HomeMy WebLinkAboutPHOENIX GROUP INFORMATION SYSTEMS 2C - 2006
. '
\NSlJtU'..NCt. ON FIL~,
'iiWK MAY PROCEED ,
:HIIL iNSURANCE EXPIRES
fO -;-04> ~_
"I E f!I\ OF COUNCli
DXii C)..,)..i.,rO(o
A-2006-262
rT F'b ().\
l0 scn-l)
THIRD AMENDMENT TO
CONSULTANT AGREEMENT
THIS THIRD AMENDMENT TO CONSULTANT AGREEMENT is entered on
September 18, 2006, by and between Phoenix Group Information Systems, a California
corporation ("Consultant") and the City of Santa Ana, a charter city and municipal
corporation of the State of California ("City").
RECITALS:
A. The parties entered into Agreement #A-2oo5-037, dated February 22, 2005
(hereinafter "said Agreement") by which Consultant has provided parking citation
processing services
B. In accordance with the terms and conditions of said Agreement, the parties wish to
increase the compensation and extend the term for an additional one-year period.
WHEREFORE, in consideration of the covenants contained in said Agreement, and
subject to all the terms and conditions of said Agreement, except those amended in this
First Amendment to Consultant Agreement, the parties agree as follows:
1. Section 2.a., COMPENSATION, shall be increased by $125,000 for the current term
and an additional $275,000 shall be provided for the 2007 calendar year. Said
Section shall be deleted in its entirety and replaced with the following:
"a. City agrees to pay, and Consultant agrees to accept as total payment for its
services, the rates and charges identified in Exhibit A. The total sum to be expended
under this Agreement during its first year shall not exceed $130,000.00. For calendar
year 2006, the total sum to be expended by the City shall not exceed $300,000.00.
The total sum to be expended by City during the 2007 calendar year shall not exceed
$275,000.00.
2. Section 3, TERM, shall be deleted in its entirety and replaced with the following:
"The term of this Agreement shall continue through December 31, 2007, unless
terminated earlier in accordance with Section 12, below, provided, however, that the
parties acknowledge and agree that this Agreement shall be canceled on thirty (30)
days written notice by the Chief of Police or his designee if a City appropriation to
pay Consultant for the last six months of this Agreement is not included in the City's
FY 07-08 budget."
3. Except as herein amended, all terms and conditions of said Agreement shall remain in
full force and effect.
, .
IN WITNESS WHEREOF, the parties hereto have executed this Third Amendment to
Consultant Agreement on the date and year first written above.
ATTEST:
.
PATRICIA E. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By: ~yiIJVc~._
Lapta Sheedy /
Assistant City Attorney
CITY OF SANTA ANA
DAV]~a-
City Manager
PHOENIX GROUP
INFORMATION SYSTEMS
ROBfJA !!::he;
President
'il~~~,ilil..,:d!.llilillj!!I:'&
61,nd.l, Insuran.. A.,ncy
750 F.lr..nt AWlnu.
P. O. 10)( 831
61.nd.l, CA D1ZOI-D831
1.18) 244-1144
IN ..10
.~t~J!:II~l~lll!rdr
......13..,. cMMlDDWYf....j
CO>6'mv
A H.rtford F I rI I nsur.n.. Co.
COMPANY
B
Pholnlx Group Inform.tlDn Sye.
2170 N. WI'n Str..t. Suit. ZOO
Sant. An.. tA 82705
COUPANY
c: N.tlon.1 Union Fir. Insuranol Com In
WW1HtMMNkW%HW
THIS IS TO CERTIFY THAT THE ~OLlCIES OF INSURANCE L1STEDBE~OWHA VE BEENISSUED TO THE INSURED NAMED ABOVE FOR THE ~O~ICY ~ERIOD
INDICA TED,NOTWITHST ANDING AN. REQUIREMENT. TERMORCONDITIONOF ANYCONTRACTOR OTHERDOCUMENTWITHRES~ECT TO WHICHTHIS
CERTIFICATE MA' BE ISSUED OR MA' PERTAIN, THE INSURANCE AFFORDED BY THE ~OlICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH ~OlICIES, liMITS SHOWN MAY HAVE BEEN REDUCED B' ~AID CLAIMS.
CO _. C. I.'U.'.- .cue. UM' "DUeY.....CTIVI ,auoy IX'..ATJON
Ln ....... - ... N." DATI(IaWDDIYY) DA1I(MMIDDIYY)
, GENERAL L1....LITY 728IUB2S35
X COMMERCIAL GENERAL LIABILITY
a..AIMS I.lAOE ~ OCCLR
i OWNER'S & CONTRACTOR'S PROT
AUTOMoIU LIAILITV 72SI"12B35
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON.oWNED AUTOS
aAR"QI UAlUTY
ANY AUTO
IXCEI, U"ILITY i\.1' 1'?-'
UMBRELLA FORM
OTHER THAN lA48RELlA FORM
wO"lCUe COMPINIATION AND
IMPLOYIRI'LIA_LlTY
n..t; PROPRIETOR/ INCl
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL
OTHIII
C C~.rClI.1 Crlm. Polloy 5520811
10/01/0B
10/01l0S
10/01l0B
10/01105
sl'O fOR
.....-.
11/15/04
11/15/OS
DIICR.nON Oil'
ATtoNI'" A 10
IClAIIIHCI
It II ..r.ad th.t tho City .t S.nt. An. I. n...d Addltlon.1
.tt'oh.~ '4dltl.... InlYrad Endor....nt.
Inlur.d ./r..ard to e.n.ral LiabilIty oov.r.... .nd p.r the
t~~/t.fl...te~.,~:..j;~itMf@1nhf@Jf1~MH~jiH!Hihjh@MmiHMt~n;tWdl[4)n~nf:
.. .... .:,.~ .,::....:.:1:..:~:"JkntwdtM~E~UW~1i*!id~M~mI1lmm~1MmM1HlliW!WMIIH
LllIIlTe
GENEAAL AGGREGATE S 2.000,000
PROOUCTS.COMP/OP Aoo S 2.000,000
PERSONAl &. AnV INJURY S 1 ODD,ODO
EACH OCClRENCE I 1,000 000
FIRE DAMAGE (An)' one fire) . 3GO.OOD
MED EXP (An)' one person} I 5 ODO
CaelNED SINGLE lI~JT .
2.DOO,aDQ
BOOll Y INJURY S
(Per person)
BODILY INJURY S
(Per eccldent)
PROPERTY DAMAGE I
AUTO ONly. e" ACClDENT I
OTI-ER THAN AUTO Oft.. Y:
EACH ACCIOENT I
AGGREGATE I
EACH OCCURRENCE I
AOOREGATE S
S
EL DISEASE.pOlICY w.m
El DISEASE.EA EMPlOYEE
I.DOO 000
1.000,000
1 ODD DOO
51.aOO,aaa Limit par loourr.no.
S21.DOO D.du.tlbl.
City .f Santa Ana
Att.ntlon: Laura sh.ddy
20 Civic C.nt.r Pla.a
S.nt. Ana, CA 12'01
IHOI.I.D ANY 0' THI "'IOYl D.ICltUO 'OUCIII I. CANCILLID "'0111 THI
I".ATION DAn 11fDIOII, 'THI laUINQ COMPANY WLI,. INDU.YO.. TO MAL
30 OAYI WIUTTIIN NOTICI TO THI ClIITIP'lCAn HOLD'" HAMID TO THI LlPT.
M"PALUIII TO MAL IUCH NOTu. IHALL 1"011 NO OllL.lDAnON 011 UAILITY
Oil ND "'0 AJIIY. rn AD INTI OR "'1..IIIUNnnYlI.
. . .
ACORD CERTIFICATE OF INSURANCE ISSUE DATE
Ir~%)W
PRODUCER THIS CERTIFlCAT!: IS m1UI!D AS A MAneR OF INFORMATION ONLY AND CONFERS
DICKERSON EMPLOYEE BENEFITS NO RIGHTS UFON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
1918 RNERSIDE DR. AMEND EXTEND OR AI. TiR THE COVERAGE AFFORDED IY THE POLICIES BELOW,
lLos ANGELES, CA 90039 COMPANIES AFFORDING COVERAGE
~"",PANT
INSURED lETTER A .~,~~
PHOENIX GROUP INFORMATION COMPANY
lETTER I
2670 N, MAIN STREET COMPANY
SUITE #200 lETTER C
SANTA ANA, CA 92705 COMPANY
LETTER D
COMPANY
LETTER E
COVERAGES THIS IS TO CERTIFY THAT THE POUCIE8 Of' INSURANCE LISTI!D SElOW HAVE IEEN ISSUED TO THE INSURED NAMED AIlOVE
FOR THE POLICY PERIODIND/CATED, NOTWITHSTANDING ANY ReQUIREMENT, TERM DR CONomON OF ANY CONTRACT OR OTHeR DOCUMENT
WITH RESPECT TO WHICH THIS CERTIFICATe MAY SE ISSUED OR P&RTAIN. THe INSURANCIAFFOROED BY THE POliCIES DEBCRI8ED HEREIN
IB SUBJECT TO ALL THE TERMS, EXcLUSIONS AND CONDITIONS OF 8UCH POLICle&. LIMITS SHOWN MAY HAVE BEEN REDUCED SYPAJO ClAJMS.
CO TYPI! O',NSURANCE POLICY NUMBiR POLICY I'I'ECTIV' POLICY EXPIRATION UMIT'I
LTR OATE DATE"""'lmv'
GENERAL UABIUTY GENERAL AOGREGATE .
- PROllllC'Ts.COlolPJOPa AGO S
COMMERCIAl. GENERAL lIAIllLlTY
t- O CLAIMS MADE 0 OCCUR PERSONAL 'AllY.INJURY $
r- OWNER'S & CONTRACTORS PROT, EACH OCCURRENCE .
I- FIRE DAMAGE (Ally.... fIrw) $
l- . ,
.. . . MED. EXPEII8& (Any"", p_ $
AUTOMOlllLE llAlllrry f!f";~i rfu COMBlNEDSINGI.E
I- ANY AUTO LIMIT $
" - ......-- '7>'---'-
- ALL OWNED AUTOS ~.; __..1]' SOOIl Y INJURY
SCHEDULED AUTOS J.,'l...J:>l".U Liry Altor .cy (por penon) $
- HiReD AUTOB $
PRQFERTY DAW.GE
t- GARAGE llABlLITY
EXCESS LWlILITY EACH OCCIIRRENce $
~ UMSRElLA FORM AGGRlGATI! $
OTHER THAN UMBRELLA PORM
ISTATUTORV
WORKERS' COIIPIINlIATlON SA81- liMITS
A AND 1005- 10/1/05 10/1/06 EACH ACCIDBNT 11.000,000
EMPLOYERS' liABILITY 24384 DISEASE PDl.ICY lIMIT $1 000 000
DISIASII EACH !MPLOYI!E U. 000.000
OTHER
DESCRIPTION OF OPERATlDNSILOCATIONSN\!HICLES/BPlCIAL ITEJoIS
CATE HOLDBR CAl/CILLATlON SHOULD ANY OF THE ABOVE DESCRISED POlICIED SE
City of Santa Ana
Attn: Laura Sheddy
20 Civic Center Plaza
Santa Ana, CA 92701
CANCI!LLED OFORE 'M! EXPIRATION ~U! lHI!~IOF, THE ISSUING
COMPANY Wl.l ENDEAVOR TO MAlI. 30 DAYS WRITTEN NOllCE TO
THE CERTIFICATE HOLDI!R NAMED TO THE LfFT. aur F.....URl! TO MAIL
SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR llAlllllTY OF ANY KIND
UPON THE COMPANY, ITS AGENTS DR RiPRl!SENTATlVES,
~ -:ZJ-<c~~_ .......-....
AUTHORIZED REPRESENTATIVE
Acfiim~ ceRTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDNY)
8/3112006
PRODUCER GUl:NDALE INSURANCE AGENCY, INC. 1lI1S CERllFICA TE IS ISSUED AS A MA ITER OF INFORMATION
P. O. Box 831 ONLY AND CONFERS NO RIGHTS UPON THE CERllFICA TE
HOLDER. 1lI1S CERllACA TE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Glendale CA 91209-0831
_____ ~_1818}~44-1~44_ INSURERS AFFORDING COVERAGE
~~_._------------ American "Economy Insurance CompanY- - .....
INSURED INSURER A:
Phoenix Group Information Systems National Union Fire Insurance Company . ---.....----
INSURER B:
2670 North Main Street, #200 -.------
~~RC; -.'----------
INSURER 0:
Santa Ana CA 92705 .-
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1~~11 TYPE OF ~~SURANCE - POLlC~ NUMBER POLICY EFFECTIVE POLlCY EXPIRATION
I GENERAL LIABILITY
I xl CqMMERCIAL GENERAL LIABILITY
Ail-I ~AIMSMADE L!J OCCUR
- -- --- - -- ----
~~'L AGGRE~E LIMIT A~~l~;S PEA:
X I POLICY i i "~,9~ I I LOC
02BP50901610
10/112006
101112007
LIMITS
~~~H OCCU~RENCE ___L~__
FIRE DAMAGE (Anyone fire) [$
MED EXP (Anyone person) $
PERSONAl & ADV INJURY ,_L~___ M__
GENERAl AGGREGATE $
PRODUCTS - COMP/OP AGG $
2,000,000
. __~()O,OOO
10,000
2,000,000
4,Ooo,OC?~
4,000,000
AUTOMOBILE LIABILITY
I ANY AUTO
C
!______ ALL OWNED AUTOS
SCHEDULED AUTOS
A 'x-I HIRED AUTOS
';~~-:! NON-OWNED AUTOS
I . i -"---- ...----
~~IRAGE LIABILITY
I ANY AUTO
10/112007
COMBINED SINGLE LIMIT
(Eaaccident)
--..-.- -- ----- ------ - - . -----
I
1$
-I .------------
1$
rp~~~~d~nt?AMAGE _ ---~----------------------
$
2,000,000
02BP50901610
10/112006
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
A
- --
01WC10616010
10/112006
10/112007
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC +---!.-..
AUTO ONLY: AGG $
EACH OCCURRENCE $
_~~~~A~_____ ___~~~:=J~~__~_____- -=~~=~_-_
I=~---=--:~-* ------
..h'Z~~L~Ms I IOJ~-J____n ..._
E.L. EACH ACCIDENT +-s- 1 ,000,000
E.L. DISEASE - EA EMPLOYE" $ 1,000,000
E.L. DISEASE. POLICY LIMIT $ - ---'.000,000
$1,00??oo Limit per
Occurrence
$25,000 Deductible
EXCESS LIABILITY
tL.:l' OCCUR [-I CLAIMS MADE
I --:1 DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
OTHER
B Commercial Crime Policy
4949735
11/1612005
11/1612006
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
It Is agreed that the Certificate Holder Is named Additional Insured w/regard to General
liability coverages.
J?:. //;~", ~~'/ //~
~7L. / /",- '-
CERllFICA TE HOLDER I i ADDITIONAL INSURED; INSURER LETTER'
1
CANCELLA liON
SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NonCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVeS.
A I'f" "";\SZ::~ -i7...
City of Santa Ana
Attention: Ron Stires '111410
5f\1"i:l
60 Civic Center Plaza
Santa Ana CA 92702
ACORD 2S-S (7/97)
LM: lPWv1.9.8on 1016106 . 11:05 by UserName
lP: LPWv1.9.Bon 10/6106-11:06 :'userNarl'
@ACORD CORPORAll0N 1988
PFv1.0.1
0-.L
,. , .
. .
.'
Insured: Phoenix Group Information Systems, Inc.
POLICY NUMBER: 02BP50901610 COMMERCIAL GENERAL LIABILITY
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 Person or Organization:
City of Santa Ana
60 Civic Center Plaza
Santa Ana, CA 92702
(If no entry appears above. information required to complete this endorsement will be shown in the Declara-
tions as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown
in the Schedule as an insured but only with respect to liability arising out of your operations or premises
owned by or rented to you.
;(115 ~VL
CG 20 26 11 85
Copyright, Insurance Services Office, Inc., 1984
ACOBlt. CERTIFICA~ OF LIABILITY INSUr-\NCE 0::;>
URANCE AGENCY THIS CER11FICAlE IS ISSUED AS A MATTER OF INFORMAnON
ONLY AND CONFERS NO RIGHTS UPON THE CER11FICATE
HOlDER. THIS CERTIFlCAlE DOES NOT AIlEND, EXTEND OR
ALlER 1HE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
THE POUClES OF INSUAANCE USTEO BElOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. N01WITHSTANDlNO
ANY REOUlREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIT1-I RESPECT TO WHICH THIS CERllACATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE PCll.IClES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, exQ.USIONS AND CONDITIONS OF SUCH
POUClES. AOOREOATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO a.AlMS.
,If'!I\\' lYPEOFl1l8URANCE POUCYIlUIII8I!R ~ ~~
:..!!"ER"L I.JA8LJTY
X COMMERCIAl GENERAL UABtUTY
,-U CLAIMS MADE 00 OCCUR
A_
SHOULD NfYOfIlIlaMOVlDDCIlIHD POl.IC881CANCI!UED -.oRl!THEEXPlRAlIOM
DATE 1HERIOF. 'fItE"UING 1H8UMR WILL I!NDI!AVOR TO MAIL 30 DAYS WAITTEH
NOT1CnO 1IlIe CERTlFlCAft ItOUlER NAIII!D TOTHI! LEFT, 8UI' FAILURE TO DO 1O.wJ.
lIII'OIE NO O8l.JGAnON OR UA8LITY OF MY lORD UPOtI ~ 1N8URER, ITS AGENT8 DR
R!PRI!sl!NrAnvES. A ~ ..",... _ I
AUT'MORIZI!D REPRI!8Efn'ATlW / , , ',/It,
("'---l.". II
It ACORO" CORPORATION 1988
GlendllIe
818 244-1144
CA 91209
_UIlID
INSURER A: AmerICan Econom lneul'llnce Com n
... INSURER B: National Union Fire Insurance Com n
INSURER c:
INllOREfl 0:
INSUAEA E:
Phoenix Group Inform..lon System8
2670 North Main Street, 1200
Santa
COVERAGES
CA92706
O2BP5090162
UMIT8
$
S
S
S
GENERAL AGGREGATE S
PRODUCTS. COMPIOP AGO S
1011flOO7
1011/2008
EACH OCCURRENCE
FIRE DMlABE (Mj one ftre)
MED EXP (Any -1*Mlfl)
PERSONAl. & ArN IHJURY
-
~L~UMIT N'P~S PER:
IXIPOlIC'fI I~ , ILOC
~UAIIIUTY
I--NlYAUTO
'-- AU. OWNED AUTOS
A -:- SCHEDUlED AUTOS
-! HIRED AUT08
.!. NON-OWNED AUTOS
'--
A-2005-037
^ ..........- ......... ....
A-2006- 62
^ ")nnc IC") n.
A-2006-026
COMBINED SINGLE LNIT
(Ea lDXIIrd)
028P5090162
101112008
900ILY INJURY
(per pel'IClll)
1011/2007
IlOOlI. Y IHJURY
cPir ..ndenI)
I'ROPERTY DAMAGE
(Per accIdentl
~GAIIAGE.I.IAIIlUTY
MlV AUTO
/'/9' P
EXCH8UAaJTY ~.7
=:J"OCCUR 0 CLAlMSMAbE" ~ .....
AUTO ONLY - EA ACCIDENT
EA ACe
NaG
S
S
S
$
S
S
$
$
~llv~
10f112OO8 E.L EACH ACCIDENT $
E.L DISEASE. EA EMPLOYEE $
E.L DISEASE. POlICY LIMIT $
$1,000,000
1111812007 per Occurrence
$25.000Deductlble
DE8CflIPllDN OF 0PeRA11DNSI\.OCA11ON8M!HlCt.I!lI/EXQ UIlIOHI ADIlI!D BY ENDOR8EMENTIlPEClAL PROYIIIOllS
It Is under8tooc:l and agreed that the c.urlcate Hold.. named below Is named Addlttonal
Insured w/regard to General Liability Coveragee.
All rights of subrogation are waived a8 respects the c.tIffcate Holder by the Workers'
Compenaatlon Insurance Carrier.
I
OTHER THAH
AUTO ONLY:
=i:e
-;
EACH OCCURRENCE
AGGREGATE
s
WDRICI!RI COWINeAnON AND
1IIPLOVER8' LlAaITY
A
01 WC1 0818020
10f1flOO7
ernEA
A Commercial Crtme Policy
009858183
1111&12008
CERnFICATE HOLDER I I ADDmOIW..IN8URED;IN8URERLEr1l!R:
87
CANCEU,A,l1ON
City of Santa Ana
Attention: Yolanda Bautista
60 Civic Center Plaza
Santa ~
ACORD 26-8 (7117)
LM: LPW v1 .9.8 on 9i12107 . 13:06 by UserName
CA 92702
LP: l.PW .1.9.8 on 11/12107 - 13:09 by UserName
2.000.000
300.000
10.000
2.000.000
4.000.000
4,000,000
S
2,000,000
$
s
$
1,000,000
1,000,000
1.000.000
--
PF .1.0.1
\
-
IMPORTANT
If the certlftcate holder is an ADDITIONAL INSURED, the poIicy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the tenns and conditiOns of the policy, certain policies may
require an encJorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsernent(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authoriZed representative or producer. and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 26-8 (7/97)
Ltot lPW v'.1l.8 on 9t'12107. 13:0&1ly ~
\.P; lPW vl.9.8 on 9fl2I07 . 13:09 by UserName
PF v1.o.1