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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) D8128/2021 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 endorsements . PRODUCER Ann Risk Services, Inc of Florida CONTACT NAME: Aon Risk Services, Inc of Florida 1001 Bdckell Bay Drive, Suite N1100 Mlaml, FL 33137-4937 NE FAX AIC No Ext: 800-743-8130 AIC No: 800522-7514 MAIL ADDRESS: ADPAOLOenter Aon.com INSURER(S) AFFORDING COVERAGE NAICIf INSURER A: AIU Insurance Company 19399 INSURED ADP TotalSoorce DE IV, Inc. INBURER B: INSURER C: 10200 Sunset Drive Mlaml, FL 33173 INSURER D: UGF Keyser Marston Associates, Inc. 1299 Fourth St. Ste 408 INSURER E San Rafael, CA 94901 INSURER F: 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. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MMIDDrMY MMIDDNYYY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACHOCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Anyno DWS01d $ PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PROJECT ❑ LOD GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGO $ OTHER $ AUTOMOBILE LIABILITY COMBINED SI OLE LIMITEa accident $ BODILY INJURY Per arson $ ANYAUTO OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peraccident $ UMBRELLA LIAB OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEC RETENTION$ A WORKERS COMPENSATION AND EMPLOYERS'LIASILITY YIN ANY PROPRIETORRARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA WC 038367524 CA 07/01/2021 07/01/2022 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory in NH) If yes, untler E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTIONOFOPERATIONSbelow IPTII DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) See attached Certificate Holder Cancellation Notice. All worksite employees working for KEYSER MARSTON ASSOCIATES, INC., paid under AUP TOTALSCURCE, INC's payroll, are covered under the above stated policy. CERTIFICATE HOLDER CANCELLATION Clly of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISInNs AUTHORIZED REPRESENTATIVE °' R4$?,1mi$etMdDiddWt �[ �4��e1 �tEWi'U 6m.}N�PRVJEO aY: (j R¢k Managrn,enttlenrol Aide ©1988-2015 ACORD CC ACORD 25 (2015103) The ACORD name and logo are registered marks of ACORD