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HOWRGEN-01 D RTIZ
<br /> CERTIFICATE OF LIABILITY INSURANCE DAT515/2025
<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 _NAME: __-
<br /> MG Skinner&Associates
<br /> 1666 20th St Ste 200 (AHrCC,N o,Ext):(310)478-5041 jAAiCC,No):(310)479$707
<br /> Santa Monica,CA 90404-3827 ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Tokio Mari ne-Specialt)iAnsurance Company 23850
<br /> INSURED INSURERB:Ace American Ins Co 22667
<br /> AppleOne,Inc.dba AppleOne Employment Services INSURERC:
<br /> fka:Howroyd Wright Employment Agency,Inc.
<br /> P.O.Box 29048 INSURER D:
<br /> Glendale,CA 91209-9048 INSURER E-:. _
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: _
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> ----- --- ---
<br /> INSR 'ADDL'SUBR POLICY EFF POLICY EXP
<br /> L TYPE OF INSURANCE INSD''+V+(C__ POLICY NUMBER (MMIDDIYYYYI I IMMIDDIYY'YY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I$ 2,000,000
<br /> DAMAGE TO RENTED 100,000
<br /> CLAIMS-MADE ��OCCUR X �( pPK2679926-002 4/1/2025 4!1l2026 pR-EMISES:Ea occurrences '$
<br /> X Contractual Liab. MED EXP(Any on"ersonl !$ 5'000
<br /> i PERSONAL&ADV INJURY__$ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: � GENERALAGG,REGATE. $ 4,000,000
<br /> X POLICY' JECT ^J LOC _PROD /O UCTS-COMPPAG_G. $ 4'000'000
<br /> OTHER:
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> (Ea accident) __$
<br /> X ANY AUTO �PPK2679926-002 4/1/2025 4/1/2026 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> _ AUTOS ONLY AUTOS I BODILY INJURY(Per accident)I$
<br /> X HIRED X NON-0WNED PerOP.ER entDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY -- --
<br /> 3
<br /> A X UMBRELLA LIAB i X I OCCUR EACH OCCURRENCE $ 10,000,000
<br /> EXCESS LIAB —I CLAIMS-MADE 'PUB909174-002 4/1/2025 411/2026 10,000,000
<br /> AGGREGATE $
<br /> DED X RETENTION$ 10,000` $
<br /> B 'WORKERS COMPENSATION I I X STATUTE ORH__
<br /> AND EMPLOYERS'LIABILITY
<br /> YEN I ;WLRC72610118 4l112025 4/1/2026 1,000,000
<br /> i ANY PROPRIETORIPARTNER/F>CECUTIVE '—i E.L.EACH ACCIDENT $ _ _
<br /> (Mandatory in NH)EXCLUDED? N/A' 1,000,000
<br /> � E.L.DISEASE-EA EMPLOYEE'.$ _ _
<br /> If yes,describe under f 1,000,000
<br /> DESCRIPTION OF OPERATIONS below ! E.L.DISEASE-POLICY LIMIT
<br /> A (Crime(3rd Party) PPK2679926-002 4/1/2025 4/1/2026 Occurrence/Aggregate 3,000,000
<br /> A �E&O/Prof.Liab. �PPK2679926-002 4/1/2025 4/1/2026 Occurrence/Aggregate 3,000,000
<br /> I
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Job ID 009500724003
<br /> Re:City of Santa Ana Agreement No.A-2018-146.The City of Santa Ana,officers,agents,employees and volunteers are named additional insured on this
<br /> policy pursuant to written contract,agreement,or memorandum of understanding. Primary and Non-Contributory coverage will apply.Waiver of Subrogation
<br /> is covered under General Liability for clerical positions only. Notice of Cancellation under applicable policies:30 days/10 days for non-payment of premium.
<br /> Tu Tran y
<br /> T,Tran Nguyenby APPROVED
<br /> Hate:2025.05.08
<br /> Nguyen o9:zz:25 m•00• By Tu Tran Nguyen at 9:21 am, May 08, 2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ty ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn:Jay Jenkins
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92701-4010 AUTHORIZED REPRESENTATIVE
<br /> rJfL
<br /> ACORD 25(2016103) (� ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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