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PROOF OF INSURANCE (2022) CLOSED
DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/02/2022 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 NA�eEE, Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA PHONE — — FAX (888) 202-3007 ( C,9.. 5 Concourse ParkwayEMAIL Suite 2150 ADDRESS: contact@hiscox.com Atlanta GA, 30328 INSURERA: Hiscox Insurance Company Inc _MAIC# _ ____ _INSURERS AFFORDING COVER c 10200 INSURED TM Consulting 20300 Channing Lane Yorba Linda CA 92887 INSURER B : INSURER C INSURER D INSURER E INSURER F t rnVFRAnPQ rFRTIFIrATF NIIMRFR• RFVISION Nt1MRFR- 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. ..... .......... ---LIMITS ..... .. ..., ...... ..... ..... ... ILTR ..,..,. ....TYPE VD I .,MPOLICY POLICY NUMBER------- OF INSURANCE iiA�tlti'Lisl INSD MIDD/YEYYY MM PDIYYYY MERCIAL AL LIABILITY X. COMCLAIMS EACH OCCURRENCE [f $ 1,000,000 1 A X � �At�'Ad �' 1't,�Ial N�4:: C�' ..... 100 000 MADE OCCUR CLAIMS -MADE ... r P _PR FSnLF.a ¢rrrurr€;nr.Pj $ .................. MED EXP_ (Any one person) s 5,000 A UDC-5035868-CGL 21 12/14/2021 12/14/2022 PERSONAL INJURY 1,000,000 GyN L AGGREGAiMITaPP.PER: GENERAA-AGGREGATE s2,000,000 �,,....,. POLICY JEC"1' LOG ---- PRODUCTS - COMP/OP AGO ... S SIT Gen A� OTHER. 5 AUTOMOBILE LIABILITY COMBINED SO4GLE LIMIT S a L_ i4l -n— ANY AUTO BODILY INJURY (Per person) S OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY � AUTOS .....m HIRED NON -OWNED PROPERTY DAMAGE � AUTOS ONLY _ AUTOS ONLY (Pere acctdonl) ........ S L...... UMBRELLALIAB OCCUR..... ..EACH OCCURRENCE ....................... _.._----, EXCESS LIA CLAIMS-MADE AGGREGATE 5.......... DPURETENTION S I WORKERS COMPENSATION PER OTH- T~ I. EsR L.....--- AND EMPLOYERS' LIABILITY Y / N .... ..T�?TF E.L EAC.N ACCIDENT ___--------------- ..........- ..........,. I S ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a V N/A (Mandatory in NH)" " EL DISEASE - EA EMPLOYEE .. .......... ._..___,_,_ S ....._.. If yes, describe under. DESCRIPTION OF OPERATIONS below E �' SE POLICY LIMIT DISEAS S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD fifft HISCOX Policy Number: Named Insured: Endorsement Number: Endorsement Effective UDC-5035868-CG L-21 TM Consulting 18 February 1, 2022 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 C"MIra AN* 0�* M�ft lar ro ONO Muwow I(s"Momwd A *WA n;* tq 4 ft,C0 #A, A%