Arthur J. Gallagher Risk Management Services, LLC BATMI1San Francisco, CA 94111Phone:(415)546-9300Invoice #61954171 of 4 ACCOUNT NUMBER DATESANTAANA-17/6/2026 BALANCE DUE ON AMOUNT DUE7/1/2026$3,660,938.201 of 4 City of Santa Ana20 Civic Center Plaza, M-24Santa Ana, CA 92701 Excess Workers CompPolicyNumber:ABL1000008-07Company:Response Indemnity Company of CaliforniaEffective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441686827/1/20267/1/2026RENBWC Buffer - $500K xs $1.5M SIR-IDC Issued$392,538.00Terrorism StandalonePolicyNumber:D27D07260801Company:Beazley Excess and Surplus Insurance, Inc.Effective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441822597/1/20267/1/2026RENB$10M Prop/Liability Combined Terrorism$14,460.00Difference in ConditionsPolicyNumber:ESP30001763406Company:Endurance American Specialty Ins CoEffective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441679407/1/20267/1/2026RENBPrimary EM/EMSL/Flood - $5M part of $10M$331,615.00 441679467/1/20267/1/2026SLTXSurplus Lines Taxes$9,948.45 441679497/1/20267/1/2026STFXStamping Fees$596.91Difference in ConditionsPolicyNumber:INP-00633-26Company:Palms Insurance Company, LimitedEffective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441681827/1/20267/1/2026RENBPrimary EM/EMSL/Flood - $2.5M part of $10M$165,807.00 Please return this portion with your payment. Include your invoice number on your remittance to expedite processing. BATMI1City of Santa AnaInvoice #619541720 Civic Center Plaza, M-24Santa Ana, CA 92701 ACCOUNT NUMBER DATESANTAANA-17/6/2026 BALANCE DUE ON AMOUNT DUE7/1/2026$3,660,938.20 AMOUNT PAIDPlease send your remittance to:Arthur J. Gallagher Risk Management Services, LLCPO Box 39735Chicago, IL 60694-9700 PAY ONLINE AT:www.ajg.com/ezpay
Arthur J. Gallagher Risk Management Services, LLC BATMI1San Francisco, CA 94111Phone:(415)546-9300Invoice #61954172 of 4 ACCOUNT NUMBER DATESANTAANA-17/6/2026 BALANCE DUE ON AMOUNT DUE7/1/2026$3,660,938.202 of 4 City of Santa Ana20 Civic Center Plaza, M-24Santa Ana, CA 92701 441681877/1/20267/1/2026CFEECarrier Policy Fee$1,500.00 441681927/1/20267/1/2026SLTXSurplus Lines Taxes$5,019.21 441681967/1/20267/1/2026STFXStamping Fees$301.15Difference in ConditionsPolicyNumber:LHD958795Company:Landmark American Insurance CompanyEffective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441683007/1/20267/1/2026RENBPrimary EM/EMSL/Flood - $2.5M part of $10M$165,807.00 441683377/1/20267/1/2026SLTXSurplus Lines Taxes$4,974.21 441683427/1/20267/1/2026STFXStamping Fees$298.45Excess Difference in ConditiPolicyNumber:MCQ0101601Company:Mt Hawley Insurance CompanyEffective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441682677/1/20267/1/2026RENBXS EM/EMSL/FL - $5M xs $10M$205,000.00 441682727/1/20267/1/2026CFEECatastrophe Analysis Fee$900.00 441682747/1/20267/1/2026SLTXSurplus Lines Taxes$6,177.00 441682777/1/20267/1/2026STFXStamping Fees$370.62Excess LiabilityPolicyNumber:N1-A3-RL-0000163-01Company:Princeton Excess & Surplus Lines Ins CoEffective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441677597/1/20267/1/2026RENB26-27 Excess Liability Buffer - $3M$1,738,425.00 Please return this portion with your payment. Include your invoice number on your remittance to expedite processing. BATMI1City of Santa AnaInvoice #619541720 Civic Center Plaza, M-24Santa Ana, CA 92701 ACCOUNT NUMBER DATESANTAANA-17/6/2026 BALANCE DUE ON AMOUNT DUE7/1/2026$3,660,938.20 AMOUNT PAIDPlease send your remittance to:Arthur J. Gallagher Risk Management Services, LLCPO Box 39735Chicago, IL 60694-9700 PAY ONLINE AT:www.ajg.com/ezpay
Arthur J. Gallagher Risk Management Services, LLC BATMI1San Francisco, CA 94111Phone:(415)546-9300Invoice #61954173 of 4 ACCOUNT NUMBER DATESANTAANA-17/6/2026 BALANCE DUE ON AMOUNT DUE7/1/2026$3,660,938.203 of 4 City of Santa Ana20 Civic Center Plaza, M-24Santa Ana, CA 92701 441677937/1/20267/1/2026SLTXSurplus Lines Taxes$52,152.75 441677987/1/20267/1/2026STFXStamping Fees$3,129.17Excess Difference in ConditiPolicyNumber:PE708734Company:Palomar Excess and Surplus Insurance CompanEffective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441684287/1/20267/1/2026RENBXS EM/EMSL - $10M xs $15M$303,500.00 441684747/1/20267/1/2026CFEECatastrophe Analysis Fee$800.00 441684797/1/20267/1/2026SLTXSurplus Lines Taxes$9,129.00 441685687/1/20267/1/2026STFXStamping Fees$547.74Excess Difference in ConditiPolicyNumber:TSAHDC0003285-01Company:MS Transverse Specialty Insurance CompanyEffective:7/1/2026to7/1/2027 Item #Trans Eff DateDue DateTransDescriptionAmount 441819177/1/20267/1/2026RENB XS EM/EMSL - $15M xs $25M$239,500.00 441819227/1/20267/1/2026CFEECatastrophe Analysis Fee$800.00 441819237/1/20267/1/2026SLTXSurplus Lines Taxes$7,209.00 441819327/1/20267/1/2026STFXStamping Fees$432.54 Please return this portion with your payment. Include your invoice number on your remittance to expedite processing. BATMI1City of Santa AnaInvoice #619541720 Civic Center Plaza, M-24Santa Ana, CA 92701 ACCOUNT NUMBER DATESANTAANA-17/6/2026 BALANCE DUE ON AMOUNT DUE7/1/2026$3,660,938.20 AMOUNT PAIDPlease send your remittance to:Arthur J. Gallagher Risk Management Services, LLCPO Box 39735Chicago, IL 60694-9700 PAY ONLINE AT:www.ajg.com/ezpay
Arthur J. Gallagher Risk Management Services, LLC BATMI1San Francisco, CA 94111Phone:(415)546-9300Invoice #61954174 of 4 ACCOUNT NUMBER DATESANTAANA-17/6/2026 BALANCE DUE ON AMOUNT DUE7/1/2026$3,660,938.204 of 4 City of Santa Ana20 Civic Center Plaza, M-24Santa Ana, CA 92701Total Invoice Balance:$3,660,938.20 Please return this portion with your payment. Include your invoice number on your remittance to expedite processing. BATMI1City of Santa AnaInvoice #619541720 Civic Center Plaza, M-24Santa Ana, CA 92701 ACCOUNT NUMBER DATESANTAANA-17/6/2026 BALANCE DUE ON AMOUNT DUE7/1/2026$3,660,938.20 AMOUNT PAIDPlease send your remittance to:Arthur J. Gallagher Risk Management Services, LLCPO Box 39735Chicago, IL 60694-9700 PAY ONLINE AT:www.ajg.com/ezpay
Chubb INA Excess and Surplus Insurance Services, Inc. 436 Walnut Street Philadelphia, PA 19106 PA License #24194 TankSafe® Storage Tank Liability Insurance Policy (claims-made coverage) Coverage Quotation CHUBB ENVIRONMENTAL DATE: 06/16/2026 TO: Tay Gonzalez Arthur J Gallagher Risk Management Services Llc 50 California St Ste 12 San Francisco, California 94111 [email protected] QUOTATION #1 INSURER: Illinois Union Insurance Company A.M. BEST RATING: A++ XV FIRST NAMED INSURED: Santa Ana, City of ADDRESS: 20 Civic Center Plaza Santa Ana, California 92701 RENEWAL OF: G72534153 005 HOME STATE: California PLACEMENT. INCEPTION DATE: 07/02/2026 EXPIRATION DATE: 07/02/2027 RETROACTIVE DATE: AS PER PF-31164 SCHEDULE OF COVERED STORAGE TANKS LIMITS OF LIABILITY DEDUCTIBLE AMOUNT TERM (YEARS) PREMIUM TRIA PREMIUM* $1,000,000 Per Storage Tank Incident Limit of Liability (Claims and Remediation Costs) $2,000,000 Aggregate Limit of Limit of Liability (Claims and Remediation Costs) for all Storage Tank Incidents $1,000,000 Aggregate Limit of Limit of Liability for all Legal Defense Expenses for all Storage Tank Incidents $3,000,000 Total Policy Aggregate Limit of Liability for all Storage Tank Incidents $25,000 Per Storage Tank Incident 1 $9,439 $472 The premium in this quote includes commission in an amount equal to 15.00% of such premium. COMMISSION: 15.00%
*THE OPTIONAL TERRORISM RISK INSURANCE ACT (TRIA) PREMIUM AS QUOTED ABOVE IS THE ADDITIONAL PREMIUM THAT WILL BE INCLUDED IN THE TOTAL PREMIUM FOR THIS POLICY IF TRIA COVERAGE IS ELECTED. THIS CHARGE IS FOR TRIA COVERAGE PER THE ATTACHED DISCLOSURE LETTER. WE MUST RECEIVE A SIGNED COPY OF THE ATTACHED DISCLOSURE LETTER INDICATING THAT TRIA COVERAGE HAS BEEN ACCEPTED OR DECLINED. TERMS & CONDITIONS Covered Storage Tanks: As Per PF-31164 Schedule of Covered Storage Tanks Policy Form: PF-31181 (10/10) Tanksafe Policy Form (US) 10.2010 As per policy form, known conditions under this policy are not covered. Additional Terms and Conditions: 1. Premium is 100% Minimum-Earned as of inception of the Policy 2. PF-34075 (07/11) Closure, Removal Or Replacement Amendatory 3. PF-47058 (10/15) Exposure-Specific Deductible (Schedule Storage Tanks) Endorsement 4. PF-54022 (02/20) Extended Reporting Period Scope Confirmation (First-Party Discovery) Endorsement 5. PF-31172 (09/10) Financial Responsibility Condition 6. PF-31174 (09/10) Loading And Unloading Coverage (Time Element) 7. PF-57403 (10/22) Other Insurance Amendatory Endorsement 8. PF-31164 (09/10) Schedule of Covered Storage Tanks 9. PF-31185 (09/10) UST Specific Sublimits of Liability 10. SL-34255b (04/23) Service Of Suit Endorsement 11. ALL-21101 (11/06) Trade Or Economic Sanctions Endorsement 12. LD-5S23l (10/24) Signatures 13. SL-17888 (01/20) California Surplus Lines Notification 14. ALL-20887a (03/16) Chubb Producer Compensation Practices & Policies 15. ILP 001 01 04 U. S. Treasury Department's Office of Foreign Assets Control ("OFAC") Advisory Notice to Policyholders TRIA Forms: IF THE INSURED ELECTS TO PURCHASE TERRORISM COVERAGE PER THE ATTACHED DISCLOSURE LETTER FOR THE ADDITIONAL PREMIUM NOTED ABOVE, THE FOLLOWING ENDORSEMENTS WILL APPLY: 1.PF-23728b (02/20) Terrorism Risk Insurance Act Endorsement 2.TRIA11e (08/20) Disclosure Pursuant To Terrorism Risk Insurance Act IF THE INSURED ELECTS TO DECLINE TERRORISM COVERAGE PER THE ATTACHED DISCLOSURE LETTER, THE FOLLOWING ENDORSEMENTS WILL APPLY: 1.TRIA24a (08/20) Policyholder Disclosure Notice of Terrorism Insurance Coverage Value-Added Services Chubb Environmental is committed to developing long-term relationships with our valued insureds. It is our philosophy to partner with our insureds and become an extension of their risk management team, in an effort to enhance the environmental risk management culture within their organization. Working with our inswill utilize Environmental Incident Alert, in addition to Chubb Risk Engineering, a Chubb loss control subsidiary, to customize and deliver quality environmental engineering risk control services focused on helping them minimize potential loss exposures. Environmental Incident Alert is a complimentary program developed to assist Chubb Environmental clients find and dispatch qualified incident response contractors, monitor cleanup costs (in real time) and mitigate potential liabilities associated with environmental releases. ALL TERMS, CONDITIONS, AND PRICING ARE SUBJECT TO RECEIPT, REVIEW, AND APPROVAL OF THE FOLLOWING, PRIOR TO BINDING:
1 Completed, signed Policyholder Disclosure Notice of Terrorism Insurance Coverage form, prior to binding - only required if declining TRIA coverage (attached) 2 Surplus Lines Information Surplus Lines Insurer: ILLINOIS UNION INSURANCE COMPANY Coverage will be provided on a surplus lines basis. Collection and filing of all taxes and fees is the responsibility of the producing surplus lines broker, as is inclusion of state-mandated surplus lines disclaimer language on or in the policy. Please forward a copy of your surplus lines license for our records. Please advise your client that Chubb INA Excess and Surplus Insurance Services, Inc. (CESIS) is offering this quote as representative of its affiliated surplus lines insurance company, Illinois Union Insurance Company. CESIS is not acting on behalf of your client and does not seek placements in other surplus lines markets. Policy Form PF-31181 (10/10) Tanksafe Policy Form (US) 10.2010 This quotation contemplates the use of Chubb forms, issued on the paper indicated above in this document. All terms and conditions are per those forms and endorsements unless otherwise noted herein. OFAC OFAC NOTICE: The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presidential declarations of "national emergency." OFAC has identified and listed numerous Foreign agents, Front organizations, Terrorists, Terrorist organizations, and Narcotics traffickers as "Specially Designated Nationals and Blocked Persons." This list can be located on the United States Treasury's web site http://www.treas.gov/ofac . In accordance with OFAC regulations, if it is determined that you or any other proposed named insured has violated U.S. sanctions law or is a Specially Designated National or Blocked Person, as identified by OFAC, we reserve the right to withdraw this quote at any time prior to binding. TRIA TRIA NOTICE: Presently, the Terrorism Risk Insurance 7. The premium quoted above includes a separate premium charge for terrorism coverage over the entire Policy Period. In the unlikely event that you elect to receive TRIA coverage and it is not renewed before 12/31/27, or TRIA otherwise expires at some point during the Policy Period, we will refund the unearned portion of our TRIA premium to you on a pro-rata basis. In the event that new legislation is enacted requiring the Insurer to offer coverage for terrorism that is materially different than the coverage requirements included in the current version of TRIA that expires on 12/31/27, the Chubb Companies reserve the right to re-price and tailor TRIA coverage to conform with the statutory requirements and risks presented in the new legislation. Disclaimer Please read this quotation carefully, as the limits, coverage and other terms and conditions may vary significantly from those requested in your submission and/or from the expiring policy. Terms and conditions that are not specifically mentioned in this quotation are not included. The terms and conditions of this quotation supersede the submitted insurance specifications and all prior proposals and binders. Actual coverage will be provided by and in accordance with the policy as issued. The insurer is not bound by any statements made in the submission purporting to bind the insurer unless such statement is reflected in the policy or in an agreement signed by someone authorized to bind the insurer. This quotation has been constructed on reliance of the data provided in the submission. A material change or misrepresentation of that data voids this quotation. Premium Payment IN THE EVENT COVERAGE IS BOUND, THE PREMIUM INDICATED ABOVE MUST BE REMITTED TO US STATEMENT BILL. eDelivery including delivery of the policy as an e-mail attachment. We will deliver the policy to the email address shown above. If the insured would like to withdraw their consent to electronic delivery and exclusively receive a printed paper copy of the policy, please contact the undersigned. Quotation Expiration THIS BINDABLE QUOTATION SHALL EXPIRE AT 5:00 pm E.S.T. on: 07/02/2026 Thank you for the opportunity to quote on this risk. For underwriting questions or concerns, please contact Patrick Cassidy at 2676054135 (phone) or [email protected] (email). Chubb Environmental Gerald J. Rojewski Chubb INA Excess and Surplus Insurance Services, Inc.
PA Surplus Lines Broker License #467816
MEMORANDUM
To: Alex Trinidad, Executive Director of FMS Date: 7/1/2026 From: Lori Schnaider, Executive Director of HR
Subject: Invoice Clarification – Insurance for Underground Storage Tanks The invoice from CHUBB Environmental / Arthur J. Gallagher Risk Management Services for the insurance premium to provide insurance to cover the underground storage tanks does not include the following taxes and fees. These will need to be paid with the invoice for the premium.
Surplus lines tax of $283.17
Stamping fee of $16.99
TRIA premium of $472
cc: Accounts Payable