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HomeMy Public PortalAboutC-16-021 - Intelli-Flex, Inc. Amendment No. 2, Avaya Phone System SupportAMENDMENTNO2TOAGREEMENTFORCONTRACTSERVICESTHISAMENDMENTTOTHEAGREEMENTFORCONTRACTSERVICES(“Amendment”)byandbetweentheCITYOFCARSON,aCaliforniamunicipalcorporation(“City’)andINTELLI-FLEX,FNC.,aCaliforniacorporation(“Consultant”)iseffectiveasofthedayofApril,2020.RECITALSA.CityandConsultantenteredintothatcertainAgreementforContractServicesdatedOctober1,2016(“Agreement”)wherebyConsultantagreedtoprovideAvayasoftwareandhardwaremaintenanceandsupportservices.B.TheCityandConsultantdesired,andtheCityCoLincil’sactionapproved,theAgreementforatermofthree(3)years,foratotalContractSumnottoexceed$59,610.C.TheAgreementultimatelyexecutedbythepartiesinctudedaprovisionthatdidnotconformtotheintentofthepartiesandwasinconsistentwiththeCouncil’sapproval.D.Specifically,Councilawardedathree(3)yearcontract,buttheAgreementprovidedforaone(1)yearcontract,withtheoptiontorenewthetermfortwoadditionalone-yearterms.E.CityandConsultantenteredintothatcertainAmendmentNo.ItoAgreementforContractServicesdatedAugust8,2019(“AmendmentNo.1”)wherebythepartiesagreedtoamendtheAgreementto(1)reconciletheAgreementtermswiththeCityCouncil’sapprovaloftheAgreementbyextendingthetermoftheAgreementsothatitexpiresonSeptember30,2020,(2)expandtheScopeofServicestoincludeAvayasoftwareandhardwaremaintenanceandsupportservicesfor12Cityparks,and(3)increasecompensationby$43,961.86tocoverthecostoftheextendedtermandservicesfor12Cityparks,foratotalContractSumnottoexceed$103,571.86.F.CityandConsultantnowdesiretoagainamendtheAgreementtoaddcompensationfor100additionalAdHocServiceshoursincreasingcompensationby$12,800.00foratotalContractSumnottoexceed$116,371.86.TERMS1.ContractChanges.TheAgreementisametidedasprovidedherein(newtextinbolditalicsanddeletedtextinstrikethrough).a.Section2.1,“ContractSum,”isherebyamendedasfollows:“SubjecttoanylimitationssetforthinthisAgreement.CityagreestopayConsultanttheamountsspecifiedinthe“ScheduleofCompensation”attachedheretoasExhibit“C”andincorporatedhereinbythisreference.Thetotal010070001/6365462 compensation,includingreimbursementforactualexpenses,shallnotexceedOneHundredSixteenThousandThreeHundredSeventyOneDollarsandEightySixCents($116,371.86)(the“ContractSum”),unlessadditionalcompensationisapprovedpursuanttoSection1.8.”b.SectionII.ofExhibitC,“ScheduleofCompensation,”isherebyamendedasfollows:“II.ConsultantshallperformallAdHocServicesdescribedinSectionIIofExhibit“A,”ScopeofServicesattherateof$100/hour,foramaximumannualamotintof$10,000exceptthatbetweenMarch17,2020throughSeptember30,2020,anadditional$12,800maybeincurredby(‘onstiltant,followingsubmissionofamonthlyinvoice,inaccordancewithSection2.4andparagraphIII,below.”c.SectionIV.ofExhibitC,“ScheduleofCompensation,”isherebyamendedasfollows:“ThetotalcompensationforRegularServicespursuanttoSectionIofExhibit“A.”ScopeofServices,forallfour(4)years,shallnotexceed$63,571.86.ThetotalcompensationforAdHocServicespursuanttoSectionIIofExhibit“A,”ScopeofServicesforallfour(4)years,shallnotexceed$52,800.Thus,theoveralltotalcompensationforRegularServicesandAdHocServicesforallfour(4)yearsshallnotexceed$116,371.86,asprovidedinSection2.1ofthisAgreement.”2.ContinuingEffectofAgreement.ExceptasamendedbythisAgreement,allprovisionsoftheAgreementshallremainunchangedandinfullforceandeffect.FromandafterthedateofthisAmendment.whenevertheterm“Agreement”appearsintheAgreement,itshallmeantheAgreement,asamendedbythisAmendmenttotheAgreement.3.AffirmationofAgreement;WarrantyReAbsenceofDefaults.CityandConsultanteachratifyandreaffirmeachandeveryoneoftherespectiverightsandobligationsarisingundertheAgreement.EachpartyrepresentsandwarrantstotheotherthattherehavebeennowrittenororalmodificationstotheAgreementotherthanasprovidedherein.EachpartyrepresentsandwarrantstotheotherthattheAgreementiscurrentlyaneffective,valid,andbindingobligation.ConsultantrepresentsandwarrantstoCitythat,asofthedateofthisAmendment,CityisnotindefaultofanymaterialtermoftheAgreementandthattherehavebeennoeventsthat,withthepassingoftimeorthegivingofnotice,orboth,wouldconstituteamaterialdefaultundertheAgreement.CityrepresentsandwarrantstoConsultantthat,asofthedateofthisAmendment,ConsultantisnotindefaultofanymaterialtermoftheAgreementandthattherehavebeennoeventsthat,withthepassingoftimeorthegivingofnotice,orboth,wouldconstituteamaterialdefaultundertheAgreement.--010070001/6365462 4.AdequateConsideration.ThepartiesheretoirrevocablystipulateandagreethattheyhaveeachreceivedadequateandindependentconsiderationfortheperformanceoftheobligationstheyhaveundertakenpursuanttothisAmendment.5.Authority.ThepersonsexecutingthisAmendmentonbehalfofthepartiesheretowarrantthat(i)suchpartyisdulyorganizedandexisting,(ii)theyaredulyauthorizedtoexecuteanddeliverthisAmendmentonbehalfofsaidparty,(iii)bysoexecutingthisAmendment,suchpartyisformallyboundtotheprovisionsofthisAmendment,and(iv)theenteringintothisAmendmentdoesnotviolateanyprovisionofanyotheragreementtowhichsaidpartyisbound.[SIGNATURESONFOLLOWINGPAGE]-3-010070001/6365462 INWITNESSWHEREOF,thepartiesheretohaveexecutedthisAmendmentontheCITY:ARSON,a9iilporationAlrtRoblcs,MayorAPPROVEDASTOFORM:ALESHIRE&WYNDER,LLPSunnyK.Soltani,CityAttDmey[ij1]CONSULTANT:tntelli-FIex,Inc.By:__ccin2NamMii+crtoTitle:CEOAddress:Intelli-Flex.Inc.-Crete-M’eaioQCvprCA-983OcrnkTwocorporateomcersignaturesrequiredwhenConsultantLaacorporation,withonesignaturerequtrdfromeachofthefollowinggroups:1)ChairmanattheBoard,PresidentoranyVicePresident;and2)Secretary,anyAssistantSecretary,ChiefFinancialOmccroranyMslstantTreasurer.CONSULTANT’SSIGNATURESSHALLBEDULYNOTARIZED,ANDAPPROPRIATEATTESTATIONSSHALLBEINCLUDEDASMAYREREQUIREDBYTHEBYLAWS,ARTICLESOFINCORPORATifiN,OROTHERRULESORREGULA11ONSAPPLICABLETOCONSULTANT’SBUSINESSENTITY.DonesiaGauseAtdana,ity010070001K365462-4- CALIFORNIAALL-PURPOSEACKNOWLEDGMENTAnotarypublicorotherofficercompletingthiscertificateverifiesonlytheidentityoftheindividualwhosignedthedocumenttowhichthiscertificateisattached,andnotthetruthfulness,accuracyorvalidityofthatdocument.STATEOFCALIFORMACOUNTYOFLOSANGELESOn___________,2020beforeme,__________________,personallyappeared__________________,provedtomeonthebasisofsatisfactoryevidencetobetheperson(s)whosenames(s)is/aresubscribedtothewithininstrumentandacknowledgedtomethathe/she/theyexecutedthesameinhis/her/theirauthorizedcapacity(ies),andthatbyhis/her/theirsignature(s)ontheinstrumenttheperson(s),ortheentityuponbehalfofwhichtheperson(s)acted,executedtheinstrument.Icertif’underPENALTYOFPERJURYunderthelawsoftheStateofCaliforniathattheforegoingparagraphistrueandcorrect.WITNESSmyhandandofficialseal.Signature:_________________________________________OPTIONALThoughthedatabelowisnotrequiredbylaw,itmayprovevaluabletopersonsrelyingonthedocumentandcouldpreventfraudulentreattachmentofthisform.CAPACITYCLAIMEDBYSIGNERDESCRIPTIONOFATTACHEDDOCUMENTHINDIVIDUALHCORPORATEOFFICERTITLE(S)TITLEORTYPEOFDOCUMENTHPARTNER(S)HLIMITEDHGENERALHATTORNEY-IN-FACTHTRUSTEE(S)NUMBEROfPAGESHGUARDIAN/CONSERVATORHOTHER______________________SIGNERISREPRESENTING:DATEOFDOCUMENT(NAMEOFPERSON(S)ORENTITY(IES))_____________________SIGNER(S)OTHERTHANNAMEDABOVE010070001/636546.2 CALIFORNIAALL-PURPOSEACKNOWLEDGMENTAnotarypublicorotherofficercompletingthiscertificateverifiesonlytheidentityoftheindividualwhosignedthedocumenttowhichthiscertificateisattached,andnotthetruthfulness,accuracyorvalidityofthatdocument.STATEOFCALIFORNIACOUNTYOFLOSANGELESOn___________,2020beforeme,__________________,personallyappeared__________________,provedtomeonthebasisofsatisfactoryevidencetobetheperson(s)whosenames(s)is/aresubscribedtothewithininstrumentandacknowledgedtomethathe/she/theyexecutedthesameinhis/her/theirauthorizedcapacity(ies),andthatbyhis/her/theirsignature(s)ontheinstrumenttheperson(s),ortheentityuponbehalfofwhichtheperson(s)acted,executedtheinstrument.Icerti1’underPENALTYOfPERJURYunderthelawsoftheStateofCaliforniathattheforegoingparagraphistrueandcorrect.WITNESSmyhandandofficialseal.Signature:_________________________________________OPTIONALThoughthedatabelowisnotrequiredbylaw,itmayprovevaluabletopersonsrelyingonthedocumentandcouldpreventfraudulentreattachmentofthisform.CAPACITYCLAIMEDBYSIGNERDESCRIPTIONOFATTACHEDDOCUMENTLIINDIVIDUALLICORPORATEOFFICERTITLE(S)TITLEORTYPEOFDOCUMENTLIPARTNER(S)LILIMITEDLIGENERALLIATTORNEY-IN-FACTLITRUSTEE(S)NUMBEROFPAGESLIGUARDIAN/CONSERVATORLIOTHER______________________SIGNERISREPRESENTING:DATEOFDOCUMENT(NAMEOFPERSON(S)ORENT[TY(IES))___________SIGNER(S)OTHERTHANNADABOVE01007.0001/636546.2 THEHARTFORDBUSINESSSERVICECENTERTHE3600WISEMANBLVDHARTFORDSANANTONIOTX78251January23,2020CITYOFCARSON701ECARSONSTCARSONCA90745-2224AccountInformation:___________________________________________________ContactUsPolicyHolderDetails:INTELLI-FLEXINC._______________________________________________________________BusinessServiceCenterBusinessHours:Monday-Friday(7AM-7PMCentralStandardTime)Phone:(866)467-8730Fax:(888)443-6112Email:agency.servicesthehartford.comWebsite:https://business.thehartford.comEnclosedpleasefindafortheabovereferencedPolicyholder.Pleasecontactusifyouhaveanyquestionsorconcerns.Sincerely,YourHartfordServiceTeamWLTROO5 CERTIFICATEOFLIABILITYINSURANCETHISCERTIFICATEISISSUEDASAMATTEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTIFICATEHOLDER.THISCERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIESBELOW.THISCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZEDREPRESENTATIVEORPRODUCER,ANDTHECERTIFICATEHOLDER.IMPORTANT:Ifthec.rtlficat.holderisanADDITIONALINSURED,thepollcy(I.s)mustbeendorsed.IfSUBROGATIONISWAIVED,subjecttoth.termsandconditIonsofthepolIcy,certaInpoliciesmayrequireanendorsement.Astatementonthiscertificatedoesnetconferrightstothecertificatehold.rInlieuofsuchendorsement(s).PRODUCERCONTACTCBIAINC/PHSPHONY(866)467-8730FAX(888)443-611233750118rnac,Na,Ext):(AIC,No):TheHartford8usinessServiceCenter3600WisemanBlvdE-MAILSanAntonio,TX78251ADDRESSINSURER(S)AFFORDINGCOVERAGENAIcIINSUREDINSURERA:SentinelinsuranceCompanyLtd.11000INTELLI-FLEXINC.INSURER8:HartfordFireanditsP&CAffiliates0091417315STUDEBAKERRDSTE332INSURERC:HartfordAccidentandindemnityCompany22357CERRITOSCA90703-2508INSURERDINSURERE:INSURERFCOVERAGESCERTIFICATENUMBER:REVISIONNUMBER:THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIODINDICATEO.NO1WTHSTANOINQANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWiTHRESPECTTOVMICHTHISCERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS,EXCLUSIONSANDCONDITIONSOFSUCHPOLICIES.LIMITSSHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS.CEPOLICYNUMBERPOliCYEFFPolicYtxpLIMITSLTRTYPEOFINSURANIMUIDDNWYIIMMID{31YYYY1ZIMERCIALGENERALLIABIUWEACHOCCURRENCE$2,000,000CLAIMS1AOE[IOCCURDAMAGETORENTED-$1000000RFMISEStaorrenc.IxGeneralLiabilityMEDEXPtPersonl$1o,oooAj____________________XX33S8AGC435802/21/202002)21/2021PERSO&VURY$2,000,000GELAGGREGATELIMItAPPLIESPERGENERALAGGREGATE$4,000,0001POUCY[j[]1°CPRODUCTS-COMPIOPAGO$4,000,000jOTHER:AUTOUOBILEUABIUVI’COMBINEDSINGLELIMIT—‘EaaideclXANYAUTOBODILYINJURY(Perparson)ALLOVENEDl—SCHEDULEDCAUTOS._AUTOSXX33UECFU6839021211202002/21/2021BODILYINJURY(Paraccdt(,,,HIREDNON-OVINEDPROPERTfDAMAGE‘AUTOSAUTOS(Peraccidenl)UUBRECLAUABXIOCCUR——EACHOCCURRENCECLAIMS-AEXCESS(JABX33SBAGC435802121/202002/21/2021AGGREGATE$1,000,000lED)XIRETENTION$io,ooo——RKERSCOMPENSATIONXPER10TH-ANDEMPLOYERS’UABJUTtSTATUTEIERANYYINEL.EACHACCIDENT$1,000,000BPROPRIETORIPARTNERIEXECUTIVENIA33WEC10353308/01/201908/01/2020OFFICER/MEMBEREXCLUDED?[ELDISEASE.EAEMPLOYEE$1,000,000(MandatoryInNH)ifyes,describeunderCLDISEASE-POLICYLIMIT$1,000,000DESCRIPTIONOFOPERATIONSbelowAFAILSAFETECHNOLOGYEOR33SBAGC435802/21/202002/21)2021EachGlitch$2,000,000Aggregate$2,000,000DESCRIPflONOFOPERAVONSILOCATIONSIVEHICLES(ACORD101.AddItionalRemarksSchedule,maybeattachedIfmorespaceisrequired)ThoseusualtotheInsured’sOperations.PleaseseeAdditionalRemarksSchedUleAcerdForm101attached.cERTIFICATEHOLDERCANCELLATIONSHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDCITYOFCARSON701ECARSONST,4f.6JBEFORETHEEXPIRATIONDATETHEREOF,NOTICEWILLBEDELIVEREDINACCORDANCEWITHTHEPOLICYPROViSIONS.CARSONCA90745-2224AUTHORIZEDREPRESENTATIVE4.—/7t—2-o_ac-c3I’t)@1988-2016ACORDCORPORATION.Allrightsreserved.ACORD26(2016/03)TheACORDnameandlogoareregisteredmarksofACORD AGENCYCUSTOMERID:___________________________________LOC#:__________________ADDITIONALREMARKSSCHEDULEPage2of2AGENCYNAMEDINSUREDCBIAINC/PHSINTELLI-FLEXINC.POUCYNUMBER17315STUDEBAKERRDSTE332SEEACORD25CERRITOSCA90703-2508CARRIERNAICCODESEEACORD25EFFECUVEDATE:SEEACORD25ADDITIONALREMARKSTHISADDITIONALREMARKSFORMISASCHEDULETOACORDFORMFORMNUMBER:ACORD25FORMTITLE:CERTIFICATEOFLIABILITYINSURANCECertificateholderisanadditionalinsuredpertheBusinessLiabilityCoverageFormSS0008,theUmbrellaLiabilityProvisionsFormSX8002,andtheCommercialAutoBroadFormEndorsementHA9916,attachedtothispolicy.WaiverofSubrogationappliesinfavoroftheCertificateHolderpertheBusinessLiabilityCoverageFormSS0008,andCommercialAutoBroadFormEndorsementHA9916,attachedtothispolicy.NoticeofCancellationwillbeprovidedinaccordancewithFormsSS1223,Form1H0313,andWC990394,attachedtothesepolicies.CoverageisprimaryandnoncontributorypertheBusinessLiabilityCoverageFormSS0008,attachedtothispolicy.ACORD101(2014101)©2014ACORDCORPORATION.Allrightsreserved.TheACORDnameandlogoareregisteredmarksofACORD POLICYNUMBER:33SBAGC4358THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY.ADDITIONALINSURED-OWNER,LESSEESORCONTRACTORTHECITYOFLONGBEACH,ITSOFFICIALS,EMPLOYEESANDAGENTS333NOCEANBLVDFL12LONGBEACH,CA90802THECITYOFLONGBEACH,THEBOARDOFWATERCOMMISSIONERS,ANDTHEIROFFICIALS,EMPLOYEESANDAGENTS1800EWARDLOWRDLONGBEACH,CA90807THECOUNTYOFLOSANGELES,ITSSPECIALDISTRICTS,ITSOFFICIALSOFFICERS,ANDEMPLOYEES1100NEASTERNAVERMGuSLOSANGELES,CA90063RISKMANAGEMENTCITYOFCARSON701ECARSONSTCARSON,CA90745-2224FormIH12001185TSEQ.NO.004PrintedinU.S.A.Page001(CONTINUEDONNEXTPAGE)ProcessDate:11/27/19ExpirationDate:02/21/21 POLICYNUMBER:33UECFU6839THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY.Thisendorsementmodifiesinsuranceprovidedunderthefollowing:ADDITIONALINSUREDCOMMERCIALAUTOCOVERAGEPARTLOSANGELESDEPARTMENTOFWATERANDPOWERRISKMANAGEMENTSECTIONP.O.BOX51111RN465LOSANGELES,CA90051-0100MMCALTDP0BOX390909MINNEAPOLIS,MN55439CITYOFSIMIVALLEY2929TAPOCANYONRDSIMIVALLEY,93063DEPT.OFWATER&POWERRISKMANAGEMENTSECTIONRM.465111N.HOPEST.LOSANGELES,CA90012THECITYOFSIMIVALLEYANDITSRESPECTIVEBOARDS,DISTRICTS,OFFICERS,AGENTSANDEMPLOYEES2929TAPOCANYONRDSIMIVALLEY,CA,93063RISKMANAGEMENTCITYOFCARSON701ECARSONSTCARSON,CA90745CARUSOMANAGEMENTCOMPANY,LTDGFM,LLCFormIH12011185SEQ.NO.01PrintedinU.S.A.PAGE1(CONTINDEDONNEXTPAGE) THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY.WAIVEROFOURRIGHTTORECOVERFROMOTHERSENDORSEMENT-CALIFORNIAPolicyNumber:33WEC1D3533EndorsementNumber:EffectiveDate:08/01/19EffectivehouristhesameasstatedontheInformationPageofthepolicy.NamedInsuredandAddress:INTELLI-FLEXINC5696CORPORATEAVECYPRESSCA90630Wehavetherighttorecoverourpaymentsfromanyoneliableforaninjurycoveredbythispolicy.WewillnotenforceourrightagainstthepersonororganizationnamedintheSchedule.(Thisagreementappliesonlytotheextentthatyouperformworkunderawrittencontractthatrequiresyoutoobtainthisagreementfromus.)YoumustmaintainpayrollrecordsaccuratelysegregatingtheremunerationofyouremployeeswhileengagedintheworkdescribedintheSchedule.Theadditionalpremiumforthisendorsementshallbe5%oftheCaliforniaworkers’compensationpremiumotherwisedueonsuchremuneration.SCHEDULEPersonorOrganizationJobDescriptionCityofCarson,701ECarsonSt.CarsonCA90745002Countersignedby____________________________________________________AuthorizedRepresentativeFormWC040306(1)PrintedinU.S.A.ProcessDate:06/22/19PolicyExpirationDate:08/01/20 THE___HARTFORDSelectCustomerInsuranceCenter8711UNIVERSITYEASTDRIVECHARLOTTENC28213Policyholder,pleasecallusat:(866)467-8730Agent,pleasecallusat:(866)467-8730INSURANCEENDORSEMENTATTACHEDPLEASEREVIEWTHECHANGEEnclosedisanendorsementforyourbusinessinsurancepolicy.Pleasereviewitatyourconvenience,Ifyouhavequestionsorneedtomakefurtherchanges:Policyholder,pleasecallusat:(866)467-8730Agent,pleasecallusat:(866)467-8730between7A.M.and7P.M.CST.Thepremiumbillingwillbemailedtoyouseparately.Youcanexpecttoreceiveitsoon.Thankyouforallowingustoserviceyourbusinessneeds.CBIAINC/PHSTHEHARTFORDSELECTCUSTOMERINSURANCECENTERTheHartfordHartfordFireInsurancecompanyanditsAffiliatesOneHartfordPlaza,Hartford,Connecticut06155 THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY.POLICYCHANGEThisendorsementchangesthepolicyeffectiveontheInceptionDateofthepolicyunlessanotherdateisindicatedbelow:PolicyNumber:33SBAGC4358DVNamedInsuredandMailingAddress;INTELLI-FLEXINC.17315STUDEBAKERRDSTE332CERRITOSCA90703PolicyChangeEffectiveDate:02/21/20EffectivehouristhesameasstatedintheDeclarationsPageofthePolicy.PolicyChangeNumber:002AgentName:CBIAINC/PHSCode:750118POLICYCHANGES:SENTINELINSURANCECOMPANY,LIMITEDANYCHANGESINYOURPREMIUMWILLBEREFLECTEDINYOURNEXTBILLINGSTATEMENT.IFYOUAREENROLLEDINREPETITIVEEFTDRAWSFROMYOURBANKACCOUNT,CHANGESINPREMIUMWILLCHANGEFUTUREDRAWAMOUNTS.THISISNOTABILL.ADDITIONALPREMIUMDUEATPOLICYCHANGEEFFECTIVEDATE:$37.00RATESANDPREMIUMSARECHANGED.FORMNUMBERSOFENDORSEMENTSREVISEDATENDORSEMENTISSUE:1H12001185WAIVEROFSUBROGATIONPRORATAFACTOR:1.000THISENDORSEMENTDOESNOTCHANGETHEPOLICYEXCEPTASSHOWN.FormSS12110405TPage001ProcessDate:03/25/20PolicyEffectiveDate:02/21/20PolicyExpirationDate:02/21/21 POLICYNUMBER:33SBAGC4358THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY.WAIVEROFSUBROGATION730AVEFSTE210PLANO,TX75074210RE:AFFILIATEDTELEPHONE,INC.,COM-NET,INC.,AFFILIATEDTELEPHONE-AUSTIN,INC.,AFFILIATEDTELEPHONE-HOUSTON,INC.,NORTHAMERICACONNECTION,INC.,ANDAFFILIATEDCOMMUNICATIONS,INC.COUNTYOFKERNATTN:PURCHASING1115TRUXTUNAVEFL3BAKERSFIELDCA93301THEDISTRICTOFCOLUMBIAATTEN:OFFICEOFTHECHIEFTECHNOLOGYOFFICER200IST.SEWASHINGTON,D.C.20003CITYOFCARSON701ECARSONSTCARSON,CA90745-2224FormIH12001185TSEQ.NO.002PrintedinU.S.A.Page001ProcessDate:03/25/20ExpirationDate:02/21/21 SelectCustomerInsuranceCenter8711UNIVERSITYEASTDRIVECHARLOTTEPolicyholder,pleasecallusat:(866)467-8730Agent,pleasecallusat:(877)853-2582INSURANCEENDORSEMENTATTACHEDPLEASEREVIEWTHECHANGEEnclosedisanendorsementforyourbusinessinsurancepolicy.Pleasereviewitatyourconvenience.Ifyouhavequestionsorneedtomakefurtherchanges:Policyholder,pleasecallusat:(866)467-8730Agent,pleasecallusat:(877)853-2582between7A.M.and7P.M.CST.Thepremiumbillingwillbemailedtoyouseparately.Youcanexpecttoreceiveitsoon.Thankyouforallowingustoserviceyourbusinessneeds.CBIAINC/PHSTHEHARTFORDSELECTCUSTOMERINSURANCECENTERTheHartfordHartfordFireInsuranceCompanyanditsAffiliatesOneHartfordPlaza,Hartford,Connecticut06155THEHARTFORDNC28213 THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY.MISCELLANEOUSCHANGEENDORSEMENTPOLICYNUMBER:33UECFU6839DVCHANGENUMBER:003AThisendorsementmodifiesinsuranceprovidedunderthefollowing:rTHEY3HARTFORDBUSINESSAUTOCOVERAGEFORMThisendorsementchangesthepolicyeffectiveontheinceptiondateofthepolicyunlessanotherdateisindicatedbelow.(Premiumadjustment,ifany,fortheaddition,deletionorotherchangedescribedinthisendorsementisshowninthePremiumColumnbelow.)EffectiveDate:03/11/20NamedInsured:INTELLI-FLEXINC.ProducersName:CBIAINC/PHSProRataFactor:951DescriptionofChange:ANYCHANGESINYOURPREMIUMWILLBEREFLECTEDINYOURNEXTBILLINGSTATEMENT.IFYOUAREENROLLEDINREPETITIVEEFTDRAWSFROMYOURBANKACCOUNT,CHANGESINPREMIUMWILLCHANGEFUTUREDRAWAMOUNTS.THISISNOTABILL.HARTFORDACCIDENTANDINDEMNITYCOMPANYNOCHANGEINPREMIUMTHEFOLLOWINGENDORSEMENT(S)IS/AREADDED:WAIVEROFTRANSFEROFRIGHTSOFRECOVERYAGAINSTOTHERSTOUS(WAIVEROFSUBROGATION)Countersignedby03/25/20(Whererequiredbylaw)AuthorizedRepresentativeDateFormHA99100107T POLICYNUMBER:33USCFU6839COMMERCIALAUTOCHANGENUMBER:003ACA04441013THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY.WAIVEROFTRANSFEROFRIGHTSOFRECOVERYAGAINSTOTHERSTOUS(WAIVEROFSUBROGATION)Thisendorsementmodifiesinsuranceprovidedunderthefollowing:AUTODEALERSCOVERAGEFORMBUSINESSAUTOCOVERAGEFORMMOTORCARRIERCOVERAGEFORMWithrespecttocoverageprovidedbythisendorsement,theprovisionsoftheCoverageFormapplyunlessmodifiedbytheendorsement.Thisendorsementchangesthepolicyeffectiveontheinceptiondateofthepolicyunlessanotherdateisindicatedbelow.NamedInsured:EndorsementEffectiveDate:SCHEDULEName(s)OfPerson(s)OrOrganization(s):CITYOFCARSONInformationrequiredtocompletethisSchedule,ifnotshownabove,willbeshownintheDeclarations.TheTransferOfRightsOfRecoveryAgainstOthersToUsconditiondoesnotapplytotheperson(s)ororganization(s)shownintheSchedule,butonlytotheextentthatsubrogationiswaivedpriortothe“accident’orthe“loss”underacontractwiththatpersonororganization.CA04441013©InsuranceServicesOffice,Inc.,2011Page1ofI