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HomeMy WebLinkAboutASIAN AMERICAN SENIOR CITIZENS SERVICES CENTER (AASCSC) (2)INSURANCE ON FILE N-2024-107-01 WORK MAY PROCEED UNTIL INSURANCE EXPIRES IU of 10 CITY CLERK FIRST AMENDMENT TO PARTNERSHIP AGREEMENT WITH DATE: DEC 0 2,N&N AMERICAN SENIOR CITIZENS SERVICES CENTER (AASCSC) FOR DEC 0 2 2024 TITLE LEVEL PARTNERSHIP 0, PPLSR to) THIS FIRST AMENDMENT to the above -referenced agreement is entered into on October 1, 2024, Cori Uftft(kc) by and between Asian American Senior Citizens Services Center (AASCSC), a California non-profit corporation ("Partner'), 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"). A. The parties entered into Agreement No. N-2024-107 ("Agreement") dated February 1, 2024, for a 2024 Title Level Partnership for City events. B. The Agreement is in full force and effect through January 31, 2025. C. The parties now wish to amend the Agreement to reduce the scope and decrease the compensation of the Agreement. The Parties therefore agree: 1. Section 1, Partner Benefits, is hereby amended to replace Exhibit A of the original Agreement with Exhibit A-1 of this First Amendment, attached hereto and incorporated by reference. 2. Section 3, Partnership Consideration, is hereby amended to decrease the total Partnership Consideration by $6,500 as further described in Exhibit A-1. Partner shall provide to the City in -kind contributions valued at $28,500. 3. Except as modified by this First Amendment, all terms and conditions of the Agreement shall remain in full force and effect. [signature page follows] SIGNATURE PAGE FOR FIRST AMENDMENT TO PARTNERSHIP AGREEMENT WITH ASIAN AMERICAN SENIOR CITIZENS SERVICES CENTER (AASCSC) FOR TITLE LEVEL PARTNERSHIP IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first written above. ATTEST: Fol APPROVED AS TO FORM SONIA R. CARVALHO City Attorney By: Brando�a vl atierra Deputy City Attorney FOR APPROVAL �J'b' Hawk Scott Executive Director, Parks, Recreation and Services Agency CITY OF ANTA AN ,47A 4 Alvaro Nunez City Manager TU►1 t Jennifer . WangJennifer . Wang Executive Director EXHIBIT A-1 Sa%16 nta Ana AA4 4a and 2cc>aKo. Program overview: EXHIBIT A-1 CITY OF SANTA ANA Parks, Recreation, & Community Services Agency 2024 Annual Title Level Partnership: Asian American Senior Citizens Service Center Asian American Senior Citizens Service Center (AASCSC) will be providing $28,500 value of in - kind contributions to the City of Santa's Parks, Recreation, and Community Services Agency (PRCSA) as an annual Title Level Partner to participate in planning efforts for three city-wide standard events and two city-wide premium events. In exchange, PRCSA will provide Recreation Center space for approved free community enrichment programs, marketing recognition, and designated exhibitor space. The allowable activations will provide opportunities for city-wide community engagement, distribution of information, interactive activities, and giveaways for participants. An annual Title Level Partnership streamlines participation in PRCSA events and allows for additional collaborative opportunities with an in -person presence in Santa Ana events and programs on a regular basis. AASCSC physical activations will be included at the following: • Premium Event (6,000+ attendees) o Santa Ana Fourth of July Celebration • Thursday, July 4, 2024 • Centennial Park o Fiestas Patrias • September 14-15, 2024 • Flower Street Standard Events and Programs: o Tet (Lunar New Year) Festival • Saturday, February 3, 2024 • Centennial Park o International Older Adults Celebration • Friday, September 27, 2024 • Jerome Park o Mid -Autumn Festival • Saturday, October 5, 2024 • Centennial Park o Invitations for AASCSC to participate and lead enrichment programs at Recreation and Senior Centers, during mutually agreed upon times, with final content approval by designated Community Services Supervisor AASCSC responsibilities: • A value of $28,500 in -kind contributions will be made up of staffing and volunteer assistance, event food and beverage, event supplies, consultation fees, event supplies, translation services, and enrichment programs o $16,000 of in -kind contributions towards Tet (Lunar New Year) Festival and Mid - Autumn Festival • AASCSC staff cultural consultation and administrative fee: $10,000 THE CITY OF SANTA ANA 20 Civic Center Plaza • 2nd Floor • Santa Ana, CA 92701 (714) 571-4200 • Web Site. www.santa-ana.org/depaitinents/parks-recreation EXHIBIT A-1 • AASCSC staff for day -of event: $2,500 • Food and beverage for event volunteers: $2,500 • Event activity supplies: $1,000 o $2,500 of in -kind contributions towards Chinese translation services for marketing materials o $10,000 of in -kind contributions towards a minimum of five enrichment programs at Centers AASCSC's booth footprint (10'x20') and booth supplies for all five events with participant activity and giveaways AASCSC grants PRCSA the right to use Partner's trademark(s), trade name(s), logo designs and company descriptions as prepared and delivered to City by Partner in any medium of advertising, marketing materials, and/ or promotional goods distributed in conjunction with the Event and in accordance with the Partner's usage guidelines. PRCSA responsibilities: • Title Partner Level inclusions for all five events o Designated exhibitor space (10'x20') during the event(s) o Stage mention at event(s) o Day -of event(s) social media acknowledgment in form of a story on @santanaparks o Social media acknowledgment in caption of recap event(s) post on @santaanaparks o Designated advertising printed signage provided by PRCSA with AASCSC advertisement, marks, and/ or reference, as supplied by AASCSC, on signage as appropriate for the individual event that may include, but is not limited to stage banner(s), 24"x36" A-frame(s), photography backdrop, etc. o Inclusion of AASCSC advertisement, marks, and/ or reference, as supplied by AASCSC, on signage as appropriate for the individual event that may include, but is not limited to main event marketing materials with logo placements, such as fliers, posters, day -of signage, and event website subpage(s). o Partnership recognition in event(s) press release • AASCSC advertisement, marks, and/ or reference, as supplied by Partner, with link optional taglines, and partnership identification, (the "Internet Marks"), linking to designated AASCSC website, as provided by Partner, from highly visible locations sitewide on City' s official website, www.santa-ana.org/annual-partners-and-sponsors/ AASCSC will also receive partnership identification on each of the event website subpages on the City's official website. The Internet Marks will be placed and provided by City upon content approval of Partner. The Internet Marks will be active and accessible to the general public upon execution of this Agreement through the end of Agreement term. • Provide Recreation Center space, during regular and available operating hours, for AASCSC to participate in program services by proving free community enrichment programs at City operated Recreation Centers when City staff are on site. AASCSC programs and workshops provided by AASCSC must be approved by Center Supervisor and provide overall community benefit. THE CITY OF SANTA ANA 20 Civic Center Plaza • 2nd Floor • Santa Ana, CA 92701 (714) 571-4200 • Web Site: www.santa-ana.org/departtnents/parks-recreation First Amendment_AASCSC (Title Partnership)_ F I NAL_9.30.24-signed Final Audit Report 2024-11-26 Created: 2024-11-26 By: Stephanie Garcia (SGarcia5@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAAEGQgUSJCFEeJmdDggHmR6MeyXyOxSWYs "First Amendment _AASCSC (Title Partnership)_FINAL_9.30.24- signed" History Document created by Stephanie Garcia (SGarcia5@santa-ana.org) 2024-11-26 - 5:14:38 PM GMT 1,7,� Document emailed to Hawk Scott (hscott@santa-ana.org) for signature 00OZas WIM''SEZiANk r[Hi•YI Email viewed by Hawk Scott (hscott@santa-ana.org) 2024-11-26 - 5:37:39 PM GMT d© Document e-signed by Hawk Scott (hscott@santa-ana.org) Signature Date: 2024-11-26 - 5:37:48 PM GMT -Time Source: server Agreement completed. 2024-11-26 - 5:37:48 PM GMT Q Adobe Acrobat Sign Acill CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD YYY 1 09/10/2024 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 endomement(s). PRODUCER CONTACT Pauline Durbin NAME: Newfron[ Insurance Services PHONE -7542 FA t ( 650 ) 412 (650)488-8566 a No Ex : AIC No: 777 Mariners Island Blvd. E-MAIL pauline.durbin@theabdteam.com ADDRESS: Suite 250 INSURER(S) AFFORDING COVERAGE NAIC If INSURERA: Nonprofits' Insurance Alliance San Mateo CA 94404 INSURED INSURER B: State Comp. Ins. Fund 35076 Asian American Senior Citizens Service Center, Inc INSURER C : Underwriters at Lloyd's, London 0000 850 North Birch Street INsuRER D : NSURER E Santa Ana CA 92701 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2491064407 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 ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMMDIYYYY POLICYEXP MMIDDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 19 OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence S 500,000 MED EXP (An one rson) S 20,000 PERSONAL B ADV INJURY S 1,000,000 A Y Y 2024-01391 06/05/2024 06/05/2025 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY PRO, COLOG GENERAL AGGREGATE g 3,000,000 PRODUCTS - COMPIOPAGG $ 3,000,000 S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) S ANYAUTO A OWNED SGREDULEO AUTOS ONLY AUTOS 2024-01391 06/05/2024 06/05/2025 BODILY INJURY (Per accident) S X PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY /� AUTOS ONLY U MBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS LIAB CLAIMS-MAOE DED RETENTION $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILItt YIN ANY PROPRIETORIPARTNER(EXECUTIVE OFFICERaAEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA Y 9100741-23 10101/2023 10/01/2024 PER I OTH- % STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Cyber Liability ESN0240065424 09101/2024 09/01/2025 Limit Ded. $1,000,000 $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be allached If more space is required) Insr LIr:A: Sexual Conduct Liability coverage; Policy #2024-01391; Policy Eff. dates: 06105/2024-06105/2025; Limit: Each Claim: $1,000,000; Aggregate: $1.000,000 Insr Ltr:A: Social Services Professional Liability; Policy #2024-01391: Policy Eff. dates: 06/05/2024-06/0512025: Each Event: $1,000,000; Each Aggregate: $2,000,000 City of Santa Ana is included as additional insured on General liability policy per the attached tone. General liability coverage is primary and non-contributory per the attached forth. Waiver of Subrogation applies to General Liability and Worker's Compensation policies per the attached forms. 30 Days Notice of CERTIFICATE HOLDER 111IMPIM°^° ^°^'°^^ CANCELLATION SHOD LID ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702c,.Ml ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00025528 ACC)RO LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Newfront Insurance Services NAMED INSURED Asian American Senior Cltizens Service Center, Inc POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance applies to General Liability policy. © 2008ACORD The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2024-01391 COMMERCIAL GENERAL LIABILITY Named Insured: Asian American Senior Citizens Service Center, Inc. CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED 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) Location(s) Of Covered Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. 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" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 20 10 12 19 0 Insurance Services Office, Inc., 2012 Page 1 of 2 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 2 of 2 POLICY NUMBER: 2024-01391 COMMERCIAL GENERAL LIABILITY Named Insured: Asian American Senior Citizens Service Center, Inc. CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. 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. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 NONPROFITS INSURANCE ALLIANCE OFCALIFOPMA A Head for Insurance. A Heartfor Nonprofit. POLICY NUMBER: 2024-01391 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: A. Section II —WHO IS AN INSURED is amended to include: 4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury"caused, in whole or in part, by: a. Your negligent acts or omissions; or b. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. B. Section III — LIMITS OF INSURANCE is amended to include: 8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. C. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c. below; or NIAC-E61 02 19 Page 1 of 2 NONPROFITS INSURANCE ALLIANCE OF CALIFORN IA A Head for Insurance. A Heartfor Nonprofits. POLICY NUMBER: 2024-01391 (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for .your work' (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE. (a) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)' rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. NIAC-E61 02 19 Page 2 of 2 NONPROFITS POLICY NUMBER: 2024-01391 FORM: NIAC-E26 11 17 INSURANCE NAMED INSURED: Asian American Senior Citizens Service Center, Inc. ALLIANCE OF CALIFO&NIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. NIAC-E26 11 17 Page 1 of 1 ENDORSEMENT AGREEMENT BROKER COPY WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SANFRANCISCO EFFECTIVE OCTOBER 1, 2023 AT 12.01 A.M. ALLEFFECTIVE DATESARE AND EXPIRING OCTOBER 1, 2024 AT 12.01 A.M. AT 1201 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME AASCSC 850 N BIRCH ST SANTA ANA, CA 92701 WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION BLANKET WAIVER OF FOR WHOM THE NAMED INSURED SUBROGATION HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER 9100741-23 RENEWAL NA 1-81-08-39 PAGE 1 OF 1 NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY ALTER WAIVE OR EXTEND ANY OF THE TERMS CONDITIONS AGREEMENTS OR LIMITATIONS OF THIS POLICY OTHER THAWAS STATED NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY ALTER WAIVE OR LIMIT THE TERMS CONDITIONS AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT COUNTERSIGNED AND ISSUED AT SAWN FFRRANCISCO- OCTOBER 4, 2023 2572 AUTHORIZED REPRESEN PRESIDENT AND CEO SCIF FORM 10217 (REV 7 2014) OLD DP 217