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HomeMy WebLinkAboutKEENAN & ASSOCIATES (5)INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES N-2021-145 JUL 13 2021 CLERKI01 OF COUN 1 pit DATE: AGREEMENT WITH KEENAN & ASSOCIATES FOR AIRBO VIRTUAL EMPLOYEE o: H12(Cavf.G uswf� (�L i BENEFITS FAIR THIS AGREEMENT is made and entered into on this 6" day of July, 2021 by and between Keenan & Associates, ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a Consultant having special skill and knowledge in the field of providing software offering an online platform for a virtual employee benefits fair. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SERVICES Consultant shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in the purchase order - Exhibit A and the terms and conditions- Exhibit B, attached hereto and incorporated by reference. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the rates and charges identified in the purchase order - Exhibit A. The total amount to be expended during the term of this Agreement shall not exceed three thousand seven hundred and twenty-five dollars ($3,725). b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work, which fails to meet the standards of performance set forth in the Recitals, which may reasonably be expected by City. 3. TERM This Agreement shall commence on September 20, 2021 and terminate on November 20, 2021, unless terminated earlier in accordance with the terms of the Exhibit B. The term of this Page 1 of 6 #19793v3 Agreement can be extended by a writing by the City Manager and the City Attorney. 4. INSURANCE a. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit: shall be twice the required occurrence limit. b. Workers' Compensation insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. c, Cyber Liability Insurance, with limits not less than $2,000,000 per occurrence or claim; $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to the duties and obligations as is undertaken by Consultant in this agreement and shall include, but not be limited to, claims involving security breach, system failure, data recovery, business interruption, cyber extortion, social engineering, infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, and alteration of electronic information. The policy shall provide coverage for breach response costs, regulatory fines and penalties as well as credit monitoring expenses. d. Technology Professional Liability Errors and Omissions Insurance appropriate to the Consultant's profession and work hereunder, with limits not less than $2,000,000 per occurrence. Coverage shall be sufficiently broad to respond to the duties and obligations as is undertaken by the Consultant in this agreement and shall include, but not be limited to, claims involving security breach, system failure, data recovery, business interruption, cyber extortion, social engineering, infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, and alteration of electronic information. The policy shall provide coverage for breach response costs, regulatory fines and penalties as well as credit monitoring expenses. i. The Policy shall include, or be endorsed to include, property damage liability coverage for damage to, alteration of, loss of, or destruction of electronic data and/or information "property" of the City in the care, custody, or control of the Consultant. If not covered under the Consultant's liability policy, such "property" coverage of the Agency may be endorsed onto the Consultant's Cyber Liability Policy as covered property as follows: Page 2 of 6 #19793v3 f. If the Consultant maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. g. The insurance policies are to contain, or be endorsed to contain, the following provisions: i. Additional Insured Status- The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts, or equipment furnished in connection with such work or operations. General liability coverage can be provided in the form of an endorsement to the Consultant's insurance (at least as broad as ISO Form CG 20 10 11 85 or both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 forms if later revisions used). ii. Primary Coverage- For any claims related to this contract, the Consultant's insurance coverage shall be primary. Coverage for commercial liability shall be at least as broad as ISO CG 20 0104 13 as respects the City, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Consultant's insurance and shall not contribute with it. iii. Notice of Cancellation- Each insurance policy required above shall state that coverage shall not be canceled, except with notice to the City. iv. Waiver of Subrogation- Consultant hereby grants to City a waiver of any right to subrogation, which any insurer of said Consultant may acquire against the City by virtue of the payment of any loss under such insurance. Consultant agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. v. Self -Insured Retentions- Self -insured retentions must be declared to and approved by the City. The City may require the Consultant to provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self -insured retention may be satisfied by either the named insured or City. vi. Acceptability oflnsurers- Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A-:VII, unless otherwise acceptable to the City. vii. Claims Made Policies- If any of the required policies provide coverage on a claims -made basis: 1. The Retroactive Date must be shown and must be before the date of the contract or the beginning of contract work. 2. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work. 3. If coverage is canceled or non -renewed, and not replaced with another claims -made policy form with a Retroactive Date prior to Page 3 of 6 #19793v3 the contract effective date, the Consultant must purchase "extended reporting" coverage for a minimum of five (5) years after completion of contract work. viii. Verification of Coverage- Consultant shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to the City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Consultant's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. ix. Subcontractors- Consultant shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Consultant shall ensure that City is an additional insured on insurance required from subcontractors. x. Special Risks or Circumstances- City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. 5. CONFLICT OF INTEREST CLAUSE Consultant 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. 6. NON-DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this .Agreement. Consultant affirms that it isanequal opportunity employer and shall comply with all . applicable federal, state and local laws and regulations. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. #19793v3 Page 4 of 6 8. PROFESSIONAL LICENSES Consultant shall, throughout the term 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. Consultant shall notify the City 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. NOTICE 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 City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Executive Director, Human Resources Agency City of Santa Ana 20 Civic Center Plaza (M-24) P.O. Box 1988 Santa Ana, California 92702 To Contractor: Keenan & Associates 2355 Crenshaw Boulevard, Suite 200 Torrance, California 90501 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) days 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 Page S of 6 #19793v3 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. 10. MISCELLANEOUS PROVISIONS a. 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 shalt indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. The Agreement is the final and complete agreement and any prior or contemporaneous agreements for similar services between the parties is superseded by this Agreement. This shall not apply where the Parties are currently engaged and Consultant is providing services not contemplated by this Agreement C. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Daisy Gomez Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: Xrxuno� A Re'�ai.n� Laura A. Rossini Chief Assistant City Attorney RECOMMENDED FOR APPROVAL: Ja inMotsick xecutive Director Human Resources Agency #19793v3 CITY OF SANTA ANA Kristine Ridge �— City Manager CONSULTANT: KEENAN & ASSOCIATES 2Gp�C�- Laurie LoFranco Sr. VP Municipality Practice Leader Page 6 of 6 Ol holly signed by F,annneR Francine R. Villareal Villareal rate: 20211s.0112:1331 oTOW Aac ® Ill CERTIFICATE OF LIABILITY INSURANCE DATE(MMIOOMW) �� 05/28/2021 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 CONTACT Jeanne Vezina NAME: AssuredPartners Northeast, LLC plc No (914)761-3749 (914)e.vezinaassure Ezt: (A, Np: 123 Main Street @ P761-9000 EMAIL eannd artnem.com ADDRESS: I 14lh Floor INSURER(S) AFFORDING COVERAGE NAIC4 White Plains NY 10601 INSURERA: Charter Oak Fire Insurance Co 25615 INSURED INSURER B: The Travelers Indemnity Co. 25658 Keenan &Associates INSURERC: Travelers Property Casualty Company ofAmenca 25674 c/o The Assured Partners Group, LP INSURER D: Federal Insurance Co. 20281 200 Colonial Center Parkway INSURER E: Ace American Ins. Co. 37540 Lake Mary FL 32746 INSURER F: COVERAGES CERTIFICATE NUMBER: CL20111362381 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INS LTR TYPE OF INSURANCE INSD Me POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -NUDE � OCCUR RRENCE $ 1,000,000 Ea occurrence $ 110001000 ny one person) $ 10,000 ADV INJURY MGENE�LAGGREGATE $ 1,000,000 A Y Y 6301C226998 10/01/2020 10/01/2021 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECTOTHER: GREGATE $ 10,000,000 -COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY SINGLE LIMIT E... ident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO 6 OWNED SCHEDULED AUTOS ONLY AUTOS BA6N912905 10/01/2020 10/01/2021 BODILY INJURY (Par accdent) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY n PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 C EXCESS LIAR ICLAIMS-MADE CUP9J434350 10/01/2020 10/01/2021 DEO I I RETENTION $ S 1 C WORKERS COMPENSATION Y AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE � OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA UB-9P291231-20-14-E 10/01/2020 10/011202, PER OTH- X STATLFFE Eft E.L. EACH ACCIDENT S 1,000.000 E.L. DISEASE - EA EMPLOYEE $ 1.000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 EMPLOYEE THEFT D 8225-9951 10/01/2020 10/01/2021 $10,000,000 LIMIT $200,000 DED. DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Insurer E: Cyber Liability, Policy #D94933262, 11/6120-1116/21. $10,000,000 Limit, $250,000 Deductible. Re: City of Santa Ana Employee Benefits Consulting Services Agreement 7/112021-7/3012022. The City of Santa Ana, its officers, officials, employees, or volunteers are included as additional insured on a primary and noncontributory basis if required by written contract with respects to General Liability. Awaiver of subrogation applies with respects to General Liability. 30 Day Notice of Cancellation applies. City of Santa Ana, Risk Management Division 20 Civic Center Plaza 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. AUTHORIZED REPRESENTATIVE 10 U-1:i:11171bZ[K11]T ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD RiakMmugemmtDlWlon ell REVIEWED S {{APPROVED BY} r F'1a1M1fMZ h. VtL(//14((. �. ® Risk Management Malys[ '- Policy Number: Y6301C226998 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: However, if you specifically agree in a written con- tract or written agreement that the insurance pro- vided to an additional insured under this Coverage Pad must apply on a primary basis, or a primary and non-contributory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs; and b. The "personal injury' or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other pdmary in- surance available to you is deleted. 3. The following is added to Paragraph b. Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reset Rlale Manageme d DMsfan RE\AE vED 6 APPROVE) BV ®' Ruk Management Analyst ': COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 6301C226998 ISSUE DATE 10/01/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s): ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE AGREND BY A WRITTEN CONTRACT. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury', "property damage", "personal injury' or "advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf. A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 04 1104 08 0 Matt The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Ofllce, Inc. with Its permission. RiakMmsgammtDivision REVIEWED & APPROVED BY: Comm Risk tvlanagement Aialy t POLICY NUMBER: Y-630-1C226998-COF-18 COMMERCIAL GENERAL LIABILITY GENERALPURPOSEENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR SERVICE INDUSTRIES -ASSURED PARTNERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Broadened Named Insured —Management Con- trol B. Blanket Additional Insured —Broad Form Vendors C. Damage To Premises Rented To You • Perils of fire, explosion, lightning, smoke, water • Limit increased to $300,000 D. Blanket Waiver Of Subrogation I. Amended Bodily Injury Definition J. Bodily Injury To Co -Employees And Co -Volunteer Workers K. Aircraft Chartered With Crew L. Non -Owned Watercraft —Increased From 25 Feet To 50 Feet M. Increased Supplementary Payments Cost of bail bonds increased to $2,500 E. Blanket Additional Insured — Owners, Managers • Loss of earnings increased to $500 per day Or Lessors Of Premises N. Knowledge And Notice Of Occurrence Or Offense F. Blanket Additional Insured — Lessors Of Leased Equipment O. Unintentional Omission G. Incidental Medical Malpractice P. Reasonable Force — Bodily Injury Or Property Damage H. PersonalInjury —AssumedByContract PROVISIONS A. BROADENED NAMED INSURED —"MANAGEMENT CONTROL" 1. The following is added to SECTION II- WHO IS AN INSURED: Any organization" over which you maintain ownership interest or "management control' on the effec- tive date of the policy qualifies as a Named Insured if there is no other insurance which provides simi- lar coverage to that "organization". However, coverage for any such 'organization" will cease as of the date during the policy period that you no longer maintain ownership interest or "management con- trol' in such "organization". 2. The following replaces Paragraph 4. of SECTION II- WHO IS AN INSURED: 4. Any organization" you newly acquire or form and over which you maintain ownership interest or "management control' will qualify as a Named Insured if there is no other insurance which provides similar coverage to that "organization". However: a. Coverage afforded under this provision only applies to the operations of such "organization"; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred beforeyou acquired or formed the organization"; c. Coverage B does not apply to "personal injury" or "advertising injury" fense committed before you acquired or formed the "organization" ar Fl kMansganad DMslon REVIEWED & APPROVED By. ' F�+•o�.t P.. V�tLvuf CG T8 00 © 2017 The Travelers Indemnity Company. All right reserved. Ruk Nlanagenxnt Anatys[ Includes copyrighted material of Insurance Services Office, Inc., with its permi COMMERCIAL GENERAL LIABILITY d. Coverage for any such "organization" will cease as of the date during the policy period that you no longer maintain ownership interest or "management control" in such "organization". 3. The following is added to the DEFINITIONS Section: "Organization" means any of the following: a. Partnership orjoint venture; b. Limited liability company; c. Corporation; or d. Trade name. "Management control" means the authorization by written contract executed prior to loss, to do one or more of the following: a. Director manage the "organization"; b. Hire or fire "employees" of the "organization'; or c. Enter into contracts binding on the "organization", including contracts to purchase or sell assets on behalf of the "organization", including the right and authority to delegate any of the above activities to others. B. BLANKET ADDITIONAL INSURED —BROAD FORM VENDORS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a vendor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury" or "property damage" that: a. Is caused by an "occurrence" that takes place after you have signed and executed that contract or agreement; and b. Arises out of "your products" which are distributed or sold in the regular course of such vendor's business. The insurance provided to such vendor is subject to the following provisions: a. The limits of insurance provided to such vendor will be the limits which you agreed to provide in the writ- ten contract or agreement, or the limits shown in the Declarations of this Coverage Part, whichever are less. b. The insurance provided to such vendor does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in "your products" made intentionally by such vendor, (4) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5) Any failure to make such inspections, adjustments, tests or servicing as vendors agree to perform or normally undertake to perform in the regular course of business, in connection with the distribution or sale of "your products'; (6) Demonstration, installation, servicing or repair operations, except such operations perfonned at such vendor's premises in connection with the sale of "your products'; or (7) "Your products" which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for such vendor. Coverage under this provision does not apply to: RIA Mw%vnmt Divislon REVIEWED &APPRDV®aY.- Page 2 of 8 ® 2017 The Travelers Indemnity Company. All right reserved. _21�ww' Ruk Management Maiyst Includes copyrighted material of Insurance Services Office, Inc., with Its permissi COMMERCIAL GENERAL LIABILITY a. Any person or organization from whom you have acquired "your products", or any ingredient, part or con- tainer entering into, accompanying or containing such products; or b. Any vendor for which coverage as an additional insured specifically is scheduled by endorsement. C. DAMAGE TO PREMISES RENTED TO YOU 1. The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I —COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Exclusions c. through n. do not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water. A separate limit of insurance applies to such damage to premises as described in Paragraph S. of Section III — Limits Of Insurance. This insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a. Rupture, bursting, or operation of pressure relief devices; b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water; c. Explosion of steam boilers, steam pipes, steam engines, or steam turbines. 2. The following replaces Paragraph 6. of SECTION III — LIMITS OF INSURANCE: Subject to 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Cover- age A for damages because of "property damage" to any one premises while rented to you, or temporari- ly occupied by you with permission of the owner, caused by fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water. The Damage To Premises Rented To You Limit will apply to all damage proximately caused by the same "occurrence", whether such damage results from fire; ex- plosion; lightning; smoke resulting from such fire, explosion, or lightning; water, or any combination of any of these. The Damage To Premises Rented To You Limit will be the higher of: a. $300,000; or b. The amount shown on the Declarations of this Coverage Part for Damage To Premises Rented To You Limit. 3. The following replaces Paragraph a. of the definition of "insured contract' in the DEFINITIONS Section: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: (1) Fire; (2) Explosion; (3) Lightning; (4) Smoke resulting from such fire, explosion, or lightning; or (5) Water. is not an "insured contract` 4. The following replaces Paragraph 4.b.(1)(b) of SECTION IV —COMMERCIAL CONDITIONS: CG T8 00 © 2017 The Travelers Indemnity Company. All right reserved. Includes copyrighted material of Insurance Services Office, Inc., with its penni: Al 1 IAQII ITV o, RIAMmugM0dDMSbn EWED & APPROVM By: [REVI f �IMKM.I R. YM.IAAPRC Risk lvlanagemen[Malys[ COMMERCIAL GENERAL LIABILITY (b) That is insurance for premises rented to you, or temporarily occupied by you with the permission of the owner; D. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph S., Transfer Of Rights Of Recovery Against Others To Us, of SEC- TION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of premises owned or occupied by or rented or loaned to you; ongoing operations performed by you or on your behalf, done under a contract with that person or organization; "your work"; or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you prior to loss. E. BLANKET ADDITIONAL INSURED —OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION 11— WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to name as an additional insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury' or "property damage" caused by an "occurrence" that takes place, or "personal injury' or "advertising injury" caused by an offense that is committed, after you have signed and executed that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following provisions: a. The limits of insurance provided to such premises owner, manager or lessor will be the limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations of this Coverage Part, whichever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) "Bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" or "advertising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, manager or lessor. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collecti- ble other insurance available to such premises owner, manager or lessor, unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. F. BLANKET ADDITIONAL INSURED —LESSORS OF LEASED EQUIPMENT The following is added to SECTION II —WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to li- ability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" or "advertising injury" caused by an offense that is committed, after you have signed and executed that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use by you of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations of this Coverage Part, which- ever are less. .00 RinkMwvgement I)Msi n t REVIEWED S APPROVED BY. t Page 4 of 8 ® 2017 The Travelers Indemnity Company. All right reserved. ` Risk Managenwnt Analyst Includes copyrighted material of Insurance Services Office, Inc., with its pennissi COMMERCIAL GENERAL LIABILITY b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property dam- age" caused by an "occurrence" that takes place, or "personal injury" or "advertising injury" caused by an offense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, unless you have agreed in a written contract for this insurance to ap- ply on a primary or contributory basis. G. INCIDENTAL MEDICAL MALPRACTICE The following is added to the definition of "occurrence" in the DEFINITIONS Section: Unless you are in the business or occupation of providing professional health care services, "occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services" to a person. 2. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies orappliances; c. First aid; or d. "Good Samaritan services". "Good Samaritan services" means any emergency medical services for which no compensation is de- manded or received. 3. The following is added to Paragraph 2.a.(1) of SECTION 11-WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to any "bodily injury" arising out of any providing or failing to provide "incidental medical services" by any of your "employees", other than an employed doctor. Any such "employees" providing or failing to provide "incidental medical services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION I - COVERAGES - COW ERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury' or "property damage" arising out of the willful violation of a penal statute or ordinance relat- ing to the sale of pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5. The following is added to Paragraph 5. of SECTION III - LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in the providing or failing to provide "incidental medical services" to any one person will be considered one "occurrence". 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV - COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contin- gent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Par- agraph 2.a.(1) of SECTION 11-WHO IS AN INSURED. H. PERSONAL INJURY -ASSUMED BY CONTRACT 1. The following replaces Exclusion e., Contractual Liability, in Paragraph 2. of SECTION I - COVERAG- ES - COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY: Rls1 Management Dvisian REVIEWED & APPROVED BY: Ruknaanagement Analyst e. Contractual Liability CG T8 00 © 2017 The Travelers Indemnity Company. All right reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permi., COMMERCIAL GENERAL LIABILITY "Personal injury" or "advertising injury" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to: (1) Liability for damages that the insured would have in the absence of the contract or agreement; or (2) Liability for damages because of "personal injury" assumed in a contract or agreement that is an "insured contract", provided that the "personal injury" is caused by an offense committed subse- quent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured will be deemed to be damages because of "personal injury", provided that. (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract", and (b) Such attorney fees and litigation expenses are for defense of that party against a civil or al- ternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 2. The following replaces the third sentence of Paragraph 2. of SUPPLEMENTARY PAYMENTS — COW ERAGES A AND B: Notwithstanding the provisions of Paragraph 2.b.(2) of Section I — Coverage A — Bodily Injury And Prop- erty Damage Liability or Paragraph 2.e. of Section I — Coverage B — Personal and Advertising Injury Lia- bility, such payments will not be deemed to be damages because of "bodily injury", "property damage" or "personal injury", and will not reduce the limits of insurance. 3. The following replaces Paragraph 2.d. of SUPPLEMENTARY PAYMENTS — COVERAGES A AND B: d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no conflict appears to exist between the interests of the insured and the interests of the indem- nitee; 4. The following replaces the first subparagraph of Paragraph f. of the definition of "insured contract" in the DEFINITIONS Section: f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury," "property damage" or "personal injury" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. I. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. J. BODILY INJURY TO CO -EMPLOYEES AND CO -VOLUNTEER WORKERS The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Paragraph (1)(a) above does not apply to "bodily injury" to a co -"employee" in the course of the co - "employee's" employment by you or performing duties related to the conduct of your business, or to "bodily in- jury" to your other "volunteer workers" while performing duties related to the conduct of your business. K. AIRCRAFT CHARTERED WITH CREW The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COV- ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with crew to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or property for a charge. Page 6 of 8 @ 2017 The Travelers Indemnity Company. All right reserved. Includes copyrighted material of Insurance services Office. Inc., with its pennissic Risk Managonmt Division REVIEWEDSAPPRO BY. �. ® Risk Managemen[Analys[ COMMERCIAL GENERAL LIABILITY L. NON -OWNED WATERCRAFT 1. The following replaces Paragraph (2) of Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (2) A watercraft you do not own that is: (a) Fifty feet long or less; and (b) Not being used to carry any person or property for a charge. 2. The following is added to Paragraph 2. of SECTION II —WHO IS AN INSURED: Any person or organization that, with your express or implied consent, either uses or is responsible for the use of a watercraft that you do not own that is: (1) Fifty feet long or less; and (2) Not being used to carry any person or property for a charge. M. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVERAGES A AND B of SECTION I — COVERAGES: b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVERAGES A AND B of SECTION I — COVERAGES: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or de- fense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. N. KNOWLEDGE AND NOTICE OF OCCURRENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the insurance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II — Who Is An In- sured: (1) Notice to us of such "occurrence" or offense must be given as soon as practicable only after the "oc- currence" or offense is known to you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your trustees who is an individual (if you are a trust), any of your "executive officers" or directors (if you are an organization other than a partnership, joint venture, limited liability company or trust) or any "employee" authorized by you to give notice of an "occur- rence" or offense. (2) If you are a partnership, joint venture, limited liability company or trust, and none of your partners, joint venture members, managers or trustees are individuals, notice to us of such "occurrence" or of- fense must be given as soon as practicable only after the "occurrence" or offense is known by: (a) Any individual who is: (I) A partner or member of any partnership or joint venture; (ii) A manager of any limited liability company; (iii) A trustee of any trust; or (iv) An executive officer or director of any other organization; that is your partner, joint venture member, manager or trustee; or (b) Any "employee" authorized by such partnership, joint venture, limited liability company, trust or other organization to give notice of an "occurrence" or offense. CG T8 00 © 2017 The Travelers Indemnity Company. All right reserved. Includes copyrighted material of Insurance services Office, Inc., with its penni. {REVIEWED& RIAMougmrent!)MAon APPR�O MBY.' r�hfYiN�E Z W&WI Risk MTnagenwnr Malys[ COMMERCIAL GENERAL LIABILITY (3) Notice to us of such "occurrence" or offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your workers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons described in Paragraphs e.(1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this policy includes an endorsement that provides limited coverage for "bodily injury" or "prop- erty damage" or pollution costs arising out of a discharge, release or escape of "pollutants" which con- tains a requirement that the discharge, release or escape of "pollutants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. O. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Representations, of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. P. REASONABLE FORCE —BODILY INJURY OR PROPERTY DAMAGE The following replaces Exclusion a., Expected Or Intended Injury, in Paragraph 2. of SECTION I — COV- ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: a. Expected or Intended Injury or Damage "Bodily injury' or "property damage" expected or intended from the standpoint of the insured. This exclu- sion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect any person or property. Page 8 of 8 - ® 2017 The Travelers Indemnity Company. All right reserved. Includes copyrighted material of Insurance Services Office, Inc,, with its pennissii IN Rie4MamgmRrt DWI= 6 RWEWED 6 APPROV®BY: M Risk Management Analyst POLICY NUMBER 6301C226998 ISSUE DATE: 10-01-2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY- NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 PERSON OR ORGANIZATION: City of Santa Ana, Risk Management Division 20 Civic Center Plaza Santa Ana CA 92702 ADDRESS: PROVISIONS: If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, and a number of days is shown for cancellation in the schedule above, we will mail notice of cancellation to the person or organization shown in the schedule above. We will mall such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. IL T4 05 03 11 02011 The Travelers Indemnity Company. All rights reserved. Rhtk Moo ..dDMSI0n & APPRweIm By: CReAewm a Risk Manzgenien[Analyst Kt ACORa CERTIFICATE OF LIABILITY INSURANCE DATE(/03/2 YYYY) 1103/2020 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(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 CONTACT NAME: Heather Verdui Mike Smith, New Jersey Lic. P&C /Surplus N 9940165 Axis Insurance Services, LLC PAICHONE (201)847-9175 FAX , No : (201)847-9174 l : AIC E-MAILEx IL hverdui@axisins.com ADDRESS: 795 Franklin Avenue, Suite 210 Franklin Lakes NJ 07417 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Allied Word Insurance Co 22730 INSURED INSURER B INSURER C : Keenan &Associates INSURER D: 2355 Crenshaw Blvd, Suite 200 INSURER E: Torrance CA 90501 INSURER F: COVERAGES CERTIFICATE NUMBER- 10760 EO20121 Priominkl MI still 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. IXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MWDDINWY MWDYI YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 15,000,000 PREMISES Ea occurrence) 8 CLAMS -MADE OCCUR MED EXP(Any one person) $ Limits are Per Claim X Emors & Omissions PERSONAL &ADV INJURY s A 0307-7977 10/01/2020 10/01/2021 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY PRO- JECT LOC. GENERALAGGREGATE $ 15,000,000 PRODUCTS - COMPIOPAGG $ OTHER: Retro 3/31/2017 Retention Per Claim $ 250,000 AUTOMOBILE LIABILITY GLE LIMIT COMBINED SINEa accident) $ BODILY INJURY(Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per aedtlent $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORMARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE S (Mandatory In NH) If yes, describe untler EL.DISEASE-POLICY LIMIT 8 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may beattached if more space is required) Professional Services include Insurance Agent/Broker, Claims Administration, HR Consultant, Benefits Administrator, Enrollment Services and Third Party Administrator. The definition of an Insured in this policy includes both the company and individuals in their roles as Principals, employees, sub -agents, sub -brokers and independent Contractors of the Insured. These individuals are automatically insured for covered Professional Services when they are performed on behalf of and at the direction of the Insured. City of Santa Ana 20 Civic Center Plaza (M-24) Santa Ana ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CA 92702 ©1988.20' The ACORD name and logo are registered marks of ACORD RlakMlmaganent Division A T rR�EMEWED&APPROVED BY: Risk Management Analyst 00 Additional Named Insureds Other Named Insureds ;s,r_tl2�_taers Groan GP, LLC; The Assured�6__.._-s ter, _- '.e _rcc-ertners, Inc. Risk Mcnagentent Division fi AP1P,R�O,}V/m � �� (REVIEWED ACO V CERTIFICATE OF LIABILITY INSURANCE DATE(MMNDri �� 05/28/2021 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 NAAME:ME: Jeanne Vezina Assured Partners Northeast, LLC. PHONE 91761-9000 FA% 4 ) No: (914)761-3749 445 Hamilton Avenue E-MANO ADOREss: Leanne.vezinaQassuredpartners.com 11 Floor INSURERB) AFFORDING COVERAGE NAIC p White Plains NY 10601 INSURER": ACE American Insurance Company 10030 INSURED INSURER a : Keenan & Associates INSURER C : c/o The AssuredPartners Group, LP INSURER D : 200 Colonial Center Parkway INSURER E : Lake Mary FL 32746 1 INSURER F: COVERAGES CERTIFICATE NUMBFR• CL2152872700 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSD Me POLICY NUMBER MMIDU/YYYFY MMNDIYWY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES Ea occunance $ CLAIMS -MADE OCCUR VIED EXP (Anvers person) $ PERSONAL &ADV INJURY $ N/A GEN'L AGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ POLICY PRO ❑ PRODUCTS - COMPIOP ADS $ ECT OC OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accitlent)$ ANY AUTO BODILY INJURY(P., person) $ OWNED SCHEDULED WA BODILY INJURY IPeraccltlenD $ AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accitlent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE N/A DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L EACH ACCIDENT S ANY PROPRIETORRARTNEWEXECUTIVE [HN] OFFICETMEMBER EXCLUDEDP NIA N/A (Mandatory in NH) atory In (wend E.L. DISEASE -EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below CYBER LIABILITY A SECURITY& PRIVACY COVERAGE D94933262 11/06/2020 11/06/2021 $10,000,000 LIMIT $250.000 DED. DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) FOR EVIDENCE PURPOSES ONLY City of Santa Ana, Risk Management Division 20 Civic Center Plaza 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. AUTHORIZED REPRESENTATIVE M ©1988.2015 ACORC ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD RiekMarogamad D(W I REMEWED Is pAPPROVE) Br IFBI/ NN R. V.U.4r r1 Ruk Management AnalystOf F