COI - ADP TotalSource DE IV, Inc. - Expires 2024-07-01ACOROCERTIFICATE OF LIABILITY INSURANCE
DATEIYYW)
i
04I18I2023®
023
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
CONTANAME CT Marsh Affinity
Marsh Affinity
NC No, EXt: 800-743S130 AIC, No:
E4AAgDDRIESS: ADPToIalSource@marsh cam
a division of Marsh USA LLC.
PO BOX 14404
INSURER(S) AFFORDING COVERAGE
NAIC#
Des Moines, IA 503069686
INSURER A: AID Insurance Company
19399
INSURED
INSURER Ill
INSURERC:
ADP TotalSource DE IV, Inc.
INSURERD:
5800 Wral rd Parkway
Alpharetta, GA 30005
L/C/F
INSURER E:
INSURER F:
Hinderliter de Llamas & Associates
120 S STATE COLLEGE BLVD
Suite 200
Brea. CA 928210000
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
TYPEOFINSURANCE
ADOLSUBR
INSD
WVD
POLICY NUMBER
POLICYEFF
(MMIDDNYYY)
POLICY EX P
I MIDDIYYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
S
CLAIMS -MADE ❑OCCUR
DAMAGETORENTED
PREMISES Ea occurrence
S
MED EXP (Any one Person)
S
PERSONAL& ADV INJURY
S
GEN'L
AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
S
POLICY PROECT �LOC
PRODUCTS-COMP/OP AGG
S
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
S
BODILY INJURY (Porpoise.)
S
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
S
PROPERTYDAMAGE
Per accident
S
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
UMBRELLA LIAR
EACH OCCURRENCE
$
HOCCUR
AGGREGATE
EXCESSUAB
CLAIMS -MADE
Di RETENTIONS
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY YIN
-
X STATUTE ER
E.L. EACH ACCIDENT
ANYPROPRIETORRARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED' ❑
/Mandatory In NH)
NIA
VIC 034279274 CA
07/01I2023
07101/2024%�
E.L. DISEASE -EA EMPLOYEEfff
42,",0DO
yes, describe untlerDESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule. may be atlached if more Space Is required)
All worksim employees working for HINDERLITER DE LLAMAS 8 ASSOCIATES, paid under ADP TOTALSOURCE,
INC'S payroll, are covered untler the above Stated policy.
MRD
L.CKIIr'1LlA1C r1VLLICK UAPJI CLLHI IVIV
City of Gilroy
7351 Rosanna Street GILROY CITY CLERICS OFFICE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Gilroy, CA 95020 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATVE
reserved.
fhe ACORD name and logo are registered marks of ACORD