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HomeMy WebLinkAboutCATHYJON ENTERPRISES, INC. DBA HB STAFFING (2) A-2023-122-02A MAYOR "` CITY MANAGER Valerie Amezcua I AI r�`�,;,,+. Alvaro Nuoez MAYOR PRO TEM J IvI� � at';�; CITY ATTORNEY David Penaloza Sonia R.Carvalho COUNCILMEMBERS CITY CLERK Phil Bacerra ; I Jennifer L.Hall Johnathan Ryan Hernandez :' Jessie Lopez Thai Viet Phan Benjamin Vazquez CITY OF SANTA ANA HUMAN RESOURCES 20 Civic Center Plaza I PO Box 1988 Santa Ana,California 92702 www.santa-ana.org May 11, 2026 CATHYJON ENTERPRISES, Inc. dba HB Staffing Attn: Jonathan Davis 7777 Center Ave, Suite 220 Huntington Beach, CA 92647 Re: Extension of Agreement No. A-2023-122-02 to provide on-call temporary staffing services Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by Cathyjon Enterprises Inc dba HB Staffing and the City of Santa Ana, which commenced on July 1, 2023, the parties hereby exercise their option to extend the term of the Agreement for an additional one(1)year througll June 30,2027.Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, o�-Id�L__� Lori Schnaider Executive Director of Human Resources CITY O SANTA A AT t Alvaro Nunez Jennifer all a City Manager City Cie APPROVED AS TO FORM CONSULTANT Laura Rossini By: Jonathan Davis Chief Assistant City Attorney Title: Vice President SANTA ANA CITY COUNCIL Valerie Amezcua David Penaloza Thai Viet Phan Benjamin Vazquez Jessie Lopez Phil Bacerra Johnathan Ryan Hernandez Mayor Mayor Pro Tem-Ward 6 Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 vamezcualMsaril"na ora doenalozar@santa-ana.oro lohenlDsanla-ana.ora bvazauez(alsanta-ana.ora iessielooeznsanta-ana.arn obacerr Osanta-ana.cm irvanhemandezr6tisanta-ana orn AC R CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �.. 5/15/2027 1 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): EMAIL 444 W.47th St.,Ste.900 ADDRESS: Kansas City MO 64112-1906 INSURERS 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 LTR INSD WVD POLICY NUMBER MM/DD/YYYY MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY A X Y Y PHPK2713505-001 5/15/2026 5/15/2027 EACH OCCURRENCE $ 1,000,000 � OCCUR DAMAGESI RENTED CLAIMS-MADE 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 JPRO- POLICY LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y PHPI{2713505-001.. 5/15/2026 5/15/2027 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED (Per accident) BODILY INJURY(Pident) $ AUTOS ONLY AUTOS XXXXXXX X HIRED I X NON-OWNED PROPERTY DAMAGE $ XXXXXXX 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 $ 51000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION$ 10,000 $ XXXXXXX B AND EMPLOYERS'LIABILITY WORKERS COMPENSATION Y/N Y WC092-00002-026 5/15/2026 5/15/2027 X STER ATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000.000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1000,000 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 PHPIC2713505-001 5/15/2026 5/15/2027 $1M OCC/$2MAGG C EMP PRAC LIAB V39A53260201 5/15/2026 5/15/2027 $2M OCC/$2M AGG DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) **SEE ATTACHED** APPROVED By To Tran Nguyen at 8:42 am,Jun 09,2026 CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20958134 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS. ATTTN:HUMAN RESOURCES 20 CIVIC CENTER PLAZA,M-24 AUTHORIZED REPRESENTATIV. SANTA ANA CA 92701 ©1988 015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD :ONTINUATION DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/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, IIIRED&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. 4CORD 25(2016/03) Certificate Holder ID:20958134 Attachment Code:D658503 Certificate ID:20958134 POLICY NUMBER: PHPK2713505-001 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 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 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 i 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 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 i 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 age 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 r 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) i 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 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: 5/15/2026 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 i