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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />INSURER(S) AFFORDING COVERAGE <br />INSURER F : <br />INSURER E : <br />INSURER D : <br />INSURER C : <br />INSURER B : <br />INSURER A : <br />NAIC # <br />NAME:CONTACT <br />(A/C, No):FAX <br />E-MAILADDRESS: <br />PRODUCER <br />(A/C, No, Ext):PHONE <br />INSURED <br />REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />OTHER: <br />(Per accident) <br />(Ea accident) <br />$ <br />$ <br />N / A <br />SUBR <br />WVD <br />ADDL <br />INSD <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />$ <br />$ <br />$ <br />$PROPERTY DAMAGE <br />BODILY INJURY (Per accident) <br />BODILY INJURY (Per person) <br />COMBINED SINGLE LIMIT <br />AUTOS ONLY <br />AUTOSAUTOS ONLY <br />NON-OWNED <br />SCHEDULEDOWNED <br />ANY AUTO <br />AUTOMOBILE LIABILITY <br />Y / N <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />DESCRIPTION OF OPERATIONS below <br />If yes, describe under <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />$ <br />$ <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. EACH ACCIDENT <br />EROTH-STATUTEPER <br />LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />EXCESS LIAB <br />UMBRELLA LIAB $EACH OCCURRENCE <br />$AGGREGATE <br />$ <br />OCCUR <br />CLAIMS-MADE <br />DED RETENTION $ <br />$PRODUCTS - COMP/OP AGG <br />$GENERAL AGGREGATE <br />$PERSONAL & ADV INJURY <br />$MED EXP (Any one person) <br />$EACH OCCURRENCE <br />DAMAGE TO RENTED $PREMISES (Ea occurrence) <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO-JECT LOC <br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />CANCELLATION <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016/03) <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />CERTIFICATE HOLDER <br />The ACORD name and logo are registered marks of ACORD <br />HIRED <br />AUTOS ONLY <br />6/7/2024 <br />Modern Reign Insurance Brokers LLC <br />27762 Antonio Parkway,Ste.L-1 #473 <br />Ladera Ranch CA 92694 <br />Deborah Chisholm <br />19499912423 <br />dchisholm@modernreign.com <br />License#:6001386 Federal Insurance Company 20281 <br />INNOCLA-01 Scottsdale Insurance Company 41297InnovativeClaimSolutions,Inc <br />12677 Alosta Boulevard <br />Suite 335 <br />San Ramon CA 94583 <br />Ace American Insurance Co. <br />1510723860 <br />A X 1,000,000 <br />X 1,000,000 <br />10,000 <br />1,000,000 <br />2,000,000 <br />X <br />Y 35754610WUC 4/1/2024 4/1/2025 <br />Included in Agg <br />A 1,000,000 <br />X X <br />73513506 4/1/2024 4/1/2025 <br />A X 5,000,000 <br />X <br />79797000 4/1/2024 4/1/2025 <br />5,000,000 <br />B <br />A <br />C <br />Professional Liability <br />Fiduciary /Crime Pkg <br />Cyber <br />EKI3519311 <br />68054061 <br />D95331476 <br />4/1/2024 <br />4/1/2024 <br />4/1/2024 <br />4/1/2025 <br />4/1/2025 <br />4/1/2025 <br />Occurrence /Aggregate <br />Occurrence /Aggregate <br />Occurrence/Aggregate <br />3,000,000 <br />2,000,000 <br />10,000,000 <br />Certificate Holder is included as additional insured in regard to General Liability per the attached endorsement. <br />City of Pleasanton <br />C/O Maribeth Kushon <br />PO Box 520 <br />Pleasanton CA 94566-0802 <br />DocuSign Envelope ID: 177B557A-79FB-4E9E-B338-6359A5FCBAB8