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be <br />A`OR" CERTIFICATE OF LIABILITY INSURANCE <br />GATEMMID 211, M <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 />Assurance, a Marsh & McLennan Agency LLC company <br />20 North Martingale Road <br />Suite 100 <br />Schaumburg IL 60173 <br />CONTACT <br />NAME: WhitneyPlumery <br />PHONE 312 625-5597 ac No: 847 440-9126 <br />Exth <br />ADDRESS: wplumery@assuranceagency.com <br />INSURERS AFFORDING COVERAGE <br />NAIC0 <br />INSURER A: Benchmark Insurance Company <br />41394 <br />INSURED TRUSTEM-01 <br />Trust Temporary Services, Inc. dba Helpmates Staff <br />1200 Main Street <br />INSURER B: Philadelphia Indemnity Insurance <br />18058 <br />INSURER : Coalition Insurance Solutions <br />INSURER D: <br />Suite A <br />Irvine CA 92614 <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 797071742 REVISION NUMBER - <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 <br />LTR <br />rypE OF INSURANCE <br />ADDLSUBR <br />POLICY NUMBER <br />POLICYEFF <br />IMMIDD1YYYY1 <br />POLICYEXP <br />MMIDOIYYNY1 <br />LIMITS <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 1XI OCCUR <br />PHPK2256963 <br />4/1/2021 <br />4/l/2022 <br />EACH OCCURRENCE <br />$1.000.000 <br />DAMAGETORENTED <br />PREMISES E. occurrence <br />$1,000,00o <br />MED EXP (Any one person) <br />$ 20,000 <br />PERSONAL &ADV INJURY <br />$1.000,000 <br />DEVIL <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY D jE`CT LOC <br />GENERALAGGREGATE <br />$2.000,000 <br />X <br />PRODUCTS - COMP/OP AGG <br />$2,000,000 <br />$ <br />OTHER: <br />B <br />PHPK2256963 <br />4/1/2021 <br />4/l/2022 <br />COMBINED SINGLE LIMIT <br />Ea accidentANY <br />$1,000,000 <br />NJURY(Per person) <br />$ <br />AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />POMOBIUEUABIUTY <br />RY Per accident <br />( )HIRED <br />$ <br />X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />DAMAGE <br />$ <br />E=2y <br />B <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />PHUB762457 <br />4/1/2021 <br />4/l/2022 <br />RRENCE <br />$5,000,000 <br />E <br />$5,000,000 <br />EXCESS LNB <br />CLAIMS -MADE <br />RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />WCBITS000014400 <br />8/9/2020 <br />8/9/2021 <br />E ERH <br />E.L. EACH ACCIDENT <br />' <br />$1,000.000 <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? F­N1 <br />N/A <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory In NH) <br />If yes, tlescnba antler <br />DESCRIP ION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1.000.000 <br />B <br />Come - Client Property <br />PHSD1619270 <br />4/1/2021 <br />4/1/2022 <br />Limit <br />3.000,000 <br />B <br />C <br />Professional Liability <br />Cyber Liability <br />PHPK2256963 <br />C4MJT008811CYBER2021 <br />4/1/2021 <br />4/1/2021 <br />4/1/2022 <br />4/1/2022 <br />Occ/Agg, <br />Limit <br />$2M/$4M <br />1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more space is required) <br />Proof of Insurance <br />Re: City of Santa Ana Agreement No. A-2018-148 <br />It is agreed that the following are added as Additional Insureds, when required by written contract, on the General Liability on a primary and non-contributory <br />basis with respect to operations performed by the Named Insured in connection with this project: THE CITY OF SANTA ANA, ITS OFFICERS , EMPLOYEES, <br />AGENTS, AND REPRESENTATIVE <br />A Blanket 30 Day Notice of Cancellation applies to the General Liability and Hired and Non -Owned Automobile Policies. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th floor <br />Santa Ana CA 92701 <br />ACORD 25 (2016103) <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 PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />RlBrmadikl. <br />REVIEWED&EDfi APMO/V®BY: <br />©1988.2015 ACORD C s, F�.1.arnn t)?, V:LlfI 1YA� <br />The ACORD name and logo are registered marks of ACORD <br />Risk Management Analyst <br />