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HomeMy Public PortalAboutC-20-048 - ADMINISTRATIVE SERVICES AMENDMENT NO. 3 2023 MAY 15AMENDMENT NO.3 TO AGREEMENT FOR CONTRACT SERVICES THIS THIRD AMENDMENT TO THE AGREEMENT FOR CONTRACT SERVICES ("Amendment") by and between the CITY OF CARSON, a California municipal corporation ("City"), and ADMINISTRATIVE SERVICES COOPERATIVE, INC., a California corporation ("Contractor"), is effective as of the i5�-"day of M 3, 2023. RECITALS A. City and Contractor 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. The Agreement provided for an initial contract term of three years, from July 1, 2020 through June 30, 2023, and a not -to -exceed -Contract Sum of $1,500,000. The Agreement also provided City with the option to extend the initial three-year contract term for up to two additional one-year extension periods. B. On September 1, 2020, City and Contractor entered into Amendment No. 1 to the Agreement, to implement a Lyft-style model ("Expedited DAR"), to which the following was applied: (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. Amendment No. 1 also removed the age restrictions and disability status eligibility requirements from the Standard DAR. C. On June 23, 2022, City and Contractor entered into Amendment No. 2 to the Agreement, to remove all travel restrictions in the defined area outside of City boundaries as depicted in Exhibit "A-1" of the Agreement, to adjust the map set forth in said Exhibit "A-1" to reflect the removal of travel restrictions in such areas (designated as the "additional unrestricted destinations" in the map), and to correct certain prior errors and omissions in the Agreement provisions, all with no change in compensation. D. City and Contractor now desire to amend the Agreement for the third time, by this Amendment, to exercise the first of the City's two options to extend the term of the Agreement for a one-year extension period pursuant to Section 3.4 and Section I of Exhibit "D" (Schedule of Performance) of the Agreement, making its new expiration date June 30, 2024, and to increase the not -to -exceed Contract Sum by $500,000, from $1,500,000 to $2,000,000, to fund the services for the one-year extension period at the rates set forth in Exhibit "C" (Schedule of Compensation) of the Agreement. TERMS 1. Contract Changes. The Agreement is amended as provided herein (new text is indicated in bold italics and deleted text in strip). -1- 01007.0001/862203.2 A. Section 2. 1, "Contract Sum," of the Agreement is hereby amended to read in its entirety as follows: "2.1 Contract Sum. Subject to any limitations set forth in this Agreement, City agrees to pay Contractor 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 Two Million Dollars ($2,000,000) One Millie., Five H+md.oa Theusand Dollars /Q 1 cnn nnm for the four-year dial --term of the Agreement (the "Contract Sum"), or Five Hundred Thousand Dollars ($500,000) per year, unless additional compensation is approved pursuant to Section 1.8." B. Section 3.4, "Term," of the Agreement is hereby amended to read in its entirety as follows: "3.4 Term. Unless earlier terminated in accordance with Article 7 of this Agreement, this Agreement shall continue in full force and effect until completion of the services but not exceeding four (4) wee (3) years from the date hereof with a City option for one (1) twe (2) additional one-year extension$, except as otherwise provided in the Schedule of Performance (Exhibit "D")." C. Section V of Exhibit "C," "Schedule of Compensation," of the Agreement is hereby amended to read in its entirety as follows: "V. The total compensation for the Services shall not exceed $2,000,000 $1,500,000, or $500,000 per year, as provided in Section 2.1 of this Agreement." D. Section I of Exhibit "D," "Schedule of Performance," of the Agreement is hereby amended to read in its entirety as follows: "I. This Agreement shall commence on July 1, 2020 and shall remain in full force and effect for four (4) three (3) years thereafter, unless earlier terminated in accordance with Article 7 of this Agreement. The City may extend this Agreement for up to one (1) twe (2) additional 1 -year term$." 2. Continuing Effect of Agreement. Except as amended by this Amendment, all provisions of the Agreement (as amended by Amendments No. 1 and No. 2) 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 Amendments No. 1 and No. 2 and this Amendment to the Agreement. 3. Affirmation of Agreement; Warranty Re Absence of Defaults. City and Contractor each ratify and reaffirm each and every one of the respective rights and obligations -2- 01007.0001/862203.2 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. Contractor 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 Contractor that, as of the date of this Amendment, Contractor 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 parry, (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- 01007.0001/862203.2 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 a Davis -Holmes, Mayor ATTEST: P � C Dr. Khaleah K. Bradshaw, City Clerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney [sap;brj] CONTRACTOR: ADMINISTRATIVE S ICES COOPE TI i By: - —. -- - Name: John Rouse Title: Secretary By: - - Name: Marco Soto Title: Vice President Address: 1515 West 190`h Street Suite 250 Gardena. CA 90248 Two corporate officer signatures required when Contractor 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. CONTRACTOR'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 CONTRACTOR'S BUSINESS ENTITY. -4- 01007.0001/862203.2 IN WITNESS WHEREOF, the parties hereto have executed this Amendment on the date and year first -above written. ATTEST: Dr. Khaleah K. Bradshaw, City Clerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney [sap;brj] CITY: CITY OF CARSON, a municipal corporation Lula Davis -Holmes, Mayor CONTRACTOR: ADMINISTRATIVE S ICES COOPE TI By: Name: John Rouse Title: Secretary By: Name: Marco Soto Title: Vice President Address: 1515 West 190th Street Suite 250 Gardena, CA 90248 Two corporate officer signatures required when Contractor 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. CONTRACTOR'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 CONTRACTOR'S BUSINESS ENTITY. -4- 01007.0001/862203.2 anmiAFR-n9 MrION ,a►coRO CERTIFICATE OF LIABILITY INSURANCE `� F;DATE(MWDD/YYYY) 6/3/2022 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 License # OC36861 CONTMA ACT Nicole Ick San Diego-Alliant Insurance Services, Inc. B St 6th FI San Diego, CA 92101 PHONri No, (619) 541-4832 FAX No): EpAIE . Nicole.Ick@alliant.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Golden Bear Insurance Company 39861 INSURED INSURER 8: INSURER C: Administrative Services Cooperative, Inc. et al (*See below) X 1515 W 190th Street Suite #250 INSURER D: INSURER E: Gardena, CA 90248 INSURER F: MED EXP (Any oneperson) 5,000 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 LTRTYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR X X GBL13000415-00 6/1/2022 6/1/2023 PRMMGETORENTEDn 100,000 MED EXP (Any oneperson) 5,000 PERSONAL &ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY � PRO ❑LOC JECT GENERAL AGGREGATE $ 2,000,000 2,000,000 PRODUCTS -COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ BODILY INJURY Perperson) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE (per..$ HIRED NON SWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N SPER TAT ORH ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA A E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE 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) 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 included as an Additional Insureds as required by written contract per attached policy form. General Liability Waiver of Subrogation applies as required by written contract per attached policy fq�rn,� WAL Liability is Primary and Non -Contributory as required by written contract per attached policy form. IIV�Ut(A CE APPROVED PIG SEE ATTACHED ACORD 101 3/23/2023 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Carson INSURANCE APPROVED THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ty ACCORDANCE WITH THE POLICY PROVISIONS. 701 E. Carson Street Carson, CA 90745 AUTHORIZED REPRESENTATIVE 6/22/2022 ACORD 25 (2016/03) 0 1 988-201 5 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACRO AGENCY CUSTOMER ID: ADMISER-02 LOC #: ADDITIONAL REMARKS SCHEDULE NICK Page 1 of 1 AGENCY San Diego-Alliant Insurance Services, Inc. License # OC36861 NAMED INSURED Administrative (*See below) Services Cooperative, Inc. 1515 W 190th Street Suite #250 Gardena, CA 90248 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: Schedule of Named Insureds: 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. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GBL13000415-00 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 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 Orpanization(s) II entities as required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tions) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "per- sonal 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: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rent- ed to you. Additional Premium: 1500.00 Other Insurance -subject to all terms and provisions of the policy, insurance as provided by this endorsement shall be deemed primary ffffd al kPRjkT*ary andntributory, but only with respect to work performed by or on behalf of the named insured in connection with the described project CG 20 26 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 13 GBL13000415-00 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: GBL13000415-00 COMMERCIAL GENERAL LIABILITY CG 24 04 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: BLANKET AS REQUIRED BY WRITTEN CONTRACT (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: 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. Additional Premium: $1,000.00 CG 24 04 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of I ❑ ADMISFR-n2 NI RI K AcoR� CERTIFICATE OF LIABILITY INSURANCE DAT8/4/2 D/YYYY) 8/4/2022 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 License # OC36861 San Diego-Alliant Insurance Services, Inc. 701 B St 6th FI San Diego, CA 92101 CONTACT Nicole Ick NAME: PHONro, Ext); (619) 541-4832 FAX No): A'"A'L . Nicole.ick@alliant.com INSURERS AFFORDING COVERAGE NAIC # INSURER A : Paratransit Insurance Company a Mutual Risk Retention Group 44130 INSURED INSURER B: Administrative Services Cooperative, Inc. et al dba: Yellow Cab INSURER C : CLAIMS [::] OCCUR 1515 W. 190th St.,Ste. 250 INSURER D : INSURER E : Gardena 90248 INSURER F: DAMAGE TO RENTED COVERAGES CERTIFICATE NUMBER: RFVISION NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS [::] OCCUR DAMAGE TO RENTED -MADE PREMISES a occurrence) $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER, POLICY ❑ JECT [] LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ BODILY INJURY Perperson) $ ANY AUTO X X PG 1241 22 8/1/2022 8/1/2023 OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ HIRED NON- WNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N I PER OTH- TA TE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 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 SEE ATTACHED ACORD 101 City of Carson 701 E. Carson Street Carson, CA 90745 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 Vm ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACVR17 411, " AGENCY CUSTOMER ID: ADMISER-02 LOC #: ADDITIONAL REMARKS SCHEDULE NICK Page 1 of 1 AGENCY an Die o-Alliant Insurance Services Inc. g License # OC36861 NAMED INSURED Administrative Services Cooperative, Inc. et al dba: Yellow Cab 1515 W. 190th St.,Ste. 250 Gardena 90248 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: 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. Enterprise Finance, Inc. Wilmington Cab Company of California, Inc. Van Ness Management, Inc. City of Carson, its elected and appointed officers, employees, volunteers, and agents are included as an Additional Insureds as required by written contract per attached policy form. General Liability Waiver of Subrogation applies as required by written contract per attached policy form. General Liability is Primary and Non -Contributory as required by written contract per attached policy form. 30 Day notice of Cancellation -10 Days for Non -Payment with regards to General Liability. Certificate holder is included as an Additional Insured with respects to Auto Liability per the attached policy form. Auto Liability Waiver of Subrogation applies as required by written contract per attached policy form. *10 Day notice of cancellation in the event of non-payment of premium with respects to Auto Liability. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Endorsement #35 ADDITIONAL INSURED THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. For a covered auto, it is hereby agreed and understood that the following is an Additional insured under your policy: City of Carson 701 E. Carson Street Carson, CA 90745 Section III.H. is amended to include as an additional insured the person(s) or organization(s) listed above, but only with respect to bodily injury or property damage resulting from the acts or omissions of: 1. You (the Named Insured) 2. Any of your employees, agents, or independent contractors authorized to operate a vehicle in furtherance of your business. 3. Any person, except the additional insured or any employee or agent of the Additional insured, operating a covered auto with the permission of any of the above. The additional insured(s) listed above must comply with all notice and cooperation Conditions in the Policy, including those set forth in Section V. As a further condition of Coverage, the additional insured shall not negotiate or settle claims independently of the Named Insured and/or the Company. Attached to and forming part of: PG 124122 Insured: ADMINISTRATIVE SERVICES COOPERATIVE, INC. Effective: 8/1/2022 Date issued: 7/29/2022 WDD A� Rte® CERTIFICATE OF LIABILITY INSURANCE DAo2io 02 ) 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 CONTACT Lorelei C. Noonan NAME* Faith Branvold c/o Sunset Business Insurance Solutions PHONE FAX3-301---3280 7590 N Glenoaks Boulevard, Suite 200 E-MAIL ADDRESS: lori@sunsetbis.com Burbank, CA 91504 INSURER(S) AFFORDING COVERAGE NAIC# INSURED Administrative Services Cooperative, Inc. 1515 W. 190th St. Suite 250 Gardena, CA 90248 INSURERA: StarStone National Insurance Company 25496 INSURER B :. INSURER C : INSURER E : COVERAGES CERTIFICATE NUMBER- RFVISInN Nt1MRFR- 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 POLICY NUMBER POLICY EFF MWDDM'YY POLICY EXP mwoo I LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-1 OCCUR EACH OCCURRENCE $TO RENTED a enact $ MED EXP (Any one person) $ PERSONAL A ADV INJURY 5 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 1:1�. 7 LOC OTHER: GENERAL AGGREGATE 5 PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PERTY 5 P S UMBRELLALIAB EXCESS LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DED ' RETENTION $ S A �DESCRIPTIONOF WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNER/EXECUTIVE Y/NE.L. OFFICERIMEMBEREXCLUDED9 N� i(MandatoryinNH) It yyes, describe under OPERATIONS below N/A N T10230845 01/31/2023 01/31/2024 X S TllT EACH ACCIDENT S 1,000,000 — -- E.L. DISEASE - EA EMPLOYEE S 1,000.000 E.L. DISEASE -POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) —M lr IVMIG r7VLLGR l./i1Y l.CLL.A l IV1V City of Carson SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 701 E. Carson Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Carson, CA 90745 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Lorelel.C. Noo uxn © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Jason Jo From: Marco Soto <msoto@layellowcab.com> Sent: Tuesday, December 04, 2018 3:47 PM To: Jason Jo Subject: Fwd: Cert Attachments: Certificate - City of Carson.pdf; ATT00001.htm Hi Jason, Here is our Workers Comp cert. We do not have a waiver because we don't have employees. Begin forwarded message: From: Jeremiah Phipps < phipps@layellowcab.com> Date: November 27, 2018 at 8:03:38 PM PST To: Marco Soto <;�;at� aiayeiio,vcab. or,�> Subject: Cert Here is the cert