The URL can be used to link to this page

2020/06/12 TriNet HR lll-A, Inc.T3-ONH A'� DATE (MMY) C t �'y Q CERTIFICATE OF LIABILITY INSURANCE s/12/20202020 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 Risk Management Department Commercial Lines - (305) 443-4886 PHONE FAx (866)443-8489 Arc INc: (800)889-0021 USI Insurance Services LLC ADDRESS- E-MAIL Work.Comp@Trinet.com 2601 South Bayshore Drive, Suite 1600 INSURER(S) AFFORDING COVERAGE NAIC* Coconut Grove, FL 33133 INSURERA: Indemnity Insurance Company of North America 43575 INSURED INSURER B TriNet HR III -A, Inc. INSURERC: L/C/F LeadsOnline LLC INSURER D 9000 Town Center Parkway INSURER E : Bradenton, FL 34202 INSURER F : COVFRAf.FS CFRTIFICATF NII IMRFR- 15051894 RF\/I1ZI(\RI III IRAQ=0- Scc F—l—, 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. rLTR TYPE OF INSURANCE DD U POLICYNUMBER POLICY %Y.YYY MMIDDIYYYYPY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FlOCCUR EACH OCCURRENCE S PREMIS Ea occurrence $ MED EXP tAny one person) $ PERSONAL &ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY D JECT LOC OTHER: GENERAL AGGREGATE $ PRODUCTS -COMP/OP AGG $ S AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED r NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED,SINGL L 8 ai-wdem $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE n $ $ UMBRELLALIAB EXCESS LI{AB OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE $ DED I RETENTION$ $ A AND EMPS YERS' LSA IONILIT AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDED? C (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS beIDW NIA WLR C67487503 07/01/2020 07/01/2021 —'is EATUTE EDR E. L. EACH ACCIDENT 2,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Workers' Compensation coverage is limited to worksite employees of LeadsOnline LLC through a co -employment agreement with TriNet HR III -A, Inc. CERTIFICATE HOLDER CANCELLATION City of Menifee and its officers, employees, agents, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN and authorized volunteers ACCORDANCE WITH THE POLICY PROVISIONS. 29844 Haun Road Menifee, CA 92586 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 11111111111 IIIIHI III 111 HH 1111111111111 NII 111 III 111111111 IIIH IIIII IIII 11 -CY.I)IA1210026f 1102/02/0/0/0/0' COMMERCIAL LINES - (305) 443-4886 USI INSURANCE SERVICES LLC 2601 SOUTH BAYSHORE DRIVE, SUITE 1600 COCONUT GROVE, FL 33133 CITY OF MENIFEE AND ITS OFFICERS, EMPLOYEES, AGENTS, AND AUTHORIZED VOLUNTEERS 29844 HAUN ROAD MENIFEE, CA 92586 Would you like to receive this certificate via email or fax? We offer expedited delivery to better serve our mutual clients. To update the delivery method for revisions to this certificate and for next year's copy, please enter this information in your browser: https://www.cybersure.com/cybersure/forms/iyoc/cdmu.aspx When prompted, enter this information for security purposes: Client ID: T3-ONH Cert ID: 15051894 Passcode: 76E83F7D Follow the instructions and let us know your delivery preference. You'll receive future copies of this certificate via the method you provide. Thank you for helping us provide certificates to you more quickly. WW**********WWW*************WW********WW*W*************W*W****!rW*****W****k**W*******a!**W*WF***********W***W*W****** 11111111111111111111111111111111 IN 11111111111111111111111111111111111111111111111 IN _.200266401.._