PCR SERVICES CORPORATION 2 - 2012

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DATE(M14/12YYY) CERTIFICATE OF LIABILITY INSURANCE 08!14/12 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 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 CONTACT Aon Risk Services, Inc of Florida NAME: Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite #1100 PHONE FAX Miami, FL 33131-4937 MA No, Ext : 800-743-8130 (A/C, No): 800-522-7514 EMAIL ADDRESS: AD P. COI. Center@Aon.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : National Union Fire Ins Cc of Pittsburgh 19445 INSURED ADP TotalSource FL XVI, Inc. INSURER B 10200 Sunset Drive INSURER C : Miami, FL 33173 L/C/F INSURER D : PCR Services Corporation INSURER E 1 Venture Suite 150 Irvine, CA 92618 INSURER F : COVERAGES CERTIFICATE NUMBER: 508447 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. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MMIDD/YYYY) MM/DO/YYYY GENERAL LIABILITY EACH OCCURRENCE $ GENERAL LIABILITY DAMAGES ( RENTED TO PREMISES Ea occurrence $ CLAIMS-MADE F-1 OCCUR MED EXP An one person) $ PERSONAL 8 ADV INJURY $ ROV S TO FO M&I GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PROJECT LOC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ G ANY AUTO BODILY INJURY Per person) $ ALL OWNED SCHEDULED HOME AUTOS AUTOS BODILY INJURY Per accident $ ta; NON-OWNED ty Attormy P RTY DAMA E HIREDAUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC RETENTION $ WORKERS COMPENSATION X WC STATU- OTH- A AND EMPLOYERS' LIABILITY YIN WC 038096984 CA 08/01/12 07/01/13 TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 71 NIA E.L. EACH ACCIDENT $ 2,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 2,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) All worksite employees working for the above named client company, paid under ADP TOTAL SOURCE, INC's payroll, are covered under the above stated policy. CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE 0,1i 'o o:lPiee, Arse a dl%,ida ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD