proposal,and supersede all prior negotiations,agreements and understandings as to such matters. 41 i �� JJ i1111111III1111�D�lllll ll»�Il� JJ jell _ _ ,,,,,,,,,,,��««��«�««��«��«��«ioiiiiuilli��f��illlllllfolllflllflllllll«OIIIIII�III�OIIIIIIIIIIIII01 � �� II�I�OI�I��III��III��I�I��I�IIIIII�(O�IIII�III�IIIIIII��III��IIIIIII��IIII�IIII�O�I IIII�III�I��I�IIIIII�III��II�II II��I��III�IIII IIII� fgpl/ City of Santa Ana G a I I a g h e r CORE 360' rr ChHer1t &g,-,"II , ture quhr',& e E", 42 ............. IMPORTANT NOTICE: 1. The insurance policy that you are applying to purchase is being issued by an insurer that is not licensed by the State of California. These companies are called "nonadmitted" or "surplus line" insurers. 2. The insurer is not subject to the financial solvency regulation and enforcement that apply to California licensed insurers. 3. The insurer does not participate in any of the insurance guarantee funds created by California law. Therefore, these funds will not pay your claims or protect your assets if the insurer becomes insolvent and is unable to make payments as promised. 4. The insurer should be licensed either as a foreign insurer in another state in the United States or as a non-United States (alien) insurer. You should ask questions of your insurance agent, broker, or "surplus line" broker or contact the California Department of Insurance at the toll-free number 1-800-927-4357 or internet website www.insurance.ca.gov. Ask whether or not the insurer is licensed as a foreign or non-United States (alien) insurer and for additional information about the insurer. You may also visit the NAIC's internet website at www.naic.org. The NAIC—the National Association of Insurance Commissioners—is the regulatory support organization created and governed by the chief insurance regulators in the United States. 5. Foreign insurers should be licensed by a state in the United States and you may contact that state's department of insurance to obtain more information about that insurer. You can find a link to each state from this NAIC internet website: https://naic.org/state_web_map.htm. 6. For non-United States (alien) insurers, the insurer should be licensed by a country outside of the United States and should be on the NAIC's International Insurers Department (IID) listing of approved nonadmitted non-United States insurers. Ask your agent, broker, or "surplus line" broker to obtain more information about that insurer. 7. California maintains a "List of Approved Surplus Line Insurers (LASLI)." Ask your agent or broker if the insurer is on that list, or view that list at the internet website of the California Department of Insurance: www.insurance.ca.gov/01-consumers/120-company/071asli/lasli.cfm. 8. If you, as the applicant, required that the insurance policy you have purchased be effective immediately, either because existing coverage was going to lapse within two business days or because you were required to have coverage within two business days, and you did not receive this disclosure form and a request for your signature until after coverage became effective, you have the right to cancel this policy within five days of receiving this disclosure. If you cancel coverage, the premium will be prorated and any broker's fee charged for this insurance will be returned to you. Date: Insured: D-1 (Effective January 1, 2020) fgp` City of Santa Ana G a I I a g h e r CORE 360' rr Ch ,Fr',rt "to Coverage After careful consideration of Gallagher's proposal dated 6/1/2025,we accept the following coverage(s). Please check the desired coverage(s)and note any coverage amendments below: El Accept El Reject Excess Liability Buffer-$1 M xs$2M SIR El Option# 1 General Star Indemnity Company El Option#2 Princeton Excess&Surplus Lines Ins Co El Accept 0 Reject TRIA-Excess Liability Buffer-$1 M xs$2M SIR El Accept El Reject Excess Workers'Compensation El Option# 1 Response Indemnity Company of California $500K xs$1,500,000 SIR—Premium: $327,547 El Option#2 Response Indemnity Company of California $750K xs$1,250,000 SIR- Premium: $475,721 El Option#3 Response Indemnity Company of Californi $1 M xs$1 M SIR- Premium: $735,719 Included* TRIA-Excess Workers'Compensation El Accept El 7eject DIC-$5M Part of$10M Endurance American Specialty Ins Co El Accept El Reject DIC-$2.5M Part of$10M Palms Insurance Company, Limited El Accept El Reject DIC-$2.5M Part of$10M Landmark American Insurance Company El Accept El Reject Excess DIC-$5M xs$10M Mt Hawley Insurance Company, Lloyd's Synd 1458(RenaissanceRe Synd) El Accept 0 Reject TRIA-Excess DIC-$5M xs$10M El Accept El Reject Excess DIC-$10M Excess$15M Palomar Excess and Surplus Insurance Company, Princeton Excess&Surplus Lines Ins Co El Accept El Reject Excess DIC-$5M Excess$25M Palomar Excess and Surplus Insurance An additional $5M in limits for an additional Company, Princeton Excess&Surplus Lines Ins $92,862.00 in premium Co 45 City of Santa Ana /% CORE 360' err ❑Accept❑ Reject Excess DIC-$10M Excess$25M Palomar Excess and Surplus Insurance An additional $10M in limits for an additional Company, Princeton Excess&Surplus Lines Ins $170,247.00 in premium Co ❑Accept❑ Reject Excess DIC-$15M Excess$25M Palomar Excess and Surplus Insurance An additional $15M in limits for an additional Company, Princeton Excess&Surplus Lines Ins $252,791.00 in premium Co ❑Accept❑ Reject Terrorism ❑ Option# 1 Lloyd's Syndicate 3623(Beazley Furlonge Limited) ❑ Option#2 Texas Insurance Company ❑Accept❑ Reject TRIA-Terrorism For this coverage,TRIA cannot be rejected Additional Recommended Coverages Gallagher recommends that you purchase the following additional coverages for which you have exposure. By checking the box(es)below,you are requesting that Gallagher provide you with a Proposal for this coverage. By not requesting a Proposal for this coverage, you assume the risk of any uncovered loss. The above coverage(s)does not necessarily represent the entirety of available insurance products. If you are interested in pursuing additional coverages other than those listed in the Additional Recommended Coverages, please list below: pio y��gpg�y'NN$ll QIVIVJIUlIIf y��UUUJkkNN� N+'JkNAI11J�JUIJ�A'�'RNN i�U�IIIVD�IOU°YI�N11�V'�IllV11�11D I� Exposures and Values You confirm the payroll, values, schedules, and any other information pertaining to your operations, and submitted to the underwriters,were compiled from information provided by you. If no updates were provided to Gallagher, the values, exposures and operations used were based on the expiring policies.You acknowledge it is your responsibility to notify Gallagher of any material change in your operations or exposures. Additional Terms and Disclosures Gallagher is not an expert in all aspects of your business. Gallagher's Proposals for insurance are based upon the information concerning your business that was provided to Gallagher by you. Gallagher expects the information you provide is true, correct 46 �� jj JJ i1111111III1111�D�lllll ll»�Il� JJ��Il _ _ ,,,,,,,,,,, «««�««��«��«��«�o��u�ll��i��illlllllfolllflllflllllll«OIIIIII�III�OIIIIIIIIIIIII01 � �� II�I�OI�I��III��III��I�I��I�IIIIII�(O�IIII�III�IIIIIII��III��IIIIIII��IIII�IIII�O�I IIII�III�I��I�IIIIII�III��II�II II��I��III�IIII IIII� /%e City of Santa Ana rr CORE 360' and complete in all material respects. Gallagher assumes no responsibility to independently investigate the risks that may be facing your business, but rather have relied upon the information you provide to Gallagher in making our insurance Proposals. Gallagher's liability to you arising from any of Gallagher's acts or omissions will not exceed $20 million in the aggregate.The parties each will only be liable for actual damages incurred by the other party, and will not be liable for any indirect, special, exemplary, consequential, reliance or punitive damages. No claim or cause of action, regardless of form (tort, contract, statutory, or otherwise), arising out of, relating to or in any way connected with the Proposal, any of Gallagher's services or your relationship with Gallagher may be brought by either party any later than two(2)years after the accrual of the claim or cause of action. Gallagher has established security controls to protect Client confidential information from unauthorized use or disclosure. For additional information, please review Gallagher's Privacy Policy located at https://www.?ig.com/ rivac - olicv/. You have read, understand and agree that the information contained in the Proposal and all documents attached to and incorporated into the Proposal, is correct and has been disclosed to you prior to authorizing Gallagher to bind coverage and/or provide services to you. By signing below, or authorizing Gallagher to bind your insurance coverage through email when allowed, you acknowledge you have reviewed and agree with terms, conditions and disclosures contained in the Proposal. By: Print Name(Specify Title) Company Signature Date: 47 jj i �� JJ i1111111III1111�D�lllll ll»�Il� JJ��Il _ _ ,,,,,,,,,,, «««�««��«��ii��i«loiiiiu�ll��i��illlllllfolllflllflllllll«OIIIIII�III�OIIIIIIIIIIIII01 � �� II�I�OI�I��III��III��I�I��I�IIIIII�(O�IIII�III�IIIIIII��III��IIIIIII��IIII�IIII�O�I IIII�III�I��I�IIIIII�III��II�II II��I��III�IIII IIII� POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE You are hereby notified that under the Terrorism Risk Insurance Act of 2002,as amended("TRIA"),that you now have a right to purchase insurance coverage for losses arising out of acts of terrorism,as defined in Section 102(1)of the Act,as amended:The term "act of terrorism"means any act that is certified by the Secretary of the Treasury,in consultation with the Secretary of Homeland Security and the Attorney General of the United States,to be an act of terrorism;to be a violent act or an act that is dangerous to human life,property,or infrastructure;to have resulted in damage within the United States,or outside the United States in the case of an air carrier or vessel or the premises of a United States mission;and to have been committed by an individual or individuals,as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion.Any coverage you purchase for"acts of terrorism"shall expire at 12:00 midnight December 31,2027,the date on which the TRIA Program is scheduled to terminate,or the expiry date of the policy whichever occurs first,and shall not cover any losses or events which arise after the earlier of these dates. YOU SHOULD KNOW THAT COVERAGE PROVIDED BY THIS POLICY FOR LOSSES CAUSED BY CERTIFIED ACTS OF TERRORISM IS PARTIALLY REIMBURSED BY THE UNITED STATES UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER,YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE,SUCH AS AN EXCLUSION FOR NUCLEAR EVENTS. UNDER THIS FORMULA,THE UNITED STATES PAYS 80%OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE INSURER(S) PROVIDING THE COVERAGE.YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT,AS AMENDED,CONTAINS A USD100 BILLION CAP THAT LIMITS U.S.GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS USD100 BILLION.IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED USD100 BILLION,YOUR COVERAGE MAY BE REDUCED. THE PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDED BELOW AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS COVERED BY THE FEDERAL GOVERNMENT UNDER THE ACT. I hereby elect to purchase coverage for acts of terrorism for a prospective premium of USD$84,774.50 X I hereby elect to have coverage for acts of terrorism excluded from my policy. I understand that I will have no coverage for losses arising from acts of terrorism. Policyholder/Applicant's Signature Syndicate on behalf of Palms Insurance Company, Limited Print Name Policy Number Date LMA9184 09 January 2020 46.r SOMPO POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE Named Insured: City of Santa Ana Offer Date: April 28, 2025 Policy Number: Effective Date: July 01, 2025 Insurance Endurance American Specialty Insurance Company Company: You are hereby notified that under the Terrorism Risk Insurance Act, as amended, you have a right to purchase insurance coverage for losses resulting from acts of terrorism. As defined in Section 102(1) of the Act: The term "act of terrorism" means any act or acts that are certified by the Secretary of the Treasury--in consultation with the Secretary of Homeland Security, and the Attorney General of the United States--to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. DISCLOSURE OF FEDERAL PARTICIPATION: YOU SHOULD KNOW THAT WHERE COVERAGE IS PROVIDED BY THIS POLICY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM, SUCH LOSSES MAY BE PARTIALLY REIMBURSED BY THE UNITED STATES GOVERNMENT UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER, YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE, SUCH AS EXCLUSION FOR NUCLEAR EVENTS. UNDER THE FORMULA, THE UNITED STATES GOVERNMENT GENERALLY REIMBURSES 80% BEGINNING ON JANUARY 1, 2020, OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE INSURANCE COMPANY PROVIDING THE COVERAGE. THE PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDED BELOW AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS THAT MAY BE COVERED BY THE FEDERAL GOVERNMENT UNDER THE ACT. DISCLOSURE OF CAP ON LOSSES: YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS A $100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS $100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED $100 BILLION, YOUR COVERAGE MAY BE REDUCED. ACCEPTANCE OR REJECTION OF TERRORISM INSURANCE COVERAGE: Your signature and the return of this notice are required prior to binding related commercial insurance coverage. Premium is based on exposures at policy inception and may change if exposures change during the policy term. I hereby elect to purchase certified acts of terrorism $33,910 coverage for the prospective premium of: EX I hereby decline to purchase terrorism coverage for certified acts of terrorism. I understand that I will have no coverage for losses resulting from certified acts of terrorism. Insured: Title: Date: This Notice does not form a part of your insurance contract. If there is any conflict between this Notice and the policy(including its endorsements), the provisions of the policy (including its endorsements) apply. SIL PN 011 (01 20)SIN Includes copyrighted material of the National Page 1 of 1 Association of Insurance Commissioners,with its permission. /%e City of Santa Ana rr i �� JJ it I�11�III1111�D��1�llll lUl�ll��JJ��Il 0 r � I c ca ct3 000 � '1 ' IIIII� o I o o I o 0 o I o 0 0 0 0 0 0 o o rl- c0 0 0 0 0 0 �1� o o � o LO � o o v LOcD N MO O_ O N CD � (D Cl) Cl _ (I; it Et} ER EA b4 64 EA fla U�l (3 c U a Q n a a o N� ;1� 0 0o 0 0 0 o m aa)) aD) � C� C9 C� C7 C� co , u 0 m a) a) a) a) a) U) w ai (n ca U) C C C 73 14 N (6 t L CD o �r c U U U U U L � � tY a a U U U U U Q Q I Q I I 1 L C: rn m > U_ U_ m L T Oco L O a E m coE a) a n3 ^ _ E 0 a � m a) a) C 0 O_ _N Q (D U) Q O c U O C J � EO J J r J L o o Q a) U m a) m U o >T U 0o cL) " o co 0 m c� C c m U m � m Lo E o o >, >,m o o � . 0 a) o= a) o � a) Eo U � »k U@ U L) (D Q a) U) U amico co Q m a � m m C a) 7 7 M C7 if s CO Z m U -O U) U) TO N N h iii L 2 CD .L) U) T >, m Q E Q 3 <n U) U) is is l g cu X a Q ti m X o c� w a) a) m =_ O X w C �p ^% N U E J W N c m m U J E U II ii4i V .L w .L O Q d d d J r I I I I X 7 7 O O U) O LO Z U) U) m m-se e» e» 6' _ N N O i� tl d U �m � y�Z o 2 U? � E. En 0 Z �� u) x a) x � a) a) U) N �, +• m () m a a() m aa)) o WWW ] taW WW H Lp Y C V ii�f o 0 J kkryrypp. 'k110 m and r i r i IIIb .�� @ O_ � u j r I Q U� E co E�p N U _0 m x CC$ o a �J t 3 N � R 0 � OS � 1 E . 3 o 0 O O � o r�( � U � II IIIp @ N 0 N IOI / O O~ C d o N O N E N E O W > m R !;2 O Lo O U U N > w N p O Y -C U CL O Y O p .N M w M a) � 'I U C � � U @ @ 00 m a 0 C d = @ 0 CD Q m @ a N N Q y L O E N -0 O d 75 @ U co LID L Y N p o 01 0 LQ LO L lCD @ N cn (6 N -C U) N _ N E o O o L U O- 704 c_ N C .5 ._ > @ O -r- a C @ C O i6 O U) @ 3 C R i d w N .0 O R O R 0 Q f 0 to p N 7 Q > U U G U ' C a E > f6 @ @ O O C U) 0) U U N d v N o o TT U) U @ C r� OU CO X c E U O U) C N E .Q � m w m a o_ (D o Q @ c: E U OU "� 0 N - �, @L a U En coy @ C E C Q O @ @ a E o o —InC U O U @ O C N O R > .. -0 L '6 @ '6 j 0 _N LID CDR @ C O 3 U a N O U) N U N N N LO R c i E@ > �' m °' p M °r° C Q E c C C , .= @ w a) C) L R C C z x c� 0 0 0 nU v p y w N J ° �' o .� � o U j w OO) G> O t_ y y O _ dti U) N N w (0 O N 0) CoG .R O C .6 N > , (0-9Q Q Q m m 0 O > U E City of Santa Ana /% CORE 360' err nI e "t I iu�ii�Upllll�llJlgUU�J�JN�'i��6ilq�1V�»;N'�ii� �JJ��UUU uuuJ� ��J�"aN1�i�ip �� y�ii�U!ullll)111ViiJl�Ujl N��"N��In�ll11f�1�'I�NNNN�1'/��f��UI��JIk Subject To: D-1 (Effective January 1, 2020) Excess Liability Buffer-$1 M xs Signed TRIA Form. $2M SIR General Star Indemnity Company Confirmation of Binding Coverage must be signed at Binding Copy of signed E&S due diligence affidavit from retail agent must accompany any request to bind coverage. Subject To: Excess Liability Buffer-$1 M xs D-1 (Effective January 1, 2020) $21VI SIR Signed TRIA Form Princeton Excess&Surplus Lines Ins Co . Prior to binding, the Insurer requires a completed, signed, and dated UM/UIM acceptance/rejection form. Confirmation of Binding Coverage must be signed at Binding Excess Workers'Compensation Response Indemnity Company of N/A California DIC-$51VI Part of$10M Signed Terrorism Disclosure Form prior to binding Endurance American Specialty Ins Co D-1 (Effective January 1, 2020) Subject to - requested information is received within 30 days, automatic NOC must be sent contingent upon receipt of information DIC-$2.51VI Part of$10M D-1 (Effective January 1, 2020) Palms Insurance Company, Limited Signed TRIA Disclosure Notice(s)(required at binding) The complete Named Insured listing (if any)is per schedule on file with the Program Manager DIC-$2.51VI Part of$10M Landmark American Insurance D-1 (Effective January 1, 2020) Company Subject to D-1 (Effective January 1, 2020) Excess DIC-$51VI xs$10M Please include up-to-date additional interest information such as Additional Named Mt Hawley Insurance Company Insureds,Additional Insureds, Mortgagees and Loss Payees with the bind request, if Lloyd's Synd 1458(RenaissanceRe applicable. Synd) Conditional binding subject to receipt and review of primary binder within 5 days.Any changes or discrepancies may invalidate this binder Subject to receipt of the primary policy within 45 days of binding. Excess DIC-$10M Excess $15M Subject to Palomar Excess and Surplus D-1 (Effective January 1, 2020) Insurance Company Princeton Excess&Surplus Lines Signed Insurance Applications and Acknowledgement of State Fraud Warnings. Ins Co Notice Regarding Surplus Lines Filing Confirmation and TRIPRA Rejection Forms 51 ��44 CDllllllll IIIIIIIJIIIIIIIIiiI�1J1111�1 i�,� . .....,,,,,,, ..«< City of Santa Ana /% CORE 360' err pum�li�U1N >YN�j1�1 OIIUJJUI➢°11IIIIICIIIIII ICOJ��UU uu��NNUI>�I��y�JNNR�� !iq!!li�k>r�k_11i�fi VigU�>jIII�lUIIiI IIIi�IDU))1U11111UIIIlUIUJiD�U�UICII� Terrorism Subject to The Return of a Completed and Signed Surplus Lines Verification Form Lloyd's Syndicate 3623 (Beazley Must be Received in our Office Within Twenty(20) Days of Binding/California Surplus Furlonge Limited) Lines Disclosure Statement(Pre Bind) Subject to Terrorism Texas Insurance Company -The return of a completed and signed Surplus Lines Verification Form must be received in our office within twenty(20)days of binding 52 i �,�,� JJ II I�111<,<II1111�D��1�llll lUl�ll�>I�JJ III _ _ ,,,,,,,,,,,��,,,,��«�««��«��«��«��«�IIIIIIIIIIIIiiloiii�illfIIIIIIIff0111111IIIIl011IIIIII��I�IOI � �� II III011lllf I��I��I�I��I�IIIIII�(O�I��I��IIIIIII��I��II�III��IIIIIIIIIIOII IIII��I�I��I�IIIIII�III��IIIII Il��l��f I��IIIII _.'y of Santa . -_ _ a I I a g h e r /_� ��_�� U�^�� ^�� U^� ��n~~�. . .~~ n �.~ ~~n u�. . �� n n� �� ~~ �� Immediately report all claims. Each insurer requires notice of certain types of claims depending on the potential exposure or particular injury types. |tioimportant to thoroughly review your policy to ensure you are reporting particular incidents and claims, based upon the insurer's policy requirements. If you are using a third party administrator("TPA"),your TPA may or may not report claims to an insurer on your behalf. Although we will assist you where requested, it is important that you understand whether your TPA will be completing this notification. Reporting Direct to Carrier[Only When Applicable] /%e City of Santa Ana rr �ri�lnCORE 360' IN ��; �� 1r1�J�J�J��1��r��'Ir��Irl�r�I�I�pllili�Jil�l��l�pl �i��ll'll�l�l��r1r'�„�p��I,IrIrIIr��I�Irlrp�q�IplJilll�lgq�lrl�llrlrll�gl��r��IC1111�u1 glpulr��ilr�Ir��Irlrrl��lru �IrIr��I�II�In1�1ru1JgCll��l�l�l��lr�c��lr�li Insurer: General Star Indemnity Insurer/TPA Name: General Star Indemnity Policy period: 7/01/2025 7/01/2026 Phone: 203-628-5700/312-526-7574 Email: GStarCaaims@generalstar.com Web: https://www.generalstar.com/claims/re op rt-a- claim.html ,", Irlrlrl Ir lr ri a 7'N uu ,�� Iriq Im rrr r i,r,rrr�a r'r'Imp I rlrlri i �rl"rl" a Iriri�lr I I� i Jlb I'll "Ilf', ,N• M U ,I U IIN IIIII, 11111ll I I ,rll>��+'"�'J .,r � � � � .� �..� ' �I�I II, l �II ��rl , ,,, .,. �iil��IIaIIJ�I�NN�iN��i��1� l Insurer:if he f=brinceton I:::xcess and Sulrpllus I1....lines Insurer/TPA Name: FIhe f='Irinceton 1:::::xcess alnd Sulrpllus Insurance Coil Il....ines Ilirr,:,uraince Coil Policy period: '7/01/2025 "7/01/2026 Phone: 1 866 311 9636 Email: clmsins munichreamerica.com Web: ill I Jill Insurer: Palomar Excess and Surplus Insurance Company Insurer/TPA Name: Palomar Excess and Surplus Policy period: 7/1/2025 to 7/1/2026 Insurance Company Phone: Email: Web: l!"��N�1��I�1gIIU��J��I� �plli�llll��llll�1U11�11Jlliq mligllllllll II i Insurer: Princeton Excess&Surplus Lines Ins Co Insurer/TPA Name: Princeton Excess&Surplus Lines Ins Policy period: 7/1/2025 to 7/1/2026 Co Phone: 1-888-729-2242/1-866-220-3505 Email: Web: htto•//WWW.pesioc.com/en.htmi ilrpia.Illlllll.IIIIIIYYIllr!;i1"11U!r'" IrlrinyliN"i"IUIccIIIIrI�!��, �pp' ''�llinruCPJ "��"llq�JN,""� ,�� pnnrNl'pp11�11Jriririq�, , �I�N��I�li,ll•�i��„�,�� ."niil�ll��,I„�'4,, Y�� I'�� (II(f�I��rO��•,��;.,lpi ,11,>r��>y�>'1// �i�� Insurer: RESPONSE INDEMNITY COMPANY OF Insurer/TPA Name: RESPONSE INDEMNITY COMPANY CALIFORNIA Policy period: 7/1/2025 to 7/1/2026 OF CALIFORNIA Phone: Email: Web: �� innn�)IU11irI1�IINIpJ11111�1)11rllN��q�jl�" � , II��k��n�N�aifilualla��Kallal��ulr(i�i�l��1��ullll(((((�ull�fllalluil�il(( Insurer: Texas Insurance Company Insurer/TPA Name:Texas Insurance Company Policy period: 7/1/2025 to 7/1/2026 Phone: 1-855-497-0578 Email: SEClaims@ajg.com Web: 54ur �� DU1�0 II)1J)pJJII�,IIIIIIIl�Ul6iJIII�JJ��U�� !�N , _ .,,.,,,,,��«<��«��«��nnnnnlnlllllll�I�IIiillliillloiiliii�ol�I�I�o��Il�o��IIlOIIIl011llllllllll�lll �� °I�� IttIIIIIIIIIIIIf11��11111011�11��01111111�01�11�IIII��011I1011�111�1�1(OIIIIIII�I�i�IIIIIIIIIIIIIl01111111�1111111111111 /%e City of Santa Ana rr CORE 360' �10ruciyliiruil,r� Insurer: Underwriters Lloyds at London Insurer/TPA Name: Underwriters Lloyds at London Policy period: 7/1/2025 to 7/1/2026 Phone: 1-855-497-0578 Email: SEGlaims@aig.com Web: Reporting to Gallagher or Assistance in Reporting 11�I 1�J)J1JRjjj1gIur' �III111U U1� Iq��u JllJ UkNNNh%iYf�IIIIIIV�11111IIlIIIl�1111111111111�111�1��1��1��1�� 6 Gallagher Claim Center Phone: 855-497-0578 Fax: 225-663-3224 Email: ggb.nrcclaimscenter@ajg.com 55 i �� JJ it I�11�III1111�D��1�llll lUl�ll�>I�JJ 1�I1 _ _ ,,,,,,,,,,,��««��«�««��«��«��IIIIIIIIIIII�ii��ii�oiii�illfIIIIIIIff0111111IIIIl011IIIIII��I�IOI � �� II III011lllflll�IIIIIIIIIII��(OII�II�III II��I��II�III��IIIIIIIIIIOIIIIII��I�I��I�IIIIII�III��IIIIIII��I��fI��IIIII IIIII II I„ I I I I I II,1 I I I I I I I I I I I I I I I I I I I I I I I I I � . I I I I I I I I I I I I I I I I I I I I I I I I I I I S � ,�1,,,/,lllfl>l�lll 111111 l 1 �l 1 1 1 I I I ITEP Gallagher i , r I I I I 1 I I lu n y Ily,r 0 I� I 1 I � � „ , TIIIIIII Ills U 01 p !(f ( I � 1D IlllUll��1 lu lY 111 all la 1 I � I li„r1 I Ul i 11,y n( I, I I I I I, I I I illa, Ilallllla I,I�I�1i ll I I ,r,I II II .rlllr, I lil I I II a�11 I AM/A u a r r 14d m„ Nil Reduce Your Risk and Simplify Training Most I"opufar !-',,) (,'fy kdIHI In0(,f1'r4111,41'1(f edIl(:< h011,.I M,r k,l'I)I fi)I E31"IG,wpm , am crltI(:,I 'Ior 11'raIiV iII-ig I(rrfl,ui (¢,ar /�i(f(,rl1r;, it r,�r: a�;irn, Ir'Qal flr)II and In r`irrll/nl(r your t:01.r (:r,,`,' of rI`,Ik II"w", �VJf.I�,`",rrlf,'r11 )rlrs L11�/.rllrulf�llra 1rl{,<,m11 gall'1 Iran"Ilrr;f WWgh r SaNty TrairIng Educes`u rn PIMfonn (STEP) N (my rar/,PH pry IF,,arrrI I I f lud'„afM')/ 'rrw n g rrl,3rlag r IIC fr_Ir�l(r1YrrM(IS)thatII Iri ;rr1�1 err, ( L,�` �(r 1 y '1/ lI,(f � rl, Ilro'ocl"r feralf� /_frr Irrsirurll� r �I, yr e `" ul') to did VuH'1 fku ,r1(,, p a�a OV yf,�ri(�a&,,, , [ �,IYr,fff„u P "r1f r,{III r`',l f y �,afe I!f'f Ing r:rIic("y f)(4c' "Ivr,I If l nnr',, Register (r,: (IC) to 10 I(H✓ UyA '),, fr(M),a Illrrwy of Il,lo,rr 00 1't,Ilurlrl rl W ,ONY A/rl , In r,(ir1111r�1r1 rrlorith y G I,IHM ,,, avalkl,lle, l rr, Prr,,14:IIlIoI I I')a"Ir a (,ov rll llJ 11141 (.`, `alJ(,I1 r > (fenei, a �Iri I'll,ll'"rorl Ilrot.'r",jv(�lml,Il,ll"JrYn;?PIT fI1"Afrl rllld 131 P.r[{ramrld(�ru�rIrTn Irul,af:iar;� Save v MnUe i jnp oy D ,a q II q f)IrIraIIlee flWlrWWJ UHd 1((.9001'Iny Ihy Ir MY plro(rr(ass ami (.((I"r'1I`/I(ail(w iu"u'ropauf t1'rr,I Ir(,( W,', Of tr a I II I(r to r f,ay it r (,,(r1[rllrn a rA r.,rl(a rr,/r.;>I1'.l ( (/',rfy r 0414 I CIt13 13 . Onboard and bG'u° uor do >rn0nml1M IIIarIIom of ;am n 1,°1h?" rM"I( III(; ycrl,r (,y,r `,kdc.(I IfroI or0rnl )I11 a n. om v nv p.)I,o-W"nn i(N y4..Hn r r,i i',r, , ,1 Iryn Unnq Mad am] rrl(adule �%J km d f:I your 5ua,Jl c 1`., a (i )( I ,l""}fIr'I (""1: `)I'rX.(.(fln`e s and f,`"1'1": rrM S for rdI %'I"f(fod f( f^. u, VISIL to (earn Ir"1!:'1f(' 1 IIIUIIIIIII............. I II II1� 1111J �il lllll�lll��llll��l��l��l�l�� )i�� I�inaroa,rr, «fll U�Illl(�(cau////lflflf IIIIIII«« IfIIfII101�111111011fIIIIIIIIIIIOIII�II�I««� 11111 1 C -, F�, , '( h I k. Ow e I�',�� C-, "Q r �1 Gallagher In surinc,,��,r Risk Management I Consult g aiiiprae o A vca[iab,1e i r-in,iu N IIod . 1 s c nud IS Da ava � ,irn n [Ru. <o n,t•d T'rk fl/¢ g Oh P.ir' . . ;I :I rl l ) r r, ) a I rI a i ,i , I Al a, i il, �, I,„ ,r fail,. �� ,,r. _ a �r�7` • ,, _.. Szif tY 11°.AI`Itwrz, �. �i. 'ljlI •�� .I • F r r r •��. )lt'-,� �) _ r If', , . -r=,}; .I N �,,,;,...�� ,i Ali' ,. i "°1';� ., r 6 r ¢ af.;ItY , YoI C �0 I)(aG. fj PJ�VPG�d�IIIL ( �111, �' r,:,,sE. v ,'j, P,tirfl/ir,/g a,g, t r ,,1 c) ecni 111U,/ INVOICE INDEPENDENT CITIES RISK MANAGEMENT AUTHORITY INA Joint Powers Authority Bill To: Customer#: Invoice#: CITY OF SANTA ANA CUS 1047 4407 20 Civic Center Plaza Invoice Date: Due Date: 4th Floor(Risk Management) 07/01/2025 07/31/2025 Santa Ana,CA 92701 Total Due: $9,501,254.00 Description Amount Liability Program 2025/2026 8,202,559.00 Workers'Compensation Program 2025/2026 428,629.00 Property&Equipment Breakdown Program 2025/2026 538,928.00 Auto Physical Damage APD Program 2025/2026 188,102.00 Crime Program 2025/2026 18,518.00 C ber Program 2025/2026 119,518.00 2025/2026 Risk Management Fund Contribution-OPTIONAL 5,000.00 TOTAL AMOUNT DUE $9,501,254.00 Payment Instructions Wire(ACH)pg3 ments: Bank Name: California Bank&Trust Bank Address: 520 Capitol Mall, Suite 380, Sacramento, CA 95814 Routing Number: 121002042 Account Number: 1030068561 For credit to: Independent Cities Risk Management Authority Checks: * ICItMA Finance Department mailing address has changed Please mail payments to: ICRMA c/o Eide Bailly LLP Attn: Jessica Andersen 25231 Pasco De Alicia, Ste. 100 Laguna Hills, CA 92653 In accordance with Article V Section D.1-3 of the ICRMA Bylaws,unless other arrangements for payment have been approved by the Governing Board, Members with delinquent amounts due shall be assessed a penalty which shall be one percent of the unpaid amount due and payable to the Authority 30 days after the initial invoice due date.A penalty of another one percent shall accrue after an additional 45 days. Interest shall accrue on all delinquent amounts due and payable to the Authority at the applicable rate of 10%per annum from the due date of the billing until the date finally posted by the designated financial institution. A member may appeal any surcharge assessed in accordance with Article XII of the ICRMA Bylaws. 18201 Von Karman,Suite 200, Irvine,CA 92612 Phone:760-217-4952 Questions: ICRMA-Payments@eidebailly.com