Loading...
HomeMy WebLinkAboutITERIS, INC. (3) !NSURfiNiCE � w 6F WORD MAY PROCEEL) A-2022-023-01 A UNTIL IN5URj*N(1 r:tPIRt`S MAYOR CITY CLERK .. CITY MANAGER Valerie Amezcl ;F. Alvaro Nuriez MAYOR PRO TEM I.W. CITY ATTORNEY Benjamin Vazquez JU �7Jr Sonia R.Carvalho COUNCILMEMBERS CITY CLERK Phil Bacerra Jennifer L. Hall Johnathan Ryan Hernandez Jessie Lopez 1yUA� �� David Penaloza Thai Viet Phan CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza.P.O,Box 108 Santa Ana,California 92702 www.santa-ana.orq April 16,2025 Iteris,Inc. Attn: Ramin Massoumi, Sr. Vice President 1700 Carnegie Ave., Ste. 100 Santa Ana, CA 92705 Re: Extension of Amement No.A-2022-023-01 to provide on-call transportation and traffic engineering services Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by Iteris, Inc. ("Consultant") and the City of Santa Ana dated February 15, 2022,the time period of the Agreement is hereby extended for an additional one-year period through June 25,2026. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in fill force and effect. Sincerely, �I- Nabil Saba, P.E. (1 Executive Director, Public Works Agency CITY OF TA ANA ATTEST r•)0.Y lvaro Nunez ?-7--cior fer . Ha City Manager APPROVED AS TO FORM: CONSULTANT SONIA R. CARVALHO City Attorney Kel Nellesen By: Steven Bradley Assistant City Attorney Title:Senior Vice President SANTA ANA CITY COUNCIL Valerie Amezcua Benjamin Vazquez Thai Viet Phan Jessie Lopez Phil Bacerra Johnathan Ryan Hernandez David Penaloza Mayor Mayor Pm Tom,ward 2 Ward t Ward 3 Ward 4 ward 5 Ward 6 vamezcua(a)sant"naoro hvazauezAsanta-ana are IphanCrksanla-ana ora iessielooe,,o santa-ana.aro ptacema@sarta-ana.org irvanhomandezCr�sanlaana.ora dpenaloza;santa-ana am AC ® DATE(MWDDIYYYY) t�,,,� CERTIFICATE 4F LIABILITY INSURANCE 1 00/09/2025 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 pollcy(les)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 endorsemeni(s). PRODUCER CONTACT N Aon Risk Insurance Services West, Inc. NAME; (866) 283-7122 (800) 363-0105 y LOS Angeles CA Office AJC,No.Ext; FANG.No,: .A 707 wilshire Boulevard EMAIL 0 Suite 2600 ADDRESS: Z LOS Angeles CA 90017-0460 USA INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURER A: Valley Forge Insurance Co 20508 Iteris, Inc. INSURERB: The Continental insurance Company 35289 1700 Carnegie Avenue Suite 100 INSURERe: American Casualty Co. of Reading PA 20427 Santa Ana CA 92705 USA INSURER0: Lexington Insurance Company 19437 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:670111968503 REVISION NUMBER: THIS IS TO CERTIFYTHAT 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. Limits shown are as requested Lm TYPE OF INSURANCE I DoBD WVD POLICY NUMBER MMIDD71'YYY LIMITS X COMM£NCIAL GENERAL LIABILITY Nllppryy EACH OCCURRENCE $1,000,000 CLAIMS-MADE X❑OCCUR PREMISES Ea occurrence $1,000,000 MED EXP(Anyone person) $15,000 PERSONAL&ADV INJURY $1,000,000 0 GENTAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $2,000,000 X POLICY ❑PRO ❑LOC JEOT PRODUCTS-COMPlOPAGG $2,000,000 OTHER: I In h A AUTOMOBILE LIABILITY 8018834790 04/01/2025 04/01/2026 COMBINED SINGLE LIMIT 'n (Ea acoIdent) $1,000,000 X ANYAUTO BODILY INJURY(Per person) Z OWNED SCHEDULED BODILY INJURY(Per accident) (D AUTOS ONLY AUTOS HIREDAUTOS NON-OWNS❑ PROPERTY DAMAGE ONLY AUTOS ONLY Peraccident B x UMBRELLA LIAO X OCCUR 8018834742 04 01/2025 04/01/2026 EACH OCCURRENCE $25,000,000 EXCESS LIAR CLAIMS-MACE AGGHEGATE $25,000,OQO DED I X RETENTIONS10,000 A WORKERS COMPENSATION AND 8018835079 04/01/2025 04/01/2026 X I PER STATUTE I OTH - EMPLOYERS'LIABILITY YIN A05 EIR ANY PROPHIETORI PARTNER I#:XECU7IVE E.L.EACH ACCIDENT $110001000 C OFFICERIMEMBEREXCLUDED4 NIA 8018834966 04/01/2025 04/01/2026 (Mandatory In NH1 CA E.L.DISEASE-EA EMPLOYEE $1,000,000 II yes,describe ondar DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,0GO---� D Architects. & Engineers 015136071 04/01/2025 04/01/2026 Each Claim $5,000,000 Professional Aggregate $5,000,000 SIR $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) RE: On-Call ITIS Agreement. City of Santa Ana, its city Council, officers, officials, employees, and agents are included as Additional Insured in accordance with the policy provisions of the general Liability policy, A waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability policy. Tu Tran rnglraiy:rg�dep Tu Tran Rguyen ))ate;1025,06.13 Nguyen-56s5.a'. APPROVED By'Tu Tran"Nguyenaf`8'S6 am Jun 13 2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXP RATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, city of Santa Ana AUTHORIZED REPRESENTATIVE Attn: zed Kekula 20 Civic Center Plaza, M-43 Santa Ana CA 92702 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/03/2026 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: Aon Risk Insurance Services West, Inc. PHONE (866) 283-7122 FAX (800) 363-0105 Los Angeles CA Office (A/C.No.Ext): A/C.No.: -a 707 Wilshire Boulevard E-MAIL p Suite 2600 ADDRESS: _ Los Angeles CA 90017-0460 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Valley Forge Insurance Co 20508 Iteris, Inc. INSURER B: The Continental Insurance Company 35289 1700 Carnegie Avenue suite 100 INSURERC: AIG Specialty Insurance Company 26883 Santa Ana CA 92705 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570119278205 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 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD I POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X❑OCCUR PREMISES Ea occurrence) $1,000,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 0 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ❑PRO- El LOC PRODUCTS-COMP/OP AGG $2,000,000 rn OTHER: o A 8018834790 04/01/2026 04/01/2027 COMBINED SINGLE LIMIT `n AUTOMOBILE LIABILITY $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) 0 Z OWNED SCHEDULED BODILY INJURY(Per accident) 0 AUTOS ONLY AUTOS R HIRED AUTOS NON-OWNED PROPERTY DAMAGE V ONLY AUTOS ONLY Per accident B X UMBRELLALIAB X OCCUR 8018834742 04/01/2026 04/01/2027 EACH OCCURRENCE $25,000,000 U EXCESS LIAB CLAIMS-MADE AGGREGATE $2 5,000,000 DED RETENTION B WORKERS COMPENSATION AND 8018835079 04/01/2026 04/01/2027 X I PER STATUTE I OTH- EMPLOYERS'LIABILITY Y/N AOS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 B OFFICER/MEMBER EXCLUDED? N/A 8018834966 04/01/2026 04/01/2027 (Mandatory in NH) CA E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000- C E&O - Technology 060789708 12/31/2025 12/31/2026 Tech/E&O & A&E E&O $10,000,000— claims Made SIR $294,078 SIR applies per policy terns & conditions DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: On-Call IT I5 Agreement. City of Santa Ana, its City Counsel, officers, officials, employees, agents and volunteers are included as Additional insureds per the terms of the General Liability policy. A waiver of subrogation is granted in favor of the City of Santa Ana, its City Counsel, officers, officials, employees, agents and volunteers per the terms of the General Liability, Auto Liability, and Workers Compensation policy. APPROVED By Tu Tran Nguyen a[8:14 am,May 04,202 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana AUTHORIZED REPRESENTATIVE Attn: Zed Kekula 20 Civic Center Plaza, M-43 _ An � WIM Y�� � ?11 Santa Ana CA 92702 USA e�(s�/a e/S!� ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 8018834238 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 City of Santa Ana, its City Counsel, officers, officials, employees, agents and volunteers 20 Civic Center Plaza, M-43 Santa Ana CA 92702 USA 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III— Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 8018834238 COMMERCIAL GENERAL LIABILITY CG 2010 0413 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 City of Santa Ana, its City Counsel,officers,officials, employees,agents and volunteers 20 Civic Center Plaza, M-43 Santa Ana CA 92702 USA nformation 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage or personal and advertising injury "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. 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. CG 2010 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 10 0413 CANIA CNA PARAMOUNT Changes - Notice of Cancellation or Material Restriction Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART EMPLOYEE BENEFITS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART STOP GAP LIABILITY COVERAGE PART TECHNOLOGY ERRORS AND OMISSIONS LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY— NEW YORK DEPARTMENT OF TRANSPORTATION SCHEDULE Number of days notice (other than for nonpayment of premium): 30 Number of days notice for nonpayment of premium: Name of person or organization to whom notice will be sent: City of Santa Ana Address: 20 Civic Center Plaza, M-43 Santa Ana CA 92702 USA If no entry appears above, the number of days notice for nonpayment of premium will be 10 days. It is understood and agreed that in the event of cancellation or any material restrictions in coverage during the policy period, the Insurer also agrees to mail prior written notice of cancellation or material restriction to the person or organization listed in the above Schedule. Such notice will be sent prior to such cancellation in the manner prescribed in the above Schedule. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA74702XX (1-15) Policy No: 8018834238 Effective Date: 4/1/2026 Insured Name: Iteris, Inc. Copyright CNA All Rights Reserved. CNA Business Auto Policy Policy Endorsement NOTICE OF CANCELLATION O, OR ORGANIZATION It is understood and agreed that this endorsement amends the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM In the event of cancellation or material change that reduces or restricts the insurance provided by this Coverage Form, we agree to send prior notice of cancellation or material change to the person or organization scheduled below at the address scheduled below. This endorsement does not amend our obligation to notify the Named Insured of cancellation as described in the Common Policy Conditions or in another endorsement attached to this policy. SCHEDULE 1. Number of days advance notice: 10 Days if we cancel for non-payment of premium. 30 Days if the policy is cancelled for any other reason, or if coverage is restricted or reduced by endorsement. 2. Person or Organization's Name and Address Name: City of Santa Ana Attention: Street Address: 20 Civic Center Plaza, M-43 City, State, ZIP: Santa Ana CA 92702 USA e-mail address: All other terms and conditions of the policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Form No: CNA72315XX(04-2019) Policy No:8018834790 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 04/01/2026 Endorsement No: 1; Page: 1 of 1 Policy Page: 1 of 1 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 °Copyright CNA All Rights Reserved. DNA Workers Compensation And Employers Liability Insurance Policy Endorsement NOTICEOF • OR MATERIAL CHANGE ENDORSEMENT This endorsement modifies insurance provided under the WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY: In the event of cancellation or material change that reduces or restricts coverage during the policy period, we agree to send prior written notice in the manner prescribed, to the person or organization listed in the Schedule. SCHEDULE 1. Number of days advance notice: For nonpayment of premium: 10 For any other reason: 30 2. Name and Address of Person or Organization: City of Santa Ana, its City Counsel, officers, officials,employees, agents and volunteers 20 Civic Center Plaza, M-43 Santa Ana CA 92702 USA Form No: CNA87380XX (1 1-2016) Policy No:WC 8018834966 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:04/01/2026 Endorsement No: 2; Page: 1 of 1 Policy Page:1 of 1 Underwriting Company: American Casualty of Readings PA, 151 N Franklin St, Chicago, IL 60606 °Copyright CNA All Rights Reserved. CNA CNA PARAMOUNT Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of Santa Ana, its City Counsel, officers, officials, employees, agents and volunteers 20 Civic Center Plaza, M-43, Santa Ana CA 92702 USA (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work included in the products-completed operations hazard. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75008XX (10-16) Policy No: 8018834238 Effective Date: 4/1/2026 Insured Name: Iteris, Inc. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CNABusiness Auto Policy WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: ITERIS, INC. Endorsement Effective Date: 04/01/2026 SCHEDULE Name(s) Of Person(s) Or Organization(s): City of Santa Ana, its City Counsel, officers,officials, employees, agents and volunteers 20 Civic Center Plaza, M-43 Santa Ana CA 92702 USA 1 I I 1 1 1 I 1 Form No: CA 04 44 10 13 Policy No: 8018834790 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 04/01/2026 Endorsement No: 1 Page: 1 of 1 Policy Page: 1 of 1 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 °Copyright Insurance Services Office, Inc., 2011 DNA Workers Compensation And Employers Liability Insurance Policy Endorsement WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description City of Santa Ana,its City Counsel,officers,officials,employees,agents and volunteers 20 Civic Center Plaza, M-43 Santa Ana CA 92702 USA All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers,takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: WC 04 03 06 (04-1984) Policy No:WC 8018834966 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:04/01/2026 Endorsement No: 19; Page: 1 of 1 Underwriting Company: American Casualty of Readings PA 151 N Franklin St, Chicago, IL 60606 Copyright 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual c 2001.