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A`oCERTIFICATE OF LIABILITY INSURANCE <br />OATS (023 YYY <br />oslze/zz3RDO <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTANAME: CT Marsh Affinity <br />Marsh Affinity <br />PHONE Ex[: 80GT4381M =, No: <br />E-MAIL pDPTotalSource@marsh.com <br />ADDRESS: <br />a division of Marsh USA LLC. <br />PO BOX 14404 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />Des MOlnee, IA 503069686 <br />INSURER A: New Hampshire Insurance Co. <br />23841 <br />INSURED <br />INSURERS: <br />INSURER C: <br />ADP TolaGource NH XXVIII, Inc. <br />INSURER D: <br />5800 Windward Parkway <br />Alpha.", GA 30005 <br />Alternate Employer: <br />INSURER E: <br />INSURER F: <br />Invengo American Corp <br />536 SILICON DRIVE STE 100 <br />Southlake, TX 760920000 <br />COVERAGES CERTIFICATE NUMBER: 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 />TYPEOFINSURANCE <br />ADDL <br />INSD <br />UBR <br />WVD <br />POLICY NUMBER <br />POLICYEFF <br />(MMMDIYYYY) <br />POUCYEXP <br />(MMIDDIYYYY) <br />LIMITS <br />COMMERCIALGENERAL LIABILITY <br />CLAIMS -MADE ❑OCCUR <br />EACH OCCURRENCE <br />It <br />DAMAGETO RENTED <br />PREMISES (Ea occurrence) <br />$ <br />MED EXP (Any one person) <br />$ <br />PERSONAL&ADV INJURY <br />$ <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑JECT r]LOC <br />OTHER: <br />GENERALAGGREGATE <br />It <br />PRODUCTS AGG <br />IO <br />$ <br />$ <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />H <br />I <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />F_ <br />8 <br />UMBRELLA UABH <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED1 I RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />ANDEMPLOYERS LIABILITY YIN <br />ANYPROPRIETOR/PARTNERTEXEWTIVE ❑ <br />OFFICE"EMBER EXCLUDED? <br />(Mandatory In NH) <br />R yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />WC 034275014 TX <br />07/01/2023 <br />0710112024 <br />X STATUTE ER <br />E.L EACH ACCIDENT <br />$ 2,000,001) <br />EL DISEASE -EA EMPLOYEE <br />8 2JXO,000 <br />E.L. DISEASE -POLICY LIMIT <br />$ 2.0=000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 1DI, Additional Remarks Schedule, may be attached if more space Is requiredl <br />All wcrksits employees working for Invengo American Corp paid under ADP TOTALSOURCE, INC.'s payroll, <br />are covered under the above slated policy. Invengo American Carp is an alternate employer under this <br />policy. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <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 REFRESGNIAIIVE <br />The ACORD name and logo are registered marks of ACORD <br />ar RWeMarugenenlDbislon <br />RENEWED 6 APPROVED BY: <br />® Rlsk Management Spectalut <br />