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<br />DATE (MM/DD/YYYY) <br />CERTIFICATE OF LIABILITY INSURANCE <br />03/12/2026 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />CONTACT <br />PRODUCER <br />NAME: <br />FAX <br />PHONE <br />Paul Hughes (Rippling) <br />(A/C, No): <br />(A/C, No, Ext): <br />c/o Libertate Insurance Services <br />E-MAIL <br />peo-wc@rippling.com <br />ADDRESS: <br />20 North Orange Avenue; Suite 500 <br />Orlando, FL 32801 <br />INSURER(S) AFFORDING COVERAGENAIC # <br />American Zurich Insurance Company40142 <br />INSURER A : <br />INSURED <br />INSURER B : <br />Rippling PEO 1, Inc. Labor Contractor, for co-employees of: C3 Office Solutions LLC <br />INSURER C : <br />dba: C3 Tech <br />430 California St 11th Floor <br />INSURER D : <br />San Francisco, CA 94104 <br />INSURER E : <br />INSURER F : <br />25NY0201282223 <br />COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ADDLSUBR <br />INSRPOLICY EFFPOLICY EXP <br />TYPE OF INSURANCELIMITS <br />POLICY NUMBER <br />LTR(MM/DD/YYYY)(MM/DD/YYYY) <br />INSDWVD <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE$ <br />DAMAGE TO RENTED <br />CLAIMS-MADEOCCUR$ <br />PREMISES (Ea occurrence) <br />MED EXP (Any one person)$ <br />PERSONAL & ADV INJURY$ <br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ <br />PRO- <br />POLICYLOCPRODUCTS - COMP/OP AGG$ <br />JECT <br />$ <br />OTHER: <br />COMBINED SINGLE LIMIT <br />AUTOMOBILE LIABILITY$ <br />(Ea accident) <br />ANY AUTO <br />BODILY INJURY (Per person)$ <br />OWNEDSCHEDULED <br />BODILY INJURY (Per accident)$ <br />AUTOS ONLYAUTOS <br />NON-OWNED <br />HIREDPROPERTY DAMAGE <br />$ <br />(Per accident) <br />AUTOS ONLYAUTOS ONLY <br />$ <br />UMBRELLA LIAB <br />EACH OCCURRENCE$ <br />OCCUR <br />EXCESS LIAB <br />CLAIMS-MADEAGGREGATE$ <br />$ <br />DEDRETENTION$ <br />PEROTH- <br />WORKERS COMPENSATION <br />X <br />STATUTEER <br />AND EMPLOYERS' LIABILITY <br />Y / N <br />ANYP ROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT$ <br />1,000,000 <br />N / A <br />WC 69-08-189-0012/01/202512/01/2026 <br />A <br />OFFICER/MEMBER EXCLUDED?X <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE$1,000,000 <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />Location Coverage Period:12/01/202512/01/2026Client#452322754-CA <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers <br />C3 Office Solutions LLC dba: C3 Tech <br />Coverage is provided for <br />1536 East Warner Ave <br />only those co-employees <br />Santa Ana, CA 92705 <br />of, but not subcontractors <br />to: <br />Endorsements: Waiver of Subrogation <br />CzUvUsboOhvzfobu:;25bn-Nbs34-3137 <br />CERTIFICATE HOLDERCANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana Attn: Informational Technology Department <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza, M-42 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD <br /> <br />