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n d CERTIFICATE OF LIABILITY INSURANCE 5DATE /6% 02MM/DD/YYYY) 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 CONSTITUE 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 an endorsement(s). PRODUCER PAYCHEX INS AGENCY INC 150 SAWGRASS DR ROCHESTER, NY 14620 CONTACT NAME: PHONE (A/C. No. Ext.): (877) 362-6785 FAX (A/C. No. Ext.): (888) 872-8921 E-MAIL ADDRESS: paychexr@travelers.com INSURED INSURER(S) AFFORDING COVERAGE NAIC e INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA AMERICA ON TRACK INSURER B : 600 W SANTA ANA BLVD STE 710 SANTA ANA, CA 92701 INSURER C : INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. IN9R LTR TYPEOFINSURANCE DD INSO UB Me POLICYNUMBER POLICY EFF MMmC POLICY EXP MMmO LIMITS CO MMERCIALGENERALLMBILITY CLAIMS -MADE ❑ OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY O PROJECT OLOC OTHER EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea O.rv.. $ MED EXP (My one rsen $ PERSONAL S ADV INJURY $ GENERALAGGREGATE $ PRODUCTS-COMP/OP AGG S AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea acddent $ BODILY INJURY Per person)$ BODILY INJURY Per acddent $ PROPERTY DAMAGE Peracddent S S UMBRELLA LIMB OCCUR EXCESS LAS CLAIMS -MADE OEO ❑RETENTION EACH OCCURRENCE $ AGGREGATE $ q WORKERS COMPENSATION ANDEMPLOYERS'UMILITY YIN ANY PROPRIETORPARTNERIEXECUTIVE OFFICEWMEMBER EXCLUDED' (Mandatory in NH) E NYCS, desunbe uncer DESCRIPTION OF OPERATIONS BELOW N/A UB-3L272199-22-42 01/012022 01/0112023 V n PE BTANTE OT {R E.L. EACH ACCIDENT $1.000.000 E.L. DISEASE -EA EMPLOYEE $1,000.000 E.L. DISEASE -POLICY LIMIT $1.000.000 $ is DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) GERI IFIGATE HOLDER CANCELLATION CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED RISK MANAGEMENT DIVISION BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS AUTHHOORLIZFEEDREPRESENTATIVE SANTA ANA, CA 92701 ©1993-2015 ACORD--------'_' ACORD 25 (201613) The Acord name and logo are registered marks of ACOF o s RUkManepnentDisision a+N 1&MEWED 6 APPROVED Or s I � �,a A+gcr AuPufo Risk Management SproAist