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ACORbF CERTIFICATE OF LIABILITY INSURANCE <br />+fir Acct#: 1171322 <br />DATE(MMIDD/YYYY) <br />F <br />1 10/01/2017 <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(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <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 require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Lockton Companies, LLC <br />5847 San Felipe, Suite 320 <br />Houston, TX 77057 <br />CONTACT 888-828$365 <br />NAME:PHONE <br />I FAX <br />A/c No : <br />E-MAIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURER A: Ace American Insurance CO. 22667 <br />INSURED <br />Insperity, Inc. LIC/F <br />INSURER B: <br />INSURER C <br />KOSMONT 8 ASSOCIATES, INC. <br />19001 Crescent Springs Drive <br />Kingwood, TX 77339 <br />INSURER D <br />INSURER E: <br />INSURER F: <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence $ <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. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />IMMIDDrYYYY1 <br />POLICY EXP <br />(MMIDDNYYY)LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />CLAIMS -MADE FIOCCUR <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence $ <br />MED EXP (Any one person) $ <br />PERSONAL S ADV INJURY $ <br />GEN -L AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE $ <br />JPRO- PRO- ❑ LOC <br />PRODUCTS-COMP/OP AGG $ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ <br />Ea accident <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) $ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />PROPERTY DAMAGE $ <br />Per need I <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />XPER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT $ 1,000,000 <br />A <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />064742280 <br />10/01/2017 <br />10101/2018 <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE- POLICY LIMIT 1.000,000 <br />_�$ <br />" <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />I( V <br />nvEuCR <br />CITY OF SANTA ANA <br />ATTN: MARC MORLEY <br />20 CIVIC CENTER PLAZA (M-25) <br />SANTA ANA, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Ht Urvu w 1zu 1ru I I nu ear VMIJ 114111V unu Iuau are IUUIb1UrVU nrArN5 or Aa VMu <br />