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URM TECHNOLOGIES
City of Santa Ana `11 Clerk of the Council J AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes 0 No fv-(] Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with United Records Management, Inc. COTC Office Use Oniv RK OF THE COUNCIL FEB 2'23 Prt4:413 No. A-2020-203-02 was completed on 12/21 /2021 and final payment has been made. (List all amendments. Use space below N needed.) Department: Planning and Building Phone/Ext.: 51131 Signature: _\ H _ Date: 02/02/2023 tlagreements%formsVa" - agreement termination form_goldenrad.doc 10' INSURANCE NOT ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL DATE: A-2020-203-02 AGREEMENT BETWEEN THE CITY OF SANTA ANA AND UNITED RECORDS MANAGEMENT, INC. FVNI THIS AGREEMENT is made and entered into on this 20a' day of October, 2020 by and between United Records Management, Inc. dba URM Technologies ("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 scanning, digitizing and indexing services. B. On July 30, 2020, the Request for Proposal No. 20-043 was released in order to provide an opportunity for vendors to submit proposals for the scanning, digitizing and indexing services for Building Safety. Eight proposals were received and three vendors received the highest rankings, as each of these vendors demonstrated in their proposals that they are qualified and capable of providing the needed services. 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: 1. 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 Proposal dated August 20, 2020, attached hereto and incorporated herein as Exhibit A. 2. COMPENSATION a. City neither warrants nor guarantees any minimum or maximum compensation to Consultant under this Agreement. Consultant shall be paid only for actual services performed under this Agreement, the rates and charges identified in Exhibit A. b. The total amount to be expended during the term of this Agreement, as approved by city council amongst the three (3) selected consultants shall not exceed $500,000.00, c. 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. #63706v1 Pagel of S 3. TERM This Agreement shall commence on the date first written above for an initial four (4) year term, through October 19, 2024, unless terminated earlier in accordance with Section 15, below. There shall an option to extend for an additional two (2) year period, exercisable by the City Manager. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent Consultant and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data'). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of Page 2 of S #63706v1 insurance shall be not less than the following; single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 of the Labor Code, Contractor, if Consultant has any employees, is required . to be insured against: liability for worker's compensation or to undertake self insurance.. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as an architect or engineer; Professional liability (errors and omissions) insurance, with a combined single limit of not less thari 91,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section; i. Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. ii. Certificates of insurance shall be famished to the City upon execution of this Agreement and shall be approved by the City. iii. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. iv. Where_ the amounts or coverage provided by the certificates of insurance provides coverage greater than those listed by this Agreement, the amounts . provided by the certificates of insurance shall be incorporated by reference into the Agreement. v. Consultant shall supply City with a fully executed additional insured endorsement. f If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Contractor's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. Page 3 of 8 #63706v1 7. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Contractor, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages,, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City; regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement, City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Contractor's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United. States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Consultant to the City pursuant to this Agreement, 9. RECORDS Consultant shall keep records and. invoices in connection with the work to be performed under this Agreement, Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such 463706v1 Page 4 of 8 information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care, "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (e) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 11. 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. 12. NON-DISCRIMINATION Provider 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. Provider affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations, 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor, and supersedes any and all other agreements, oral or written, between the parties, fn the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Contractor. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, #63706v1 Page 5 of 8 Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Contractors retained by City. 15. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions; a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made fox work which fails to meet the standard of performance specified in the Recitals of this Agreement. 16. 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, 17. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 18. 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. Page 6 of 8 463706v1 19. N(YTICE 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: Minh Thai, Executive Director Planning & Building Agency City of Santa Ana 20 Civic Center Plaza (M-20) P,O. Box 1988 Santa Ana., California 92702 To Consultant: Tom Giese, Sales Manager URM Technologies 28470 Witherspoon Pkwy. Valencia, CA 91355 Phone: (800) 280-5180 Email: tgiese@URMeorp,com 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 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. 20, 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 Page 7 of 8 #k63706v1 A-2020-203-02 this Agreement, and shall 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.,, - (. , Lisa E. Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: O Minh Thai, Executive Director Planning & Building Agency #63706vi CITY OF SANTA ANA Kns neK � Ridge City Manager CONSULTANT: United Records Management, Inc. Tom Giese Sales Manager Page 8 of 8 EXHIBTI' A PROPOSAUSCOPE OF SERVICES J Sate IT LA August20, 2020 RFPNo. 20-043 S2nning, Digitiangand/ndexingSrvices Tom Giese United Records Management, Inc. evalencia(@urmcorL3.com (661) 705-0500 r / rl • 1 ♦ • r 1 / ♦ r Contents COST PROPOSAL VOLUME ESTIMATES PROJECT OVERVIEW / SCOPE OF WORK PICKUP OF FILES DOCUMENT PREP SCANNING INDEXING REQUIREMENTS OUTPUT FORMAT DISPOSITION OF HARD COPY DELIVERY OF IMAGES SCHEDULE/TURNAROUND AVAILABILITY OF FILES SECURITY 2 3 3 3 5 01 Cost Proposal Below are line -item costs, as well as an estimated total project cost based on estimates of volumes. URM is prepared and able to do the entire backfile conversion at once, or to phase it in over two or three years if that works best for the city's budget. Item prep and scan Building Permits, B&W, Grayscale, or Color prep and scan Plan Sets B&W prep and scan Plan Sets greyscale (or color) prep and scan 16mm Building Permits prep and scan 35mm Plan Sets Item Building Permits Plan Sets 16mm Building Permits prep and scan 35mm Plan Sets Item Pickup & Delivery of Hard Copy 24-hour rush electronic delivery SCANNING' Volume Unit Cost 902,400 $0.044 per image 0 $0.58 per image 86,250 $0.64 per image 181 $30.00 per roll 87 $30.00 per roll Metadata Capture Per RFQ Specs Total $39,705.60 $0.00 $55,200.00 $5,430.00 $2,610.00 Volume Unit Cost Total 169,200 $0.120 per permit $20,304.00 25,875 $0.120 per permit $3,105.00 81,450 $0.120 per permit $9,774,00 3,306 $0.120 per permit $396.72 Other Services Volume Unit Cost 10 $75.000 per trip 0 $30.000 per document Total $750.00 $0.00 NOT TO EXCEED COST - $190,060.06 URM will invoice this backfile project based upon the unit costs outlined above. Volumes up to 110% of URM's volume estimates will be covered by the Not -to -Exceed cost of $190,000.00. Day -forward volumes and volumes exceeding 110% of the volume estimates are not covered by Not -to -Exceed cost. FA Volume Estimates Hard Copy Permits — 188 file cabinet drawers, average 300 files per drawer. Estimating about 16 pages and 3 permits per file. 56,400 files 902,400 pages 169,200 permit numbers Hard Copy Building Plans — Fifty 12" x 36" shelves hold about 125 plan sets per shelf. 38 12 x 24 x 17 boxes hold about 62.5 plan sheets each. Estimating about 10 sheets and 3 permit numbers per plan set. 8,625 plan sets 86,250 sheets 25,875 permit numbers 16mm Microfilm Permits — 181 16mm reels hold about 450 permits and 900 images per reel. 181 reels 162,900 images 81,450 permits 35mm Microfilm Building Plans — 87 microfilm reels hold about 38 plan sets and 380 total images per roll. 87 reels 33,060 images 3,306 plan sets Project Overview / Scope of Work Pickup of Files URM will pick up the files for scanning on a mutually agreed -upon schedule, or on an on -call basis. URM has the capacity to pick up all the files at the start of the project if that is desired. URM will provide bar-code labels which may be placed on boxes and noted on the city's manifest to track all boxes. Boxes can also be tracked by the city's box number. Firm(s) will take all necessary precautions to ensure the integrity of the drawings during the process. All drawings shall remain in the firm(s) custody until the scanning and indexing are complete or until requested for quality control by the City. Document Prep URM personnel will prep the files for scanning. This will be done in accordance with specs from the RFP. This may entail repairing tears, handling post -it notes per instructions, etc. Scanning URM will ensure that all information that can be interpreted on the original can be interpreted on a full-size printout of the scanned image. Resolution shall be sufficient to ensure that all information legible on the original is legible on the tagged image file format. Images will be stored in the Tagged Image File Format (TIFF) with Group 4-1V compression. URM understands that the City reserves the right to change the format to JPG and/or PDF at any -time (file format should not be limited to the above -mentioned formats). All images shall be correctly oriented with the topside up and skew of less than three degrees. Permits and Documents shall be scanned in Black and White. All drawings / Blueprints shall be scanned in Greyscale. URM will be responsible for ensuring that the number of pages in each drawing set matches the number of images scanned for the set. URM will scan any missing pages from a set if they are discovered by the City after the fact for up to a year at no additional cost. City reserves the right to have the firm(s) redo any scan that does not meet City's quality standards at no cost to the City. Indexing Requirements All scanned documents that are contained in the Laserfiche Briefcase shall be indexed to a Laserfiche template. All scanned documents shall be named by permit number or Certificate of Occupancy number and type of document. Example: Permit _101102591_issued date or Plan _101102591_issued date and COO_80420618. Indexes for these scanned documents should include the fields as listed in the RFP. If the city provides a database of valid street names, street qualifiers, or street addresses, URM will use the database to eliminate human error in the indexing process. Output Format URM is a Laserfiche reseller. Images and metadata will be in Laserfiche Briefcase format if desired. Disposition of Hard Copy After scanning, the hard copy can be returned to the client, shredded, or stored at URM Technologies. Delivery of Images URM will import the files and metadata directly to the city's Laserfiche environment if access is granted. An encrypted USB I also be provided. If files are delivered to electronically there is no sales tax. Schedule/Turnaround Files can be picked up on a set schedule or on -call. In no case will URM have hard copy for more than 45 days before delivering scanned, indexed, and formatted output to the city. We could do the Permits in four weekly pickups so that all files are not out at once. Scanned images will be returned to the customer in one week from pickup. Building Plans can be done in ten weekly pickups. Availability of Files Should a file be needed urgently while in our possession, URM will scan the file and make it available the next business day via FTP or secure shared folder. Otherwise, a hard copy of the file will be returned to the City within three business days. Security URM is ITAR and HIPAA Compliant Facilities • Our facility is equipped with seismically braced racking, alarms, fire extinguishers, and a fire suppression system compatible with storage of documents, electronic media, film -based records, and computer backup media. • Facility was built under the latest and most stringent earthquake, fire, and safety codes and is maintained in accordance with the strictest standards. • Facility is monitored 24 hours a day via CCTV cameras and motion detectors. A DVR system records activity and playback is available. • All points of entry are equipped with badge access control. • URM carries a $2 million general liability policy. Employees • All URM employees are US Citizens or Green Card holders with the legal right to work in this country. • URM checks 1-9 documents prior to hiring and uses E-Verify to confirm employee eligibility. • All employees are subject to a full background investigation. • All employees are required to execute a confidentiality agreement prior to employment. Technology & Accuracy • All boxes are identified with a unique barcode number upon pickup and tracked throughout the process to endure a complete chain of custody. • Clients can view inventory via web portal. • URM has strict backup procedures to ensure the security and integrity of your information. Francine R. Villareal Digitally signed by Francine R.Villa real Date: 2021.02.1015:20:13-08'00' ACoR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 02/05/2021 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 Esther Cam os NAME: p Rene Williams Agency A CC No Ext : ONE310 317 4433 FAX No): E-MADDRESS: Rwilliams@farmersagent.com 22837 Pacific Coast Hwy Ste D INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: ATAIN SPECIALTY INSURANCE COMPANY Malibu CA 90265-5841 INSURED INSURERB: MID CENTURY EXCHANGE INSURERC : MARKEL AMERICAN INSURANCE COMPANY URM Technologies Inc. DBA United Records Management Inc. INSURER D: LLOYDS OF LONDON INSURANCE Data Microimaging Company Portashred INSURER E : 4961 Capital Road INSURER F : Shafter CA 93263 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE �X OCCUR DAMAGE TO RENTED EMISES Ea PRoccurrence $ 100,000 X MED EXP (Any one person) $ 5,000 CONTRACTUAL LIABILITY PERSONAL & ADV INJURY $ NOTINCLUDED A Y Y BWPF0002451 02/01/2021 02/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY PRO LOC El JECT X PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO B OWNED X SCHEDULED AUTOS ONLY AUTOS Y Y 094299431 02/01/2021 02/01/2022 X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 3,000,000 X AGGREGATE $ 3,000,000 C EXCESS LAB CLAIMS -MADE N N EZXS3042890 02/01/2021 02/01/2022 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ PROFESSIONAL LIABILITY PER CLAIM $1,000,000 D N N PGIARK07476 06/28/2020 06/28/2021 AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Certificate Holder is a additional insured under this policy. City of Santa Ana its officers, employees, agents, volunteers and representatives 20 Civic Center Plaza 4th Floor Santa Ana, Ca 92701 Cancellation notices are mailed 30 days prior Non pay cancellations mailed 10 days prior CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division 20 Civic Center Plaza 4th Floor Santa Ana ACORD 25 (2016103) 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 92701 A HORIZED REPRESENTATIVE ��r w ,AMwagmerttDiVisiun REVIEWED & APPROVED BY: @ 1988-2015 ACORD C The ACORD name and logo are registered marks of ACORD _ _ Risk Management Analyst ENDORSEMENT This Endorsement Changes the Policy — Please Read it Carefully PRIMARY AND NON-CONTRIBUTING INSURANCE (Sole Negligence) This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV — Commercial General Liability Conditions, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: Specifically and solely for the Third -Party shown below, notwithstanding the provisions of sub -paragraphs a, b, and c of this paragraph, it is hereby agreed that in the event of any "suit" where the damages are caused by the insured's sole negligence, this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non- contributory. The Third -Party to whom this endorsement applies is: Any party for whom the insured is performing services, at a specified project set forth in a written contract, that: (1) has been signed by all parties, including the named insured and the party seeking coverage under this endorsement; and (2) has been entered into before any loss has occurred. Any coverage provided pursuant to this endorsement shall be subject to all other terms, conditions, exclusions and endorsements of the policy to which this form is attached. The endorsement is effective on the inception date of the policy unless otherwise stated below. Policy Number:BWPF0002451 Named Insured:United Records Management, Inc. Endorsement Effective Date:2/5/2021 AF001397 (09/16) ew cF RAMwagementDMsian Jy/\'x REVIEWED & APPROVED BY.- ,v --� Risk janagement Analyst C>R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) . Acct#: 2669349 9/17/2020 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 888-828-8365 NAME Lockton Companies, LLC PHONE FAX 3657 Briarpark Dr., Suite 700 A/c No Ext : A/C No): E-MAIL Houston, TX 77042 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA : Indemnity Insurance Co. of North America 43575 INSURED Insperity, Inc. L/C/F INSURER B URM TECHNOLOGIES, INC INSURER 19001 Crescent Springs Drive Kingwood, TX 77339 INSURER D INSURER E : INSURER F : 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE1:1 OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT LOC ❑ PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY Y / N OFFICER/MEMBER EXCLUDED? ECUTIVE ❑ N / A X C68766734 10/1/2020 10/1/2021 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) WAIVER OF SUBROGATION IN FAVOR OF CITY OF SANTA ANA WHEN REQUIRED BY WRITTEN CONTRACT. 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. AUTHORIZED REPRESENTATIVE CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M-20 _ cF RiskMowgementDwtslan SANTA ANA, CA 92701 �40 �q pREVIEWED & APPROVED BY: i 1 © 1988-2014 ACORD C — ----� Risk Management Analyst ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Insperity, INC. L/C/F URM TECHNOLOGIES, INC Policy Number 19001 Crescent Springs Drive Symbol: RWC Number: C68766734 Kingwood, TX 77339 Policy Period Effective Date of Endorsement 10/1 /2020 TO 10/1 /2021 10/1 /2020 Issued By (Name of Insurance Company) Indemnity Insurance Co. of North America Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. 191M11701:10Ile\TITIAkT1 ;1:1101&O1I1:aNN:lli110]:7MIX004:aa:101vi[e119:1;1:t:14011Biel:411MILM401111I This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule (X) Specific Waiver Name of person or organization: CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M-20 SANTA ANA, CA 92701 ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium: The premium charge for this endorsement shall be INCLUDED percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: INCLUDED WC 99 03 22 ......................................................... ........ "R'uthonzecT"Represe"'nt"ative� cF IZAManagmentDivisian k4e \'x REVIEWED & APPROVED BY.- V"° --� Risk janagement Analyst Digitally signed by Ton Pierson Tori Pierson Date: 2021.07.21 10:40:01 -07'00' / ACOR" CERTIFICATE OF LIABILITY INSURANCE Ill DATE (MM/DD/YYYY) 1 07/12/2021 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 Esther Campos NAME: P Rene Williams Agency A CC No Ext : ONE310 317 4433 FAX No): E-MADDRESS: Rwilliams@farmersagent.com 22837 Pacific Coast Hwy Ste D INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: ATAIN SPECIALTY INSURANCE COMPANY 17159 Malibu CA 90265-5841 INSURED INSURERB: MID CENTURY EXCHANGE 21687 INSURERC : MARKEL AMERICAN INSURANCE COMPANY 28932 URM Technologies Inc. DBA United Records Management Inc. INSURER D: ARGONAUT INSURANCE COMPANY 19801 Data Microimaging Company Portashred INSURER E : 4961 Capital Road INSURER F : Shafter CA 93263 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ 5,000 CONTRACTUAL LIABILITY PERSONAL & ADV INJURY $ NOT INCLUDED A Y Y BWPF0002451 02/01/2021 02/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC JECT X PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO B OWNED X SCHEDULED AUTOS ONLY AUTOS Y Y 094299431 02/01/2021 02/01/2022 X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 3,000,000 X AGGREGATE $ 3,000,000 C EXCESS LAB CLAIMS -MADE N N EZXS3042890 02/01/2021 02/01/2022 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ PROFESSIONAL LIABILITY PER CLAIM $1,000,000 D N N 121MPL020104700 06/28/2021 06/28/2022 AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Certificate Holder is a additional insured under this policy. City of Santa Ana its officers, employees, agents, volunteers and representatives 20 Civic Center Plaza 4th Floor Santa Ana, Ca 92701 Cancellation notices are mailed 30 days prior Non pay cancellations mailed 10 days prior CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza 4th Floor Santa Ana Ca 92701 A HORIZ�E�D)REPRESENTATIVE Risk Mmrgmwerimsm /, J, REmEwED & A�� araavm By / (/may v , 70zi Y[f ttPbr6 @ 1988-2015 ACORD C( - "'S"'" nage ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD iIII: IIM40Ll•l:M4Lh140hgo] :► 0Eel*SIII :l=1;IQ III CWw;JIII mFi =1:7=FelarieYe1:14All III AA ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM E*§]:14 01111114 Name of Additional Insured Person(s) Or Organization(s): Location(s) of Covered Operations II persons or organizations as required by written contract with the insured. 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 for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such a person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. A person' or organizations status as an additional insured under this endorsement ends when your operations for that additional insured are completed. A. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability " Bodily injury" or "property damage" for which the "additional insured(s)" are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations or Work " Bodily injury" or "property damage" occurring after: (1) 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 (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. Negligence of Additional Insured "Bodily injury" or "property damage" directly caused by or resulting from the negligence of the "additional insured(s)". ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED This endorsement is effective on the inception date of the policy unless otherwise stated below. (The information below is required only when this endorsement is issued subsequent to preparation of the policy). Policy Number: BWPF0002451 Named Insured: United Records Management, Inc. Endorsement Effective date: AF 000 859 Included copyrighted material of ISO Properties, INC. Page 1 of 07/2012 with its permission Rick Mudgancni nhiakm ReoEwm & APPROVED BY' /QiG �[£/SP.Qf2 Risk NFanagement Cl eriral Aide ENDORSEMENT This Endorsement Changes the Policy — Please Read it Carefully PRIMARY AND NON-CONTRIBUTING INSURANCE (Sole Negligence) This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV — Commercial General Liability Conditions, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: Specifically and solely for the Third -Party shown below, notwithstanding the provisions of sub -paragraphs a, b, and c of this paragraph, it is hereby agreed that in the event of any "suit" where the damages are caused by the insured's sole negligence, this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non- contributory. The Third -Party to whom this endorsement applies is: Any party for whom the insured is performing services, at a specified project set forth in a written contract, that: (1) has been signed by all parties, including the named insured and the party seeking coverage under this endorsement; and (2) has been entered into before any loss has occurred. Any coverage provided pursuant to this endorsement shall be subject to all other terms, conditions, exclusions and endorsements of the policy to which this form is attached. The endorsement is effective on the inception date of the policy unless otherwise stated below. Policy Number:BWPF0002451 Named Insured:United Records Management, Inc. Endorsement Effective Date:2/5/2021 AF001397 (09/16) Ri& Mudgmati Dhiakm ReoEwm & APPROVED BY' /QiG �[£/SP.Qf2 Risk NFanagement Cl eriral Aide . J`'4 CERTIFICATE OF LIABILITY INSURANCE Acct#: 2669349 DATE (MM/DD/YYYY) 9/17/2020 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 Lockton Companies, LLC 3657 Briarpark Dr., Suite 700 CONTACT 888-828-8365 NAME PHONE FAX A/c No Ext : A/C No E-MAIL Houston, TX 77042 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA : Indemnity Insurance Co. of North America 43575 INSURED Insperity, Inc. L/C/F INSURER B URM TECHNOLOGIES, INC INSURER 19001 Crescent Springs Drive Kingwood, TX 77339 INSURER D INSURER E : INSURER F : 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGES( RENTED CLAIMS -MADE OCCUR ccurrence)$ PREMISES Ea Occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT LOC ❑ PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY Y / N OFFICER/MEMBER EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE ❑ N / A X C68766734 10/1/2020 10/1/2021 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) WAIVER OF SUBROGATION IN FAVOR OF CITY OF SANTA ANA WHEN REQUIRED BY WRITTEN CONTRACT. 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. AUTHORIZED REPRESENTATIVE - Risk MawgmweDivmm CITY OF SANTA ANA REmewm 6 Almzavm BY: 20 CIVIC CENTER PLAZA M-20 (A"SANTA ANA, CA 92701 ' Risk Marugemeni CI eriral Aide © 1988-2014 ACORD COKFU A I IUN. Ali rlgnts reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Insperity, INC. L/C/F URM TECHNOLOGIES, INC Policy Number 19001 Crescent Springs Drive Symbol: RWC Number: C68766734 Kingwood, TX 77339 Policy Period Effective Date of Endorsement 10/1 /2020 TO 10/1 /2021 10/1 /2020 Issued By (Name of Insurance Company) Indemnity Insurance Co. of North America Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. 191M11701:10Ile\TITIAkT1;1:1101&OTIJ:aNN:III i%11VMIX0/4:aa:101vi[e119:1;1:t'14011Biel:411MILM401111I This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule (X) Specific Waiver Name of person or organization: CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M-20 SANTA ANA, CA 92701 ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium: The premium charge for this endorsement shall be INCLUDED percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: INCLUDED WC 99 03 22 . ��i u orize epresen a ive Rick Mudgmati nhiakm ReoEwm & APPROVED BY' /QiG �[£/SP.Qf2 Risk NFanagement Cl eriral Aide