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1 <br />°►� CERTIFICATE OF LIABILITY INSURANCE <br />GATE (MMIOOIYYYY) <br />09/03/2020 <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 />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 />PRODUCER <br />Doug Jones Justworks <br />Go Artex Risk Solutions, Inc. <br />8840 E. Chaparral Rd.; Suite 275 <br />Scottsdale, AZ 85250 <br />TACT <br />NAME, Justworks Customer Success <br />PHONE 888 534-1711 F' <br />E-MAIL ort ustworks.com <br />ADDRESS: su pp @1 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC If <br />INSURER A: American Zurich Insurance Company <br />40142 <br />INSURED <br />Justworks Employment Group LLC Labor Contractor, for co -employees of: Desmond, <br />Marcello & Amster, LLC <br />INSURER B : <br />INSURER C <br />PO BOX 7119 Church Street Station <br />INSURER D: <br />INSURER E <br />New York, NY 10008-7119 <br />INSURER F : <br />RAGES CERTIFICATE NUMBER' 20NY0171007122 REVISION RUMBtK: <br />COVE <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 />INSR I TYPE OF INSURANCE ADOL SUBR POLICY NUMBER MMIUDnrYYY MM/DOIYYYY LIMITS <br />TR <br />COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br />OA GETORENT <br />CLAIMS -MADE E OCCUR PREMISES Ea occurrence $ <br />MED EXP (Any one person) $ <br />PERSONAL &ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ <br />POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ <br />OTHER: COMBINED SINGLE LIMIT <br />AUTOMOBILELIASIUTY Ea accitlenl $ <br />ANY AUTO BODILY INJURY (Per person) $ <br />OWNED SCHEDULED BODILY INJURY (Per accident) $ <br />AUTOS ONLY AUTOS <br />HIRED NON-0WNED PROPERTY DAMAGE $ <br />AUTOS ONLY AUTOS ONLY Per accident <br />UMBRELLA LIAB OCCUR EACHOCCURRENCE $ <br />EXCESS LIAB CLAIMS -MADE AGGREGATE $ <br />DEO RETENTION$ A $ <br />WORKERS COMPENSATION I X STATUTE I I ER <br />AND EMPLOYERS' LIABILITY YIN <br />A OFFIOEPRIET WPXCLUDEEXECUTIVE ❑ N/A WC 49-71-032-01 06/01/2020 OB/01/2021 E.L. EACH ACCIDENT $ 2,000 ODD <br />E.L. DISEASE -EA EMPLOYE $ 2,DDO,000 <br />(Mandatory in NH) <br />If yes, describe under DESCRIPTION OOPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 <br />F <br />Location Coverage Period: 06/01/2020 06/01/2021 Client# 53146-CA <br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may beattached'd more space is required) <br />provided for Desmond, Marcello&Amster, LLC <br />Coverage is pro6060 Center Drive Ste 825 <br />only those co-employeesvidedfor <br />of, but not subcontractors Los Angeles, CA 90045 <br />to: <br />City of Santa Ana <br />dba: Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />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 PROVRNk E/ <br />EDDivision <br />RENEW <br />1 <br />f�li+ryr.t R. VtlLvlul <br />Risk Management Analyst <br />©1988-2015 ACORD <br />ACORD 25 (2016103) The ACORD name and loco are registered marks of ACORD <br />City of Santa Ana <br />dba: Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />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 PROVRNk E/ <br />EDDivision <br />RENEW <br />1 <br />f�li+ryr.t R. VtlLvlul <br />Risk Management Analyst <br />©1988-2015 ACORD <br />ACORD 25 (2016103) The ACORD name and loco are registered marks of ACORD <br />