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Ac®RH CERTIFICATE OF LIABILITY INSURANCE III DATE (MM/DD/YYYY) 9/27/2017 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(ies) must be endorsed. If SUBROGRATION 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 Willis Towers Watson CONTACT NAME: Ontario 12980 Metcalf Ave Suite 500 PHONE (A/C, No Ext): (909) 284-7540 FAX (A/C, NO): (360) 828-0699 Overland Park KS 66213 LIMITS LTR EMAIL ADDRESS: Angela.Scott@bbsihq.com INSR INSURER(S) AFFORDING COVERAGE iNAIC # INSURER A: 'ACE American Insurance Company 22667 INSURER B: INSURED Barrett Business Services, Inc. L/C/F INSURER C. DEKRA-LITE INDUSTRIES, INCORPORATED INSURER D: 3102 W ALTON AVE INSURER E SANTA ANA, CA 92704 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUES OR MAY PERTAIN. THE INSURANCE AFFORDED BV 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. INSR TYPE OF INSURANCE ADDL SUER POLICYNUMBER POLICYEFF POLICY EXP LIMITS LTR INSR Me (MM/DDIYYYY) (MMIDD/YYYYI GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMB-MADE ❑OCCUR DAMAGE TO RENTED PREMISES (En $ occurental MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG S POLICY POT J- LOC $ ECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) ALL OWNED AUTOS F_'] SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) g PROPERTY DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB OCCUR AGGREGATE $ DED RETENTION $ 1$ WORKERS COMPENSATION AND EMPLOYERS' RWC 10/01/17 10/01/2018`/ wcsrATU- OTH- LIABILITY VIN ANVCER/MEETOR/PARTNDE EXECUTIVE Y OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N/A X 064400125 Covered Stffie5: CA / J TORY LIMITS ER $2,000,000 E.L. EAEASE - ANT E.L. DISEASE - EA EMPLOYEE $2,000,000 E.L. DISEASE -POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) In the event of any payment under this policy for a Loss for which the named insured has waived the right of recovery in a written contract entered into prior to the Loss, insurer hereby agrees to also waive our right of recovery but only with respect to such Loss. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Santa Ana EXPIRATION DATA THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 Authorized Rep V/ c) 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD. 1 r