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2021/07/01 ADP TotalSource FL XVI, Inc. Certificate Number 3518145ACCORtr CERTIFICATE OF LIABILITY INSURANCE DATE 06/09/2D/tMh1^rYYJ 021 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 Aon Risk Services, Inc of Florida CONTACT Aon Risk Services, Inc Of Florida NAME: PH E MR (AIC, Na Ex! : 800-743-8130 AiC No): 800.522-7514 1001 Brickell Bay Drive, Suite #1100 Miami, FL 33131-4937 EMAIL ADDRESS: AORCOI.Center on.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: AIU Insurance Company 19399 INSURED ADP TotalSource FL XVI, Inc. INSURER B INSURER C : 10200 Sunset Drive Miami, FL 33173 INSURER D : L/C/F Goldfarb & Lipman LLP 1300 Clay Street, Eleventh Floor INSURER E INSURER F Oakland, CA 94612 COVERAGES CERTIFICATE NUMBER: 3518145 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. LIMIT'S SHOWN AREAS REOUES'I'ED. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS CpMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE Sf RENTED PREMISES Ea occurrence) $ MED EXP (Any one arson) $ PERSONAL & ADV INJURY $ GEML AGGREGATE LIMIT APPLIES PER: POLicy ❑ PROJECT ❑ LOC OTHER GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY (EaM NEO E I_i IT accident) $ BODILY INJURY Per oerson $ BODILY INJURY Per accident $ PROPERTY DAMAGE 'Per accident) $ $ UMBRELLA LIAR I EXCESS LAB J OCCUR ICLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DEC I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC 038364422 CA 07/01/2021 07/01/2022 X SPR EATUTE �R EL EACH ACCIDENT $ 2,000,000 El DISEASE -EA EMPLOYEE $ 2,000,000 E.L DISEASE -POLICY LIMIT 1 $ 2,000,000 J t __F I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All worksite employees working for GOLDFARB & LIPMAN LLP, paid under ADP TOTALSOURCE, INC's payroll, are covered under the above stated policy. CERTIFICATE HOLDER CANCELLATION City of Menifee Jeff Wyman SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 29714 Haun Road THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Menifee, CA 92566 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (740AAlb k I fa'tvicea.4, 411za of ('fo iat±a ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD .i 004639 90011446900 4 02 02 0 0000 0 000 1079721