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0 CERTIFICATE 4F LIABILITY INSURANCE DATE{MMlDDlYYYY) 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(les)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 t0 the certificate holder In lieu of such endorsement(s). PRODUCER CONNAME CT Marsh Affinity Marsh Afflnity AlC No,Ext: B00 743�136 FA No): a division of Marsh USA LLC, ADDR SAIL S: ADPTotaf3vurce{g7marsh.00m PO SOX 14404 Des Moines,IA 5030MB86 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: AIU Insurance Company 19399 INSURED INSURER B: ADP TotalSource DE IV,Inc. INSURERC: 5800 Windward Parkway INSURER D: Alpharetta,GA 30005 LICIF: INSURER E: Common Arts,Inc, DBA Studio One Eleven INSURER F: 245 E 3RD ST Long Beach,CA 908020000 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 TYPEOFINSURANCE ADDLSUBR POLICY NUMBER POLICYEFF POLICYEXP LIMITS LTR INSD WVD (MMIDDIYYYY) (MMfDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑OCCUR DAMAGETORENTED $ PREMISES Es occurrence MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PPOLICY PRO 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 avcide $ no UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESSLIAS CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y1 N x TA7UTE ER ANYPROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 2,000,000 OFFICERIMEMSER EXCLUDED? F NIA X WC 063531332 CA 0710112025 0710112026 /4 fMandatory in NH) E,L.DISEASE-EA EMPLOYEE $ 2,000,000 f yea,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2 00o-00D DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) All workslte employyees working for Common Arts,Inc.DBA Studio One Eleven paid under ADP TOTALSOURCE,INWs payroll,are covered under the above stated policy,ProprielorfPartnerlt_xecutive OfflcerlMember are not excluded as Iong as they are In the ADPTS pa roll or have oompieled the SEI Participallon Addendum,WAIVER OF SUBROGATION IN FAVOR OF City of Santa Ana AS RESPECTS OF JOB PERFORMED BY Common Arts,Inc.DBA Studio One Eleven AS REQUIRED BY WRITTEN CONTRACT. APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 8.18 am,Apr27;2t12t City of Santa Ana 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana,CA 92702 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 1N ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE _ Q ACORD 25(2016103) 01988-2016 ACORD CORPOP 6XION. All rights reserved. The ACORD name and logo are registered marks of ACORD