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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD1YYYY) 04112/2025 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 CONTACT NAME: Marsh Affinity PHONE 8007436130 FAX Marsh Affinity A1C,Na EXt: A1C No): a divisionof Marsh USA LLC. BOX14404 ADDRESS:PO BOX ADPTotalSource@marsh.com Des Molnes,IA 50306-9696 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A: AIU insurance Company 19399 INSURED INSURER B: ADP TotalSource DE IV,Inc. INSURER C: 5800 Windward Parkway INSURER D' Alpharetta,GA 30005 LICIF: INSURER E: PACIFIC COAST CABLING,INC INSURER F: 20717 PRAIRIE ST Chatsworth,CA 913110000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 ADDLSUBR POLICY EFF POLIO XP LTR TYPEOFINSURANCE INSD WVD POLICY NUMBER (MM1DD IYYYY) (MMIDDfYYYY) LIMITS COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES Ea occu ence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY jECT ❑LOG PRODUCTS-COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS � ( ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION PER - AND EMPLOYERS'LIABI LITY YIN XISTATUTE ER ANYPROPRIETORfPARTNERJIXECUTIVE F.L.EACH ACCIDENT $ 2,000,000 OFFICEMMEMBER EXCLUDED? N 2025 NIA X WC 063633556 CA 0710112025 07/011 14 (Mandatory In NH) E,L,DISEASE-EA EMPLOYEE $ 2,000,000 f yes,describo under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 ? NglWlysigned Tu DESCRIPTION OF OPERATIONS I LOCATIONS[VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) bys—a Nguyen All worksite employees working for PACIFIC COAST CABLING,INC paid under ADP TOTALSOURCE,INC.'s payroll,are covered under the above stated policy.ProprietorlPartnerlExecutive OfficerlMember are N g u\fed oater2025.08.22 not excluded as IonrJ as they are In the ADPTS payroll or have completed the SO Participation 7 M2123 A7'00' Addendum.WAIVER OF SUBROGATION IN FAVOR OF The Clty of Santa Ana,its officers,employees,a ent%, volunteers and representatives AS RESPECTS OF JOB PERFORMED BY PACIFIC COAST CABLING,INC AS REQUIRED BY WRITTEN CONTRACT. APPROVED By Tu Tran Nguyen at 3�22�, CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division 20 Civic a, CA Plaza 4th Floor Santa SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana,CA 9270Z THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016103) O 1988-2016 ACORD CORPOFMIGN. All rights reserved. The ACORD name and logo are registered marks o(ACORD