HomeMy WebLinkAboutBENEVATE, INC.0` NANCE NOT A-2020-085-05-01
. ON FILE
CLERK MAY MOTPROCEED
91W4 AMENDMENT TO BENEVATE INC SAAS SERVICES AGREEMENT
DATE:12/ZVZMETWEEN BENEVATE INC AND CITY OF SANTA ANA, CALIFORNIA
U'.(DA(1)MiK. LtSc i
THIS FIRST AMENDMENT TO SAAS SERVICES AGREEMENT (this "First Amendment") ismade
�.. Q. effective as of November 17, 2020, between Benevate, Inc ("Company") and CITY OF SANTA ANA,
CALIFORNIA ("Customer").
RECITALS
A. The Company and Customer entered into a SAAS SERVICES AGREEMENT dated May 12,
2020 (the "Agreement"), for the Company to provide hosted software for the administration
and management of the Customer's housing and cornmunity development programs.
B. The Customer has determined that it is necessary to amend the Agreement with the Company to
(i) add additional services to the Scope of Work of the Agreement (the "Additional Services")
and (ii) increase the compensation of the Company for the Additional Services.
C. The Company and the Customer desires to enter into this First Amendment to (i) include the
Additional Services and (ii) increase the compensation of the Company for the Additional
Services.
AGREEMENT
NOW, THEREFORE, in consideration of the foregoing recitals, which are incorporated herein
by reference, the following mutual covenants and conditions and other good and valuable consideration,
the receipt and sufficiency of which are hereby acknowledged, the Company and the Customer hereby
agree to amend the Agreement as follows:
Per User/Program Pricing. The Company shall provide the Additional Administrative
Licenses as set forth in Exhibit D, attached hereto and incorporated herein by
reference.
2. Compensation. The Customer shall pay Company One -Time Implementation fee(s) as
set forth in Exhibit D, attached hereto and incorporated herein by reference.
3. Effect of Amendment. In all other respects, the Agreement is affirmed and ratified and,
except as expressly modified herein, all tenns and conditions of the Agreement shall
remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this instrument as of the date and
year set forth above.
Company CITY OF SANTA ANA, CALIFORNIA:
a�
as Rusnak, President
Kristine Ridge, City Manager
RECOMMENDED FOR APPROVAL: Approved as to form: ATTEST:
Steven Mendoza Rya Ho ge Daisy Gomez
Executive Director Assistant City Attorney Clerk of the Council
Community Development
Per User/Program Pricing
Additional programs and licenses may be purchased, pro-rata to the Initial Service Term, based on the pricing
table below.
ANNUAL TOTAL: $15,000.00
6 month (November, 2020 - May, 2021) PRO -RATED TOTAL: $7,500.00
CERTIFICATE OF LIABILITY INSURANCE DATE
CERTIFICATE
_ 06r21/2020
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 p011cy(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 Ilou of such andorsamonttsl_
PRODUCER
CustomerSuccess
CANT Justworks Customer Success
Doug Jones Justworks
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(888) 534 1711
do Adex Risk Solutions, Inc.
jjEEAf_c�Ho F,SU
8840 E. Chaparral Rd.; Suite 275
ADDRESS support@fustworks cam
Scottsdale, AZ 85250
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INSURED
Justworks Employment Grout) LLC Labor Contractor, for co�omp!oysas of, Benevato,
Inc.
55 Water Street 29th Floor
Newyork, NY 10041
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THIS
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NOTWITHSTANDING ANY REQUIREMENT,
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DESCRIPTION Of OPERATIONS I LOCATIONS r VEHICLES ACORD 101, AdditionalRamarkx Schedule, maybe anachod If more space Is rxyulretll
only Nose rn providedfor 3423 Piedmont Road NE Suite 216
Covonly Unno is-emmI.J ms Benevate,3423 Pied Inc. REVIEWED CX APPROVED
of, but not subcontractors Atlanta, GA 30305
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Benevate, Inc.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
3423 Piedmont Road NE
Suite 216
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Atlanta, GA 30305
AUTHORIZEEDDREP�RE�SEENTATIVE
v 1000-AVID AL LJKLJ L.Ut(HUP(A I PUN. Ail rights reserved.
ACORD 25 (2016/03) The ACORD nano and logo are registered marks of ACORD
CERTIFICATE UT LIABILITY INSURANCE
DATF,(MMNOMYYY)
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TIRS CEltl'IFICATE IS ISSUEU,i$ A ANiTER OF INFORMATION ONLY AND GUNFERS NO RIOOTS UPON TILE CERTIFICATE HOLDER. TI11N CERTIFICATE DOES NOT APFIRAIATIVELY Olt NEGATIVELY AMEND, ESTERS UN
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PRODUCER
CONTACT NAME:
FounderShleld, LLC
119 W NOR SIONL Dd Floor
PHONE (MC No, ERA): 646-BS4-I0S8 rAX (AC No):
E-NIAIL ADDR Mi xoI a(jluenderso leld.rion
New York, Sex York, 10011
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Ir^ SHOULD ANY OP5'HEAROVE. DESCRIBES POLICIES DR CANCELLED IMPOSE THE EXPIRAT10N DATE150 '.
Clry a(Sul4 Alk THCREOF, NOTICE WILL BE DELVCRED INACCORDANCE WITH TIIE POLICY PROVISIONS,
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491988-2016 ACORD CORPORA110N, All rlghls reserved.
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Help Us To Serve You Better
Every effort has been made to produce a quality product for you. Please review this transaction, and If It is
Incorrect list the correction needed in the space provided below and fax this Quality Assurance Form to us at
877.363-8669 or email, to cietocna.com
Questions pertaining to any transaction should be referred to
Center at 877-574-0540, Option 3
CNA Customer Interaction
Please send routine requests via standard ACORD forms through the same method you are using today. The
preferred method is by fax to 877.363.8669
Insured/Account Name: Benevate, Inc
Policy Number: B 6024686380
Line of Business: CNP
Agent Name: FOUNDER SHIELD
Producer code: 081956
Branch: NEW YORK CITY
Transaction Type: Endorsement
Transaction Effective Date: 05/13/2020
Your Transaction was processed by Commercial
Insurance Center - Lake Mary, FL
C ID: BY C772551
Transaction Incorrect —See Below.
Transaction Processed Correctly
Correction needed:
REVIEWED & APPROYM
... ---.
BY Risk MANAtEMENT .II
`�""""
l�NGIE ACEVCCIO
Rmcia�iYiaaY.c:. :�? ' r:45M1a.a,MAILSW
POLICY NUMBER INSURED NAME AND ADDRESS
S 6024686380 Benevate, Inc
3423 PIEDMONT RD NE
ATLANTA, GA 30305 ,g
ADDITIONAL INTEREST SCHEDULE
LOCATION 1 BUILDING
The following has been added to your policy effective 03/13/2020
Type; Notice of. Cancellation
Additional Interest Name and
CITY OF SANTA ANA
RISK MANAGEMENT DIVISION
20 CIVIC CENTER PLAZA
SANTA ANA
or Material Coverage Change
Address:
CA 92702
Types State, Political -Permits
Additional interest Name and Address:
CITY OF SANTA ANA
RISK MANAGEMENT DIVISION
20 CIVIC CENTER PLAZA
SANTA ANA , CA 92702
REVIEWED & APPROVED
try Risk MANAgeMENT DiVisjON
ju�*02Q
AN(ile Acevedo
AGENT Page 3 of
BOLXCY NUMBER INSURED NAME AND ADDRESS
B 6024686380 Benevate, Inc
3423 PIEDMONT RD NE
Yy ATLANTA, GA 30305
Y Mv,
FORMS AND ENDORSEMENTS SCHEDULE
The following list shows the Forms, Schedules and Endorsements by Line of Business that are
a part of this policy.
COMMON
The following forms have been added to your policy, effective 05/13/2020
FORM NUMBER FORM TITLE
SB147052C 06/2016 Notice of Cancellation or Material Coverage Change
G56015B 11/1991 ENDORSEMENT EFFECTIVE 05/13/2020
G56015B 11/1991 ENDORSEMENT EFFECTIVE 05/13/2020
Che�
REVILWED & APPROVED
By Wisk RNACIFMFW DlVIS(ON
mym��
Ar4gk Acurdo
countersignature
�Secreut
SB-146895-A (Ed. 01/06) AGENT Page 4 0£ 4
POLICY NUMEER INSURED NAME AND ADDRESS
E 6024686380 Eenevate, Inc
3423 PIEDMONT RD NE
x ATLAN.CA, GA 30305
POLICY CHANGES
END. RShMEIT Bf PECTIVE 05/13/2020
This Change Endorsement changes the Policy. Please read it carefully.
This Change Endorsement is a part of your Policy and takes effect on the
effective date of your Policy, unless another effective date is shown.
CHANGES - NOTICE TO CERTIFICATEHOLDERS OF CANCELLATION
OR MATERIAL COVERAGE CHANGE
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COMMON POLICY CONDITIONS
In the event of cancellation or material change that reduces or
restrict„ the insurance afforded by this Coverage Part (other
than the reduction of aggregate limits through payment of
claims), we agree to mail written notice of cancellation or
material change at a minimum of thirty (30) days prior to such
cancellation or material change, to:
SCHEDULE
Name of Designated Entity: CITY OF SANTA ANA
Address/Contact Information of Designated Entity:
RISK MANAGEMENT DIVISION
20 CIVIC CENTER PLAZA
SANTA ANA, CA 92702
*Information required to complete this Schedule, if net shown
above, will be shown in the Declarations.
The following conditions are added:
1. If the policy is cancelled or not renewed, we will give
written notice of such cancellation or nonrenewal to the
Designated Entity shown in the Schedule above, or in the
Declarations, at a minimum of thirty (30) days prior to
such cancellation or nonrenewal. Suchnotice may be
delivered or sent by any means of our choosing. The notice
to the Designated Entity will state the effective date of
Ghelrman bf fho aoat
G-56015-5 (ED. 11/91)
RBy Risk MANACIC [ti Div si N
JUN 6 202D
ANGiE AMC&
tlSememr
4 y,
POLICY NUMBER INSURED NAME AND ADDRESS
B 6024686380 Benevate, Inc
3423 PIEDMONT RD NE
ATLANTA, GA 30305
POLICY CHANGES
E ORS�FECTIVE 05/13/2020
This Change Endorsement changes the Policy. Please read it carefully.
This Change Endorsement is a part of your Policy and takes effect on the
effective date of your Policy, unless another effective date is shown.
cancellation or nonrenewal. However, such notice of
cancellation or nonrenewal is solely for the purpose of
informing the Designated Entity of the effective date of
cancellation or nonrenewal and does not grant, alter, or
extend any rights or obligations under this policy.
2. If we cancel or elect not to renew the policy for any
reason other than nonpayment of premium, we will give
written notice to the Designated Entity shown in the
Schedule above, or in the Declarations, at a minimum of
thirty (30) days prior to such cancellation or nonrenewal,
at the same time notice is given to the first Named
Insured.
3. if we cancel or elect not to renew this policy for
nonpayment of premium, we will give written notice to the
Designated Entity shown in the Schedule above, or in the
Declarations. Such notice may be provided before or after
the effective date of cancellation or nonrenewal.
4. Failure to give notice in accordance with the terms of
this endorsement does not:
a. Alter the effective date of: policy cancellation,
nonrenewal or expiration;
b. Render such cancellation or nonrenewal ineffective;
c. Grant, alter, or extend any rights or obligations
under this policy; or
d. Extend the insurance beyond the effective date of
cancellation or policy expiration, whichever comes
first.
All other terms and conditions of the Policy remain unchanged.
REVIEWED & APPROVED
By Risk hMNACjLh9l:Ni DIVISION
jU 11 21320
ANgiE ACEVEdo
cnaie soaM�
G-56015-B (ED. 11/91)
(!94drSrw y