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``� CERTIFICATE OF LIABILITY INSURANCE DATOB/22/1, 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 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 endorsemerd(s). PRODUCER Ann Risk Services, ]beef Florida CONTACT NAME: Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite#1100 Miami, FL 33131-4937 A/C, No, Ent 800-743-8130 ( ) (AIC, No): 800-522-7514 EMAIL ADDRESS: ADP.COLCenter@A00.cOm INSURER(S) AFFORDING COVERAGE NAIC If INSURER A: American Home Assurance Co. 19380 INSURED ADP TotalSource I, Inc. INSURER B INSURER C : 10200 Sunset Drive Miami, FL 33173 INSURER D : IJC/F Chazey Partners Inc. 52 Chestnut Ave, INSURER E INSURER F : Los Gatos, CA 95030 �.WvL=rvw!Eaa CER11FIVNIC NUIYIGCR: zbuvtbB REVISION NIIMRFR- THIS IS TO CERTIFY THAT THE 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 RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY 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. LIMITS SHOWN ARE AS REQUESTED. INSR LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MMIOD/YYYY POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Eeocaunence $ MED EXP (My one Person $ PERSONAL a ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: POLICY PROJEQT❑ LOG GENERALAGGREGATE $ PRODUCTS - COMP/OP AGG $ OTHER AUTOMOBILE LIABILITY UELIMII Ea accident $ BODILY INJURY Per arson $ ANY AUTO OWNED BCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peraccitl.nl $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB CLAIMS -MADE DEC RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- X STATUTE ER A ANYPOFFICEIRIMETORIPAXCLUEXECUTIVE ❑ W EXCLUDED? N I A WC 080392099 CA 8/l/2019 7/1/2020 LL EACH ACCIDENT $ 2.000.000 E.L. pISEASE - EA EMPLOYEE $ 2,000,000 (Mandy y In NH) (Mandatory in NH) byes, erscnbeuneer E.L. DISEASE -POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS be. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) All worksile employees working for CHAZEY PARTNERS INC., paid under ADP TOTALSOURCE, INC a payroll, are covered under the above stated policy. REVIEWED & APPROVED IVI$ION CERTIFICATE HOLDER—, - --- CANCELLATION City Ana A ofMSanta Risk Management Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza, 4ih Floor THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0#on frisk 8etvLw.i, One o f(f to ada © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD