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<br /> <br /> <br /> P8R <br /> CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />11/27/2024 <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 <br />endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endors ement. A <br />statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />AON RISK SERVICES SOUTH INC <br />3550 LENOX ROAD NORTHEAST <br />SUITE 1700 <br />ATLANTA GA 30326 <br />CONTACT <br />NAME: Aon Risk Services, Inc of Florida <br />PHONE <br />(A/C, No, Ext): 833-506-1544 FAX <br />(A/C, No): <br />EMAIL <br />ADDRESS: work.comp@trinet.com <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A : ACE American Insurance Company 22667 <br />INSURED <br />TriNet Group, Inc. L/C/F PowerPivotPro LLC <br />1 Park Place, Suite 600 <br />Dublin, CA 94568-7983 <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 15797340 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA MED 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 TYPE OF INSURANCE ADDL <br />INSR <br />SUBR <br />WVD POLICY NUMBER POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY) LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED <br />PREMISES (Ea occurrence) $ <br /> MED EXP (Any one person) $ <br /> PERSONAL & ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ <br /> OTHER $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br />(Ea accident) $ <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> OWNED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS BODILY INJURY (Per accident) $ <br /> HIRED <br />AUTOS ONLY <br />NON-OWNED <br />AUTOS ONLY <br />PROPERTY DAMAGE <br />(Per accident) $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEC RETENTION $ <br />A <br /> <br />WORKERS COMPENSATION <br />Y / N <br />N <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N / A X WLR_C57632124 <br /> 07/01/2024 07/01/2025 <br />X PER <br />STATUTE OTH- <br />ER <br />E.L. EACH ACCIDENT $ 2,000,000 <br />E.L. DISEASE - EA EMPLOYEE $ 2,000,000 <br />E.L. DISEASE - POLICY LIMIT $ 2,000,000 <br /> <br /> <br /> <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Workers Compensation coverage is limited to worksite employees of PowerPivotPro LLC through a co-employment agreement with TriNet HR III, Inc.. <br />Waiver of subrogation in favor of City of Santa Ana Public Works Agency - Water Resources Division as required by written contract. <br />A 30 day notice of cancellation is endorsed to the policy for the City of Santa Ana Public Works Agency - Water Resources Division. <br /> <br />CERTIFICATE HOLDER CANCELLATION <br /> <br />City of Santa Ana Public Works Agency - Water Resources Division <br />20 Civic Center Plaza (M-30), PO BOX 1988 <br />Santa Ana, CA 92702 <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 REPRESENTATIVE <br /> <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD