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GOVESTA-02 MPEAK
<br />A4CC> CERTIFICATE OF LIABILITY INSURANCE DAT6(MMmnmvvl
<br />1 1211812014
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polloy(les) must be endorsed, If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such ondorsement(s).
<br />PRODUCER
<br />CTK North American Insurance Services, LLC
<br />1240 North Lakeview Avenue, #240
<br />Anaheim, CA 92607
<br />CONTACT
<br />NAMM
<br />_
<br />PHo , (714) 779.2000 Acx Na : 714 778 4128
<br />e -MAIL
<br />E -MAI
<br />.��IN$tatER{57 AFFORTNO COVERAGa
<br />NACN_
<br />X
<br />ENSURER A: Zurich American Insurance Co. of IL
<br />27855
<br />0511012015
<br />INSURED
<br />INSURERB:American Guarantee and Liabill Ins. Co.
<br />26247
<br />I"SURER c'
<br />__,_
<br />MED E%P IAn ore eBon) $10,00
<br />Government Staffing Service dba: Munitemps
<br />P.O- Box 718
<br />Imperial Beach, CA 91983
<br />INSURER D:
<br />INSURER E: .. ._
<br />INSURER P:
<br />___ J^�
<br />PERSONAL&ADVINJURY $ .. 1,000,0_0
<br />__�_.
<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.
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<br />R
<br />TYPE OF INSURANCE
<br />POLICY N MaER .�MMIDONYFP
<br />MIDD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENER�ALUASIUTY
<br />CLAIMS -MADE t ^ I OCCUR
<br />X
<br />PRA969B06302
<br />0511012014
<br />0511012015
<br />EACHOCCURRENCE $ 1,000,00
<br />PREMISES a er,ce $ 100,000_..
<br />__,_
<br />MED E%P IAn ore eBon) $10,00
<br />___ J^�
<br />PERSONAL&ADVINJURY $ .. 1,000,0_0
<br />__�_.
<br />_
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POUCY ❑ EE T ' LOC
<br />GENERALAGGREGATE SLL
<br />2,000,00
<br />PRODUCTS-COMPIOP AGO $ ...... 2,000,00
<br />O E
<br />$
<br />AUTOMOBILE UADIUTY
<br />OaoGtleMSN t /MIT $ 1,000,00
<br />A
<br />ANY AUTO
<br />PRA969906302
<br />05/1012014
<br />06110/2016
<br />OODILY INJURY /Par pereon) $
<br />^- AALL Ur09�lED SCHAUTEDULED
<br />y` HIRED AUTOS X 11NAUTOS
<br />84DlLY IN,R7RY {PeraecplanC §
<br />Per erg Id nEAG $
<br />I
<br />X
<br />UMBREUALIAS X
<br />OCCUR
<br />OCCURRENCE $ 1,000,00
<br />_EACH
<br />AGGREGATE $ 1,094,04
<br />B
<br />F7
<br />EXCESS UAB
<br />CLAIMSMAUE
<br />UMS948734702
<br />0511012014
<br />05/1012415
<br />»�-...� $ •...,�R._.^..
<br />BED X RETENTK)N
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' UABIUTY
<br />ANYPROPRIErOR/PARTNERIEXECUTNE YIN
<br />CFRCERRMEMBER EXCLUDE01 F-1
<br />NIA
<br />_ TAT TE ERH —
<br />E.L iE CHACCIDENT S
<br />E, L, DISEASE •EA EMPLOYE $
<br />(Myaanedatory In NH}
<br />OESGRIPTION OF OPERATIONS bn w
<br />E.L DISEASE PCH $
<br />A
<br />Crime
<br />PRA969906302
<br />05110/2014
<br />06/10/2015
<br />2,600 Deductible 100,00
<br />A
<br />Prof. Liability
<br />PRAD69906302
<br />06110/2014
<br />05/10/2016
<br />$1M1$2M
<br />DESCRPt1ON OF OPERATIONS/ LOCATIONS i VEHICLES (ACORO 104, AddWanat Ramarka Sanedaie, mey ba aaachad amara space N reNuirad)
<br />Schedule of Named insured($)
<br />Govornment Staffing Service dba I'd
<br />Herrera & Associates Staffing Services �`� 'c'' .��U_!�'
<br />Government Staffing Service dba: Munigroup
<br />Government Staffing Service dba: Mundamps -'
<br />Government Staffing Service dba: Munistaff
<br />SEE ATTACHED ACORD 101
<br />City of Santa Ana
<br />Attn: Ellen Smiley
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE 09WVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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