Loading...
HomeMy WebLinkAboutDATA TICKET INC (2)A-2017-026-02 MAYOR Miguel A. Pulitlot MAYOR PRO ttU 2 9 2020 Juan Villages COUNCILMEMBERS Phil Bacerra Cecilia Iglesias David Penaloza Vicente Sarmlenlo Jose Solodo INSURANCE ON FILL WORK MAY PROCEED UNTIL INSURANCE EXPIRES 7/1 L/LoLJ CLERK OF COUNCIL DATE: 0 Oki) 3417rkk lowav} d, Data Ticket, Inc. CITY OF SANTA ANA SANTA ANA POUCE DEPARTMENT 20 Civic Center Plaza . P O Box 1988 Santa Ana, California 92702 www.sants-anav 4600 Campus Drive Newport Beach, California 92660 December 19, 2019 Re: Extension of Consultant Agreement No. A-2017-026 To Data Ticket, Inc.: CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R Carvalho CLERK OF THE COUNCIL Daisy Gomez Pursuant to Section 3 of Agreement No. A-2017-026 entered into by Data Ticket, Inc., and the City of Santa Ana, dated February 7, 2017, the term of the Agreement is hereby extended for an additional one (1) year period from February 7, 2020 through February 6, 2021. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement, as amended, remain unchanged and in full force and effect. �SincereI (_--bavid Valentin Chief of Police CITY OF SANTA ANA �'6 .� Kristine Ridge City Manager AS TO FORM DATA TICKET, INC. losian City Attorney Titler�fn4 SANTA ANA CITY COUNCIL M,guel A Pu1Mo Juan Weaae V. e G Samaenlo D. M Por.l. Joae SW.'. Phi aecarro C.I. Wp .al Mayor Meyer Pro Tam, Ward 5 Wm11 Word 2 Wad J Wmd 4 Word 6 mwlMbIDsanle erne ary v'illevae,}daa%a fl der Wenalv,vaa"en CA IXa ana ay avM, aeaTeanta'eno ao a2190iy1 ACC)R kfts� O CERTIFICATE OF LIABILITY INSURANCE `4019 DATE(M10:23,2019 YY) 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: H 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 endorsements . PRODUCER NAME: Lynette (Lynn) Eye Pbk Select Insurance Solutions AN: Na eaL: IROS) 975-3531 IMC. xoi: ADOREea: Iynn.c%ela.piaselecLcom I 100 Industrial Rd., e? INSURER($) AFFORDING COVERAGE NAIL e San Carlos CA 94070 INSURER A: AmCo Insurance Company 002014 INSURED INSURERS: Employcninsurancc Group 10346 Dam Ticket. Inc. INSURER C DBA: Revenue Experts INSURER D: LNSURER E: 2603 Main Street. Ste. 300 INSURER F: Irvine CA 92614 COVERAGES CERTIFICATE NUMBER: 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. LTR TYPE OF INSURANCE )NSO VIVD POLICY NUMBER IMMIDI1MYri) IMMIDOIYYYYI MWTe A X COMMERC GENERAL LIABILITY CLAIMS•41AOE OCCUR Y Y ACP BPO 3059509589 11 01 2019 It 01 20_0 EACH OCCURRENCE $ 2,000.000 PREMISES Ee ormrn,) S 300.000 MED EXP IMF ans Poison) 5 5.000 PERSONAL a AOV INJURY s Excluded G�ENL AGGREGATE LIMIT APPLIES PER: Aa POLICY �JEl6T ❑LOC OTHER OENERALAGGREGATE 4.000.000 PRODUCTS-COMPIOPAGG S 4,000,000 5 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOSONLY At1T03 HIRED NON-OWNEC AUTOS ONLY X AUTOS ONLY ACP BP030595095a9 ILD12019 II OL2020 IEa nizMPnr S 1,000.000 BODILY INJURY (Par Perron) 5 BODILY INJURY (Per ecci0an11 S Per actlden9 S 5 A '( UMBRELLA LIAR EXCESS ME I OCCUR ICLAIIS-MM)E ACP CAA 30i9509589 11,01,1019 11 01 2020 EACH OCCURRENCE S 3.000.000 AGGREGATE 5 2.000,000 DED I I RETENTIONS S B RIVE S YERS' S UT i,NNp EMPLOYERS' LIA&IJTY Y PROPRIETORPARTNEREXECUTIVE YIN FFICERAtEMSER EXCLUDEO> 5❑' Mandatory In NH) i yyeesa desomm under ESCRIPTION OF OPERATIONS bebw NIA 1' EIG_BG9443 O7I2Q019 0T 1220_0 X STATUTE ER EL EACH ACCIDENT 5 1.000,9W E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT S 1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddMenM Bamerks SCheduM, may ba amaahetl N mom sines Is Inquired) City of Santa Ana, officers, agents, employees. and volunteers are named as additional insured on the General Liability Policy pursuant to written contract, agreement or memorandum of understanding_ The General Liability policy includes a Waiicl of Subrogation. Primary & Non -Contributory wording and 30 day notice ofcancellation as required by written contract (see attached). Workers Compensation includes a blanket Waiver of Subrogation (see attached), CERTIFICATE HOLDER CANCELLATION REVIEWED By Risk City of Santa Ana &APPROVE NAGEMENT DIVISION THE EXPIRATION DATE THEREOF, NOTICE WILL BESHOULD ANY OF THE ABOVE DESCRIBED DELIVEREDIN BE BEFORE ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Ci.ic Center Plaara, 4th Floor 27 2019 AUTOO REDREPRESENTATIVE Si... Ana CA 92702 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD BUSINESSOWNERS PB 29 97 07 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - ADVANCED NOTICE - CANCELLATION OR MATERIAL COVERAGE REDUCTION This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS COMMON POLICY CONDITIONS In the event of cancellation (other than non-payment of premium) or material change that reduces or restricts the insurance afforded by this Policy, we agree to mail prior written notice of cancellation or material change to: SCHEDULE Name and Address: CITY OF CORONA C/O EXIGIS INSURANCE COMPLIANCE SERVICES PO BOX 4668-ECW43-605 NEW YORK, NY 10163-4668 CITY OF SANTA ANA, RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA, 4TH FLOOR SANTA ANA, CA 92702 Number of Days Advance Notice: 030 All terms and conditions of this policy apply unless modified by this endorsement. Includes copyrighted material of Insurance Services Office, Inc., with Its permission. d ISO Properties, Inc., 2004 PB 29 97 07 07 11 ACP BPO 3069609689 AACEUTY Page 1 of 1 47 17710 TA 0 TICKET `m. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92701 August 1, 2019 Data Ticket, Inc. has no owned autos. Thank you, Brook Westcott Chief Operating Officer A CALIFORNIA CORPORATION FOUNDED IN 1989 & APPROVED .'vMFNT DiviSION 7 2019 M. LAM13ERT 2603 Main Street Suite 300 Irvine, CA 92614 949.752.6937 fax: 949.281.3195 www.DataTicketcom CERTIFICATE OF LIABILITY INSURANCE DATE IMM/OOIYYYYI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS V 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 endnre.menrml PROouCER Ashbrook•Clevidence, Inc. 3000 W MacArthur Blvd, Suite 320 Santa Ana, CA 92704 License #: 0188788 NAIC a INSURED NSURERB: S o %dale lnsunBnce CorngAft 41297 Data Ticket, Inc. _ DBA Revenue Experts INSURER C: _ 2603 Main Street Suite 300 INSURER D: Irvine, CA 92614 INSURERE. INSURERF: COVERAGES CERTIFICATE NUMBER- DnmsledLeru Rggg vcymm�u uuuvee. 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. TYPE DFIN$DRANDE �� POLICY NUMBER IRSoTRR POLICY EFF PDUCY"P -- - MMIOOrvYYY NNIDDrrYYY LIMITS ' COMMERCULLGENERALUABILJTY !EACH OCCURRENCE S CLAIMSMADE OCCUR _ _ DAMA 'f6R�NTE5 — '- =PREMISES Ea oca?re,es�_r4 _ one penani 5 PERSONAL S ADV INJURY S GENLAGGREGATE UMIT APPLIES PER GENERAL AGGREGATE S POLICY ''� - -�I JECT LOC PRODUCTS COMPIOP AGG S _ - !OTHER S AUTOMOBILEUABIUTY 0MBINED SINGLE LIMIT �(Ea acodenll 5 ANY AUTO BODILY INJURY leer peraw) DAMIS SCHEDULED AUTOS ONLY AUTOS ~y BOOILY INJURYIPeramdenll S HIRED NON-OMED AUTOS ONLY AUTOS ONLY H PROPERtt DAMAGE IParal'dtleMl S S �EACESS UMBRELLA LAB _ OCCUR UAB EACH OCCURRENCE _ s CLAIM'MADE! AGGREGATE I5 S DIED RETENTIONS WORKERS COMPENSATION PER OTR- AND EMPLOYERSUABNTY - YIN' TATUTE ER EL EACH ACCIDENT S ANY PROPRIETORJPARTNER/ CUTNE OFFICERIMEMBER E%CLUOED ❑INIA IMMldatorylnNH) _ - s EL DISEASE -E4 EMPLOY E desrnbe 99II yyees, ureter 6RIPTIONOFOPERATIONS belme -- - - EL DISEASE - POLICY LIMIT S A Errors & Omm 287188360 11/01/2019 11101/2020 Ded. $10K $2,000,000 B ICyberLiability I EKS3310469 1110V2019 11/01/2020 Deduct$26K $1MM12MM DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule. may be aldched it more space is meuiradl Certificate evidences Professional Liability (Errors & Omissions)& Includes Personal Injury, Cyber Liability and Crime (provided by Travelers Casualty & Surety Company of America NAIC #31194) City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th I Santa Ana, CA 92702 0 SHOULD ANY DF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 n1 •�" • """ ©1983-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACO�RdL rP rero repis+e.e. —arks of ACORD SAMANTHA M. LAMBERT Pnnted by MXC on November 04. 2019 at 09 34AM