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ACCJFLL7� CERTIFICATE OF LIABILITY INSURANCE DA05/21'/202YY) 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((es) 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(s). PRODUCER Doug Jones Justworks c/o Artex Risk Solutions, Inc. 8840 E. Chaparral Rd.; Suite 275 CONTACT Justworks Customer Success NAME:ME: PHONE FAX QUIT (888 ) 5341711E,MAlc,Ne1: ADDRIESS: support@justworks.com INSURERS AFFORDING COVERAGE NAIC H Scottsdale, AZ 85260 INSURER A: American Zurich Insurance Company- 40142 _ INSURED Justworks Employment Group LLC Labor Contractor, for cc -employees of: Benevate, Inc. INSURER B : _ INSURERC: INSURER D 55 Water Street 291h 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 LTR TYPE OF INSURANCE ADDLSUBR INSD MD POLICYNUMBER POLICYEFF MMIDDNYYY POLICY EXP MM/DDiYTYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE1:1 OCCUR EACHOCCURRENCE $ D MAGETORE PREMISES E occurrence $ MED EXP Any one person) $ PERSONAL &ADV INJURY $ GENL AGGREGATE LIMIT APPLIES PER: POLICY❑JECTPRO- ❑ LOC GENERALAGGREGATE $ PRODUCTS-COMPIOP AGO $ $ OTHER: AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT Ea accidentl $ BODILY INJURY (Per person) _ $ ANY AUTO OWNED F7 SCHEDULED AUTOS ONLY AUTOS H BODILY INJURY P (Per accIdent) $ HIRED F7 NON -OWNED AUTOS ONLY AUTOS ONLY PROPEIff DAMAGE Per accidsnl $ UMBRELLALIAB OCCUR EACHOCCURRENCE $ _ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION ANDEMPLOYERSLIABILITY- YIN X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2000,000 A OFFIC ANYPRORPMEMBEREXCLU EO?ECUTIVE ❑ N/A WC 49-71-166-01 06/01/2020 06/01/2021 EL DISEASE - EA EMPLOYE _ $ 2,000,000 (Mandatory In NH). If yes, describe m dor DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ 2000,000 Location Coverage Period: 06/01/2020 06/01/2021 Client# 25327-GA DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Benevate, Inc. Coverage Is provided for 3423 Piedmont Road NE Suite 216 only those co -employees Atlanta, GA 30305 of, but not subcontractors to: Benevate, Inc, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3423 Piedmont Road NE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Suite 216 ACCORDANCE WITH THE POLICY PROV Atlanta, GA 30305 I AUTHORIZED REPRESENTATIVE y !•� sun RAMarn mentDWIon yry q REVIEWED SpAPPPROVED BY.' �-' tialq Management Analyst ©1988-2015 ACORD C � < _ - _ , . -. ACORD 25 (2016/031 The ACORD name and loco are registered marks of ACORD