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pennsAvania <br />DEPARTMENT OF LABOR & INDUSTRY <br />STATE WORKERS' INSURANCE FUND <br />CERTIFICATE OF INSURANCE <br />Certificate Issued to: <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />This is to certify that Policy Number 06259400 issued in the name of: <br />Zoo Advisors LLC <br />113 Tenby Rd <br />Havertown, PA 19083 <br />Is in force on the date hereof, as follows <br />Kind of Insurance: Workers' Compensation and Employers Liability <br />Policy Period: Effective: 03/06/2019 at 12:01 AM <br />Expiration: 03/06/2020 at 12:01 AM <br />Limits of Liability: Workers' Compensation Insurance fully complies with the provisions of the <br />Pennsylvania Workers' Compensation Act and the Pennsylvania Occupational Disease Act as <br />re-enacted. <br />Employers Liability Insurance: <br />Bodily Injury by Accident $100,000 Each Accident <br />Bodily Injury by Disease $100,000 Each Employee <br />Bodily Injury by Disease $500,000 Policy Limit <br />Job/Site Memo: Certificate covers only Pennsylvania Employees. <br />***BE ADVISED THAT THIS POLICY ONLY COVERS SALES AND/OR CLERICAL. IF THE <br />EMPLOYEES ARE PERFORMING ANY OTHER FUNCTION, PLEASE NOTIFY SWIF.*** <br />Description of Work Covered: <br />0951 SALESPERSON - OUTSIDE <br />day' � <br />Coverage includes all operations incidental to the business of the insured f®or �P Mania <br />employees only and includes Pennsylvania employees whose duties requiT"" m to go beyo <br />the territorial limits of the Commonwealth as provided by Section 305.2 of Pennsylvania <br />Compensation Act as amended. G,\e <br />ca\p <br />30-Day Cancellation Clause: In accordance with the procedures forgaftellatig tko�81ate <br />Workers' Insurance Fund will endeavor to give 30 days notice before the cancel 1 n becomes <br />effective. However, the policyholder may cancel forthwith without prior notice to SWIF. <br />SWIF - POL077A Page 2 of 3 <br />Department of Labor & Industry I State Workers' Insurance Fund 1 100 Lackawanna Avenue <br />P.O. Box 5100 1 Scranton, PA 18505-5100 1 570-963-4635 1 www.dli.state.pa.us/swif <br />Auxiliary aids and services are available upon request to individuals with disabilities. <br />Equal Opportunity Employer/Program <br />