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Insurance - TriNet HR III-A, Inc. L/C/F spring ML, Inc - 2020-02-28116M» ACORU� CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. 2/28/2020 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(iss) 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 NAME: Risk Management Department Commercial Lines - (305) 443-4886 PHONE FAX (A/C, Ext): (866)443-8489 (Arc, No): (800)889-0021 USI Insurance Services LLC ADDRESS: Work.Comp@Trinet.com 2601 South Bayshore Drive, Suite 1600 EACH OCCURRENCE S Coconut Grove, FL 33133 INSURER(S) AFFORDING COVERAGE NAIC ay INSURER A: ACE American Insurance Company / 22667 INSURED TriNet HR III -A, Inc. INSURER B INSURER C UC/F springML, Inc PREMISES Ea occurrence S 9000 Town Center Parkway INSURER D: Bradenton, FL 34202 INSURER E INSURER F: -------'-- - .•r V~Fv IV 9Vv1T1LL.F%. v vcivvr 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP !NSD WVO POLICY NUMBER MM1DO/YYYYI (MMIDO/YYYY1 LIMITS COMMERCIAL GENERAL LIABILITY 7 CLAIMS -MADE 7 OCCUR EACH OCCURRENCE S AM O _ PREMISES Ea occurrence S — _ MED EXP (Any one person) $ -- PERSONAL & ADV INJURY S GEN'LAGGREGATE LIMIT APPLIES PER: i _ GENERAL AGGREGATE S PRO POLICY' FI - - - _ JECTLOC PRODUCTS - COMP/OP AGG S — —- OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)S ANY AUTO BODILY INJURY (Per person) i $ OWNED SCHEDULED BODILY INJURY (Per accident)! S AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY ( PROPERTY DAMAGE Per accident` $ S UMBREILALIAB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE:AGGREGATES DED RETENTION S Is ( A WORKERS COMPENSATION_ AND EMPLOYERS' LIABILITY WLR C66182848 7/1/2019 7/1/2020 X STATUTE ERH Y 1 N OFF CER/MIEMBEI EXCLUDED? ECUTIVE j � �' L� NIA A E.L. EACH ACCIDENT S 2,000,000 E.L. DISEASE - EA EMPLOYEES 2,000,000 (Mandatory in NH) If as, describe under E.L. DISEASE - POLICY LIMIT S 2,000,000 DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS f LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mare space is required) Workers' Compensation coverage is limited to worksite employees of springML, Inc through a co -employment agreement with TnNet HR III -A, Inc. 4 -CK I if!GAI L MULI]tK t�A►t/�Ci 1 AT1nw1 Costa Mesa Sanitary District�� j /� %O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 290 Paularino Avenue `'� ` r OPV Costa Mesa, CA 92626 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 7 ACORD 25 (2016103) 1 ne ACUKu name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved.