PROOF OF INSURANCE (2025) CLOSEDUYC
ACDA0/4/�d
C IILITY SU A CE 52/2024
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 endorsements .
PRODUCER CONTACT Aon Risk Services, Inc of Florida
3550 AON RISK SERVICES SOUTH INC NAME:
LENOX ROAD NORTHEAST SUITE 1700 INC, No Ext . 833-506-1544 AIC No
SUIT
ATLANTA GA 30326 Anrr0ecc. swrnrk rnnrnatrinaf morn
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: ACE American Insurance Company 22667
INSURED
INSURER B :
TriNet Group, Inc. L/C/F Califa Group
1 Park Place, Suite 600
INSURER C :
Dublin, CA 94568-7983
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER.* /5772001
•
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.
NNS'R'
LTR
TYPE OF INSURANCE
ADDL
INSR
SUBR
I WVD
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MMIDD
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
CLAIMS -MADE OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence.
$
MED EXP (Any oneperson)
$
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
POLICY PROJECT LOC
PRODUCTS - COMP/OP AGG
$
—17
$
OTHERR
AUTOMOBILE LIABILITY
COMBINEDD S L. I. I.:
Ea accident)
$$
SOMLY INJURY Per erson)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY Per accident
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DEC I I RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
X PER H-
STATUTE ER
E.L. EACH ACCIDENT
$ 2,000,000
A
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? �'
N/A
WLR_C57373404
07/01/2024
07/01/2025
E.L. DISEASE - EA EMPLOYEE
$ 2,000,000
(Mandatory in NH)
E.L. DISEASE - POLICY LIMIT
$ 2,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Workers Compensation coverage is limited to worksite employees of Califa Group through a co -employment agreement with TriNet HR lll, Inc..
CERTIFICATE HOLDER CANCELLATION
City of El Segundo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
350 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
El Segundo, CA 90245-3813 ACCORDANCE WITH THE POLICY PROVISIONS.
I
AUTHORIZED REPRESENTATIVE
oqoa 0�jsh i6e+tvices (-Touth lac
C 1988-2015 ACORD CORPORATION. All rights reservt
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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