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Ar—" rtia l 'IlRL! CERTIFICATE OF LIABILITY INSURANCE DAIE (MWDD/YYYY) 1 05/21/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statementon this certificate does notconfer rights to the certificate holder in lieu of such endorsements . PRODUCER Aon Risk Services, Inc of Florida CONTACT Aon Risk Services, Inc of Florida NAME: PHONE FAX (A/C, No, Ext):800-743-8130 (A/C, No):800-522-7514 1001 Brickell BayDrNe, Suite#1100 Miami, FL 33131-4937 EMAIL ADDRESS ADP.COI.Certer@Aon.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: American Home Assurance Co. 19380 INSURED ADP TotalSource DE IV, Inc. INSURER B : INSURER C : 10200 Sunset Drive Miami, FL 33173 UC/F INSURER D : Keyser Marston Associates, Inc. 1299 Fourth St. Ste 408 INSURER E : INSURER F : San Rafael, CA 94901 COVERAGES CERTIFICATE NUMBER: 3295294 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERON IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITSSHOWNMAYHAVE BEENREDUCEDBYPAIDCLAIMS. LIMITSSHOWN AREAS REQUESTED. LTR TYPE OF INSURANCE INSR WVD POLICYNUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIALGENERAL LIABILITY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE S Ea occurrence) PREMISES PREMISES (Ea occurrence) $ MED EXP (Anyone person) $ PERSONAL&ADVINJURY $ GEN'LAGGREGATELIMITAPPLIESPER : POLICY PROJECT LOC OTHER GENERALAGGREGATE $ PRODUCTS- COMP/OPAGG $ $ AUTOMOBILE LIABILITY ANYAUTO OVMIED SCHEDULED AUTOSONLY AUTOS HIRED NON-OVMIED AUTOS ONLY AUTOS ONLY (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEC RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatoryin NH) If es, describe under DESCRIPTION OF OPERATIONS below NIA WC 027119589 CA 07/01/2020 07/01/2021 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE- EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATICNS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) See attached Certificate Holder Cancellation Notice. All worlsite employees worNng for KEYSER MARSTON ASSOCIATES, INC., paid under ADP TOTALSOURCE, INC'spayroll, are covered under the above stated policy. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Ri sk Manag ement Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD ACORD 25 (2016/03) The ACORD nam a and logo are registered marks of ACORD �oRaN RAManagementDiVisian REVIEWED & APPROVED BY. o r CMUM Risk Management Analyst