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ACC)Rb CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDD /YYYY) <br />7/812015 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL_ INSURED, the policy(Les) must be endorsed. If SUBROGRATION IS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does <br />not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER OnPoint UndeNvriting Inc. <br />CONTACT NAME: Steven McComb <br />0390 E Crescent Pkwy, Suite 200 <br />PHONE (A /C, No Ext): (360)82B-0644 FAX (A /CG NO): (360) 828 -0699 <br />Greenwood Village, CO 80111 <br />SUBR <br />POLICYNUMBER <br />EMAIL ADDRESS: <br />POLICY EXP <br />INSURERS) AFFORDING COVERAGE NAIC # <br />INSURER A: ACE American Insurance Company 22667 <br />INSURER B. <br />INSURED <br />Barrett Business Services, Inc. UC /F <br />INSURER C: <br />CALIFORNIA PROFESSIONAL ENGINEERING INC. <br />INSURER D: <br />929 OTTERSEIN AVE UNIT E <br />INSURER E: <br />ROWLAND HEIGHTS, CA 91748 <br />INSURER P <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 INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUES OR MAY PERTAIN. THE INSURANCE AFFORDED BY <br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED <br />BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />ABBE <br />SUBR <br />POLICYNUMBER <br />POIJCYEFF <br />POLICY EXP <br />LIMITS <br />LTR <br />INSR <br />WVD <br />(MMIDOIYYYY) <br />(MMIDDIYYYY) <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GFNERAI- LIABILITY <br />DAMAGE TO RENTED PREMISES E. <br />$ <br />CLAIMS -WADE 1:1 <br />-_ <br />EXGCCUR ore) <br />WEED D EXP (Any one person) <br />$ <br />PERSONAL &ADV INJURY v <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODIICT$GOMPIOP AGG <br />$ <br />POLICY PROJ- LOC <br />a <br />ECT <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea ncsldant) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />i <br />ALL OWNED AUTOS SCHEDULED AUTOS <br />FARED AUTOS NON -OWNED AUTOS <br />BODILY INJURY (Per accirI <br />$ <br />PROPERTY DAMAGE <br />$ <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS IJAS <br />OCCUR <br />AGGREGATE <br />$ <br />DEU <br />RETEN TON '$ <br />A <br />WORKERS COMPENSATION AND EMPLOYERS' <br />RW6 <br />12119114 <br />12/0 /2-0 <br />115 <br />We STATU <br />OTH- <br />LIABILITY YIN <br />648161562 <br />TORYUMITS <br />ER <br />.__. <br />E.I. EACH ACCIDENT <br />ANY PROPRIE-rOR /PARTNER! EXECUTIVE Y <br />OFFICEMMEMSER EXCLUDED? <br />Pl / A <br />Covered states: <br />E.I- .DISEASE - EA EMPLOYEE <br />§2,004000 <br />(Mandatory In NFL) If yes. does,ibe Under <br />DESCRIPTION OF OPERATIONS bolow <br />CA <br />E.L. DISEASE -POLICV LIMIT <br />§2,000.000 <br />OESCRIPTION OF OPERATIONS 1 LOCATIONS (VEHICLES (Altesh ACORD 101, Additional Remarks Snhedulo. if more mace is roquusd) <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana <br />EXPIRATION DATA THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE <br />POLICY PROVISIONS. <br />WITH THE <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701 <br />a—NCV–� <br />Richard Poling <br />c) 1908 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are r glstere marks of ACORD. <br />CALIFORNIA PROFESSIONAL ENGINEERING A- 2015 -090 REVIEWED BY. 0L EUNICE HEREDIA (PG 6 OF 7) <br />