ADP_TS_COI_Standard_WC_Acord_25_162543147.pdf

This document is an ACORD Certificate of Liability Insurance issued by Marsh Affinity, a division of Marsh USA LLC, for ADP TotalSource CO XXI, Inc. The insurance policy is with New Hampshire Insurance Co. (NAIC #23841) and covers Integrated Medical Evaluations Inc., located in Tempe, Arizona. The certificate is dated 11/13/2025 and provides workers' compensation insurance for worksite employees of Integrated Medical Evaluations Inc. paid under ADP TotalSource, Inc.'s payroll.

The insurance policy is effective from 07/01/2025 to 07/01/2026, with coverage limits of $2,000,000 for each occurrence, disease-each employee, and policy limit. The policy specifically includes proprietors, partners, executive officers, and members who are on the ADP TotalSource payroll or have completed the SEI Participation Addendum. The workers' compensation policy is specific to Arizona, with the policy number WC 063575226 AZ, and ensures that all worksite employees are covered under the stated policy terms.