Loading...
DS Technical Training & Consulting 2015; QuestAGREEMENT FOR PROFESSIONAL SERVICES FOR TECHNICAL TRAINING AND CONSULTING This Agreement is made and entered into this 3I5 i day of March, 2015, by and between the CITY OF SAN RAFAEL (hereinafter "CITY"), and Quest Media and Supplies, Inc. (hereinafter "CONTRACTOR"). RECITALS WHEREAS, CITY needs to train its staff on Windows7, Office 2010, and other computer topics, and lacks the resources to conduct such training; and WHEREAS, CONTRACTOR has the expertise to provide training in Windows 7, Office 2010, and other computer topics to CITY staff; AGREEMENT NOW, THEREFORE, the parties hereby agree as follows: 1. PROJECT COORDINATION. A. CITY'S Project Manager. The CITY's IT Manager is hereby designated the PROJECT MANAGER for the CITY, and said PROJECT MANAGER shall supervise all aspects of the progress and execution of this Agreement. B. CONTRACTOR'S Project Director. CONTRACTOR shall assign a single PROJECT DIRECTOR to have overall responsibility for the progress and execution of this Agreement for CONTRACTOR. Ray Aldrich is hereby designated as the PROJECT DIRECTOR for CONTRACTOR. Should circumstances or conditions subsequent to the execution of this Agreement require a substitute PROJECT DIRECTOR, for any reason, the CONTRACTOR shall notify the CITY within ten (10) business days of the substitution. 2. DUTIES OF CONTRACTOR. CONTRACTOR shall perform the duties as described in the Scope of Services attached as Exhibit A hereto. DUTIES OF CITY. CITY will provide space on City property or at other facilities in the City of San Rafael equipped with the necessary equipment for CONTRACTOR to perform the required services, and k Ff 1v.. 17.,�,, p Rev. Date: 1!30114 I Ll h will pay the compensation to CONTRACTOR as provided in Paragraph 4. 4. COMPENSATION. For the full performance of the services described herein, CITY shall pay CONTRACTOR at the hourly rate of $95.00 per hour, or such greater hourly rate as may be agreed upon in writing by the parties, and will pay CONTRACTOR's expenses in connection with such services, provided that the total amount paid to CONTRACTOR for its services and expenses will not exceed $20,000.00. Payment will be made monthly upon receipt by PROJECT MANAGER of itemized invoices submitted by CONTRACTOR. 5. TERM OF AGREEMENT. The term of this Agreement shall be for 4 months(s) commencing on April 1, 2015 and ending on July 31, 2015. Upon mutual agreement of the parties, and subject to the approval of the City Manager the term of this Agreement may be extended for an additional period of up to 12 months. 6. TERMINATION. A. Discretionary. Either party may terminate this Agreement without cause upon thirty (30) days written notice mailed or personally delivered to the other party. B. Cause. Either party may terminate this Agreement for cause upon fifteen (15) days written notice mailed or personally delivered to the other party, and the notified party's failure to cure or correct the cause of the termination, to the reasonable satisfaction of the party giving such notice, within such fifteen (15) day time period. C. Effect of Termination. Upon receipt of notice of termination, neither party shall incur additional obligations under any provision of this Agreement without the prior written consent of the other. D. Return of Documents. Upon termination, any and all CITY documents or materials provided to CONTRACTOR and any and all of CONTRACTOR's documents and materials prepared for or relating to the performance of its duties under this Agreement, shall be delivered to CITY as soon as possible, but not later than thirty (30) days after termination. 7. OWNERSHIP OF DOCUMENTS. The written documents and materials prepared by the CONTRACTOR in connection with the performance of its duties under this Agreement, shall be the sole property of CITY. CITY may use said property for any purpose, including projects not contemplated by this Agreement. 8. INSPECTION AND AUDIT. Rev. date: 110/14 Upon reasonable notice, CONTRACTOR shall make available to CITY, or its agent, for inspection and audit, all documents and materials maintained by CONTRACTOR in connection with its performance of its duties under this Agreement. CONTRACTOR shall fully cooperate with CITY or its agent in any such audit or inspection. 9. ASSIGNABILITY. The parties agree that they shall not assign or transfer any interest in this Agreement nor the performance of any of their respective obligations hereunder, without the prior written consent of the other party, and any attempt to so assign this Agreement or any rights, duties or obligations arising hereunder shall be void and of no effect. 10. INSURANCE. A. Scope of Coverage. During the term of this Agreement, CONTRACTOR shall maintain, at no expense to CITY, the following insurance policies: 1. A commercial general liability insurance policy in the minimum amount of one million dollars ($1,000,000) per occurrence/two million dollars ($2,000,000) aggregate, for death, bodily injury, personal injury, or property damage. 2. An automobile liability (owned, non -owned, and hired vehicles) insurance policy in the minimum amount of one million dollars ($1,000,000) dollars per occurrence. 3. If any licensed professional performs any of the services required to be performed under this Agreement, a professional liability insurance policy in the minimum amount of two million dollars ($2,000,000) per occurrence/four million dollars ($4,000,000) aggregate, to cover any claims arising out of the CONTRACTOR's performance of services under this Agreement. Where CONTRACTOR is a professional not required to have a professional license, CITY reserves the right to require CONTRACTOR to provide professional liability insurance pursuant to this section. 4. If it employs any person, CONTRACTOR shall maintain worker's compensation and employer's liability insurance, as required by the State Labor Code and other applicable laws and regulations, and as necessary to protect both CONTRACTOR and CITY against all liability for injuries to CONTRACTOR's officers and employees. CONTRACTOR'S worker's compensation insurance shall be specifically endorsed to waive any right of subrogation against CITY. B. Other Insurance Requirements. The insurance coverage required of the CONTRACTOR in subparagraph A of this section above shall also meet the following requirements: 1. Except for professional liability insurance, the insurance policies shall be specifically endorsed to include the CITY, its officers, agents, employees, and volunteers, as Rev. date: 1/30/14 additionally named insureds under the policies. 2. The additional insured coverage under CONTRACTOR'S insurance policies shall be primary with respect to any insurance or coverage maintained by CITY and shall not call upon CITY's insurance or self-insurance coverage for any contribution. The "primary and noncontributory" coverage in CONTRACTOR'S policies shall be at least as broad as ISO form CG20 0104 13. 3. Except for professional liability insurance, the insurance policies shall include, in their text or by endorsement, coverage for contractual liability and personal injury. 4. The insurance policies shall be specifically endorsed to provide that the insurance carrier shall not cancel, terminate or otherwise modify the terms and conditions of said insurance policies except upon ten (10) days written notice to the PROJECT MANAGER. 5. If the insurance is written on a Claims Made Form, then, following termination of this Agreement, said insurance coverage shall survive for a period of not less than five years. 6. The insurance policies shall provide for a retroactive date of placement coinciding with the effective date of this Agreement. 7. The limits of insurance required in this Agreement may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and noncontributory basis for the benefit of CITY (if agreed to in a written contract or agreement) before CITY'S own insurance or self-insurance shall be called upon to protect it as a named insured. 8. It shall be a requirement under this Agreement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be available to CITY or any other additional insured party. Furthermore, the requirements for coverage and limits shall be: (1) the minimum coverage and limits specified in this Agreement; or (2) the broader coverage and maximum limits of coverage of any insurance policy or proceeds available to the named insured; whichever is greater. C. Deductibles and SIR's. Any deductibles or self-insured retentions in CONTRACTOR's insurance policies must be declared to and approved by the PROJECT MANAGER and City Attorney, and shall not reduce the limits of liability. Policies containing any self-insured retention (SIR) provision shall provide or be endorsed to provide that the SIR may be satisfied by either the named insured or CITY or other additional insured party. At CITY's option, the deductibles or self-insured retentions with respect to CITY shall be reduced or eliminated to CITY's satisfaction, or CONTRACTOR shall procure a bond guaranteeing payment of losses and related investigations, claims administration, attorney's fees and defense expenses. D. Proof of Insurance. CONTRACTOR shall provide to the PROJECT Rev. date: 1/30/14 MANAGER or CITY'S City Attorney all of the following: (1) Certificates of Insurance evidencing the insurance coverage required in this Agreement; (2) a copy of the policy declaration page and/or endorsement page listing all policy endorsements for the commercial general liability policy, and (3) excerpts of policv language or specific endorsements evidencing the other insurance requirements set forth in this Agreement. CITY reserves the right to obtain a full certified copy of any insurance policy and endorsements from CONTRACTOR. Failure to exercise this right shall not constitute a waiver of the right to exercise it later. The insurance shall be approved as to form and sufficiency by PROJECT MANAGER and the City Attorney. 11. INDEMNIFICATION. A. Except as otherwise provided in Paragraph B., CONTRACTOR shall, to the fullest extent permitted by law, indemnify, release, defend with counsel approved by CITY, and hold harmless CITY, its officers, agents, employees and volunteers (collectively, the "City Indemnitees"), from and against any claim, demand, suit, judgment, loss, liability or expense of any kind, including but not limited to attorney's fees, expert fees and all other costs and fees of litigation, (collectively "CLAIMS"), arising out of CONTRACTOR'S performance of its obligations or conduct of its operations under this Agreement. The CONTRACTOR's obligations apply regardless of whether or not a liability is caused or contributed to by the active or passive negligence of the City Indemnitees. However, to the extent that liability is caused by the active negligence or willful misconduct of the City Indemnitees, the CONTRACTOR's indemnification obligation shall be reduced in proportion to the City Indemnitees' share of liability for the active negligence or willful misconduct. In addition, the acceptance or approval of the CONTRACTOR's work or work product by the CITY or any of its directors, officers or employees shall not relieve or reduce the CONTRACTOR's indemnification obligations. In the event the City Indemnitees are made a party to any action, lawsuit, or other adversarial proceeding arising from CONTRACTOR'S performance of or operations under this Agreement, CONTRACTOR shall provide a defense to the City Indemnitees or at CITY'S option reimburse the City Indemnitees their costs of defense, including reasonable attorneys' fees, incurred in defense of such claims. B. Where the services to be provided by CONTRACTOR under this Agreement are design professional services to be performed by a design professional as that term is defined under Civil Code Section 2782.8, CONTRACTOR shall, to the fullest extent permitted by law, indemnify, release, defend and hold harmless the City Indemnitees from and against any CLAIMS that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of CONTRACTOR in the performance of its duties and obligations under this Agreement or its failure to comply with any of its obligations contained in this Agreement, except such CLAIM which is caused by the sole negligence or willful misconduct of CITY. C. The defense and indemnification obligations of this Agreement are undertaken in addition to, and shall not in any way be limited by, the insurance obligations contained in this Agreement, and shall survive the termination or completion of this Agreement for the full period of time allowed by law. Rev. date: 1130x"14 5' 12. NONDISCRIMINATION. CONTRACTOR shall not discriminate, in any way, against any person on the basis of age, sex, race, color, religion, ancestry, national origin or disability in connection with or related to the performance of its duties and obligations under this Agreement. 13. COMPLIANCE WITH ALL LAWS. CONTRACTOR shall observe and comply with all applicable federal, state and local laws, ordinances, codes and regulations, in the performance of its duties and obligations under this Agreement. CONTRACTOR shall perform all services under this Agreement in accordance with these laws, ordinances, codes and regulations. CONTRACTOR shall release, defend, indemnify and hold harmless CITY, its officers, agents and employees from any and all damages, liabilities, penalties, fines and all other consequences from any noncompliance or violation of any laws, ordinances, codes or regulations. 14. NO THIRD PARTY BENEFICIARIES. CITY and CONTRACTOR do not intend, by any provision of this Agreement, to create in any third party, any benefit or right owed by one party, under the terms and conditions of this Agreement, to the other party. 15. NOTICES. All notices and other communications required or permitted to be given under this Agreement, including any notice of change of address, shall be in writing and given by personal delivery, or deposited with the United States Postal Service, postage prepaid, addressed to the parties intended to be notified. Notice shall be deemed given as of the date of personal delivery, or if mailed, upon the date of deposit with the United States Postal Service. Notice shall be given as follows: TO CITY's Project Manager: TO CONTRACTOR's Project Director: 16. INDEPENDENT CONTRACTOR. Gus Bush City of San Rafael 1400 Fifth Avenue P.O. Box 151560 San Rafael, CA 94915-1560 Ray Aldrich 5822 Roseville Road Sacramento, CA 95842 For the purposes, and for the duration, of this Agreement, CONTRACTOR, its officers, Rev. date: 1/30/14 agents and employees shall act in the capacity of an Independent Contractor, and not as employees of the CITY. CONTRACTOR and CITY expressly intend and agree that the status of CONTRACTOR, its officers, agents and employees be that of an Independent Contractor and not that of an employee of CITY. 17. ENTIRE AGREEMENT -- AMENDMENTS. A. The terms and conditions of this Agreement, all exhibits attached, and all documents expressly incorporated by reference, represent the entire Agreement of the parties with respect to the subject matter of this Agreement. B. This written Agreement shall supersede any and all prior agreements, oral or written, regarding the subject matter between the CONTRACTOR and the CITY. C. No other agreement, promise or statement, written or oral, relating to the subject matter of this Agreement, shall be valid or binding, except by way of a written amendment to this Agreement. D. The terms and conditions of this Agreement shall not be altered or modified except by a written amendment to this Agreement signed by the CONTRACTOR and the CITY. E. If any conflicts arise between the terms and conditions of this Agreement, and the terms and conditions of the attached exhibits or the documents expressly incorporated by reference, the terms and conditions of this Agreement shall control. 18. SET-OFF AGAINST DEBTS. CONTRACTOR agrees that CITY may deduct from any payment due to CONTRACTOR under this Agreement, any monies which CONTRACTOR owes CITY under any ordinance, agreement, contract or resolution for any unpaid taxes, fees, licenses, assessments, unpaid checks or other amounts. 19. WAIVERS. The waiver by either party of any breach or violation of any term, covenant or condition of this Agreement, or of any ordinance, law or regulation, shall not be deemed to be a waiver of any other term, covenant, condition, ordinance, law or regulation, or of any subsequent breach or violation of the same or other term, covenant, condition, ordinance, law or regulation. The subsequent acceptance by either party of any fee, performance, or other consideration which may become due or owing under this Agreement, shall not be deemed to be a waiver of any preceding breach or violation by the other party of any term, condition, covenant of this Agreement or any applicable law, ordinance or regulation. 20. COSTS AND ATTORNEY'S FEES. The prevailing party in any action brought to enforce the terms and conditions of this Rev. date: 1/30/'14 Agreement, or arising out of the performance of this Agreement, may recover its reasonable costs (including claims administration) and attorney's fees expended in connection with such action. 21. CITY BUSINESS LICENSE / OTHER TAXES. CONTRACTOR shall obtain and maintain during the duration of this Agreement, a CITY business license as required by the San Rafael Municipal Code CONTRACTOR shall pay any and all state and federal taxes and any other applicable taxes. CITY shall not be required to pay for any work performed under this Agreement, until CONTRACTOR has provided CITY with a completed Internal Revenue Service Form W-9 (Request for Taxpayer Identification Number and Certification). 22. APPLICABLE LAW. The laws of the State of California shall govern this Agreement. IN WITNESS WHEREOF, the parties have executed this Agreement as of the day, month and year first above written. CITY OF SAN RAFAEL CONTRACTOR 1, 11 "Al 11 NANCY MA KLE, City Manager ATTEST: G - gr --c ESTHER C. BEIRNE, City Clerk APPROVED AS TO FORM: ROBERT F. EPSTEIN, City Attorney Rev. date: 1/30/14 :w Name: f,.a..a.�: �. �.. ✓� r Title: Scope of Services OVERVIEW Quest is pleased to provide Professional Consulting Services, as outlined in this Scope of Services, dated January 30, 2015. The content of this Scope of Services is based on our current understanding of the City of San Rafael's (Client's) business objectives and requirements. SERVICE REQUESTED Quest will supply Client with the necessary skill sets to address the tasks/technologies listed below. The Quest -supplied consultant will be under the direction of Client management and tasks will be assigned and tracked by Client management. Consulting Services for a Technical Consultant to assist Client in: - Windows 7 training - Office 2010 training - Other computer training (to be determined) DESCRIPTION OF SERVICES This engagement between Client and Quest is for Consulting Services. The Quest - supplied consultant will be under the direction of Client to perform any task as identified by Client providing advanced notice of request for service. Services are based on dispatch Monday — Friday, 8:00 am — 5:00 pm schedule, with minimum 4 hours for onsite work, and any deviations from this agreed upon schedule will be discussed and agreed on by both parties prior to initiation. Rates may be increased for services outside of this schedule. Services provided after-hours are billed at 1.5 times the rate quoted. Exhibit A ® DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE I(131 3/20G5 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(les) 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 endorsement(s). PRODUCER CONTACT NAME: Michelle Robinson John 0. Bronson Co. / #0425149 PHONE FAX, 916-48(1-41;8 IA X, Nal; 916-` 93-72�h 3636 American Riser Drive Shite. 200 E-MAIL Sacramento, CA 95864 ADDRESS.;..inrobinsonl,r'iohnobrcroson.cclur 916-974-7800 INSURERS) AFFORDING COVERAGE NAIL # INSURER A: National Fire Ins of Hartford (CNA, San Francisco) .INSURED Quest Niedia and Supplies Inc INSURER„B: Valley, Forge Ins Co (CNA, SanFrancisco, CA) INSURER C; American Casualty Co of'Readingr, PA (CNA, SF) PO Box 41039 INSURER D l ravclers Property Casualty Co (Saeiamento. t etI Sacramento, CA 95841 INSURER E Axis Surplus Insurance Co 159c6us. Stn Francisco) INSURER F: COVERAGES CERTIFICATE BER: 20343 REVISION BER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DDIYYYY) (MMIDDIYYYYI GENERAL LIABILITY I EACH OCCURRENCE S 1,000,000 40_64905_ 1 1 01 15 1101 16 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurreme) S 550,000 CLAIMS -MADE X OCCUR MED EXP (Any one pernc n; S 10,000 A X PERSONAL & ADV INJURY 5 1.000.000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP, OF AGG S 2,000,000 POLICY [ I ,PF® 7 LOC S I A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I (Ea S 1.000,000 4026490504 UOIr'15 1101,16 I BODILY INJURY (Per I S X ANY AUTO person B ALL OWNED SCHEDULED X I BODILY INJURY (Pee aeodent) S _ AUTOS AUTOS NON -OWNED I PROPERTY DAMAGE $ _ HIRED AUTOS AUTOS (Per acc.denu $ UMBRELLA LIAR I X OCCUR 4026490518 1:01 15 1,01 16 EACH OCCURRENCE S 10,000,000 C X EXCESS LIAB CLAIMS -MADE AGGREGATE S 10,000.000 DED I I RETENTIONS S WORKERS COMPENSATIONX WC STATU- I OFTR EMPLOYERS' AND LIABILITY YIN 9D58069A 15 101,15 1'Olr' 16 ANY PROPRIETORIPARTNER)EXECUTIVE NIA E.L. EACH ACCIDENT S 1,000,000 D OFFICER/MEMBER EXCLUDED? I 1,000,000 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POL.CY LMIT S 1,000,000 ECN22553201 32814 32815 E Professional Liability Per Act'Aggregate Limit: 55,000,000 Deductible $25,000 - Claim Made Policy DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) RE: IT Services Add'i City of San Rafael, its officers, agents, employees and volunteers Interests: forms: G 140331 B 0109, CA2048 0299, WC990376A CERTIFICATE HOLDER • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit Of San Rafael THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 1400 Fifth avenue AUTHORIZED REPRESENTATIVE San Rafael, CA 94915-1560 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Named Insured: Quest Media and Supplies Inc Policy Number: 4026490521 G -140331-B CNA(Ed. 01 /09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE (OPTIONAL) Name of Additional Insured Person(s) Or Organizations (As required by written contract/agreement per Paragraph A. below.) City of San Rafael, its officers, agents, employees and volunteers Address: 1400 Fifth avenueSan Rafael, CA 94915-1560 Location(s) of Covered Operations (As per the written contract/agreement, provided the location is within the "coverage territory" of this Coverage Part.) IT Services (Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.) A. Section II - Who Is An Insured is amended to include as an additional insured any person(s) or organization (s), including any person or organization shown in the Schedule above, whom you are required to add as an additional insured on this Coverage Part under a written contract or written agreement, provided: a. The written contract or written agreement was executed prior to: 1. The "bodily injury" or "property damage"; or 2. The offense that caused the "personal and advertising injury" for which the additional insured seeks coverage under this Coverage Part; and b. The written contract or written agreement pertains to your ongoing operations or "your work" for the additional insured(s). B. The insurance provided to the additional insured is limited as follows: 1. The 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: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insured(s) or c. "Your work" that is included in the "products -completed operations hazard" and performed for the additional insured, but only if this Coverage Part provides such coverage, and only if the written contract or written agreement requires you to provide the additional insured such coverage. G -140331-B Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 2 (Ed. 01/09) CNA 2. However, we will not provide the additional insured any broader coverage or any higher limit of insurance than the least of those: a. Required by the written contract or written agreement; b. Described in B.1. above; or c. Afforded to you under this policy. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract or agreement requires this insurance to be primary. In that event, this insurance will be primary relative to insurance which covers the additional insured as a named insured. We will not require contribution from such insurance if the written contract or written agreement also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. 4. The insurance provided to the additional insured terminates when your operations for the additional insured are complete. But if the written contract or written agreement specifies a date until which this insurance must apply, then this insurance terminates: a. On the date specified in the written contract or written agreement; or b. When this policy expires or is cancelled, whichever occurs first. C. With respect to the insurance afforded to the additional insured, the following additional exclusions apply. This insurance does not apply to: G -140331-B (Ed. 01/09) premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this Coverage Part. D. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 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 E specifications; and b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury," "property damage," or "personal and advertising injury" arising out of any 1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an "occurrence" or an offense which may result in a claim or "suit" under this insurance, and of any claim or "suit" that does result; (2) Tender the defense and indemnity of any claim or "suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part; (3) Except as provided in Paragraph B.3 of this endorsement, agree to make available any other insurance the additional insured has for a loss we cover under this Coverage Part; and (4) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or "suit." We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or "suit." 2. With respect only to the insurance provided by this endorsement, the first sentence of Paragraph 4.a. of the Other Insurance Condition is deleted and replaced with the following: 4. Other Insurance a. Primary Insurance This insurance is primary and non- contributory except when rendered excess by this endorsement, or when Paragraph b. below applies. The provisions of the written contract or written agreement do not in any way broaden or amend this Coverage Part. G -140331-B Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 2 of 2 (Ed. 01/09) NAMED INSURED: Quest Media and Supplies Inc POLICY NUMBER: 4026490504 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 03/23/15 Named Insured: Countersigned By: SCHEDULE Name of Person(s) or Organization(s): City of San Rafael, its officers, agents, employees and volunteers 1400 Fifth avenueSan Rafael, CA 94915-1560 (Authorized Representative) (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 ❑ AW TRAVELERS J WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A)— POLICY NUMBER: 9D58069A15 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium. Schedule Person or Organization City of San Rafael, its officers, agents, employees and volunteers Address 1400 Fifth avenueSan Rafael, CA 94915-1560 Job Description IT Services 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.) Endorsement Effective 03/23/15 Policy No. Insured Quest Media and Supplies Inc Insurance Company Travelers Property Casualty Company Countersigned by Endorsement No. Premium Page 1 of 1 300179 0 A�® CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDDM(YY) � 04'21r20li 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 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: Michelle Robinson John O. Bronson Co. A Division of HUB International r'#0757776 PHONErtl 9161180 4158 I FAX. No): 916-993-7258 3636 American River Drive Suite 200 E-MAIL Sacramento, CA 95864 AODREss: michelle.robinson@hubiutentationaLcom 916-974-7800Sacramento, I INSURER(S) AFFORDING COVERAGE NAIC # DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: 1T Services Add'[ City of San Rafael, its officers, agents, employees and volunteers - 10 Day Notice of Cancellation for Non -Payment of Premium Interests: Forms: G140331B 0109, CA2048 0299, WC990376A CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of San Rafael THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 1400 Fifth Avenue AUTHORIZED REPRESENTATIVE San Rafael, CA 94915-1560 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD INSURER A : National Fire Ins of Hartford (CNA, San Francisco) INSURED Quest Media and Supplies Inc INSURER B : Valley Forge Ins Co (CNA, San Francisco, CA) INSURER C : American Casualty Co of Reading, PA (CNA, SF) PO Box 41039 I INSURER D : Travelers Property Casually Co (Sacramento. CA) Sacramento, CA 95841 I INSURER E : Axis Sttrolus Insurance Co (Socius. San Francisco) INSURER F: COVERAGES CERTIFICATE NUMBER: 20343 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 LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP IMMIDDIYYYYI (MMIDD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY 4026490521 1x'01 r' 15 1 `01;16 I DAMAGE TO RENTED PREMISES (Ea occurrence) 5 550,000 CLAIMS -MADE a OCCUR I MED EXP (Any one person) $ 10,000 A X I PERSONAL. & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER I PRODUCTS-COMPiOP AC;G $ 2,000,000 PF. LOC I 5 POLICY AUTOMOBILE LIABILITY A BINED SINGLE LIMIT COMaccident) s I (Ea 1.000.000 4026490504 X UO1r 15 U01 16 I BODILY INJURY (Per person) S ANY AUTO B ALL OWNED SCHEDULED X BODILY INJURY (Per accident) S AUTOS AUTOS _ NON -OWNED I PROPERTY DAMAGE s _ HIRED AUTOS AUTOS (Per accident) 5 UMBRELLA LIAB OCCUR 4026490518 1%01/15 1/01/16 EACH OCCURRENCE s 10,000,000 C X EXCESS LIAB CLAIMS -MADE AGGREGATE 5 10,000,000 I I I DED RETENTIONS s WORKERS COMPENSATIONI X I WC STATU- I 1OTH- AND EMPLOYERS' LIABILITY YIN N 9D58069A15 1101/15 1/01/16 TnRY I IMITS FR 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE NIA X E.L. EACH ACCIDENT 5 D OFFICER/MEMBER EXCLUDED? ❑ 1,000,000 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE S It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 5 1,000,000 ECN22551501 3x28/15 3/28/16 E Professional Liability Per Act/Aggregate Limit: $5,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: 1T Services Add'[ City of San Rafael, its officers, agents, employees and volunteers - 10 Day Notice of Cancellation for Non -Payment of Premium Interests: Forms: G140331B 0109, CA2048 0299, WC990376A CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of San Rafael THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 1400 Fifth Avenue AUTHORIZED REPRESENTATIVE San Rafael, CA 94915-1560 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD Named Insured: Quest Media and Supplies Inc Policy Number: 4026490521 G -140331-B CNA(Ed. 01/09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE (OPTIONAL) Name of Additional Insured Person(s) Or Organizations (As required by written contract/agreement per Paragraph A. below.) City of San Rafael, its officers, agents, employees and volunteers - 10 Day Notice of Cancellation for Non -Payment of Premium Address: 1400 Fifth AvenueSan Rafael, CA 94915-1560 Location(s) of Covered Operations (As per the written contract/agreement, provided the location is within the "coverage territory" of this Coverage Part.) IT Services (Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.) A. Section II - Who Is An Insured is amended to include as an additional insured any person(s) or organization (s), including any person or organization shown in the Schedule above, whom you are required to add as an additional insured on this Coverage Part under a written contract or written agreement, provided: a. The written contract or written agreement was executed prior to: 1. The "bodily injury" or "property damage"; or 2. The offense that caused the "personal and advertising injury" for which the additional insured seeks coverage under this Coverage Part; and b. The written contract or written agreement pertains to your ongoing operations or "your work" for the additional insured(s). B. The insurance provided to the additional insured is limited as follows: 1. The 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: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insured(s) or c. "Your work" that is included in the "products -completed operations hazard" and performed for the additional insured, but only if this Coverage Part provides such coverage, and only if the written contract or written agreement requires you to provide the additional insured such coverage. G -140331-B Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 2 (Ed. 01/09) �aYA7713 2. However, we will not provide the additional insured any broader coverage or any higher limit of insurance than the least of those: a. Required by the written contract or written agreement; b. Described in B.1. above; or c. Afforded to you under this policy. 3. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract or agreement requires this insurance to be primary. In that event, this insurance will be primary relative to insurance which covers the additional insured as a named insured. We will not require contribution from such insurance if the written contract or written agreement also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. 4. The insurance provided to the additional insured terminates when your operations for the additional insured are complete. But if the written contract or written agreement specifies a date until which this insurance must apply, then this insurance terminates: a. On the date specified in the written contract or written agreement; or b. When this policy expires or is cancelled, whichever occurs first. C. With respect to the insurance afforded to the additional insured, the following additional exclusions apply. This insurance does not apply to: G -140331-B (Ed. 01/09) premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this Coverage Part. D. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 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 E specifications; and b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury," "property damage," or "personal and advertising injury" arising out of any 1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an "occurrence" or an offense which may result in a claim or "suit" under this insurance, and of any claim or "suit" that does result; (2) Tender the defense and indemnity of any claim or "suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part; (3) Except as provided in Paragraph B.3 of this endorsement, agree to make available any other insurance the additional insured has for a loss we cover under this Coverage Part; and (4) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or "suit." We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or "suit." 2. With respect only to the insurance provided by this endorsement, the first sentence of Paragraph 4.a. of the Other Insurance Condition is deleted and replaced with the following: 4. Other Insurance a. Primary Insurance This insurance is primary and non- contributory except when rendered excess by this endorsement, or when Paragraph b. below applies. The provisions of the written contract or written agreement do not in any way broaden or amend this Coverage Part. G -140331-B Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 2 of 2 (Ed. 01/09) NAMED INSURED: Quest Media and Supplies Inc POLICY NUMBER: 4026490504 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 04i21115 Named Insured: Countersigned By: SCHEDULE (Authorized Representative) Name of Person(s) or Organization(s): City of San Rafael, its officers, agents, employees and volunteers - 10 Day Notice of Cancellation for Nan -Payment of Premium 1400 Fifth AvenueSan Rafael, CA 94915-1560 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0 TRAVELERS. WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ; ENDORSEMENT WC 99 03 76 ( A) — POLICY NUMBER: 9D58069A15 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium. Schedule Person or Organization City of San Rafael, its officers, agents, employees and volunteers - 10 Day Notice of Cancellation for Non -Payment of Premium Address 1400 Fifth AvenueSan Rafael, CA 94915-1560 Job Description IT Services 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.) Endorsement Effective 04"121/15 Policy No. Endorsement No. Insured Quest Media and Supplies Inc Premium Insurance Company Travelers Property Casualty Company Countersigned by T"" O— Page 1 of 1 CNA CNA PARAMOUNT Renewal Insured Name: QUEST MEDIA AND SUPPLIES INC. P.O. BOX 41039 SACRAMENTO, CA 95841-1039 Policy Number: 4026490521 Producer's information: JOHN O. BRONSON CO., INC. 3636 AMERICAN RIVER PO BOX 255387 (95865) SACRAMENTO, CA 95864 (916)974-7800 CNA Branch Number: 250 Effective Date: 01/01/2015 Policy Period: 01/01/2015— 01/01/2016 Producer Code: 073506 CNA Branch Name and Address: SAN FRANCISCO 555 MISSION ST., STE 200 SAN FRANCISCO, CA 94105 (415)932-7500 0 Thank you for choosing CNAI With your CNA Paramount package policy, you have insurance covetage tailored to meet the needs of your modern business. The International network of insurance professionals and the financial strength of CNA, rated "A" by A.M. Best, provide the resources to help you manage the daily risks of your organization so that you may focus on what's most important to you. § Claim Services—There When You Need Us a Claims are reported through a single point of entry available 2417, connecting you to the individuals and Information to help you resume your business when you need it most. To reports claim, please call (877) CNA -ASAP, fax (800) 953-7389, email lossreport@cnaasap,com, or visit www.cna.comlclalm. Risk Control Services — Help Avoid A Claim Before it Occurs As a CNA policyholder, you have access to certifled risk control professionals, risk mitigation programs and online resources to help identify and manage exposures that may disrupt your operation. We collaborate with business leaders to develop customized programs to assist you in safeguarding your assets and Improving the bottom line. To learn how our award-winning Risk Control services can help your business, please call (866) 262-0540, email us at rlskcontrolwebinfo®cna.com or visit www.cna.com/riskcontrol. When It comes to providing the coverage, service and resources paramount to your business success ... we can show you more. INSURED Copyright CNA Atl Righis Reserved. CNA I I. CNA PARAMOUNT A. Policyholder Notices CNA PARAMOUNT Schedule of Forms and Endorsements k Form Tltte (Policy Holder Notice - Countrywide Policy Holder Notice - Countrywide Policy Holder Notice - Florida Policy Holder Notice - Florida Policy Holder Notice - Florida Policy Holder Notice - Florida `IMP INF Economic And Trade Sanctions Condition Important Information Imp Info For Insureds Who Hire Subcontractors PolloyNumber: 40264905211 Form Number Form Edluon CNA6282OXX 09--12 CNA62823XX 09-12 CIIA62926FL 09-12 CNA62827FL 09-12 CNA62828PL 09-12 CRA62829FL 09-12 G145041A 05-03 G147201A 12-04 C44120B 11-04 CNA62640XX 09-12 Page 1 o 3 Copyright CNA AU FUghts Reserved. P,o1'icy- ; 4; i,j' = �' a ;. tiJ,� , �J>, y ,�, �_ «. •, , , ,Terms&�Cgndiiions .:; $ Policy Declarations CNA62639XX 09•-12 0 Schedule of Forma and Endorsements CNA6264OXX 09-12 Common Terms and Conditions CNA6264= 09-12 First Party Glossary of Defined Terms CNA62641XX 09-12 First Party Terms and Conditions CNA62647XX 09-12 :�I' POLICY,COVERAGE,;PARTS• -" :'r'.; .; •�;;s ?.i+�,�;-: ,s3• v;S., tl' . � �=�a,'�,t�. � G: 'r. '" �• - .J _, ,.a , ..... ___ _ ;7 .r � •s •:,: •- '�'i"•t ' •.?. A; Bus�nass' Proper yti`"`` ; v �_.. '.;:;rr' .�.;' , K� 'g vt•r .�•..+JS .`� .. :i* •r; • JI ',:;rap.;1 ,' ;': , . . c .•. ,. ,Business Property Coverage Part Declarations CRA62643XX 09-12 Business Property Schedule of Coverages and Limits CXA62645XX 09-12 Business Property Schedule of Locations CNA62644XX 09-12 Business Property Coverage Part CNIL6264M 09-12 Business Income and Extra Expense Equipment CNA62652XX 09-12 Breakdown Deductible Endorsement Technology Property Extension Endorsement - CA CNA62665CA 12-13 , CNA62640XX 09-12 Page 1 o 3 Copyright CNA AU FUghts Reserved. CAM CNA PARAMOUNT Schedule of Forms and Endorsements Form ittla • :,.. " _ _ : -. � ; _ , -, _ •1=:� ;�.: ::, � - .-� : '' . � - Sinkhole Collapse Endorsement - Florida Earthquake Endorsement (Sub -limit) - California Earthquake Endorsement (Sublimit) Legal Liability Coverage Endorsement Notice to Policyholders Jurisdictional Inspections Policy Number: 4026490521 1 Form Number: '-,k'.- ' ' Form Edition•. - _ , CNA62702FL 09-12 CNA62705CA 12-13 CNA62705XX 09-12 CNA62724XX 09-12 01471211 02-14 �. - '� 'f 1 TI'• 1 • 1�i, •1• �••kN t��r• �.�1, • ,�, J ��,4 r�,x�'i"'M,••i. _ d0-•:,,'IIIland ,Marir�a:� s';' �i, �.l r! .�•Y.-;'.:'N .+:fL;�,�y, o:.. , - ._5' °' 41'7Y_?6,...'''a`3.,'a. V:. Inland Marine Coverage Part Declarations 055232 01-97 Contractora Equipment Declaration -Policy Level 0300665B 11-09 Contractors Equipment Declaration -Add Cov and Ext C300666B 11.-09 Commercial Inland Marine Conditions CM0001 09-04 Loss Payable Provision IGIS028A 08-89 Contractors Equipment Coverage Form 1044080H 111-09 ty} '� �. I• �.,. r _ ,• � y• :J .!; �t 1.:t�' �'v; :' i-' " �� i.' �L _ `�'� •1" i N. .. _. s'.:' General Liability Coverage Part Declaration P55170A 01-86 SCHEDULE CG 2404 G56015B 11-91 FORM 0138921C G56015B i1-91 Employee Benefits Liability Supplemental Schedule G15104A 10-89 Commercial General Liability Coverage Form CG0001 04-13 Employment -Related Practices Exclusion CO2147 12-07 Cap on Losses for Certified Acts of Terrorism CG2170 01-08 Exclusion - Contractors - Professional Liability CO2279 07-98 Waiver -Trans Rights Recovery Against Others To Us CG2404 05-09 Designated Construction Project(s) - Genl Agg CG2503 05-09 Designated Location(s) General Aggregate Limit CG2504 05-09 California Changes CG3234 01-05 Amendatory Endorsement - Pollution Exclusion G132263B 11-04 Noncontractors Additional Insured Endorsement G134802C 11-04 Amdt of Ina Agree -Known or Continuing Inj or Damg 0136080A 02-00 CNA6264OXX 09-12 Page 2 of 3 Copyright CNA All Rights Reserved. La Q 8 8 CNA CNA PARAMOUNT Schedule of Forms and Endorsements Form Title •- Exclusion - Construction Wrap -Up Program `Exclusion -Subsidence (Blanket Addl Insd - Owner, Lessee Cntratr - w/C-O Fungi/Mold/Mildew/Yeast/Microbe Exclusion -Contract Technology General Liability Extension Endt Exterior Finish System Prod/Comp Ops Exclusion Residential Construction Defect PCO Exclusion Exclusion - Asbestos Employee Benefits Liability Coverage Premium Bases Policy Number: 4026490521 1 Form Number Form Edition G136107A 03-00 0138931C 02-05 0140331D 01-13 G14256IA04 06-02 G144294C99 12-06 G300250A 02-06 G136106D 02-05 G43316C 06-98 G43815C 08-01 G55157B 02-88 IIL : POLTGY ENDORSEMENTS- ' �':' . 'zr• :-s=. ; j�'s .;.'.' : r gr_ `, ter'. •'t ' .. Amendment to Policy Declarations- Named Insured CNA6270OXX 09-12 Endorsement Bridge Endorsement CNA62646XX 09-12 Cancellation / Non -Renewal - California CNA62814CA 09-12 Amendatory Endorsement - California CDTA62815CA 09-12 Cap on Losses from Certified Acts of Terrorism CNA62691XX 09-12 Endorsement Coordination of Deductibles G1.23096C 9.2-06 Economic And Trade Sanctions Condition G144191A 03-03 Nuclear Energy Liab Exclusion Endt (Broad Form) IL0021 04-96 California Changes - Actual Cash Value IL0102 05-05 CNA62640XX 09-12 Page 3 o 3 Copyright CNA All Rights Reserved. _ =- -• - POLICY NUMBER INSURED NUB AND ADDRESS C 4026490521 QUEST MEDIA AND SUPPLIES INC. P.O. BOA 41039 SACRAMENTO, CA 95841-1039 In return for the payment of the premium, and subject to all the terms and conditions contained here -in, we agree to provide the insurance as stated. LIMITS OP INSURANCE DESCRIPTION LIMIT Each Occurrence $1,000,000 Personal & Advertising Injury $1,000,000 Medical Expense - Any One Person $5,000 Damage To Premises Rented To You Limit $550,000 Products/Completed Operations Aggregate $2,000,000 General Aggregate $2,000,000 Employee Benefits Liability Coverage Each Employee $1,000,000 Aggregate $1,000,000 SCHEDULE OS' LOCATIONS AND COVERAGES PRmalu i ESTIMATED COVERAGE AWARD DESCRIPTION EXPOM=- BASIS RATE PREUIM POLICY 15EMM COV89WES Fire Damage Legal Liability - Increased Limits Technology General Liability Extension Endorsement Subcontractors Blanket Additional Insured Class Code 41675 Computer Consulting or Programming. Products - completed operations are subject to the General Aggregate Limit. Premises & Operations INSURED Page 2 of 4 4 l , ^w�Ih �ce Ire 11i„ul;N PROFESSIONAL SERVICES AGREEMENT/CONTRACT COMPLETION CHECKLIST AND ROUTING SLIP Below is the process for getting your professional services agreements/contracts finalized and executed. Please attach this "Completion Checklist and Routing Slip” to the front of your contract as you circulate it for review and signatures. Please use this form for all professional services aLrreements/contracts (not just those requiring City Council approval). This process should occur in the order presented below. Step Responsible Department 1 City Attorney 2 ; Contracting Department 3 Contracting Department 4 City Attorney 5 City Manager 11 Mayor / or Department .Head 6 City Clerk Description Review, revise, and comment on draft agreement. Forward final agreement to contractor for their signature. Obtain at least two signed originals from contractor. Agendize contractor -signed agreement for Council approval, if Council approval necessary (as defined by City Attorney/City Ordinance*). Review and approve form of agreement; bonds, and insurance certificates quid endorsements. Agreement executed by Council authorized official. City Clerk attests signatures, retains original agreement and forwards copies to the contracting department. Completion Date -olLi�r„�,I %--I 'a ASL- Cwq,, clu cc . ro 31rbs Ail,t OA5 To be completed by Contracting Department: Project Manager: _Gus Bush Project Name:—Technical Computer Training Agendized for City Council Meeting of (if necessary): N/A .................... If you have questions on this process, please contact the City Attorney's Office at 485-3080. * Council approval is required if contract is over $20,000 on a cumulative basis.