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HomeMy WebLinkAboutDATA TICKET INC (3)d1JUi1ANCE ON FILE �r4E' vi,WK MAY PROCEED UN'HL INSURANCE E) MAYOR II I zlOa. Vicente Sarmiento C MAYOR PRO TEM 6LERK OF COUNCIL David Penaioza DA I E: COUNCILMEMBERS Phil Bacema Johnathan Ryan Hernandez Jessie Lopez Nelida Mendoza Thai Viet Phan �; pDUtCl�r�ty-GcrJlix�-(��F� Data Ticket. Inc. 4600 Campus Drive Newport Beach, CA 92660 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza . P.O. Box 1988 Santa Ana, California 92702 W Ww.sanla-ana oro (7141647-3320 February 12. 2021 A-2017-026-03 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez Re: Final Extension of Agreement of Consultant Agreement (A-2017-026) Pursuant to Section 3 ('Ternn") of the above -referenced Agreement, entered into by Data Ticket, Inc., and the City of Santa Ana, dated February 7, 2017, the time period of the Agreement is hereby extended for an additional, and final one-year period, from February 7, 2021 through February 6, 2022. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other teens and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, David Valentin Chief of Police CITY OF SANTA ANA Kri tine,dgee - City Manager APPROVED AS TO FORM amara Bogosian Senior Assistant City Attorney ATTEST 0 Daisy Gomez Clerk of the C uncil DATA TICKET, INC. 1 `. Y:'P_Ne"�jk we' {fx a f} Title:C_i U� h+,) Or-FI -er— SANTA ANA CITY COUNCIL vaentl Samwnlo Oavq Penalass Tnai V., Wun J.... Lopez Phil aawm JoanalMn Ryan Hemandei Ni"... Mngoze Mayor Mayo. Pip TBm Ward3 WiI W"3 Wama Wi5 Wi6 y lPIO�BBnI0 a,, oN ddenabzanfleOPlo-ani Om IpPeP�60aPli-aaO Mo _LebwilByll Od-<erta2i4d11 IMnPemander�iiP dP,nloxa.®ianyii ern A-2017-026-03 Digitally ligned by Francine P. Francine R. Villareal Villareal Date: 202h.03.0208.02:40-08'00' 4�i CERTIFICATE OF LIABILITY INSURANCE OF DATE1/7/20/YYYY) 1 I/72020 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(!") must have ADDITIONAL INSURED or b provisions eendorsed. H SUBROGATION IS WANED, 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 certiflcate holder in lieu of such endomement(s). PRODUCER WNTACT NAME: Lynette (Lynn) Eye PIA Select Insurance Solutions 1100Industrial Rd, Y3 ac. (SOS)975-3531 INC, N.): ADDRESS: lynlLeyeGpiaselec[.com INSURER(S) AFFORDING COVERAGE NAICIt San Carlos CA W70 INSURER A: Amco Insurance Company 002014 INSURED INSURER B : Employers Insurance Group 10346 Data Ticket, Inc. INSURER C DBA: Revenue Experts INSURER D: 2603 Main Street, Ste. 300 INSURER E Irvine CA 92614 INSURER F: COVERAOE6 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 INSO yyyD POLICY NUMBER (MMIDD MMIDO LWITS A X COMMERCIALGENERN-UmIILrTY CLAIMS -MADE 7K OCCUR Y Y ACP G103069509589 11/012020 11/012021 EACH OCCURRENCE $ 2,000,000 PREMISES(Ea accunence) t 100,000 APED EXP (Any one person) t 5,000 PERSONAL S ADV INJURY $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: X POLICY F-JJE T FILOC OTHER GENERAL AGGREGATE s 4,000,000 PRODUCTS-COMP/OP AGG s 4,000,000 $ A'AAUUTOS AUTOMOBILE UAINLITY ONLY AUTOSULED HIRED NON-0WNED AUTOS ONLY X AUTOS ONLY ACP GLO 3069509589 I1/012020 I1/012021 Ea acckent $ 1.000,000 BOOILYINJUW(Perperaoa) S JANYAUTO BODILY INJURY (Per modern) S Per ecciden0 s t A X USISRELLALWB EXCESS LIAe occult CMMS+ E ACP CAA 3069509589 11/01/2020 11/01/2021 EACH OCCURRENCE s 2,000,000 AGGREGATE F 2,000,000 OED I I RETENTIONS $ B ORNERS COMPENSATION kND EMPLOYERS LIABILITY YIN MY PROPRIETOFUPARTNERrEXECUTIVE E FFICER/MEMBER EXCLUDED? ammtmy In NH) yes, dee be under ESCRIPTION OF OPERATIONS below RIA Y EIG4581764-01 IIIOM020 1//0112021 X STATUTE ER El. EACH ACCIDENT s 11000,000 E.L.DISEASE-EAEMPLOYE-ES 1.000,000 E.L. DISEASE -POLICY LIMIT $ 1.000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD lal, Additional Remark. SchaduK may be attached N mare Space u required) City of Santa Ana, officers, agents, employees, and volunteers are named as additional insured on the General Liability policy pursuant to written contract, agrectil or memorandum of understanding. The General Liability policy includes a Waiver of Subrogation, Primary & Non -Contributory warding and 30 day notice of cancellation as required by written contract (sec attached). Workers Compensation includes a blanket Waiver of Subrogation (sec attached). SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division AMC, 0REPRESENTATNE 20 Civic Center Playa, 4th Floor Santa Ana CA 92702 ManagmMrdDivatnn �=tom, lhak - 01988-2015 ACORD 9 1e$ REVIEWED 6 APPROVED Br. a.t.�;. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD tr' ' Fdl.e %, ViLVL 11 Rak Management Analyst ACP GLO 3069509589 COMMERCIAL GENERAL LIABILITY CG 20 33 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such 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. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. CG 20 33 04 13 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. © Insurance Services Office, Inc., 2012 1-77 R1akMWWg=edD[V610n fte`nr & APPRovED By. ®' Risk Management Malys[ CG 20 33 0413 2. "Bodily injury' or "property damage" occurring after: a. 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 b. 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 other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 2 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All terms and conditions apply unless modified by this endorsement. © Insurance Services Office, Inc., 2012 emxp ' R1&k Mv119wwdDMs1on REvaW n a AFPRaVM ar � ,4R��uu.uu_l_11 e. 1 [,�A4YNf.1. Y�WPRG Risk Management Analyst OF ACP GLO 3069509589 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or .your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Q Insurance Services Office, Inc.. 2008 �s, { n• (�l/•REVIEWED&APPRcvEDBy., rWZ*4 Z M"4,4 Risk Management Analyst ACP GLO 3069509589 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Risk ManagmedWslan t REVIEWED &APPRovE7 By: `=Y9�1.11-r ) F444,1r, .e ram. V:>!iRna �. ® Risk Management Analyst WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description With respect to all employees subject to the workers' compensation laws of the state of California, any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 11/01/2020 Policy No. EIG 4581764 01 Issued to DATA TICKET. INC. Premium Countersigned at at 12:01 AM standard time, forms a part of Of the EMPLOYERS PREFERRED INS. CO. Carrier Code 00920 Endorsement No. Z�'& on By: maR managm urnsum WC 04 03 06 g REvexrso&APPRO By. (Ed. 4-84) O 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights res >r��-u-ra-r=' f'w+ Z VA( � ® Risk Management Analyst AC40MV CERTIFICATE OF LIABILITY INSURANCE llta./ DAM(MMIDDn'YYv) 1 10/28/2020 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 endomement(s). PaooucER Ashbrook-Clevidence, Inc. 3000 W MacArthur Blvd, Suite 320 Santa Ana, CA 92704 r,uAMCONTACT Beverly Lyall PA/ .HONE Eat: (714)979A023 FAc No: (714)979-2609 ADDRESS, Beverlyl@acievidence.com INSURERBAFFORDING COVERAGE NAICY License #: 0188788 INSURERA: Continental Casually Company INSURED INSURER B: Scottsdale Data Ticket, Inc. INSURER C: 2603 Main Street Suite 300 INSURER D: Irvine, CA 92614 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: 00012154-8975280 REVISION NUMBER: 50 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 Sp SUBR POLICYNUMBER POLICY EFF MMIDO POLICY EXP MMIDD LIMITS COMMERCMLGENERALLIABILDY EACH OCCURRENCE $ CLAIMSMADE ❑ OCCUR DAMAGE TO RENTEDccu0e PREMISES Eaonce $ $ MED EXP(Any one person) $ PERSONAL B ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER $ GENERALAGGREGATE POLICY ❑ PEO- LOC PRODUCTS -COMPIOP AGG $ 3- OTHER: AUTOMOBILE LIABILITY COM Ea aBINED SINGLEUMIT cdtlenl $ $ ANYAUTO BODILY INJURY (Per person) H O"ED ASCHEDULED AUTOS ONLY UTOB BODILY INJURY (Per accitleni) $ HIRED NON-OMED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peraccident $ a 1 1 UMBRELLA LMB OCCUR EACH OCCURRENCE $ $ EXCESS DAB CLAIMS -MADE AGGREGATE DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED) NIA I PER OTK STATUTE ER E.L. EACH ACCIDENT $ $ (Mandatory in NH) ELDISEASE-EAE10PILOYEE (ryes, describe under DESCRIPTION OF OPERATIONS bales EL DISEASE -POUCY LIMIT $ A Errors & Ommissions 287188360 11/0112020 11/0112021 Deductible $10K $2,000,000 B Cyber Liability EKS3362231 11/0112020 11/01/2021 Deductible $25K $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate also evidences Crime provided by Travelers Casualty & Surety Company of America NAIC #31194, policy number105702099 with effective dates of 11/112019-11/1/2022 and limits of $1,000,000. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92702 AUTHORIZED REPRESENTA VE © 98 15 AC RD CO at"""• WaF MarugnnrntDiki$IwI ACORD 25 (2016103) The ACORD name and logo are registered me A REviEwED &APPROVED By: Printed by Bx Feu R- V:&L Risk Management Analyst