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ACOR" CERTIFICATE OF LIABILITY INSURANCE <br />5/1/2026 <br />DATE (MM/DDIYYYY) <br />1 5/15/2025 <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 />PRODUCER Lockton Companies, LLC <br />CONTACT <br />NAME: <br />444 W 47th St., Ste. 900 <br />Kansas City MO 64112-1906 <br />(816)960-9000 <br />PHONE FAX <br />Ext : A/C No <br />E-MAILo <br />ADDRESS: <br />kcasu@lockton.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURERA: Philadelphia Indemnity Insurance Co. <br />18058 <br />INSURED CATHYJON ENTERPRISES INC. <br />1541642 DBA HB STAFFING <br />INSURER B : SUNZ Insurance Company <br />34762 <br />INSURER C : Beazley Insurance Company,Inc. <br />37540 <br />INSURER D : <br />7711 CENTER AVENUE, SUITE 670 <br />HUNTINGTON BEACH CA 92647 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 20958134 REVISION NUMBER: XXXXXXX <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DDIYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />PHPK2713505-000 <br />5/15/2025 <br />5/15/2026 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE FXI OCCUR <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 200,000 <br />MED EXP (Any one person) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 3,000,000 <br />X POLICY PRO LOC <br />JECT <br />PRODUCTS - COMP/OP AGG <br />$ 3 000000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />Y <br />Y <br />PHPK2713505-000.. <br />5/15/2025 <br />5/15/2026 <br />COMBINEDnt SINGLE LIMIT <br />Ea accide <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ XXXXXXX <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ XXXXXXX <br />X <br />PROPERTY DAMAGE <br />Per accident <br />$ XXXXXXX <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />$XXXXXXX <br />A <br />X <br />UMBRELLA LIAB <br />OCCUR <br />N <br />N <br />PHUB919987-000. <br />5/15/2025 <br />5/15/2026 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />AGGREGATE <br />$ 5,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />1) RETENTION $ 10,000 <br />$ XXXXXXX <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? N <br />(Mandatory in NH) <br />N I A <br />Y <br />WC092-00002-025 <br />5/1 /2025 <br />5/1 /2026 <br />PERX STATUTE EORH <br />E.L. EACH ACCIDENT <br />$ 1 000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1 000,000 <br />C <br />CRIME (+EMP THFT) <br />N <br />N <br />V39A7C250101... <br />5/15/2025 <br />5/15/2026 <br />$2M OCC/AGG <br />A <br />PROF LIAB <br />PHPK2713505-000 <br />5/15/2025 <br />5/15/2026 <br />$1 M OCC/$2M AGG <br />C <br />EMP PRAC LIAB <br />V39A53250101 <br />5/15/2025 <br />5/15/2026 <br />$2M OCC/$2M AGG <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />**SEE ATTACHED** <br />Tu Tran Nguyen <br />Tu Tran Digita"y5igned by APPROVED <br />Date: 2025.06.14 <br />Nguyen 09:35:46-07'00' By Tu Tran Nguyen at 9:35 am, Jun 04, 2025 <br />CERTIFICATE HOLDER CANCELLATION See Attachments <br />20958134 <br />CTTY OF SANTA ANA <br />ATTTN: HUMAN RESOURCES <br />20 CIVIC CENTER PLAZA, M-24 <br />SANTA ANA CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENT <br />I, + �{`i 9 <br />Cc� 198A 015 ACORD CORPORATION_ All rinhtc rPwprvarl <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />