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ACORV CERTIFICATE OF LIABILITY INSURANCE 1.-- DATE(MMIDONM) 6/10/2016 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 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 Brenda Durham Little S Smith Inc. 202 Church Street PHONE (990)429 -9395 N , EAIL 0EBg ,bdurhamOlittleandamith I com P. O. Box 1089 Marietta GA 30061 -_ INSURER1S) AFFORDING COVERAGE NAIC4 INSURER ASIECUrit National Ins.Cc. INSURED HR Outsourcing Hold: LLC L /C /F INSURERS: EACH OCCURRENCE Sandwaod Enterprises, Inc. INSURER C: - ATvT�GE`f6N -Nl S PREMISES PHA Orange County Sandbagger INSURER D: MED EXP(Anyone peson ) 1588 Atkinson Road Ste 201 INSURER E: _ Lawrenceville GA 30043 INSURER F: GENE AGGREGATE LIMIT APPLIES PER: POLICV[::] JEST � LOC OTHER: COVERAGES CERTIFICATE NUMBER:2015 /2016 Orange Countv RFVICIr3m mu MRGR: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE L18TED 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. - ILTR TYPE OF INSURANCE A LS D POLICY NU BER MOpI EFF MMI00MP LIMITS Community Development Agency 20 Civic Center Plaza, M -25 Santa Ana, CA 92701 COMMERCIAL GENERAL LIABILITY CL AIMS -MADE ❑OCCUR EACH OCCURRENCE - ATvT�GE`f6N -Nl S PREMISES MED EXP(Anyone peson ) $ PERSONAL &ADV INJURY $ GENE AGGREGATE LIMIT APPLIES PER: POLICV[::] JEST � LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO AUTOS NED gUTO5ULED NONAWNED HIRED AUTOS _ AUTOS 0 cc d nl N LE L A T $ BODILY INJURY (Per person) $ BODILY INJURV (Paracddenl) $ PROPERTY AMAGE Par esdtlen $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAI -MADE EACH OCCURRENCE $ AGGREGATE $ DEO EN ION $ A WORKERS COMPENSATION ANDEMPLOYERS'LIABILIT PIN ANY PROPRIETOWPARTNEtlEXECUTIVE OFFICERIMEMSER EXCLUDE[9 (Mandatary in NH) If yes dasadlle under OES RIF IONOF OPERATIONS below NIA SWC1098315- ORANGE COUNTY 12/31/2015 12/31/2016 X PER T OTH- E.L. EACH ACCIDENT $ 1 000, 00 El, DISEASE - EA EMPLOYE $ 1, 000 000 E.L. DISEASE - POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may heaeached if more space is required) UEK I II-ICA l t HULUtK CANCELLATION ©19882014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INSD25i n1dmi SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Anst/ Attn: Sonia Carvalho /City Attorney THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Administrative Services Division AUTHOR1250 REPRESENTATIVE Community Development Agency 20 Civic Center Plaza, M -25 Santa Ana, CA 92701 Eugene Northcutt /ItEC ©19882014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INSD25i n1dmi