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HomeMy WebLinkAboutKIMCO STAFFING (2) 0[dil A-2023-122-04A MAYOR ; _1"2� b 4 CITY MANAGER Valerie Amezcua "r Fr +' Alvaro Nunez MAYOR PRO TEM MAY 2 72976 ..s..�r CITY ATTORNEY David Penaioza Sonia R.Carvalho COUNCILMEMBERS CITY CLERIC Phil Bacerra ..,7. Z.� Jennifer L.Hall Johnathan Ryan Hernandez '� ''� "� Jessie Lopez Thai Viet Phan Benjamin Vazquez CITY OF SANTA ANA 0- Ry-N HUMAN RESOURCES rU I I ei7Gf DZ) 20 Civic Center Plaza I PO Box 1988 v Santa Ana,California 92702 WWW.santa-ana-ora May 11, 2026 Kimco Staffing Services, Inc. Attn: Tom Megonigal, President 1200 Main Street, Suite A Irvine, California 92614 Re: Extension of Agreement No. A-2023-122-04 to provide on-call temporary staffing services Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by Kimco Staffing Services, Inc., and the City of Santa Ana, which commenced on July 1, 2023, the parties hereby exercise their option to extend the term of the Agreement for an additional one (1)year through June 30, 2027. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, 6 on Schnaider Executive Director of Human Resources CITY OF SANTA ANA ATTEST Alvaro Nunez ni er all . City Manager City Cler APPROVED AS TO FORM CONSULTANT saw,a, ,k P. � 7w- Laura Rossini By: Tom Megonigal Chief Assistant City Attorney Title: President SANTA ANA CITY COUNCIL Valene Amezcua David Penalaze Thai V6et Phan Benjamin Vazquez Jessie Lopez Phil Bacerra Johnathan Ryan Hernandez Mayor Mayor Pro Tem-Ward 6 Ward t Ward 2 Ward 3 Ward 4 Ward 5 vamezcuwansanta-ana.arn dpenaloza[p)santa-ane.org IphamMsanta-ana ora bvaznuezRsanta-anA.arn iessielooezasanta-ana.ora abacena0santaana.om irvanhemandeNsanta-ana.org KIMCSTA-01 MMCALLISTER CERTIFICATE OF LIABILITY INSURANCE DATE 12IY5 I26/26i2025 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 License#OM70471 CONTACT NAME: Orion Risk Management Insurance Services,An Alera Group Insurance PHONE,Exrl:(949 263-885D FAX Agency, LLC ) {A1C,Nol:(949)263-8860 18575 Jamboree Rd,Suite 500 AMDRESS: Irvine,CA 92612 INSURER.S AFFORDING COVERAGE _ NAIC# INSURER A:PHILADELPHIA INDEMNITY INSURANCE COMPANIES' 18058 INSURED INSURERB:XL Insurance America Inc 24554 Kimco Staffing Services,Inc. INSURER C: 17872 Cowan Ave INSURER D: Irvine,CA 92614 INSURER E: INSURER F: 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 TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR NSD WVD MMfDDIYYYY MMIDD A X COMMERCIALGENERALLIABILITY EACH OCCURRENCE g 1,000,000 CLAIMS-MADE [X] OCCUR X X PHPK2599195007 91112025 9/1/2026 pRErAGE TO a oecu rice $ 100,000 ME[)EXP(Any one erson $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GFN1 AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 3,000,000 X POLICY[_] PRO" 0 LOG 3,000,600 JFGT PRODUCTS ACG S OTHER: SEXUAL PHYSICAL 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident S X ANY AUTO X X PHPK2599195007 91112025 9/1/2026 HOUILY INJURY Per erson S OWNED SCHEDULED AUTOSONLY AUTOS HODILYINJURY Per accident $ X HIRED X NON-OWNED PROPERPerTY DAMAGE AUTOS ONLY AUTOS ONLY accident S S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATF S DED I I RETENTION S S B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOWPARTNERIEXECUTiVE YIN X RWD300121609 12l28I2025 12I28I2026 1,000,000 OFFICERIM EMBER EXCLUDED? Y� N i A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,DOD,a00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liabili X PHPK2599195007 911I2025 9/1/2026 Each Claim 1,000,000 A Professional Liabili PHPK2599195007 911/2025 9/1/2026 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES IACORD 101,Additional Remarks Schedule,may be attached if more space is requiredl City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are listed as additional insured with respects to General Liability and Auto Liability per the terms of the attached endorsements. Waiver of Subrogation applies per the terms of the attached General Liability,Auto Liability,Workers Compensation,and Professional Liability endorsements. Digirally signed TU Tran by TuTf3e Nguyen Nguye 3in9 aoo2 APPROVED CERTIFICATE HOLDER CANCELLATION 1 By TO Tran Nguyen of 1:30 pm,Jan 12,2026 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Attention: Human Resources 20 Civic Center Plaza Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) Cc31988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Kimco Staffing Services, Inc. Policy Number: PHPK2599195007 PI-GI_D-TS (11/15) Policy Term: September 1, 2025-September 1, 2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT; TEMPORARY STAFFING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page Damage to Premises Rented to You $1,000,000 2 Expected or Intended Injury—Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 2 Non-Owned Watercraft Less than 58 feet 3 Damage to Property You Own, Rent or Occupy $30,000 3 Medical Payments $20,000 3 Medical Payments Reporting Period 3 Years 3 Athletic Activities Amended 3 Supplementary Payments—Bail Bonds $2,500 4 Supplementary Payments—Loss of Earnings $500 per day 4 Employee Indemnification Defense Coverage $25,000 4 Who Is An Insured Included 4 Additional Insured—Newly Acquired or Formed Organization Additional Insured—Broadened Named Insured Additional Insured—Blanket Additional Insureds When Required by Contract Duties in the Event of Occurrence, Offense, Claim or Suit Included 4 Transfer of Rights of Recovery Against Others To Us Clarification 5 Liberalization Included 5 Unintentional Failure to Disclose Hazards Included 5 Bodily Injury—Includes Mental Anguish Included 5 Personal and Advertising Injury—Includes Abuse of Process, Included 6 Discrimination Other Insurance—Primary Clarification Clarification 6 PI-GLD-TS (11/15) Page 1 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) Staffing Services Exclusions Clarification 7 Staffing Services Definitions Clarification 8 A. Damage to Premises Rented to You If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part: 1. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event,whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof; 2. The word fire is changed to fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in: a. The last paragraph of SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III—LIMITS OF INSURANCE, Paragraph 6.; and c. SECTION V—DEFINITIONS, Paragraph 9.a.; and 3. The words fire insurance are changed to insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4,Other Insurance, Paragraph b. Excess Insurance. B. Expected or Intended Injury—Property Damage SECTION I--COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph a. Expected Or Intended Injury is deleted in its entirety and replaced by the following: a. Expected Or Intended Injury "Bodily injury"or"property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to"bodily injury"or"property damage" resulting from the use of reasonable force to protect persons or property. C. Limited Rental Lease Agreement Contractual Liability SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraph b. Contractual Liability is amended by adding the following: Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to$50,000, PI-GLD-TS (11115) Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) This coverage extension only applies to rental lease agreements and is excess over any renter's liability insurance of the client. D. Non-Owned Watercraft SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, g.Aircraft,Auto Or Watercraft, Paragraph (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. E. Damage to Property You Own, Rent or Occupy SECTION I--COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions,j. Damage To Property, Paragraph (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a$30,000 limit. A client is defined as a person under your direct care and supervision. F. Medical Payments 1. If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part the Medical Expense Limit is changed subject to all of the terms of SECTION III—LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. Under SECTION I—COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, Paragraph a., Item (b) is amended to read: (b) The expenses are incurred and reported to us within three years of the date of the accident; and G. Athletic Activities SECTION I--COVERAGES, COVERAGE C MEDICAL PAYMENTS,2. Exclusions, Paragraph e. Athletics Activities is deleted in its entirety and replaced with the following: PI-GLD-TS (11/15) Page 3 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11116) e. Athletics Activities To a person injured while taking part in athletics. H. Supplementary Payments SECTION I—COVERAGES, SUPPLEMENTARY PAYMENTS—COVERAGES A AND B, Items 1.b. and 1.d. are amended as follows: b. The limit for the cost of bail bonds is changed from $250 to$2,500; and d. The limit for loss of earnings is changed from $250 a day to$500 a day. I. Employee Indemnification Defense Coverage SECTION I—COVERAGES, SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is amended to include the following: We will pay, on your behalf, defense costs incurred by an"employee" in a criminal proceeding. The most we will pay for any"employee"who is directly involved in a criminal proceeding is$25,000 regardless of the numbers of"employees,"claims or"suits" brought or persons or organizations making claims or bringing "suits." J. Who is An Insured SECTION II—WHO IS AN INSURED is amended as follows: 1. Newly Acquired or Formed Organization If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is amended to read: a. Coverage under this provision is afforded until the and of the policy period; 2. Each of the following is also an insured: a. Broadened Named Insured—Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. b. Blanket Additional Insureds When Required by Contract—Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for"bodily injury,""property damage"or"personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III-- LIMITS OF INSURANCE. PI-GLD-TS (11115) Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. PI-GLD-TS (11/15) c. interns—Your interns only while performing duties related to the conduct of your business. d. Contractors—Any individual or organization underwritten contractor written agreement with you who provides "staffing services" on your behalf and at your direction for your clients. K. Duties in the Event of Occurrence, Offense,Claim or Suit 1. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, 2.a.the requirement that you must see to it that we are notified as soon as practicable of an"occurrence"or an offense, applies only when the`occurrence"or offense is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An "executive officer" or insurance manager, if you are a corporation. 2. SECTION 1V—COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. b. the requirement that you must see to it that we receive notice of a claim or"suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or"suit" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An "executive officer"or insurance manager, if you are a corporation. L. Transfer of Rights of Recovery Against Others To Us SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us includes the following clarification: Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. M. Liberalization SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. N. Unintentional Failure To Disclose Hazards SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition: Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period PI-GLD-TS (1 Ill 5) Page 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11115) of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. 0. Bodily Injury—Mental Anguish SECTION V—DEFINITIONS, Paragraph 3. is amended to read: "Bodily injury": a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. P. Personal and Advertising Injury—Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of"personal and advertising injury" is amended as follows: 1. SECTION V—DEFINITIONS, Paragraph 14., Item b. is revised to read: b. Malicious prosecution or abuse of process; 2. SECTION V—DEFINITIONS, Paragraph 14. is amended to include the following: "Personal and advertising injury" also means discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Q. Section IV—Commercial General Liability Conditions is amended by the addition of the following: The following language is added to Item 4. Other Insurance: Insurance under this endorsement is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. PI-GLD-TS (11/15) Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. PI-GLD-TS (11/15) This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or"occurrence"we cover for this Additional Insured. R. Staffing Services Exclusions The following exclusions are added to SECTION I—COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE; Actions Or Activities Of PEO Worker "Bodily injury" or"property damage" arising from the actions or activities of any"PEO worker'. Professional Services Exclusion "Bodily injury" or"property damage"due to the rendering of or failure to render any professional service. This exclusion does not apply to your liability for"bodily injury"or"property damage"arising out of your"employee's"providing or failing to provide professional health care services to another of your"employees", but no"employee" is an insured for his or her providing or failure to provide such professional health care services. Wrongful Acts "Bodily injury"or"property damage" arising from a wrongful act in the rendering or failure to render services to or for your client. For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing"staffing services"to your clients by you or by any person for whose acts you are legally responsible. SECTION I—COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is amended as follows: 1. Exclusion k. does not apply. 2. Exclusions a., b., e., f., g., h., I., I., and p.do not apply to any insured who did not personally acquiesce in or remain passive after having personal knowledge of such conduct. Our obligation to pay shall begin once the full extent of the assets of the responsible insured has been exhausted and once the Deductible as shown in the Declarations of the policy has been satisfied. 3. The following exclusions are added to Paragraph 2. Exclusions: Actions Or Activities Of PEO Worker "Personal and advertising injury" arising from the actions or activities of any"PEO worker". Professional Services Exclusion "Personal and advertising injury"due to the rendering of or failure to render any professional service. Wrongful Acts "Personal and advertising injury" arising from a wrongful act in the rendering or failure to render services to or for your client. PI-GLD-TS (11/15) Page 7 of S Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-TS (11/15) For the purposes of this exclusion, wrongful act shall mean any actual or alleged act, error, or omission, misstatement, or misleading statement in the course of providing"staffing services"to your clients by you or by any person for whose acts you are legally responsible. S. Staffing Services Definitions 1. SECTION V—DEFINITIONS, Paragraph 5. is revised to read: "Employee" includes but is not limited to a"leased worker"and a"staffing service employee". "Employee" does not include a"temporary worker" or a"PEO worker". 2. The following definitions are added to SECTION V—DEFINITIONS: a. "PEO service" means staffing related services as a Professional Employer Organization (PEO)you provide to your clients and to"PEO workers" in connection with employment of such workers. b. "PEO worker" means a person you lease to your client under a written "PEO service" agreement or contract. c. "Staffing Services" means services provided by a staffing company to their clients including but not limited to: (1) Fulfillment of any of the administrative functions which would otherwise be normally fulfilled by an employer's human resource function; (2) Staffing related administrative services provided by an Administrative Services Organization (ASO); (3) "PEO service"; (4) Staffing related services provided to your clients for the recruitment, selection and placement of a person for employment with a client. (5) Temporary, contingent or contract placement services; (6) Vendor Management Service (VMS), means the facilitation, purchase and management of"staffing services" for clients including the placement and fulfillment of orders for "staffing service employees"; (7) Services performed on behalf of your client by a"staffing service employee"who is not a direct hire or permanent placement; (8) Services performed for a client company to supply that client company with a"staffing service employee". d. "Staffing service employee" means a person who is furnished by you to your client to perform the duties to which you have agreed. PI-GLD-TS (11/15) Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: PHPX2599195007 COMMERCIAL GENERAL LIABILITY CG24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section 1V—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 06 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: PHPK2599195007 COMMERCIAL,AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "Insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Kimco Staffing Services, Inc. Endorsement Effective Date: 09/01/2025 SCHEDULE Name of Person(s) or Organization(s): Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional Insured but only for liability arising out of the negligence of the named insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of'I POLICY NUMBER: PHPK2599195007 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following; BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Kimco Staffing Services, Inc. Endorsement Effective Date: 09/01/2025 SCHEDULE Name(s)Of Person(s) Or Organiization(s): Any person or organization who you are required to add by written contract which is executed prior to the occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Oth- ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac- cident" or the "loss" under a contract with that person or organization. CA 04 44 03 10 0 Insurance Services Office, Inc., 2009 Page 1 of 1 Kimco Staffing Services,Inc. Policy Number: PHPK2599195007 PI-TS-013 (06/12) Policy Term:September 1, 2025-September 1,2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT (Including Waiver of Subrogation) This endorsement modifies and is subject to the insurance provided under the following: STAFFING SERVICE PROFESSIONAL LIABILITY COVERAGE FORM STAFFING SERVICE PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE COVERAGE FORM A. The following is added to SECTION 11—WHO IS AN INSURED: Any person or organization where required by contract executed prior to a loss is an insured, but only with respect to that person's or organization's liability for"damages" arising out of a"wrongful act" during the rendering of"staffing services". B. Paragraph I. in SECTION IV. CONDITIONS is deleted in its entirety and replaced with the following: Transfer of Rights of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring"suit"or transfer those rights to us and help us enforce them. The insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a contract. ©2012 Philadelphia Indemnity Insurance Company Page 1 of'I WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Where required by written agreement signed prior to loss. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12-28-2025 Policy No. RWD300121609 Endorsement No. Insured Kimeo Staffing Services, Inc. insurance Company Countersigned by XL Insurance America, Inc. WC000313 (Ed,4-84) 0 1983 National council on Compensation Insurance.