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Digit ally signed by Francine R.
<br />Francine R. Villareal Y11a,e.l
<br />aate2021,07.1311:26:50-07'00'
<br />GTYTECH-01 BAGASCHE
<br />'4 R" CERTIFICATE OF LIABILITY INSURANCE
<br />°AT7171202 7/7/202Y,"'
<br />1
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT:. If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Henderson Brothers Inc
<br />920 Ft. Duquesne Blvd.
<br />Pittsburgh, PA 15222
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />IArC, No, Ext). (412) 261-1842 (Arc, Nol:(412) 261-4149
<br />noo"RIEs : mailroom@hendersonbrothers.com
<br />—INSURER ($) AFFORDING COVERAGE
<br />NAIC p
<br />INSURER A : Hartford Fire Insurance Colippany Payable
<br />19682
<br />INSURED Questica Software Inc.
<br />GTY Technology Holdings, Inc.
<br />INSURER B.: Trumbull Insurance Co
<br />27120
<br />INSURER C: Hartford Casualty Insurance Company
<br />29424
<br />INSURER D : Endurance Risk Solutions
<br />43630
<br />603 Michigan Dr.
<br />Oakville, ON L6L OC4
<br />CANADA
<br />INSURER E
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: RFVICrnAI N1IMRER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />TYPE OF INSURANCE
<br />ADDLINSD
<br />ISUBDR
<br />pOLIGY NUMBER
<br />POLICDY EFF
<br />POLICY EXPTR
<br />LIMITS
<br />A
<br />X
<br />_
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />40 UUN CF0154
<br />6115121121
<br />6115/2022
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />300,000
<br />$
<br />MED EXP (Any one person
<br />$ 10,000
<br />_
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE UMITAPPLIES PER
<br />POLICY F�7l PRO- [J LOG
<br />I�-,_j JECT
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />$ 2,000,000
<br />GENT
<br />X
<br />PRODUCTS - COMPlOP qGG
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />E� , an SINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY Per person)$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />X
<br />40 LIEN CF0128
<br />6115/2021
<br />6115/2022
<br />BODILY INJURY Per accident
<br />'—
<br />s
<br />X
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />j
<br />ROPERTYOAMAGE -�
<br />Per accident
<br />$
<br />$
<br />C
<br />I X
<br />UMBRELLA LIAB
<br />EXCESSLIAS
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />X
<br />I
<br />40 XHU CD8436
<br />6115/2021
<br />6/1512022
<br />EACH OCCURRENCE
<br />AGGREGATE ��
<br />$ 5,000,000
<br />5,000,000
<br />' OED I X I RETENTION $ 10,000
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTNE ❑
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N ! A
<br />4O WB AL4MYB
<br />I
<br />611512021
<br />6/1512022
<br />X PER OTH-
<br />STATUTE R
<br />E.L. EACH ACCIDENT
<br />i 1,000,000
<br />$
<br />E.L. DISEASE -EA EMPLOYE
<br />1,000,000
<br />$
<br />EL, DISEASE - POLICY LIMIT
<br />_
<br />I $ 1,000,000
<br />A
<br />Professional/Cyber
<br />40 TE 0391564 21
<br />6/1512021
<br />6/1512022
<br />j 5,000,006
<br />D
<br />Excess PL1Cyber
<br />PRX30007896400
<br />6115/2021
<br />6/1112022
<br />5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />The City of Santa Ana, its officers, officials, employees„ and volunteers are included as Additional Insureds for General Liablity, Auto Liability and Umbrella
<br />Liability when required by written contract.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th floor
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />WekMmuglarmtDivbian
<br />- + " REVSEwm & APPROVED BY:
<br />ACORD 25 (2016I03)
<br />O 1988-2015 ACORD C
<br />The ACORD name and logo are registered marks of ACORD ~� Risk r0anagementAnalyst
<br />
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