ALL CITY MANAGEMENT SERVICES INC. (ACMS) 5D - 2013

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bP CERTIFICATE OF LIABILITY INSURANCE °A / 9/ 0 Y"' 2 2 o 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(les) 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 Z.ONTAOT NAME: HR Comp LLC 7317 Cli PHONE FAX OAEXt)L8f5-44&'t5 ac yQL865-938-2b61 nton Hwy Suite 101 a00RESS: Powell, TN 37849 PROWLER INSURER(S) AFFORDING COVERAGE ^r_ NAIC M INSURED INSURER A : CNA HR Comp Payroll Services, LLC & _ ? INSURER 8: All City Management Services, Inc. INSURER C : 2910 S. Archibald Ave. #A643 - - - ---- Ont i CA 91761 INSURER D : _ ar o, INSURER E : INSURER F : COVERAGES CERTIFICATE NUMHFR: DcvlslnKI AttlaaMCD 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. IN LT LT TYPE OF INSURANCE ADDL A INAR S Min POLICY NUMBER POUCYEFF MMMIDO POLICY EXP MMro YD/YYXYPY I LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DA GE TO RENTED PREMISES(Eao2Wffer e) 5 CLAIMS-MADE OCCUR _ MED EXP (Any one person S PERSONAL & AOV INJURY $ T 4 E I GENERALAGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: ., POLICY j PRO• LOC ' . AUT OMOBILE LIABILITY j COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S ALL ONMEO AUTOS i BODILY INJURY (Pet person) S I SCHEOULEDAUTOS BODILY INJURY (Per accident) S? PROPERTY DAMAGE HIRED AUTOS i (Per accident) S NOWOWNED AUTOS I j S I UMBRELLA LIAR OCCUR i EACH OCCURRENCE t S EXCESS LIAR CLAIMS-MADE AGGREGATE ! S _ DEDUCTIBLE S I RETENTION S I S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N 1 4031615529 04/1712012 04117!2013 STATU• H-i X ANY PROPRIETORIPARTNER/EXECUTIVE ? OFFICERrMEMBEREXCLUOED? O I NIA ( E.L. EACH ACCIDENT 5 1 O (Mandatory a In NH) 1 E.L. DISEASE • EA EMPLOYE S ?. ?QQ,QOO.oa E.L. DISEASE • POLICY LIMIT S r I I1 r DESCRIPTION OF OPERATIONS] LOCATIONS /VEHICLES (Attach ACORD 10t, Additional Remarks Scheduls, If more apace Is required) This coverage is afforded only to All City Management Services, Inc., incase Evidence of Insurance for Workers Compensation coverage for employees of HR Comp that are recruited and screened by All City Management Services, Inc., and placed on assignment by HR Comp in coordination With All City Management Services, Inc. on behalf of the certificate holder. Client effective date: 0411712012. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE City of Santa Ana POLICY PROVISIONS. 20 Civic Center Plaza, M29 AUTHOR¢9aAI!F E-S-E MWTTiVE Santa Ana, CA 92702 ACORD 25 (2009/09) The ACORD name and logo are re 0 1988 2009 ACORD CORPORATION. All rights reserved. mar of ACORD