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HomeMy WebLinkAboutCIVIC PLUS, INC.FEB 0 8 2021 MAYOR Miguel A. Pultdo MAYOR PRO TEM Juan Villegas COUNCILMEMBERS Phil Bacerra Nelida Mendoza David Penaloza Vicente Sarmiento Jose Solorio INSURANCE NOT ON FILE WORK MAY NOT PROOFED CLERK OF COUNt DATE: 0: PR CSR (Sl1 '° Cwe`k's) 0 LS CITY OF SANTA ANA PARKS, RECREATION, AND COMMUNITY SERVICES AGENCY 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 w .santa-ana.oro September 29, 2020 CivicPlus, Inc. 302 South 4th Street, Suite 500 Manhattan, Kansas 66502 Attention: Mr. Tim Grant, Director of Sales A-2017-076-01 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez, MMC Re: Extension of Agreement No. A-2017-076 to Provide Activity Registration and Site Reservation Software. Dear Mr. Grant: Pursuant to Section 3 ("Tenn") of the above -referenced Agreement, entered into by CivicPlus, Inc. and the City of Santa Ana, dated April 19, 2017, the term of the Agreement is hereby extended for a one-year period, from December 1, 2020 through November 30, 2021. 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 full force and effect. Please sign below and return this extension to the City at your earliest convenience. Sincerely, ((,�((// Lisa Rudloff Executive Director, Parks, Recreation, and Community Services Agency CITY OF SANTA ANA /ATTEST L UA Kristine Ridge Daisy Gomez, CMC City Manager Clerk of the Council APPROVED AS TO FORM CIYICPL US, INC. XawLa.. A. k cam, -G)t-k""563 Laura A. Rossini'NameAmy Vlkandef Acting Chief Assistant City Attorney Title: Vice President of Client RP ices #8019v1 Francine R. Digitally signed by Francine R. Villareal Villareal Date: 202n.02.n1a23 90' 1 of 2 ACC?RV CERTIFICATE OF LIABILITY INSURANCE ��- DATE02/02/2021 /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 Willis Towers Watson Northeast, Inc. c/o 26 Century Blvd P.O. Box 305191 CONTACT Willis Towers Watson Certificate Center NAME: PHONE 1-877-945-7378 FAX 1-888-467-2378 A/C No Ext : A/C, No): E-MAIL ADDRESS: certificates@willis.com INSURER(S) AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURERA: Great Northern Insurance Company 20303 INSURED CivicPlus, LLC 302 S 4th Street, Suite 500 INSURER B: Federal Insurance Company 20281 INSURERC: Westchester Surplus Lines Insurance Compan 10172 INSURER D 7 Manhattan, KS 66502 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: W20029459 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 MMIDD/YYY POLICY EXP MMIDD/YYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR PREMISES DAMAGE TO PREMISES Ea occurrence $ 2,000,000 MED EXP (Any one person) $ 10,000 A Y 3602-53-12 05/17/2020 05/17/2021 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO LOC JECT PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 7358-87-92 05/17/2020 05/17/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE 7989-49-14 05/17/2020 05/17/2021 DED X RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A (21) 7174-92-49 05/17/2020 05/17/2021 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 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 Technology Errors and Omissions F15611984 001 05/17/2020 04/30/2021 Aggregate/ ded $5,000,000/$25,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) This Voids and Replaces Previously Issued Certificate Dated 05/14/2020 WITH ID: W16465526. The City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are included as Additional Insureds as respects to General Liability. General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be 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 Risk Management Division AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza, 4th Floor cF RAManagamedUlMslart Santa Ana, CA 92702 x REVIEWED &APPROVED BY.- © 1988-2016 ACORD Cl�,?` ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD _ _— RilManagement Analyst SR ID: 20678329 BATCH: 1972733 AGENCY CUSTOMER ID: LOC #: ACCOR" ® ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc. CivicPlus, LLC 302 S 4th Street, Suite 500 POLICY NUMBER Manhattan, KS 66502 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS C: H U a a" Liability Insurancc Policy Period Effechve Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: GENERAL LIABILITY ffi�= -� Additional Insured - Scheduled Person Or Organization Liability Insurance MAY 17,2020 TO MAY 17,2021 MAY 17,2020 3602,53-12, TPA CIVICPLIJS' LLC GREAT NORTHERN INSURANCE COMPANY MAY 15,2020 Under Who Is An Insured, the following provision is added, Persons or organizations shown in the Schedule are Insureds; but they are insureds only if you are obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by this policy. However, the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule, • to the extent such contract or agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur, in whole or in part, before the execution of the contract or agrees rent; and • with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision-, • that is more specifically identified under any other provision of the Who Is An Insured section (regardless of any limitation applicable thereto)'. • with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. Additional Insured - Scheduled Person Or ONanizadon Form 80-02-2367 (Rev 5-07) Endorsement cF Risk MmRgmedDMsiun REVIEWED & APPROVED BY.- F04c"�" P, VX*vd RtWjanagementftalpt Liability Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other Insurance. Conditions Other Insurance — If you are obligated, pursuant to a contract or agreernent, to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization, PERSONS OR ORGAN MATIONSTHAT YOU ARE OBLIGATED, PURSUANT TO A CONTRACr OR AGREEMENT, TO PROVIDE WlTH SUCH INSURANCE AS IS AFFORDED BY THIS POLICY. All other terms and conditions remain unchanged. Authorized Representative J. Liability Insurance Additional Insured - Scheduled Person Or OManizadbn Form 80-02-2367 (Rev 5-07) Endomemant cF Risk MmRgmerdDMsiun REVIEWED & APPROVED BY.- F04c"�" P, VX*vd RtWjanagementftalpt C H U B B° Policy Conditions Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: COMMON POLICY CONDITIONS Conditions Cancellation Policy Conditions MAY 17, 2020 TO MAY 17, 2021 MAY 17, 2020 3602-53-12 TPA CIVICPLUS, LLC GREAT NORTHERN INSURANCE COMPANY MAY 15, 2020 The following changes are made as respects exposures in the state of Kansas. Under Conditions, Cancellation and When We Do Not Renew are deleted and replaced by the following: We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation, stating the reasons for cancellation, at least: • 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or • 30 days before the effective date of cancellation if we cancel for any other reason. If this policy has been in effect for 90 days or more, or if it is a renewal of a policy we issued, we may cancel this policy only for one or more of the following reasons: • nonpayment of premium; • this policy was issued because of a material misrepresentation; • you or any other insured violated any of the material terms and conditions of this policy; • unfavorable underwriting factors, specific to the insured, existed that were not present at the inception of this policy; Kansas Mandatory Form 80-02-9737 (Ed. 3-96) Endorsement cF Risk ManagementDMsian REVIEWED & APPROVED BY.- V"° --� Risk janagement Analyst Conditions Cancellation (continued) When We Do Not Renew Policy Conditions a determination by the insurance commissioner that continuation of coverage could place us in a hazardous financial condition or in violation of the laws of the state of Kansas; or a determination by the insurance commissioner that we no longer have adequate reinsurance to meet our needs. If we decide not to renew this policy, we will mail or deliver written notice of nonrenewal, stating the reasons for nonrenewal, to the first Named Insured at least 60 days prior to the expiration date of the policy. Any notice of nonrenewal will be mailed or delivered to the first Named Insureds last mailing address known to us. If notice is mailed, proof of mailing will be sufficient proof of notice. All other terms and conditions remain unchanged. Authorized Representative Kansas Mandatory Form 80-02-9737 (Ed. 3-96) Endorsement cF Risk MmRgmedDMsiun REVIEWED & APPROVED BY.- V"° --� Risk janagement Analyst A _ : — Diaitally si edbv AC6RhP CERTIFICATE OF LIABILITNrINA WRICE Angie cW9022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CO NOT F OR ATIVELY ICIES BELOW. THIS CERTIFICATE CERT FIICATEOES OFATIVELY INSURANCE DOES NOT CONSTITUTE TUTEXA CONTRACT BETWEEN TF;F ISSUING�I L S �al1TI'I0R ZEID j 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 Willis Towers Watson Northeast, Inc. c/o 26 Century Blvd P.O. Box 305191 CONTACT Willis Towers Watson Certificate Center NAME: PHONE 1-877-945-7378 F' 1-888-467-2378 A/C No Ext : A/C, No : E-MAIL ADDRESS: certificates@willis.com INSURER(S) AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURERA: Great Northern Insurance Company 20303 INSURED CivicPlus, LLC and its direct and indirect subsidiaries 212 West Main St Suite 500 INSURER B: Federal Insurance Company 20281 INSURERC: Endurance American Specialty Insurance Com 41718 INSURER D Durham, NC 27701 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: W25464256 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 x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 2,000,000 MED EXP (Any one person) $ 10,000 A Y 36025312 05/17/2022 05/17/2023 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY PRO- JECT LOC x PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT Ea accident $ 1,000,000 x BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 7358-87-92 05/17/2022 05/17/2023 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY B UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 x AGGREGATE $ 5,000,000 EXCESS LAB CLAIMS -MADE 7989-49-14 05/17/2022 05/17/2023 DED x RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICE R/M EMBER EXCLUDED? (Mandatory in NH) N/A (23) 7174-92-49 05/17/2022 05/17/2023 x PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 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 Technology Errors and Omissions PR030018745600 04/30/2022 04/30/2023 Aggregate/ ded $5,000,000/$25,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) This Voids and Replaces Previously Issued Certificate Dated 05/23/2022 WITH ID: W24809984. The City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are included as Additional Insureds as respects to General Liability. General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be 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 Risk Management Division 20 Civic Center Plaza, 4th Floor � Santa Ana, CA 92702sN REviEwED & APPROVED BY: © 1988-2016 ACORD °( e Aeevaa ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD — Risk Management specialist SR ID: 22865989 BATCH: 2605326 AGENCY CUSTOMER ID: LOC #: ACCOR" ® ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc. CivicPlus, LLC and its direct and indirect subsidiaries 212 West Main St Suite 500 POLICY NUMBER Durham, NC 27701 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS C H U B B° Liability Insurance Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date issued This Endorsement applies to the following forms: MAY 17, 2022 TO MAY 17, 2023 MAY 17, 2022 3602-53-12 TPA CIVICPLUS, LLC VIGILANT INSURANCE COMPANY JULY 1, 2022 GENERAL LIABILITY Under Who Is An Insured, the following provision is added Who Is An Insured Additional Insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by Or Organization this policy. However, the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; • to the extent such contract or agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur, in whole or in part, before the execution of the contract or agreement; and • with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: • that is more specifically identified under any other provision of the Who Is An Insured section (regardless of any limitation applicable thereto). • with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. Liability Insurance Additional insured - Scheduied Person Or Organization Form 80-02 2367 (Rev. 5-07) Endorsement Risk Muaigmad DlMsian E REVIEWED & APPROVED BY: e Aeevaa '�--'Rfsk Management Specialist CHUBB" Liability Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other Insurance. Conditions Other Insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. Schedule PERSONS OR ORGANIZATIONS THAT YOU ARE OBLIGATED, PURSUANT TO A CONTRACT OR AGRFM4ENT, TO PROVIDE WITH SUCH INSURANCE AS IS AFFORDED BY THIS POLICY. All other terms and conditions remain unchanged. Authorized Representative Liability Insurance Additional insured - Scheduied Person Or Organization Form 80-02 2367 (Rev. 5-07) Endorsement Risk DlMsian E o N,`P' REVIEWED & APPROVED BY: '�--'Rfsk Management Specialist