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KIMCO STAFFING
INSURANCE NOT ON FILE WORK MAY NOT PROCEED CITY CLERK DATE: A-2023-122-04 u) CONSULTANT AGREEMENT BETWEEN THE CITY OF SANTA ANA AND �VOAS.J?Xv6m,-)f4 KIMCO STAFFING SERVICES, INC. FOR ON -CALL TEMPORARY STAFFING SERVICES N THIS AGREEMENT is made and entered into on this 20th day of June, 2023 by and between Kimco Staffmg Services, Inc. ("Consultant'), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of ® California ("City"). RECITALS A. On April 19, 2023 the City issues a Request for Proposal ("RFP") No. 23-051, by which it desired to retain a Consultant having special skill and knowledge in the field of temporary employee staffing services on an on -call basis for the City's Human Resources Department. B. Consultant submitted a responsive proposal that was among those selected by the City. Consultant represents that it is able and willing to provide such services described in the scope of work that was included in the RFP No. 23-051. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform the services that were described in the scope of work included in the RFP No. 23-051, during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in "Scope of Services - Exhibit All, attached hereto and incorporated by reference, and as further described in Consultant's Proposal, attached hereto an incorporated herein by this reference as "Consultant's Proposal - Exhibit B". 2. COMPENSATION a. City neither warrants nor guarantees any minimum or maximum compensation to Consultant tinder this Agreement. Consultant shall be paid only for actual services performed under this Agreement at the rates and charges identified in Consultant's Fee Proposal, which is attached hereto and fully incorporated herein by this reference as "Compensation - Exhibit C". Consultant is one of eight (8) separate consultants selected to provide services on an on -call basis under RFP No. 23-051. The total compensation for services provided by all consultants selected under RFP No. 23-051 shall not exceed the shared aggregate amount of $2,000,000.00 during the term of this Agreement, including any extension periods, as set forth in Section 3, below. Page 1 of 10 b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures, Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. c. Notwithstanding any contrary terms contained within Consultant's Fee Proposal, Consultant's fees shall not exceed 3% annually over the term of this Agreement, including any extension periods, unless directly affected by Prevailing Wage laws, 3. TERM This Agreement shall commence on July 1, 2023 and end on June 30, 2026 for an initial three-year term, with the option for the City to grant tip to two, one-year extensions exercisable by a writing by the City Manager and the City Attorney, unless terminated earlier in accordance with Section 15, below, 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subconsultants to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subconsultant prepares under this Agreement, Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data, Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Page 2 of 10 Consultant shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder and the results of that work by the Consultant, its agents, representatives, employees or subconsultauts. a. Consultant shall not commence work for the City until it has provided evidence satisfactory to the City that it has secured all insurance required under this Section. In addition, Consultant shall not allow any subconsultant to commence work on any subcontract until it has secured all insurance required under this Section. b. Insurance coverage shall be at least as broad as: (i) Commercial General Liability (CGL): Insurance Services Office Form CO 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000.00 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CO 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. (ii) Automobile Liability. Insurance Services Office ("ISO") Form Number CA 00 01 covering, Code 1 (any auto), or if Consultant has no owned autos, Code 8 (hired) and 9 (non -owned), with limit no less than $1,000,000.00 per accident for bodily injury and property damage. (iii) Workers' Compensation insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000.00 per accident for bodily injury or disease. (iv) Professional Liability (Errors and Omissions) Insurance appropriates to the Consultant's profession, with limit no less than $1,000,000.00 per occurrence or claim, $2,000,000.00 aggregate. (v) If the Consultant maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Consultant. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. c. Other Insurance Provisions. The insurance policies are to contain, or be endorsed to contain, the following provisions: (i) Additional Insured Status, The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGI, policy with respect to liability arising out of work or operations Page 3 of 10 performed by or on behalf of the Consultant including, materials, parts, or equipment furnished in connection with such work or, operations. General liability coverage can be provided in the form of an endorsement to the Consultant's insurance (at least as broad as ISO Form CG 20 10 1185 or both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 forms if later revisions used). (it) Primary Coverage. For any claims related to this contract, the Consultant's insurance coverage shall be primary insurance primary coverage at least as broad as ISO CG 20 01 04 13 as respects the City, its officers, officials, employees, and volunteers. Any insurance or self- insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Consultant's insurance and shall not contribute with it. (iii)luotiee of Cancellation. Each insurance policy required above shall state that coverage shall not: be canceled, except with notice to the City, (iv) Waiver of Subrogation. Consultant hereby grants to City a waiver of any right to subrogation which any insurer of said Consultant may acquire against the City by virtue of the payment of any loss under such insurance, Consultant agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. (v) Self -Insured Retentions. Self -insured retentions must be declared to and approved by the City. The City may require the Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self -insured retention may be satisfied by either the named insured or City. (vi)Acceptability of Insurers. Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A: VII, unless otherwise acceptable to the City. (vii) Verification of Coverage. Consultant shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins, However, failure to obtain the required documents prior to the work beginning shall not waive the Consultant's obligation to provide them, The City reserves the right to require Page 4 of 10 ebinpere, certified copies of all required insurance policies, including , endorsements required by these specifications, at anytime. (viii) Special Risks or Circumstances. City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. 7. INDEMNIFICATION The Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from , the negligent operations, or any willful misconduct, of Consultant, its subconsultants, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 'of this Agreement;, and (2)"from any claim that personal injury, damages, just compensation,,, restitution, judicial or equitable:relief is due by reason of the terms of or effects arising From this :Agreement, This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terns of, or effects, arising from 'this Agreement. City -may snake all reasonable decisions with respect to its representation in any legal proceeding, Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil. Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant, - The City agrees to defend, and shall indemnify and hold harmless the Consultant, its officers, agents, employees, consultants, special counsel, and representatives from liability; (1) for personal igjriry, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations,, or willful misconduct, of the City, its subconsultants, agents, employees, or'other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (Z) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. Consultant may make all reasonable decisions with respect to its representation in any legal proceeding. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. Page 5 of 10 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably 5understood to be confidential and/or proprietary; Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like. importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either panty by any subsidiary and/or agent of tho4otber party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any - information that (a) has been disclosed in publicly available sources; (b) is, -through no fault of the Consultant disclosed in a publicly available source; (o) is in rightful possession of the Consultant without an obligation of confidentiality;'(d) is required to be disclosed -by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 11. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any mariner with performance of servicesspecified under this Agreement. 12, NON-DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this Agreement. Consultant affirins that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations, Page 6 of 10 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terns of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that areinconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein: 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void, Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultant and/or consultants retained by City. 15, TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions, a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement, 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a. continuing waiver unless the writing so specifies. Page 7 of 10 17. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties farther agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 18. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers,and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies, Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions, Said inability shall be cause for termination of this Agreement. 19. NOTICE Any notice, tender, dernand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Jennifer L. Hall City Cleric , City of Santa Ana 20 Civic Center Plaza (1\4-30) P,O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Jason Motsicic Executive Director of Human Resources City of Santa Ana 20 Civic Center Plaza P.O. Box 1988 Santa Ana, California 92702 Page 8 of 10 To Consultant. Leticia ICelch Vice President Kimco Staffing Services, Inc, 17872 Cowan Ave, hvine, CA 92614 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address, If sent by mail, commmunication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 20, MISCELLANEOUS PROVISIONS a, Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. [Signatures on Following Page] Page 9 of 10 A-2023-122-04 SIGNATURE PAGE FOR CONSULTANT AGREENIL, NT BETWEEN THE CITY OF SANTA ANA AND HIMCO STAFFING SERVICES, INC. FOR ON -CALL TEMPORARY STAFFING SERVICES IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. s IN APPROVED AS TO FORM: SONIA R, CARVALHO City Attorney 704HAN T. MART `Assistant City Attorney RECOMMENDED FOR APPROVAL: J,A,KON MOTSICI{ �xecuiive Director Human Resources Department CITY OF SANTA ANA 7� IWSTINE RIDGE City Manager CONSULTANT: T TICI KELCH Vice President Page 10 of 10 NOTICE OF COMPLIANCE CITY "A,AM I1111RINT I'III I Pi I1111 AGE AND INCLUDE Ck I 111 1AGREEMENTTOT111I➢C CLERK CSC 1111IE COUNCIL Contractor Kimco Staffing Services, Inc. Name: Project A-2023-122-04 Number: Project Consultant Agreement Between The City Of Santa Ana And Kimco Name: Staffing Services, Inc. For On -Call Temporary Staffing Services The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: TYPE OF INSURANCE POLICY EXPIRATION COI DATE FILE NAME NUMBER DATE 23-24 All Lines AUTOMOBILE LIABILITY PHPK2599195 09/01/2024 09/01/2023 22-23 WC - City of Santa Ana - COLpdf 23-24 All Lines GENERAL LIABILITY PHPK2599195 09/01/2024 09/01/2023 22-23 WC - City ; of Santa Ana - COLpdf 23-24 All Lines PROFESSIONAL LIABILITY PHPK2599195 : 09/01/2024 09/01/2023 22-23 WC - City of Santa Ana - COLpdf WORKERS COMPENSATION AND RWD300121606 12/31/2023 06/30/2023 KIMCO Staffing EMPLOYERS' LIABILITY COLpdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 9/11/2023 1:13 PM NOTICE OF COMPLIANCE CITY W Y "A';CCC. I1111RI C T' I'III:I Pi 1111AGE AND INCLUDE Ck IT111 1AGREEMENTTOT111I➢C CLERK CSC 1111IE COUNCIL Contractor Kimco Staffing Services, Inc. Name: Project A-2023-122-04 Number: Project Consultant Agreement Between The City Of Santa Ana And Kimco Name: Staffing Services, Inc. For On -Call Temporary Staffing Services The Certificate of Insurance (COI) submitted indicates that the coverages comply with the insurance requirements. The compliant coverage(s) are: TYPE OF INSURANCE POLICY EXPIRATION COI DATE FILE NAME NUMBER DATE 23-24 All Lines AUTOMOBILE LIABILITY PHPK2599195 09/01/2024 09/01/2023 22-23 WC - City of Santa Ana - COLpdf 23-24 All Lines GENERAL LIABILITY PHPK2599195 : 09/01/2024 09/01/2023 22-23 WC - City of Santa Ana - COLpdf 23-24 All Lines PROFESSIONAL LIABILITY PHPK2599195 09/01/2024 09/01/2023 22-23 WC - City of Santa Ana - COLpdf 23-24 All Lines - WORKERS COMPENSATION AND Evidence of EMPLOYERS' LIABILITY RWD300121607 , 12/31/2024 12/22/2023 Insurance Kimco - City of Sant Ana.pdf No further action is required at this time. Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 1/23/2024 1:04 PM A�ORO KIMCSTA-01 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 7/30/2024 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 endorsement(s). PRODUCER License # OM70471 CONT_NAMEACT Jo) Lay I Orion Risk Management InsuranAnqie es, An Alera Group4hsurance PHONE Agency, LLC (A/C, No, Ext): / o) 1800 Quail Street, Suite 110 E-MAIL DDDRS,!jiay ~< I firZU6Mi— Newportort Beach, CA 92660 IN URER S AFFARDING COVEIi4GE A NAIC PF INSURERA : PH', \D D nf"ecmeevon INSURED INSURER13:X.In'ura aAmerica. 24554 Kimco Staffing Services, Inc. INSURERC: .scot cial Ins 17872 Cowan Ave INS ERr --uai-e Irvine, CA 92614 n �� �� ` AV �� COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOI / Ht ✓E BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIvry 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X X PHPK2599195 9/1/2023 9/1/2024 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X PRO LOC POLICY JE PRODUCTS - COMP/OP AGG $ 3,000,000 SEXUAL PHYSICAL $ 1,000,000 OTHER: A AUTOMOBILE LIABILITY CMBINED SINGLE LIMIT EaOaccident 1,000,000 $ X BODILY INJURY Perperson) $ ANY AUTO X X PHPK2599195 9/1/2023 9/1/2024 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident) ccident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE PHUB880493 9/1/2023 9/1/2024 AGGREGATE $ 5,000,000 DED X RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/ R/EXECUTIVE EXCLU OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A X RW D300121607 12/31 /2023 12/31 /2024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ C Employment Practice MLPC241000131902 7/1/2024 7/1/2025 Each Claim/Aggregate 2,000,000 A Professional Liability PHPK2599195 9/1/2023 9/1/2024 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory. Waiver of Subrogation applies to the Workers Compensation, Auto Liability, and General Liability endorsements. 30 Days' Notice of Cancellation with 10 Days' Notice of Non -Payment of Premium in accordance with the policy provisions SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREO City of Santa Ana ACCORDANCE WITH THE POLICY PRG Risk Management Division ;"orz,"�E RAManagmumtDMs(an 20 Civic Center Plaza i REVIEWED Santa BY. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE A ' t`avdo e—mm,� Risk Management Specialist ACORD 25 (2016/03) © 1988-2015 ACORD The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK2599195 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. F RiskMwugementDMs1crn % REVIEWED & APPROVED BY. R91LM, As• :e {cevedo ® Risk Management Specialist CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: PHPK2599195 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Kimco Staffing Services, Inc. Endorsement Effective Date: 09/01/2023 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Oth- ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac- cident" or the "loss" under a contract with that person or organization. F RiskMougmumtDMslcrn %x REVIEWE<7&PaPPROVmBY: — Risk Management Specialist CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page 1 of 1 Kimco Staffing Services, Inc. Policy Number: PHPK2599195 Policy Term: September 1, 2023 - September 1, 2024 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Liability Deluxe Temporary Staffing PI-GLD-TS (11/15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: TEMPORARY STAFFING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page# Damage to Premises Rented to You $1,000,000 2 Expected or Intended Injury - Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 2 Non -Owned Watercraft Less than 58 feet 3 Damage to Property You Own, Rent or Occupy $30,000 3 Medical Payments $20,000 3 Medical Payments Reporting Period 3 Years 3 Athletic Activities Amended 3 Supplementary Payments - Bail Bonds $2,500 4 Supplementary Payments - Loss of Earnings $500 per day 4 Employee Indemnification Defense Coverage $25,000 4 Who Is An Insured Included 4 Additional Insured - Newly Acquired or Formed Organization Additional Insured - Broadened Named Insured Additional Insured - Blanket Additional Insureds When Required by Contract Duties in the Event of Occurrence, Offense, Claim or Suit Included 5 Transfer of Rights of Recovery Against Others To Us Clarification 5 Liberalization Included 5 All other terms and conditions of this Policy remain unchanged. RiskMamgementDMsian s �} REVIEWED & APPROVED BY: � tq� t�ceve�Z ® Risk Management Specialist Page 1 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Unintentional Failure to Disclose Hazards Included 5 Bodily Injury - Includes Mental Anguish Included 6 Personal and Advertising Injury - Includes Abuse of Included 6 Process, Discrimination Other Insurance - Primary Clarification Clarification 6 Staffing Services Exclusions Clarification 7 Staffing Services Definitions Clarification 8 A. Damage to Premises Rented to You If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part: 1. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof; 2. The word fire is changed to fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in: a. The last paragraph of SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III - LIMITS OF INSURANCE, Paragraph 6.; and C. SECTION V - DEFINITIONS, Paragraph 9.a.; and 3. The words fire insurance are changed to insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance. cn All other terms and conditions of this Policy remain unchanged. ;"�rz'"`E Ride D&A APPROVED BY. s �}°' REVIEWED & PaPPROVm BY: � tq� t�ceve�Z ® Risk Management Specialist Page 2 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY B. Expected or Intended Injury - Property Damage SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph a. Expected Or Intended Injury is deleted in its entirety and replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. C. Limited Rental Lease Agreement Contractual Liability SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph b. Contractual Liability is amended by adding the following: Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements and is excess over any renter's liability insurance of the client. D. Non -Owned Watercraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, g. Aircraft, Auto Or Watercraft, Paragraph (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; All other terms and conditions of this Policy remain unchanged. RiskMamgementDMsian s }°' REVIEWED & APPROVED BY: � tq� t�ceve�Z ® Risk Management Specialist Page 3 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. E. Damage to Property You Own, Rent or Occupy SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, j. Damage To Property, Paragraph (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. F. Medical Payments 1. If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part the Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. Under SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, Paragraph a., Item (b) is amended to read: (b) The expenses are incurred and reported to us within three years of the date of the accident; and G. Athletic Activities SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, 2 All other terms and conditions of this Policy remain unchanged. Exclusions, orz,N�F RiskMougmumtDMsbn r' REVIEWED & APPROVED BY: x ® Risk Management Specialist Page 4 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Paragraph e. Athletics Activities is deleted in its entirety and replaced with the following: e. Athletics Activities To a person injured while taking part in athletics. H. Supplementary Payments SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B, Items 1.b. and 1.d. are amended as follows: b. The limit for the cost of bail bonds is changed from $250 to $2,500; and d. The limit for loss of earnings is changed from $250 a day to $500 a day. I. Employee Indemnification Defense Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended to include the following: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding. The most we will pay for any "employee" who is directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing "suits." J. Who is An Insured SECTION II - WHO IS AN INSURED is amended as follows: 1. Newly Acquired or Formed Organization If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is amended to read: a. Coverage under this provision is afforded until the end of the All other terms and conditions of this Policy remain unchanged. RiskMougmumtDMsian REVIEWED & APPROVED BY: ® Risk Management Specialist Page 5 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY policy period; 2. Each of the following is also an insured: a. Broadened Named Insured - Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. b. Blanket Additional Insureds When Required by Contract - Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III - LIMITS OF INSURANCE. C. Interns - Your interns only while performing duties related to the conduct of your business. d. Contractors - Any individual or organization under written contract or written agreement with you who provides "staffing services" on your behalf and at your direction for your clients. K. Duties in the Event of Occurrence, Offense, Claim or Suit 1. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 2.a. the requirement that you must see to it that we are notified as soon as practicable of an "occurrence" or an offense, applies only when the "occurrence" or offense is known to: a. You, if you are an individual; All other terms and conditions of this Policy remain unchanged. orz,N�F RiskMougementDMslcrn r' REVIEWED & APPROVED BY: x ® Risk Management Specialist Page 6 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY b. A partner, if you are a partnership; or C. An "executive officer" or insurance manager, if you are a corporation. 2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. b. the requirement that you must see to it that we receive notice of a claim or "suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or "suit" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or C. An "executive officer" or insurance manager, if you are a corporation. L. Transfer of Rights of Recovery Against Others To Us SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us includes the following clarification: Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. M. Liberalization SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. cn All other terms and conditions of this Policy remain unchanged. ;"�rz'"`E Ride D&A APPumt ROVED BY. s �}°' REVIEWED & PaPPROVm BY: � tq� t�ceve�Z ® Risk Management Specialist Page 7 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY N. Unintentional Failure To Disclose Hazards SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Bodily Injury - Mental Anguish SECTION V - DEFINITIONS, Paragraph 3. is amended to read: "Bodily injury": a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. P. Personal and Advertising Injury - Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V - DEFINITIONS, Paragraph 14., Item b. is revised to read: b. Malicious prosecution or abuse of process; 2. SECTION V - DEFINITIONS, Paragraph 14. is amended to include the following: All other terms and conditions of this Policy remain unchanged. RiskMamgementDMsian s }°' REVIEWED & APPROVED BY: � tq� t�ceve�Z ® Risk Management Specialist Page 8 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY "Personal and advertising injury" also means discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or C. Directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Q. Section IV - Commercial General Liability Conditions is amended by the addition of the following: The following language is added to Item 4. Other Insurance: Insurance under this endorsement is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for cn All other terms and conditions of this Policy remain unchanged. ;"�rz'"`E Ride D&A APPumt ROVED BY. s �}°' REVIEWED & PaPPROVm BY: � tq� t�ceve�Z ® Risk Management Specialist Page 9 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY this Additional Insured. R. Staffing Services Exclusions The following exclusions are added to SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE: Actions Or Activities Of PEO Worker "Bodily injury" or "property damage" arising from the actions or activities of any "PEO worker". Professional Services Exclusion "Bodily injury" or "property damage" due to the rendering of or failure to render any professional service. This exclusion does not apply to your liability for "bodily injury" or "property damage" arising out of your "employee's" providing or failing to provide professional health care services to another of your "employees", but no "employee" is an insured for his or her providing or failure to provide such professional health care services. Wrongful Acts "Bodily injury" or "property damage" arising from a wrongful act in the rendering or failure to render services to or for your client. For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing "staffing services" to your clients by you or by any person for whose acts you are legally responsible. SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is amended as follows: 1. Exclusion k. does not apply. 2. Exclusions a., b., e., f., g., h., i., 1., and p. do not apply to any insured who did not personally acquiesce in or remain passive after having cn All other terms and conditions of this Policy remain unchanged. ;"�rz'"`E Ride D&A APPumt ROVED BY. s �}°' REVIEWED & PaPPROVm BY: � tq� t�ceve�Z ® Risk Management Specialist Page 10 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY personal knowledge of such conduct. Our obligation to pay shall begin once the full extent of the assets of the responsible insured has been exhausted and once the Deductible as shown in the Declarations of the policy has been satisfied. 3. The following exclusions are added to Paragraph 2. Exclusions: Actions Or Activities Of PEO Worker "Personal and advertising injury" arising from the actions or activities of any "PEO worker". Professional Services Exclusion "Personal and advertising injury" due to the rendering of or failure to render any professional service. Wrongful Acts "Personal and advertising injury" arising from a wrongful act in the rendering or failure to render services to or for your client. For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing "staffing services" to your clients by you or by any person for whose acts you are legally responsible. S. Staffing Services Definitions 1. SECTION V - DEFINITIONS, Paragraph 5. is revised to read: "Employee" includes but is not limited to a "leased worker" and a "staffing service employee". "Employee" does not include a "temporary worker" or a "PEO worker". 2. The following definitions are added to SECTION V - DEFINITIONS: a. "PEO service" means staffing related services as a Professional Employer Organization (PEO) you provide to your clients and to "PEO workers" cn All other terms and conditions of this Policy remain unchanged. ;"�rz'"`E Ride D&A APPumt ROVED BY. s �}°' REVIEWED & PaPPROVm BY: � tq� t�ceve�Z ® Risk Management Specialist Page 11 of 12 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY in connection with employment of such workers. b. "PEO worker" means a person you lease to your client under a written "PEO service" agreement or contract. C. "Staffing Services" means services provided by a staffing company to their clients including but not limited to: (1) Fulfillment of any of the administrative functions which would otherwise be normally fulfilled by an employer's human resource function; (2) Staffing related administrative services provided by an Administrative Services Organization (ASO); (3) "PEO service", (4) Staffing related services provided to your clients for the recruitment, selection and placement of a person for employment with a client. (5) Temporary, contingent or contract placement services; (6) Vendor Management Service (VMS), means the facilitation, purchase and management of "staffing services" for clients including the placement and fulfillment of orders for "staffing service employees"; (7) Services performed on behalf of your client by a "staffing service employee" who is not a direct hire or permanent placement; (8) Services performed for a client company to supply that client company with a "staffing service employee". d. "Staffing service employee" means a person who is furnished by you to your client to perform the duties to which you have agreed. All other terms and conditions of this Policy remain unchanged. orz,N�F RiskMwugementDMs1crn r' REVIEWED & APPROVED BY: x ® Risk Management Specialist Page 12 of 12 POLICY NUMBER: PHPK2599195 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Kimco Staffing Services, Inc. Endorsement Effective Date: 09/01/2023 SCHEDULE Name of Person(s) or Organization(s): Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional Insured but only for liability arising out of the negligence of the named insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 F RiskMwugementDMs1crn %x REVIEWE<7&PaPPROVmBY: — Risk Management Specialist Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Where required by written agreement signed prior to loss. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12-31-2023 Insured Kimco Staffing Services, Inc. Insurance Company XL Insurance America, Inc. WC 00 03 13 (Ed. 4-84) Policy No. RWD300121607 Countersigned by Endorsement No. RAManagmumtDMsian % x REVIEWED & APPROVED BY. °�,1 aifl �d• l'.` As.�:e {icevedo ® Risk Management Specialist © 1983 National Council on Compensation Insurance. ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 3/18/2025 License # 0M70471 (949) 263-8850 (949) 263-8860 18058 Kimco Staffing Services, Inc. 17872 Cowan Ave Irvine, CA 92614 24554 A 1,000,000 X X PHPK2599195006 9/1/2024 9/1/2025 100,000 10,000 1,000,000 3,000,000 3,000,000 SEXUAL PHYSICAL 1,000,000 1,000,000A X PHPK2599195006 9/1/2024 9/1/2025 B X RWD300121608 12/31/2024 12/31/2025 1,000,000 Y 1,000,000 1,000,000 A Professional Liabili PHPK2599195006 9/1/2024 Each Claim 1,000,000 A Professional Liabili PHPK2599195006 9/1/2024 9/1/2025 Aggregate 2,000,000 City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers are listed as additional insured with respects to General Liability per the terms of the attached endorsement. Waiver of Subrogation applies per the terms of the attached General Liability, Auto Liability, Workers Compensation, and Professional Liability endorsements. City of Santa Ana Attention: Human Resources 20 Civic Center Plaza, M-24 Santa Ana, CA 92701 KIMCSTA-01 MMCALLISTER Orion Risk Management Insurance Services, An Alera Group Insurance Agency, LLC 18575 Jamboree Rd, Suite 500 Irvine, CA 92612 PHILADELPHIA INDEMNITY INSURANCE COMPANIES* XL Insurance America, Inc X 9/1/2025 X X X X X X PI-GLD-TS (11/15) PI-GLD-TS (11/15) Page 1 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: TEMPORARY STAFFING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page # Damage to Premises Rented to You $1,000,000 2 Expected or Intended Injury – Property Damage Included 2 Limited Rental Lease Agreement Contractual Liabilit y $50,000 2 Non-Owned Watercraft Less than 58 feet 3 Damage to Property You Own, Rent or Occupy $30,000 3 Medical Payments $20,000 3 Medical Payments Reporting Period 3 Years 3 Athletic Activities Amended 3 Supplementary Payments – Bail Bonds $2,500 4 Supplementary Payments – Loss of Earnings $500 per day 4 Employee Indemnification Defense Coverage $25,000 4 Who Is An Insured Additional Insured – Newly Acquired or Formed Organization Additional Insured – Broadened Named Insured Additional Insured – Blanket Additional Insureds When Required by Contract Included 4 Duties in the Event of Occurrence, Offense, Claim or Suit Included 4 Transfer of Rights of Recovery Against Others To Us Clarification 5 Liberalization Included 5 Unintentional Failure to Disclose Hazards Included 5 Bodily Injury – Includes Mental Anguish Included 5 Personal and Advertising Injury – Includes Abuse of Process, Discrimination Included 6 Other Insurance – Primary Clarification Clarification 6 Kimco Staffing Services, Inc. Policy Number: PHPK2599195006 Policy Term: September 1, 2024 - September 1, 2025 PI-GLD-TS (11/15) PI-GLD-TS (11/15) Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Staffing Services Exclusions Clarification 7 Staffing Services Definitions Clarification 8 A. Damage to Premises Rented to You If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part: 1. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof; 2. The word fire is changed to fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in: a. The last paragraph of SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III – LIMITS OF INSURANCE, Paragraph 6.; and c. SECTION V – DEFINITIONS, Paragraph 9.a.; and 3. The words fire insurance are changed to insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance. B. Expected or Intended Injury – Property Damage SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph a. Expected Or Intended Injury is deleted in its entirety and replaced by the following: a. Expected Or Intended Injury “Bodily injury” or “property damage” expected or intended from the standpoint of the insured. This exclusion does not apply to “bodily injury” or “property damage” resulting from the use of reasonable force to protect persons or property. C. Limited Rental Lease Agreement Contractual Liability SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph b. Contractual Liability is amended by adding the following: Based on the named insured’s request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. PI-GLD-TS (11/15) PI-GLD-TS (11/15) Page 3 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. This coverage extension only applies to rental lease agreements and is excess over any renter’s liability insurance of the client. D. Non-Owned Watercraft SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, g. Aircraft, Auto Or Watercraft, Paragraph (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. E. Damage to Property You Own, Rent or Occupy SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, j. Damage To Property, Paragraph (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another’s property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. F. Medical Payments 1. If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part the Medical Expense Limit is changed subject to all of the terms of SECTION III – LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. Under SECTION I – COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, Paragraph a., Item (b) is amended to read: (b) The expenses are incurred and reported to us within three years of the date of the accident; and G. Athletic Activities SECTION I – COVERAGES, COVERAGE C MEDICAL PAYMENTS, 2. Exclusions, Paragraph e. Athletics Activities is deleted in its entirety and replaced with the following: PI-GLD-TS (11/15) PI-GLD-TS (11/15) Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. e. Athletics Activities To a person injured while taking part in athletics. H. Supplementary Payments SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS – COVERAGES A AND B, Items 1.b. and 1.d. are amended as follows: b. The limit for the cost of bail bonds is changed from $250 to $2,500; and d. The limit for loss of earnings is changed from $250 a day to $500 a day. I. Employee Indemnification Defense Coverage SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS – COVERAGES A AND B is amended to include the following: We will pay, on your behalf, defense costs incurred by an “employee” in a criminal proceeding. The most we will pay for any “employee” who is directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or “suits” brought or persons or organizations making claims or bringing “suits.” J. Who is An Insured SECTION II – WHO IS AN INSURED is amended as follows: 1. Newly Acquired or Formed Organization If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is amended to read: a. Coverage under this provision is afforded until the end of the policy period; 2. Each of the following is also an insured: a. Broadened Named Insured – Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. b. Blanket Additional Insureds When Required by Contract – Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations. The Additional Insured’s limits of insurance do not increase our limits of insurance, as described in SECTION III – LIMITS OF INSURANCE. PI-GLD-TS (11/15) PI-GLD-TS (11/15) Page 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. c. Interns – Your interns only while performing duties related to the conduct of your business. d. Contractors – Any individual or organization under written contract or written agreement with you who provides “staffing services” on your behalf and at your direction for your clients. K. Duties in the Event of Occurrence, Offense, Claim or Suit 1. SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, 2.a. the requirement that you must see to it that we are notified as soon as practicable of an “occurrence” or an offense, applies only when the “occurrence” or offense is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An "executive officer" or insurance manager, if you are a corporation. 2. SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. b. the requirement that you must see to it that we receive notice of a claim or “suit” as soon as practicable will not be considered breached unless the breach occurs after such claim or “suit” is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An "executive officer" or insurance manager, if you are a corporation. L. Transfer of Rights of Recovery Against Others To Us SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us includes the following clarification: Therefore, the insured can waive the insurer’s rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. M. Liberalization SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. N. Unintentional Failure To Disclose Hazards SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period PI-GLD-TS (11/15) PI-GLD-TS (11/15) Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Bodily Injury – Mental Anguish SECTION V – DEFINITIONS, Paragraph 3. is amended to read: “Bodily injury”: a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. P. Personal and Advertising Injury – Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of “personal and advertising injury” is amended as follows: 1. SECTION V – DEFINITIONS, Paragraph 14., Item b. is revised to read: b. Malicious prosecution or abuse of process; 2. SECTION V – DEFINITIONS, Paragraph 14. is amended to include the following: “Personal and advertising injury” also means discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Q. Section IV – Commercial General Liability Conditions is amended by the addition of the following: The following language is added to Item 4. Other Insurance: Insurance under this endorsement is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. PI-GLD-TS (11/15) PI-GLD-TS (11/15) Page 7 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or “occurrence” we cover for this Additional Insured. R. Staffing Services Exclusions The following exclusions are added to SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE: Actions Or Activities Of PEO Worker “Bodily injury” or “property damage” arising from the actions or activities of any “PEO worker”. Professional Services Exclusion "Bodily injury" or "property damage" due to the rendering of or failure to render any professional service. This exclusion does not apply to your liability for "bodily injury" or "property damage" arising out of your "employee's" providing or failing to provide professional health care services to another of your "employees", but no "employee" is an insured for his or her providing or failure to provide such professional health care services. Wrongful Acts “Bodily injury” or “property damage” arising from a wrongful act in the rendering or failure to render services to or for your client. For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing “staffing services” to your clients by you or by any person for whose acts you are legally responsible. SECTION I – COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is amended as follows: 1. Exclusion k. does not apply. 2. Exclusions a., b., e., f., g., h., i., l., and p. do not apply to any insured who did not personally acquiesce in or remain passive after having personal knowledge of such conduct. Our obligation to pay shall begin once the full extent of the assets of the responsible insured has been exhausted and once the Deductible as shown in the Declarations of the policy has been satisfied. 3. The following exclusions are added to Paragraph 2. Exclusions: Actions Or Activities Of PEO Worker “Personal and advertising injury” arising from the actions or activities of any “PEO worker”. Professional Services Exclusion "Personal and advertising injury" due to the rendering of or failure to render any professional service. Wrongful Acts “Personal and advertising injury” arising from a wrongful act in the rendering or failure to render services to or for your client. PI-GLD-TS (11/15) PI-GLD-TS (11/15) Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing “staffing services” to your clients by you or by any person for whose acts you are legally responsible. S. Staffing Services Definitions 1. SECTION V – DEFINITIONS, Paragraph 5. is revised to read: “Employee” includes but is not limited to a “leased worker” and a “staffing service employee”. “Employee” does not include a “temporary worker” or a “PEO worker”. 2. The following definitions are added to SECTION V – DEFINITIONS: a. “PEO service” means staffing related services as a Professional Employer Organization (PEO) you provide to your clients and to “PEO workers” in connection with employment of such workers. b. “PEO worker” means a person you lease to your client under a written "PEO service" agreement or contract. c. “Staffing Services” means services provided by a staffing company to their clients including but not limited to: (1) Fulfillment of any of the administrative functions which would otherwise be normally fulfilled by an employer’s human resource function; (2) Staffing related administrative services provided by an Administrative Services Organization (ASO); (3) “PEO service”; (4) Staffing related services provided to your clients for the recruitment, selection and placement of a person for employment with a client. (5) Temporary, contingent or contract placement services; (6) Vendor Management Service (VMS), means the facilitation, purchase and management of “staffing services” for clients including the placement and fulfillment of orders for “staffing service employees”; (7) Services performed on behalf of your client by a “staffing service employee” who is not a direct hire or permanent placement; (8) Services performed for a client company to supply that client company with a “staffing service employee”. d. "Staffing service employee" means a person who is furnished by you to your client to perform the duties to which you have agreed. POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 Name Of Person Or Organization: Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. PHPK2599195006 POLICY NUMBER: COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. SCHEDULE The Transfer Of Rights Of Recovery Against Oth- ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac- cident" or the "loss" under a contract with that person or organization. CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page 1 of 1 Named Insured: Endorsement Effective Date: Name(s) Of Person(s) Or Organization(s): Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. PHPK2599195006 09/01/2024 Kimco Staffing Services, Inc. ¤¤ 1983 National Council on Compensation Insurance. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Where required by written agreement signed prior to loss. This endorsement changes the policy to which it is attached and is e ffective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12-31-2024 Policy No. RWD300121608 Endorsement No. Insured Kimco Staffing Services, Inc. Insurance Company Countersigned by __________________________________________ XL Insurance America, Inc. WC 00 03 13 (Ed. 4-84) PI-TS-013 (05/12) ©2012 Philadelphia Indemnity Insurance Company Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT (Including Waiver of Subrogation) This endorsement modifies and is subject to the insurance provided under the following: STAFFING SERVICE PROFESSIONAL LIABILITY COVERAGE FORM STAFFING SERVICE PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE COVERAGE FORM A.The following is added to SECTION II – WHO IS AN INSURED: Any person or organization where required by contract executed prior to a loss is an insured, but only with respect to that person’s or organization’s liability for “damages” arising out of a “wrongful act” during the rendering of ”staffing services”. B.Paragraph I. in SECTION IV. CONDITIONS is deleted in its entirety and replaced with the following: Transfer of Rights of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring “suit” or transfer those rights to us and help us enforce them. The insured can waive the insurer’s rights of recovery prior to the occurrence of a loss, provided the waiver is made in a contract. Kimco Staffing Services, Inc. Policy Number: PHPK2599195006 Policy Term: September 1, 2024 - September 1, 2025 KIMCSTA-01 MMCALLISTER ,d►coRo CERTIFICATE OF LIABILITY INSURANCE D 1TE 1/18/20YYYY) 1/18/ 25 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 endorsement(s). PRODUCER License#OM70471 CONTACT NAME: Orion Risk Management Insurance Services,An Alera Group Insurance PHONE FAX Agency, LLC (A/C,No,Ext): (949)263-8850 No):(949)263-8860 18575 Jamboree Rd,Suite 500 A DD E-MAIL Irvine,CA 92612 INSURERS AFFORDING COVERAGE NAIC# INSURERA:PHILADELPHIA INDEMNITY INSURANCE COMPANIES* 18058 INSURED INSURERB:XL Insurance America Inc 24554 Kimco Staffing Services,Inc. INSURER 7 17872 Cowan Ave INSURER D: Irvine,CA 92614 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PHPK2599195007 9/1/2025 9/1/2026 rl DAMAGE TO RENTED 100,000 X X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PRO LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: SEXUAL PHYSICAL $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X X PHPK2599195007 9/1/2025 9/1/2026 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION X PER AND EMPLOYERS'LIABILITY STATUTE EERR RWD300121608 12/31/2024 12/31/2025 1,000,000 ANY PROPRIETOR/EXCLUDED? R/EXECUTIVE N/A X E.L.EACH ACCIDENT $ OF EXCLUDED? LyJ(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liabili X PHPK2599195007 9/1/2025 9/1/2026 Each Claim 1,000,000 A Professional Liabili PHPK2599195007 9/1/2025 9/1/2026 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are listed as additional insured with respects to General Liability and Auto Liability per the terms of the attached endorsements. Waiver of Subrogation applies per the terms of the attached General Liability,Auto Liability,Workers Compensation,and Professional Liability endorsements. Tu Tran Digitally signed by Tu Tran Nguyen Date:2025.11.20 APPROVED Nguyen 09:51:22-08,00' By Tu Tran Nguyen at 9:50 am, Nov 20,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Human Resources 20 Civic Center Plaza Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Kimco Staffing Services, Inc. Policy Number: PHPK2599195007 PI-GLD-TS (11/15) Policy Term: September 1, 2025-September 1, 2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: TEMPORARY STAFFING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page Damage to Premises Rented to You $1,000,000 2 Expected or Intended Injury— Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 2 Non-Owned Watercraft Less than 58 feet 3 Damage to Property You Own, Rent or Occupy $30,000 3 Medical Payments $20,000 3 Medical Payments Reporting Period 3 Years 3 Athletic Activities Amended 3 Supplementary Payments —Bail Bonds $2,500 4 Supplementary Payments—Loss of Earnings $500 per day 4 Employee Indemnification Defense Coverage $25,000 4 Who Is An Insured Included 4 Additional Insured — Newly Acquired or Formed Organization Additional Insured — Broadened Named Insured Additional Insured — Blanket Additional Insureds When Required by Contract Duties in the Event of Occurrence, Offense, Claim or Suit Included 4 Transfer of Rights of Recovery Against Others To Us Clarification 5 Liberalization Included 5 Unintentional Failure to Disclose Hazards Included 5 Bodily Injury— Includes Mental Anguish Included 5 Personal and Advertising Injury—Includes Abuse of Process, Included 6 Discrimination Other Insurance — Primary Clarification Clarification 6 PI-GLD-TS (11/15) Page 1 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Staffing Services Exclusions Clarification 7 Staffing Services Definitions Clarification 8 A. Damage to Premises Rented to You If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part: 1. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof; 2. The word fire is changed to fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in: a. The last paragraph of SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III —LIMITS OF INSURANCE, Paragraph 6.; and c. SECTION V—DEFINITIONS, Paragraph 9.a.; and 3. The words fire insurance are changed to insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance. B. Expected or Intended Injury— Property Damage SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph a. Expected Or Intended Injury is deleted in its entirety and replaced by the following: a. Expected Or Intended Injury "Bodily injury" or"property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or"property damage" resulting from the use of reasonable force to protect persons or property. C. Limited Rental Lease Agreement Contractual Liability SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph b. Contractual Liability is amended by adding the following: Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. PI-GLD-TS (11/15) Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) This coverage extension only applies to rental lease agreements and is excess over any renter's liability insurance of the client. D. Non-Owned Watercraft SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, g. Aircraft, Auto Or Watercraft, Paragraph (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. E. Damage to Property You Own, Rent or Occupy SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions,j. Damage To Property, Paragraph (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. F. Medical Payments 1. If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part the Medical Expense Limit is changed subject to all of the terms of SECTION III — LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. Under SECTION I—COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, Paragraph a., Item (b) is amended to read: (b) The expenses are incurred and reported to us within three years of the date of the accident; and G. Athletic Activities SECTION I —COVERAGES, COVERAGE C MEDICAL PAYMENTS, 2. Exclusions, Paragraph e. Athletics Activities is deleted in its entirety and replaced with the following: PI-GLD-TS (11/15) Page 3 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) e. Athletics Activities To a person injured while taking part in athletics. H. Supplementary Payments SECTION I—COVERAGES, SUPPLEMENTARY PAYMENTS—COVERAGES A AND B, Items 1.b. and 1.d. are amended as follows: b. The limit for the cost of bail bonds is changed from $250 to $2,500; and d. The limit for loss of earnings is changed from $250 a day to $500 a day. I. Employee Indemnification Defense Coverage SECTION I—COVERAGES, SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is amended to include the following: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding. The most we will pay for any"employee" who is directly involved in a criminal proceeding is $25,000 regardless of the numbers of"employees," claims or"suits" brought or persons or organizations making claims or bringing "suits." J. Who is An Insured SECTION II —WHO IS AN INSURED is amended as follows: 1. Newly Acquired or Formed Organization If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is amended to read: a. Coverage under this provision is afforded until the end of the policy period; 2. Each of the following is also an insured: a. Broadened Named Insured—Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. b. Blanket Additional Insureds When Required by Contract—Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for"bodily injury," "property damage" or"personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III— LIMITS OF INSURANCE. PI-GLD-TS (11/15) Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) c. Interns—Your interns only while performing duties related to the conduct of your business. d. Contractors—Any individual or organization under written contract or written agreement with you who provides "staffing services" on your behalf and at your direction for your clients. K. Duties in the Event of Occurrence, Offense, Claim or Suit 1. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, 2.a. the requirement that you must see to it that we are notified as soon as practicable of an "occurrence" or an offense, applies only when the "occurrence" or offense is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An "executive officer" or insurance manager, if you are a corporation. 2. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. b. the requirement that you must see to it that we receive notice of a claim or"suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or"suit" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An "executive officer" or insurance manager, if you are a corporation. L. Transfer of Rights of Recovery Against Others To Us SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us includes the following clarification: Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. M. Liberalization SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. N. Unintentional Failure To Disclose Hazards SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period PI-GLD-TS (11/15) Page 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Bodily Injury— Mental Anguish SECTION V—DEFINITIONS, Paragraph 3. is amended to read: "Bodily injury": a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. P. Personal and Advertising Injury—Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of"personal and advertising injury" is amended as follows: 1. SECTION V—DEFINITIONS, Paragraph 14., Item b. is revised to read: b. Malicious prosecution or abuse of process; 2. SECTION V—DEFINITIONS, Paragraph 14. is amended to include the following: "Personal and advertising injury" also means discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Q. Section IV—Commercial General Liability Conditions is amended by the addition of the following: The following language is added to Item 4. Other Insurance: Insurance under this endorsement is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. PI-GLD-TS (11/15) Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or"occurrence" we cover for this Additional Insured. R. Staffing Services Exclusions The following exclusions are added to SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE: Actions Or Activities Of PEO Worker "Bodily injury" or"property damage" arising from the actions or activities of any"PEO worker". Professional Services Exclusion "Bodily injury" or"property damage" due to the rendering of or failure to render any professional service. This exclusion does not apply to your liability for"bodily injury" or"property damage" arising out of your"employee's" providing or failing to provide professional health care services to another of your"employees", but no "employee" is an insured for his or her providing or failure to provide such professional health care services. Wrongful Acts "Bodily injury" or"property damage" arising from a wrongful act in the rendering or failure to render services to or for your client. For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing "staffing services"to your clients by you or by any person for whose acts you are legally responsible. SECTION I—COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is amended as follows: 1. Exclusion k. does not apply. 2. Exclusions a., b., e., f., g., h., i., I., and p. do not apply to any insured who did not personally acquiesce in or remain passive after having personal knowledge of such conduct. Our obligation to pay shall begin once the full extent of the assets of the responsible insured has been exhausted and once the Deductible as shown in the Declarations of the policy has been satisfied. 3. The following exclusions are added to Paragraph 2. Exclusions: Actions Or Activities Of PEO Worker "Personal and advertising injury" arising from the actions or activities of any"PEO worker". Professional Services Exclusion "Personal and advertising injury" due to the rendering of or failure to render any professional service. Wrongful Acts "Personal and advertising injury" arising from a wrongful act in the rendering or failure to render services to or for your client. PI-GLD-TS (11/15) Page 7 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing "staffing services"to your clients by you or by any person for whose acts you are legally responsible. S. Staffing Services Definitions 1. SECTION V—DEFINITIONS, Paragraph 5. is revised to read: "Employee" includes but is not limited to a "leased worker" and a "staffing service employee". "Employee" does not include a "temporary worker" or a "PEO worker". 2. The following definitions are added to SECTION V—DEFINITIONS: a. "PEO service" means staffing related services as a Professional Employer Organization (PEO) you provide to your clients and to "PEO workers" in connection with employment of such workers. b. "PEO worker" means a person you lease to your client under a written "PEO service" agreement or contract. c. "Staffing Services" means services provided by a staffing company to their clients including but not limited to: (1) Fulfillment of any of the administrative functions which would otherwise be normally fulfilled by an employer's human resource function; (2) Staffing related administrative services provided by an Administrative Services Organization (ASO); (3) "PEO service"; (4) Staffing related services provided to your clients for the recruitment, selection and placement of a person for employment with a client. (5) Temporary, contingent or contract placement services; (6) Vendor Management Service (VMS), means the facilitation, purchase and management of"staffing services" for clients including the placement and fulfillment of orders for "staffing service employees"; (7) Services performed on behalf of your client by a "staffing service employee" who is not a direct hire or permanent placement; (8) Services performed for a client company to supply that client company with a "staffing service employee". d. "Staffing service employee" means a person who is furnished by you to your client to perform the duties to which you have agreed. PI-GLD-TS (11/15) Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: PHPK2599195007 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: PHPK2599195007 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Kimco Staffing Services, Inc. Endorsement Effective Date: 09/01/2025 SCHEDULE Name of Person(s) or Organization(s): Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional Insured but only for liability arising out of the negligence of the named insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 POLICY NUMBER: PHPK2599195007 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Kimco Staffing Services, Inc. Endorsement Effective Date: 09/01/2025 SCHEDULE Name(s) Of Person(s) Or Organ izat ion(s): Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Oth- ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac- cident" or the "loss" under a contract with that person or organization. CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Where required by written agreement signed prior to loss. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12-31-2024 Policy No. RWD300121608 Endorsement No. Insured Kimco Staffing Services, Inc. Insurance Company Countersigned by XL Insurance America, Inc. WC 00 03 13 (Ed. 4-84) 0 1983 National Council on Compensation Insurance. Kimco Staffing Services, Inc. Policy Number: PHPK2599195007 PI-TS-013 (05/12) Policy Term: September 1, 2025-September 1, 2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT (Including Waiver of Subrogation) This endorsement modifies and is subject to the insurance provided under the following: STAFFING SERVICE PROFESSIONAL LIABILITY COVERAGE FORM STAFFING SERVICE PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE COVERAGE FORM A. The following is added to SECTION II—WHO IS AN INSURED: Any person or organization where required by contract executed prior to a loss is an insured, but only with respect to that person's or organization's liability for"damages" arising out of a "wrongful act" during the rendering of"staffing services". B. Paragraph I. in SECTION IV. CONDITIONS is deleted in its entirety and replaced with the following: Transfer of Rights of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. The insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a contract. ©2012 Philadelphia Indemnity Insurance Company Page 1 of 1 KIMCSTA-01 MMCALLISTER ,d►CORO CERTIFICATE OF LIABILITY INSURANCE DATE 12/26/20YYYY) 2/26/ 25 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 endorsement(s). PRODUCER License#OM70471 CONTACT NAME: Orion Risk Management Insurance Services,An Alera Group Insurance PHONE FAX ,No):(g49)263-8860 Agency, LLC (A/C,No,Ext): (949)263-8850 18575 Jamboree Rd,Suite 500 ADDRESS: Irvine,CA 92612 INSURERS AFFORDING COVERAGE NAIC# INSURER A:PHILADELPHIA INDEMNITY INSURANCE COMPANIES* 18058 INSURED INSURER B:XL Insurance America, Inc 24554 Kimco Staffing Services,Inc. INSURER C: 17872 Cowan Ave INSURER D: Irvine,CA 92614 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PHPK2599195007 91112025 91112026 DAMAGE TO RENTED 100 000 X X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY JJECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: SEXUAL PHYSICAL $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X X PHPK2599195007 91112025 91112026 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER YIN RW D300121609 1212812025 1212812026 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liabili X PHPK2599195007 91112025 91112026 Each Claim 1,000,000 A Professional Liabili PHPK2599195007 91112025 91112026 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are listed as additional insured with respects to General Liability and Auto Liability per the terms of the attached endorsements. Waiver of Subrogation applies per the terms of the attached General Liability,Auto Liability,Workers Compensation,and Professional Liability endorsements. Digitally signed Tu Tran by Tu Tran Nguyen Nguyen D3 t.:2026.01.12 APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 1:30 pm,Jan 1Z 2026 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Human Resources 20 Civic Center Plaza Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Kimco Staffing Services, Inc. Policy Number: PHPK2599195007 PI-GLD-TS (11/15) Policy Term: September 1, 2025-September 1, 2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: TEMPORARY STAFFING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page Damage to Premises Rented to You $1,000,000 2 Expected or Intended Injury— Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 2 Non-Owned Watercraft Less than 58 feet 3 Damage to Property You Own, Rent or Occupy $30,000 3 Medical Payments $20,000 3 Medical Payments Reporting Period 3 Years 3 Athletic Activities Amended 3 Supplementary Payments—Bail Bonds $2,500 4 Supplementary Payments—Loss of Earnings $500 per day 4 Employee Indemnification Defense Coverage $25,000 4 Who Is An Insured Included 4 Additional Insured — Newly Acquired or Formed Organization Additional Insured — Broadened Named Insured Additional Insured — Blanket Additional Insureds When Required by Contract Duties in the Event of Occurrence, Offense, Claim or Suit Included 4 Transfer of Rights of Recovery Against Others To Us Clarification 5 Liberalization Included 5 Unintentional Failure to Disclose Hazards Included 5 Bodily Injury— Includes Mental Anguish Included 5 Personal and Advertising Injury—Includes Abuse of Process, Included 6 Discrimination Other Insurance— Primary Clarification Clarification 6 PI-GLD-TS (11/15) Page 1 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Staffing Services Exclusions Clarification 7 Staffing Services Definitions Clarification 8 A. Damage to Premises Rented to You If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part: 1. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof; 2. The word fire is changed to fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in: a. The last paragraph of SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III —LIMITS OF INSURANCE, Paragraph 6.; and c. SECTION V— DEFINITIONS, Paragraph 9.a.; and 3. The words fire insurance are changed to insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance. B. Expected or Intended Injury— Property Damage SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph a. Expected Or Intended Injury is deleted in its entirety and replaced by the following: a. Expected Or Intended Injury "Bodily injury" or"property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or"property damage" resulting from the use of reasonable force to protect persons or property. C. Limited Rental Lease Agreement Contractual Liability SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph b. Contractual Liability is amended by adding the following: Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. PI-GLD-TS (11/15) Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) This coverage extension only applies to rental lease agreements and is excess over any renter's liability insurance of the client. D. Non-Owned Watercraft SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, g.Aircraft, Auto Or Watercraft, Paragraph (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. E. Damage to Property You Own, Rent or Occupy SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions,j. Damage To Property, Paragraph (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. F. Medical Payments 1. If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part the Medical Expense Limit is changed subject to all of the terms of SECTION III —LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. Under SECTION I—COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, Paragraph a., Item (b) is amended to read: (b) The expenses are incurred and reported to us within three years of the date of the accident; and G. Athletic Activities SECTION I —COVERAGES, COVERAGE C MEDICAL PAYMENTS, 2. Exclusions, Paragraph e. Athletics Activities is deleted in its entirety and replaced with the following: PI-GLD-TS (11/15) Page 3 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) e. Athletics Activities To a person injured while taking part in athletics. H. Supplementary Payments SECTION I —COVERAGES, SUPPLEMENTARY PAYMENTS—COVERAGES A AND B, Items 1.b. and 1.d. are amended as follows: b. The limit for the cost of bail bonds is changed from $250 to $2,500; and d. The limit for loss of earnings is changed from $250 a day to $500 a day. I. Employee Indemnification Defense Coverage SECTION I —COVERAGES, SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is amended to include the following: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding. The most we will pay for any "employee"who is directly involved in a criminal proceeding is $25,000 regardless of the numbers of"employees," claims or"suits" brought or persons or organizations making claims or bringing "suits." J. Who is An Insured SECTION II —WHO IS AN INSURED is amended as follows: 1. Newly Acquired or Formed Organization If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is amended to read: a. Coverage under this provision is afforded until the end of the policy period; 2. Each of the following is also an insured: a. Broadened Named Insured —Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. b. Blanket Additional Insureds When Required by Contract—Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for"bodily injury," "property damage" or"personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III — LIMITS OF INSURANCE. PI-GLD-TS (11/15) Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) c. Interns—Your interns only while performing duties related to the conduct of your business. d. Contractors—Any individual or organization under written contract or written agreement with you who provides "staffing services" on your behalf and at your direction for your clients. K. Duties in the Event of Occurrence, Offense, Claim or Suit 1. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, 2.a.the requirement that you must see to it that we are notified as soon as practicable of an "occurrence" or an offense, applies only when the "occurrence" or offense is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An "executive officer" or insurance manager, if you are a corporation. 2. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. b. the requirement that you must see to it that we receive notice of a claim or"suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or"suit" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An "executive officer" or insurance manager, if you are a corporation. L. Transfer of Rights of Recovery Against Others To Us SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us includes the following clarification: Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. M. Liberalization SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. N. Unintentional Failure To Disclose Hazards SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period PI-GLD-TS (11/15) Page 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Bodily Injury—Mental Anguish SECTION V— DEFINITIONS, Paragraph 3. is amended to read: "Bodily injury": a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. P. Personal and Advertising Injury—Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of"personal and advertising injury" is amended as follows: 1. SECTION V— DEFINITIONS, Paragraph 14., Item b. is revised to read: b. Malicious prosecution or abuse of process; 2. SECTION V— DEFINITIONS, Paragraph 14. is amended to include the following: "Personal and advertising injury" also means discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Q. Section IV—Commercial General Liability Conditions is amended by the addition of the following: The following language is added to Item 4. Other Insurance: Insurance under this endorsement is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. PI-GLD-TS (11/15) Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or"occurrence"we cover for this Additional Insured. R. Staffing Services Exclusions The following exclusions are added to SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE: Actions Or Activities Of PEO Worker "Bodily injury" or"property damage" arising from the actions or activities of any"PEO worker". Professional Services Exclusion "Bodily injury" or"property damage"due to the rendering of or failure to render any professional service. This exclusion does not apply to your liability for"bodily injury" or"property damage" arising out of your"employee's" providing or failing to provide professional health care services to another of your "employees", but no "employee" is an insured for his or her providing or failure to provide such professional health care services. Wrongful Acts "Bodily injury" or"property damage" arising from a wrongful act in the rendering or failure to render services to or for your client. For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing "staffing services"to your clients by you or by any person for whose acts you are legally responsible. SECTION I —COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is amended as follows: 1. Exclusion k. does not apply. 2. Exclusions a., b., e., f., g., h., L, I., and p. do not apply to any insured who did not personally acquiesce in or remain passive after having personal knowledge of such conduct. Our obligation to pay shall begin once the full extent of the assets of the responsible insured has been exhausted and once the Deductible as shown in the Declarations of the policy has been satisfied. 3. The following exclusions are added to Paragraph 2. Exclusions: Actions Or Activities Of PEO Worker "Personal and advertising injury" arising from the actions or activities of any"PEO worker". Professional Services Exclusion "Personal and advertising injury"due to the rendering of or failure to render any professional service. Wrongful Acts "Personal and advertising injury" arising from a wrongful act in the rendering or failure to render services to or for your client. PI-GLD-TS (11/15) Page 7 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing "staffing services"to your clients by you or by any person for whose acts you are legally responsible. S. Staffing Services Definitions 1. SECTION V— DEFINITIONS, Paragraph 5. is revised to read: "Employee" includes but is not limited to a "leased worker" and a "staffing service employee". "Employee" does not include a "temporary worker" or a "PEO worker". 2. The following definitions are added to SECTION V— DEFINITIONS: a. "PEO service" means staffing related services as a Professional Employer Organization (PEO)you provide to your clients and to "PEO workers" in connection with employment of such workers. b. "PEO worker" means a person you lease to your client under a written "PEO service" agreement or contract. c. "Staffing Services" means services provided by a staffing company to their clients including but not limited to: (1) Fulfillment of any of the administrative functions which would otherwise be normally fulfilled by an employer's human resource function; (2) Staffing related administrative services provided by an Administrative Services Organization (ASO); (3) "PEO service"; (4) Staffing related services provided to your clients for the recruitment, selection and placement of a person for employment with a client. (5) Temporary, contingent or contract placement services; (6) Vendor Management Service (VMS), means the facilitation, purchase and management of"staffing services"for clients including the placement and fulfillment of orders for "staffing service employees"; (7) Services performed on behalf of your client by a "staffing service employee" who is not a direct hire or permanent placement; (8) Services performed for a client company to supply that client company with a "staffing service employee". d. "Staffing service employee" means a person who is furnished by you to your client to perform the duties to which you have agreed. PI-GLD-TS (11/15) Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: PHPK2599195007 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: PHPK2599195007 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Kimco Staffing Services, Inc. Endorsement Effective Date: 09/01/2025 SCHEDULE Name of Person(s) or Organization(s): Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional Insured but only for liability arising out of the negligence of the named insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 POLICY NUMBER: PHPK2599195007 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Kimco Staffing Services, Inc. Endorsement Effective Date: 09/01/2025 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Oth- ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac- cident" or the "loss" under a contract with that person or organization. CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page 1 of 1 Kimco Staffing Services, Inc. 05/12013 TS- Policy Number: PHPK2599195007 PI- ( ) Policy Term: September 1, 2025-September 1, 2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT (Including Waiver of Subrogation) This endorsement modifies and is subject to the insurance provided under the following: STAFFING SERVICE PROFESSIONAL LIABILITY COVERAGE FORM STAFFING SERVICE PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE COVERAGE FORM A. The following is added to SECTION II—WHO IS AN INSURED: Any person or organization where required by contract executed prior to a loss is an insured, but only with respect to that person's or organization's liability for"damages" arising out of a "wrongful act" during the rendering of"staffing services". B. Paragraph I. in SECTION IV. CONDITIONS is deleted in its entirety and replaced with the following: Transfer of Rights of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. The insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a contract. ©2012 Philadelphia Indemnity Insurance Company Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Where required by written agreement signed prior to loss. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12-28-2025 Policy No. RWD300121609 Endorsement No. Insured Kimco Staffing Services, Inc. Insurance Company Countersigned by XL Insurance America, Inc. WC000313 (Ed. 4-84) ©1983 National Council on Compensation Insurance.