Cities Index.
Exhibit 1 - Contract

Alameda City Council
April 19, 2022

Document
Exhibit 1 - Contract
Meeting
April 19, 2022
Body
Alameda City Council
Original file
4.2 MB
Text extracted from the city's file for reading and search. Open the original on legistar1.granicus.com. That file is the official record.

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SERVICE PROVIDER AGREEMENT

This SERVICE PROVIDER AGREEMENT (“Agreement”) is entered into this day of ________, 2022 (“Effective Date ”), by and between the CITY OF ALAMEDA, a municipal corporation (the “City”), and CentralSquare Technologies, LLC, a Delaware limited liability company whose address is 1000 Business Center Dr., Lake Mary, FL 32746 ( t h e “Provider”), in reference to the following facts and circumstances:

RECITALS
A. The City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of the City.

B. The City is in need of the following: Enterprise Asset Manageme nt (EAM) System Licensing Fees for Lucity. The City of Alameda previously purch ased the EAM System from Centralsquare Technologies, LLC, so this sole-source agreement for the licensing fees is necessary to be able to continue to use the system.

C. Provider is specially trained, experienced and competent to per form the special services which will be required by this Agreement.

D. City and Provider desire to enter into an agreement to purchas e Enterprise Asset Management System Licensing Fees for Lucity, upon the terms and conditions herein.

AGREEMENT

NOW, THEREFORE, in consideration of the forgoing, which are inc orporated herein by reference, and for good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the City and Provider agree as follows:

1. TERM:

The term of this Agreement shall retroactively commence on the 1st day of November 2021, and shall terminate on the 30th day of June 2026, unless terminated earlier as set forth herein.

2. SERVICES TO BE PERFORMED:

Provider agrees to provide 50 licenses for the EAM System (Lucity).

3. COMPENSATION TO PROVIDER:
a. The total five-year compensation for this Agreement shall not exceed $229,673.21.

Compensation for work done under this Agreement, shall not exceed as follows:

Contract (CPI) CPI Total
Each Year
TOTAL
FY21-22 0% $ 0.00 $ 43,260.00
FY22-23 3% $1,297.80 $ 44,557.80
FY23-24 3% $1,336.73 $ 45,894.53
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FY25-26 3% $1,418.14 $ 48,689.51
TOTAL 12% $5,429.51 $229,673.21

4. TIME IS OF THE ESSENCE:

Provider and the City agree that time is of the essence regardi ng the performance of this Agreement.

5. STANDARD OF CARE:

Provider agrees to perform all se rvices hereunder in a manner c ommensurate with the prevailing standards of like professionals or service providers, as applicable, in the San Francisco Bay Area and agrees that all services shall be performed by qua lified and experienced personnel who are not employed by the City.

6. INDEPENDENT PARTIES:

Provider hereby declares that Provider is engaged as an independent business and Provider agrees to perform the services as an independent contractor. The manner and means of conducting the services and tasks are under the control of Provider except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Provider’s se rvices. None of the benefits provided by the City to its employees, including but not limite d to unemployment insurance, workers’ compensation plans, vacation and sick leave, are available from the City to Provider, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an em ployer-employee relationship from any compensation due to Provider. Payments of the above items, if required, are the responsibility of Provider.

7. IMMIGRATION REFORM AND CONTROL ACT (IRCA):

Provider assumes any and all responsibility for verifying the i dentity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Provider shall indemnify, defend, and hold the City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Provider.

8. NON-DISCRIMINATION:

Consistent with the City’s policy and state and federal law tha t harassment and discrimination are unacceptable conduct, Provider and its employees, contractors, and agents shall not harass or discriminate against any job applicant, City emp loyee, or any other person on the basis of any kind of any statutorily (federal, state or local) protected class, including but not limited to: race, religious creed, color, national origin, ancestry, di sability (both mental and physical) including HIV and AIDS, medical condition (e.g. cancer), genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, pregnancy, political affiliation, military and veteran status or legitimate union activities. Provider agrees that any violation of this provision shall constitute a material breach of this Agreement.

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Provider shall maintain insurance coverage and limits at least as broad as:
(1) Workers’ Compensation:

Statutory coverage as required by the State of California. (2) Liability:

Commercial general liability coverage in the following minimum limits:

Bodily Injury: $1,000,000 each occurrence
$2,000,000 aggregate - all other
Property Damage: $1,000,000 each occurrence
$2,000,000 aggregate
If submitted, combined single limit policy with per occurrence limits in the amounts of $2,000,000 and aggregate limits in the amounts of $4,000,000 will be considered equivalent to the required minimum limits shown abov e. Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required. (3) Automotive:

Comprehensive automobile liabil ity coverage (any auto) in the f ollowing minimum limits:

Bodily injury: $1,000,000 each occurrence
Property Damage: $1,000,000 each occurrence
or
Combined Single Limit: $2,000,000 each occurrence
Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required.

(4) Cyber Liability:

Coverage shall be sufficiently broad to respond to the duties and obligations as are undertaken by Provider in t his Agreement and shall inclu de, but not be limited to, claims involving infringement of intellectual prope rty, copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, alteration of electronic information, extortion and network security. The policy shall provide coverage for breach response costs as well as regulatory fines and penalties as well as credit monitoring expenses with limits sufficient to respond to these obligations with the following minimum limits:
$2,000,000 per occurrence or claim.

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c. SUBROGATION WAIVER:

Provider hereby agrees to waive rights of subrogation that any insurer of Provider may acquire from Provider by virtue of the payment of any loss. Provider ag rees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether the City has received a waiver of subrogation endorsement from the insurer. The Workers’ Compensation policy shall be endorsed with a waiver of subrogat ion in favor of the City for all work performed by Provider, its employees, agents and subcontractors.

d. FAILURE TO SECURE:

If Provider at any time during the term hereof should fail to s ecure or maintain the foregoing insurance, the City shall be permitted to obtain such insurance in Provider’s name or as an agent of Provider and shall be compensated by Provider for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid.
e. ADDITIONAL INSUREDS:

The City, its City Council, boa rds, commissions, officials, employees, agents, and volunteers shall be named as additional insured(s) under all insurance coverages, except workers’ compensation and professional liability insurance. The naming of an additional insured shall not affect any recovery to which such additional insured would be e ntitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional i nsured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy.

Additional Insured coverage unde r Provider’s policy shall be pr imary and non-contributory and will not seek contribution from the City’s insurance or self-insurance. Any available insurance proceeds broader than or in excess of the specified minimum ins urance coverage requirements and/or limits shall be available to the additional insured(s).

E. SUFFICIENCY OF INSURANCE:

The insurance limits required by the City are not represented as being sufficient to protect Provider. Provider is advised to consult Provider’s insurance broker to determine adequate coverage for Provider. The coverage and limits shall be (1) the minimum coverage and limits specified in this Agreement; or (2) the broader coverage and ma ximum limits of the coverage carried by or available to Provider; whichever is greater.

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11. CONFLICT OF INTEREST:

Provider warrants that it is not a conflict of interest for Provider to perform the services required by this Agreement. Provider may be required to fill out a conflict of interest form if the services provided under this Agreement require Provider to make certain governmental decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of the California Code of Regulations.

12. PROHIBITION AGAINST TRANSFERS:
a. Provider shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law o r otherwise, without prior written consent of the City Manager. Provider shall submit a written request for consent to transfer to the City Manager at least thirty (30) days in advance of the desire d transfer. The City Manager or their designee may consent or reject such request in their sole and absolute discretion. Any attempt to do so without said consent shal l be null and void, and any a ssignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money against the City under this Agreement may be assigned by Provider to a bank, trust company or other financial institution without prior written consent. b. The sale, assignment, transfer or other disposition of any of t he issued and outstanding capital stock, membership interest, partnership interest, or the equivalent, which shall result in changing the control of Provider, shall be construed as an assignment of this Agreement.

Control means fifty percent or more of the voting power of Provider.

13. APPROVAL OF SUB-PROVIDERS:
a. Only those persons and/or businesses whose names and resumés are attached to this Agreement shall be used in the performance of this Agreement. However, if after the start of this Agreement, Provider wishes to use sub-providers, at no additional costs to the City, then Provider shall submit a written request for consent to add sub-providers including the names of the sub- providers and the reasons for the request to the City Manager at least five (5) days in advance. The City Manager may consent or reject such requests in their sole and absolute discretion. b. Each sub-provider shall be requi red to furnish proof of worker s’ compensation insurance and shall also be required to carry general, automobi le and professional liability insurance (as applicable) in reasonable conformity to the insurance carried by Provider. c. In addition, any tasks or service s performed by sub-providers s hall be subject to each provision of this Agreement. Provider shall include the following language in their agreement with any sub-provider: “Sub-provi ders hired by Provider agree to be bound to Provider and the City in the same manner and to the same extent as Provider is bound to the City.” d. The requirements in this Section 13 shall not apply to persons who are merely providing materials, supplies, data or information that Provider then analyzes and incorporates into its work product.

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14. PERMITS AND LICENSES:

Provider, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City business license that may be required in connection with the performance of the services and tasks hereunder.

15. REPORTS:
a. Each and every report, draft, work product, map, record and oth er document produced, prepared or caused to be prepared by Provider pursuan t to or in connection with this Agreement shall be the exclusive property of the City.
b. No report, information or other data given to or prepared or assembled by Provider pursuant to this Agreement shall be made available to any indiv idual or organization by Provider without prior approval of the City Manager or their designee. c. Provider shall, at such time and in such form as City Manager or their designee may require, furnish reports concerning the status of services and tasks required under this Agreement.

16. RECORDS:
a. Provider shall maintain complete and accurate records with respect to the services, tasks, work, documents and data in sufficient detail to permit an evaluation of Provider’s performance under the Agreement, as well as maintain books and records related to sales, costs, expenses, receipts and other such information required by the C ity that relate to the performance of the services and tasks under this Agreement (collectively the “Records”). b. All Records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Provider shall provide free access to the Records to the representatives of the City or its designees during regular business hours upon reasonable prior notice. The City has the right to examine and audit the Records, and to make copies or transcripts therefrom as necessary, and to allow insp ection of all proceedings and activities related to this Agreement. Such Records, together w ith supporting documents, shall be kept separate from other documents and records and shall be maintained by Provider for a period of three (3) years after receipt of final payment.
c. If supplemental examination or a udit of the Records is necessar y due to concerns raised by the City’s preliminary examination or audit of record s, and the City’s supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of this Agreement or failure to act in good faith, then Provider shall reimburse the City for all reasonable costs and expenses associ ated with the supplemental examination or audit.

17. NOTICES:
a. All notices shall be in writing and delivered: (i) by hand; or (ii) sent by registered, express, or certified mail, with return receipt requested or wi th delivery confirmation requested from the U.S. postal service; or (iii) sent by overnight or sam e day courier service at the party’s respective address listed in this Section.

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c. Either party may, at any time, change its notice address (other than to a post office box address) by giving the other party three (3) days prior written notice of the new address. d. All notices, demands, requests, or approvals from Provider to the City shall be addressed to the City at:

City of Alameda
Public Works Department
950 W. Mall Square, Room 110
Alameda, CA 94501
ATTENTION: Erin Smith
Ph: (510) 747-7930 / Fax: (510) 769-6030

e. All notices, demands, requests, or approvals from the City to Provider shall be addressed to Provider at:

Legal Counsel Office
CentralSquare Technologies, LLC
1000 Business Center Drive
Lake Mary, Florida
PH: 407-304-3235

f. All updated insurance certificates from Provider to the City shall be addressed to the City at:

City of Alameda
Public Works Department
1616 Fortmann Way
Alameda, CA 94501
ATTENTION: Gail Carlson
Ph: (510) [747-7925] / Fax: (510) [769-6030]

18. SAFETY:
a. Provider will be solely and comp letely responsible for conditio ns of all vehicles owned or operated by Provider, including the safety of all pers ons and property during performance of the services and tasks under this Agreement. Th is requirement will apply continuously and not be limited to normal working hours. In addition, Provider will comply with all safety provisions in conformance with U.S. Department of La bor Occupational Safety and Health Act, any equivalent state law, and all other applicable federal, state, county and local laws, ordinances, codes, and any regulations that may be detailed in other parts of the Agreement. Where any of these are in conflict, the more stringent requirements w ill be followed. Provider’s failure DRAFT

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19. TERMINATION:
a. In the event Provider fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Provider shall be deemed in default in the performance o f t h i s A g r e e m e n t . I f s u c h d e f a u l t i s n o t c u r e d w i t h i n t w o ( 2 ) business days after receipt by Provider from the City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, the City may thereafter immediately terminate the Agreement forthwith by giving to Provider written notice thereof. b. The foregoing notwithstanding, the City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days’ prior written notice to Provider as provided herein.
c. Upon termination of this Agreement either for cause or for convenience, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. The obl igation of the parties under this Section 19.c. shall survive the expiration or early termination of this Agreement.

20. ATTORNEYS’ FEES:

In the event of the bringing of any action or suit by a party h ereto against the other party by reason of any breach of any covenants, c onditions, obligation or provision arising out of this Agreement, the prevailing pa rty shall be entitled to recov er from the non-prevailing party all of its costs and expenses of the action or suit, including reasonable attorney’s fees, experts’ fees, all court costs and other costs of action incurred by the preva iling party in connection with the prosecution or defense of such action and enforcing or establishing its rights hereunder (whether or not such action is prosecuted to a judgment). For the purpo ses of this Agreement, reasonable fees of attorneys of the Alameda City Attorney’s office shall be based on the fees regularly charged by private attorneys with the e quivalent number of years of exp erience in the subject matter area of the law for which the services were rendered who practice in Alameda County in law firms with approximately the same number of attorneys as employed by the Alameda City Attorney’s Office.

21. HEALTH AND SAFETY REQUIREMENTS.

Provider acknowledges that the City shall have the right to imp ose, at the City’s sole discretion, requirements that it deems are necessary to protect the health and safety of the City employees, residents, and visitors . Provider agrees to comply with all such requirements, including, but not limited to, ma ndatory vaccinations, the use of personal protective equipment DRAFT

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22. COMPLIANCE WITH ALL APPLICABLE LAWS:

During the term of this Agreement, Provider shall keep fully in formed of all existing and future state and federal laws and all municipal ordinances and regulations of the City of Alameda which affect the manner in which the services or tasks are to be performed by Provider, as well as all such orders and decrees of bodies or tribunals having any j urisdiction or authority over the same. Provider shall comply with all applicable laws, state an d federal and all ordinances, rules and regulations enacted or issued by the City.

23. CONFLICT OF LAW:

This Agreement shall be interpr eted under, and enforced by the laws of the State of California without regard to any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the par ties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities). Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Alameda, State of California.

24. WAIVER:

A waiver by the City of any breach of any term, covenant, or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character.

25. INTEGRATED CONTRACT:

Subject to the language of Section 30, the Recitals and exhibit s are a material part of this Agreement and are expressly incorporated herein. This Agreemen t represents the full and complete understanding of every kind or nature whatsoever betwe en the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or n ature are merged herein. No verbal agreement or implied cove nant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both the City and Provider.

26. CAPTIONS:

The captions in this Agreement are for convenience only, are no t a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement.

27. COUNTERPARTS:

This Agreement may be executed in any number of counterparts (i ncluding by fax, PDF, DocuSign, or other electronic means), each of which shall be deemed an original, but all of which shall constitute one and the same instrument.

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28. SIGNATORY:

By signing this Agreement, signatory warrants and represents th at they executed this Agreement in their authorized capacity and that by their signat ure on this Agreement, they or the entity upon behalf of which they acted, executed this Agreement.

29. CONTROLLING AGREEMENT:

In the event of a conflict between the terms and conditions of this Agreement (as amended, supplemented, restated or otherwise modified from time to time) and any other terms and conditions wherever contained, including, without limitation, terms and conditions included within exhibits, the terms and conditions of this Agreement shall control and be primary.

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CentralSquare Technologies, LLC CITY OF ALAMEDA
A Delaware Limited Liability Company A Municipal Corporation

David Zolet E r i c J . L e v i t t
C E O C i t y M a n a g e r

______________________________ RECOMMENDED FOR APPROVAL B a r r y M e d i n t z
General Counsel & Corporate Secretary

E r i n S m i t h
P u b l i c W o r k s D i r e c t o r

APPROVED AS TO FORM:

City Attorney

E l i z a b e t h M a c K e n z i e
C h i e f A s s i s t a n t C i t y A t t o r n e y

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Certification of Compliance
With the City of Alameda’s Vaccination Requirement
The City of Alameda (“City”) requires all individuals who perfo rm work for the City to be fully vaccinated1 against COVID-19. All service providers and contractors for t he City must sign the following statement certifying compliance with this requirement.

By signing below, I certify that all of our personnel who are performing work for the City are fully vaccinated against COVID-19. I also acknowledge that the City reserves the right to review any relevant records to demonstrate our compliance with this requirement.

I declare under penalty of perjury that the foregoing is true and correct.

D a t e :______________________ CentralSquare Technologies, LLC. __________________________________
By: [Na
me of Authorized Individual]
Its [Title]
1 For the purposes of this Certification of Compliance, an individual is considered to be fully vaccinated if two weeks have passed since their second dose in a 2-dose series (such as the Pfizer or Moderna vaccines) or if two weeks have passed since receiving their single-dose vaccine (such as Johnson & Johnson’s Janssen vaccine).

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SHOULD AN Y OF THE ABOVE DESCRIBED POLICIES BE CAN CELLED BEFORE

THE EXPIRATION DATE THEREOF, N OTICE WILL BE DELIVERED IN ACCORDAN CE WITH THE POLICY PROVISION S.

IN SURER(S) AFFORDIN G COVERAGE
IN SURER F :

IN SURER E :

IN SURER D :

IN SURER C :

IN SURER B :

IN SURER A :

N AIC #
N AM E:

CON TACT
(A/C, N o):

FAX

E-M AIL
ADDRESS:

PRODUCER
(A/C, N o, Ext):

PHON E

IN SURED
REVISION N UM BER:CERTIFICATE N UM BER:COVERAGES
IM PORTAN T: If the certificate holder is an ADDITION AL IN SURED, the policy(ies) must have ADDITION AL IN SURED 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).

THIS CERTIFICATE IS ISSUED AS A M ATTER OF IN FORM ATION ON LY AN D CON FERS N O RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES N OT AFFIRM ATIVELY OR N EGATIVELY AM EN D, EXTEN D OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF IN SURAN CE DOES N OT CON STITUTE A CON TRACT BETWEEN THE ISSUIN G IN SURER(S), AUTHORIZED REPRESEN TATIVE OR PRODUCER, AN D THE CERTIFICATE HOLDER.

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
IN SD

THIS IS TO CERTIFY THAT THE POLICIES OF IN SURAN CE LISTED BELOW HAVE BEEN ISSUED TO THE IN SURED N AM ED ABOVE FOR THE POLICY PERIOD IN DICATED. N OTWITHSTAN DIN G AN Y REQUIREM EN T, TERM OR CON DITION OF AN Y CON TRACT OR OTHER DOCUM EN T WITH RESPECT TO WHICH THIS

CERTIFICATE M AY BE ISSUED OR M AY PERTAIN , THE IN SURAN CE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM S, EXCLUSION S AN D CON DITION S OF SUCH POLICIES. LIM ITS SHOWN M AY HAVE BEEN REDUCED BY PAID CLAIM S. $
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COM BIN ED SIN GLE LIM IT

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SCHEDULEDOWN ED

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Y / N

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AN D EM PLOYERS' LIABILITY
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(M andatory in N H)
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If yes, describe under

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DATE (M M /DD/YYYY)

CAN CELLATION

AUTHORIZED REPRESEN TATIVE
ACORD 25 (2016/03)
© 1988-2016 ACORD CORPORATION . All rights reserved.

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

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T h e C it y of A lam ed a, it s C it y C ou n cil, b oar d s, com m ission s, officials, em p loy ees, an d v olu n t eer s, is in clu d ed as ad d it ion al in su r ed w h er e r eq u ir ed b y w r it t en con t r act w it h r esp ect t o G en er al an d A u t o L iab ilit y . W aiv er of su b r og at ion is ap p licab le w h er e r eq u ir ed b y w r it t en con t r act w it h r esp ect t o G en er al L iab ilit y an d W or k er s C om p en sat ion . T h e G en er al L iab ilit y is p r im ar y an d n on -con t r ib u t or y ov er an y ex ist in g in su r an ce an d lim it ed t o liab ilit y ar isin g ou t of t h e op er at ion s of t h e n am ed in su r ed an d w h er e r eq u ir ed b y w r it t en con t r act . 2 ,0 0 0 ,0 0 0
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XX
A
C it y of A lam ed a
of M arsh USA Inc.
2 2 6 3 San t a C lar a A v en u e, R oom # 2 8 0
A lam ed a, C A 9 4 5 0 1
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ACORD 101 (2008/01)
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THIS ADDITION AL REM ARKS FORM IS A SCHEDULE TO ACORD FORM , FORM N UM BER: FORM TITLE:

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M A R SH U SA , I N C .
2 2
C en t r alSq u ar e T ech n olog ies, L L C
L u cit y , I n c.
1 0 0 0 B u sin ess C en t er D r .

L ak e M ar y ,F L 3 2 7 4 6
25 Certificate of Liability Insurance
CN 130114897
Atlanta
E x cess E & O /C y b er :

C ar r ier : C er t ain U n d er w r it er s at L loy d s, L on d on Policy N u m b er : A C X 1 0 0 7 9 2 1
E ffect iv e D at e: 0 8 /3 1 /2 0 2 1
E x p ir at ion D at e: 0 8 /3 1 /2 0 2 2
L im it : $ 5 M x $ 5 M
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BA-6S783539-21-I3-G

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