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HomeMy WebLinkAboutCATHYJON ENTERPRISES, INC. DBA HB STAFFINGINSURANCE ON FILE WORK MAY PROCEED A-2023-122-02 UNTIL INRAIJCE EXPIRES CITY CLERK �f�� DATE: CONSULTANT AGREEMENT BETWEEN THE CITY OF SANTA ANA AND CATHYJON ENTERPRISES, INC. DBA HB STAFFING FOR ON -CALL TEMPORARY STAFFING SERVICES l� THIS AGREEMENT is made and entered into on this 20th day of June, 2023 by and between CATHYJON ENTERPRISES, INC. dba HB Staffing ("Consultant"), and the City of Santa Ana, o a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). 0 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 A", 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 under 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 52,000,000.00 during the tern of this Agreement, including any extension periods, as set forth in Section 3, below. b. Payment by City shall be made within forty-five (=45) days following receipt of proper Page 1 of 9 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 Pee 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 up 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 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 Page 2 of 9 the performance of the work hereunder and the results of that work by the Consultant, its agents, representatives, employees or subconsultants. 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 Linder 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 CG 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 CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence Limit. (H) 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 CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts, or equipment furnished in connection with such work or operations. Page 3 of 9 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 11 85 or both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 forms if later revisions used). (ii) 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)Notice 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: VIl, 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 complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. Page 4 of 9 (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 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 of the Consultant, its subconsultants, agents, employees, or other persons acting on its behalf which relates to the services described in section I 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 terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make 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. 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. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed Linder 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 shalt 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. Page 5 of 9 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood 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 party by any subsidiary and/or agent of the other 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; (c) 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 manner with performance of services specified 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 affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 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 terms 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 are inconsistent 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. Page 6 of 9 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. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. lb. 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, faihire, 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. 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 further 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 teen 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 Page 7 of 9 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, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be property 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 Clerk City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Jason Motsick Executive Director of Human Resources City of Santa Ana 20 Civic Center Plaza P.O. Box 1988 Santa Ana, California 92702 To Consultant: Jonathan Paid Vice President/GM of Government Solutions Cathyjon Enterprises, Inc. DBA HB Staffing 7711 Center Ave, Suite 670 Huntington Beach, CA 92647 Fax:650-241-1385 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, communication shall be effective or deenned 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 -tour (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. Page 8of9 p,_2023-1 22-02 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 iniuries 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 filly set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTFRT- APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: NATHAN T. MARTAICZ Assistant City Attorney RECOMMENDED FOR APPROVAL: ve Director Resources Department CITY OF SANTA ANA K!dSSTINE RIDGE City Manager CONSULTANT: 6/5/2023 JONATHANPAUL Vice President/GM of Government Solutions Page 9 of 9 EXHIBIT A SCOPE OF SERVICES (9) CITY OF SANTA ANA EXHIBIT I SCOPE OF SERVICES Contractor shall provide services as set forth below: A. GENERAL CONTRACTOR REQUIREMENTS 1. Contractor shall provide a comprehensive catalog of clerical, office, accounting, other related administrative support service and professional options to the City. 2. Contractor must also agree to: a. Provide appropriate methods to match the City's needs within the specified time frames; b. Coordinate all schedule work dates with City at least one business day before the start of assignment; c. Provide a detailed proposal and invoice, according to the specifications prescribed by the City department; and d. Ensure the following criteria prior to recommending any temporary worker for placement at the City: • Work authorization has been obtained and is current for individuals referred to the City for assignment via Form 1-9, Employment Eligibility Verification. • Live Scan fingerprinting and/ or background check have been processed, completed and passed (if requested by the City) . • Selected temporary worker(s) recommended for an assignment meet all essential job function and minimum qualification requirements for the various types of services. • Typing speed of the selected temporary worker is at least 30 wpm, and Microsoft Office abilities have been tested and are met with positive results as required. • Contractor conducts due diligence employment verification/references of the temporary worker selected for an assignment to verify positive work history. • The selected temporary worker is bilingual in English and Spanish or Vietnamese when required for the assignment. • Verifies that temporary worker is not a retired annuitant of the California Public Employees' Retirement System (CaIPERS). 3. Contractor shall not impose a temporary to permanent placement fee. It is not applicable for temporary workers that are hired by the City through the competititve recruitment process, regardless of introduction or assignment by Contractor. Direct hire placement is only applicable for direct hire placement requests or if a temporary worker was hired without a competitive recruitment process. rg® CITY OF SANTA ANA B. SPECIFICATIONS/ SCOPE OF SERVICES 1. The City of Santa Ana Human Resources Department shall contact the Contractor for temporary services and provide the title and any special skills or experience required. Certain positions may require bilingual skills. Contractor shall provide temporary worker(s) as required and approved by City departments to work at the various City of Santa Ana department locations. 2. The Contractor will compare job requirements with worker qualifications and will email resume(s) and test results of temporary workers as requested. 3. The Contractor will follow up with the City within two (2) hours to provide name(s) for City approval. a. If Contractor is unable to locate a qualified candidate within four (4) hours of the initial request, the City reserves the right to contact other temporary agencies for placement. 4. Once a candidate is selected, and the hourly pay rate has been agreed upon, Contractor shall provide the City with a detailed proposal to include the specific job description, the hourly pay rate for the temporary worker, and the mark-up rate. The City shall then review and sign the proposal if approved. 5. All invoices must include: a. Agreement number; b. Requesting City Department c. Department Contact Name / Requester Name d. Candidate Name e. Hourly pay rate and mark-up rate f. Dates of assignment duration g. Total hours worked during duration of assignment 6. Contractor shall provide temporary workers who have the skills required for the assignment. 7. At the City's discretion, City reserves the right to immediately end a temporary worker's assignment if work performed is substandard, attendance is poor, or for other business related reasons. 8. Contractor shall remove any temporary worker from assignment upon the City's request; at the specified time and date. Contractor shall provide replacement temporary worker if required by City. Contractor shall be responsible for all decisions concerning matters of hiring, firing; discipline; payroll practices; and employee benefits such as vacation, sick, and other leave benefits. Temporary workers provided by the agency shall be considered employees of the agency and shall in no sense be considered employees or agents of the City. 10. Contractor shall be responsible for communication with temporary workers with respect to their duties as they are employees of the Contractor. 11. Contractor must provide City with testing resources for regular status positions as requested. These services shall be provided at the rates set forth in Cost Proposal Form, ATTACHMENT G. CITY OF SANTA ANA 12. Individual temporary workers are not permitted to work more than 960 hours in any fiscal year period (July 1 — June 30). Contractor is solely responsible for tracking hours worked by all temporary workers, and to notify the Department contact and the Human Resources Department within 30 working days of any temporary worker reaching the limit of 960 hours. 13. Contractor must comply with all applicable local, state, and federal laws and regulations, including California Assembly Bill 1028 (effective January 1, 2012) and CalPERS rules regarding CaIPERS Retired Annuitants, whether formerly employed by the City or other public agency employers subscribing to CaIPERS. Contractor must also ensure that no employee provided under this agreement would need to be reinstated to CalPERS employment or considered to be in violation of the retirement law or otherwise in unlawful employment as a result of their work at the City prior to assigning any temporary worker to any City request. C. SERVICE CATEGORIES Please note the service categories listed in this document are provided for purposes of this RFP and should not be construed as a detailed description of the tasks to be performed but rather a broad general outline. General Administrative Office Support Temporary Administrative Support role (e.g., Administrative Assistant and Office Specialist) is responsible for but not limited to: opening and routing mail, answering telephones, providing customer service at public counters, drafting general correspondence, preparing minutes of meetings, may operate computer, and other administrative duties assigned. 2. Executive/Senior Administrative Office Support In addition to the tasks required of General Administrative Office Support, temporary Executive/ Senior Administrative Office Support Roles perform highly responsible secretarial and routine administrative duties in the office of the City Manager, City Attorney, or reports directly to an Executive team member with a higher level of professionalism and experience. Professional Accounting and Financial Administrative Support Temporary Accounting Support role is responsible for but not limited to reconciling accounting records; preparing accounting reports and budgets; reviewing and verifying payroll documents and compliance documents for completeness, correct pay rate and reasonableness; producing reported work hours summary reports, posting accounting entries; summarizing accounting records; accepting and processing invoice payments. Temporary professional accountant is responsible for but not limited to accounting duties requiring the application of accounting principles and practices. 4. Legal Secretary / Paralegal Support Temporary Legal Secretary Support roles perform a variety of complex and responsible legal secretarial and clerical work involving specialized legal terminology, documents and procedures; processes legal papers and documents in accordance with established procedures and formats; and performs confidential secretarial and minor legal procedures for one or more attorneys, as assigned, including maintaining court and appointment calendars. 5. Other Technical and Professional Classifications as Determined 0 CITY OF SANTA ANA Other technical and professional classification(s) relevant to city operations in which the Contractor may possess placement experience, such as human resources administration, building permit or plan check services, housing or job placement eligibility, facilities or vehicle maintenance, etc. City classification specifications can be found and defined on the City's job description site: hftps://www.governmentmobs.com/careers/santaana/classspecs- D. SERVICE UTILIZATION REPORTS Contractor must provide to the City's Human Resources Department the following reporting in Excel format: 1. Quarterly Reports which include at minimum: a. Number of temporary workers hired under this contract; b. Number of hours worked per temporary staff during reporting period, by name; c. Number of hours worked per classification citywide; d. Department to which temporary worker was assigned; e. Billing rate for each temporary worker f. Sum per criteria above 2. Annual Report which includes grand totals of each of the criteria included in Quarterly Reports and listed above. EXHIBIT B CONSULTANT'S PROPOSAL " HB STAFFING POWERED BY A//RRAY • A Provider of Workforce Solutions San Diego 9655 Granite Ridge Drive, Suite 200 San Diego, CA 92123 (714) 960-2800 www.hbstaffing.com Huntington Beach Headquarters 7711 Center Ave, Suite 670, Huntington Beach, CA 92647 (714)960-2800 Inland Empire 1255 W. Colton Avenue, Suite 124 Redlands, CA 92374 (714)960-2800 1. Statement of Qualifications (SOQ) Table of Contents 1. Statement of Qualifications (SOQ) 2 Table of Contents 3 a. Cover Letter 4 b. Services Provided 5 Interviewing and Selection 5 Standardized Assessment Process 5 Training and Support Services 5 Sick Leave Policy and Costs 5 Ongoing Quality Assurance 6 Performance Issues and Preventing Service Disruptions 6 Reporting 6 HB Staffing Temporary Employee Benefits 6 Equal Employment Opportunity Employer 7 Orientation and Training 7 Customized Orientation 7 Specialized Skills Training 7 c. Agreement Statement 7 d. Firm and Team Experience 8 Firm Description 8 Experience 8 Team Resumes g e. Proposed Work Plan 10 i. Anticipated Approach 10 Recruitment 10 Interviewing and Qualifying 11 ii. Suggestions or special concerns 11 iii. Description of deliverables and implementation plan 11 Onboarding 11 Ongoing Quality Assurance 12 Attachment A: Proposer's Certification and Proposal Item Pricing 13 Attachment B: References 14 2. Cost Proposal 21 a. Cover Letter April 19, 2023 Lori Schnaider, Operations Manager City of Santa Ana — Human Resources Department 20 Civic Center Plaza Santa Ana, CA 92701 Subject: Response to RFP #23-051: Temporary Staffing Services Dear Lori Schnaider, Thank you for the opportunity to provide the City of Santa Ana ("the City") with a customized proposal, outlining our detailed service capabilities in response to RFP #23-051 for Temporary Staffing Services upon request to support for specialty areas that will include, but are not limited to, Accountant, Accounting Assistant, Legal Secretary, Office Specialist, Paralegal, Receptionist, and Secretary. We will demonstrate in our proposal why CathyJon Enterprises, Inc., DBA HB Staffing (a subsidiary of Array Corporation) can offer the best value and quality service while providing temporary personnel in conformance with contract requirements. HB Staffing is very qualified in providing Temporary Staffing Services and has ample experience with numerous cities, counties, districts, local authorities, and federal organizations. As a Minority -Owned Business, we are confident that our extensive experience within the specific classifications requested, financial capability, and quality staffing performance throughout the past twenty-two (22) years will prove us to be a qualified bidder for the City. Our delivery of reliable service will ensure good faith, quality performance on this contract. HB Staffing's proposer and primary contact person during the proposal process is Megan Ignacio, General Manager. She can be reached via phone at (657) 6604116, email at mignacio@hbstaffing.com, or fax at (657) 660-4116 from our corporate address of 7711 Center Avenue, Suite 670, Huntington Beach, CA 92647. There are no events foreseen that could impede our ability to fulfill this contract. HB Staffing will not work with subcontractors on this contract, and we do not have any arrangements, formal or informal, with any other party that might interfere with our ability to provide independent and unbiased advice and assistance under this RFP. In addition, HB Staffing is a financially stable DE C-Corporation, with a strong positive cash flow. We have not defaulted on any of our contracts. In fact, we have sustained steady growth at 10-30% per year for the past four years. We look forward to supporting the City of Santa Ana's mission to "deliver efficient public services in partnership with our community which ensures public safety, a prosperous economic environment, opportunities for our youth, and a high quality of life for residents." HB Staffing stands ready to deliver an exceptional experience as we accommodate the name's requirements and requests. 1, Jonathan Paul, certify that I am authorized to legally bind CathyJon Enterprises, Inc. DBA HB Staffing, to a contract resulting from RFP #23-051 Temporary Staffing Services and that this proposal, with the total fixed price contained therein, shall remain firm for a period of one hundred eighty days (180) after the proposal closing date. I acknowledge all addenda. 4/19123 Signature: Jonathan Paul, Vice President/GM of Government Solutions Date b. Services Provided HB Staffing is highly qualified in providing Temporary Staffing Services and has ample experience with numerous cities, counties, districts, local authorities, and federal organizations. Our experience enables us to find and place qualified candidates quickly. We have the systems in place to have a candidate onsite in as little as 2-4 hours following the client's request. We have proven time and again that we can bring our recruiting methodology to markets where we have a limited candidate pool and supply a highly qualified group of candidates that exceed our client's expectations. HB Staffing trains temporary employees to be our staff is educated on the City's procedures, and professional in appearance. Interviewing and Selection prepared for their assignments on Day 1. We ensure that fully prepped and trained to perform their assigned jobs, In interviewing potential candidates, we understand that we need to find people who have both the hard and soft skills to perform the job successfully. We match hard skills with those technology/software skills that contribute to successful placements. Recruiting best practices today include anticipating the City's needs and executing a recruitment and candidate screening campaign from the beginning of the award to identify and onboard highly qualified candidates relevant to the City's requirements. Our process is to identify 3-7 plausible candidates for each position that we are given the privilege to fill. While only one will be hired, the resumes and contact information of the remaining prospects are added to the database as immediate consideration for future vacancies. Should the City face another vacancy, a potential back -fill becomes immediately available. Our sourcing and recruiting staff is highly skilled and experienced in identifying the key skill and experience components to select the most qualified employees that the City will require. Standardized Assessment Process HB Staffing uses a "Quantum Gut Evaluation Rubric' to assess a candidate's skills, aptitudes, mindset, and expertise. Our recruitment team builds a comprehensive and thorough Quantum Gut Rubric based on the details of the job description and the preferred skills and aptitudes of the hiring manager. We ask the same questions of each candidate to minimize bias in our interview process. Training and Support Services HB Staffing provides mandatory Sexual Harassment Prevention Training to every employee. HB Staffing temporary employees will be provided with customized training to best prepare them to report for work assignments at the City and be successful. Vetted HB Staffing temporary employees will participate in a mandatory orientation customized to the City's workplace culture. Sick Leave Policy and Costs HB Staffing follows the mandated minimum California State requirements for sick leave, and we also follow the sick leave policy per the County/City policies. Temporary workers earn sick pay hours at the rate of one hour per every 30 hours they work. Eligible sick leave is tracked, but we use a lump -sum system which means they receive the full hours once they reach eligibility. After 90 days of employment, workers become eligible to use the accrued sick leave hours and may use up to 24 hours of sick leave per calendar year. Temporary workers may carry over unused hours into the next year. All of this is at no cost to the client. Ongoing Quality Assurance Quality assurance is a corporate -level matter at HB staffing. As a minority -owned business, corporate support consists of Project Support, Employee Customer Service, and Quality Control. General Manager, Megan Ignacio, will act as the uniting person in this structure, providing the overall administration and coordination while maintaining lines of communication between HB Staffing and the City's project personnel. The purpose of quality assurance is to both prevent, as well as provide a simple, convenient approach to resolving problems. HB Staffing Key Personnel will be available to the City on a daily basis, giving us the flexibility to respond quickly to the City's questions and requests. We will provide the City with direct phone lines, fax numbers, and email addresses for all team members. Our prime objective is to ensure that the City receives the highest quality of service throughout the life of the contract; thus, all HB Staffing Team members are held accountable for quality assurance efforts right up to General Manager, Megan Ignacio, who is readily available 24/7 to answer any of the City's questions and concerns. Performance Issues and Preventing Service Disruptions In the event that any personnel placed by HB Staffing must be released for any reason, as per the City's request, we will not charge the City for the temporary employee's first four (4) hours of employment. After consulting with the City, we will replace the employee immediately with a qualified, vetted substitute utilizing our "Two on the Bench" policy - for every qualified candidate we place, we have two vetted, equally qualified temporary employees on standby, ready to hit the ground running. Reporting HB Staffing uses a robust and customizable staffing software called Ultra -Staff EDGE Applicant, Client, and Employee Tracking System, which is fully capable of integrating the latest in data security, including cloud storage. Our Team will use this system's features to collect, maintain, track, and report all payroll, invoicing, and expense data and provide required reports. Ultra -Staffs cutting -edge system capabilities would complement the partnership between the City and HB Staffing. Through Ultra -Staff EDGE, the City would be given a Client Portal and an Employee Portal. Some of the key features include the ability to place job orders, receive candidate submissions, view employees, review past orders, review, modify and approve employee time entry (can be done 24/7 at your convenience); and view open/paid invoices. In addition to the City having access, all temporary employees will use Ultra -Staff EDGE to input their hours, which allows the City and HB staffing to view their hours worked. This user-friendly system makes timecards easy, accessible, and trackable. Additionally, Ultra -Staff EDGE generates consolidated management reports, including a weekly or monthly listing of all temporary employee hours worked and employment terminations. Reports can be customized in a variety of formats (including DOC, PDF, XLS, and CSV) for the City and are available on any periodic basis requested. We have Team Associates who can walk through Ultra -Staff EDGE training with users if needed. If a client chooses another option on time/attendance (such as manual timecards), we can accommodate. HB Staffing Temporary Employee Benefits HB Staffing values the most important part of our business: our temporary workers. One of our primary methods of reducing turnover is our comprehensive benefits package, which underscores and supports our commitment to retaining HB Staffing employees: • Competitive wages determined by careful analysis of the local labor market. • Medical coverage • Sick pay (accrued- up to three days per year) - eligible after 90 days of employment • Paid holidays after meeting the 1000-hour eligibility threshold in a calendar year • 401 (k) Retirement Benefits • $100 referral bonuses Equal Employment Opportunity Employer As an Equal Opportunity Employer, HB Staffing is committed to a strong diversity and inclusion policy. Our diversity initiatives are not limited to our practices and policies on recruitment and selection; compensation and benefits; professional development and training, promotions; transfers, and terminations. We pursue the ongoing development of work environments built on the premise of gender and diversity equity that encourage and enforce respect within all work cultures that we staff. Our Minority -Owned Business does not discriminate against nor tolerate from our clients discrimination of candidates/employees based on race, creed, color, age, gender, religion, national origin, marital status, sexual orientation, veteran status, or any other protected categories under federal, state, and local ordinances. We take these issues seriously. Complaints are thoroughly investigated, with appropriate actions taken to resolve the situation. We will recruit, select and place candidates based on qualifications, competencies, and merit. This policy encompasses all aspects of the employment relationship, including application and initial employment, job assignment, selection for training opportunities, and salary/benefits. Orientation and Training HB Staffing's employee training for their positions with the City is two -fold: we provide a customized orientation, specific to the City job assignment; and we have specialized training in over 100 different subject areas designed to improve our employee's skills, when necessary. Customized Orientation HB Staffing temporary employees will be provided with customized training to best prepare them to report for work assignments at the City and be successful. Vetted HB Staffing temporary employees will participate in a mandatory orientation customized to the City's workplace culture. Specialized Skills Training Our parent company, Array, is a training and technology innovator which specializes in workforce skill/value enrichment. These unique technologies and training are aimed at supporting/increasing client production and satisfaction through a more skilled and motivated workforce. Over the next several months, we will begin rolling out our training program to all temporary employees. HB Staffing temporary employees will have access to hundreds of training videos and PowerPoints aimed at creating well-rounded and experienced employees. In addition, our employees will have access to training throughout the whole time working with HB Staffing for any further growth. We believe that training is vital because it enhances performance, boosts productivity, and reduces employee turnover. We shall pay our employees for any time spent taking synchronous training and for any approved 3rd party training. There is no limit to the amount of training that they're allowed to take and be compensated for. These costs shall not be transferred to the City; however, the City shall benefit from our highly -trained workforce. c. Agreement Statement HB Staffing concurs with all provisions as contained in EXHIBIT 11 d. Firm and Team Experience Firm Description CathyJon Enterprises, Inc., DBA HB Staffing was founded in April 2000 by staffing industry veterans Cathy Volpe and Jonathan Paul. Over its 22-year history, HB Staffing has dedicated its energies and resources to providing the highest level of service. We embrace an innovative and diverse company culture to meet the ever -changing temporary staffing demands of our clients and our employees. HB Staffing's cultural commitment to exceptional client services and employee betterment is inspired and enhanced by our parent company, Array Corporation, which acquired HB Staffing in October 2021. Array Corporation is a Silicon -valley based company focused on revolutionizing how labor is bought, sold, and delivered to enable universal access to the American Dream. HB Staffing operates independently with proven successful past performance and now enjoys the training and technology support afforded by an exceptional industry innovator. Since its inception, HB Staffing has placed thousands of talented individuals with over 1,000 businesses and government organizations. Currently, HB Staffing has 47 active public agency contracts. HB Staffing has ample experience providing services to numerous cities, counties, districts, local authorities, and federal organizations. Our core classification specialties are administration/office, accounting, professional (i.e., legal, insurance, HR), IT, manufacturing and assembly, events, and customer service & retail. Today, HB Staffing continues to be managed day-to-day by Megan Ignacio, our General Manager. Our dedicated internal Team of 17 places thousands of temporary personnel each year. Our nearest address serving the City of Santa Ana is our corporate office in Huntington Beach, California. We have additional offices in the Cities of Redlands and San Diego. Experience HB Staffing has been providing temporary staffing for 22 years; over the past 12 years, we have served dozens of public agency clients. The needs of each agency are unique, and we have the flexibility and depth of knowledge to respond accordingly. We bring in the experienced staff necessary to ensure that each client relationship receives maximum support. Our experience includes but is not limited to: Working with centralized and decentralized agencies; Assisting clients in ensuring that temporary employee assignment limits are followed; Adhering to hiring rules related to former employees and/or public pension participants; Working with dozens of departments within a single agency; Staffing a wide range of job classifications, and Engaging in high -volume recruitment to successfully meet agency needs. HB Staffing was awarded the temporary staffing contract with the City of Santa in 2018 to ensure consistent availability for on -call employees as needed. Qualified, vetted employees have been placed in the following roles: Accountant, Accounting Assistant; Admin Assistant; Executive Secretary; Housing Specialist; HR Analyst; Legal Secretary; Maintenance Technician; Office Assistant, Office Specialist, Part-time Mailroom Clerk; Receptionist; Senior Accountant Assistant; Senior Admin Assistant; Store Clerk In addition, we have extensive past and current experience with public agency clients. Notably, we were chosen to be the PRIME contractor for the County of San Diego, CA, and staff approximately 50 departments within the County because of our excellent reputation for outstanding service and delivery. Our recruitment team focuses on providing exceptional customer service to counties, cities, authorities, districts, and federal departments. These are a few examples of the clients we serve: 1. Cities such as Santa Ana (since 2018), Huntington Beach (since 2010), Newport Beach (since 2015), Anaheim (since 2016), Irvine (since 2018), Murrieta (since 2018), California City (since 2018). Moreno Valley (since 2019), West Hollywood (since 2020). Redwood City (since 2020), Park City (UT) (since 2020), Redmond (WA) (since 2020), Encinitas (2021), Tucson (AZ) (since 2021), Board of Election Commissioners for the City of Chicago (IL) (since 2022), and Glendale (AZ) (since 2022). among others — providing services including general and multilingual clerical, supervisory clerical, maintenance, utility workers, labor, accounting/finance, customer service, permit technicians, and IT personnel as well as payroll and direct hire services. 2. Counties such as County of San Diego (since 2017), County of Los Angeles Registrar - Recorder / County Clerk (since 2019), County of Riverside, ROV (since 2019), County of San Diego ROV (since 2020), County of Monterey (since 2021), County of San Bernardino ROV (since 2021) County of Frederick (MD) (since 2022) County of Placer (since 2022), County of Napa (since 2022), and County of Yolo (since 2022), among others — providing services including administrative, clerical, data entry, warehouse/general labor, stock clerks, accounting/finance, medical unit clerks, patient services representatives, investigative aides, and technical IT support services, in addition to other support personnel, including election support. 3. Districts such as Midway City Sanitary District (since 2007), Orange County Sanitation District (since 2018), Metropolitan Water District (since 2018), North County Transit District (since 2019), and South Coast Air Quality Management District (since 2020), among others — providing services including clerical, administrative, accounting, IT customer service, marketing, and air quality instrument technician personnel. HB Staffing's proposer and primary contact person during the proposal process is Megan Ignacio, General Manager. She can be reached via phone at (657) 660-4116, email at mignacio@hbstaffing.com, or fax at (657) 660-4116 from our corporate address of 7711 Center Avenue, Suite 670, Huntington Beach. CA 92647. Team Resumes Megan Ignacio, General Manager 1 (657) 660-41161 mignacio@hbstaffing.com Role with the City: General Manager (GM) and Project Manager (PM) Qualifications: In addition to experience serving HB Staffing as General Manager, Megan spent one (1) year at HB Staffing as FIR Operations Coordinator in our Operations and Management department and two (2) years as our Public Agency Account Manager overseeing all our government accounts. Her perspective on projects is two -fold, stemming from her comprehensive understanding of the operations side and her adeptness in meeting the recruitment needs on the client side. Megan oversees the whole company and is tasked with overseeing daily business activities, improving overall business functions, training heads of departments, managing budgets, developing strategic plans, creating policies, and communicating business goals. Experience: Megan used to oversee all the recruiters at HB Staffing and now oversees the whole company, so she has experience with all our past projects. Megan is the project manager on county contracts, including the County of Los Angeles, Riverside, Orange, and San Diego; many municipal contracts, including, but not limited to, West Hollywood, Redwood City, and Moreno Valley; as well as district and authority contracts. She is also the Project Manager for our contract with the California Secretary of State, Department of ROV. Education and Credentials: With a Bachelor of Science in Human Resources from California State University, Long Beach, Megan also earned her Certified Staffing Professional (CSP) certification from the American Staffing Association. Cristia Kish, Government Account Manager 1925-239-2522 1 ckish@hbstaffing.com Role with the City: Government Account Manager Qualifications: Prior to joining the HB Staffing team as Government Account Manager, Cristia worked for four (4) years as an Account Manager and Recruiter for Experis and has another four (4) years as Resource Manager and Resource Development Manager. Cristia's job as Government Account Manager is to serve as the liaison between HB Staffing and our clients. Her core priority is addressing customers' needs and concerns as quickly and effectively as possible. Cristia works in lockstep with Megan and Paige to ensure that the contract is being followed and that our client's goals are met. Experience: Cristia is the account manager for all of HB Staffing's Public Agency clients. Education and Credentials: Cristia has a Bachelor of Science in Business focusing on Human Resources Administration. Paige McAllister, Director of Recruiting 1 (909) 490-4796 1 pmcallister@hbstaffing.com Role with the City: Alternate Project Manager (APM) and Director of Recruiting Qualifications: Before becoming Director of Recruiting, Paige began as a Recruiting Assistant, and rose through the ranks to Recruiter/Account Manager to Recruiting Manager/Account Manager finally to Director of Recruiting. Paige oversees all the recruiters at HB Staffing. She will be the main contact for job orders by phone, email, or fax, handling the details involved in understanding each order, along with distribution. Experience: Paige is the project manager on contracts including the City of Moreno Valley, Housing Authority of San Bernardino County, Omnitrans, City of Murrieta, San Bernardino County Transit Authority, County of Riverside, and County of San Diego. Education and Credentials: Paige is currently completing her Associate in Business Administration from San Bernardino Valley College. Heather Robertson, Talent Engagement Manager 1 (909) 284-6183 1 hrobertson@hbstaffing.com Role with the City: Key Liaison for Talent Management Qualifications: Heather brings over 15 years of customer service and management experience to her job as Talent Engagement Manager. She is responsible for developing talent by assisting them with acquiring skills when necessary and coaching them in their career paths. Prior to her current role, she worked as an account manager and recruiter at HB Staffing. Before that she worked for years as a Manager of a pharmacy and at a retail store. Experience: Heather has extensive experience working with HB Staffing clients in recruiting qualified candidates, as well as managing the overall relationship. She builds excellent rapport with employees to ensure career growth for them, as well as a positive experience for our clients. Alex Rendon, Payroll Specialist j (657) 660-3608 i arendon@hbstaffing.com Role with the City: Point of Contact for Operations Qualifications: Prior to working at HB Staffing, Alex worked for four (4) years as a Tech Consultant, Recruiter, and HR Specialist. Alex first joined the HB Staffing team as a recruiter before being promoted to the role of Payroll Specialist. His experience working on the recruitment team has allowed him to excel in the Operations department with the knowledge he has of the front -office processes. Through this two -fold understanding of both operations and recruitment, he has shown himself to be a huge asset to our team by maintaining an A -level professional service to applicants, candidates, employees, clients and vendors by phone, email, or face to face. Alex is responsible for payroll, weekly invoicing, and handling accounts receivable activities, he also supervises and executes AR and Collections functions for public agency accounts. Alex has hands in every department ensuring that everything is running smoothly and efficiently within HB Staffing. Experience: Manage all daily clients operations: payroll, billing, contract compliance. Education and Credentials: Alex has a Bachelors of Arts degree in Psychology from the University of California, Riverside and a CTE Certificate in Human Resource Management from Cerritos College. e. Proposed Work Plan i. Anticipated Approach Our goal is to facilitate the smooth transition of appropriately screened and credentialed temporary employees into your workplaces. Our project plan is conducted via the following processes: Recruitment 1. Recruitment Campaign — Our team will implement the recruitment plan based on information from the kick-off meeting, City's job category descriptions, and scope of work. We will recruit and attract relevant qualified personnel that can meet City -centered job -related work experience, skills, stability, location, and education prerequisites. We stay connected to the job force in and around the City, utilizing local job developers to assist in recruiting potential candidates. 2. Sourcing Candidates — HB Staffing recruiters will conduct an initial search within our database of over 8,000 vetted candidates. Our search efforts are enhanced by utilizing key talent portals such as Indeed, ZipRecruiter, and Craigslist, in addition to posting job offerings on our website and social media sites (Facebook and Linkedln). We will expand search efforts using cutting -edge technological tools (i.e.: Hiretual) to quickly and accurately source talent through key talent portals. We will also source community resources weekly, targeting colleges, non-profit organizations, trade groups, online communities, job boards, job fairs, and community and local charity events. 3. Pre -Screening Interviews — HB Staffing recruiters will schedule and conduct pre-screening interviews to determine qualifications, interest, and availability. In addition, recruiters will determine the fit and relevance to the City's needs when determining the applicant's availability. 4. Applicant Tracking — When a candidate is new to our system, our Recruiters will onboard them into our pool of candidates within our Ultra -Staff EDGE database. All candidates are onboarded into our system for future opportunities, regardless of whether or not they fit a specific job category. Interviewing and Qualifying 1. Gut Rubric — HB Staffing uses a "Quantum Gut Evaluation Rubric" to assess a candidate's skills, aptitudes, mindset, and expertise. Our recruitment team builds a comprehensive and thorough Quantum Gut Rubric based on the details of the job description and the preferred skills and aptitudes of the hiring manager. 2. Interviewing — The finest available candidates undergo a rigorous vetting process designed to assess each work history and performance on the job. Our Recruitment Team uses the Gut Rubric to ask the same questions of each candidate to minimize bias in our interview process. Applicants participate in a thorough behavioral interview in order to determine if they are suitable for a position with the City. In interviewing potential candidates, we understand that we need to find people who have both the hard and soft skills to perform the job successfully. We match hard skills with those technology/software skills that contribute to successful placements. 3. Skills Assessments — Applicants who pass pre-screening will complete an online application and various skills assessments tailored to each position through PreValuate. With many assessments to choose from, should the City require a specific or elevated software proficiency, HB Staffing is more than willing to offer that assessment at no charge to the City. Test results, interview notes, credentials, and references are entered into our Ultra -Staff EDGE database. 4. Submitting Candidates to the City — Once our candidates have been fully screened by our recruiters, we will send resumes of the best -fit candidates to the City. We will ensure that, if the City wishes to conduct an interview, we will coordinate and prepare all the candidate(s) for the interview. Our process is to identify 3-7 plausible candidates for each position that we are given the privilege to fill. While only one will be hired, the resumes and contact information of the remaining prospects are added to the database as immediate consideration for future vacancies. Should the City be faced with another vacancy, a potential backfill becomes immediately available. ii. Suggestions or special concerns HB Staffing has no suggestions or special concerns. iii. Description of deliverables and implementation plan Onboarding 1. Efficient Forms — The HB Staffing Recruitment Team uses Efficient Forms, a cloud -based employee application, paperless onboarding, and compliance software solution. This is state -specific and customizable to ensure that all required onboarding and candidate requirements are completed per the City's guidelines. All employees complete State and Federal Tax forms, Company Policies, 1-9, and e-verify through this system. 2. Background Checks — HB Staffing conducts a comprehensive background using Checkr, which provides a full background check for each county our temporary employee has lived im ensuring zero felonies, sex offense charges, and misdemeanors within seven (7) years from the date of an assignment request. Per the City's requirement, HB Staffing will also provide drug testing. We use Concentra as the primary vendor to administer drug screens to applicants. The results of these tests are posted on a dashboard that is accessible by HB Staffing's recruitment team. Refusal to be tested for drugs or alcohol will be treated the same as a positive test result. 3. Job Start Confirmation — Our team will send a job start confirmation to the employee that includes the employee handbook, job expectations, and a customized orientation. Our team will also send the job start confirmation to the City. Ongoing Quality Assurance 1. First Day of Assignment — On the first day of the assignment, a member of the Recruitment Team will follow up with the City's hiring manager and our HB Staffing temporary employee to ensure everything proceeds smoothly. 2. Employee Quality Assurance Phone Calls — Our Recruitment Team makes 'quality assurance' phone calls to the employees to ensure that they are satisfied and productive. During these calls, our team will verify that job progress is per the City's requirements. 3. Quality Assurance Phone Calls — Our Project Manager or Account Manager will make 'quality assurance' phone calls to the City (as permitted) to ensure that job progress is positive. We have a proactive approach when it comes to concerns. Whenever the City expresses a concern, we counsel our employees immediately, log this into their records and provide ongoing support and follow-up with the City to quickly resolve the problem. 4. Quality Assurance Meetings — Our team will meet with the City on a semi-annual to annual basis (or as often as agreed upon) to ensure ongoing satisfaction. We will work with the City to set internal goals that meet project standards, assess management strategies, and suggest ideas to potentially improve the City project outcome. 5. Service Disruption Prevention Processes — In the event that any personnel placed by HB Staffing must be released for any reason, as per the City's request, we will not charge the City for the temporary employee's first four (4) hours of employment. After consulting with the City, we will replace the employee immediately with a qualified, vetted substitute utilizing our "Two on the Bench" policy - for every qualified candidate we place, we have two vetted, equally qualified temporary employees on standby, ready to hit the ground running. VII. Certifications (Attachments) CITY OF SANTA ANA ATTACHMENT A PROPOSER'S CERTIFICATION, PROPOSAL PRICING Certification - I certify that I have read, understand and agree to the terms and conditions of this Request for Proposals. I have examined the Scope of Services (Exhibit 1) and am qualified to provide services being requested as specified herein. I understand and agree that I am responsible for reporting any errors, omissions or discrepancies to the City for clarification prior to the submission of my proposal. PROPOSER'S STATEMENT: I have read, understood and agree to the terms and conditions on all pages of the Request for Proposals. Upon request, I will transfer and deliver goods or services to the City in accordance with said terms and conditions. CathyJon Enterprises, Inc. DBA HB Staffing LEGAL NAME OF COMPANY 7711 Center Ave, Suite 670, Huntington Beach, CA 92647 BUSINESS ADDRESS Jonathan Paul PRINTED NAME OF AUTHORIZED AGENT RE OF AUTHORIZED AGENT DATE 33-0907010 FEDERAL ID NUMBER (IF APPLICABLE) p: (714) 960-2800 f: (650) 241-1385 PHONE AND FAX NUMBERS Vice President/GM of Government Solutions TITLE jpaul@arraycorp.com E-MAIL ADDRESS N/A CONTRACTOR LICENSE NUMBER (IFAPPLICABLE) THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. (9) CITY OF SANTA ANA ATTACHMENT B REFERENCES List and describe fully the contracts performed by your firm which demonstrate your ability to provide the supplies, equipment or services included in the scope of the proposal specifications. Attach additional pages if required. The City reserves the right to contact each of the references listed for additional information regarding your firm's qualifications. REFERENCE Customer Name: City of Santa Ana, CA Contact Individual: Cindi Sangenito, Executive HR Secretary Address: 605 West Santa Ana Boulevard, Building #20 Phone Number: Santa Ana, CA 92701 (714)647-5374 EMAIL: csangenito@santa-ana.org Contract Amount: $400,000 annually Year: 2018 - 2021, with two (2) 1-year options Description of supplies, equipment, or services provided: Supplier of temporary clerical and administrative personnel REFERENCE Customer Name: City of Anaheim, CA Contact Individual: Luz Flores, Principal Human Resources Analyst Address: 201 South Anaheim Boulevard Anaheim, CA 92805 Number: (714) 765-4572 EMAIL: Iflores@anaheim.net Contract Amount: $200 000 annually Year: 2016 - 2020, re -awarded 2020 - 2021, with a 2-year option Description of supplies, equipment, or services provided: Supplier of temporary clerical, administrative, accounting, customer service, and housing personnel REFERENCE Customer Name: City of Huntington Beach, CA Contact Individual: Debbie Gilbert, Senior Administrative Analyst Address: 2000 Main Street Phone Number: (714)374-1643 Huntington Beach, CA 92648 EMAIL: dgilbert@surfcity-hb.org Contract Amount: Services are as -needed Year: Ongoing business since 2005 Description of supplies, equipment, or services provided: Supplier of temporary clerical and administrative personnel, as well as payroll only services THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. CITY OF SANTA ANA ATTACHMENT C PROPOSER'S STATEMENT Proposer understands and agrees that this written RFP (or any part thereof specifically designated and accepted by the City of Santa Ana, hereinafter City) shall constitute the entire agreement between proposer and the City only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Executive Director or his duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to proposer or deposited with the United States Postal Service properly addressed to the proposer with the correct postage affixed thereto. Proposer further agrees that upon delivery (as defined above) of the accepted agreement he/she will furnish City all required bonds and certificate of liability insurance within ten (10) days (excluding Saturdays, Sundays and City's legal holidays), or the funds, check, draft, or proposer's bond substituted in lieu thereof accompanying this proposal shall become the property of the City and shall be considered as payment of damages due to the delay and other causes suffered by City because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered by City is difficult to ascertain; otherwise said funds, check drafts, or proposer's bond substituted in lieu thereof shall be returned to the undersigned. Proposer understands that a proposal is required for the entire work, that the estimated quantities set forth in the RFP schedule are solely for the purpose of comparing proposals, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. All terms contained in the specifications, the certification of nondiscrimination by contractors, and the required insurance certificates are to be incorporated by reference into this agreement and are made specifically as part of this RFP. Firm CathyJon Enterprises, Inc. DBA HB Staffing Signed and Printed Name: Title Vice President/GM of Government Solutions Date 4/19/23 Jonathan Paul THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. (a CITY OF SANTA ANA ATTACHMENT D NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the proposer declares that the proposal is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the proposal is genuine and not collusive or sham; that the proposer has not directly or indirectly induced or solicited any other proposer to put in a false or sham proposal, and has not directly or indirectly colluded, conspired, connived or agreed with any proposer or anyone else to put in a sham proposal, or that anyone shall refrain from bidding; that the proposer has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the proposal price of the proposer or any proposer, or to fix any overhead, profit, or cost element of the proposal price, or of that of any other proposer, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the proposal are true; and, further, that the proposer has not, directly or indirectly, submitted his or her proposal price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham proposal. Note: The above non -collusion affidavit is part of the proposal. Signing this proposal on the signature portion thereof shall also constitute signature of this non -collusion affidavit. Proposers are cautioned that making a false certificationmay subject the certifier to criminal prosecution. Signed State of JZL. County of Su nbedAd s orn to (or affirmed) before me on this_L day of_/�, 20�, by & _ 2x047 . proved to me on the basis of satisfactory evid ce to be the person(s) who appeared before me. i QUL ar ublic Signature Notary Public Seal THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. �v�- A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of ORANGE Subscribed and sworn to (or affirmed) before me on this 11 day of APRIL 20 23 , by ]ON PAU L proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. geNotary PUbhc _a:domfa fi Orange Ccun[y Commission ! 2389445 a I CCTW. E1.i' s lar (Seal) Siq natur '�d.>' P CITY OF SANTA ANA ATTACHMENT E NON -LOBBYING CERTIFICATION The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Signed:. mod- V Title: Vice President/GM of Government Solutions Firm: CathyJon Enterprises, Inc. DBA HB Staffing Date: 4/19/23 THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. CITY OF SANTA ANA ATTACHMENT NON-DISCRIMINATION CERTIFICATION The undersigned consultant or corporate officer, during the performance of this contract, certifies as follows: The Consultant shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Consultant shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Consultant agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Consultant shall, in all solicitations or advertisements for employees placed by or on behalf of the Consultant, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Consultant shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Consultant's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Consultant shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Consultant shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. In the event of the Consultant's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Consultant may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. 2. The Consultant shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract (2) CITY OF SANTA ANA or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Consultant becomes involved in, or is threatened with, litigation with a subconsultant or vendor as a result of such direction by the administering agency, the Consultant may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, no discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any consultant of public works violating this Section is subject to all the penalties imposed for a violation of the Chapter. Signed: li Title: Vice President/GM of Government Solutions Firm: CathyJon Enterprises, Inc. DBA HB Staffing Date: 4/19/23 THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. EXHIBIT C COMPENSATION Consultant's Fee Proposal including hourly rates if applicable CITY OF SANTA ANA ATTACHMENT G COST PROPOSAL FORM FOR EVALUATION PURPOSES, THE FOLLOWING PROPOSAL PRICING MUST BE BASED ON THE CITY'S ASSUMED 9/80 WORK SCHEDULE AND DETAILED CRITERIA AS SPECIFIED HEREIN. ALL RATES PROPOSED MUST BE INCLUSIVE OF ALL APPLICABLE TAXES, LABOR, BUSINESS EXPENSES, ETC. ADD AS MANY ADDITIONAL ROW(S) FOR ADDITIONAL CLASSIFICATION(S) FOR CONSIDERATION FOR INCLUSION IN YOUR RESPONSE, AS STATED IN SECTION C. SERVICE CATEGORIES, SUBSECTION 5. CITY OF SANTA PRICING ANA Hourly Pay Min Bill Rate Max Bill Rate Mark-up Overtime Overtime CLASSIFICATION Rate Bill Rate Mark-up Accountant $ 31.00-$34.00 $ 45.26 $ 49.64 46 % $ 67.89-$74.46 46 % Accounting Assistant $ 24.00- 28.00 $ 35.04 $ 40.88 46 % $ 52.56-$61.32 46 % Legal Secretary $25.00-$29.00 $ 36.50 $ 42,34 46 % $ 54.75-$63.51 46 Office Specialist $17.00-$19.00 $ 24.82 $ 27.74 46 % $ 37.23-$41.61 46 % Paralegal $ 29.00-$32.00 $ 42.34 $ 46.72 46 % $ 63.51-$70.08 46 % Receptionist $21.00-$24.00 $ 30.66 $ 35.04 46 % $ 45.99-$52.56 46 % Secretary $23.50-$27.00 $34.31 $39.42 46 % $ 51.47-$59.13 46 % Provide markup percentage rate agency will utilize to negotiate prices for positions not listed above. 46 OTHER TECHNICAL AND PROFESSIONAL CLASSIFICATIONS AS DETERMINED. LIST CLASSIFICATIONS IN ALPHABETICAL ORDER. DIRECT HIRE PLACEMENT Direct Hire Lump Sum Fee (Please Explain Below) $ 20% of the first year's salary Temp -to -perm placement fee is not applicable for temporary workers that are hired by the City through the competititve recruitment process, regardless of introduction or assignment by Contractor. Direct hire placement is only applicable for direct hire placement requests or if a temporary worker was hired without a competitive recruitment process. Please Ho, Josephine From: City of Santa Ana <certificate-request@ctraxjdidata.com> Sent: Thursday, February 2, 2023 10:57 AM To: mignacio@hbstaffing.com; Lynch, Breanna; Crystal.wellborn@cacspecialty.com; Ho, Josephine; Schnaider, Lori Subject: Internal Notice of Compliance NOTICE OF COMPLIANCE C TI'VSTAFF: PRINT THIS PAGE AND INCLUDE V1'ITH AGREENIEN7"ro THE CLERK OF THE COUNCIL Contractor CathyJon Enterprises Inc. Name: Project A-2018-147-01 Number: Project Extension of Temporary Staffing Services Agreement No. A-2018-147 Name: 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 NUMBER EXPIRATION COI FILE NAME DATE DATE AUTOMOBILE INCLUDED 01/31/2024 01/30/2023 23 LIABILITY 24CJEIHBS_COI_CityofSantaAna.pdf GENERAL LIABILITY LIMITSIMOCC2MAGG 01/31/2024 01/30/2023 23 24CJEIHB S_COI_C ityofSantaAna.pdf GENERAL LIABILITY LIMITSIMOCC2MAGG 01/31/2024 01/30/2023 2' 24CJEIHB S_COI_CityofSantaAna.pdf WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Thank you, KEY0145812 City of Santa Ana Risk Management Division 01/01/2024 12/29/2022 City of Santa Ana Risk Management Department.pdf 1 ACCORD® CERTIFICATE OF LIABILITY INSURANCE `....�� DATE(MM/DD/YYYY) 2/28/2024 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 h der in lieu of s c endorsement(s). D Y 8 0 �7i Dr. #105 Acevedo Plano, 75024 Date. 2024.03.14 ac i crystal Wellborn A/C N Ext : 205-414-8100 FAX No ADDE-MARESS:/ Cr stal.wellborn@cacspecialty.com 09:46.05SURER(S)AFFORDING COVERAGE NAIC# INSURERA: Everest National Insurance Company 10120 INSURED CathyJon Enterprises Inc. DBA HB Staffing 7711 Center Avenue, Suite670 Huntington Beach CA 92647 INSURERB: Everest Indemnity Insurance Company 10851 INSURERC: StarNet Insurance Company 40045 INSURERD: Trisura Specialty Insurance Company 16188 INSURER E7 INSURER F : COVERAGES CERTIFICATE NUMBER: 78862138 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A COMMERCIAL GENERAL LIABILITY ✓ 91ML002518241 3/1/2024 3/1/2025 EACH OCCURRENCE $1,000,000 CLAIMS -MADE IV/] OCCUR DAMAGE TO RETED PREMISES(Ea occurrrence)$ 200,000 ✓ MED EXP (Any one person) $10,000 Professional Liab (Ded: $5K) Limits: $1 M Occ/$5M Agg ✓ Emp Practices Liab (Ded: $25K) PERSONAL &ADV INJURY $1,000,000 Limits: $1 M Occ/$2M Agg GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $3,000,000 POLICY ❑PRO- JECT ❑ LOC ✓ PRODUCTS - COMP/OP AGG $ 3,000,000 OTHER: Fire Legal Liabilit Limits: $200,000 ✓ Abuse or Molestation $1,000,000 A AUTOMOBILE LIABILITY ✓ 91ML002518241 3/1/2024 3/1/2025 C(EaOMBINEDSINGLE$1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ ✓ PR E Peorr acdenDAMAGE $ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY Alternate Employer Endt $ included B �/ UMBRELLALIAB �/ OCCUR 91CUN00401241 3/1/2024 3/1/2025 EACH OCCURRENCE $2,000,000 EXCESS LAB CLAIMS -MADE (Follows Form) AGGREGATE $2,000,000 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OF ICER/MEMBEREXCLUDED? ECUTIVE ❑N N/A KEY0145812 KEY0162432 (CA) 1/1/2025 1/1/2026 �/ SPER TATUTE OERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 A Crime (including Employee Theft) 91CR001299241 3/1/2024 3/1/2025 Occ&Agg/Deductible $1,000,000/$10,00 D Cyber Liability ATB662537602 10/1/2023 10/1/2024 Occ&Agg/Deductible $5,000,000/$25,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Contract # A-2018-147. The City of Santa Ana, its officers, employees, agents, and representatives are named as additional insured as respects to General and Auto Liability. The City of Santa Ana shall be given 30 days written notice of cancellation. Insurance afforded is primary and non-contributory. Separation of Insured endorsement. "All Owned Auto" does not apply as the insured does not own any company autos and there is no exposure for their type of operations. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Department 20 Civic Center Plaza, 4th Floor Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC oR.N a RA ManagementDMstan AUTHORIZED REPRESENTATIVE zI f ,°x RWLNVED & PaPPROVm BY: 4d�xl W Afg I Aezv Crystal Wellborn � R Disk Management Specialist ACORD 25 (2016103) © 1988-2015 ACORD V The ACORD name and logo are registered marks of ACORD 78862138 24-25 CathyJon Ent I Crystal Wellborn 12/28/2024 7:46:01 PM (CST) Page 1 of 16 This certificate cancels and supersedes ALL previously issued certificates. Policy Number: 91ML002518241 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. •a � 0 4 no : 0 [11111I MeW 0 We-] 9 M 1:4 za I z Rif I _14A L M11111M k This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 @ Insurance Services Office, Inc., 2012 Risk Mwaganad DlMsian REVIEWED & APPROVED BY: A4+e Aczvdo Hi5k Management Specialist y Page I of 1 78862138l ?4-25 Cathyjon Ent I Crystal Wellborn 1 2/28/2024 7:46:01 PM (CST) I Page 2 of 16 This certificate cancels and supersedes ALL previously issued certificates. Policy Number: 91ML002518241 ECG 04 780 08 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. STAFFING INDUSTRY COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Paragraph 2. Exclusions under Section I — Coverages (Coverage A — Bodily Injury and Property Damage Liability) is amended as follows: Exclusion g. is deleted and replaced by the following: g. Aircraft, Auto or Watercraft Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (5) Liability assumed under any "insured contract" for the maintenance or "loading or unloading" of an "auto"; (6)"Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". Exclusion j. is deleted and replaced by the following: j. Damage To Property "Property damage" to: (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; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; E RA ManagementDMsian f ° REVIEWED & APPROVED BY. of <" Afg ezv Risk Management Specialist ECG 04 780 08 16 © Everest Reinsurance Company, 2016 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 3 of 16 This certificate cancels and supersedes ALL previously issued certificates. (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Additionally, paragraphs (3), (4), (5) and (6) do not apply to: (a) "Property Damage" to property rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by your "employee", "volunteer worker" or intern while that person is performing "staffing services" for your clients; or (b) Liability arising out of services performed by 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. Paragraphs (4), (5) and (6) do not apply to "property damage" arising out of "staffing services". Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations hazard". 2. Section I — Coverages (Coverage B — Personal and Advertising Injury) is amended as follows: Exclusion k. does not apply. Exclusions a., b., e., If., 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 being once the full extent of the assets of the responsible insured has been exhausted and once the Deductible as shown on the Declarations Page has been satisfied. 3. The following Exclusions are added to the policy: This insurance does not apply to: A. "Bodily injury" or "property damage" or "personal and advertising injury" arising out of any activities or services rendered by any "PEO worker'. B. "Bodily injury" or "property damage" or "personal and advertising injury" arising out of a "wrongful act" in the rendering of, or failure to render, any professional service for your client. For the purposes of this exclusion, "wrongful act" shall mean any actual or alleged error, omission, misstatement, or misleading statement by you or by any person for whose acts you are legally responsible during the course of providing "staffing services" to your clients. C. "Bodily injury" or "property damage" or "personal and advertising injury" 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. 4. Paragraph 1.d. under the Supplementary Payments Section of the policy is deleted and replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of times nff frnm %Ainrk �,�P—", Risk ManagementDMsian �II f °;' REVIEWED & APPROVED BY. °" Aezv 1" Risk Management Specialist ECG 04 780 08 16 © Everest Reinsurance Company, 2016 V NJ 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 4 of 16 This certificate cancels and supersedes ALL previously issued certificates. 5. Section II —Who Is An Insured is replaced by the following SECTION II — WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than an individual, partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Your "volunteer workers" or interns only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" or interns are insureds for: (1) 'Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" or interns while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" or intern as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (2) "Property damage" to property: (a) Owned, occupied or used by; (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your "employees", "volunteer workers", interns, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). However, your "employee", "volunteer worker", or intern is an insured for "property damage" to property rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by your "employee", "volunteer worker" or intern while that person is performing "staffing services" for your clients. b. Any person (other than your "employee" or "volunteer worker" or intern), or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. e. Any individual or organization under written contract or written agreement with y, E Risk ManagementDMsian services" on your behalf and at your direction for your clients. =f °x ReAeWEo&APPROVED BY. Risk Management Specialist ECG 04 780 08 16 © Everest Reinsurance Company, 2016 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 5 of 16 This certificate cancels and supersedes ALL previously issued certificates. f. With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: 1. "Bodily injury" to an insured if another insured is driving the equipment; or 2. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is insured under this provision. 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. Paragraph 2.a. is replaced by the following: 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an 'occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the 'occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the 'occurrence" or offense. You will not be considered to have knowledge of an "occurrence" or an offense which may result in a claim until any of the following is aware of such "occurrence" or offense: (1) If you are an individual, you or your Risk Manager; (2) If you are a corporation, your Corporate Officer or your Risk Manager; (3) If you are a partnership or joint venture, your partner or member, or your Risk Manager; or (4) If you are a limited liability company, your member or your Risk Manager. 2. Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us is amended to include the following: However, if any insured is required by a written contract or written agreement which is executed before a "staffing services" occurrence to waive their rights of recovery from others, we agree to waive our rights of recovery. 3. The following Condition is added: Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as the day the revision is effective in your state. SECTION V — DEFINITIONS is amended as follows: 1. The definition of "coverage territory is replaced by the following: Risk Management Division "Coverage Territory" means anywhere in the world.f E °x� Remeo&AaPRovmt3r: �1 �, Aezv OM 2. The definition of "employee" is replaced by the following: — --- Ri5k Management Specialist ECG 04 780 08 16 © Everest Reinsurance Company, 2016 V NJ 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 6 of 16 This certificate cancels and supersedes ALL previously issued certificates. "Employee includes but is not limited to a "leased worker' and a "staffing services worker". "Employee" does not include a "temporary worker" or a "PEO worker". 3. The following definitions are added: 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) Staffing related administrative services provided by an Administrative Services Organization (ASO). (2) "PEO service"; (3) Staffing related services provided to your clients for the recruitment, selection and placement of a person for employment with a client. (4) Vendor Management Service (VMS), means the facilitation, purchase and management of "staffing services" for clients including the placement and fulfillment of orders for "staffing services workers". (5) Temporary, contingent or contract placement services; (6) Services performed for a client company to supply that client with a "staffing services worker"; (7) Services performed on behalf of your client by a "staffing services worker' who is not a direct hire or permanent placement. d. "Staffing services worker" 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 apply. oR,N a Risk ManagementDMsian f ' REVIEWED & APPROVED BY. °Aezv 1" Risk Management Specialist ECG 04 780 08 16 © Everest Reinsurance Company, 2016 V NJ 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 7 of 16 This certificate cancels and supersedes ALL previously issued certificates. Policy Number: 91MLOO2518241 COMMERCIAL GENERAL LAIBILITY ECG 04 751 01 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON -OWNED AUTO LIABILITY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE All numbers and letters used to designate paragraphs in this endorsement are specific to this endorsement only. They do not reference any paragraphs in the Commercial General Liability Coverage Part. Insurance is provided only with respect to those coverages for which a specific Limit of Insurance is shown: Limit Of Insurance Coverage Per "Occurrence" Aggregate Limit Premium Hired/Non-Owned Auto $ 1,000,000 $ 1,000,000 $ Included Liability Insurance Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Hired Auto Liability The insurance provided under the Bodily Injury And Property Damage Liability coverage applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. B. Non -Owned Auto Liability The insurance provided under the Bodily Injury And Property Damage Liability coverage applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person in the course of your business. C. Changes In Exclusions With respect to the insurance provided by this endorsement: 1. The following Bodily Injury And Property Damage Liability exclusions do not apply: a. Contractual Liability; b. Liquor Liability; c. Employer's Liability; d. Aircraft, Auto Or Watercraft; e. Mobile Equipment; b. "Bodily injury" to: Damage To Property; (1) An "employee" of and in the cc E RAMougementDMsian f ° REVIEWED & APPROVED BY. of ezv ECG 04 751 01 15 Copyright, Everest Reinsurance Co., 2015 ` --�Risk Management Specialist Includes copyrighted material of Insurance Services Office, IncIZ" NJ with its permission g. Damage To Your Product; h. Damage To Your Work; i. Damage To Impaired Property Or Property Not Physically Injured; and j. Recall Of Products, Work Or Impaired Property. 2. The following Bodily Injury And Property Damage Liability exclusions are added: This insurance does not apply to: f. a. "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 8 of 16 This certificate cancels and supersedes ALL previously issued certificates. (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay the damages because of the injury. This exclusion does not apply to: (1) Liability assumed by the insured under an "insured contract"; or (2) "Bodily injury" to domestic "employees" not entitled to workers' compensation benefits. c. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. D. Who Is An Insured For the purposes of this endorsement only, the Who Is An Insured section is replaced by the following: WHO IS AN INSURED 1. Each of the following is an insured under this insurance to the extent set forth below: a. You. b. Any other person using a "hired auto" with your permission. c. With respect to a "non -owned auto", any partner or "executive officer" of yours, but only while such "non -owned auto" is being used in your business. d. Any other person or organization, but only with respect to their liability because of acts or omissions of an insured under Paragraphs a., b. or c. above. 2. None of the following is an insured: a. Any person engaged in the business of his or her employer with respect to "bodily injury" to any co -employee of such person injured in the course of employment; b. Any partner or "executive officer" with respect to any "auto" owned by such part- ner or officer or a member of his or her household; c. Any person while employed in or otherwise engaged in performing duties related to the conduct of an "auto business", other than an "auto business" you operate; d. The owner or lessee (of whom you are a sublessee) of a "hired auto" or the owner of a "non -owned auto" or any agent or "employee" of any such owner or lessee; e. Any person or organization with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. E. Limits Of Insurance For the purposes of this endorsement only, the SECTION III Limits Of Insurance section is replaced by the following: LIMIT OF INSURANCE Regardless of the number of "hired autos", "non -owned autos", insureds, premiums paid, claims made or vehicles involved in the "occurrence", the most we will pay for all damages resulting from any one "occurrence" is the applicable limit shown in the Schedule of this endorsement or in the Declarations. The Aggregate Limit shown in the Schedule of this endorsement or in the Declarations is the most we will pay for the sum of all "occurrences" covered by this endorsement. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the addition- al period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. oR,N a RiskMougementDMsian °� f ' REVIEWED & APPROVm BY. Aezv ECG 04 751 01 15 Copyright, Everest Reinsurance Co., 2015 ` --` Ri5k Management Specialist Includes copyrighted material of Insurance Services Office, IncIZ NJ with its permission 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 9 of 16 This certificate cancels and supersedes ALL previously issued certificates. F. Changes In Conditions For the purposes of this endorsement only, the Other Insurance provision of the Commercial General Liability Conditions section is replaced by the following: OTHER INSURANCE This insurance is excess over any primary insurance covering the "hired auto" or "non -owned auto". G. Additional Definitions For the purposes of this endorsement only, the following definitions are added to the Definitions section. "Auto business" means the business or occupation of selling, repairing, servicing, storing or parking "autos". 2. "Hired auto" means any "auto" you lease, hire, rent or borrow. This does not include any "au- to" you lease, hire, rent or borrow from any of your "employees", your partners or your "exec- utive officers", or members of their households. 3. "Non -owned auto" means any "auto" you do not own, lease, hire, rent or borrow which is used in connection with your business. This in- cludes "autos" owned by your "employees", your partners or your "executive officers", or members of their households, but only while used in your business or your personal affairs. oR,N a RiskMougementDMsian f ' REVIEWED & APPROVm BY. °Afg Aezv ECG 04 751 01 15 Copyright, Everest Reinsurance Co., 2015 ` --` Ri5k Management Specialist Includes copyrighted material of Insurance Services Office, IncIZ NJ with its permission 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 10 of 16 This certificate cancels and supersedes ALL previously issued certificates. Policy Number: 91MLOO2518241 COMMERCIAL GENERAL LAIBILITY ECG 04 751 01 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON -OWNED AUTO LIABILITY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE All numbers and letters used to designate paragraphs in this endorsement are specific to this endorsement only. They do not reference any paragraphs in the Commercial General Liability Coverage Part. Insurance is provided only with respect to those coverages for which a specific Limit of Insurance is shown: Limit Of Insurance Coverage Per "Occurrence" Aggregate Limit Premium Hired/Non-Owned Auto $ 1,000,000 $ 1,000,000 $ Included Liability Insurance Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Hired Auto Liability The insurance provided under the Bodily Injury And Property Damage Liability coverage applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. B. Non -Owned Auto Liability The insurance provided under the Bodily Injury And Property Damage Liability coverage applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person in the course of your business. C. Changes In Exclusions With respect to the insurance provided by this endorsement: 1. The following Bodily Injury And Property Damage Liability exclusions do not apply: a. Contractual Liability; b. Liquor Liability; c. Employer's Liability; d. Aircraft, Auto Or Watercraft; e. Mobile Equipment; b. "Bodily injury" to: Damage To Property; (1) An "employee" of and in the cc E RAMougementDMsian f ° REVIEWED & APPROVED BY. of ezv ECG 04 751 01 15 Copyright, Everest Reinsurance Co., 2015 ` --�Risk Management Specialist Includes copyrighted material of Insurance Services Office, IncIZ" NJ with its permission g. Damage To Your Product; h. Damage To Your Work; i. Damage To Impaired Property Or Property Not Physically Injured; and j. Recall Of Products, Work Or Impaired Property. 2. The following Bodily Injury And Property Damage Liability exclusions are added: This insurance does not apply to: f. a. "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 11 of 16 This certificate cancels and supersedes ALL previously issued certificates. (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay the damages because of the injury. This exclusion does not apply to: (1) Liability assumed by the insured under an "insured contract"; or (2) "Bodily injury" to domestic "employees" not entitled to workers' compensation benefits. c. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. D. Who Is An Insured For the purposes of this endorsement only, the Who Is An Insured section is replaced by the following: WHO IS AN INSURED 1. Each of the following is an insured under this insurance to the extent set forth below: a. You. b. Any other person using a "hired auto" with your permission. c. With respect to a "non -owned auto", any partner or "executive officer" of yours, but only while such "non -owned auto" is being used in your business. d. Any other person or organization, but only with respect to their liability because of acts or omissions of an insured under Paragraphs a., b. or c. above. 2. None of the following is an insured: a. Any person engaged in the business of his or her employer with respect to "bodily injury" to any co -employee of such person injured in the course of employment; b. Any partner or "executive officer" with respect to any "auto" owned by such part- ner or officer or a member of his or her household; c. Any person while employed in or otherwise engaged in performing duties related to the conduct of an "auto business", other than an "auto business" you operate; d. The owner or lessee (of whom you are a sublessee) of a "hired auto" or the owner of a "non -owned auto" or any agent or "employee" of any such owner or lessee; e. Any person or organization with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. E. Limits Of Insurance For the purposes of this endorsement only, the SECTION III Limits Of Insurance section is replaced by the following: LIMIT OF INSURANCE Regardless of the number of "hired autos", "non -owned autos", insureds, premiums paid, claims made or vehicles involved in the "occurrence", the most we will pay for all damages resulting from any one "occurrence" is the applicable limit shown in the Schedule of this endorsement or in the Declarations. The Aggregate Limit shown in the Schedule of this endorsement or in the Declarations is the most we will pay for the sum of all "occurrences" covered by this endorsement. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the addition- al period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. oR,N a RiskMougementDMsian °� f ' REVIEWED & APPROVm BY. Aezv ECG 04 751 01 15 Copyright, Everest Reinsurance Co., 2015 ` --` Ri5k Management Specialist Includes copyrighted material of Insurance Services Office, IncIZ NJ with its permission 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 12 of 16 This certificate cancels and supersedes ALL previously issued certificates. F. Changes In Conditions For the purposes of this endorsement only, the Other Insurance provision of the Commercial General Liability Conditions section is replaced by the following: OTHER INSURANCE This insurance is excess over any primary insurance covering the "hired auto" or "non -owned auto". G. Additional Definitions For the purposes of this endorsement only, the following definitions are added to the Definitions section. "Auto business" means the business or occupation of selling, repairing, servicing, storing or parking "autos". 2. "Hired auto" means any "auto" you lease, hire, rent or borrow. This does not include any "au- to" you lease, hire, rent or borrow from any of your "employees", your partners or your "exec- utive officers", or members of their households. 3. "Non -owned auto" means any "auto" you do not own, lease, hire, rent or borrow which is used in connection with your business. This in- cludes "autos" owned by your "employees", your partners or your "executive officers", or members of their households, but only while used in your business or your personal affairs. oR,N a RiskMougementDMsian f ' REVIEWED & APPROVm BY. °Afg Aezv ECG 04 751 01 15 Copyright, Everest Reinsurance Co., 2015 ` --` Ri5k Management Specialist Includes copyrighted material of Insurance Services Office, IncIZ NJ with its permission 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 13 of 16 This certificate cancels and supersedes ALL previously issued certificates. Policy Number: 91ML002518241 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit' is brought. oR,N a Risk ManagementDMsian f °;' REVIEWED & APPROVED BY. °Afg Aezv 1" Risk Management Specialist CG 00 01 04 13 © Insurance Services Office, Inc., 2012 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 14 of 16 This certificate cancels and supersedes ALL previously issued certificates. Page 13 of 16 KEY0145812 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 Policy Term: 01/01/2025 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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 State Description AR Any party with whom the insured agrees to waive subrogation in a written contract. AZ Any party with whom the insured agrees to waive subrogation in a written contract. CA Any party with whom the insured agrees to waive subrogation in a written contract. CO Any party with whom the insured agrees to waive subrogation in a written contract. CT Any party with whom the insured agrees to waive subrogation in a written contract. DC Any party with whom the insured agrees to waive subrogation in a written contract. DE Any party with whom the insured agrees to waive subrogation in a written contract. FL Any party with whom the insured agrees to waive subrogation in a written contract. GA Any party with whom the insured agrees to waive subrogation in a written contract. ID Any party with whom the insured agrees to waive subrogation in a written contract. MD Any party with whom the insured agrees to waive subrogation in a written contract. MT Any party with whom the insured agrees to waive subrogation in a written contract. NC Any party with whom the insured agrees to waive subrogation in a written contract. OK Any party with whom the insured agrees to waive subrogation in a written contract. PA Any party with whom the insured agrees to waive subrogation in a written contract. TN Any party with whom the insured agrees to waive subrogation in a written contract. TX Any party with whom the insured agrees to waive subrogation in a written contract. UT Any party with whom the insured agrees to waive subrogation in a written contract. VA Any party with whom the insured agrees to waive subrogation in a written contract. VT Any party with whom the insured agrees to waive subrogation in a written contract. "P—", Risk ManagementDMsian REVIEWED & APPROVED BY. Afg Aezv WC 00 03 13 — 1-" Risk Management Specialist (Ed. 4-84) y NJ 78862138 q 2§$4-�o11�i2��,1PPiL'c7Yhl�s�y��924 7:46:01 PM (CST) Page 15 of 16 This certificate cancels and supersedes ALL previously issued certificates. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 State Description (Ed. 4-84) WV Any party with whom the insured agrees to waive subrogation in a written contract. HI Any party with whom the insured agrees to waive subrogation in a written contract. 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.) Effective Date: Policy No: Insured: Insurance Company: WC 00 03 13 (Ed. 4-84) © 1983 National Council on Compensation Insurance. Countersigned by: Endorsement No.: Premium: oR.N a RAManagmumtDMsian f ° REVIEWED & APPROVED BY. 1" Risk Management Specialist V NJ 78862138 24-25 CathySon Ent Crystal Wellborn 12/28/2024 7:46:01 PM (CST) I Page 16 of 16 This certificate cancels and supersedes ALL previously issued certificates. ACORO° CERTIFICATE OF LIABILITY INSURANCE 4i1/2025 DATE (MMIDDIYYYY) 1 2/6/2025 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 LOckton Companies, L.L.0 CONCT NAME 444 W. 47th St., Ste. 900 Kansas City MO 64112-1906 (816) 960-9000 PHONE FAX Ext : A/C, No MAIo ADDRESS: kcasuCajockton.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Everest National Insurance Company 10120 INSURED CATHYJON ENTERPRISES INC. 1541642 DBA HB STAFFING INSURER B : SUNZ Insurance Company 34762 INSURER C : Everest Indemnity Insurance Company 10851 INSURER D : 7711 CENTER AVENUE, SUITE 670 HUNTINGTON BEACH CA 92647 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 209SR114 REVISION NUMBER: XXXXXXX 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY y Y 91ML002518241 3/1/2024 4/1/2025 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1XI OCCUR PREM SESOEa oNcurrDence $ 200,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $ 3000000 POLICY ❑ PRO - POLICY ❑ LOC X PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y y 91ML002518241 3/1/2024 4/1/2025 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ XXXXXXX X PROPERTY DAMAGE Per accident $ XXXXXXX HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX C X UMBRELLA LIAB X OCCUR N N 91CUN00401241. 3/1/2024 4/1/2025 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ XXXXXXX B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N I A Y WC092-00002-24 4/1 8/2024 4/1/2025 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1000 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 A CRIME (+EMP THFT) N N 91CR001299241... 3/1/2024 4/1/2025 $1M OCC/AGG A PROF LIAB 91ML002518241 3/1/2024 4/1/2025 $1M0CC/$5MAGG A EMPPRACLIAB 91ML002518241.... 3/1/2024 4/1/2025 $1 M OCC/$2M AGG DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. **SEE ATTACHED** Tu Tran Digitally signed by APPROVED Tu Tran Nguyen Date: 101102.18 Nguyen 09:3a:57-08'00' By Tu Tran Nguyen at 9:38 am, Feb 18, 2025 CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 134 20958 13 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS. ATTTN: HUMAN RESOURCES AUTHORIZED REPRIESENTATIVF..' 20 CIVIC CENTER PLAZA, M-24 SANTA ANA CA 92701 / ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CONTINUATION DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS (Use only if more space is required) CONTRACT # A-2018-147. THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED AS RESPECTS TO GENERAL LIABILITY AND HIRED AND NON -AUTOMOBILE LIABILITY ONLY AS REQUIRED BY WRITTEN CONTRACT. A WAIVER OF SUBROGATION APPLIES IN FAVOR OF THE ADDITIONAL INSUREDS AS RESPECTS TO GENERAL LIABILITY, HIRED & NON -OWNED AUTOMOBILE LIABILITY AND WORKERS' COMPENSATION ONLY AS REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. THE CITY OF SANTA ANA SHALL BE GIVEN 30 DAYS WRITTEN NOTICE OF CANCELLATION AS RESPECTS TO THE GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICIES ONLY AS REQUIRED BY WRITTEN CONTRACT. THE GENERAL LIABILITY INSURANCE AFFORDED IS PRIMARY AND NON-CONTRIBUTORY ONLY AS REQUIRED BY WRITTEN CONTRACT. SEPARATION OF INSURED ENDORSEMENT APPLIES TO THE GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICIES. "ALL OWNED AUTO" DOES NOT APPLY AS THE INSURED DOES NOT OWN ANY COMPANY AUTOS AND THERE IS NO EXPOSURE FOR THEIR TYPE OF OPERATIONS. SUBJECT TO POLICY TERMS AND CONDITIONS. ACORD 25 (2016/03) Certificate Holder 1D: 20958134 Attachment Code: D658503 Certificate 1D: 20958134 POLICY NUMBER: 91 ML002518241 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) who you are required by contract or agreement to name as additional insured (s) on this policy as per the terms of this endorsement. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 Attachment Code: D660147 Certificate 1D: 20958134 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION BY US TO THIRD PARTY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART STAFFING SERVICES INDUSTRY EMPLOYMENT PRACTICES LIABILITY POLICY (CLAIMS -MADE) STAFFING SERVICES INDUSTRY PROFESSIONAL LIABILITY POLICY STAFFING SERVICES INDUSTRY PROFESSIONAL LIABILITY POLICY (CLAIMS MADE) Schedule 30 days before the effective date of cancellation by us we will mail or deliver notice to: Name: CITY OF SANTA ANA 20 CIVIC CENTER PLAZA, M-24 SANTA ANA, CA 92701 The following condition is added to the policy: Notice of Cancellation by Us to Third Party 1. If we cancel this policy, we will give 30 days prior written notice to the person or organization shown in the Schedule above. However, we shall not give notice if we cancel for nonpayment of premium or if the insured elects not to renew this policy. 2. We will mail or deliver our notice to the third party at the address shown in the Schedule. 3. If notice is mailed, proof of mailing will be sufficient proof of notice. EIL 00 725 08 16 Attachment Code: D658504 Certificate 1D: 20958134 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 Attachment Code: D658510 Certificate 1D: 20958134 POLICY NUMBER: 91ML002518241 ECG 04 780 08 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. STAFFING INDUSTRY COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Paragraph 2. Exclusions under Section I Coverages (Coverage A Bodily Injury and Property Damage Liability) is amended as follows: Exclusion g. is deleted and replaced by the following: g. Aircraft, Auto or Watercraft Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (5) Liability assumed under any "insured contract" for the maintenance or "loading or unloading" of an "auto"; (6) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". Exclusion j. is deleted and replaced by the following: j. Damage To Property "Property damage" to: (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; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property Attachment Code: D658510 Certificate 1D: 20958134 damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Additionally, paragraphs (3), (4), (5) and (6) do not apply to: (a) "Property Damage" to property rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by your "employee", "volunteer worker" or intern while that person is performing "staffing services" for your clients; or (b) Liability arising out of services performed by 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. Paragraphs (4), (5) and (6) do not apply to "property damage" arising out of "staffing services". Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations hazard". 2. Section I Coverages (Coverage B Personal and Advertising Injury) is amended as follows: Exclusion k. does not apply. 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 being once the full extent of the assets of the responsible insured has been exhausted and once the Deductible as shown on the Declarations Page has been satisfied. 3. The following Exclusions are added to the policy: This insurance does not apply to: A. "Bodily i or property damage or "personal and advertising injury" arising out of any activities or services rendered by any "PEO worker". B. "Bodily injury" or "property damage" or "personal and advertising injury" arising out of a "wrongful act" in the rendering of, or failure to render, any professional service for your client. For the purposes of this exclusion, "wrongful act" shall mean any actual or alleged error, omission, misstatement, or misleading statement by you or by any person for whose acts you are legally responsible during the course of providing "staffing services" to your clients. C. "Bodily injury" or "property damage" or "personal and advertising injury" due to the rendering of or failure to rend 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. 4. Paragraph 1.d. under the Supplementary Payments Section of the policy is deleted and replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. 5. Section II Who Is An Insured is replaced by the following SECTION II WHO IS AN INSURED 1. If you are designated in the Declarations as: Attachment Code: D658510 Certificate 1D: 20958134 a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than an individual, partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Your "volunteer workers" or interns only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" or interns are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other 'volunteer workers" or interns while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" or intern as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (2) "Property damage" to property: (a) Owned, occupied or used by; (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your "employees", 'volunteer workers", interns, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). However, your "employee", 'volunteer worker", or intern is an insured for "property damage" to property rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by your "employee", 'volunteer worker" or intern while that person is performing "staffing services" for your clients. b. Any person (other than your "employee" or "volunteer worker" or intern), or any organization while acting as your real estate manager. Attachment Code: D658510 Certificate 1D: 20958134 c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. e. 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. f. With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: 1. "Bodily injury" to an insured if another insured is driving the equipment; or 2. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is insured under this provision. 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. Paragraph 2.a. is replaced by the following: 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an 'occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the 'occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. You will not be considered to have knowledge of an 'occurrence" or an offense which may result in a claim until any of the following is aware of such "occurrence" or offense: (1) If you are an individual, you or your Risk Manager; (2) If you are a corporation, your Corporate Officer or your Risk Manager; (3) If you are a partnership or joint venture, your partner or member, or your Risk Manager; or Attachment Code: D658510 Certificate 1D: 20958134 (4) If you are a limited liability company, your member or your Risk Manager. 2. Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us is amended to include the following: However, if any insured is required by a written contract or written agreement which is executed before a "staffing services" occurrence to waive their rights of recovery from others, we agree to waive our rights of recovery. 3. The following Condition is added: Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as the day the revision is effective in your state. SECTION V DEFINITIONS is amended as follows: 1. The definition of "coverage territory is replaced by the following: "Coverage Territory" means anywhere in he world. 2. The definition of "employee" is replaced by the following: "Employee includes but is not limited to a "leased worker" and a "staffing services worker". "Employee" does not include a "temporary worker" or a "PEO worker". 3. The following definitions are added: 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) Staffing related administrative services provided by an Administrative Services Organization (ASO). (2) "PEO service"; (3) Staffing related services provided to your clients for the recruitment, selection and placement of a person for employment with a client. (4) Vendor Management Service (VMS), means the facilitation, purchase and management of "staffing services" for clients including the placement and fulfillment of orders for "staffing services workers". (5) Temporary, contingent or contract placement services; (6) Services performed for a client c to supply that client with a "staffing services worker"; (7) Services performed on behalf of your client by a "staffing services worker" who is not a direct hire or permanent placement. d. "Staffing services worker" 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 apply. ECG 04 780 08 16 Attachment Code: D658509 Certificate 1D: 20958134 POLICY NUMBER: 91ML002518241 COMMERCIAL GENERAL LAIBILITY ECG 04 751 01 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON -OWNED AUTO LIABILITY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE All numbers and letters used to designate paragraphs in this endorsement are specific to this endorsement only. They do not reference any paragraphs in the Commercial General Liability Coverage Part. Insurance is provided only with respect to those coverages for which a specific Limit of Insurance is shown: Coverage: Hired & Non -Owned Auto Liability Insurance Limit Of Insurance Per "Occurrence": $1,000,000 Aggregate Limit: $1,000,000 Premium: Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Hired Auto Liability The insurance provided under the Bodily Injury And Property Damage Liability coverage applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. B. Non -Owned Auto Liability The insurance provided under the Bodily Injury And Property Damage Liability coverage applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person in the course of your business. C. Changes In Exclusions With respect to the insurance provided by this endorsement: 1. The following Bodily Injury And Property Damage Liability exclusions do not apply: a. Contractual Liability; b. Liquor Liability; c. Employer's Liability; d. Aircraft, Auto Or Watercraft; e. Mobile Equipment; f. Damage To Property; g. Damage To Your Product; h. Damage To Your Work; i. Damage To Impaired Property Or Property Not Physically Injured; and j. Recall Of Products, Work Or Impaired Property. Attachment Code: D658509 Certificate 1D: 20958134 2. The following Bodily Injury And Property Damage Liability exclusions are added: This insurance does not apply to: a. "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. b. "Bodily injury" to: This exclusion applies: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay the damages because of the injury. This exclusion does not apply to: (1) Liability assumed by the insured under an "insured contract"; or (2) "Bodily injury" to domestic "employees" not entitled to workers' compensation benefits. c. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. D. Who Is An Insured For the purposes of this endorsement only, the Who Is An Insured section is replaced by the following: WHO IS AN INSURED 1. Each of the following is an insured under this insurance to the extent set forth below: a. You. b. Any other person using a "hired auto" with your permission. c. With respect to a "non -owned auto", any partner or "executive officer" of yours, but only while such "non -owned auto" is being used in your business. d. Any other person or organization, but only with respect to their liability because of acts or omissions of an insured under Paragraphs a., b. or c. above Attachment Code: D658509 Certificate 1D: 20958134 2. None of the following is an insured: a. Any person engaged in the business of his or her employer with respect to "bodily injury" to any co -employee of such person injured in the course of employment; b. Any partner or "executive officer" with respect to any "auto" owned by such part-ner or officer or a member of his or her household; c. Any person while employed in or otherwise engaged in performing duties related to the conduct of an "auto business", other than an "auto business" you operate; d. The owner or lessee (of whom you are a sublessee) of a "hired auto" or the owner of a "non -owned auto" or any agent or "employee" of any such owner or lessee; e. Any person or organization with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. E. Limits Of Insurance For the purposes of this endorsement only, the SECTION III Limits Of Insurance section is replaced by the following: LIMIT OF INSURANCE Regardless of the number of "hired autos", "non -owned autos", insureds, premiums paid, claims made or vehicles involved in the 'occurrence", the most we will pay for all damages resulting from any one "occurrence" is the applicable limit shown in the Schedule of this endorsement or in the Declarations. The Aggregate Limit shown in the Schedule of this endorsement or in the Declarations is the most we will pay for the sum of all "occurrences" covered by this endorsement. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. F. Changes In Conditions For the purposes of this endorsement only, the Other Insurance provision of the Commercial General Liability Conditions section is replaced by the following: OTHERINSURANCE This insurance is excess over any primary insurance covering the "hired auto" or "non -owned auto". G. Additional Definitions For the purposes of this endorsement only, the following definitions are added to the Definitions section. 1. "Auto business" means the business or occupation of selling, repairing, servicing, storing or parking "autos". 2. "Hired auto" means any "auto" you lease, hire, rent or borrow. This does not include any "au -to" you lease, hire, rent or borrow from any of your "employees", your partners or your "exec-utive officers", or members of their households. 3. "Non -owned auto" means any "auto" you do not own, lease, hire, rent or borrow which is used in connection with your business. This in-cludes "autos" owned by your "employees", your partners or your "executive officers", or members of their households, but only while used in your business or your personal affairs. ECG 04 751 01 15 Attachment Code: D658506 Certificate 1D: 20958134 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE COMPANY WC9903013 (Ed. 7-09) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be $ 500 Schedule Person or Organization: All persons or organizations as required by written contract executed prior to the date of loss. This only applies to contracts for work in CA. Job Description: 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: WC092-00002-24 Policy No.: WC092-00002-24 Endorsement No.: Insured: CATHYJON ENTERPRISES INC. Insurance Company: SUNZ Insurance Company WC 99 03 13 (7-09) ACORO® CERTIFICATE OF LIABILITY INSURANCE 5/1/2025 —DATE/DD /YYYY) 2/6/2 2/6/2025 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 LOckton Companies, LLC CONTACT NAME: 444 W. 47th St., Ste. 900 City MO 64112-1906 (816)960-9000 PHONE FAX o Ext : A/C No (AtKansas E-MAIL ADDRESS: kcasu@lockton.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Everest National Insurance Company 10120 INSURED CATHYJON ENTERPRISES INC. 1541642 DBA HB STAFFING INSURER B : SUNZ Insurance Company 34762 INSURER C : Everest Indenmity Insurance Company 10851 INSURER D : 7711 CENTER AVENUE, SUITE 670 HUNTINGTON BEACH CA 92647 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 20958134 REVISION NUMBER: XXXXXXX 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER EFF MM/DDPOLICYIYYYY Y EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 91ML002518241 3/1/2024 5/15/2025 EACH OCCURRENCE $ 1000 000 CLAIMS -MADE � OCCUR DAMAGE TO FIR SES Ea oNccu ante $ 200,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3000000 POLICY PR- JJECT LOC X PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y 91ML002518241 3/1/2024 5/15/2025 COMBINED SINGLE LIMIT Ea accident $ 1 000 000 BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ XXXXXXX X PROPERTY DAMAGE Per accident $ XXXXXXX HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX C X UMBRELLA LIAB OCCUR N N 91CUN00401241. 3/1/2024 5/15/2025 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ XXXXXX X B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECU I — OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A Y WC092-00002-24 4/18/2024 5/1/2025 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A CRIME (+EMP THFT) N N 91CR001299241... 3/1/2024 5/15/2025 $1M OCC/AGG A PROF LIAB 91ML002518241 3/1/2024 5/15/2025 $1M OCC/$5MAGG A EMP PRAC LIAB 91ML002518241.... 3/1/2024 5/15/2025 $ 1 M OCC/$2M AGG DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. **SEE ATTACHED** Tu Tran Dlglt0ysign Tu Tran Nguye Date: 2025.04. CERTIFICATE HOLDER CANCELLATION See Attachments I Jyuyt:n 12:15:49-07'00' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 13 20958 134 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY SANTA ANA ATTTN: HUMAN RESOURCES AUTHORIZED REPRESENTATIV . 20 CIVIC CENTER PLAZA, M-24 SANTA ANA CA 92701 ACORD 25 (2016/03) © 1988�015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CONTINUATION DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS (Use only if more space is required) CONTRACT # A-2018-147. THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED AS RESPECTS TO GENERAL LIABILITY AND HIRED AND NON -AUTOMOBILE LIABILITY ONLY AS REQUIRED BY WRITTEN CONTRACT. A WAIVER OF SUBROGATION APPLIES IN FAVOR OF THE ADDITIONAL INSUREDS AS RESPECTS TO GENERAL LIABILITY, HIRED & NON -OWNED AUTOMOBILE LIABILITY AND WORKERS' COMPENSATION ONLY AS REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. THE CITY OF SANTA ANA SHALL BE GIVEN 30 DAYS WRITTEN NOTICE OF CANCELLATION AS RESPECTS TO THE GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICIES ONLY AS REQUIRED BY WRITTEN CONTRACT. THE GENERAL LIABILITY INSURANCE AFFORDED IS PRIMARY AND NON-CONTRIBUTORY ONLY AS REQUIRED BY WRITTEN CONTRACT. SEPARATION OF INSURED ENDORSEMENT APPLIES TO THE GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICIES. "ALL OWNED AUTO" DOES NOT APPLY AS THE INSURED DOES NOT OWN ANY COMPANY AUTOS AND THERE IS NO EXPOSURE FOR THEIR TYPE OF OPERATIONS. SUBJECT TO POLICY TERMS AND CONDITIONS. ACORD 25 (2016/03) Certificate Holder ID: 20958134 Attachment Code: D658503 Certificate ID: 20958134 POLICY NUMBER: 91ML002518241 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) who you are required by contract or agreement to name as additional insured (s) on this policy as per the terms of this endorsement. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 Attachment Code: D660147 Certificate ID: 20958134 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION BY US TO THIRD PARTY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART STAFFING SERVICES INDUSTRY EMPLOYMENT PRACTICES LIABILITY POLICY (CLAIMS -MADE) STAFFING SERVICES INDUSTRY PROFESSIONAL LIABILITY POLICY STAFFING SERVICES INDUSTRY PROFESSIONAL LIABILITY POLICY (CLAIMS MADE) Schedule 30 days before the effective date of cancellation by us we will mail or deliver notice to: Name: CITY OF SANTA ANA 20 CIVIC CENTER PLAZA, M-24 SANTA ANA, CA 92701 The following condition is added to the policy: Notice of Cancellation by Us to Third Party 1. If we cancel this policy, we will give 30 days prior written notice to the person or organization shown in the Schedule above. However, we shall not give notice if we cancel for nonpayment of premium or if the insured elects not to renew this policy. 2. We will mail or deliver our notice to the third party at the address shown in the Schedule. 3. If notice is mailed, proof of mailing will be sufficient proof of notice. EIL 00 725 08 16 Attachment Code: D658504 Certificate ID: 20958134 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 Attachment Code: D658510 Certificate ID: 20958134 POLICY NUMBER: 91ML002518241 ECG 04 780 08 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. STAFFING INDUSTRY COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Paragraph 2. Exclusions under Section I Coverages (Coverage A Bodily Injury and Property Damage Liability) is amended as follows: Exclusion g. is deleted and replaced by the following: g. Aircraft, Auto or Watercraft Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (5) Liability assumed under any "insured contract" for the maintenance or "loading or unloading" of an "auto"; (6) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". Exclusion j. is deleted and replaced by the following: j. Damage To Property "Property damage" to: (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; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property Attachment Code: D658510 Certificate ID: 20958134 damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Additionally, paragraphs (3), (4), (5) and (6) do not apply to: (a) "Property Damage" to property rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by your "employee", "volunteer worker" or intern while that person is performing "staffing services" for your clients; or (b) Liability arising out of services performed by 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. Paragraphs (4), (5) and (6) do not apply to "property damage" arising out of "staffing services". Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations hazard". 2. Section I Coverages (Coverage B Personal and Advertising Injury) is amended as follows: Exclusion k. does not apply. 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 being once the full extent of the assets of the responsible insured has been exhausted and once the Deductible as shown on the Declarations Page has been satisfied. 3. The following Exclusions are added to the policy: This insurance does not apply to: A. "Bodily i or property damage or "personal and advertising injury" arising out of any activities or services rendered by any "PEO worker". B. "Bodily injury" or "property damage" or "personal and advertising injury" arising out of a "wrongful act" in the rendering of, or failure to render, any professional service for your client. For the purposes of this exclusion, "wrongful act" shall mean any actual or alleged error, omission, misstatement, or misleading statement by you or by any person for whose acts you are legally responsible during the course of providing "staffing services" to your clients. C. "Bodily injury" or "property damage" or "personal and advertising injury" due to the rendering of or failure to rend 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. 4. Paragraph 1.d. under the Supplementary Payments Section of the policy is deleted and replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. 5. Section II Who Is An Insured is replaced by the following SECTION II WHO IS AN INSURED 1. If you are designated in the Declarations as: Attachment Code: D658510 Certificate ID: 20958134 a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than an individual, partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Your "volunteer workers" or interns only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" or interns are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" or interns while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" or intern as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (2) "Property damage" to property: (a) Owned, occupied or used by; (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your "employees", "volunteer workers", interns, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). However, your "employee", "volunteer worker", or intern is an insured for "property damage" to property rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by your "employee", "volunteer worker" or intern while that person is performing "staffing services" for your clients. b. Any person (other than your "employee" or "volunteer worker" or intern), or any organization while acting as your real estate manager. Attachment Code: D658510 Certificate ID: 20958134 c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. e. 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. f. With respect to "mobile equipment' registered in your name under any motor vehicle registration law, any person is insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: 1. "Bodily injury" to an insured if another insured is driving the equipment; or 2. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is insured under this provision. 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. Paragraph 2.a. is replaced by the following: 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an 'occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the 'occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. You will not be considered to have knowledge of an 'occurrence" or an offense which may result in a claim until any of the following is aware of such "occurrence" or offense: (1) If you are an individual, you or your Risk Manager; (2) If you are a corporation, your Corporate Officer or your Risk Manager; (3) If you are a partnership or joint venture, your partner or member, or your Risk Manager; or Attachment Code: D658510 Certificate ID: 20958134 (4) If you are a limited liability company, your member or your Risk Manager. 2. Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us is amended to include the following: However, if any insured is required by a written contract or written agreement which is executed before a "staffing services" occurrence to waive their rights of recovery from others, we agree to waive our rights of recovery. 3. The following Condition is added: Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as the day the revision is effective in your state. SECTION V DEFINITIONS is amended as follows: 1. The definition of "coverage territory is replaced by the following: "Coverage Territory" means anywhere in he world. 2. The definition of "employee" is replaced by the following: "Employee includes but is not limited to a "leased worker" and a "staffing services worker". "Employee" does not include a "temporary worker" or a "PEO worker". 3. The following definitions are added: 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) Staffing related administrative services provided by an Administrative Services Organization (ASO). (2) "PEO service"; (3) Staffing related services provided to your clients for the recruitment, selection and placement of a person for employment with a client. (4) Vendor Management Service (VMS), means the facilitation, purchase and management of "staffing services" for clients including the placement and fulfillment of orders for "staffing services workers". (5) Temporary, contingent or contract placement services; (6) Services performed for a client c to supply that client with a "staffing services worker"; (7) Services performed on behalf of your client by a "staffing services worker" who is not a direct hire or permanent placement. d. "Staffing services worker" 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 apply. ECG 04 780 08 16 Attachment Code: D658509 Certificate ID: 20958134 POLICY NUMBER: 91ML002518241 COMMERCIAL GENERAL LAIBILITY ECG 04 751 01 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON -OWNED AUTO LIABILITY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE All numbers and letters used to designate paragraphs in this endorsement are specific to this endorsement only. They do not reference any paragraphs in the Commercial General Liability Coverage Part. Insurance is provided only with respect to those coverages for which a specific Limit of Insurance is shown: Coverage: Hired & Non -Owned Auto Liability Insurance Limit Of Insurance Per "Occurrence": $1,000,000 Aggregate Limit: $1,000,000 Premium: Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Hired Auto Liability The insurance provided under the Bodily Injury And Property Damage Liability coverage applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. B. Non -Owned Auto Liability The insurance provided under the Bodily Injury And Property Damage Liability coverage applies to "bodily injury" or "property damage" arising out of the use of a "non -owned auto" by any person in the course of your business. C. Changes In Exclusions With respect to the insurance provided by this endorsement: 1. The following Bodily Injury And Property Damage Liability exclusions do not apply: a. Contractual Liability; b. Liquor Liability; c. Employer's Liability; d. Aircraft, Auto Or Watercraft; e. Mobile Equipment; f. Damage To Property; g. Damage To Your Product; h. Damage To Your Work; i. Damage To Impaired Property Or Property Not Physically Injured; and j. Recall Of Products, Work Or Impaired Property. Attachment Code: D658509 Certificate ID: 20958134 2. The following Bodily Injury And Property Damage Liability exclusions are added: This insurance does not apply to: a. "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. b. "Bodily injury" to: This exclusion applies: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay the damages because of the injury. This exclusion does not apply to: (1) Liability assumed by the insured under an "insured contract"; or (2) "Bodily injury" to domestic "employees" not entitled to workers' compensation benefits. c. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. D. Who Is An Insured For the purposes of this endorsement only, the Who Is An Insured section is replaced by the following: WHO IS AN INSURED 1. Each of the following is an insured under this insurance to the extent set forth below: a. You. b. Any other person using a "hired auto" with your permission. c. With respect to a "non -owned auto", any partner or "executive officer" of yours, but only while such "non -owned auto" is being used in your business. d. Any other person or organization, but only with respect to their liability because of acts or omissions of an insured under Paragraphs a., b. or c. above Attachment Code: D658509 Certificate ID: 20958134 2. None of the following is an insured: a. Any person engaged in the business of his or her employer with respect to "bodily injury" to any co -employee of such person injured in the course of employment; b. Any partner or "executive officer" with respect to any "auto" owned by such part-ner or officer or a member of his or her household; c. Any person while employed in or otherwise engaged in performing duties related to the conduct of an "auto business", other than an "auto business" you operate; d. The owner or lessee (of whom you are a sublessee) of a "hired auto" or the owner of a "non -owned auto" or any agent or "employee" of any such owner or lessee; e. Any person or organization with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. E. Limits Of Insurance For the purposes of this endorsement only, the SECTION III Limits Of Insurance section is replaced by the following: LIMIT OF INSURANCE Regardless of the number of "hired autos", "non -owned autos", insureds, premiums paid, claims made or vehicles involved in the 'occurrence", the most we will pay for all damages resulting from any one "occurrence" is the applicable limit shown in the Schedule of this endorsement or in the Declarations. The Aggregate Limit shown in the Schedule of this endorsement or in the Declarations is the most we will pay for the sum of all "occurrences" covered by this endorsement. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. F. Changes In Conditions For the purposes of this endorsement only, the Other Insurance provision of the Commercial General Liability Conditions section is replaced by the following: OTHERINSURANCE This insurance is excess over any primary insurance covering the "hired auto" or "non -owned auto". G. Additional Definitions For the purposes of this endorsement only, the following definitions are added to the Definitions section. 1. "Auto business" means the business or occupation of selling, repairing, servicing, storing or parking "autos". 2. "Hired auto" means any "auto" you lease, hire, rent or borrow. This does not include any "au -to" you lease, hire, rent or borrow from any of your "employees", your partners or your "exec-utive officers", or members of their households. 3. "Non -owned auto" means any "auto" you do not own, lease, hire, rent or borrow which is used in connection with your business. This in-cludes "autos" owned by your "employees", your partners or your "executive officers", or members of their households, but only while used in your business or your personal affairs. ECG 04 751 01 15 Attachment Code: D658506 Certificate ID: 20958134 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE COMPANY WC9903013 (Ed. 7-09) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be $ 500 Schedule Person or Organization: All persons or organizations as required by written contract executed prior to the date of loss. This only applies to contracts for work in CA. Job Description: 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: WC092-00002-24 Policy No.: WC092-00002-24 Endorsement No.: Insured: CATHYJON ENTERPRISES INC. Insurance Company: SUNZ Insurance Company WC990313 (7-09) ACOR" CERTIFICATE OF LIABILITY INSURANCE 5/1/2026 DATE (MM/DDIYYYY) 1 5/15/2025 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 Lockton Companies, LLC CONTACT NAME: 444 W 47th St., Ste. 900 Kansas City MO 64112-1906 (816)960-9000 PHONE FAX Ext : A/C No E-MAILo ADDRESS: kcasu@lockton.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Philadelphia Indemnity Insurance Co. 18058 INSURED CATHYJON ENTERPRISES INC. 1541642 DBA HB STAFFING INSURER B : SUNZ Insurance Company 34762 INSURER C : Beazley Insurance Company,Inc. 37540 INSURER D : 7711 CENTER AVENUE, SUITE 670 HUNTINGTON BEACH CA 92647 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 20958134 REVISION NUMBER: XXXXXXX 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y PHPK2713505-000 5/15/2025 5/15/2026 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE FXI OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 200,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 3 000000 $ OTHER: A AUTOMOBILE LIABILITY Y Y PHPK2713505-000.. 5/15/2025 5/15/2026 COMBINEDnt SINGLE LIMIT Ea accide $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ XXXXXXX X PROPERTY DAMAGE Per accident $ XXXXXXX HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX A X UMBRELLA LIAB OCCUR N N PHUB919987-000. 5/15/2025 5/15/2026 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE 1) RETENTION $ 10,000 $ XXXXXXX B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N I A Y WC092-00002-025 5/1 /2025 5/1 /2026 PERX STATUTE EORH 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 CRIME (+EMP THFT) N N V39A7C250101... 5/15/2025 5/15/2026 $2M OCC/AGG A PROF LIAB PHPK2713505-000 5/15/2025 5/15/2026 $1 M OCC/$2M AGG C EMP PRAC LIAB V39A53250101 5/15/2025 5/15/2026 $2M OCC/$2M AGG DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) **SEE ATTACHED** Tu Tran Nguyen Tu Tran Digita"y5igned by APPROVED Date: 2025.06.14 Nguyen 09:35:46-07'00' By Tu Tran Nguyen at 9:35 am, Jun 04, 2025 CERTIFICATE HOLDER CANCELLATION See Attachments 20958134 CTTY OF SANTA ANA ATTTN: HUMAN RESOURCES 20 CIVIC CENTER PLAZA, M-24 SANTA ANA CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT I, + �{`i 9 Cc� 198A 015 ACORD CORPORATION_ All rinhtc rPwprvarl ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CONTINUATION DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS (Use only if more space is required) CONTRACT # A-2018-147. THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED AS RESPECTS TO GENERAL LIABILITY AND HIRED AND NON -AUTOMOBILE LIABILITY ONLY AS REQUIRED BY WRITTEN CONTRACT. A WAIVER OF SUBROGATION APPLIES IN FAVOR OF THE ADDITIONAL INSUREDS AS RESPECTS TO GENERAL LIABILITY HIRED & NON -OWNED AUTOMOBILE LIABILITY AND WORKERS' COMPENSATION ONLY AS REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. THE CITY OF SANTA ANA SHALL BE GIVEN 30 DAYS WRITTEN NOTICE OF CANCELLATION AS RESPECTS TO THE GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICIES ONLY AS REQUIRED BY WRITTEN CONTRACT. THE GENERAL LIABILITY INSURANCE AFFORDED IS PRIMARY AND NON-CONTRIBUTORY ONLY AS REQUIRED BY WRITTEN CONTRACT. SEPARATION OF INSURED ENDORSEMENT APPLIES TO THE GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICIES. "ALL OWNED AUTO" DOES NOT APPLY AS THE INSURED DOES NOT OWN ANY COMPANY AUTOS AND THERE IS NO EXPOSURE FOR THEIR TYPE OF OPERATIONS. SUBJECT TO POLICY TERMS AND CONDITIONS. ACORD 25 (2016/03) Certificate Holder ID: 20958134 Attachment Code: D658503 Certificate ID: 20958134 POLICY NUMBER: PHPK2713505-000 LIABILITY COMMERCIAL GENERAL CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organ ization(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 for'bodily injury", "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the Named Insured. Information reauired to complete this Schedule. if not shown above. will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Attachment Code: D660147 Certificate ID: 20958134 PI-CANXAICH-002 (05/11) 19:1R24kiIBig] *441,,7i14ki111944:/_1kiN*1119:I=1as] I1WA»W-A-11 =1:7:r_11j1IID _ N411111J4A'w CANCELLATION NOTICE TO SCHEDULED ADDITIONAL INSURED OR CERTIFICATE HOLDER This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART COMMERCIAL CRIME COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART SCHEDULE OF ADDITIONAL INSUREDS OR CERTIFICATE HOLDERS Al or CH Additional Insured or Certificate Holder Address CH & Al Any person or organization with whom you have Various greed to provide 30 days prior written notice of ancellation as provided by your insurance broker f such person or organization and that list is rovided to us prior to any such cancellation The following is added to A. CANCELLATION of the Common Policy Conditions of the above applicable coverage part: A. In the event we cancel the policy in accordance with the policy's terms and conditions, we will endeavor to mail written notice of cancellation to Additional Insureds or Certificate Holders, shown in the above SCHEDULE within the time frame listed below. However, failure to mail such notice shall impose no obligation of any kind upon us, our agents or representatives. 1. 30 days before the effective date of cancellation if we cancel for any reason other than for non - payment of premium. As respects Additional Insureds, the above cancellation provision applies only when the Additional Insured shown in the above SCHEDULE is added to the policy by a separate additional insured endorsement as the CANCELLATION NOTICE TO ADDITIONAL INSURED OR CERTIFICATE HOLDER does not provide additional insured coverage. Page 1 of 1 Attachment Code: D658504 Certificate ID: 20958134 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 imit of Insurance age Damage to Premises Rented to You 1,000,000 Expected or Intended Injury — Property Damage ncluded Limited Rental Lease Agreement Contractual Liability 50,000 Non -Owned Watercraft ess than 58 feet Damage to Property You Own, Rent or Occupy 30,000 Medical Payments $20,000 Medical Payments Reporting Period 3 Years Athletic Activities Amended Supplementary Payments - Bail Bonds 2,500 Supplementary Payments — Loss of Earnings 500 per day Employee Indemnification Defense Coverage 25,000 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 ncluded Duties in the Event of Occurrence, Offense, Claim or Suit ncluded Transfer of Rights of Recovery Against Others To Us 7,larification Liberalization ncluded Unintentional Failure to Disclose Hazards ncluded Bodily Injury— Includes Mental Anguish ncluded Personal and Advertising Injury— Includes Abuse of Process, Discrimination ncluded PI-GLD-TS (11/15) Page 1 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code: D658504 Certificate ID: 20958134 IOther Insurance — Primary Clarification (Clarification r Staffing Services Exclusions larification Staffing Services Definitions larification 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; SECTION III - LIMITS OF INSURANCE, Paragraph 6.; and a. 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. 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. PI-GLD-TS (11/15) Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code: D658504 Certificate ID: 20958134 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: 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 PI-GLD-TS (11/15) Page 3 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code: D658504 Certificate ID: 20958134 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, 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 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: 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: PI-GLD-TS (11/15) Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code: D658504 Certificate ID: 20958134 "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 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 5 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code: D658504 Certificate ID: 20958134 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 6 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code: D658510 Certificate ID: 20958134 POLICY NUMBER: PHPK2713505-000 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 ame Of Person Or Organization: ny person or organization who you are required to add by written contract which is executed prior to the =rrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence DM 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 Attachment Code: D658509 Certificate ID: 20958134 POLICY NUMBER: PHPK2713505-000.. 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 modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision 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: Endorsement Effective Date: SCHEDULE Name of Person(s) or Organ ization(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 Attachment Code: D658506 Certificate ID: 20958134 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE COMPANY WC9903013 (Ed. 7-09) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be $ 500 Schedule Person or Organization: All persons or organizations as required by written contract executed prior to the date of loss. This only applies to contracts for work in CA. Job Description: 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: 5/1/2025 Policy No.: WC092-00002-025 Endorsement No.: Insured: CATHYJON ENTERPRISES INC. Insurance Company: SUNZ Insurance Company WC 99 03 13 (7-09) Attachment Code: D668643 Certificate ID: 20958134 POLICY NUMBER: PHPK2713505-000.. 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 modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) 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 "accident" or the 'loss" under a contract with that person or organization. CA 04 44 03 10 PAGE 1 OF 1 DATE(MMIDDIYYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 5/15/2027 5/14/2026 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 Lockton Companies,LLC CONTACT NAME: DBA Lockton Insurance Brokers,LLC in CA PHONE FAX CA license#OF15767 (A/C,No Ext: A/C,No E-MAIL 444 W.47th St.,Ste.900 ADDRESS: Kansas City MO 641 12-1906 INSURER(S)AFFORDING COVERAGE NAIC# (816)960-9000 kcasu@lockton.com INSURER A:Philadelphia Indemnity insurance Company 18058 INSURED CATHYJON ENTERPRISES INC. INSURER B:SUNZ Insurance Company 34762 1541642 DBA HB STAFFING INSURER C:Beazley insurance Company,inc. 37540 7711 CENTER AVENUE,SUITE 670 INSURER D: HUNTINGTON BEACH CA 92647 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 20958134 REVISION NUMBER: XXXXXXX 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DDIYYW W MMIDD/ YY A X COMMERCIAL GENERAL LIABILITY Y Y PTTPK2713505-001 5/15/2026 5/15/2027 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 1XI OCCUR DG PREMISESAMAETO EaRENTED occurrence $ 200,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 � POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY y y PHPK2713505-001.. 5/15/2026 5/15/2027 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX X HIRED X NON-OWNED PROPERTY DAMAGE $ XXXXXrXXr AUTOS ONLY AUTOS ONLY Per accident $ XXXXXXX A X UMBRELLA LIAB X OCCUR N N PHUB919987-001. 5/15/2026 5/15/2027 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ 1 O OOO $ XXXXXXX WORKERS COMPENSATION PER OTH- B AND EMPLOYERS'LIABILITY YIN Y WC092-00002-026 5/15/2026 5/15/2027 X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N N I A (Mandatory in NH) 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 CRIME(+EMP THFT) N Y V39A7C260201... 5/15/2026 5/15/2027 $2M OCC/AGG A PROF LIAB PHPK2713505-001 5/15/2026 5/15/2027 $1M OCC/$2MAGG C EMP PRAC LTAB V39A53260201 5/15/2026 5/15/2027 $2M 0CC/$2M AGG DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) "SEE ATTACHED* APPROVED By Tu Tran Nguyen at 8:42 am,Jun 09,2026 CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 134 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20958 CITY 13 SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS. ATTTN:HUMAN RESOURCES 20 C1VIC CENTER PLAZA,M-24 AUTHORIZED REPRESENTATIVF� SANTA ANA CA 92701 254- 198840115 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CONTINUATION DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS(Use only if more space is required) CONTRACT#A-2018-147. THE CITY OF SANTA ANA,ITS OFFICERS,EMPLOYEES,AGENTS,AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED AS RESPECTS TO GENERAL LIABILITY AND HIRED AND NON-AUTOMOBTLE LIABILITY ONLY AS REQUIRED BY WRITTEN CONTRACT.A WAIVER OF SUBROGATION APPLIES IN FAVOR OF THE ADDITIONAL INSUREDS AS RESPECTS TO GENERAL LIABILITY, HIRED&NON-OWNED AUTOMOBILE LIABILITY,WORKERS'COMPENSATION AND PROFESSIONAL LIABILITY ONLY AS REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. THE WAIVER OF SUBROGATION DOES NOT APPLY TO THE CRIME OR THE EMPLOYMENT PRACTICES LIABILITY POLICIES. THE CITY OF SANTA ANA SHALL BE GIVEN 30 DAYS WRITTEN NOTICE OF CANCELLATION AS RESPECTS TO THE GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICIES ONLY AS REQUIRED BY WRITTEN CONTRACT. THE GENERAL LIABILITY INSURANCE AFFORDED IS PRIMARY AND NON-CONTRIBUTORY ONLY AS REQUIRED BY WRITTEN CONTRACT. SEPARATION OF INSURED ENDORSEMENT APPLIES TO THE GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICIES. "ALL OWNED AUTO"DOES NOT APPLY AS THE INSURED DOES NOT OWN ANY COMPANY AUTOS AND THERE IS NO EXPOSURE FOR THEIR TYPE OF OPERATIONS. SUBJECT TO POLICY TERMS AND CONDITIONS. ACORD 25(2016/03) Certificate Holder ID: 20958134 Attachment Code:D658503 Certificate ID: 20958134 POLICY NUMBER: PHPK2713505-001 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured 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 for'bodily injury", "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the Named Insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or"personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III—Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Attachment Code:D660147 Certificate ID: 20958134 PI-CANXAICH-002 (05/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTICE TO SCHEDULED ADDITIONAL INSURED OR CERTIFICATE HOLDER This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART COMMERCIAL CRIME COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART SCHEDULE OF ADDITIONAL INSUREDS OR CERTIFICATE HOLDERS Al or CH Additional Insured or Certificate Holder Address CH &Al Any person or organization with whom you have Various greed to provide 30 days prior written notice of cancellation as provided by your insurance broker f such person or organization and that list is provided to us prior to any such cancellation The following is added to A. CANCELLATION of the Common Policy Conditions of the above applicable coverage part: A. In the event we cancel the policy in accordance with the policy's terms and conditions, we will endeavor to mail written notice of cancellation to Additional Insureds or Certificate Holders, shown in the above SCHEDULE within the time frame listed below. However, failure to mail such notice shall impose no obligation of any kind upon us, our agents or representatives. 1. 30 days before the effective date of cancellation if we cancel for any reason other than for non - payment of premium. As respects Additional Insureds, the above cancellation provision applies only when the Additional Insured shown in the above SCHEDULE is added to the policy by a separate additional insured endorsement as the CANCELLATION NOTICE TO ADDITIONAL INSURED OR CERTIFICATE HOLDER does not provide additional insured coverage. Page 1 of 1 Attachment Code:D658504 Certificate ID: 20958134 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 Expected or Intended Injury—Property Damage Included Limited Rental Lease Agreement Contractual Liability $50,000 Non-Owned Watercraft Less than 58 feet Damage to Property You Own, Rent or Occupy $30,000 Medical Payments $20,000 Medical Payments Reporting Period 3 Years Athletic Activities Amended Supplementary Payments- Bail Bonds $2,500 Supplementary Payments—Loss of Earnings 500 per day Employee Indemnification Defense Coverage $25,000 Who Is An Insured Included 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 Transfer of Rights of Recovery Against Others To Us Clarification Liberalization Included Unintentional Failure to Disclose Hazards Included Bodily Injury—Includes Mental Anguish Included Personal and Advertising Injury— Includes Abuse of Process, Included Discrimination PI-GLD-TS (11/15) Page 1 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code:D658504 Certificate ID: 20958134 (Other Insurance— Primary Clarification (Clarification Staffing Services Exclusions Clarification Staffing Services Definitions Clarification 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; SECTION III - LIMITS OF INSURANCE, Paragraph 6.; and a. 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. 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. PI-GLD-TS (11/15) Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code:D658504 Certificate ID: 20958134 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: 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 PI-GLD-TS (11/15) Page 3 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code:D658504 Certificate ID: 20958134 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, 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 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: PI-GLD-TS (11/15) Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code:D658504 Certificate ID: 20958134 "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 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 5 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code:D658504 Certificate ID: 20958134 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 6 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Attachment Code:D658510 Certificate ID: 20958134 POLICY NUMBER: PHPK2713505-001 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 Attachment Code:D658509 Certificate ID: 20958134 POLICY NUMBER: PHPK2713505-001.. 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 modified by this endorsement. This endorsement identifies person(s)or organization(s)who are "insureds" under the Who Is An Insured Provision 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: Endorsement Effective Date: 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'I Attachment Code:D658506 Certificate ID: 20958134 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE COMPANY WC9903013 (Ed. 7-09) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be $ 500 Schedule Person or Organization: All persons or organizations as required by written contract executed prior to the date of loss. This only applies to contracts for work in CA. Job Description: 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: 5/15/2026 Policy No.: WC092-00002-026 Endorsement No.: Insured: CATHYJON ENTERPRISES INC. Insurance Company: SUNZ Insurance Company WC 99 03 13 (Ed. 7-09) Attachment Code:D668643 Certificate ID: 20958134 POLICY NUMBER: PHPK2713505-001.. 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 modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) 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 "accident' or the "loss" under a contract with that person or organization. CA 04 44 03 10 PAGE 1 OF 1