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HomeMy WebLinkAboutFD 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
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i N. atme ohn % � i ah&
Title: President
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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
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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
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INSURER B : Farmers Insurance Exchange
INSURER C: Mid Century Insurance Company
INSURER D:
INSURER E :
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SAN RAFAEL CA 94901
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COVERAGES CERTIFICATE NUMBER:
REVISION NUMBER:
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INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION
OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
WHICH THIS
INSURER D:
INSURER E :
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21709
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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
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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
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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 :
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+ 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.