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HomeMy Public PortalAboutC-20-048 - Administrative Services Cooperative, Inc. Amendment No. 1, Dial-A-RideAMENDMENT NO. 1 TO AGREEMENT FOR CONTRACT SERVICES VTHIS AMENDMENT TO THE AGREEMENT FOR CONTRACT SERVICES ("Amendment") by and between the CITY OF CARSON, a California municipal corporation v ("City"), and ADMINISTRATIVE SERVICES COOPERATIVE, INC., a California corporation p U ("Consultant"), is entered into effective as of the --A— day of September, 2020. RECITALS A. City and Consultant entered into that certain Agreement for Contract Services dated July 1, 2020 ("Agreement") whereby Consultant agreed to provide City Dial -A -Ride demand responsive services ("Standard DAR") based on the curb -to -curb concept for registered participants. B. City and Consultant now desire to amend the Agreement to implement a Lyft-style model ("Expedited DAR"), to which the following will apply: (i) there will be no age restrictions or disability status eligibility requirements; (ii) riders must be residents of the City; (iii) the entire ride must take place within the City; (iii) each rider is limited to 20 rides per calendar month; (iv) there will be no registration requirement in order to request a ride; and (v) City and rider will each pay 50% of the fare up to a maximum of $10.00 per ride to be paid by City with any overages to be paid by rider. C. City and Consultant now also desire to amend the Agreement to remove the age restrictions and disability status eligibility requirements from the Standard DAR. TERMS 1. Contract Changes. The Agreement is amended as provided herein (new text in bold italics and deleted text in striketlfreugh). A. Exhibit "A," Scope of Services, of the Agreement is hereby replaced in its entirety with an amended Exhibit "A," Scope of Services, attached hereto and incorporated herein and made part hereof. B. Section III of Exhibit `B" of the Agreement, "Special Requirements," is hereby amended to read in its entirety as follows: "8.12 City's Obligations. (a) Intake: City staff shall provide intake services for qualifying applicants, receive and process applications, and provide the Contractor with new users and their respective user identification pictures for applicants of Standard DAR. There shall exist no intake services for Expedited DAR since there are no age -eligibility or disability status requirements to call for a ride. -1- 01007.0001/665871.1 (ab) Participant Co -Pays: City staff shall collect, record, and apply the $2.00 participant prepaid co -pays for each trip to the respective profiles of the participants." C. Section I of Exhibit "C," Schedule of Compensation, of the Agreement is hereby amended to read as follows: "I. Contractor shall perform the following tasks at the following rates: WAT&WRIJURT. SERVICE A. Flag Drop: S. Distance: C. Processing Fee: D. Admin overhead + web portal access_ E. Swipe/Tap Card System: EXPEDITED DAR: MONTHLY RATE 52.85 for the first 1/9 mile or any portion thereof $2.70 for each additional mile or any portion thereof $_50/trip for the first 25,000 trips_ $35/trip thereafter $3,000.00 per month $5.00 per new or replacement ID cards Participants shall pay their drivers 50% of the meter -based cab fare and the City will pay the remaining 50% up to a maximum City subsidy of $10.00 per ride; put another way, so long as the total fare is $20.00 or less, City will pay 50%. Participants will pay for any overages exceeding $20.00 per ride." 2. Continuing Effect of Agreement. Except as amended by this Amendment, all provisions of the Agreement shall remain unchanged and in full force and effect. From and after the date of this Amendment, whenever the term "Agreement" appears in the Agreement, it shall mean the Agreement, as amended by this Amendment to the Agreement. 3. Affirmation of Agreement; Warranty Re Absence of Defaults. City and Consultant each ratify and reaffirm each and every one of the respective rights and obligations arising under the Agreement. Each party represents and warrants to the other that there have been no written or oral modifications to the Agreement other than as provided herein. Each party represents and warrants to the other that the Agreement is currently an effective, valid, and binding obligation. Consultant represents and warrants to City that, as of the date of this Amendment, City is not in default of any material term of the Agreement and that there have been no events that, with the passing of time or the giving of notice, or both, would constitute a material default under the Agreement. -2- 01007.0001/665871.1 City represents and warrants to Consultant that, as of the date of this Amendment, Consultant is not in default of any material term of the Agreement and that there have been no events that, with the passing of time or the giving of notice, or both, would constitute a material default under the Agreement. 4. Adequate Consideration. The parties hereto irrevocably stipulate and agree that they have each received adequate and independent consideration for the performance of the obligations they have undertaken pursuant to this Amendment. 5. Authority. The persons executing this Amendment on behalf of the parties hereto warrant that (i) such parry is duly organized and existing, (ii) they are duly authorized to execute and deliver this Amendment on behalf of said party, (iii) by so executing this Amendment, such party is formally bound to the provisions of this Amendment, and (iv) the entering into this Amendment does not violate any provision of any other agreement to which said party is bound. [SIGNATURES ON FOLLOWING PAGE] -3- 01007.0001/665871.1 IN WITNESS WHEREOF. the parties hereto have executed this Amendment on the date and year first -above written. A Donesia Gause- City Cle APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP 6;; Sunny K. Soltani. City Attorney CI'T'Y: CITY DE CARSON, a municipal co ration A"7— f — Albert Robles, ayor CONSULTANT: ADMINISTRA Name: �JpIt n Title: 5,ec,-4, ES COOPERATIVE, Name:,o*,w',,-, /S. � Title: �% �%r.rd►` ��rstols,. .,F � Address: 1515 W. 1401h Street, Suite 250 Gardena, CA 90248 Two corporate officer signatures required when Consultant is a corporation, with one signature required from each of the following groups: I) Chairman of the Board, President or any Vice President; and 2) Secretary, any Assistant Secretary, Chief Financial Officer or any Assistant Treasurer. CONSULTANT'S SIGNATURES SHALL BE DULY NOTARIZED, AND APPROPRIATE ATTESTATIONS SHALL BE INCLUDED AS MAY BE REQUIRED BY THE BYLAWS, ARTICLES OF INCORPORATION, OR OTHER RULES OR REGULATIONS APPLICABLE TO CONSULTANT'S BUSINESS ENTITY. -4- 01007,00011665871 4- 010070001{66871 1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy or validity of that document. STATE OF CALIFORNIA COUNTY OF LOS ANGELES {E/rMBF.! SArAAJ $ D.M,4VAtC I%%.i tCO foT� Ofi , 2020 before me, , personally appeared , proved to me on the basis of satisfactory evidence to be the person(s) whose names(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. SUSAN B. OSTANEK Notary Public - California Z los Angeles County Signature: ._szf_� Commkslon * 21882825 .• 11107 e Y 1,04/(3 L /C Comm. EX008 Nov 12, 2020 OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. 01007.0001/665871.1 CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE(S) TITLE OR TYPE OF DOCUMENT ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) NUMBER OF PAGES ❑ GUARDIAN/CONSERVATOR ❑ OTHER SIGNER IS REPRESENTING: DATE OF DOCUMENT (NAME OF PERSON(S) OR ENTITY(IES)) SIGNER(S) OTHER THAN NAMED ABOVE 01007.0001/665871.1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy or validity of that document. STATE OF CALIFORNIA COUNTY OF LOS ANGELES O %•rte S'p..t*N 9 /ply /!/.!C � 5020 before me, j2rj7 �j & , personally appeared �/ ,proved to me on the basis of satisfac" tory evidence to be the person(s) whose names(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. SUSAN 0.0STN*X Notary Pubac - Cwmon* LOS Anon Cow* Signature: Commit" N 2168285 A107-,414 )00' CQf0M. Nor t2 2026 OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. ❑ ❑ CAPACITY CLAIMED BY SIGNER INDIVIDUAL CORPORATE OFFICER TITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) 01007.0001/665871.1 DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT OTHER THAN NAMED ABOVE EXHIBIT "A" SCOPE OF SERVICES I. The City's Dial -A -Ride ("DAR") Program provides demand -responsive services based on the curb -to -curb concept for registered participants. The DAR Program consists of both the City's standard DAR program ("Standard DAR') and a newly adopted DAR program ("Expedited DAR') with less restrictions than the Standard DAR. Contractor will perform the following services for the City's DAR Program in accordance with the following standards, which, unless otherwise specified, shall apply to both the Standard DAR and Expedited DAR: A. Hours of Operation: Services shall be made available to participants twenty-four (24) hours per day, three hundred sixty-five (365) days per year, including all holidays. B. Eligibility: 1. Criteria: C^^tr-aeter- shall ro 0 0 requests for- an dispateh Dial n Ride taxi ser ieest9Gity6f Cason residents ...1,eare-() at least smay (60) years ) disabled adults eighteen (19 cci�-vr-cgc-vr-vxc er v"he-aune un-abletouse-ph=ie trait beeause-meal,-mobile, hearing and/or- vision impairment. Criteria: Contractor shall receive requests for and dispatch Dial -A -Ride taxi services to City of Carson residents without regard to the resident's age or whether or not the resident is disabled due to physical, mobile, hearing and/or visual impairment. Expedited DAR: 1. Criteria: Participants do not sign up and register with the City. Each resident is limited to 20 rides per calendar month. Standard DAR and Expedited DAR: 2. Intake: Contractor acknowledges that City staff shall provide intake services for qualifying applicants, receive and process applications, and provide the Contractor with new users and their respective user identification pictures for applicants of Standard DAR. Contractor shall issue picture -bearing identification swipe/tap cards to City staff for distribution via postage mail. There shall exist no intake services for Expedited DAR since there are no age -eligibility requirements, disability status requirements, or prepaid user identification cards required to call for a ride. 01007.0001/665871.1 Standard DAR: 3. Participant Co -Pays: Contractor acknowledges that City staff shall collect, record, and apply the $2.00 participant prepaid co -pays for each trip to the respective profiles of the participants. Expedited DAR: 4 Fare: Participants shall pay their drivers 50% of the meter -based cab fare and the City will pay the remaining 50% up to a maximum City subsidy of $10.00 per ride; put another way, so long as the total fare is $20.00 or less, City will pay 50%. Participants will pay for any overages exceeding $20.00 per ride. C. Requesting a Ride: Standard DAR: 1. Dispatch: To request a dial -a -ride trip, passengers must call dispatch at least one (1) hour in advance of their requested pick-up time and provide their user identification number or their first and last name. Participants requesting a Wheelchair Accessible Van (WAV) must call dispatch at least twenty-four (24) hours in advance of their requested pick-up time. Passengers must also physically present their identification card to their driver and confirm their destination prior to embarking. Expedited DAR: 1. Dispatch: To request a dial -a -ride trip, passengers must call dispatch to request pick-up. Dispatch operators shall request the passenger's name, phone number, origin and destination, and shall dispatch a taxi cab to the pick-up location. Passengers must provide their driver's license or California ID card to confirm residency and physically present their identification card to their driver and confirm their destination prior to embarking. Standard DAR: 2. Response Times: All drivers shall arrive within a twenty (20) minute window (+/-20) of their scheduled pick up time. If a driver arrives more than twenty (20) minutes past the scheduled pick up time, the trip shall be free of charge and City shall not be billed for any portion of the trip. Contractors shall still be obligated to complete the trip for the passenger and record such trips as a Courtesy Ride. Drivers shall drop off passengers at their destinations no later than twenty (20) minutes past their required drop time. However, the Contractor shall not be held responsible for failure to provide on-time service due to forces beyond its immediate control. These are instances that would be considered "force majeure" situations. In 01007.0001/665871.1 the event of such an occurrence, sufficient documentation of the circumstances shall be provided to the City for approval by the Contract Officer. Expedited DAR: 2. Response Times: There is no time window for required pick up of passengers but generally pick-ups occur within 10-20 minutes of the call placed to dispatch. D. Dispatch Center: 1. Wait Times: Contractor's initial hold time for reservation calls shall not exceed two (2) minutes and the average initial hold time shall not exceed one (1) minute. Standard DAR: 2. Contractor shall provide a dedicated telephone number for the exclusive use of participants of the program. Contractor shall have dispatch operators identify themselves by saying "Carson Dial -A -Ride" within their greeting. Expedited DAR: 2. Contractor shall provide a dedicated and toll-free telephone number, separate from the dedicated telephone line used for the Standard DAR, for the exclusive use of participants of the Expedited DAR program. Contractor shall have live dispatch operators identify themselves by saying "Carson Dial A -Ride" within their greeting. Standard DAR and Expedited DAR: 3. Contractor's dispatching and schedule system shall include: (a) Maintain a customer database with records of past rides. (b) On-time performance monitoring with ride times, scheduled pickup times versus actual pickup times, and tracking information to verify pick-ups that were completed more than twenty (20) minutes past their scheduled time. 4. Dispatch operators shall at all times be courteous, friendly, helpful, and patient with callers. Operators must possess a strong command of the English language, have translators available for Spanish and Tagalog speaking callers, and accommodate Teletypewriter (TTY) for hearing- impaired callers. 01007.0001/665871.1 STANDARD DAR: 5. Shared Rides: Contractor shall make every reasonable effort to create shared rides in order to minimize costs to the City and to reduce environmental footprint. To encourage shared rides, passengers who are picked up at the same origin and vehicle and share the same destination shall ride for a single fare. Notwithstanding the foregoing, during the period of the COVID-19 emergency only, Contractor shall refrain from creating or allowing shared rides. E. Service Area: Standard DAR: 1. City Boundaries: Passengers may travel to and from all areas of the unrestricted City boundaries as depicted in Exhibit "A-1". Trips that originate and end within these areas may be for any purpose, including but not limited to: banking, shopping, medical, recreational, educational, and social. 2. Outside City Boundaries: Passengers may also travel to and from areas within the defined perimeter outside of City boundaries as depicted in Exhibit "A-1 ". Trips to any of these areas are allowed for medical and social service purposes ONLY. 3. Satellite locations: In addition to the defined perimeter outside of City boundaries, passengers may also travel to and from seventeen (17) City - approved satellite locations for medical and social service purposes as depicted in Exhibit "A-1". 4. The boundaries of the City and satellite destinations are subject to change at any time and are based solely on the needs of the City. 5. Should a passenger request a non-medical/social service trip to an area outside of the City boundaries, the trip shall be subsidized up to the Carson boundary and the passenger, with his/her acknowledgement, shall be charged the regular taxi rate for this latter leg of the trip. Should the passenger request a non-medical/social service trip out of an area outside of the City boundaries, the first leg leading up to the City boundary shall be charged the regular taxi rate. Expedited DAR: 1. City Boundaries: Passengers may travel only within City boundaries (both place of origin and destination) and there shall be no limitations as to the purpose of travel. 01007.0001/665871.1 F. Pick-up and Drop-off Standards: 1. Personal assistance: All drivers shall be courteous and offer curb -to -curb service for any passengers who may appear to need assistance, or as requested by the passengers, with entering/exiting the vehicle, assisting with personal items such as bags or groceries, and opening/closing vehicle doors as needed. 2. Passenger delays: All drivers shall demonstrate patience and courtesy should any passengers require more time entering/exiting the vehicle. As certain passengers may have physical conditions such as loss of hearing or stiff joints, drivers shall be professional, understanding, and safely accommodate the passengers to the best of their abilities. 3. Travel Aide: Passengers may bring up to one (1) travel aide or care provider during their trip. Passengers must request this accommodation when placing their request to the dispatch center. 4. Gratuities: Drivers are strictly prohibited from asking passengers for tips and/or other forms of gratuities. Contractor shall provide or develop a disciplinary plan to ensure adherence to this rule. Safety: Should any passengers express extreme discomfort or concerns for their safety due to the behavior of their driver, Contractor shall counsel the driver to ensure immediate correction within one (1) business day. G. Driver Requirements: Credentials: Maintain all applicable licenses as required by the State of California forthe operation of commercial vehicles. No driver shall be permitted to drive who has: (a) More than two points on his/her driving record within the prior twelve (12) months under the Department of Motor Vehicles point system; or (b) more than three points within the prior thirty-six (36) months under the Department of Motor Vehicles point system; or (c) has had his/her driving privileges placed on probation by the Department of Motor Vehicles; or (d) has been convicted in any jurisdiction of any driving offense(s) involving driving under the influence of alcohol or drugs, driving with a suspended or revoked driver's license, or reckless driving. 2. Be alert, clean in appearance and hygiene, courteous, sober, drug-free, and competent in their driving skills. 3. Operate a vehicle which is safe and clean in appearance, free of smoke and/or strong odors, mechanically sound, and seating capacity for four (4) or more passengers. 01007.0001/665871.1 4. Smoking and/or vaping inside of the vehicle is strictly prohibited at all times. 5. Under no circumstances shall drivers request gratuities and/or tips from the passenger(s) or public. H. Drug and Alcohol Testing: 1. Contractor shall conduct an ongoing drug and alcohol testing program which shall meet all applicable state and federal standards to include, but not limited to: test on incident or accident, test on reasonable suspicion, random testing, and training of supervisors to recognize drug and alcohol symptoms. I. Safety Trainings: Contractor shall have new drivers complete a driver safety training program during their onboarding. The program shall include driver training, map reading, taxicab rules and regulations, computerized dispatch systems, customer relations, sensitivity training for passengers with special needs, Americans with Disabilities Act requirements, and behind -the -wheel training. J. Vehicles: Each taxicab made available to the City's DAR program shall be a full- sized sedan or minivan and equipped with fully functioning air conditioning and heating systems, speedometers, fuel gauges, 4 -way hazard flashers, headlights, windshield washers/wipers, safety mirrors, fire extinguisher, and seat belts. Each vehicle shall also be equipped with onboard radio and/or data tablet for constant communication with dispatch. 2. Wheelchair Accessible Vehicles (WAVs) shall be made available to participants within the same service parameters as regular taxicabs. The WAVs shall meet all requirements of the Americans with Disabilities Act of 1990 and all subsequent and applicable amendments as well as all related Federal Regulations, including but not limited to, 47 CFR Parts 37 and 38. Flag drop meters in all Vehicles shall be calibrated once every twelve (12) months by an approved testing firm. The Contract Officer may require additional calibration if needed to ensure accurate calibration. K. Accidents, Incidents, Complaints: Contractor shall require that all drivers complete an "Incident Report" or "Accident Report" if they opt to participate in the City's DAR program. 01007.0001/66871.1 Reports shall be submitted to the Contract Officer within 24 hours of a reportable incident or accident associated with a trip performed for the City. 2. Contractor shall have a dedicated employee to answer the Contractor's customer service issues and complaints received by the City. The associate shall also keep a log of all complaints belonging to the City's DAR program for future review as needed. 3. Customer complaints or Service complaints include, but are not limited to: missed pickups, failure to pick-up, late pick-ups (i.e., 20 minutes or greater), and/or any behavior by Contractor that is in breach of this Agreement (i.e., asking/demanding participants for tips). All complaints must be addressed and resolved by the Contractor within three (3) business days from the original submission. L. Americans with Disabilities Act: 1. Contractor shall comply with the Americans with Disabilities Act of 1990 and all subsequent and applicable amendments as well as all related Federal Regulations, including but not limited to, 47 CFR Parts 37 and 38. II. As part of the Services, Consultant will prepare and deliver the following tangible work product to the City: Not applicable. III. In addition to the requirements of Section 6.2, during performance of the Services, Contractor will keep the City apprised of the status of performance by delivering the following status reports: Not applicable. IV. All work product is subject to review and acceptance by the City, and must be revised by the Contractor without additional charge to the City until found satisfactory and accepted by City. V. Contractor will utilize the following personnel to accomplish the Services: A. William Rouse, General Manager B. Egor Schulman, Dispatch Manager C. Marco Soto, Vice President and Director of Operations D. Michael Daniels, Safety Manager E. Debbie Ascencion, Community Relations Coordinator 01007.0001/665871.1 F. Joyce Sage, Customer Care G. Qualified Staff H. Qualified Drivers 01007.0001/665871.1 EXHIBIT "A-1" DIAL -A -RIDE SERVICE MAP owlQrawr Facilities Served Address . Q�t+rMwM ,�C�G Q #?w�wwn � Kaiser Gardena c �+ r`4 Gardena CA 2- �' � so 02414-.J" '7 i .� a .�.,""'• 4 z Gardena CA 3. Memorial Hospital of Gardena «...I Gardena CA rt..M... �.i V 1000 W. Artesia Avenue Gardena CA 5. Kaiser Permanente Harbor City 25825 S. Vermont Avenue Harbor City,CA Iy 3 a„ 1 � .p • O Lakewood CA 1. I St. Mary's Medical Center 1ObO Linden Avenue i f-�' ever : • � CE�'1!. 2 Ir iwa M N T� OW Now% �wfM ►i� 1rKM 4 v dw . r MMM Uvestnded Destwmmom n O _ Ark "'a Me(kaf or Social S"ce fackbes only '�.. n,nbe+s Represent Sateeae Destna(vans Satellite Destinations 01007.0001/665871.1 Facilities Served Address city 1. Kaiser Gardena 15446 Western Avenue Gardena CA 2- Community Hospital of Gardena 1246 155'" Street Gardena CA 3. Memorial Hospital of Gardena 1145 W. Redondo Beach Boulevard Gardena CA 4. Gardena -Carson YMCA 1000 W. Artesia Avenue Gardena CA 5. Kaiser Permanente Harbor City 25825 S. Vermont Avenue Harbor City,CA 6. Lakewood Regional Hospital 3700 South Street Lakewood CA 1. I St. Mary's Medical Center 1ObO Linden Avenue Long Beach CA 8. California Pools of Hope,Inc. 6801 N. Long Beach Long Beach CA 9_ L. B. Community Hospital 1720 Termino Avenue Long Beach CA 10. Harriman Jones Medical Center 2600 Redondo Avenue Long Beach CA 11. Kaiser Clinic 3900 E. Pacific Coast Highway Long Beach CA 12. Kaiser Dialysis 145 W. Victoria Street Long Beach CA 13. Long Beach Health Department 2525 Grand Avenue Long Beach CA 14. Long Beach Senior Center 1150 E. 41h Street Long Beach CA 15. Veteran's Hospital 5901 E. Th Street Lonq Beach CA 16. San Pedro Peninsula Hospital (Little Company of Mary Hospital) 1300 W. 7'1' Street San Pedro, CA 17. Little Company of Mary Hospital 4101 Torrance Boulevard Torrance. CA 01007.0001/665871.1 Client#: 1251842 303ADMINSER ACORDI., CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 05/27/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: CONTACT Masoud Shahri McGriff Insurance ServicesP HONE619 231-1010 FAX N Ext : A/C, No :888 328-1322 750 B Street Suite 2400 E-MAIL.,(A San Diego, CA 92101 ADDRESS: EEpACCMH��OEECCURRENCE $1,000,000 619 231-1010 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: United Specialty Insurance CO. 112537 INSURED INSURER 8: Administrative Services Cooperative Inc. PREMASTOEaoccurrOence $100000 et al ("see below) INSURER C : X BI/PD Ded: $25,000 1515 W 190th Street, Suite 250 INSURER D Gardena, CA 90248 INSURER E PERSONAL & ADV INJURY S1,000,000 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 CONTRACTOR 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. INSRTypE LTR OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY ATN2096358 6/01/2020 06/01/2021 EEpACCMH��OEECCURRENCE $1,000,000 CLAIMS -MADE 1X OCCUR PREMASTOEaoccurrOence $100000 MED EXP (Any one person) 55,000 X BI/PD Ded: $25,000 PERSONAL & ADV INJURY S1,000,000 X X GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000,000 PRO - POLICY JECT LOC PRODUCTS - COMP/OPAGG 52,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) S ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ Per accident S UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A STA U E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate is subject to policy limits, conditions and exclusions. 30 Day notice of Cancellation - 10 Days for Non -Payment. City of Carson, its elected and appointed officers, employees, volunteers, and agents are additional insureds. Waiver of subrogation is provided in favor of additional insureds. General Liability and Auto Liability policies are primary and non-contributory. (See Attached Descriptions) CANCELLATION City of Carson SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 701 E. Carson Street ACCORDANCE WITH THE POLICY PROVISIONS. Carson, CA 90745 AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S25805385/M25805356 DARAM DESCRIPTIONS (Continued from Page 1) Administrative Services Cooperative, Inc. L.A. Taxi Co -Operative, Inc. dba: Yellow cab Co -Op dba: L.A. Yellow dba: Yellow Cab dba: Yellow Cab of L.A. dba: Santa Monica Yellow Cab Long Beach Yellow Cab Co -Op, Inc. dba: Long Beach Yellow Cab Co -Op dba: Yellow Cab Yellow Cab of South Bay Cooperative, Inc. dba: South Bay Yellow Cab Co -Op dba: Manhattan Beach Yellow Cab Co -Op dba: Yellow Cab South Bay Cooperative, Inc. dba: United Checker Cab Co -Op Fiesta Taxi Cooperative, Inc. dba: Fiesta Taxi Co -Op dba: 1 -800 -TAXICAB dba: Ride Yellow Taxi Systems, Inc. Taxi Equipment Company, Inc. Enterprise Finance, Inc. TXC Finance, LLC Wilmington Cab Company of California, Inc. Van Ness Management, Inc. City of Carson, its elected and appointed officers, employees and agents are additional insureds. Waiver of subrogation is provided in favor of additional insureds. Policy is primary and non-contributory. SAGITTA 25.3 (2016/03) 2 of 2 #S25805385/M25805356 POLICY NUMBER: ATN2096358 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): When required by written contract City of Carson, its elected and appointed officers, employees, volunteers and agents are additional Insureds. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 United Specialty Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VEN 051 00 (01/15) PRIMARY AND NON-CONTRIBUTING INSURANCE ENDORSEMENT This endorsement modifies the Conditions provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Any coverage provided to an Additional Insured shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless: 1) a written contract or written agreement specifically requires that this insurance apply on a primary and non-contributory basis; or 2) prior to a loss, you request in writing and we agree that this insurance shall apply on a primary and non-contributory basis. Name Of Person(s) Or Organization(s) ity of Carson, its elected and appointed officers, employees, volunteers and lents are additional Insureds. All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. VEN 051 00 (01/15) Page 1 of 1 POLICY NUMBER: ATN2096358 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of Carson, its elected and appointed officers, employees, volunteers and agents are additional Insureds Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 4`CO�RD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 07/29/2019 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 American Business Insurance Services, Inc. A32107 W. Lindero Cyn Rd, Ste 120 Westlake Village, CA 91361 CONTACT NAME: Dylan Roberts PHONE: 800-980-1950 27 FAX: 800-980-1960 EMAIL ADDRESS: dylan@abiweb.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: New York Marine & General Insurance Co 16608 INSURED Administrative Services Cooperative, Inc. et al dba: Yellow Cab 2129 W. Rosecrans Avenue Gardena, CA 90249 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURENCE CLAIMS -MADE F__] OCCUR DAMAGE TO RENTED PREMISES Ea occurrence MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea occurrence BODILY INJURY (Per Person) 100,000 X ANY AUTO A X ALL OWNED SCHEDULED AUTOS AUTOs HIRED AUTOS X NON -OWNED AUTOS X X AU2019TLP06081 08/01/19 08/01/20 BODILY INJURY(PerAccident) 300,000 PROPERTY DAMAGE peracddent 100,000 X $25,000 Deductible UMBRELLA LIAB X OCCUR EACH OCCURENCE See Description A X EXCESS LIAB I CLAIMS -MADE AU2019TLP06082 08/01/19 08/01/20 AGGREGATE DED RETENTION $ WORKERS COMPENSATION AND YfN EMPLOYER' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE/ ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA PER STATUTE1 10 ERH E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Vehicle Schedule on File with Company. Excess Liability Coverage limit is the difference between the underlying up to $1,000,000. *10 Day notice of cancellation in the event of non-payment of premium. CERTIFICATE HOLDER CANCELLATION City of Carson SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 701 E. Carson Street EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH Carson, CA 90745 THE POLICY PROVISIONS. AUTtjQRIZE/DD REPRESENTATIVE A r^non oc /ono 1 M4 ©1988-2014 ACORD CORPORATION_ All rinhtc rasarvarl The ACORD name and logo are registered marks of ACORD ACOR" AGENCY CUSTOMER ID: yellowla LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY American Business Insurance Services Inc. NAMED INSURED Administrative Services Co -Op 2129 W. Rosecrans Avenue Gardena, CA 90249 POLICY NUMBER AU2018TLP06081 CARRIER New York Marine and General NAIC CODE 16608 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Administrative Services Cooperative, Inc. Fiesta Taxi Cooperative, Inc. dba: Fiesta Taxi Co -Op; dba: 1 -800 -TAXICAB; dba: Ride Yellow L.A. Taxi Co -Operative Inc. dba: Yellow Cab Co -Op; dba: L.A. Yellow; dba: Yellow Cab; dba Yellow cab of L.A.; dba: Santa Monica Yellow Cab Long Beach Yellow Cab Co -Op, Inc. dba: Long Beach Yellow Cab Co -Op; dba: Yellow Cab South Bay Cooperative, Inc. dba: United Checker Cab Co -Op Yellow Cab of South Bay Cooperative, Inc. dba: South Bay Yellow Cab Co -Op; dba: Manhattan Beach Yellow Cab Co -Op; dba: Yellow Cab Enterprise Finance, Inc. Taxi Equipment Company, Inc. Taxi Systems, Inc. TXC Finance, LLC Van Ness Management, Inc. Wilmington Cab Company of California, Inc. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 30 POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE AU2019TLP06081 08/01/2020 New York Marine & General Insurance Co NAMED INSURED AUTHORIZED REPRESENTATIVE Administrative Services Cooperative, Inc. et al dba: Yellow Cab COVERAGE PARTS AFFECTED Commercial Auto CHANGES THIS ENDORSEMENT HEREBY CHANGES THE POLICY IN THE FOLLOWING MANNER Policy expiration date is amended from 08/01/20 to 11/01/20 Rate Per Mile: $0.10415 Total Additional / Return Premium: --SD Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 Copyright, ISO Commercial Risk Services, Inc., 1983 Date Issued: 07/28/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 23 POLICY NUMBER Authorized POLICY CHANGES COMPANY EFFECTIVE AU2019TLP06082 08/01/2020 New York Marine & General Insurance Co NAMED INSURED AUTHORIZED REPRESENTATIVE Administrative Services Cooperative, Inc. et al dba: Yellow Cab COVERAGE PARTS AFFECTED Commercial Auto CHANGES THIS ENDORSEMENT HEREBY CHANGES THE POLICY IN THE FOLLOWING MANNER Policy expiration date is amended form 08/01/20 to 11/01/20 Rates: $350,000 CSL - $0.018 per mile $300,000/600,000/100,000 - $0.026 per mile $500,000 CSL - $0.030 per miles $1,000,000 - $0.064 per mile remium:_ Total Additional / Return Premium---S-Q-- Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 Copyright, ISO Commercial Risk Services, Inc., 1983 Date Issued: 07/28/2020 POLICY NUMBER:AU2019TLP06081 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Administrative Services Cooperative, Inc. et al dba: Yellow Cab Endorsement Effective Date: 08/01/2019 SCHEDULE Name Of Person(s) Or Organization (s): City of Carson 701 E. Carson Street Carson, CA 90745 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1, of Section II Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: AU2019TLP06082 COMMERCIAL EXCESS LIABILITY CX 21 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - DESIGNATED ONGOING OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART SCHEDULE Description Of Designated Ongoing Operation(s): All operations other than those taking place under contract with: City of Carson 701 E. Carson Street Carson, CA 90745 Limits provided for this contract are up to a Combined Single Limit of $1,000,000. Specified Location (If Applicable): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following exclusion is added to Paragraph 2. Exclusions of Section I — Coverages: 2. Exclusions Insurance provided under this Coverage Part does not apply to "injury or damage" arising out of the ongoing operations described in the Schedule of this endorsement, regardless of whether such operations are conducted by you or on your behalf or whether the operations are conducted for yourself or for others. Unless a "location" is specified in the Schedule, this exclusion applies regardless of where such operations are conducted by you or on your behalf. If a specific 'location" is designated in the Schedule of this endorsement, this exclusion applies only to the described ongoing operations conducted at that "location". For the purpose of this endorsement, 'location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of- way of a railroad. CX 21 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: AU2019TLP06082 COMMERCIAL EXCESS LIABILITY CX DS 01 09 08 COMMERCIAL EXCESS LIABILITY DECLARATIONS CAUTION: This is a sample multistate Declarations Page. Participating companies should use this material only as a guide and should modify it as necessary after review of any applicable law and the coverage form with which it is intended to be used. Consult state filing laws for filing requirements applicable to Declarations Pages. Company Name: New York Marine & General Insurance Cc Producer Name: American Business Insurance Services Inc. Named Insured(s):Administrative Services Cooperative, Inc. et al dba: Yellow Cab Mailing Address: 2129 W. Rosecrans Avenue, Gardena, CA 90249 Policy Period From: 08/01/2019 To: 08/01/2020 At 12:01 AM (Standard Time at your mailing address shown above) IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE TO PROVIDE YOU WITH THE INSURANCE AS STATED IN THIS POLICY. Excess Policy — Limits Of Insurance Each Occurrence Limit $See Endorsements CX21120413 Aggregate Limit $ Other: $ Excess Policy — Premium Premium (including premium subject to audit) $See Endorsement IL00390813 Premium Shown Is Payable: At Inception At Each Anniversary (If policy period is more than one year and premium is paid in annual installments. Audit Period (If Applicable) ❑Annually ❑ Semiannually ❑ Quarterly I 0 Monthly CX DS 01 09 08 0 ISO Properties, Inc., 2007 Page 1 of 3 0 Endorsements Attached To The Excess Policy Schedule Of Controlling Underlying Insurance Company: New York Marine & General Insurance Co Policy Number: AU2019TLP06081 Commercial Policy Period: 08/01/2019 -08/01/2020 Auto Limits Of Insurance: Liability Garage Aggregate Limit For $ Other Than Autos (if applicable) Each Accident Bodily Injury $300,000 Each Person Bodily Injury 100,000 Each Accident Property Damage 100,000 Company: Employer's Liability Policy Number: Policy Period: Limits Of Insurance: Bodily Injury By Accident Each Accident $ Bodily Injury By Disease Policy Limit $ Bodily Injury By Disease Each Employee $ Page 2 of 3 © ISO Properties, Inc., 2007 CX DS 01 09 08 0 CX DS 01 09 08 0 ISO Properties, Inc., 2007 Page 3 of 3 0 Type Of Coverage: 0 Occurrence 0 Claims -made Company: Policy Number: General Policy Period: Liability Limits Of Insurance: Each Occurrence $ Personal And Advertising Injury $ Any one person or organization Products -completed Operations $ Aggregate General Aggregate $ Type Of Coverage: 0 Occurrence F]Claims-made Other Company: Coverages Policy Number: Policy Period: Limits Of Insurance: CX DS 01 09 08 0 ISO Properties, Inc., 2007 Page 3 of 3 0 POLICY NUMBER: AU2019TLP06082 INTERLINE IL 0039 0813 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMPOSITE RATE ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Premium Basis/Exposure (As Checked By Applicable Box): X Auto X Mileage ❑ Cost Of Hire ❑ Payroll ❑ Gallons ❑ Total Cost ❑ Gross Receipts ❑ Other ❑ Excl. Fuel Surcharge ❑ Gross Sales ❑ Inter -company Sales Excluded ❑ Gross Domestic Sales ❑ Inter -company Sales Excluded Coverage/Units Of Ex osure: Coverage Description Premium Estimated Units Composite Rate Per Advance/Estimated Basis Of Exposure Rates Premium(s) Auto Liability up to Mileage 2,765,884 $0.018 Mile $49,786 $350,000 CSL Usage Rate Auto Liability up to Mileage 4,548,263 $0.026 Mile $118,255 $300,000 / $600,000 / $100,000 Usage Rate Auto Liability up to Mileage 984,125 $0.030 Mile $29,524 $500,000 CSL Usage Rate Auto Liability up to Mileage 6,628,320 $0.064 Mile $424,212 $1,000,000 CSL Usage Rate "Autos" Constructed Prior To Model Year Are Not Eligible For Comprehensive, Specified Causes Of Loss And/Or Collision coverage(s). IL 0039 0813 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 3 with its permission Minimum Exposure Units 90% Of Estimated Exposure Units Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Class Code, Premium Basis, and Rate Section of the policy Declarations is changed to apply as follows: The premium for this policy will be computed upon a composite basis as shown above in accordance with our rules, rates, rating plans, premiums and minimum premiums and the other policy terms. A. With respect to the Commercial Automobile Coverage Part, the Premium Audit condition is replaced by the following.- Premium ollowing: Premium Audit a. The estimated premium for this Coverage Form is based on the estimated exposures at policy inception and the composite rate shown in the Schedule of this endorsement. We will compute the final premium due when we determine your actual exposures, subject to the minimum exposure shown in the Schedule of this endorsement. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance, if any. The due date for the final premium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due, the first Named Insured will get a refund. b. If this policy is issued for more than one year, the premium for this policy will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy. c. The first Named Insured must maintain records in sufficient detail so that we can determine the premium for this policy, and send us copies at such times as we may request. Those records must show all changes in the units of exposure during the policy period. With respect to "autos" such records must include additions to and deletions of "autos" and must include for each "auto" the vehicle description and the date of acquisition, disposition or sale. d. If a Premium Audit provision contained in an applicable state amendatory endorsement attached to this Coverage Form conflicts with the Premium Audit provision of this endorsement, the Premium Audit provision of the applicable state amendatory endorsement will govern the premium audit for this Coverage Form. B. With respect to the Commercial General Liability Coverage Part, the Premium Audit Condition is deleted and replaced by the following: Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this policy as Advance Premium is an estimated premium based on the Exposure and Composite Rate shown in the Schedule of this endorsement. At the close of each audit period we will compute the earned premium for that period, subject to the Minimum Exposure shown in the Schedule of this endorsement, and send notice to the first Named Insured. The due date for audit is the date shown as the due date on the bill. If the sum of the Advance and Audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must maintain records in sufficient detail so that we can determine the premium for this policy, and send us copies at such times as we may request. Those records must show all changes in the units of exposure during the policy period. d. Any of the provisions of this endorsement that conflict with a law which controls the Premium Audit for this Coverage Part is changed by this statement to comply with that law. C. The units of exposure shown in the Schedule above are defined as follows: 1. "Auto" means the actual number of covered "autos" by vehicle classification. 2. "Cost Of Hire" means the total cost of hiring the "autos". If "autos" are hired without operators, this includes the actual wages of the operators of such "autos". IL 0039 0813 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 3 with its permission 3. "Gallons" means the total number of gallons of gasses invoiced on any basis to any customer, whether or not the insured actually takes possession of such gases. 4. "Gross Receipts" means the definition of "gross receipts" contained in the Truckers or Motor Carrier Declarations Page. 5. "Gross Receipts Excl. Fuel Surcharge" means the definition of "gross receipts" contained in the Truckers or Motor Carrier Declarations Page and also does not include Fuel Surcharges up to a maximum of % of all other includable Gross Receipts. Fuel Surcharges in excess of % of all other includable revenue shall be included in the Gross Receipts for rating purposes. 6. "Gross Sales" means the gross amount charged by the Named Insured, concessionaires of the Named Insured or by others trading under the insured's name for all goods or products, sold or distributed; operations performed during the policy period; rentals; and dues or fees. "Gross sales" include both foreign and domestic sales. "Gross sales" also include sales by one named insured to another, unless the "Inter -company Sales Excluded" section in the Schedule of this endorsement is indicated by an 'Y'. In determining the amount of "Gross Sales", no deduction shall be made for foreign exchange discounts, customer freight allowance, sales of consigned goods and warehouse receipts, trade or cash discounts, bad debts, or amount actually collected on repossessed items. "Gross Sales" shall not include sales or excise taxes, credits for repossessed or returned merchandise, allowances for damaged and spoiled goods, finance charges, freight charges invoiced as a separate item, or royalties. "Gross Sales" as calculated for products liability coverage also shall not include rental receipts. 7. "Gross Domestic Sales" means the gross amount charged by the Named Insured, concessionaires of the Named Insured or by others trading under the insured's name for all goods or products, sold or distributed; operations performed during the policy period; rentals; and dues or fees less any gross sales outside of the United States of America (including its territories and possessions), Puerto Rico and Canada. "Gross Domestic Sales" also include sales by one named insured to another, unless the "Inter -company Sales Excluded" section in the Schedule of this endorsement is indicated by an "x". In determining the amount of "Gross Domestic Sales", no deduction shall be made for foreign exchange discounts, customer freight allowance, sales of consigned goods and warehouse receipts, trade or cash discounts, bad debts, or amount actually collected on repossessed items. "Gross Domestic" sales shall not include sales or excise taxes, credits for repossessed or returned merchandise, allowances for damaged and spoiled goods, finance charges, freight charges invoiced as a separate item, or royalties. "Gross Domestic Sales" as calculated for products liability coverage also shall not include rental receipts. 8. "Mileage" means the total miles loaded and unloaded of all "autos", except trailers or semi -trailers, you own, hire lease or borrow for the transportation of property or people during the policy period. 9. "Payroll" means total remuneration for all "employees" of the insured as defined in our Insurance Services Office rating manuals. 10. "Total Cost" means the total cost of all work let or sublet in connection with each specific project including the cost of all labor, materials and equipment furnished, used or delivered for use in the execution of the work, and all fees, bonuses or commissions made, paid or due. Total Cost does not include the cost of finished equipment installed but not furnished by the subcontractor if the subcontractor does no other work on or in connection with such equipment. 11. "Other" means the unit of exposure as defined in the Premium Basis/Exposure Schedule of this endorsement IL 0039 0813 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 3 with its permission ACORO0 CERTIFICATE OF LIABILITY INSURANCE UATE(PProDLYYYY, 05/2812020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. B 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 Faith Branvold c/o Sunset Business Insurance Solutions 7590 N Glenaaks Boulevard, Suite 200 Burbank, CA 91504 CONTANAME: CT Lorelei C. Noonan PNONE 818-827-0315 FA Nn : 310-301-3280 E BAIL lori@sunsetbis.com INSURERtSj AFFORDING COVERAGE NAIC0 INSURERA: StarStone National Insurance Company 25496 INSURED Administrative Services Cooperative, Inc. 1515 W. 190th St. Suite 250 Gardena, CA 90248 INSURER 8: INSURER C : INSURER 0: 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 LTR TYPE OF INSURANCE A L SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F]OCCUR EACHOCCURRENCE S PREMISES Ea ocwrrance S MED EXP (Anyone parson) $ PERSONAL d ADV INJURY S GEN1. AGGREGATE LIMIT APPLIES PER: POLICY LI JE T r LOC OTHER: GENERAL AGGREGATE S PRODUCTS -COMP/OP AGG $ $ AUTONOBILELIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) S BODILY INJURY (Par accident) S PROPERTY DAMA E S Per acodent S UMBRELLA LIAR EXCESS LIAR OCCUR CLAOAS•MADE EACH OCCURRENCE S AGGREGATE S DED I I RETENTIONS S A WORKERS COMPENSATION AND EMPLOYERS' L"ILITY OFFCEWMEMBEREXCLUDED? ECUTIVE YIN (Mandatory M NH) t( es, describe under DESCRIPTION OF PERATIONS below NIA N T10200645. 01/3112020 01/31/2021 H X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE EA EMPLOYEE S 1,000,000 E.L. DISEASE POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached I more space!* required) CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carson THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 701 E. Carson St. ACCORDANCE WITH THE POLICY PROVISIONS. Carson, CA 90745 AUTHORIZEDR£PRESE ATI VE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD