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HomeMy WebLinkAboutUNISHIELD (ARGO ENTERPRISES, INC.) (2) {NSURA4NCE ON FILE wogK MAY PRnCFFr) N-2024-193-Q1 CITY CLERK iWEAN 0 7 2026 FIRST AMENDMENT TO AGREEMENT WITH ARCO ENTERPRISES,INC.DBA 0,JiM M UNISHIELD TO PROVIDE FIRST AID SUPPLIES AND SAFETY TRAINING SERVICES Sum111ya"Pi) THIS FIRST AMENDMENT to the above-referenced agreement is entered into on November 5,2025 by and between Argo Enterprises, Inc.,a California corporation dba UniShield("Contractor")and the City of Santa Ana,a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California("City"). RECITALS A. The parties entered into Agreement#N-2024-193,dated May 22,2024("Agreement")by which Contractor agreed to provide first aid supplies and safety training services. The term of the Agreement runs through June 30,2026. The Agreement is current and in-effect. B. The parties now wish to amend the Agreement to increase the overall compensation. No other changes are contemplated by this First Amendment. C. This fast amendment is prepared for approval by the City Manager under his authority provided in Santa Ana Municipal Code Section 2-748(a)(2). The Parties therefore agree: l. Section 2,a., Compensation, is amended to increase the overall compensation by S 10,000. The total amount to be expended under the term of this Agreement,including any extensions exercised by the parties,shall not exceed$60,000, 2. Except as modified by this First Amendment, all terms and conditions of the Agreement shall remain in full force and effect. ATTEST CITY OF TA ANA L.HAb k VARO NUNEZ City Clerl City Manager APPROVED AS TO FORM CONTRACTOR Sonia R.Carvalho City Attorney r � � ON SALVATIERRA MARK WDEVIT Assistant City Attorney Owner RECOMMENDED FOR APPROVAL �2-c`�r-fvG LORI SCHNAIDER Executive Director Human Resources Department 0 DATE{MMIDD/YYYY)R CERTIFICATE OF LIABILITY INSURANCE 05/1212025 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((es)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 endorsements. PRODUCER CONTACTJulia Traughb_er,CISR,CLCS _ Pacific Agents Alliance Insurance Agency; Julie Traughber Insurance Agenl 1 50.N10 F (818)203=2209 rA/c,No)! (626)799-7051 524 S Rosemead Blvd ADDRESS: julie@julletraughberins.com uliet hberins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC tF Pasadena CA 91107 INSURERA: CONTINENTAL CASUALTY COMPANY 20443 INSURED -INSURERS: Argo Enterprises,Inc.dba: UniShield INSURERC: — .4 599 4th St INSURER D: _ T INSURER E t San Fernando CA 91340 INSURER F: COVERAGES 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. INSR — - ADDL SUBR -- -- - POLICY EFF POLICY EXP ---- LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDJYYnL LIMITS - X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE [/ ,,OCCUR CIAMAGE TO RENTED - PREMISES Ea occurrenre $ 300,000 MFD FXP(Any one person) $ 10,000 A T X X B6024759005 03124/2025 03124/2026 PERSONAL&ADV INJURY $ 1,00D,000 ��GIE/EN'L AGGREGATE LIMIT APPLIES PER: � GENERAL AGGREGATE $ 2,000,000 /1 POLICY PRO- n JECT Ls I LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident_ - I $ _ ANY AUTO BODILY INJURY(Per person) ,$ B OWNED SCHEDULED BODILY INJURY(Per accident) $ H RED ONLY AUTOS PROPERTY DAMAGE MIRED NON-OWNED -'-$ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCC_UR_R_ENGE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE B6024759019 03/24/2D25 03/24/2026 AGGREGATE $ 3,000,000 DED X RETENTION 10,000 -Y $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE,_ ER- _ ANY PROPRIETO WPARTNERIEXECUTiVE CFFICERIMEMBER EXCLUDED? NIA E.L EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 11 yes,describe under DESCRIPTION OF OF OPERATIONS below E_L_DISEASE-POLICY LIMIT $ Employee Dishonesty, $1,000 deductible $25,000 A Forgery and Alteration 86024759005 03124/2025 03/24/2026 $1,000 deductible $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 161,A(loltional Remarks schedule,may be attached if more space is Mquired) It is agreed that the City of Santa Ana,its officers,officials,employees and volunteers are named Additional Insureds with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials,parts or equipment furnished in connection with such work or operations. General Liability Form CG 2026(04113)is attached.This insurance is also Primary and Non-Contributory with respect to insurance or self-insurance programs maintained by the City per Farm No.CG2001 (01104)attached. Any insurance or self-insurance maintained by the Entity,its officers,officials, employees or volunteers shall be excess of the Contractoras insurance and shall not contribute with it per CG2404(10193)attached. It is also agreed that 30 Days'Notice of Cancellation with 10 Days'Notice for Non-Payment of Premium in accordance with the policy provisions. All coverages are subject to the terms and conditions CERTIFICATE HOLDER APPROVED CANCELLATION By TO Tran Nguyen at 9:47 am,Jun 09,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dysanvs��ed ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana TLI Tran by Tu Tran Nguyen Risk Management Division Ng Uyen Da We 2025.06.09 AUTHORIZED REPRESENTATIVE 09:aa:56-m-00 20 Civic Center Plaza y Santa Ana CA 92701 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: _ LOC#: ACAOR" ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Poolflc Agents Affiance Insurance Agency; Julie Traughber Insurance Agent Argo Enterprises,Inc.dba; Uni5hield POLICY NUMBER CARRIER NAIL CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance coverages are subject to the terms and Conditions of each policy. email:tnguyan20@santa-anaxrg i ACORD 101 (2000101) Q 2008 ACORD CORPORATION.All rights reserved. The ACORD name and loge are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE OA7E(MMrDBIYYYY) 0 511 4/2 0 2 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, TIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THIS POLICIES H 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 AD131T10NAL 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 right$to the certificate holder In lieu of such endorsements . PRODUCER Auto Insurance Specialists WON 1AU PO BOX 10160 Nicole Moreno Santa Ana CA 92711•a73a PHONE 865-570-7335EdYlA14 F X Nn'000-498.3293 ADDRESS:commercial@aisinsurance.com INSURERS AFFORDING COVE RApa NAIC# INSURED Argo Enterprises,Inc. INSURERA i United Financial Casualty Co. 11770 DBA:Unishleld INSURER B: --- 599 Fourth Street INSURER C; San Fernando CA 01340 INSURER D: INSURER E; SURERF: • COVERAGES CERTIFICATE NUMBER; REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUJ O TO THE IN8URE0 NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH REBP>CT Tp 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 WAVE BEEN REDUCED BY PAID CLAIMS, IiSR TYPE OF INSURANCE DOL ER PDLppY EF POLIC HXP OL CYNU BER LIMITS OOMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ GLAIMS.MADE OCCUR "AGPREMISES Ea a t rre o $ MED EXP Any one person $ PERSONAL a ADV INJURY $ GEN'LAGGREGATELIMITAPPLIESPER:POLICY LOC GENERAL AGGREGATE $ PRO• ElJECT PRODUCTS•COMPIOP AGO $ OTHER; -- $ AIJTOMOBILELIASIL17Y OMBI D SINGLE L I ANYAUTG EEL C=14ontj $ 1,000,000 $ OWNED SCHEDULED BODILY INJURY(Per person) A A 974240806 6/14/2025 5/14/2026 AUTOS ONLY AUTOS BODILY INJURY{Par sccltient) $ HIRED NONAUTOS N L PP OBE�RdJR�AMAOF $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB HOCCUR EACH OCCURRENCE EXCESSLIAE $ a CLAIM&MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ST,T TE RH ANYPROPRIETORIPARTNERIEXE CUTIVE E,L.EACH ACCIDENT $ OFF104RIMEMBEREXCLUDED7 NIA (Mandatory In NH) if yyes desalba antler E.L.DISEASE•EA EMPLOYEE $ DESGtRI ION OF OPERATIONS below E,L,DISEASE-POLICY LIMIT $ D DESCRIPTION OF OPERATIONS!LOCATIONS IVEHICLES(ACORD 101,AddlSonal Remarks schedule,may bo allaahed If more apace la requlrad) Waiver of Subrogation applies. Automobile Liability(AL). ISO From Number CAA 00 01 covering any auto (Code 1),or if Contractor has no owner autos,hired,(Code 8)and non-owned auto(Code 9),with a limit no less than$1,000,000 per accident for bodily APPROVED Injury and property damage. I4y Tu Tran Nquyen at 9:47 am,Jun 09,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Aria THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE lO 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACa CERTIFICATE OF LIABILITY INSURANCE FDArE(MMioorvvvY) �� 05/3 012 0 2 5 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 CONTACT NAME: Automatic Data Processing Insurance Agency, Inc. Automatic Data Processing Insurance Agency, Inc. pH do Ext: 1-800-524-7024 E-MAIL ADDRESS: 1 Adp Boulevard INSURER(S)AFFORDING COVERAGE NAIC# Roseland NJ 07068 INSURER A: Employers Assurance Company 25402 INSURED Argo Enterprises Inc INSURER B: INSURER C: DBA:DBA Unishield INSURER D: 599 4th Street INSURER E: San Fernando CA 91340 INSURERF: COVERAGES CERTIFICATE NUMBER: 4345199 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 TC ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR _ POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM1DDIYYYY MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR A. A D PREMISES Ea occurrence 5 MED EXP(Any one person) 5 PERSONAL&ADV INJURY 5 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY F7 PROJECT LOC PRODUCTS-COMPIOPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED S9NGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB _ CLAIMS-MADE AGGREGATE $ DED RETENTION$ 5 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y f N STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,.000,000 A OFFICERIMEMBER EXCLUDED? NIA Y EIG111702616 10/15/2024 10/15/2025 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE S 1,000,000 Ir yes,describe under 1 ooO,1oQa DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) This certificate has a blanket Waiver of Subrogation for the following state(s):CA APPROVED By Tu Tran Nguyen at 9:48 am,Jun 09,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA,Attn:RISK MANAGEMENT DIVISION, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 45TH FL. ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA AUTHORIZED REPRESENTATIVE 11 ti Santa Ana CA 92702 J7l )'I�I — I O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: B6024759005 COMMERCIAL GENERAL LIABILITY CO 20 26 0413 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 Organization(s); Clty of Santa Ana, eta] Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section Ill — Who Is An Insured is amended to S. With respect to the Insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance, with respect.to liability for "bodily injury", "property If coverage provided to the additional insured is damage" or "personal and advertising injury" required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. Required by the contract or agreement; or 1, In the performance of your ongoing operations; or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown In the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable Limits of Insurance shown in the Insured only applies to the extent permitted by Declarations, law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured, CO 20 26 04 13 0 Insurance Services Office, Inc„2012 Wage I of 1 POLICY NUMBER: B6024759005 COMMERCIAL,GENERAL LIABILITY CG 24 0410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE DEAD IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Santa Ana,etas (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement,) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV— COMMER- CIAL GENERAL LIABILITY CONDITIONS)is amended by the addition of the following: 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 0410 93 Copyright, Insurance Services Office, Inc., 1992 Paige 1 of 1 0 Policy No. B6024769005 COMMERCIAL GENERAL LIABILITY CG20010413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REACT 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 (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this Insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other Insurance available to an additional insured under your policy provided that; (1) The additional Insured is a Famed Insured under such other insurance;and CG 20 01 0413 0 Insurance Services Office, Inc.,2012 Page 1 of 1 AIS INS SPECIALISTS ,P,R99RAAFff1YAFm PO BOX 6507 CO/Y7MERGlRL ARTESIA,CA 90702 Polity number; 974240805 Underwritten by: United Financial Cas Co ARGO ENTERPRISES, INC Insured; UNISHIELD ARGO ENTERPRISES,INC 599 FOURTH ST June 9,2025 SAN FERNANDO,CA 91340 Policy Period:Oct 16,2024-Oct 16,2025 Mailing Address United Financial Cas Co PO Box 94739 Additional insured endorsement Cleveland,CH44101 1-800-444-4487 Name of Person or Organization For customer service,24 hours a day, City of Santa Ana,city Council,off icers,employees,agents,vol 7 days a week 20 Civic Center Plaza Santa Ana,CA 92701 This endorsement modifies insurance provided under the commercial auto policy and any endorsements thereto affording liability coverage. The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and there only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page and showing liability coverage. Limit of Liability Bodily Injury Not applicable Property Damage Not applicable Combined Liability $1,000,000 each accident All other terms,limits and provisions of this policy remain unchanged. This endorsement applies to Policy Number:974240805 Issued to(Name of Insured):ARGO ENTERPRISES, INC UNISHIELD Effective date of endorsement:June 6, 2025 Policy expiration date: October 16, 2025 Form 1198(07116) I i AIS INS SPECIALISTS /R99RAAF1f1 /AFm Po BOX 6507 COMMERCIAL ARTESIA,CA 90702 Policy number: 974240805 Underwritten by, United Financial Cas Co ARGO ENTERPRISES, INC Insured; UNISHIELD ARGO ENTERPRISES,INC 599 FOURTH ST June 9,2025 SAN FERNANDO,CA 91340 Policy Period:Oct 16,2024-Oct 16,2025 Mailing Address United Financial Cas Co Po Box 94739 Cleveland,OH 44101 1-800-444-4487 For customer service,24 hours a day, 7 days a week Waiver of Subrogation Endorsement This endorsement modifies insurance provided under the following: Commercial Auto Policy Motor Truck Cargo liability Coverage Endorsement Commercial General Liability Coverage Endorsement We agree to waive any and all subrogation claims against the person or organization designated below. Name of Person or Organization: City of Santa Ana,City Council,officers,officials,employees, 20 Civic Center Plaza Santa Ana,CA 92701 This endorsement applies to policy number: 974240805 Issued to:ARGO ENTERPRISES, INC UNISHIELD Endorsement effective:June 6, 2025 Expiration: October 16,2025 All other terms, limits and provisions of this policy remain unchanged. Form 8610(02119) f:MI LO ER Workers'Compensation ion and Employers Liability Insurance Policy EMPLOYERS ASSURANCE CO. Policy Number From Policy PeriodTo A Stock Company EIG 1117026 16 10/15/gg20dd24 10/15/2025 Ins1edas'sla4edtereinmeattheaddress oftho Transaction AMENDED DECLARATIONS Effective: 10/15/2024 NCCI Carrier# 36870 WCIRB CARRIER# 00919 PRIOR POLICY NUMBER EIG1 1 1 70261 5 1. Named Insured and Address Agent ARGO ENTERPRISES INC ADP- FLORHAM PARK-SERVICE 0033001 DBA UNISHIELD FLORHAM PARK-SERVICE 599 4TH STREET 1 ADP BLVD., MIS 625 SAN FERNANDO CA 91340 ROSELAND, NJ 07068 Telephone: 8005247024 Customer# Carrier# FEIN# Risk ID# Entity of Insured 36870 954718550 CORPORATION Additional Locations: 2. The Policy Period is from 10/15/2024 to 10/15/2025 12:01 a.m. Standard Time at the Insured's mailing address. 3. A. Workers Compensation Insurance: Part ONE of the policy applies to the Workers Compensation Law of the states listed here: CA B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part TWO are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: All states except ND, OH, WA, WY and states listed in item 3.A. D. This policy includes these endorsements and schedules: See attached schedule. 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. SEE EXTENSION OF INFORMATION PAGE Minimum Premium $ 750 Expense Constant $ 160 Premium Discount $ Assessments and Taxes $ Total Estimated AnnualPremium $ 8,656 ❑ This is a Three Year Fixed Rate Policy Premium Adjustment Period: ® Annual; ❑ semiannual; ❑ Quarterly; ❑ Monthly Countersigned this Da of g Y Issued Date: 02/03/2025 Authorized Representative Issuing Office EMPLOYERS ASSURANCE CO. P.O. BOX 539003 HENDERSON, NV 89053-9003 issued Date 02/03/2025 INSURED COPY WC990630 (5/98 Ed.) j Page 1 of 3 i i�wI �� lif~� WORKERS'COMPENSATION AND EMPLOYERS call LIABILITY INSURANCE POLICY EMPLOYERS ASSURANCE CO. Policy Number: EIG 1117026 16 A Stock Company Named Insured: ARGO ENTERPRISES INC P.O.BOX 539003 HENDERSON,NV 89063-9003 Agent: ADP-FLORHAM PARK-SERVICE 0033001 EXTENSION OF INFORMATION PAGE CLASSIFICATION OF OPERATIONS Premium Basis Rate Per Estimated Code Total Est.Annual $100 of Annual No. Classification Description Remuneration Remuneration Premium California Rating Period: 10/15/2024 through 10/15/2025 Site 00001 8018 STORES-WHOLESALE 34,642 12.650000 4,382,00 8742 SALESPERSONS-OUTSIDE 605,949 0.690000 4,181.00 8810 CLERICAL OFFICE EMPLOYEES-N.O.C. 237,050 0,480000 1,138.00 Site 00001 Total $ 9,701.00 Total of Sites for Rating Period $ 9,701.00 Rating Period Total $ 9,701.00 Rating Period: 10/15/2024 through 10/15/2025 0930 WAIVER OF SUBROGATION 9,701 0,020000 250.00 9887 SCHEDULE CREDIT 9, 951 0.240000 -2,388.00 0900 EXPENSE CONSTANT 160.00 0936 STATE W.C. FRAUD ASSESSMENT 8,162 0.004122 34.00 0935 STATE W.C. ADMINISTRATIVE ASSESSMENT 8,162 0.024604 201.00 0937 CA INSURANCE GUARANTY 8,162 0938 CA UNINSURED EMPLOYERS FUND 8,162 0.001505 12.00 0939 CA SUBSEQUENT INJURY FUND 8,162 0 .015891 130.00 0940 OSHF ASSESSMENT 8,162 0.007266 59.00 0943 LABOR ENFORCEMENT & COMPLIANCE 8,162 0.007109 58.00 9741 CATASTROPHE PREMIUM 877,641 0.020000 176.00 9740 TERRORISM PREMIUM 877,641 0.030000 263.00 Rating Period Total $ 1,04 5.0 0- State Total $ 8,656.00 Policy Total $ 8,656.00 Issued Date 02/03/2025 INSURED COPY WC990630 (5198 Ed.) Page 2of3 ACC CERTIFICATE OF LIABILITY INSURANCE DATE(MMfRDMfYY► 1 212 2120 2 5 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 CONTACT NAME: Marsh Affinity Marsh Affinity AIG No,Ext: 800 743 61 30 AIC,No): a division of Marsh USA LLC. E-MAIL gDPTo[alSource@marsh.com PO BOX 14404 ADDRESS: Des Moines,IA 50306-9686 INSURERS)AFFORDING COVERAGE NAIC# INSURER A: AIU Insurance Company 19399 INSURED INSURER B: ADP TotalSource DE IV,Inc. INSURER C: 5800 Windward Parkway INSURER D: Alpharetta,GA 30005 LICIF: INSURER E: ARGO ENTERPRISES,INC. INSURER F: 599 4th St San Fernando,CA 91340 COVERAGES 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. INSR TYPEOFINSURANOI; ADDLISUBRI POLICY NUMBER POLICYEFF POLICY EXP LIMITS LTR INSD WVR (MMIDDIYYYY) (MMIDDIYYYY) COMMERCIAL GENERAL LIABILITY FACH OCCURRENCE $ CLAIMS-MADE ❑OCCUR DAMAGETORENTED $ PREMISES Ea occurrence MFD FRCP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑JECTPRO �LOG PRODUCTS-COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Par accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Par accident $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY YIN X ISTATUTE ER p ANYPROPRIETOR/PARTNERIEXECiJTIVE E.L.EACH ACCIDENT $ 2,000,000 A [Mandatory in NH}EXCLUDED? NIA X WC 063579091 CA 10/15/2025 07/01/2026 E L.DISEASE-EA EMPLOYEE $ 2,000,000 f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 Pigltallysl ned by - DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) iu ffan g yen All workslte employees working fur ARGO ENTERPRISES,INC.paid under ADP TOTALSOURCE,1NC.`s ry nate:202G 1.05 payroll,are covered under the above stated policy,ProprietodPannedExecutive ORcerlMember are Nguyen uyen 16:25117-0 VOW not excluded as long as they are In the ADPTS payroll or have completed the SEl Participation Addendum,WAIVER OF SUBROGATION IN FAVOR OF CERTIFICATE HOLDER AS RESPECTS OF JOB PERFORMED BY ARGO ENTERPRISES,INC.AS REQUIRED BY WRITTEN CONTRACT. APPROVE® By Tu Tran Nguyen at 4:24 pm,Jan 06 2026 CERTIFICATE HOLDER CANCELLATION City of Santa Ana ATTN:Human Resource Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana,CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE .6. ACORD 26(2016103) ©1988-2016 ACORD.CORPO ION.'.AII rights reserved. The ACORD name and logo are registered marks of ACORD - BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 10/15/2025 12:01 AM forms a part of Policy No. WC 063579097 CA Issued to ADP TotalSource DE IV, Inc. 5800 Windward Parkway Alpharetta, GA 30005 UCIF: ARGO ENTERPRISES, INC. 599 4th St San Fernando, CA 91340 By AIU Insurance Company We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be_% of the total estimated workers compensation premium for this policy. ANY PERSON OR ORGANIZATION TO WHOM YOU BECOME OBLIGATED TO WAIVE YOUR RIGHTS OF RECOVERY AGAINST, UNDER ANY CONTRACT OR AGREEMENT YOU ENTER INTO PRIOR TO THE OCCURRENCE OF LOSS i WC 04 03 61 Countersigned by_ y (Ed. 11190) AuthorizeV Representative I