SANDWOOD ENTERPRISES, INC. - 2016

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2►c4OR6° CERTIFICATE OF LIABILITY INSURANCE 1i DATE(YY) 6/100 /201/2016 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(ies) 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 NAME: Little & Smith Inc. 202 Church Street PHONE 70)428-3308 �� No)- (770)429 -8305 - DDRESS: MAIL bdurham @littleandsmith.com A P. O. Box 1089 INSURERS AFFORDING COVERAGE NAICH INSURER A:SeCi National Ins.Co. Marietta GA 30061 INSURED HR Outsourcing Hol LLC L /C /F din INSURER B: EACH OCCURRENCE Sandwood Enterprises, Inc. INSURER C: DAMAGE I U RENTED PREMISES Ea occurrence) DBA Orange County Sandbagger INSURER D: MED EXP (Any one person) 1588 Atkinson Road Ste 201 INSURER E: Lawrenceville GA 30043 1 INSURER F: CUVERAGES CERTIFICATE NUMBER:2015 /2016 Orance Countv RFVISIf1N MI IMPUPi 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 LTR TYPE OFINSURANCE ADDL SUER POLICYNUMBER POLICY EFF MMDD POLICY EXP MMIDDIYYYY LIMITS Santa Ana, CA 92701 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR EACH OCCURRENCE $ DAMAGE I U RENTED PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL& ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER POLICV[:] PRO- HOD GENERAL AGGREGATE $ PRODUCTS - COMP /OPAGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Pereccident ( ) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAI -MADE DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY- YIN ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? [N] NIA SWC1098315- ORANGE COUNTY 12/31/2015 12/31/2016 X STATUTE �RH E, L. EACH ACCIDENT $ 1,000 00 EL. DISEASE - EA EMPLOYE $ 1,000 000 (Mandatory In NH) If yes, describe under EL DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional RRReem(ar/kksss Schedule, �may ybb)e attached if more space Is required) / /A9 CERTIFICATE HOLDER r.AKII I I ATInM © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 t2n14nn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa An THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Sonia Carvalho /City Attorney ACCORDANCE WITH THE POLICY PROVISIONS. Administrative Services Division AUTHORIZED REPRESENTATIVE Community Development Agency 20 Civic Center Plaza, M -25 Santa Ana, CA 92701 Eugene Northcutt /KEC © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 t2n14nn