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FD Audit of Recycling & Resource Recovery AssociationAGREEMENT FOR PROFESSIONAL SERVICES FOR AUDIT OF MARIN RECYCLING & RESOURCE RECOVERY ASSOCIATION This Agreement is made and entered into this x157 day of December, 2015, by and between the CITY OF SAN RAFAEL (hereinafter "CITY"), and Maher Accountancy, a corporation (hereinafter "CONTRACTOR"). RECITALS WHEREAS, CITY's Amended Hazardous Waste Collection Program Agreement with Marin Recycling & Resource Recovery Association ("MRRRA") provides for a periodic audit of MRRRA's records related to its expenses, profit and revenues under the Agreement; and WHEREAS, CONTRACTOR has the expertise to perform the required audit; AGREEMENT NOW, THEREFORE, the parties hereby agree as follows: 1. PROJECT COORDINATION. A. CITY'S Project Manager. The Environmental Management Coordinator 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. John W. Maher 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 and/or provide the audit services provided for in the Agreement with MRRRA, as more Tully described in the CONTRACTOR's Proposal dated November 16, 2015, attached hereto as Exhibit "A", with a target completion date on or before January 29, 2016. 3. DUTIES OF CITY. CITY shall pay the compensation as provided in Paragraph 4, and cooperate with CONTRACTOR in conducting its audit services. 4. COMPENSATION. For the full performance of the services described herein by CONTRACTOR, CITY shall pay CONTRACTOR a flat fee of $12,500.00. Payment will be made upon receipt of an invoice submitted to PROJECT MANAGER by CONTRACTOR following delivery to PROJECT MANAGER of the report specified in Exhibit «A" 5. TERM OF AGREEMENT. The term of tlus Agreement shall be for a period commencing on the execution of this Agreement and ending on February 29, 2016. 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 sixty (60) days. 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. 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 ($1,000,000) per occurrence/four million dollars ($2,000,000) 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 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. 4 D. Proof of Insurance. CONTRACTOR shall provide to the PROJECT 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 policy 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. 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: Courtney Scott City of San Rafael Fire Department 1039 C Street San Rafael, CA 94915-1560 John W. Maher Maher Accountancy 1101 Fifth Avenue, Suite 200 San Rafael, CA 94901 16. INDEPENDENT CONTRACTOR. For the purposes, and for the duration, of.this Agreement, CONTRACTOR, its officers, 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 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. JC TZ ESTHER C. BEIRNE, City Clerk APPROVED AS TO FORM: 2 ROBERT F. EPSTEIN, City Attorney CONTRACTOR r' i N. atme ohn % � i ah& Title: President i in r r 4, 'i fl il' 1101 CATH AVENUE • surrE 200 • SAN RAFAEL, CA 94901 November 16, 2015 Jim Schutz, City Manager City of San Rafael 1400 Fifth Avenue, Room 203 San Rafael, California, 94901 Dear Mr. Schutz: This letter is to document our understanding of the services Maher Accountancy is to provide to San Rafael Fire Department regarding its contract Nvith Marin Recycling & Resource Recovery Association (MRRRA) dated January 26, 2012. Our objective will be to provide assurance as to the accuracy of invoices presented by testing transactions supporting invoices presented by MRRRA for the period of July 1, 2012 through June 30, 2015. Our services will be performed in accordance with attestation standards established by the American Institute of Certified Public Accountants. It is anticipated that our tests will include the following: TEL 415.459.1249 FAX 415.459.5406 WEB www.mabarpa.com Personnel costs a. Gain an understanding of the payroll and employee benefit system for MRRRA b. Select a sample of payroll transactions and: i. Inspect time card and recalculate gross pay ii. Agree employee name to list of program employees iii. Verify that no overtime costs are charged to the program iv. Trace to evidence of payment c. Inspect evidence of cost of health insurance d. Perform analytical procedures to validate the cost of payroll taxes e. Inspect evidence in support of charges for retirement benefits 2. Direct expenses a. Gain an understanding of procedures that ensure only appropriate expenditures are charged to the program. b. Select a sample of direct expenditures and i. Trace to supporting vendor invoice and verify 1. rkmount 2. Program relationship 3. Appropriateness of classification 4. evidence of authorization 5. Evidence of payment E,*1 4 A Jim Schutz, City Manager November 16, 2015 Page 2 I elm a. Make inquiry and obtain documentation about sources of data and method of allocating costs. b. Test mathematical accuracy of computations. c. Consider reasonableness of methodology and result. 4. Program revenues: a. Gain an understanding of the procedures in place to ensure that all program -related revenue is included in invoices. b. Confirm BOP revenue (as defined in the contract) with County. c. Develop and perform analytical procedures to gain assurance that revenues from Small Quantity Generators are reasonable. Our report will specify the actual procedures performed and will indicate significant Endings made. Such report will not express an opinion on the fairness of any financial statements. The report will be intended solely for use of management of San Rafael Fire Department, MRRRA and Marin County Hazardous and Solid Waste Management JPA and should be used only by those who have agreed to the procedures and have taken responsibility for the sufficiency of the procedures for their purposes. Our fee for the above services will be $12,500 under the assumption that documentation is maintained in an orderly and accessible manner. Should we encounter circumstances which we believe require additional time as the result of poor condition of records or if our procedures indicate issue for which we believe additional testing is warranted, we will notify you prior to performing such additional services. Please indicate your approval of these terms by signing this letter in the space provided and returning it as the authority to begin our services, Very truly -yours, Spr Maher Accoutita'n,cy jolirr-W—Matier, CP I President Lo ACC)R ® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 12/09/2015 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: Christi Spina(9666513) ((AICN PHONE Ex 415-382-9714 la NoL 415-382-9027 3900 Mayette Ave E-MAIL ADDRESS: rqpina0farmersaDjail(co Santa Rosa CA 95405-7227 INSURED MAHER ACCOUNTANCY 1101 5TH AVE SUITE 200 , INSURER(S) AFFORDING COVERAGE _ INSURERA: Truck Insurance Exchange INSURER B : Farmers Insurance Exchange INSURER C: Mid Century Insurance Company INSURER D: INSURER E : NAIC tf 21709 21652 21687 SAN RAFAEL CA 94901 m 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 INSURER D: INSURER E : NAIC tf 21709 21652 21687 SAN RAFAEL CA 94901 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 1 rA DDL SUER! P OLICY EFF I POLICYlEXP TYPE OF INSURANCE LTR INSR WVD POLICY NUMBER I (MMIDD/YYYYI (MMIDD/YYYYI LIMITS GENERAL LIABILITY 111 EACH OCCURRENCE $ 1,000,0001 R X COMMERCIAL GENERAL LIABILITY TO RENTED DAMAGESJEa occurrence) $ PREMISES j 75,000 I CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 A Y N 055876276 02/22/2015 02/22/2016 PERSONAL &ADV INJURY s 11000,000 GENERAL AGGREGATE ) $ 2,000,000 t. AGGREGATE LIMIT APPLIES PER, ! PRODUCTS - COMPIOP AGG s 1,000,000 PFO . i ....� .. X POLICY ,LOC I S AUTOMOBILE LIABILITY.... AUT .�! ` accidn SINGLE LIMIT �, ..IEaaccldeng ..,, .,..o -.S. .1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED A d f 055876276 } AUTOS � AUTOS 02/22/2015 02/22/2016 BODILY INJURY (Per accident) $ NON-OWNFD X PROPERTY DAMAGE $ { HIRED AUTOS AUTOS IPer accident) i Is UMBRELLA AB OCCUR I EACH OCCURRENCE s f' EXCESS AB I. CLAIMS -MADE AGGREGATE _, $ I ( DED RETENTIONS I $ WORKERS COMPENSATION WC STATU- ' ' OTH-' AND EMPLOYERS' LIABILITY YIN l �i .ER .r V .E. ANY PROPRIMBER NIA EACH ACCIDENT s EACH ACCIDENT EXCLUDED? (Mandatory In NH) EXCLUDED? OFRCE.L DISEASE - EA EMPLOYEE S If yes, describe under �El_ DESCRIPTION OF OPERATIONS below u DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CITY OF SAN RAFAEL, ITS OFFICERS AGENTS, EMPLOYEES AND VOLUNTEERS THIS CERTIFICATE IF ISSUED AS AN EVIDENCE OF INSURANCE. CERTIFICATE HOLDER IS STATED AS ADDITIONAL INSURED. 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 1400 FIFTH AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. SAN RAFAEL, CA 94901 AUTHORIZED REPRESENTATIVE Christi Spina I ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MAHEACC-01 JJOHNSON i4CORQ DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/9/2015 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 License # OE86536 CONTACTNAME-- ----- - CONT Jena Johnson Preferred Connect Insurance Center, LLC PHONE FAX P.O. Box 85234 .(AIC, No, Ext): (888.) 656-5678 (AIC, No): (866 ) 560-9099 San Diego, CA 92138 ADDRESS: INSURED Maher Accountancy, A California Accountancy Corporation 1101 5th Avenue, Suite 200 San Rafael, CA 94901 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Preferred Employers Insurance Company 10900 INSURER B : { INSURER C : i INSURER D: I INSURER E: 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,, LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY ° POLICY EFF INSR DD S BR � IMOLICY l'YYI i CLAIMS -MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT OTHER: AUTOMOBILE LIABILITY I ANY AUTO P ALL OWNED SCHEDULED (AUTOS AUTOS NON -OWNED I HIRED AUTOS ,AUTOS UMBRELLA LIAR OCCUR V I EXCESS LIAB CLAIMS -MADE 4WD, DIED , I RETENTION $ RKERS COMPENSATION 4 V AND EMPLOYERS' LIABILITY A ANY PROPRIETORIPARTNEFVEXECUTIVE VYYN� NIA AAN145943-4 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) if yes, describe under DESCRIPTION OF OPERATIONS below a y EACH OCCURRENCE " $ DAMAGE TO RENTED PREMISES (Ea occurrence) I $ MED EXP (Any one person) i S PERSONAL & ADV INJURY $ GENERAL. AGGREGATE $ PRODUCTS - COMPIOP AGG $ S ' ICOM®INFO SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) S d BODILY INJURY (Per accident), $ PROPERTY DAMAGE S (Peraccident) EACH OCCURRENCE S AGGREGATE $ ., PER . OTH- r ...., .., X ,STATUTE , ER 04/01/2015 04/01/2016 E EACH ACCIDENT S 1,000,000 E .. DISEASE - EA EMPLOYEE, $ 1,000,005 + E DISEASE -POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of San Rafael, its officers, agents, employees and volunteers. 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 ACCORDANCE WITH THE POLICY PROVISIONS. 1400 Fifth Avenue San Rafael, CA 94901 AUTHORIZED .-REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Commercial Certificate of Insurance Agency , KEVIN BYLAND Name . 1202 GRANT AVE #E & • NOVATO (CA 94945 Address • (415) 89814370 St. 46 Dist. 66 Agent 318 Insured . JOHN MAHER dba Name . MAHER ACCOUNTANCY & - 1101 5TH t SUITE 200 Address • SAN RAFAEI., CA 94901 rua[u h"pair ►FARMERS Issue Date (MM/DD/YY) 112108x"15 u This certificate is issued as a matter of information only and' „,onfers no rights upon the certificate holder. This certificate does not amend„ extra rad or after the coverage afforded by the policies shown below. Companies Providing Coverage: Company A Truck Insurance Exchanp�c Letter Company B Farmers Insurance Exchange Letter Company C Mid Century Insurance fl' ompany Letter Company D Letter Coverages This is to certify that the oticies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or � ondition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance .. """"..° afforded by the policies clo cribed herein is subject to all the terns, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. Co' Type of Insura ice Policy Number Ltr. y Date (MMlDD.... policy Effective Policy Expiration Policy Limits iyy) Date (MM/DD/YY) Y General Liability ,General Aggregate I $ Commercial General Products Comp/OPS Aggregate $ Liability � L Personal & Occurrence Versilon Advertising Injury $ Contractual Incidental Each Occurrence S Only Fire Damage (Any one fire) S Owners & Contractors Prot. Medical Expense (Any one person) $ B x Automobile Liability 178480600 12/08/15 i12/_1/16 LCombined Single � Itttt All Owned Commercial $ 2,000,000 Autos Bodily In'ury X Scheduled Autos (Per person $ 2,000,000 x Hired Autos Bodily Injury $ 2,000,000 (Per arcident,y X Non Owned Autos Garage Liability I Property Damage $ 2,000,000 i Garage Aggregate S2,000,000 Umbrella Liabilit,� Limit g Workers' Compensation Statutory and Each Accident $ Employers' Liability Disease Each Employee ogee S Disease PolicyLimit S Description of Operation sNehicles/Restrictions/Special items: COMMERCIAL AUTO POLICY. VIN WVWML7AN3AE515106 VOLKSWAGEN CC POLICY INCLUDES OWNED, NON -OWNED, AND HIRED VEI-fICLES CERTIFICATE HOLDER IS ADDITIONAL AND DESIGNATED INSURED Certificate Holder Cancellation . CITY OF SAN RAFAEL, its officers Should any of the above described policies be cancelled before the expiration date Name . agents, employees & volunteers thereof, the issuing company will endeavor to mail 30 days written notice to the & • 1400 5TH AVENUE certificate holder named to the left, but failure to mail such notice shall impose no Address . SAN RAFA E.L, CA 94901 obligation or liability of any kind upon the company, its agents or representatives. KEVIN BOLAND __,_ _—XI�:,_zf —di Auorized Representative 56 2492 4 94 Copy Distribution: Service Center Copy and Agent's Copy Hol MAHEAC1 OP ID: JR DATE/Y)CERTIFICATE OF LIABILITY INSURANCE I 12/17/2015 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 Mitchell & Mitchell-Lic0620650 NAME: 250 Bel Marin Keys Blvd, Bid E acNNo. Ext): FAX Nol: Novato, CA 94949 E-MAIL Paul W. Morris ADDRESS* 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 RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Al THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDL'SUBR POLICY EFF POLICY EXP LTR i TYPE OF INSURANCE ill wvn POLICY NUMBER � (MMIDDIYYYYI i (MM/DDIYYYYI i LIMITS GENERAL LIABILITY EACH OCCURRENCE, S PREMISES S (RENTED COMMERCIAI. GENERAL LIABILITY r PREMISE'S (E a occurrencel S CLAIMS -MADE: OCCUR MED EXP (Any lane persarip � S PERSONAL & ADV INJURY S GENS... AGGRE GATE LIMIT APPL RE S PER PRO POLICY, , JFCT LOC AUTOMOBILE LIABILITY i ANY AUTO ALL. OWNED SCHEDULED I ,AUTOS AUTOS NON OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS,MADE V DED RETENTION $.. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N ANY PROPRIE.TORIPARTNLRYE.AEi CUTIVF OFFICLRlME:MBFR F.XCLUDLDP N I A (Mandatory In NH) If yes„ describe under DESCRIPTION OF OPERATIONS below A CProf. Liability GENERAL AGGREGATE IS PRODUCTS - COMPIOP AGG S S S COMBINED SINGLE LIMIT (Ea accident] S BODILY INJURY (Per perscnl S a BODILY INJURY (Per accidentl S PROPERTY DAMAGE (PER ACCIDE'INT) S c { EACH OCCURRENCE' S i AGGREGATE S { 5 WCSTATU- OTl TORY LIMITS FR , E.L., EACH ACCIDENT 5 E ., DISEASE - EA EMPLOYEE. S E L. DISE'iASE, • POLICY LIMIT S ,APL 275496397 01/01/2015 01/01/2016 Per Claim Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Prior Acts: 6/01/93 CERTIFICATE HOLDER City of San Rafael Lawrence Moss 1400 Fifth Ave San Rafael, CA 94901 CANCELLATION 2,000,000 4,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Paul W. Morris ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Continental Casualty INSURED Maher Accountancy John W. Maher, CPA 1101 Fifth Ave., #200 INSURER B : INSURER C: San Rafael, CA 94901 INSURER D: INSURER E: 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 RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Al THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDL'SUBR POLICY EFF POLICY EXP LTR i TYPE OF INSURANCE ill wvn POLICY NUMBER � (MMIDDIYYYYI i (MM/DDIYYYYI i LIMITS GENERAL LIABILITY EACH OCCURRENCE, S PREMISES S (RENTED COMMERCIAI. GENERAL LIABILITY r PREMISE'S (E a occurrencel S CLAIMS -MADE: OCCUR MED EXP (Any lane persarip � S PERSONAL & ADV INJURY S GENS... AGGRE GATE LIMIT APPL RE S PER PRO POLICY, , JFCT LOC AUTOMOBILE LIABILITY i ANY AUTO ALL. OWNED SCHEDULED I ,AUTOS AUTOS NON OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS,MADE V DED RETENTION $.. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N ANY PROPRIE.TORIPARTNLRYE.AEi CUTIVF OFFICLRlME:MBFR F.XCLUDLDP N I A (Mandatory In NH) If yes„ describe under DESCRIPTION OF OPERATIONS below A CProf. Liability GENERAL AGGREGATE IS PRODUCTS - COMPIOP AGG S S S COMBINED SINGLE LIMIT (Ea accident] S BODILY INJURY (Per perscnl S a BODILY INJURY (Per accidentl S PROPERTY DAMAGE (PER ACCIDE'INT) S c { EACH OCCURRENCE' S i AGGREGATE S { 5 WCSTATU- OTl TORY LIMITS FR , E.L., EACH ACCIDENT 5 E ., DISEASE - EA EMPLOYEE. S E L. DISE'iASE, • POLICY LIMIT S ,APL 275496397 01/01/2015 01/01/2016 Per Claim Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Prior Acts: 6/01/93 CERTIFICATE HOLDER City of San Rafael Lawrence Moss 1400 Fifth Ave San Rafael, CA 94901 CANCELLATION 2,000,000 4,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Paul W. Morris ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Commercial Certificate of Insurance FARM E RS i Agency KEVIN BOI.AND Name 1202 GRAT AVE #E Issue Date (TYIM/DDNY) 12�O8115 & NOVATOICA 94945 Address • (415) 898-4370 This certificate is issued as a M-atteir of information only and confers no rights i DIpon ilio ccrtificate holder. This certificate does riot amend, extend or alter the St. 96 Dist. 66 Agent 318 coverage afforded by die policies shown below. Companies Providing Coverage: Insured Company A Truck Insurance Lxchange JOHN MAH ER dba Letter Name MAHER AFCOUNTANCY Company B Farmers Insurance Exchange 1101 5TI15T, SUITE 200 letter Company C Mid-Century Insurance Compdny Address •SAN RAP /SEL, CA 9:4901 L etler D C0111pily Letter toverage-S' This is to certify that the pullck�s or insurance. listed below have been issued to the insured named above for the policy period iridlcdted. Notwithstanding requirement, term or tplridition of any contract or other document with respect to "hick this certificate may be issued or may pertain. the insurance +any afforded by the policies dey'i ibed herein is subject to all the terms, exclusions and conditions of such policies. I imits shown may have been reduced by paid claims. Co. Policy Effective Policy Expiration Type Of 111SUranco Policy Number Ltl.Date (mki/m)NY) Date (MM/DD/YY) Policy Limits General Aggregate $ General Liability Products Comp/OPS Commercial Gerivia I Aggregate Liability Personal & Occurrence Versk'An Advertising Injury Contractual I lncidental i Each Occurrence S Only Fire Damage (Any one rue) s Owners & Contractors Prot, Medical Fxpense (Any one person}I m) $ -^I B x Automobile Liability 179480600 Combined Single F08,15112) Ifl 6 Limit All Owned Ccimr6rclal S2,000,000 Autos Bodily Irth.try X Scheduled Autos (Per pprson�l $2,000,000 X I Hired Autos i Bodily Injury (Per accident) S2,000,000 X Non Owned Autos Garage Liability Property Damage S2,000,000 Garage Aggregate $2,000,000 Umbrella Liability, Limit WorkersCompensation Statutory Each Accident S and Disease Lath liniployee S Employers' Liability Disease - Policy Limit S Description of Ciperations/Velikles/ Restrict ions/Special items: COMMERCIAL AUTO F OLICY. VIN WVWML7AN3AE515106 VOLKSWAGEN CC POLICY INCLUDES ONVNFD, NON-OWNED, AND HIRED VEHICLES CERTIFICATE HOLDER IS ADDITIONAL AND DESIGNATED INSURED Certificate Holder Cancellation • CITY OF SAN RAFAEL, its officers Should any of the above described policies be cancelled before the expiration date Name agents, employecs & volunteers thereof, the issuing company will endeavor to mail 30 days written notice to the 1400 STH AVENUE certificate holder named to the left, but failure to mail such notice shall impose no Address SAN RAFAI�rL, CA 94901 obligation or liability of any kind upon the company, its agents or representatives. KEVIN TROLAND Authorized Representative �102 4 1) 1 Copy Distribution: Service Center Copy and Agent's Copy ACC?R" CERTIFICATE OF 0 I I I DATE (MM/DD(YYYY) ll 12/09/2015 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 ICONTACT NAME: _ Christi Spina(9666513) �aOHcNgl3o Wi: r FAX , -382-9027 E-MAIL �A 3900 Mayette Ave ADDRESS: c5olna(b)farmer.5.ag.0 1L= INSURERfS) AFFORDING COVERAGE NAIC,A Santa Rosa CA 95405-7227 INSURER A: Truck Insurance Exchange 21709 INSURED INSURER B: Farmers Insurance Exchange 21652 MAHER ACCOUNTANCY INSURER C: Mid Century Insurance Company 21687 1101 5TH AVE SUITE 200 INSURER D: INSURER E SAN RAFAEL CA 94901 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER (MM/DDIYYYYI 1MM/DDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY 1 CLAIMS -MADE X OCCUR A Y N 055876276 GEN'L AGGREGATE LIMIT APPLIES PER. 7 POLICY n PF n LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED A Aures AUTOS 055876276 HIRED AUTOS X AUAUTTOWNED OS UMBRELLA LIAR OCCUR EXCESS LIAR HCLAIMS-MADE DED I I RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 02/22/2015 02/22/2016 02/22/2015 02/22/2016 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CITY OF SAN RAFAEL, ITS OFFICERS AGENTS, EMPLOYEES AND VOLUNTEERS THIS CERTIFICATE IF ISSUED AS AN EVIDENCE OF INSURANCE. CERTIFICATE HOLDER IS STATED AS ADDITIONAL INSURED. DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL 8 ADV INJURY GENERAL AGGREGATE PRODUCTS - COMPIOP AGG 5 75,000 $ 5,000 $ 1,000,000 $ 2,000,000 S 1,000,000 S COMBINED accident) cIc deentSINGLE LIMIT I S 1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) 5 PROPERTY DAMAGE (Por accident) Is EACH OCCURRENCE IS (AGGREGATE S I S WC STATU- 1 I O TORY I 1 FR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT S 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 1400 FIFTH AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. SAN RAFAEL, CA 94901 AUTHORIZED REPRESENTATIVE Christi Spina I ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i--� MAHEACC-01 JJOHNSON ACORO DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/9/2015 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 otic les mu11 st 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). CONTACT ..- PRODUCER License # OE86536 NAME: Jena Johnson Preferred Connect Insurance Center, LLC PHONE() - FAX P.O. Box 85234 pAIC No, E,P:88865656%8 PAIL, No): (866) 560-9099 San Diego, CA 92138 nool ESS: INSURED Maher Accountancy, A California Accountancy Corporation 1101 5th Avenue, Suite 200 San Rafael, CA 94901 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 3OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR�P' II. Ul 'SUIU'R POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVP POLICY NUMBER aMMIDDIYYYYh WMIDDIYYYYp LIMITS COMMERCIAL GENERA L LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ,II OCCURP1•,R,ry!'I "tI" ! P f:!!iWJVEi" -. PREMISES CEa occurrence) S GEN'L AGGREGATE LIMIT APPLIES PER. .... POLICY PRO- LOC JECT OTHER ,AUTOMOBILE LIABILITY ANY AUTO ALL OWNED I " SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB B OCCUR .... EXCESS LIAB l CLAIMS -MADE DED II IRETENTION S WOPKERS COMPENSATION AND EMPLOYERS' LIABILITY A ANFICERI RIE ERIEXCLUD /E ECUTIVE YIN NIA AAN145943-4 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below MED EXP (Any one person) S PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG S S COMBINED SINGLE LIMIT $ rEa accidentX BODILY INJURY (Per person) 5 BODILY INJURY (Per accident) 5 PROPERTY DAMAGE $ y Per accidenb S EACH OCCURRENCE $ AGGREGATE $ PER O X STATUTE R � I 04/01/2015 04/01/2016 DENT EL�EACHACCIH $ 1,000,000 E L DISEASE - EA EMPLOYEE $ 1,000,000 E L DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of San Rafael, its officers, agents, employees and volunteers. CERTIFICATE HOLDER City of San Rafael 1400 Fifth Avenue San Rafael, CA 94901 ACORD 25 (2014101) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE „ 4 �Itnanr. ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MAHEACI OP ID: JR ACORO DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 12/17/2015 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 Mitchell & Mitchell-Lic0620650 PHONEI FAX 250 Bel Marin Keys Blvd, Bid E I [AIC, No. Ertl: (AIC, Not: Novato, CA 94949 E-MAIL ADDRESS: Paul W. Morris I INSURER(S) AFFORDING COVERAGE NAIC p INSURER A: Continental Casualty INSURED Maher Accountancy John W. Maher, CPA 1101 Fifth Ave., #200 San Rafael, CA 94901 INSURER 8: INSURER C: INSURER D: INSURER E: I 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVn POLICY NUMBER IMMIDDIYYYYI (MMIDDIYYYYI GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR GEN'L AGGREGATE LIMIT APPLIES PER POLICY PFO I] LOC AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS H AUTOS UMBRELLA LIABHCLAIMS-MADE OCCUR EXCESS LIAB DED I I RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below A Prof. Liability CERTIFICATE HOLDER City of San Rafael Lawrence Moss 1400 Fifth Ave San Rafael, CA 94901 EACH OCCURRENCE S DAMAGE 10 RENTED PREMISES (Ea occurrence) S I MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ Ij PRODUCTS - COMP/OPAGG $ S COMBINED SINGLE LIMIT I(Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (PER ACCIDENT) $ EACH OCCURRENCE $ (AGGREGATE$ $ WC STATU- I I OT" TS FR kEL EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ E L. DISEASE - POLICY LIMIT $ APL 275496397 01/01/2015 01/01/2016 Per Claim 2,000,000 Aggregate 4,000,000 •: ,:s; r ^: z * •• s +fes THE EXPIRATION DATE THEREOF, NOTICEDELIVERED ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Commercial Certificate of Insurance Agency KEVIN BOI.AND Nance 1202 GRANT AVE #E & NOVATO I CA 94945 Address (415),998-1370 St. 96 Dist. 66 Agent 318 Insured JOHN MAI -i ER dba Nante NIAHLR ACCOUNTANCY & I 10 1 5TI I �T, SUITE 200 Address SAN RAF, EL, CA 94901 FARMERS Issue Date (IvIM/DDNY) 112/08/15 This ceitificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or aftei the cmerage afforded by the policies shown below. Companies Providing Coverage: Z3 Company A Truck insurance f-'xchange Letter cuiiipariy B Farrners Insurance Exchange 1xilel Company C Mid -Century Insurance Conilmny Letter Company D Letter Coverages This is to (ei tify 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; onclition of any contract or Other document %ith i eippct to %� hich this certificate may be issued or may pertain, the insurance afforded by the policies dew dbed herein is subject to all the terms, exclusions and conditions of such policies. Limits ..shown may have been reduced by paid claims. Co. Policy Lffective i Policy Expiration Type Of 111SLIta9ce Policy Number Dia Date (mN.uoDiYY) Policy Limits Lit General Liability General Aggregate s Products Comp/01"S Comineruil Guie1ral Aggregate Liability Personal & Occurrence Versl on Advei Using Injury S Contractual I hicitlental Each Occurrence s Only 1� ire Damage (Any one fire) s Owners & Contractors Prot. Medical Fxpensc (Any onp person) B I x Automobile Liability 178480600 12/08 15 122/21/16 Combined Single Limit All Owned Commercial S2,000,000 Autos 6 �30dily 11 ury X Schedded Autos 'Per person) $2,000,000 x Hued Autos I Bodily Injury miffint) (Per, $2,000,000 X Non Owred A:itos Garage, Lmbilfty Propei Ly Damage S2,000,000 Garage Aourewile Q L,VUU,VUV Umbrella Liability Limit $ Workers' Compensation Statutory and Eich Acciden, s Disease Eadi Pmph)ee S Employers' Liability Disease -Policy Limit , S Description of Opciations/Vehic I es/ Rest ric1ri a ns/Special items: COMMERCIAL AUTO POLICY. VIN WVW`Ml,7AN3AE5f5106 VOLKSWAGEN CC POLICY INCLUDES OWNED, NON -OWNED, AND ITIRED VEHICI,F.S CERTFFICA rF, HOLDEJ IS ADDITIONAL AND DESIGNATED INSURED Certificate Holder Cancellation CITY OF SAN RA FA FT its officers Should any of the above described policies be cancelled before the expiration (late Name agents, ernp) ryccs & % Of unteers thereof, the Ksoing company will endeavor to mail 30 clays written notice to the & • 1400 5TH AVENUE certifiraie holder named to the left, but failure to mail such notice shall impose no AVENUE "scidress SAN RAFAVL, CA 94901 obligadIm or liability of any kind upon the company, its agents of tepresematives. , KEVIN BOLAND f7 Authorized Representative 102 191 Copy Distribution: Service Center Copy and Agent's Copy 1-101 AC 0 CERTIFICATE LIABILITY INSURANCE I DATE (MMIDDIYYYY) 12/09/2015 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: Christi Spina(9666513) I AICNo. Extl: 415-382-9714 I talc. No): 415-382-9027 3900 Ma ette Ave E-MAIL y ADDRESS: CSpjna�(armprsA9pnt Crim INSURER(S) AFFORDING COVERAGE MAIC # Santa Rosa CA 95405-7227 INSURER A: Truck Insurance Exchange 21709 INSURED INSURER B: Farmers Insurance Exchange 21652 MAHER ACCOUNTANCY INSURER C: Mid Century Insurance Company 21687 1101 5TH AVE SUITE 200 I INSURER D: I INSURER E : SAN RAFAEL CA 94901 I 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 3ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH'OLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INCR Morn POLICY NUMBER IMMIDDIYYYY_I 1 IMM/DD/YYYYI LIMITS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE ® OCCUR A _ Y N 055876276 GGEEN'L AGGREGATE LIMIT APPLIES PER. X1 POLICY JF FRC LOC AUTOMOBILE LIABILITY ANY AUTO AAUTOS NED AUTOSSCHED055876276 055876276 H RED AUTOS X NON -OWNED _ AUTOS UMBRELLA LIAB OCCUR EXCESS LIAR CLAIMS MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EACH OCCURRENCE I $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrancel $ 75,000 MED EXP (Any one person) $ 5,000 02/22/2015 02/22/2016 I PERSONAL a ADV INJURY I $ 1,000,000 GENERAL AGGREGATE I $ 2,000,000 PRODUCTS - COMP/OP AGG I S 1,000,000 $ COMBINED SINGLE tINJJURY Lpa I 1,000,000 BODILYd(Per on) S 02/22/2015 02/22/2016 I BODILY INJURY (Per accident) I $ PROPERTY DAMAGE $ (Per accident) $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CITY OF SAN RAFAEL, ITS OFFICERS AGENTS, EMPLOYEES AND VOLUNTEERS THIS CERTIFICATE IF ISSUED AS AN EVIDENCE OF INSURANCE. CERTIFICATE HOLDER IS STATED AS ADDITIONAL INSURED. I EACH OCCURRENCE S (AGGREGATE $ WC STATU OTH- E.L. EACH ACCIDENT I $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ 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 1400 FIFTH AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. SAN RAFAEL, CA 94901 AUTHORIZED REPRESENTATIVE Christi Spina I ACORD 25 (2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i-� MAHEACC-01 JJOHNSON ACORO CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) `••� 122/9/2/912 015 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). CONTACT PRODUCER License # OE86536 NAME: Jena Johnson Preferred Connect Insurance Center, LLC PHONEggg 656-5678 FAX 866 560-9099 P.O. BOX 85234 QAIC No. Ex,,: ( ) dAIC„ Noy: ( ) San Diego, CA 92138 ADDRESS: INSURED Maher Accountancy, A California Accountancy Corporation 1101 5th Avenue, Suite 200 San Rafael, CA 94901 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Preferred Emplo°,,!ers Insurance Company 10900 INSURER B: INSURER C: INSURER D: INSURER E: 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 'ADII II 5011!11"! POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMMIDDIYYYY,tl xMM/DDIYYYYV ,LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S ICLAIMS-MADEOCCUR GEN'L AGGREGATE LIMIT APPLIES PER', .. y POLICY .,.... PEO- ...- V LOC CT OTHER AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR EXCESS LIAR CLAIMS -MADE DED RETENTION S WOLKERS COMPENSATION AND EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N OFFICER/MEMBER EXCLUDED? Y N I A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below AAN145943-4 04/01/2015 04/01/2016 IPIY�I II"� PREMISES JEa occurrence� $ MED EXP (Any one person) J $ PERSONAL & ADV INJURY S GENERAL AGGREGATE IIS PRODUCTS - COMP/OP AGG S S COMBINED SINGLE LIMIT $ yEa accidenl,6 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ QPer accidentd S EACH OCCURRENCE S AGGREGATE IIS S XPER I STATUTE,,,,,,„ ERH E L EACH ACCIDENTS 1,000,000 E L DISEASE - EA EMPLOYEE S 1,000,000 E L DISEASE - POLICY LIMIT I S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of San Rafael, its officers, agents, employees and volunteers. CERTIFICATE HOLDER City of San Rafael 1400 Fifth Avenue San Rafael, CA 94901 ACORD 25 (2014/01) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �ATA r".flLlJlL I ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MAHEACI OP ID: JR CERTIFICATE OF LIABILITY INSURANCE 1 D1217/201 YY) 12/17/2015 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 Mitchell & Mitchell-Lic0620650 PHONE FAX 250 Bel Marin Keys Blvd, Bid E I IA/C,-No. Ext): I (A/C, No); Novato, CA 94949 E-MAIL ADDRESS: Paul W. Morris I INSURER(SI AFFORDING COVERAGE NAIC N INSURED Maher Accountancy John W. Maher, CPA 1101 Fifth Ave., #200 San Rafael, CA 94901 INSURER A:Continental Casualty INSURER B: INSURER C: INSURER D: INSURER E: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR iNRR wvrt POLICY NUMBER IMMIDDIYYYYI (MMIDDIYYYYV GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER vl POLICY n PFRO LOC AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIARI I OCCUR EXCESS LIAB j-- CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y t N ANY PROPRIETOWPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N I A (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below A Prof, Liability RENTEDEACH OCCURRENCE $ DAMAGE TO PREMISES (Ea occurrence) S MED EXP PERSONAL & ADV INJURY $ GENERAL AGGREGATE S OD COMBINED BODILY(Ea accdentt person) ACCIDENT)BODILY INJURY (Per accident) $ PROPERTY DAMAGE S TOWC RYI IAMIITS I I OTFIR EL EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT _ $ APL 275496397 01/01/2015 01/01/2016 Per Claire 2,000,000 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS ( LOCATIONS t VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Prior Acts: 6/01/93 CERTIFICATE HOLDER City of San Rafael Lawrence Moss 1400 Fifth Ave San Rafael, CA 94901 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Paul W. Morris ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Esther Beirne From: Lawrence Moss Sent: Wednesday, December 23, 2015 11:42 AM To: Esther Beirne; Eric Davis Subject: RE: Insurance Eric: Esther and I just talked about a couple of contracts and the status of the insurance. Regarding Maher Accountancy: We have all the required lines of insurance but although named as AI I do not see a endorsement for that or primary endorsement. Note: I see that the broker is Farmer's insurance, which often will not provide endorsements or primary. Meanwhile, it's up to you but I am fine with the evidence of coverage being good enough only because this project is under the sole control of Maher and there is anything other than professional liability coverage. I will keep on it for the endorsements. Larry From: Esther Beirne Sent: Wed 12/23/2015 11:09 AM To: Lawrence Moss Subject: Insurance Hi Larry: Are you at City Hall today? Have some insurance questions. Esther 0 Esther Beirne From: Eric Davis Sent: Friday, December 18, 2015 1:50 PM To: Lawrence Moss Cc: Esther Beirne; Courtney Scott; Laraine Gittens Subject: Fire Department PSA with Maher Accountancy; Insurance Attachments: Insurance Certificates.pdf, 12 18 15 Checklist with PSA's executed by Maher Accountancy.pdf Follow Up Flag: Follow up Flag Status: Flagged Larry I received in today's mail the Contract Checklist with two signed PSA's from Maher Accountancy, as well as hard copies of the attached Insurance Certificates. It appears that all the required insurance is covered, but there are no endorsements of the CGL policy for additional insured and primary insurance coverage. Can you arrange with the brokers for the CGL, auto and workers comp policies to get their insurance certificates posted on PINS (I believe the professional liability policy certificate is already posted), and to get the CGL additional insured and primary endorsements posted as well. I will move the Contract Checklist and PSA's along to Esther to get the PSA's executed and dated by Jim Schutz, but I would like Esther to hold the Agreements until we get all the insurance posted on PINS, including the additional insured and primary endorsements on the CGL Policy. Thanks Eric 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 agreements/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 / 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 and endorsements. Agreement executed by Council authorized official. City Clerk attests signatures, retains original agreement and forwards copies to the contracting department. To be completed by Contracting Department: Fire Completion Date NIA Ap,euouto K1. = C- l , . Project Manager: Courtney Scott Project Name: Maher Accountancy Audit of MRRRA Agendized for City Council Meeting of (if necessary): FPPC: ❑ , check if required 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.