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HomeMy Public PortalAboutC-16-021 - Intelli-Flex, Inc. Amendment No. 3, Avaya Software & Hardware Maintenance and SupportAMENDMENT NO.3 TO AGREEMENT FOR CONTRACT SERVICES THIS AMENDMENT TO THE AGREEMENT FOR CONTRACT SERVICES ("Amendment No. 3") by and between the CITY OF CARSON, a California municipal corporation ("City") and INTELLI-FLEX, INC., a California corporation ("Consultant") is 1 effective as of the 30`h day of September, 2020. v RECITALS A. City and Consultant entered into that certain Agreement for Contract Services dated October 1, 2016 ("Agreement") whereby Consultant agreed to provide Avaya software and hardware maintenance and support services. B. The City and Consultant desired, and the City Council's action approved, the Agreement for a term of three (3) years, for a total Contract Sum not to exceed $59,610. C. The Agreement ultimately executed by the parties included a provision that did not conform to the intent of the parties and was inconsistent with the Council's approval. D. Specifically, Council awarded a three (3) year contract, but the Agreement provided for a one (1) year contract, with the option to renew the term for two additional one- year terms. E. City and Consultant entered into that certain Amendment No. 1 to Agreement for Contract Services dated August 8, 2019 whereby the parties agreed to amend the Agreement to (1) reconcile the Agreement terms with the City Council's approval of the Agreement, (2) extend the term of the Agreement for an additional year so that it expires on September 30, 2020, (3) expand the Scope of Services to include Avaya software and hardware maintenance and support services for 12 City parks, and (4) increase compensation by $43,961.86 to cover the cost of the extended term and services for 12 City parks, for a total Contract Sum not to exceed $103,571.86. F. City and Consultant entered into that certain Amendment No. 2 to Agreement for Contract Services dated April 7, 2020 to add compensation for additional Ad Hoc Services hours increasing compensation by $12,800.00 for a total Contract Sum not to exceed $116,371.86. G. City and Consultant are currently working on multiple projects requiring Ad Hoc Services under the Agreement which require additional time to complete and continued phone Avaya software and hardware maintenance and support services. H. Now City and Consultant desire to extend the term of the Agreement for an additional nine (9) months, expiring June 30, 2021, to give time for Consultant to complete current projects and increase compensation by $18,385 to cover continued Avaya software and hardware maintenance and support services for the additional nine months for a total Contract Sum not to exceed $134,756.86. 01007 0001 676407 1 TERMS 1. Contract Changes. The Agreement is amended as provided herein (new text in bold italics and deleted text in strip). a. Section 2.1, "Contract Sum," is hereby amended as follows: "Subject to any limitations set forth in this Agreement, City agrees to pay Consultant the amounts specified in the "Schedule of Compensation" attached hereto as Exhibit "C" and incorporated herein by this reference. The total compensation, including reimbursement for actual expenses, shall not exceed One 14undr-ed Sixteen Thousand T-hfee 14undr-ed Sevenly One Dollars and Eight), Six Gents ($116,3 7, 86) One Hundred Thirty Four Thousand Seven Hundred Fifty Six Dollars and Eighty Six Cents ($134,756.86) (the "Contract Sum"), unless additional compensation is approved pursuant to Section 1.8." b. Section 3.4, "Term," shall be amended as follows: "3.4 Term. Unless earlier terminated in accordance with Article 7 of this Agreement, this Agreement shall continue in full force and effect from October 1, 2016 through September- 30 2020 June 30, 2021, except as otherwise provided in the Schedule of ��z�� Performance (Exhibit "D")." C. Section I.B. of Exhibit A, "Scope of Services," shall be amended as follows: "B. Consultant will provide Regular Services for all Avaya software and hardware at the following City parks for the term of October 1, 2019 through , 2020 June 30, 2021: 1. Anderson Park 2. Del Amo Park 3. Hemingway Park 4. Dolphin Park 5. Mills Park 6. Scott Park 7. Dominguez Park 8. Veterans Park 9. Stevenson Park 10. Carson Park 11, Calas Park 01007 0001 676407 1 12. Carriage Crest Park" d. Section C shall be added to Section I. of Exhibit C, "Schedule of Compensation," as follows: "C. For the period of October 1, 2020 through June 30, 2021, Consultant shall perform all Regular Services described in Section I of Exhibit "A," Scope of Services, for a prepaid flat fee of $18,385." e. Section II. of Exhibit C, "Schedule of Compensation," is hereby amended as follows: "II. Consultant shall perform all Ad Hoc Services described in Section II of Exhibit "A," Scope of Services at the rate of $100/hour, for a maximum annual amount of $10,000 except that between March 17, 2020 through September- 2029 June 30, 2021, an additional $12,800 may be incurred by Consultant, following submission of a monthly invoice, in accordance with Section 2.4 and paragraph III, below." f. Section IV. of Exhibit C, "Schedule of Compensation," is hereby amended as follows: "The total compensation for Regular Services pursuant to Section I of Exhibit "A," Scope of Services, for all fur- (4) yoafs- the period of October 1, 2016 through June 30, 2021, shall not exceed $63,571.86 $81,956.86. The total compensation for Ad Hoc Services pursuant to Section II of Exhibit "A," Scope of Services for the period of October 1, 2016 through June 30, 2021, shall not exceed $52,800. Thus, the overall total compensation for Regular Services and Ad Hoc Services for the period of October 1, 2016 through June 30, 2021 shall not exceed $116,37-1.86 $134,756.86, as provided in Section 2.1 of this Agreement." g. Section I. of Exhibit D, "Schedule of Performance," shall be amended as follows: "This Agreement shall continue in full force and effect starting on October 1, 2016 and ending on September- 30, 2020 June 30, 2021. Consultant shall perform all Services timely in accordance with the terms and specifications provided for under the Agreement." 2. Continuing Effect of Agreement. Except as amended by this Amendment No. 3, all provisions of the Agreement shall remain unchanged and in full force and effect. From and after the date of this Amendment No. 3, whenever the term "Agreement" appears in the Agreement, it shall mean the Agreement, as amended by this Amendment No. 3 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 -3- 01007.0001 676407 1 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 No. 3, 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. City represents and warrants to Consultant that, as of the date of this Amendment No. 3, 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 No. 3. 5. Authority. The persons executing this Amendment on behalf of the parties hereto warrant that (i) such party 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] -4- 01007.0001/676407.1 I'll ll r—% wwauff, t& purb , h m han e. tb4 A Dia. 3 cm dint des $et ffurbh bdm won itV= thM this A«numdmmU Nd, 3 shall be eftefivt cl cat Sober lk 320. ATTR'- Doomia "Wise-:Aldma, City C1er1; APPROVED AS lkO FOR . �y ALESHME & r L NL)Elti LLP100) CITY- MYOl* CAIN, la't cc A►, lc�' wyor Dw& �nryv P� CAA -J COHSULTA.hT: 1xtcl�-dear.,1� Burne: r�tltr:,y;�e FM Marne: Dm silvcrrlm 3 itla. CFO ate: igdlj-Fiex.. Inc 17 5WAcb4er Rd Unit 332 trito GA 703 Two ourpa�are olEkxr elgentQres rcgaired wben Ccmstrrant is a cogmraIioo, with aae siicwiure required from amb of the following 9,oD ; 1) Charman of lbe OWN, PreKkkent or any Vice Prcsidm "' "Y Assent Serre", Chief Financial Off-tmr 8fu r UY MsisMnt Trearrr, COMSULiT� s SIGNAMM SHALL BE D4uLY NOTARIZED. &ND APPROPRIATE ATTESTATI"IJS SHALL BE INCLUDED AS MAY BE REQUIRED BY T"E BYLAWS, ARTICLES OE INCORPORATION, OR OTHFR RULES OR RFGULATIONS APPLICABLE TO CONSULTAN-I-S BUSIN IZSS ENITITy. nifxl,:.rmi 61641!, 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 On , 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. Signature: 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 676407.1 DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE 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 676407.1 DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE 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 On , 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. Signature: 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 SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) 01007.0001 676407 1 DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE 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 676407 1 DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE THE HARTFORD BUSINESS SERVICE CENTER THE 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 CITY OF CARSON 701 E CARSON ST CARSON CA 90745-2224 Account Information: Policy Holder Details : INTELLI-FLEX INC. January 23, 2020 %Q Contact Us Business Service Center Business Hours: Monday - Friday (7AM - 7PM Central Standard Time) Phone: (866) 467-8730 Fax: (888) 443-6112 Email: agency.services0thehartford.com Website: https:Hbusiness.thehartford.com Enclosed please find a for the above referenced Policyholder. Please contact us if you have any questions or concerns Sincerely, Your Hartford Service Team WLTRO05 .4Nr Nr'kif °ATE(M CERTIFICATE OF LIABILITY >~ �YYY) INSURAN _ THIS CERTIFICATE IS ISSUED AS • uarreQ rel: I-Ienef.se*�...... — 1-1) 0123/2020 INFORMATION r Iain 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: K the certificate holder Is on ADDITIONAL INSURED, the policypes) must be andorsed. H 8UBR66ATIONIS WAIVED, rs subject to the terms and conditions of the policy, certain POII0108 may require an endoement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsamantrsst_ CBIA INC/PHS 33750118 PHONE The Hartford Business Service Center (AIC' No, ExII: 3800 Wiseman Blvd EMAIL San Antonio, TX 78251 ADDRESS INSURERS) AFFORDING COVERAGE INTELLI-FLEX INC. INSURER A: e 17315 STUDEBAKER RD STE 332 INSURER C: CERRITOS CA 90703-2508 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BE Noy Nae ED 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. INSF TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF POLICY EXP SCH COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $2 Dd0 000 CLAIMS -MADE EOCCUR X General Liability DAMAOE TO RENTED $1,000,000 A X X 33 SBA GC4358 02/21/2020 02/21/2021 MED EXP (Any ons person; $10.000 PERSONAL a ADV INJURY $2,00000 0 OEMLAOGREGATE LIMIT APPLIES PER POLICY ❑ LOC D GENERAL AGGREGATE $4,000.000 PRODUCTS -COMPIOPAGG 54,000,000 ECEx JT OTHER AUTOMOBILELLAMUTY X ANY AUTO %.wMt21NLlJ SINOLELIMB 51,000,000 �, BODILY INJURY (Per P—) C ALL ONMED SCHEDULED AUTOS AUTOS NON-OWNED X AUTOS HIRED X AUTOS X X 33 UEC FU6839 02/21/2020 02121/2021 BODILY INJURY (Per acGdvx) DA P OPERTY MAGE (Per acculent) A UMBRELLA LIAR ( EXCESS UAB 2 OCCUR CLAIMS- MADE X 33 SBA GC4358 02/21/2020 02/21/2021 EACH OCCURRENCE $1,000.000 AGGREGATE $1,00.000 ED X RETENTION $ 10,000 COMPENSATION AND EMPLOYERS' LIABILITY X E B ANY YM OFFICERMEMBER EXCLUDED? OFFICE "Tin BER EXCLUDED? (Mandrlbry M NH) NIA 33 WEC ID3533 08/0112019 08/012020 EL EACH ACCIDENT $1,000,000 E L DISEASE -EA EMPLOYEE $1,000,000 E L DISEASE -POLICY LIMIT $1,000,000 IVs+ ��� under OF FRATlONS below A FAILSAFE TECHNOLOGY E OR 33 SBA GC4358 02212020 02212021 Each Glitch $2,000,000 O1 Aggregate $2.000,000 DESCRIPTION Of OPERATIONS/LOCATIONS/ VEHICLE! (ACORD 101. AddltlonW RsmaAu Schedule. may be anaehed H mon -pees Is requ" Those usual to the Insured's Operations Please see Additional Remarks Schedule Acord Form 101 attached. ""^ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 701 E CARSON ST � / BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED CARSON CA 90745-2224 /'7 U–f �IN ACCORDANCE WITH THE POUCY PROVISIONS. lQ-� _ AUTHORIZED REPRESENTATIVE ®1888.2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2018103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: ,4c ` ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED CBIA INC/PHS INTELLI-FLEX INC. 17315 STUDEBAKER RD STE 332 POLICY NUMBER SEE ACORD 25 CERRITOS CA 90703-2508 CARRIER NAIC CODE SEE ACORD 25 EFFECTIVE DATE: SEE ACORD 25 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Certificate holder is an additional insured per the Business Liability Coverage Form SS0008, the Umbrella Liability Provisions Form SX8002, and the Commercial Auto Broad Form Endorsement HA9916, attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, and Commercial Auto Broad Form Endorsement HA9916, attached to this policy. Notice of Cancellation will be provided in accordance with Forms SS1223, Form IH0313, and WC990394, attached to these policies. Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 33 SBA GC4358 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNER, LESSEES OR CONTRACTOR THE CITY OF LONG BEACH, ITS OFFICIALS, EMPLOYEES AND AGENTS 333 W OCEAN BLVD FL 12 LONG BEACH, CA 90802 THE CITY OF LONG BEACH, THE BOARD OF WATER COMMISSIONERS, AND THEIR OFFICIALS, EMPLOYEES AND AGENTS 1800 E WARDLOW RD LONG BEACH, CA 90807 THE COUNTY OF LOS ANGELES, ITS SPECIAL DISTRICTS, ITS OFFICIALS OFFICERS, AND EMPLOYEES 1100 N EASTERN AVE RM G115 LOS ANGELES, CA 90063 RISK MANAGEMENT CITY OF CARSON 701 E CARSON ST CARSON, CA 90745-2224 Form IH 12 00 11 85 T SEQ. NO. 004 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 11/27/19 Expiration Date: 02/21/21 POLICY NUMBER: 33 UEC FU6839 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following. ADDITIONAL INSURED COMMERCIAL AUTO COVERAGE PART LOS ANGELES DEPARTMENT OF WATER AND POWER RISK MANAGEMENT SECTION P.O. BOX 51111 RM 465 LOS ANGELES, CA 90051-0100 MMCA LTD P 0 BOX 390909 MINNEAPOLIS, MN 55439 CITY OF SIMI VALLEY 2929 TAPO CANYON RD SIMI VALLEY, 93063 DEPT. OF WATER & POWER RISK MANAGEMENT SECTION RM. 465 111 N. HOPE ST. LOS ANGELES, CA 90012 THE CITY OF SIMI VALLEY AND ITS RESPECTIVE BOARDS, DISTRICTS, OFFICERS, AGENTS AND EMPLOYEES 2929 TAPO CANYON RD SIMI VALLEY,CA,93063 RISK MANAGEMENT CITY OF CARSON 701 E CARSON ST CARSON, CA 90745 CARUSO MANAGEMENT COMPANY, LTD GFM, LLC Form IH 12 01 11 85 SEQ.NO. 01 Printed in U.S.A. PAGE 1 (CONTINUED ON NEXT PAGE) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 33 WEC ID3533 Endorsement Number: Effective Date: 08/01/19 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: INTELLI-FLEX INC 5696 CORPORATE AVE CYPRESS CA 90630 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description City of Carson, 701 E Carson St. Carson CA 90745 002 Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 06/22/19 Policy Expiration Date: 08/01/20 THE it HARTFORD Select Customer Insurance Center 8711 UNIVERSITY EAST DRIVE CHARLOTTE NC 28213 Policyholder, please callus at: (866) 467-8730 Agent, please call us at: (866) 467-8730 INSURANCE ENDORSEMENT ATTACHED *** PLEASE REVIEW THE CHANGE *** Enclosed is an endorsement for your business insurance policy. Please review it at your convenience. If you have questions or need to make further changes: Policyholder, please callus at: (866) 467-8730 Agent, please callus at: (866) 467-B730 between 7 A, M. and 7 P.M. CST . The premium billing will be mailed to you separately. You can expect to receive it soon. Thank you for allowing us to service your business needs CBIA INC/PHS THE HARTFORD SELECT CUSTOMER INSURANCE CENTER The Hartford Hartford Fire Insurance Company and its Affiliates One Hartford Plaza, Hartford, Connecticut 06155 F7 I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGE This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated below: Policy Number: 33 SBA GC4358 DV Named Insured and Mailing Address; INTELLI-FLEX INC. 17315 STUDEBAKER RD STE 332 CERRITOS CA 90703 Policy Change Effective Date: 02/21/20 Policy Change Number: 002 Agent Name: CBIA INC/PHS Code: 750118 Effective hour is the same as stated in the Declarations Page of the Policy. POLICY CHANGES: SENTINEL INSURANCE COMPANY, LIMITED ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. THIS IS NOT A BILL. ADDITIONAL PREMIUM DUE AT POLICY CHANGE EFFECTIVE DATE: $37.00 RATES AND PREMIUMS ARE CHANGED. FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: IH12001185 WAIVER OF SUBROGATION PRO RATA FACTOR: 1.000 THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. Form SS 1211 04 05 T Page ool Process Date: 03/25/20 Policy Effective Date. 02/21/20 Policy Expiration Date: 02/21/21 POLICY NUMBER: 33 SBA GC4359 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION 730 AVE F STE 210 PLANO, TX 75074210 RE: AFFILIATED TELEPHONE, INC., COM -NET, INC., AFFILIATED TELEPHONE - AUSTIN, INC., AFFILIATED TELEPHONE -HOUSTON, INC., NORTH AMERICA CONNECTION, INC., AND AFFILIATED COMMUNICATIONS, INC. COUNTY OF KERN ATTN: PURCHASING 1115 TRUXTUN AVE FL 3 BAKERSFIELD CA 93301 THE DISTRICT OF COLUMBIA ATTEN: OFFICE OF THE CHIEF TECHNOLOGY OFFICER 200 I ST. SE WASHINGTON, D.C. 20003 CITY OF CARSON 701 E CARSON ST CARSON, CA 90745-2224 Form IH 12 00 1185 T SEQ. NO. 002 Panted in U.S.A. Page 001 Process Date: 03/25/20 Expiration Date: 02/21/21 . -o ti THE!,�►' HARTFORD Select Customer Insurance Center 8711 UNIVERSITY EAST DRIVE CHARLOTTE NC 28213 Policyholder, please callus at: (8 6 6) 467-8730 Agent, please callus at: (877) 853-2582 INSURANCE ENDORSEMENT ATTACHED *** PLEASE REVIEW THE CHANGE *** Enclosed is an endorsement for your business insurance policy. Please review it at your convenience. If you have questions or need to make further changes: Policyholder, please call us at: (866) 467-873 Agent, please call us at: (87 7) 853-2582 between 7 A M. and 7 P.M. CST. The premium billing will be mailed to you separately. You can expect to receive it soon. Thank you for allowing us to service your business needs. CBIA INC/PHS THE HARTFORD SELECT CUSTOMER INSURANCE CENTER The Hartford Hartford Fire Insurance Company and its Affiliates One Hartford Plaza, Hartford, Connecticut 06155 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MISCELLANEOUS CHANGE ENDORSEMENT POLICY NUMBER: 33 UEC FU6839 DV CHANGE NUMBER: 003A This endorsement modifies insurance provided under the following: THE BUSINESS AUTO COVERAGE FORM HARTFORD This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. (Premium adjustment, if any, for the addition, deletion or other change described in this endorsement is shown in the Premium Column below.) Effective Date: 03/11/2-? Named Insured. INTELLI-FLEX INC. Producer's Name, CBIA INC/PHS Pro Rata Factor: .951 Description of Change: ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT. IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. THIS IS NOT A BILL. HARTFORD ACCIDENT AND INDEMNITY COMPANY NO CHANGE IN PREMIUM THE FOLLOWING ENDORSEMENT(S) IS/ARE ADDED: WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) Countersigned by (Where required by law) Form HA 99 10 01 07T Authorized Representative 03/25/20 Date POLICY NUMBER: 33 UEC FU6839 COMMERCIAL AUTO CRANGE NUMBER: 003A CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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 the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization (s): CITY OF CARSON I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a contract with that person or organization. CA 04 44 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1