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HomeMy Public PortalAboutC-21-167 - ECS IMAGING, INC. 2023 MARCH 09 AMENDMENT NO. 19thMarch I. The existing table is deemed amended to reflect that it applies to the period of February 2, 2022 to February 2, 2023 (Year 1).* II. A new table is added, applicable to the 12 -month period from February 2, 2023 to February 2, 2024 (Year 2)* and the 12 -month period from February 2, 2024 to February 2, 2025 (Year 3), to read as follows: Software- as -a -Service t,emdnClteaPtelatrest Demme rwpnt lotINwttermepsour RMS-4GrRta. wooer Owe Protectory Tier rows: Dort Sevc, Dote toajitioe st Rest AMo .alas, Aenrutd a litoltaia $etlt/1 . loarair peke. AIW.atet 'man G Snort, trams. AttArMN TM ilfrRRnq retort AIM rtr tar. Amore. Stoner Arit nor, ~Ow & Pietas 'NOM Arematio t McLLMt, S i.oreT 1 Worstlor Got r trot tent union: a/A9ert rttirotroot ets htS Ogre sretvert T. NS ofrrria 111 a MGdi NAM GLST/Mrob AM oRt/.awLL GSD Du.eyrr Jut t.... Q....,ry Lima Teed QLdf2 rttau CUPAt CfPaa ECSGOID LaatArto Pf Clad Prokssena(Wen (S-49) laeerfidte Pf Clod War* PA.bbc Portal pp to 1,000 Ytews/rnontV) taurfdr PP dad forms Portal {Up to 1000 SrArnasittlyrnol tauefidte PP gaud Participant Users (10-199) ECSGOtDPriority Suwon $ $ S 5 5 93000 16 5 60000 1 S 1.100 00 1 S 12000 12 S 17500 17 S 1321000 60000 110000 1.24000 2.97500 Cioud Professional Subtotal $ 20,115,00 *Notwithstanding the foregoing, City and Consultant agree that the ten (10) additional "Laserfiche PF Cloud Professional Users (5-49)" will not be added for the City's use until March 2, 2023, or the date of full execution of Amendment No. 4 to the Agreement, whichever is later. City and Consultant therefore agree that City will not be billed for these additional services until the first month during which these added services are actually provided, and will be entitled to proration for each month out of any 12 -month period during which the additional services are not actually provided. C. The total cost table at the end of Section I of Exhibit "C" (Schedule of Compensation) is amended as follows: "Total Upfront Cost (Year 1) $15,995.00 Total Annual Cost (Years 2-3) $20,095.00 $-1- 00 (Years 4-5 too if term is extended) TOTAL CONTRACT SUM $56,185.00 $39383:00" D. Section V of Exhibit "C" (Schedule of Compensation) is amended as follows: "The total compensation for the Services shall not exceed $56,185.00 $-397-541-5700 as provided in Section 2.1 of this Agreement." 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 2 01007.0001/857504.6 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. 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 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] 3 01007.0001/857504.6 IN WITNESS WHEREOF. the parties hereto have executed this Amendment on the date and year first -above written. CITY: CITY OF CARSON, a municipal corporation ATTEST: Dr Khaleah K. Bradshaw, City Clerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney [brj] a Davis-I-Iolmes. Mayor CONSULTANT: ECS IMAGING, INC., a California corporation By: ?'dame: t_')`,'-.) i ,126-(C.r;--, Title: C_ti C' By: �`✓ Name: ie /! i Title: c F c- Address: 5905 Brockton Avenue, Suite C Riverside. CA 92506 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 01007.0001/85750-4.6 IN WITNESS WHEREOF, the parties hereto have executed this Amendment on the date and year first -above written. CITY: CITY OF CARSON, a municipal corporation Lula Davis -Holmes, Mayor ATTEST: Dr. Khaleah K. Bradshaw, City Clerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney [brj] CONSULTANT: ECS IMAGING, [NC., a California corporation By: ,t44,��l�lf'�_ Name: f t & 1 : /36-10,0 Title: e.) By: I4ame: p, /1, too (re.. — Title: c RQ Address: 5905 Brockton Avenue, Suite C Riverside, CA 92506 Two corporate officer signatures required when Consultant is a corporation, with one signature required from each of the following groups: 1) 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 01007.0001/857504.6 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 , 2023 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 fonn. CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL 0 CORPORATE OFFICER 0 0 TITLE(S) PARTNER(S) 0 LIMITED 0 GENERAL ATTORNEY -IN -FACT TRUSTEE(S) GUARDIAN/CONSERVATOR OTHER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE 01007.0001/857504.6 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 , 2023 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 TITLE(S) PARTNER(S) ❑ LIMITED 0 GENERAL ATTORNEY -IN -FACT TRUSTEE(S) GUARDIAN/CONSERVATOR OTHER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNERS) OTHER THAN NAMED ABOVE 01007.0001/857504.6 ACORO® `� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 05/17/2022 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Boyd, Shackelford, Barnett & Dixon, LLC 5800 Granite Parkway Ste 350 Plano TX 75024 CONTACT Ian Sadler PHONE FAX (A/C.No, Exfl: (972) 767-2811 (A/C,No): (214) 988-5196 E-MAILD ADDRESS: nom A RESS: jedwards@bsbd grou p• INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Beazley Insurance Company, Inc 37540 INSURED (951) 787-8768 ECS Imaging, Inc 5905 Brockton Ave Ste C Riverside CA 92508 INSURERS: INSURER C: INSURERD: INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: Cert ID 32806 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 1 IADDL I TYPE OF INSURANCE i INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP I (MM/DDNYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I JET LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ , BODILY INJURY (Per person) $ OWNED j AUTOS ONLY HIRED AUTOS ONLY I SCHEDULED AUTOS ' NON -OWNED AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ I $ UMBRELLA LIAB EXCESS LIAB I OCCUR I I EACH OCCURRENCE $ CLAIMS -MADE AGGREGATE $ DED 1 RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIEFOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS �, / N 1 i I ,N/A 1 PER OTH- STATUTE ER E.L EACH ACCIDENT $ E.L DISEASE- EA EMPLOYEE $ below i E.L DISEASE - POLICY LIMIT $ A A Professional E&O Liabilit , Cyber/Network Liability VG00004828AB V000004828AB 04/10/2022 04/10/2022 04/10/2023Each 04/10/2023Each Claim Limit of Liability Claim Limit of Liability $ 2,000,000 $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Carson 701 E Carson Street Carson CA 90745 Insurance Approved By: KI Date: 12/14/2022 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Ac -40R } ,�- CERTIFICATE OF LIABILITY INSURANCE Acct#: 2405923 DATE (MM/DD/YYYY) 12/13/2022 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER - Lockton Companies, LLC 3657 Briarpark Dr., Suite 700 Houston, TX 77042 CONTACT 888-828-8365 PHONE FAX (A/C. No. Ext): (A/C, No): E-MAIL ADDRESS: INSPERITYCERTS(a,LOCKTONAFFINITY.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Ace American Insurance Co. 22667 INSURED ECS IMAGING, INC. 5905 BROCKTON AVE STE C RIVERSIDE, CA 92506-1887 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : 1 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 1ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE j OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENII AGGREGATE LIMIT APPUES JE OT- PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED I SCHEDULED AUTOS NON -OWNED AUTOS ! COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESSIJAB ; ;OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED 1 , RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below Y / N 1 ! N / A C51516138 10/1/2022 10/1/2023 X SPER 1 TATUTE ERH E.L EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POLICY LIMIT 1 $ 1000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addldonal Remarks Schedule, may be attached if more space Is required) WAIVEROF SUBROGATION IN FAVOR OF CITY OF CARSON WHEN REQUIRED BY WRITTEN CONTRACT CERTIFICATE HOLDER CANCELLATION CITY OF CARSON 701 E CARSON STREET CARSON, CA 90745 Insurance Approved By: KI Date: 12/14/2022 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured ECS IMAGING, INC. 5905 BROCKTON AVE STE C RIVERSIDE, CA 92506-1887 Endorsement Number Policy Number Symbol: RWC Number: C51516138 Policy Period 10/1/2022 TO 10/1/2023 Effective Date of Endorsement 10/1/2022 Issued By (Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( X ) Specific Waiver Name of person or organization: City of Carson 701 E Carson Street Carson, CA 90745 () Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium: The premium charge for this endorsement shall be INCLUDED percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: INCLUDED • WC 90 03 75 (05/18) THE HARTFORD City of Carson 701 E CARSON ST CARSON CA 90745 THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 Account Information: Policy Holder Details : ECS IMAGING, INC. September 2, 2022 Contact Us Need Help? Start a live chat online or call us at (866) 467-8730. We're here weekdays from 8:00 AM to 8:00 PM ET. Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WLTR005 ► - CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/02/2022 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 SUBROGATIONIS 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 HUB INTERNATIONAL INS SVCS INC/PHS 72165935 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251 CONTACT NAME: PHONE (866) 467-8730 (A/C, No, Ext): FAX (A/C, No): E-MAIL ADDRESS. INSURER(S) AFFORDING COVERAGE NAIL# INSURED ECS IMAGING, INC. 5905 BROCKTON AVE STE C RIVERSIDE CA 92506-1887 INSURER A: Sentinel Insurance Company Ltd. 11000 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 INSR SUER WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DDIYYYY) LIMITS A COMMERCIAL GENERAL X LIABILITY ]OCCUR X X 72 SBA KT6798 10/01/2022 10/01/2023 EACH OCCURRENCE $2,000,000 CLAIMS -MADE] DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 X General Liability MED EXP (Any one person) $10,000 PERSONAL&ADVINJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PRO- JECT PER: GENERAL AGGREGATE $4,000,000 POLICY X LOC PRODUCTS - COMP/OPAGG $4,000,000 OTHER: A AUTOMOBILE _ X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS 72 SBA KT6798 10/01/2022 10/01/2023 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 BODILY INJURY (Per person) _ BODILY INJURY (Per accident) X PROPERTY DAMAGE (Per accident) A X UMBRELLA LIAR EXCESS LIAR x OCCUR cuaims- MADE 72 SBA KT6798 10/01/2022 10/01/2023 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 DED X RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY Y/N PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/ A PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION City of Carson 701 E CARSON ST CARSON CA 90745 Insurance A roved pp By: KI Date: 12/14/2022 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE due`s., o Cav&.z ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: AGENCY ADDITIONAL REMARKS SCHEDULE Page 2 of 2 HUB INTERNATIONAL INS SVCS INC/PHS POLICY NUMBER SEE ACORD 25 CARRIER SEE ACORD 25 NAIC CODE NAMED INSURED ECS IMAGING, INC. 5905 BROCKTON AVE STE C RIVERSIDE CA 92506-1887 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 attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. Notice of Cancellation will be provided in accordance with Form SS1223, attached to this policy. ACORD 101 (2014/01) © 2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD