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HomeMy WebLinkAboutPRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (4)SEP 0 tl-� O'• Finan.w �RaSe,'Pe✓ez� �$��b MAYOR Vicente Sarmiento MAYOR PRO TEM David Penaloza COUNCILMEMBERS Phil Bacena Johnathan Ryan Hernandez Jessie Lopez Nelida Mendoza Thai Viet Phan INSURANCE ON FILE WORK MAY PROCEED UNTIL INSUR,NCE PIRES 01 /bl 'L622 CLERK OF COUNCIL DATE August 30, 2021 CITY OF SANTA ANA FINANCE AND MANAGEMENT SERVICES 20 Civic Center Plaza, M-36 . P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.ora Prudential Retirement Insurance and Annuity Company Attn: Robert A. Luciani 30 Sacramento Office Park Scranton, PA 18507 Re: Extension of Services Agreement No. A-2018-179 Dear Mr. Luciani, A-2018-179A - CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez Pursuant to Section G.1. ("Duration") of Agreement No. A-2018-179 entered into by Prudential Retirement Insurance and Annuity Company ("Prudential"), and the City of Santa Ana, dated October 1, 2018, the time period of said Agreement is hereby extended for two (2) additional one (1) year periods from October 1, 2021 to September 30, 2023. The insurance certificates are required to be extended and/or renewed to cover this time extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. Sincerely, IlaW, I, Kathryn Downs Executive Director, Finance and Management Services Agency CITY OF SANTA ANA Kristine Ridge City Manager PRUDENTIAL �� !A% Robert A. Luciani, Vice President Specialty Markets & Retirement Counseling ATTEST jiayGomez k of the Council APPROVED AS TO FORM 3raffon Salvatierra Deputy City Attorney SANTA ANA CITY COUNCIL Vicente Sarmiento David Penaloza Thai Vet Phan Jeasie Lopez Phil Bacerra Johnathan Ryan Hernandez Nelda Mendoza Mayor Mayor Pro Tam, Ward 2 Ward 1 Ward 3 Ward 4 Ward 5 Ward 6 vsarmientodeanta-anaoro doenaloza@sanle-anaoro tohan(alsanta-ana.orp iessielooezfolsanta-ana.ora nhacerra0santa-anaoro 'rvanhemandezaasanla-among nmendoza(0isanla-anaoro I A-2018-179A Digitally signed by Francine R. Francine R. Villareal Wilareol 4� �® CERTIFICATE OF LIABILITY INSURANCE DATE 08/0412021 nryY) 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 Marsh USA, Inc. 1166 Avenue of the Americas CONTACT NAME: PHONE Firic FAX No: New York, NY 1OD36 Attn: NmYolk.Certs@marsh.com Fax: 212-948-0500 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC9 INSURER A: Travelers Property Casualty Company of America 25674 INSURED PRUDENTIAL FINANCIAL INC. INSURER B: Endurance Assurance Corporation 11551 INSURER C : 655 BROAD STREET NEWARK, NJ 07102 INSURER D : INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-011164643-01 REVISION NUMBER: 1 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. Hart LTR rypE OF ADDLSUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YNNY LIMITS A X COMMERCIAL GENERAL LABILITY CLAIMS -MADE OCCUR TC2J-GLSA-6045X417-TIL-21 01/0112021 01/0112022 EACHOCCURRENCE $ 2,000,000 DAMAGE TO RE TE0 PREMISES Ea occurrence $ 2,000,000 GEN'L X MED EXP tAny one arson) $ 5,000 PERSONAL is ADV INJURY $ 2.000,000 AGGREGATE LIMIT APPLIES PER PRO- POLICY E JECTPRO- ❑ LOC GENERALAGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGO $ 4,000,000 $ A AUTOMOBILELIABILITY X1AUTOS ANYAUTO OWNED SCHEOULED AUTOS ONLY AUTOS HIRED NON -OWNED ONLY AUTOS ONLY TC2JCAP-8045X045-TIL-21 OV0112021 01/0112022 COMBINED SINGLE LIMIT Ea accident $ 2,000.000 BODILY INJURY (Per person) $ RY BODILY INJU(Par accident) 7 PROPERTYDAMAGE Per accident $ X UMERELLALIAB EXCESS LIAB OCCUR CLAIMS -MADE GUF30000914002 0110112021 01/0112022 EACH OCCURRENCE $ 5,000,000 N AGGREGATE $ 5,000,000 DED I I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNETEXECUTIVE OFFICEWMEMBEREXCLUDED? El (Mandatory in NH) If yes, drear be under DESCRIPTION OF OPERATIONS below NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) The City, of Santa Ana, it's officers, employees, agents, and representative are included as additional insured where required by written contract. Cityof Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Division, 4th Floor THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS - Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE RIAMnlagenlentDivislon .s'• REVIEWED & APPROVED BY. ©1988-2016 ACORD C °{ ,i ;Z VSA4441 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management Analyse rW COMMERCIAL GENERAL LIABILITY POLICY NUMBER: TC2s-GrsA-8045X417-TIL-21 ISSUE DATE: 01-15-21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organizatiorl "Any person or organization that you agreed in a written contract or agreement to include as an additional insured on this Coverage Part, provided that such written contract or agreement was signed by you before, and is in effect when, the "bodily injury" or "property damage" occurs or the "personal and advertising injury" offense is committed and only for the limits of insurance agreed to in such written contract or agreement, or the limits of insurance of this policy, whichever is less." Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG D4 11 04 08 C 2008 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office, Inc. with its permissic .vY".,use RlekNI"ganentDtWslan ..�, .� RE\A�&APPROVIDBr �' Risk Management Mays[ --.I"1 ACORL ��. CERTIFICATE OF LIABILITY INSURANCE DATE Au us[4 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 OF 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Aon Risk Services Northeast, Inc. One Liberty Plaza, 165 Broadway, Suite 3201 New York, NY 10006 CONTACT NAME PHONW.,.NPNo„E.En: We. „e.: EAIML ADDRESS, PRODUCER CUSTOMERIDO: INSURERS AFFORDING COVERAGE NAIC# INSURED Prudential Financial, Inc. and its subsidiaries 751 Broad Street Newark, NJ 07102 INSURERA: ACE AMERICAN INSURANCE COMPANY CHUBS LEAD 22667 INSURERS: _ INSURERC: INSURER D' INSURER E: INSURER F: NI IMRFR• THS IS TO CERTIFY THAT 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 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. Limits Shown are as requested �IIrn TYPE OF INSURANCE POLICY NUMBER POLICY Err DATE POIICY EXP DATE LIMITS RETENTIONS GENERAL LIABILITY EACH OCCURRENCE ❑ COMMERCIAL GENERAL LIABILITY PREMISES Ea occunenw ❑CIAIMSMAGE ❑OCCUR MEDEXPMonepe,ecn) ❑ PERSONAL & ADV INJURY ❑ GENERALAGGREGATE GEHL AGGREGATE UNIT APPLIES PER: PRODUCTS-COMP/OP AGO ❑ POLICY ❑ PROJECT ❑ LOc AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea aaaiden0 ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS BODILY INJURY (Per pe,con) ❑ HIRED AUTOS ❑ NON -OWNED AUTO BODILY INJURY (Per aoddent) PROPERTYDAMAGE ❑ ❑ UMBRELLA LIAB ❑ OCCUR EACH OCCURRENCE ❑ EXCESS LIAB ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABIDTY YIN Wb mAT4 ❑ TORY LIMITS OTHER ❑ .1 PNoaalE ranlapRTNEWE%ECMYE ❑ OMCEWMERINEREXCLUDED] E.L. EACH ACCIDENT (MandatoryIn NH) E.L. DISEASE -EA EMPLOYEE If es, tleaoabe under E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS Lelow A Insurance Company Professional Liability G21646346 019 Nov. 1, 2020 Nov. 1, 2021 At least $5,000,000 $250,000,000 A Financial Institution G29010961 004 Nov. 1, 2020 Nov. 1, 2021 At least $260,000,000 Bond, For n 25 $5,000,000 A Cyber Liability G46761029 003 Nov. 1, 2020 Nov. 1, 2021 At least $250,000,000 $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Santa Ana Risk Management Division, 4" Floor 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ACORD 25 (2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Risk Mnug..d Division REVIEWED & pAPPROVED BY: a � ��;, F�FYn.14 R. V:ILAM1TFt - Risk Management Analyst A� o® CERTIFICATE OF LIABILITY INSURANCE DATE/4/2D27ryrr) (MMIDDN 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 Edgewood Partners Insurance Center 1 American Lane CONE C Amanda Massa PHONE FAX . 203-658-0507 WC No AmmESS, amanda.massa a icbrokem.com Greenwich CT 06831-2560 INSURE 5 AFFORDING COVERAGE NAICN INSURER A: Travelers Prop Casualty Co of America 25674 INSURED PRUDEN2069A INSURER B: Prudential Financial, Inc. 751 Broad Street INSURER C: INSURERD: Newark NJ 07102 INSURER E INSURERF: COVERAGES CERTIFICATE NUMBER: 1103252456 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 SUER POLICYNUMBER POLICY EFF MMIDDIYYYY POLICY UP MMIDDNYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 JET 0 LOD GENERALAGGREGATE $ PRODUCTS -COMPIOP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per acddent) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Per accident $ $ H UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ A A WORKERS COMPENSATION AND EMPLOYERS'UABILITY YIN UBBN67B04A2151R UB8N7282432151 K 1/1/2021 1/1/2021 1/l/2022 1/1/2022 X STATUTE ERH E.L. EACH ACCIDENT $1,000.000 ANYPROPRIETORIPARTNERIEXECUTIVE ❑ OFFICER/MEMBEREXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $1,000.000 (Mandatary In NH) If yes, desonbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD IDt, Additional Remarks Schedule, may be attached if more space is required) Location Address: 751 Broad Street Prudential Property Number: N/A Property Type: Owned (Prudential occupied) City of Santa Ana Risk Management Division, 4th Floor 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988-2015 ACORD C ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk MwagamerADWIon a i REVIEWED&APPROVED BY: R. vat' ci ®, ® 2uk Wana9ement Anayst