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!E R!w CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDNWY) 05/21/2020 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 statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement($). PRODUCER Doug Jones Justworks c/o Artex Risk Solutions, Inc. 8840 E. Chaparral Rd.; Suite 275 CONTACT NAME: Justworks Customer Success PHONE (gg8) 534-1711 FAXMICNo E-MAIL _ADDRESS: support@justworks.com INSURER(S)AFFORDING COVERAGE NAIC 0 Scottsdale, AZ 85250 INSURER A: American Zurich Insurance Company 40142 INSURED Justworks Employment Group LLC Labor Contractor, for co -employees of: eenevate, Inc. INSURER e INSURER C INSURER D : 55 Water Street 29th Floor New York, NY 10041 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:20NY0171006023 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUBR INSID MD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDMIYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 0OCCUR EACH OCCURRENCE $ DAMAGE TO RE PREMISES Es occurrence I $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ GEN-L POLICY JECT LOG PRODUCTS-COMPIOP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED ASCHEDULED AUTOS ONLY UTOS BODILY INJURY Per accident) $ HIRED id NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS YIN X PER OTH� STATUTE ER E.L. EACH ACCIDENT $ 2000000 A OFFICANYPRORIMEMB REXCLUDE�I ECUTIVE ❑ NIA WC 49-71-166-01 0610112020 06101l2021 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS below Location Coverage Period: 06/01/2020 06/01/2021 Client# 25327-GA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Coverage is provided for Bon9Vate, Inc. only (hose co -employees 3423 Piedmont Road NE Suite 216 of, but not subcontractors Atlanta, GA 30305 to: TE HOLDER Benevate, Inc. 3423 Piedmont Road NE Suite 216 Atlanta, GA 30305 AUTHORIZED REPRESENTATIVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROV ,ryy=snv Risk Mmmgartent Division, a/ REVIEWED&ryAPP'R: +OVED BY: 8 fvI� d:;s�e T+,. lf�" Risk Management /amain[ 1988.2015 ACORD C ACORD 25 (2016/03) The ACORD name and l000 are registered marks of ACORD