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Home My WebLink AboutNATIONAL CENTER FOR SAFETY INITIATIVES DBA SOUTHEASTERN SECURITY CONSULTANTS, INC.IN'J G NOS( ON FILE ,V j. { MAY H-T. PROCEED N-2018-189 LLLMK ur COUNCIL AGREEMENT BETWEEN SOUTHEASTERN SECURITY d\��ENSULTAN fiINCSAMCITY OF SANTA ANA REGARDING BACKGROUND SCREENINGS Z99 This Agreement made this Aday of September, 2018 by and between National Center for Safety Initiatives doing business as Southeastern Security Consultants, Inc., a Georgia Corporation (hereinafter referred to as SSCI), and the City of Santa Ana (hereinafter referred to as COSA). WHEREAS, SSCI is engaged in a business which includes conducting background screenings for youth sports, agencies and organizations; and, WHEREAS, COSA has arranged for SSCI to provide background screenings as requested by its office, to be completed on all applicants as identified by COSA and, NOW THEREFORE, in consideration of the pricing outlined in 'Exhibit A per individual screening charged by SSCI, as set forth in this Agreement and the mutual promises and mutual undertakings of the parties herein contained, the parties hereby agree and contract as follows: 1 Pursuant to the COSA policy, background screenings will be required for COSA applicants. The COSA applicants shall provide to SSCI and/or COSA the required consent form with the necessary data needed to complete the background screening via the approved and agreed upon transmission methods. A consent form is required for the background screening process. 2. SSCI will conduct a criminal background screening as outlined in Exhibit A for every applicant submitted for COSA, and authorized by the individual. SSCI will make every reasonable effort to report its findings on background screenings through the approved, secured and agreed upon methods within 2.5 business days, on average. The compensation authorized under this Agreement shall not exceed twenty-five thousand dollars ($25,000.00) during the teen of this Agreement. 3. The term of this Agreement shall commence on the effective date and terminate on April 1, 2020 ("initial, Term"). COSA and SSCI may terminate this Agreement with or without cause (i) by written agreement of both parties, or (ii) 90 days' written notice to the other party. _ 4. SSCI shall indemnify and hold COSA harmless from all claims, damages, and expenses (including without limitation, attorney's fees) resulting or arising out of any intentionally improper or grossly negligent delivery of services performed by SSCI in providing the Services or Products hereunder. COSA agrees to indemnify and hold SSCI and each of the SSCI officers, directors, employees, and agents harmless from all claims, damages, and expenses (including without limitation, attorney's fees) that arise out of any manner related to Client's improper or negligent use of the Services or Products provided by SSCI, or any breach by Client of any of its representations or agreements in this Agreement or claims by third parties including the subject of the report. 5. During the Term, SSCI shall provide and maintain, at its expense, the following insurance: Commercial General Liability insurance with limits not less than $1,000,000 each occurrence and $2,000,000 in the aggregate. Such insurance shall include coverage for contractual liability, products liability and completed operations, personal and advertising injury, premises damage legal liability, property damage and bodily injury liability (including death) and will name COSA, its officials, employees, agents and volunteers as an additional insured on a from approved by the COSA City Attorney's Office; Worker's Compensation insurance coverage in the statutory limits, and Errors and Omissions (E&O) insurance with limits not less than $1,000,000 each occurrence and in the aggregate. SSCI Page 1 of 6 shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. Certificates of insurance shall be furnished to COSA upon execution of this Agreement and shall be approved by COSA. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days' prior written notice to COSA. If SSCI fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish to COSA the required proof that insurance has been procured and is in for and paid for, COSA will have the right, at COSA's election, to terminate this Agreement. 6. Neither party shall reveal, publish or otherwise disclose any Confidential Information to any third party without prior written consent of the other party. "Confidential Information" means any and all proprietary or secret data; sales or pricing information relating to either party, its operations, employees, products or services; and, all information relating to any customer, potential customer, Agent, and/or independent sales outlet. The Parties agree to keep this information confidential at all times during the tern of this Agreement, and continuing for five years after receipt of any Confidential Information. Notwithstanding anything contrary herein, in no event shall SSCI be required to destroy, erase or return any consumer reports or applicant data related thereto in SSCI's files, all of which SSCI shall maintain as a consumer reporting agency in strict accordance with all applicable federal, state and local laws. Neither party is responsible for any events or circumstances beyond its control that prevent it from meeting its obligations, which include but are limited to: terrorist acts, wars, riots, embargos, strikes, and/or disruptions in communications or acts of God. 8. SSCI shall, throughout the tern of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. SSCI shall notify COSA immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 9. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 10. SSCI shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. SSCI affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. it. Inasmuch as this Agreement is intended to secure the specialized services of SSCI, SSCI may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of COSA and any such assignment, transfer, delegation or subcontract without COSA's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit COSA's ability to have any of the services which are the subject to this Agreement performed by COSA personnel or by other consultants retained by COSA, 12. This Agreement represents the complete and exclusive statement between COSA and SSCI, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terns of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be Page 2 of 6 modified except by written instrument signed by COSA and by an authorized representative of SSCI. The parties agree that any terns or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate SSCI or COSA. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 13. Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To COSA: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 With courtesy copies to: and Santa Ana, CA 92702-1988 Fax 714- 647-6956 Executive Director —Human Resources City of Santa Ana 20 Civic Center Plaza (M-24) P.O. Box 1988 Santa Ana, California 92702 Fax 714- 647-5311 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Fax 714-647-6515 To SSCI: Southeastern Security Consultants Inc. 1853 Piedmont Road #100 Marietta, GA 30066 Attention: Chris Goodman Fax: A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) clays after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 14. SSCI covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 15. Page 3 of 6 N-2018-189 SSCI shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of COSA. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow COSA to exercise discretion or control over the professional manner in which SSCI performs the services which are the subject matter of this Agreement; however, the services to be provided by SSCI shall be provided in a manner consistent with all applicable standards and regulations governing such services. SSCI shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 16 Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify COSA fully, including reasonable costs and attorney's fees, for any injuries or damages COSA in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, this Agreement has been executed as of the day and year first above written. ATTEST: f. MARIA HUIZAR Cleric of the Council APPROVE AS TO FORM: Sonia R. Carvalho City Attorney By: - C1Lw %•rRa 1'w Laura A. Rossini Sgnior Assistant City Attorney FOR APPROVAL: CITY OF SANTA ANA g7i ' Raul Godinez II. City Manager CONSULTANT Clair 6aodir�ay Steven V.Wham IChris Goodman Executive Director— Human Resources Executive Director Sales and Marketing Tax1D# 81-4920537 Page 4 of 6 ExhibitA National Screening Program Details tiroi�ciioii?nio�q"n fn"ra4'i�oi7o� Background Screening Package: $18.50 per applicant o Social Security Verification •8 Verifies the applicant's name and DOB against the Social Security Number provided. e Address Trace •9 Verifies the applicant's current address and identifies previous addresses. o Local Criminal Record Search ❖ State and/or County Criminal record searches are performed to capture all available misdemeanor and felony records utilizing the Predominantly Used Index (PUI). Based on address history, MULTIPLE county searches may be performed. As an important note, all of the county record searches are conducted on site in the appropriate courthouse. The minimum number of years available is 7 years with many states extending the minimum to 10 years (this fluctuates by jurisdiction). As a standard, felony convictions are typically not purged from court systems and therefore will be reported as long as they are publically available, regardless of age. Misdemeanors are handled differently depending on the jurisdiction; however, the minimum available is 7 years. The maximum history available is always provided to you, but again, this varies by jurisdiction. Important note; sealed and expunged cases will not be reported by the court system. NOTE; If address history warrants a search in the following locations, SSCI will conduct a statewide investigation: CO, DC, GA, III, MD, MT, NM, and WI Information specific to applicant address history in New York; • In NY, the Department of Corrections search will be conducted when county level search is unavailable and in lieu of the O.C.A. due to imposed courthouse fees. o National Criminal Record Search ❖ Our national database search provides access to criminal data from all 50 states, OFAC history, including Guam and Puerto Rico. (Over 800 Million criminal records). As an important note, all possible hits will be confirmed at the county courthouse. e Sex Offender Registry Search C• Search of all SO State repositories and the District of Columbia for known sex offenders. As an important note, all possible hits will be confirmed at the county courthouse. e Verifications ❖ SSCI will validate the identifiers supplied by the applicant. This includes a comparison of the applicant's name, address, social security number (SSN), and date of birth. When discrepancies are identified during this comparison, we will request the necessary data be verified. e Results Format The City of Santa Ana online management systems will reflect a red alert for all applicants with a reportable criminal offense. SSCI will respond to all inquiries presented by the applicant regarding any disputes and/or inaccuracies with the final report. The following services are included in the flatfee pricing; •3 Multiple online background screening management systems. Page 5 of 6 Additional Services Provided: ❖ Employment Verification - $7.50 Verification of the registrant's previous or current employment: start date, end date, title, salary, reason for leaving, eligibility for rehire, verifier name, title and number from a single source - (company giving verification information can charge additional fees and those accessfees will be passed on) ❖ Education Verification - $7.50 Verification of the applicant's school, dates of attendance, graduation date, and degree or major. (Certain schools will have processing fees and those accessfees will be passed on) •S Professional License Verification - $10.00 (flat fee) Verification of type of license, state of issuance, and date of license Page 6 of 6 Ac"Rb® CERTIFICATE OF LIABILITY INSURANCE DATE 0911812018 " "' 2018 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 Marsh USA Inc. 1717 Arch Street N-2018-189 Philadelphia, PA 19103-2797 Ahm NBCU.Certrequest@marsh.com Fax 212-948-5143 CONTACT NAME: PHONE q C No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICN INSURER A: ACE American Insurance Company 22667 298523-NBCU-CAS.17-18 INSURED NBCUniversal Media, LLC INSURER B: Indemnity Ins CO Of North America 43575 INSURER c : ACE Property And Casualty Ins Co 20699 a fully owned subsidiary of Concept Corporation INSURER D : ACE Fire Underwriters Ins, Co. 20702 to include but not limited to National Center for Safety Initiatives LLC I Southeastern Security Consultants 30 Rockefeller Plaza INSURER E : Agri General Insurance Company 42757 New York, NY 10112 INSURER F COVERAGES CERTIFICATE NUMBER: CLE-006321239-04 REVISION NUMBER: 6 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 TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDM'YY LIMITS A X COMMERCIAL GENERAL LIABILITY XSLG27871252 12/01/2017 12/01/2018 EACH OCCURRENCE $ 4,900,000 CLAIMS -MADE 7X OCCUR PREMSES Ea occurrence) $ 4,900,000 X MED EXP Any one person) $ 10,000 SIR',$100,000 PERSONAL &ADV INJURY $ 4,900,000 AGGREGATE LIMIT APPLIES PER: PRO- POLICY ❑ PRO- ❑ JECT LOG GENERALAGGREGATE $ 25,000,000 GEN'L X PRODUCTS-COMP/OP AGE $ 6,000,000 $ OTHER: A AUTOMOBILE LIABILITY ISAH09063407 12/01/2017 12/01/2018 COMBINED SINGLE LIMIT Ea accident $ 10,000,000 BODILY INJURY (Per person) $ X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS id Per accent BODILY INJURY ( ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per acoitlent $ X UMBRELLALIAB X OCCUR XOO G27924840003 12/01/2017 12/01/2018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ B A D E WORKERS COMPENSATION AND EMPLOYE RS'LIABILITY ANYPROPRIETOWPARTNERIEXECUTIVE YIN OFFICER/MEMBEREXCLUDEO? (Mandatory in NH) If yea, describe under DESCRIPTION OF OPERATIONS below NIA WLRC64618933(AOS) WLRC64618945 (CA,MA) SCFC64618957(WI) WLRC64610969 (TN) / 12/01/2017 12/01/2017 12I0112017 12/01/2018 12I0112018 12/01/2018 12101I2018 g PER DTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 A Excess Workers Compensation W00064618970 12/01/2017 1210l/2018 Ea Acc/Dis Employee/Uis Polic 2,000,000 SIR 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: Exhibition Booth The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers are named as additional Insureds ('additional insureds") with regard to liability and defense o suits arising from the operations and uses performed by or on behalf of the named insured (except for Workers' Compensation) where required by written contract NBCUniversal Media, LLC subsidiaries include, but are not limited to: SportsEngine City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Tania L Knauerhaze THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O Box 1988 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manachl Mukherjee .-Prt.cti�1.,L w}Yfw.dL>\.c el @ 1988.2016 ACORD CORPORATION. All rights r erve ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ��°�� NOTICE: THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. HOWEVER, THE FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. ADDITIONAL INSURED — STATE OR POLITICAL SUBDIVISIONS — PERMITS OR AUTHORIZATIONS Named Insured Endorsement Number Comcast Corporation Policy Symbol Polloy Number Policy Period Effective Date or Endorsement XSL G27871252 12/01/2017 to 12/01/2018 9/4/2018 Issued By (Name or Insurance company) ACE American Insurance Company ......N--, ---111a- -- L..v uv ., np, v,auUllly rv4e4 uim eiiuuinmueinm I--auoe"yueui w lie Proycinuuu uilie poiwy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers. (li no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b, If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. 'Bodily injury", 'property damage" or "personal and advertising injury" arising out of operations per- formed for the federal government, state or municipality; or b. 'Bodily injury" or "property damage" included within the "products -completed operations hazard". XS-21167b (04/13) Includes copyrighted material of Insurance Services office, Inc. with its permission. Page 1 of 2 Class Code 2-14057 AC(7RG1® CERTIFICATE OF LIABILITY INSURANCE DATE(MN18 YVYV) n/2v2D1e 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 Marsh USA Inc. 1717 Arch Street CONTACT NAME: PHONE fN C No --- Philadelphia, PA 19103-2797 Attn: NBCU.Cerbequest@mamh.cem Fax 212-948-5143 E-MAIL - ADDRESS: INSURERS AFFORDING COVERAGE NAICA INSURER A : ACE American Insurance Company 22667 298523-NBCU-CAS: 18-19 INSURED NBCUniversal Media, LLC INSURER B : Indemnily Ins Co Of North America 43575 INSURER C : ACE Property And Casualty Ins Co 20699 a fully awned subsidiary of Comcast Corporation to include but not limited to National Center for Safety Initiatives LLC DBA Southeastern Security Consultants INSURER D : ACE Fire Underwriters Ins. Co. 20702 30 Rockefeller Plaza INSURER E: Neal York, NY 10112 INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-00632123MB RFVISION NIIMRFR• 6 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 TypE Of INBURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERALLUIBIUTY CLAIMS -MADE 111 OCCUR XSLG71209313 12/01/2018 12/0112019 EACH OCCURRENCE $ 4,900,000 DAMA E T RENTED PREMISES Ea occurrence) $ 4,900,000 X MED EXP (Any oneperson) $ 10,000 SIR: $100,000 PERSONAL a ADV INJURY $ 4,900,000 GENT AGGREGATE LIMIT APPLIES PER: X ❑ PRO - POLICY JECT ❑ LOC GENERALAGGREGATE $ 25,000,000 PRODUCTS - COMP/OP AGG $ 6,000,000 $ OTHER: A AUTOMOBILE LIABILITY ISAH25275354 12/0112018 12/0112019 COMBINED SINGLE LIMIT Ea accident $ 10,000,000 X BODILY INJURY (Par person) If ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Per accident $ $ X UMBRELLA UAB X OCCUR XOO G27924840004 12/01/2018 12/01/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ B A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUIVE OFncER/MEMBEREXCLUDEDT ❑N (Mandatory In NH) N/A WLRC65440398(ADS) WLRC6544043A (CA, MA) SCFC65440519 I (W) 1210112018 1210V2018 12101/2019 12/01I2019 12/01/2019 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 FL DISEASE - EA EMPLOYEE $ 2,000,000 B yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 2,000,000 A Excess Workers Compensation WCUC65440477(WA) 12/01/2018 12I01/2019 Ea Acc/Dis Employee/Dis Polic 2,000,000 SIR 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS r VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re: Exhibition Booth The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds ('additional insureds') with regard to liability and defense o suits arising from the operations and uses performed by or on behalf of the named insured (except for Workers' Compensation) where required by written contract. NBCUnivemal Media, LLC subsidiaries include, but are not limited to: SportsEngine City of Santa Ana Attn: Tania L Knauefhaze P.O. Box 1988 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. of Marsh USA Inc. Manashi Mukherjee ._Vataune " All rights reaervad_ ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AC(7RG1® CERTIFICATE OF LIABILITY INSURANCE DATE(MN18 YVYV) n/2v2D1e 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 Marsh USA Inc. 1717 Arch Street CONTACT NAME: PHONE fN C No --- Philadelphia, PA 19103-2797 Attn: NBCU.Cerbequest@mamh.cem Fax 212-948-5143 E-MAIL - ADDRESS: INSURERS AFFORDING COVERAGE NAICA INSURER A : ACE American Insurance Company 22667 298523-NBCU-CAS: 18-19 INSURED NBCUniversal Media, LLC INSURER B : Indemnily Ins Co Of North America 43575 INSURER C : ACE Property And Casualty Ins Co 20699 a fully awned subsidiary of Comcast Corporation to include but not limited to National Center for Safety Initiatives LLC DBA Southeastern Security Consultants INSURER D : ACE Fire Underwriters Ins. Co. 20702 30 Rockefeller Plaza INSURER E: Neal York, NY 10112 INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-00632123MB RFVISION NIIMRFR• 6 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 TypE Of INBURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERALLUIBIUTY CLAIMS -MADE 111 OCCUR XSLG71209313 12/01/2018 12/0112019 EACH OCCURRENCE $ 4,900,000 DAMA E T RENTED PREMISES Ea occurrence) $ 4,900,000 X MED EXP (Any oneperson) $ 10,000 SIR: $100,000 PERSONAL a ADV INJURY $ 4,900,000 GENT AGGREGATE LIMIT APPLIES PER: X ❑ PRO - POLICY JECT ❑ LOC GENERALAGGREGATE $ 25,000,000 PRODUCTS - COMP/OP AGG $ 6,000,000 $ OTHER: A AUTOMOBILE LIABILITY ISAH25275354 12/0112018 12/0112019 COMBINED SINGLE LIMIT Ea accident $ 10,000,000 X BODILY INJURY (Par person) If ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Per accident $ $ X UMBRELLA UAB X OCCUR XOO G27924840004 12/01/2018 12/01/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ B A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUIVE OFncER/MEMBEREXCLUDEDT ❑N (Mandatory In NH) N/A WLRC65440398(ADS) WLRC6544043A (CA, MA) SCFC65440519 I (W) 1210112018 1210V2018 12101/2019 12/01I2019 12/01/2019 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 FL DISEASE - EA EMPLOYEE $ 2,000,000 B yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 2,000,000 A Excess Workers Compensation WCUC65440477(WA) 12/01/2018 12I01/2019 Ea Acc/Dis Employee/Dis Polic 2,000,000 SIR 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS r VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re: Exhibition Booth The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds ('additional insureds') with regard to liability and defense o suits arising from the operations and uses performed by or on behalf of the named insured (except for Workers' Compensation) where required by written contract. NBCUnivemal Media, LLC subsidiaries include, but are not limited to: SportsEngine City of Santa Ana Attn: Tania L Knauefhaze P.O. Box 1988 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. of Marsh USA Inc. Manashi Mukherjee ._Vataune " All rights reaervad_ ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD