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_�. GOVESTA-02 PPISANO <br />ACERTIFICATE OF LIABILITY INSURANCE DAT612/2016 ) <br />THIS CERTIFICATE IS ISSUED ASA 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 CON§TITUT A i R T BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATL-a.�R4,,4 „Si� m �+ <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may( rggVJre�„�I.t. epdgrVpglgnt.f_ .l;tStemant on this certificate does not confer rights to the <br />PRODUCER <br />CTK North American Insurance Services, LLC <br />1240 North Lakeview Avenue, #240 <br />Anaheim, CA 92007 <br />INSURED <br />A —Oeo/"Y ` OC l oe <br />Government Staffing Service dba: Munitemps <br />P.O. Box 718 <br />Imperial Beach, CA 91933 <br />Zurich American Insuran <br />American Guarantee and <br />of IL <br />tv Ins. Co. <br />COVFRA('FS CERTIFICATE NLJMRFR-, REVISION NLIMRFRr <br />779.4129 <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 CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICHTHIS <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 />ILTR <br />TYPE OF INSURANCE <br />SU <br />INSD WVD. <br />POLICYNUMBER <br />MMIDDCIL <br />� <br />MMIDPA YYPY <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />i I <br />EACH OCCURRENCE $ 1,000,000 <br />CLAIMS -MADE � OCCUR <br />X <br />PRA969908303 <br />05/1012015 <br />0611012016 <br />PREMISES QgAoourrence)_„_ S 100,000 <br />MEDEXP(Any one person) $ 10,000 <br />PERSONAL&ADV INJURY $� 1,000,000 <br />I_ GE_N'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY JEC7 L00 <br />GENERAL AGGREGATE $ 2,000,000 <br />I <br />i <br />PRODUCTS - COMPIOP AGG $ 2,000,000 <br />r OTHER. <br />$ <br />AANY <br />AUTOMOBILE LIABILITY <br />AUTO <br />PRA969906303 <br />05/10/2016 <br />0611012016 <br />COMBINED SINGLE LIMIT <br />_Lacclde�0_ $ 1,000,000 <br />BODILY INJURY(Perperon) $ <br />ALLOWNED SCHEDULED <br />AUTOS AUTOS <br />HIREDAUTOS XAT09WNED <br />LXU <br />BODILY INJURY (Per accident) $ <br />OP=_ntA_- <br />_— <br />$ <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE $ 1,000,000 <br />AGGREGATE $ 1,000,000 <br />B <br />EXCESS LIAa <br />C AIMS -MADE <br />UMS946734703 <br />05/10/2016 <br />05110/2016 <br />DED I X RETENTIONS 0 <br />$ <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE YIN <br />OFFICPRIMEMER EXCLUDED? <br />IMandatary In NH) <br />PER OT - <br />STATUTE ER <br />E.L. EACH ACCIDENT Is <br />E.L. DISEASE - EA EMPLOYE $ <br />ifyes, describe under <br />DESCRI PTION OF OPERATIONS bel2w <br />E.L. DISEASE- POLICY LIMIT $ <br />A <br />Crime <br />PRA989906303 <br />05/10/2015 <br />06/10/2018 <br />2,500 Deductible 100,000 <br />A <br />Professional Liab <br />PRA969906303 <br />06/90/2016 <br />05/1012016 <br />$1ml$2m <br />DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD tot, Additional Remarks Schedule, may ba attached if mora space la raqulredl <br />Schedule of Named Insured(s) f�"' <br />Government Staffing Service des; Herrera &Associates Staffing Services - 4 J f A <br />Government Staffing Service dba: Munlgroup <br />Government Staffing Service dba: Munitemps <br />Government Staffing Service dba: Munistaff <br />SEE ATTACHED ACORD 101 <br />CF_RTIFICATE HOLDER CANCELLATION <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE <br />Cit of Santa Ana <br />City <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attn: Ellen Slnlley <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92701 <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD <br />