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2021/03/01 Total Compensation SystemsCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/29/2021 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 SUBROGATIONIS 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 PCF INS SRVCS OF THE WEST LLC/PHS 72250765 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251 CONTACT NAME: PHONE (A/C, No, Ext): (866) 467-8730 FAX (A/C, No): (888) 443-6112 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED TOTAL COMPENSATION SYSTEMS 5655 LINDERO CANYON RD STE 223 WESTLAKE VILLAGE CA 91362-4044 INSURER A :Sentinel Insurance Company Ltd.11000 INSURER B : INSURER C : INSURER D : 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/Y YYY)LIMITS A COMMERCIAL GENERAL LIABILITY X 72 SBA CK3339 03/01/2021 03/01/2022 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence)$1,000,000 X General Liability MED EXP (Any one person)$10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $4,000,000 POLICY PRO- JECT X LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY 72 SBA CK3339 03/01/2021 03/01/2022 COMBINED SINGLE LIMIT (Ea accident)$2,000,000 ANY AUTO BODILY INJURY (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS- MADE EACH OCCURRENCE AGGREGATE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/ A PER STATUTE OTH- ER Y/N E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION City of Menifee 29844 HAUN RD MENIFEE CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: CB77EAB9-77DE-40DC-8986-0C4C525DA59B REGIONAL OFFICE INSTRUCTION SHEET POLICY NUMBER:72 SBA CK3339 DX CHANGE NUMBER:003 CHANGE EFF DATE:06/29/21 ROUTING INSTRUCTIONS _SEND TO RECORDS.TRANSFER CORR IF APPLICABLE. TERMINAL ID:R004V13A OPER INIT:RPD 06/29/21 72 SBA CK3339 DX (03/01/22)PAGE 1 DocuSign Envelope ID: CB77EAB9-77DE-40DC-8986-0C4C525DA59B POLICY FACE SHEET 39 33 INSURER: CK SENTINEL INSURANCE COMPANY,LIMITED SBA CHANGE NO.:003 CHANGE EFF DATE:06/29/21 POLICY NO.72 SBA CK3339 DX RECORDS RETENTION -PERMANENT DECLARATIONS ITEMS 1.NAMED INSURED AND TOTAL COMPENSATION SYSTEMS MAILING ADDRESS:5655 LINDERO CANYON RD STE 223 THOUSAND OAKS,VENTURA CA.91362 2.POLICY PERIOD:03/01/21 03/01/22 1 INCEPTION EXPIRATION YEAR AGENT'S CODE:250765 AGENT'S NAME:PCF INS SRVCS OF THE WEST LLC/PHS PREVIOUS POLICY NO.72 SBA CK3339 3.THE NAMED INSURED IS:CORP POLICY STATUS:ACTIVE LOB LEVEL OF SUPPORT:SP-S MARKET SEGMENTATION:830 SELECT CUSTOMER AGENT SALES AGREEMENT (COMMISSION STATUS ) DIRECT ACCOUNT BILL NUMBER -40354415A DEDUCTIBLE ADDITIONAL INSURED(S) AUTOMATICALLY BOOKED CODING ENTRY NOT REQUIRED TRANS TYPE:ENDT CNTL#:004 POLICY FACE SHEET TERMINAL ID:R004V13A PAGE 2 06/29/21 72 SBA CK3339 DX (03/01/22) DocuSign Envelope ID: CB77EAB9-77DE-40DC-8986-0C4C525DA59B 3600 WISEMAN BLVD. SAN ANTONIO TX 78251 (866)467-8730 (866)467-8730 SERVICE.TX@THEHARTFORD.COM (866)467-8730 (866)467-8730 PCF INS SRVCS OF THE WEST LLC/PHS The Hartford Hartford Fire Insurance Company and its Affiliates One Hartford Plaza,Hartford,Connecticut 06155 001 06/29/21 03/01/21 03/01/22 72 SBA CK3339 DX TOTAL COMPENSATION SYSTEMS 5655 LINDERO CANYON RD STE 223 THOUSAND OAKS CA 91362 06/29/21 003 PCF INS SRVCS OF THE WEST LLC/PHS 250765 SENTINEL INSURANCE COMPANY,LIMITED ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT,CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. THIS IS NOT A BILL. NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: IH12001185 ADDITIONAL INSURED PRO RATA FACTOR:1.000 THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. Form SS 12 11 04 05 T Page Process Date:Policy Effective Date: Policy Expiration Date: 72 SBA CK3339 ADDITIONAL INSURED VILLAGE GREEN-WESTLAKE ASSOC. C/O PACIFIC EQUITIES 5655 LINDERO CANYON ROAD #320 WESTLAKE VILLAGE,CA 91362 CITY OF GARDEN GROVE,ITS OFFICERS,OFFICIALS,EMPLOYEES,AGENTS, VOLUNTEERS.11222 ACACIA PKWY,GARDEN GROVE CA 92840 SAN MATEO COUNTYCOMMUNITY COLLEGE DISTRICT 3401 CSM DRIVE SAN MATEO,CA 94402 SAN FRANCISCO UNIFIED SCHOOL DISTRICT IT'S BOARD,OFFICERS AND EMPLOYEES AS ADDITIOINAL INSURED 135 VAN NESS AVE ROOM 102 SAN FRANCISCO,CA 94102 PERRIS UNION HIGH SCHOOL DISTRICT 155 E 4TH ST PERRIS,CA 92570 SAN BERNARDINO CITY UNIFIED SCHOOL DISTRICT 777 N F ST SAN BERNARDINO CA 92410 CITY OF COLTON 650 N LA CADENA DRIVE COLTON,CA 92324 CITY OF MANHATTAN BEACH 1400 HIGHLAND AVE MANHATTAN BEACH,CA 90266 001 001 (CONTINUED ON NEXT PAGE) 06/29/21 03/01/22 72 SBA CK3339 ADDITIONAL INSURED CITY OF UKIAH 300 SEMINARY AVE UKIAH,CA 95482 CITY OF CALABASAS 100 CIVIC CENTER WAY CALABASAS,CA 91302 SAN FRANCISCO UNIFIED SCHOOL DISTRICT 555 FRANKLIN ST SAN FRANCISCO CA 94102 BASSETT UNIFIED SCHOOL DISTRICT,ITS BOARD,OFFICERS,AGENTS, EMPLOYEES AND VOLUNTEERS 904 WILLOW AVE LA PUENTE,CA 91746 THE CITY OF MENIFEE,ITS OFFICERS,AGENTS AND EMPLOYEES 29714 HAUN RD SUN CITY,CA 92586-6540 001 002 (CONTINUED ON NEXT PAGE) 06/29/21 03/01/22 PRODUCER'S FACT SHEET NAMED INSURED:TOTAL COMPENSATION SYSTEMS POL #:72 SBA CK3339 DX PRODUCER'S NAME:PRODUCER'S CODE:250765 AGENT SALES PCF INS SRVCS OF THE WEST LLC/PHS POL EFF DATE:03/01/21 POL EXP DATE:03/01/22 TRANS EFF DATE:06/29/21 DIRECT ACCOUNT BILL NUMBER -40354415A TRANSACTION TYPE:ENDORSEMENT CHANGE NO.:003 ENDORSEMENT PREMIUM:$0.00 NON-PREMIUM BEARING FORM TITLE SS 12 11 04 05 POLICY CHANGE IH 12 00 11 85 ADDITIONAL INSURED PRODUCER'S FACT SHEET PAGE 1 06/29/21 72 SBA CK3339 DX (03/01/22) DocuSign Envelope ID: CB77EAB9-77DE-40DC-8986-0C4C525DA59B WLTR005 THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 June 29, 2021 City of Menifee 29844 HAUN RD MENIFEE CA 92586 Account Information: Policy Holder Details :TOTAL COMPENSATION SYSTEMS Contact Us Business Service Center Business Hours: Monday - Friday (7AM - 7PM Central Standard Time) Phone:(866) 467-8730 Fax:(888) 443-6112 Email:agency.services@thehartford.com Website:https://business.thehartford.com Enclosed please find a Certificate Of Insurance for the above referenced Policyholder.Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team DocuSign Envelope ID: CB77EAB9-77DE-40DC-8986-0C4C525DA59B DocuSign Envelope ID: CB77EAB9-77DE-40DC-8986-0C4C525DA59B CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) INSURER(S) AFFORDING COVERAGE NAIC # PRODUCER INSURED INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : COVERAGES TYPE OF INSURANCE POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: LOCPOLICY OTHER: EACH OCCURRENCE MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ $ $ $ $ $ AUTOMOBILE LIABILITY ANY AUTO $ $ $ $ OCCUR CLAIMS-MADE DED RETENTION $ EACH OCCURRENCE AGGREGATE E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION $ $ $ $ $ Y/N CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS: FAX (A/C, No): CERTIFICATE NUMBER:REVISION NUMBER: $ UMBRELLA LIAB EXCESS LIAB AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD $ INSURER F : $ N/A SCHEDULED AUTOS NON-OWNED AUTOS ONLY OWNED AUTOS ONLY HIRED AUTOS ONLY 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 ADDL INSD POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) PRO- JECT DAMAGE TO RENTED PREMISES (Ea occurrence) COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below PER STATUTE OTH- ER SUBR WVD 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). SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 06/25/2021 PAYCHEX INSURANCE AGENCY INC 150 SAWGRASS DR ROCHESTER, NY 14620 (877) 362-6785 (877) 362-6785 (877) 677-0447 paychex@travelers.com TOTAL COMPENSATION SYSTEMS INC 5655 LINDERO CANYON #223 WESTLAKE VILLAGE, CA 91362 TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA 015014454431671 A X UB-8L784157-21 02/01/2021 02/01/2022 X 1,000,000 1,000,000 1,000,000 AS RESPECTS TO WORKERS COMPENSATION COVERAGE, FORM WC 99 03 76 - WAIVER OF OUR RIGHTS TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA (BLANKET WAIVER) HAS BEEN ATTACHED TO THE POLICY. CITY OF MENIFEE 29714 HAUN RD MENIFEE, CA 92586 DocuSign Envelope ID: CB77EAB9-77DE-40DC-8986-0C4C525DA59B