SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
E-MAIL
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
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. $ $
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
6/13/2022
Marsh & McLennan Agency LLC
5500 Cherokee Avenue, Suite 300
Alexandria VA 22312
800-274-0268
[email protected]
Lloyds Syndicate 2623/623
55555
CARAHTECHN
Hartford Casualty Insurance Company
29424
Carahsoft Technology Corp.
FedResults, Inc.
11493 Sunset Hills Road
Suite 100
Reston VA 20190
Hartford Fire Insurance Company
19682
970585742
B
X
1,000,000
X
500,000
10,000
1,000,000
2,000,000
X
Y
Y
ENP0651059
4/19/2022
4/19/2023
2,000,000
B
1,000,000
X
X
X
Y
Y
ENP0651059
4/19/2022
4/19/2023
B
X
X
5,000,000
ENP0651059
4/19/2022
4/19/2023
5,000,000
A
C
Cyber
Professional Liab
Crime
Y
Y
W301BF210101
30TP032740921
8/27/2021
2/6/2022
8/27/2022
2/6/2023
$5,000,000
$5,000,000
Occurrence
Aggregate
The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers (“Additional Insureds”) are to be covered as additional insureds on Consultant’s Commercial General Liability and Cyber Liability policies.
City of Cupertino
10300 Torre Ave
Cupertino CA 95014
Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page1of 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.COMMERCIAL GENERAL LIABILITYBROADENEDENDORSEMENT-VIRGINIAThis endorsement modifies insurance provided under the following:COMMERCIAL GENERAL LIABILITY COVERAGE PARTA.Endorsement -Tableof Contents:Coverage: Begins on Page:1.Employee Benefit Liability Coverage.......................................................................................32.Unintentional Failureto Disclose Hazards..............................................................................83.Damageto Premises Rented to You........................................................................................84.Supplementary Payments.........................................................................................................95.Medical Payments......................................................................................................................96.180 Day Coverage for Newly Formed or Acquired Organizations........................................97.Waiverof Subrogation............................................................................................................108.Automatic Additional Insured -Specified Relationships:..................................................10•Managers or Lessorsof Premises;•Lessor of Leased Equipment;•Vendors;•StateorGovernmentalAgency or Subdivisionor Political Subdivision -Permits or Authorizations RelatingtoPremises; and•Mortgagee, Assignee or Receiver9.Property Damage to Borrowed Equipment..........................................................................1310.Employees as Insureds-SpecifiedHealth Care Services and Good SamaritanServices...................................................................................................................................1411.Broadened Notice of Occurrence..........................................................................................1412.Nonowned Aircraft..................................................................................................................1413.Bodily Injury Redefined..........................................................................................................1414.Expectedor Intended Injury Redefined................................................................................1415.FormerEmployees as Insureds............................................................................................14B.Limitsof Insurance:The Commercial General Liability LimitsofInsuranceapply to the insurance provided by thisendorse-ment, except as provided below:1.Employee Benefit Liability CoverageEach Employee Limit: $1,000,000Aggregate Limit: $3,000,000DeductibleAmount:$1,0003.Damage to Premises Rentedto YouThe lesser of:a.The Each Occurrence Limitshown in the Declarations; orb.$500,000 unless otherwisestated $4.Supplementary Paymentsa.Bail Bonds:$2,500b.Lossof Earnings: $5005.Medical PaymentsMedical Expense Limit:$10,0009.Property Damage to BorrowedEquipmentEach Occurrence Limit:$10,000DeductibleAmount:$250 Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page2of 14 C.Coverages1.Employee Benefit Liability Coveragea.The followingisaddedtoSectionI -Coverages:EmployeeBenefit Liability Cover-age(1)InsuringAgreement(a)We will pay those sums thattheinsured becomes legally obligated topay asdamag-escaused by any act, erroror omissionoftheinsured,or ofany other personforwhoseactstheinsuredislegally liable, towhich thisinsurance applies. We will havethe right and duty todefend the insuredagainst any "suit"seeking thosedamages. However, wewill haveno duty to defendagainst any "suit"seekingdamagesto which this in-surance doesnotapply. We may,atour discretion, in-vestigate any reportof an act, error oromission andsettleany claimor "suit"thatmay result. But:1)The amount we will pay for damages islimited asdescribed inSectionIII -Limits of Insur-ance; and2)Our right and duty to defend ends whenwe haveused upthe appli-cablelimit of insurancein thepayment of judg-ments or settlements. No other obligation or liabil-ity topay sums orperform actsor servicesiscoveredunlessexplicitly provided forunder SupplementaryPayments.(b)Thisinsurance appliestodamagesonly iftheact, er-ror or omission, isnegligent-ly committedin the "admin-istration"ofyour "employee benefit program"; and1)Occurs during the policy period; or2)Occurredprior to the "firsteffective date"of thisendorsement pro-vided:a)You did not have knowledgeof a claim or "suit"on or before the "firstef-fectivedate"ofthisendorsement.You will bedeemed to haveknowledgeofaclaimor "suit"whenany "author-ized representa-tive";i)Reportsall, or any part,oftheact, error oromission tousor any other insurer;ii)Receives a written or ver-baldemand or claimfor dam-agesbecauseofthe act, er-ror or omis-sion; andb)Thereisno other applicable insur-ance.(2)ExclusionsThis insurancedoes not apply to:(a)Bodily Injury, Property Damageor Personal andAdvertising Injury"Bodilyinjury", "property damage"or "personaland advertising injury".(b)Dishonest,Fraudulent,Criminal or MaliciousActDamages arising out ofanyintentional, dishonest,fraudulent, criminal or mali-ciousact, error oromission,committed by any insured, includingthewillful or reck-less violation of any statute.(c)Failureto PerformaCon-tractDamages arising out offail-ureof performance ofcon-tract by any insurer.
Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page3of 14 (d)Insufficiency of FundsDamages arisingout ofaninsufficiency offundstomeet anyobligationsunder any plan includedinthe"employee benefit program".(e)Inadequacyof Perfor-manceof Invest-ment/Advice GivenWith Respect to ParticipationAny claim based upon:1)Failure ofany invest-ment to perform;2)Errors in providingin-formation on past per-formanceof investment vehicles; or3)Advice giventoany person withrespect to that person's decision to participate or not to par-ticipatein any planin-cludedin the "employeebenefit program".(f)Workers'Compensationand Similar LawsAny claim arisingout ofyour failure to comply withthemandatory provisionsofanyworkers'compensation,un-employment compensationinsurance, social security ordisability benefitslaw oranysimilar law.(g)ERISADamages forwhich any in-suredisliablebecauseofli-ability imposed onafiduci-ary by the EmployeeRe-tirement IncomeSecurity Actof1974, as now orhereafter amended,orbyany similar federal, state orlocal laws.(h)Available BenefitsAny claim for benefitsto theextent that such benefits are available, with reasonableeffort andcooperation of theinsured,from theapplicablefundsaccrued or other col-lectible insurance. (i)Taxes, Fines or PenaltiesTaxes, finesor penalties, in-cludingthose imposedun-dertheInternal RevenueCodeorany similar stateor local law.(j)Employment-Related Prac-ticesAny liability arisingout ofany:(1)Refusal to employ;(2)Termination ofemploy-ment;(3)Coercion, demotion, evaluation, reassign-ment, discipline,defa-mation, harassment, humiliation, discrimina-tionorother employ-ment -relatedpractices,acts or omissions; or(4)Consequential liability asaresultof (1), (2) or(3)above.Thisexclusion applieswhether the insuredmaybeheld liable asan employer or inany other capacity and to any obligation to sharedamageswith or repaysomeone elsewhomust paydamagesbecause of the in-jury.(3)Supplementary PaymentsSectionI-Coverages, Sup-plementary Payments -Cover-agesAand B alsoapply to thisCoverage.b.Who is an InsuredAs respectsEmployeeBenefit Lia-bility Coverage, SectionII -Who is an Insuredisreplaced by thefollow-ing:(1)If youare designated in the Dec-larationsas:(a)An individual, you andyourspouseare insureds, but on-ly withrespectto thecon-duct ofabusinessofwhichyouare the sole owner.(b)A partnership or joint ven-ture, you arean insured. Yourmembers, your part- Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page4of 14 ners,andtheir spousesarealso insureds but only with respect totheconductof your business.(c)A limitedliability company,youarean insured. Your members are alsoinsureds, butonly with respect to the conduct of your business. Yourmanagersarein-sureds, but only with respectto theirduties asyourman-agers.(d)Anorganization other than apartnership, joint ventureorlimitedliability company,you arean insured. Your "execu-tive officers"anddirectorsareinsureds,but only withrespect to their dutiesasyour officersor directors. Yourstockholdersare also insureds, butonly withre-spect to their liability asstockholders.(e)A trust, you areaninsured. Yourtrusteesarealsoin-sureds, but only with respectto their duties as trustees.(2)Each of thefollowing isalso aninsured:(a)Each ofyour "employees"who is orwas authorizedtoadminister your"employeebenefit program";(b)Any persons, organizations or "employees"having prop-er temporary authorizationto administer your "employ-ee benefit program"if you die, but only until your legalrepresentative isappointed; or(c)Your legal representativeifyoudie, butonly withre-spect to dutiesas such. That representative willhaveallyour rightsand dutiesunderthis Coverage Part.(3)Any organizationyou newly ac-quire or form, other thana part-nership,joint venture or limitedliability company, andover whichyou maintain ownership ormajor-ity interest, will qualify asanin-suredifno other similar insur-ance applies to that organization.
However, coverage under thisprovision:(a)Isafforded only untilthe180thday after you acquire or form the organization or theendof thepolicy period,whichever is earlier; and(b)Doesnot apply toany act,error oromissionthat wascommitted beforeyou ac-quired or formedthe organi-zation.c.Limitsof InsuranceAs respectsEmployeeBenefit Lia-bility Coverage, Section III-LimitsOf Insuranceisreplaced by the fol-lowing:(1)The Limitsof Insurance shown inSection B. Limits of Insurance,1.EmployeeBenefit Liability Coverage and the rules below fixthe mostwewill pay regardlessof the number of:(a)Insureds;(b)Claimsmadeor "suits"brought;(c)Personsor organizationsmaking claimsor bringing"suits";(d)Acts, errors or omissions; or(e)Benefitsincluded in your"employee benefit program".(2)The AggregateLimit shown inSection B.Limitsof Insurance, 1.EmployeeBenefit Liability Coverage ofthisendorsement is themost we will pay foralldam-agesbecauseofacts, errors or omissionsnegligently committed in the"administration"ofyour"employee benefit program". (3)Subject to thelimit describedin(2)above, the Each Employee Limit shownin SectionB.Limitsof Insurance, 1.EmployeeBenefit Liability Coverage ofthisendorsement isthe most wewillpay forall damagessus-tained by any one"employee", includingdamages sustained by such "employee's"dependentsand beneficiaries, as a result of:(a)An act, error or omission; or Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page5of 14 (b)A seriesofrelated acts, er-rorsoromissions,regard-lessoftheamount of timethat lapsesbetweensuchacts, errors or omissions;negligently committed in the"administration"ofyour "employ-ee benefit program".However, the amount paidunderthisendorsementshall not ex-ceed, and willbe subjecttothelimitsand restrictionsthat apply to the paymentofbenefits inanyplan includedin the"employeebenefit program."(4)DeductibleAmount(a)Ourobligation to pay dam-ageson behalfof the in-suredappliesonly to theamount ofdamagesin ex-cess of the DeductibleAmount stated inthe Decla-rationsas applicable toEach Employee. The limitsofinsuranceshallnot be re-duced by theamount of thisdeductible. (b)The DeductibleAmount stated in the Declarationsappliestoalldamagessus-tained by any one"employ-ee", including such"employ-ee's"dependentsand bene-ficiaries, becauseof all acts, errorsor omissions to whichthis insurance applies.(c)Thetermsofthis insurance, includingthose with respectto:1)Our right and duty to defend the insured against any "suits"seeking those damag-es; and2)Yourduties, andthe du-tiesof any other in-volvedinsured, in the event ofan act,error or omission, or claim;apply irrespective of theap-plicationoftheDeductible Amount.(d)We maypay any part orallofthe DeductibleAmount to effect settlement of any claimor "suit"and, upon no- tificationoftheaction taken,youshall promptly reim-burse usforsuch part of the Deductible Amount aswehave paid.d.Additional ConditionsAs respectsEmployeeBenefit Lia-bility Coverage, Section IV -Com-mercial GeneralLiability Condi-tionsis amended as follows:(1)Item2.Duties in theEventof Occurrence,Offense, Claim orSuitis replaced by the following:2.Duties in the Event of an Act, Erroror Omission, or Claimor Suita.You must see toit that we are notified assoon aspracticableof an act, error oromission whichmay result ina claim.Tothe extent possible,notice should include:(1)Whatthe act, error or omission wasandwhen it oc-curred; and(2)The names and addressesofany-onewho may suf-fer damages asa result oftheact, error or omission. b.If a claimismadeor "suit"isbrought againstany insured, you must: (1)Immediately recordthespecifics of the claimor "suit"andthedatereceived; and(2)Notify usas soon as practicable.You must see toit that we receive written no-tice of the claimor "suit"as soon as practicable.c.Youandany other in-volved insured must:(1)Immediately send uscopiesofany demands, notices, summonsesor le-galpapersre- Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page6of 14 ceivedinconnec-tionwiththeclaim or "suit";(2)Authorize usto ob-tainrecordsand other information;(3)Cooperatewith usin the investigation or settlement of theclaimordefense against the "suit"; and(4)Assist us, uponour request,intheen-forcement of any right against any person or organi-zationwhichmay be liable to the in-suredbecause of an act, error or omission to which thisinsurancemay also apply.d.No insuredwill, exceptat that insured's owncost, voluntarily makea payment,assumeanyobligation, or incur anyexpense without our consent.(2)Item5.OtherInsuranceisre-placed by the following:5.Other InsuranceIf other valid andcollectible insuranceisavailable to theinsured for a losswe coverunder thisCoverage Part, our obligationsare limited asfollows:a.Primary InsuranceThisinsuranceisprima-ry except when c.below applies. If this insuranceisprimary,ourobliga-tionsarenot affected unlessany oftheother insuranceisalso prima-ry. Then, wewill sharewith all that other insur-ance by the methodde-scribed in b.below.b.Methodof SharingIf all oftheother insur-ancepermitscontribu-tionby equal shares, we will followthismeth-od also. Under thisap-proach eachinsurer contributesequalamountsuntil it haspaid itsapplicable limit ofinsurance ornone of thelossremains, whichever comes first.If anyof the other in-surance doesnotpermit contributionby equalshares, wewill contrib-uteby limits. Under thismethod, eachinsurer's shareisbased on the ratio ofits applicable limit ofinsuranceto the total applicablelimitsof insurance of allinsur-ers.c.No CoverageThisinsuranceshallnot cover anylossfor whichtheinsured isentitledto recovery under any other insurance inforce previousto the effective date ofthis Coverage Part.e. Additional DefinitionsAs respectsEmployeeBenefit Lia-bility Coverage, Section V -Defini-tionsis amended as follows:(1)The following definitionsareadded:1."Administration"means:a.Providing informationto "employees", includingtheir dependents and beneficiaries, withre-spect to eligibilityfor or scope of "employee benefit programs";b.Interpreting the"em-ployee benefit pro-grams";c.Handlingrecordsin connection withthe "employee benefitpro-grams"; ord.Effecting, continuing or terminating any "em-ployee's"participation inany benefitincluded in Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page7of 14 the"employee benefitprogram".However, "administration"does not include:a.Handlingpayroll deduc-tions; orb.The failureto effect ormaintain any insuranceor adequatelimitsof coverage of insurance,including but not limited to unemployment insur-ance, social security benefits,workers'com-pensationanddisability benefits.2."Cafeteriaplans"meansplansauthorized by applica-blelawtoallow "employees"to elect to pay for certainbenefitswith pre-tax dollars.3."Employee benefit pro-grams"meansa program providing some ofallof thefollowingbenefitsto"em-ployees", whether provided through a"cafeteria plan"or otherwise:a.Group lifeinsurance; group accident or health insurance; dental, vision andhearing plans; and flexiblespending ac-counts; providedthat no oneother than an"em-ployee"may subscribeto such benefitsand such benefitsaremade generally availabletothose"employees"whosatisfy the plan's eligibil-ity requirements;b.Profit sharingplans, employeesavingsplans, employeestock ownershipplans, pen-sion plans and stock subscription plans, pro-videdthat no one other than an"employee"may subscribe to such benefitsand suchbene-fits aremadegenerally availableto all"employ-ees"who are eligibleunder theplanfor such benefits; c.Unemploymentinsur-ance, social security benefits, workers'com-pensationanddisability benefits; andd.Vacationplans, includ-ingbuy andsell pro-grams; leaveof ab-sence programs, includ-ingmilitary, maternity, family,and civil leave; tuition assistance plans; transportation and health club subsidies.4."First effective date"meansthedate upon whichcover-agewasfirst effectedin aseries of uninterrupted re-newalsof insurancecover-age.(2)The following definitions arede-letedin their entirety and re-placed by the following:8."Employee"meansa personactively employed, formerlyemployed, on leaveofab-sence or disabled,orretired."Employee"includesa"leased worker". "Employee" doesnot include a"tempo-rary worker".21."Suit"meansa civil proceed-ingin whichmoney damag-esbecauseofanact,error or omission towhich thisin-surance applies arealleged. "Suit"includes:a.An arbitration proceed-ingin which such dam-agesareclaimedand to which the insuredmustsubmit ordoessubmit with our consent;b.Anyother alternative dispute resolutionpro-ceeding in whichsuch damagesare claimed andto which the in-suredsubmitswith our consent; orc.An appealofacivilpro-ceeding.
Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page8of 14
2.UnintentionalFailure to DiscloseHaz-ardsSectionIV -Commercial General Liabil-ity Conditions, 7.Representationsisamended by the addition of the following:Basedon our dependenceupon your rep-resentations astoexistinghazards,if un-intentionallyyoushouldfail to disclose all such hazardsat the inception date of your policy,we will not reject coverage under thisCoverage Partbasedsolely on suchfailure.3.Damageto Premises Rented to Youa.The lastParagraph of2. Exclusionsunder Section I-Coverage A-Bod-ily Injury and Property DamageLi-ability is replaced by the following:Exclusionsc.throughq.do notapplyto "property damage"by fire, explo-sion,lightning, smoke or soot topremiseswhile rented toyouor tem-porarily occupiedby you withpermis-sion of the owner,for whichtheamount we will pay islimitedto theDamageto PremisesRented to YouLimitasdescribedinSectionIII-Limitsof Insurance.b.The insurance provided under Sec-tionI -CoverageA-Bodily Injuryand Property Damage Liability ap-pliesto "property damage"arising outofwater damage topremisesthat are both rented to and occupied by you.(1)As respectsWater Damage Le-galLiability,as provided inPara-graph 3.b.above:The exclusionsunder Section I -Coverage A-BodilyInjury andProperty Damage Liability,2.Exclusions, other thani. WarandtheNuclearEnergyLiabil-ity Exclusion(Broad Form),aredeleted and the following are added:This insurance does not apply to:(a)"Property damage":(i)Assumedin anycon-tractor agreement; or(ii)Caused byor resultingfromany of the follow-ing:1)Wear and tear;2)Rustor othercor-rosion,decay,de- terioration, hidden or latent defect or any quality in property that caus-esittodamage or destroy itself;3)Smog;4)Mechanical break-down, includingruptureor bursting causedby centrif-ugal force;5)Settling,cracking,shrinkingor ex-pansion; 6)Nesting orinfesta-tion, or dischargeor release of waste productsor secre-tions, by insects, birds,rodentsor other animals; or7)Presence, growth, proliferation, spread or any ac-tivity of fungus,in-cludingmoldor mildew, and any mycotoxins, spores, scentsorbyproductspro-duced or released by fungi.(b)"Propertydamage"caused directly or indirectly byanyof the following:(i)Earthquake, volcaniceruption, landslide or anyotherearthmove-ment;(ii)Water that backsup or overflowsor isother-wise dischargedfroma sewer,drain,sump, sump pumpor related equipment;(iii)Water under theground surface pressingon,or flowingor seepingthrough:1)Foundations, walls, floorsor paved surfaces;2)Basements,whether paved or not; or Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page9of 14 3)Doors, windowsorotheropenings.(c)"Propertydamage"caused byor resulting from water that leaksor flowsfrom plumbing,heating, air condi-tioning, fireprotectionsys-tems,or otherequipment,causedby or resulting from freezing, unless:(i)Youdid yourbest tomaintain heatinthebuilding or structure; or(ii)You drainedtheequip-mentandshut off the water supply ifthe heat was not maintained.(d)"Property damage"to:(i)Plumbing,heating,air conditioning, fire protec-tionsystems,or otherequipment orapplianc-es; or(ii)The interior of any buildingor structure, or to personal property inthe building or structure,causedbyor resultingfromrain, snow, sleet or ice, whether driven by wind or not.c.Limit of InsuranceWith respectto the insuranceafford-ed in Paragraphs3.a. and3.b.above,the Damage to Premises Rentedto YouLimitas shown in the Declara-tions is amended as follows:(1)Paragraph6. ofSectionIII-Limitsof Insuranceisreplaced by the following:6.Subject toParagraph5.above,theDamage to PremisesRented to YouLimit isthemost wewillpayunderCoverageA-BodilyInjury and Property Dam-ageLiabilityfor damages because of"property dam-age"to any one premises:a.Whilerented toyou,ortemporarily occupiedby youwith permission ofthe owner;b.In the caseofdamageby fire, explosion, light- ning,smoke orsoot,while rented to you; orc.In the caseofdamageby water, whilerentedto and occupied by you.(2)The most we will pay is limited asdescribedin Section B.LimitsofInsurance, 3.Damage to Prem-ises Rented to Youof this en-dorsement.4.Supplementary PaymentsUnder Section I -Supplementary Pay-ments-CoveragesAand B:a.Paragraph2.isreplacedby thefol-lowing:Up to thelimitshownin Section B.LimitsofInsurance, 4.a.Bail Bondsof thisendorsement for cost of bailbondsrequired becauseofaccidentsor trafficlaw violationsarising out oftheuse of any vehicletowhichtheBodily InjuryLiability Coverage ap-plies. We do not have to furnish thesebonds.b.Paragraph4.isreplacedby thefol-lowing:All reasonable expensesincurredby theinsuredat our requesttoassist usin theinvestigationor defenseof theclaimor "suit", including actual lossofearningsup to thelimitshown in Sec-tionB.Limits of Insurance, 4.b.LossOf Earningsofthisendorsement perday because of time off fromwork.5.Medical PaymentsThe Medical ExpenseLimit of Any OnePersonasstatedin theDeclarations isamended tothelimit shownin SectionB. Limitsof Insurance, 5.Medical Pay-mentsof this endorsement.6.180Day CoverageforNewly Formed orAcquired OrganizationsSectionII -Who is an Insuredisamended as follows:Subparagraph a.ofParagraph3.isre-placed by the following:a.Insuranceunder thisprovision isaf-forded only until the 180th day after youacquireor form the organizationor the endofthepolicy period,whichever is earlier; Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page10of 14
7.Waiverof SubrogationSectionIV -Commercial General Liabil-ity Conditions, 9.Transferof Rights of Recovery AgainstOthersto Usisamended by the addition of the following:We waiveany right ofrecovery we may haveagainst any personor organizationagainst whomyou have agreed towaivesuch right ofrecovery in a written contract or agreement because of paymentswe make for injury or damage arisingout ofyour ongoing operations or "your work"done under awrittencontractor agree-mentwith thatperson or organizationandincluded inthe "products-completed oper-ations hazard". However, our rightsmay only bewaived prior to the "occurrence"giving riseto the injury or damagefor which wemakepayment under thisCov-eragePart. The insuredmust do nothingafter a losstoimpair our rights. At our re-quest, the insured will bring"suit"or trans-fer those rightsto usand helpusenforce those rights.8.Automatic Additional Insured-Speci-fied Relationshipsa.The followingisaddedto SectionII -Who is an Insured:(1)Any person(s)or organization(s)describedin Paragraph8.a.(2)of thisendorsement (hereinafterre-ferredto as additional insured) whomyou are required to addasan additionalinsured under thisCoveragePartby reasonof a written contract,writtenagree-ment, written permit orwritten authorization.(2)Only the following persons or or-ganizationsare additional in-suredsunder thisendorsement, and insurance coverage providedto such additional insuredsis lim-ited as provided herein:(a)Managers or Lessors of PremisesThe manager or lessor ofapremisesleasedto youwithwhomyouhaveagreed perParagraph8.a.(1)of thisen-dorsement to provide insur-ance, but only with respectto liability arising out of the ownership, maintenanceoruse ofthatpart oftheprem-isesleasedto you,subjectto the following additionalexclusions:
Thisinsurancedoesnot ap-ply to:(i)Any "occurrence"whichtakesplace after you cease tobe a tenant in that premises;(ii)Structural alterations, newconstruction or demolition operationsperformedbyor onbe-half of such additionalinsured.(b)Lessor of Leased Equip-mentAny personor organizationfromwhom you lease equipment whenyouandsuch person(s) ororganiza-tion(s) haveagreedper Par-agraph8.a.(1)of thisen-dorsementto provide insur-ance. Suchperson(s) or or-ganization(s) areinsuredsonly with respect toliability for "bodily injury", "property damage"or "personaland advertising injury"caused, inwhole or inpart,by yourmaintenance, operationoruse ofequipment leasedtoyouby suchperson(s) oror-ganization(s).A person's or organization's statusasan additional insuredunder thisendorsement endswhentheir contract or agreementwith you for suchleasedequipment ends.However, thisinsurance does not ap-ply toany "occurrence"which takesplace after theequipment lease expires.(c)VendorsAny person or organization (referredto below asven-dor) withwhomyou haveagreed per Paragraph 8.a.(1)of thisendorsement to provideinsurance, but on-ly with respectto"bodily in-jury"or "property damage"arising out of "your products"which aredistributedor sold in theregular course of the vendor's business, subjectto the following additionalexclusions:
Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page11of 14 (i)The insurance afforded thevendor doesnot apply to:1)"Bodily injury"or"property damage"for whichthe ven-dorisobligatedtopay damagesby reason ofthe as-sumptionofliability in a contract or agreement. Thisexclusion doesnot apply to liability for damagesthat thevendor wouldhave in theabsence ofthecontract or agreement;2)Anyexpresswar-ranty unauthorizedby you;3)Any physical or chemical change in theproductmade intentionally by thevendor;4)Repackaging, ex-cept when un-packed solely for thepurpose ofin-spection, demon-stration,testing, or thesubstitution of partsunder in-structions from the manufacturer, and then repackaged intheoriginal con-tainer;5)Any failure to make such inspections,adjustments, testsor servicing asthe vendor hasagreed to make or normal-ly undertakesto makeintheusual courseofbusi-ness, inconnectionwith thedistribution or saleofthe products;6)Demonstration,in-stallation, servicingor repair opera-tions, except such operations per-formedat theven- dor's premisesin connectionwith thesale of the product;7)Productswhich, af-ter distribution or sale by you, have been labeledor re-labeled or used asa container,part or ingredientof any other thing or sub-stance by or for the vendor; or8)"Bodily injury"or"property damage"arising out of the sole negligenceofthevendorfor itsown actsor omis-sionsor thoseof itsemployeesor anyone else actingon itsbehalf. How-ever,this exclusion does not apply to:a)The excep-tions containedin Paragraphs(c) (i) 4) or6)of thisen-dorsement;orb)Such inspec-tions, adjust-ments, testsorservicing asthevendor hasagreed to makeor nor-mally under-takesto make in the usualcourse of business, in connection with thedistri-bution or sale of the prod-ucts. (ii)Thisinsurancedoesnot apply to any insuredperson or organization:1)Fromwhomyou have acquired such products,or any ingredient, part or container, enter-inginto, accompa-nyingorcontaining such products; or Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page12of 14 2)Whenliability in-cludedwithin the "products-completed opera-tionshazard"hasbeen excluded un-derthis CoveragePart with respect to such products.(d)Stateor Governmental Agency or Subdivision orPoliticalSubdivision-PermitsorAuthorizations Relatingto PremisesAny state or governmentalagency or subdivision or po-liticalsubdivision with whichyouhave agreed per Para-graph 8.a.(1)ofthis en-dorsement to provide insur-ance, subjectto the follow-ing additional provision:Thisinsurance appliesonlywith respect to the followinghazardsfor which thestateor governmentalagency or subdivisionor political sub-division hasissued apermitor authorization inconnec-tionwithpremisesyou own,rent or control and to which this insurance applies:(i)The existence, mainte-nance, repair,construc-tion, erection or removal ofadvertising signs,awnings, canopies, cel-lar entrances, coalholes, driveways, man-holes, marquees, hoist away openings,side-walkvaults,streetban-ners or decorations and similar exposures; or(ii)The construction, erec-tionor removal ofeleva-tors; or(iii)The ownership, mainte-nance or use of any el-evatorscovered by thisinsurance.(e)Mortgagee, Assigneeor ReceiverAny person or organization with whom you haveagreedperParagraph 8.a.(1) of thisendorsement to providein-surance, but only with re- spect to their liability asmortgagee, assignee, or re-ceiver and arising out of the ownership, maintenance,or use ofthepremisesby you.However, thisinsurance doesnotapply to structuralalterations, new constructionanddemolition operations performedbyorfor that per-son or organization.(3)The insuranceafforded toaddi-tional insureds described in Par-agraph8.a.(1)of thisendorse-ment:(a)Only appliestotheextentpermitted by law; and(b)Willnot be broaderthanthatwhich you are requiredbythewrittencontract,writtenagreement, written permit or written authorization topro-vide for suchadditional in-sured; and(c)Doesnotapply toany per-son, organization,vendor, state, governmental agencyor subdivision or politicalsubdivision,specifically namedasan additional in-suredunder any other provi-sion of, or endorsementadded to, thisCoveragePart, provided suchother provisionorendorsementcoverstheinjury or damagefor whichthisinsuranceap-plies.b.With respectto the insuranceafford-ed to theadditionalinsuredsde-scribedinParagraph8.a.(1)ofthis endorsement, thefollowingisaddedto Section III -Limits of Insurance:The mostwe will pay onbehalfof the additional insuredistheamount of in-surance:(1)Requiredby the writtencontract,written agreement, written permit or written authorizationdescribed in Paragraph 8.a.(1)of thisen-dorsement; or(2)Availableunder theapplicable Limitsof Insurance shownintheDeclarations;whicheveris less.
Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page13of 14 Thisendorsementshallnotincreasetheapplicable Limits ofInsuranceshown in the Declarations.c.SectionIV -Commercial General Liability Conditionsisamended to includethe following:Automatic Additional Insured Pro-visionThisinsurance appliesonly if the "bodily injury"or "property damage"occurs, orthe "personaland advertis-ing injury"offense is committed:(1)Duringthe policy period; and(2)Subsequentto your executionofthewritten contractor writtenagreement, orthe issuance ofawritten permit or written authori-zation,describedinParagraph8.a.(1).d.SectionIV -Commercial General Liability Conditionsisamended asfollows:Condition 5. Other Insuranceisamended to include:Primary and Noncontributory In-suranceThisinsuranceis primary to and willnotseekcontribution from any otherinsurance available toanadditionalinsured per Paragraph8.a.(1)of this endorsement provided that:(1)The additional insuredisaNamedInsured under such other insurance; and(2)You have agreedin writing inacontract,agreement, permit or authorization described in 8.a.(2)ofthisendorsement that thisin-surance would be primary andwould notseek contribution fromany other insuranceavailable tothe additional insured.9.Property Damageto BorrowedEquip-menta.The followingisadded to Exclusion2.j.Damage to PropertyunderSec-tionI -CoverageA -Bodily Injury and Property Damage Liability:Paragraphs(3)and(4)ofthisexclu-sion do not apply to toolsor equip-ment loaned to you, provided they arenotbeingused to perform operationsat the time of loss. b.With respect totheinsurance provid-ed by thissection of the endorse-ment, the following additionalprovi-sions apply:(1)The Limitsof InsuranceshownintheDeclarationsarereplaced bythelimitsdesignatedin SectionB.Limitsof Insurance, 9.Property Damage to Borrowed Equipmentof thisendorsement with respectto coverageprovid-ed bythisendorsement.These limitsare inclusiveofandnotinaddition tothelimitsbeingre-placed. The LimitsofInsuranceshownin SectionB.Limits of Insurance, 9.Property Damageto Borrowed Equipment of thisendorsement fixthemost wewillpayinanyone "occurrence"re-gardless ofthe number of:(a)Insureds;(b)Claimsmadeor "suits"brought; or(c)Personsor organizationsmaking claimsor bringing"suits".(2)Deductible Clause(a)Our obligation to pay dam-ageson your behalfappliesonly to theamount of dam-ages for each "occurrence"whichareinexcess of the Deductible Amount stated in Section B.Limits of Insur-ance, 9.Property Damage to Borrowed Equipmentof thisendorsement. The limitsofinsurance will not be re-duced by the application of such Deductible Amount.(b)SectionIV-CommercialGeneral Liability Condi-tions,2. Dutiesin theEvent of Occurrence, of-fense,Claim Or Suit,ap-pliesto eachclaimor "suit"irrespective of the amount.(c)We maypay any part orallofthedeductibleamount toeffect settlement of any claimor "suit"and, upon no-tificationoftheaction taken,youshall promptly reim-burse usforsuch partof thedeductible amount ashas been paid by us.
Includes copyrighted material of InsuranceGA210 VA 09 17Services Office, Inc., with its permission.Page14of 14
10.Employees As Insureds -SpecifiedHealth Care ServicesAnd GoodSamar-itan ServicesParagraph 2.a.(1)(d)under SectionII-Who Is An Insureddoes not apply to:a.Your"employees"who provide pro-fessional healthcare services on yourbehalf asa duly licensednurse, emergency medical technicianor paramedicin the jurisdiction where an"occurrence"or offense towhich thisinsurance applies takes place; orb.Your"employees"or "volunteer work-ers", other thanan employedorvol-unteer doctor, providing firstaid or good samaritanservicesduring theirworkhoursfor youwill be deemed tobeacting withinthe scopeoftheir employment by youor performing du-tiesrelatedto theconduct ofyourbusiness. 11.Broadened Notice Of OccurrenceParagrapha.ofCondition2. DutiesIn The Event Of Occurrence, Offense, ClaimOr SuitunderSection IV -Com-mercial GeneralLiabilityConditionsisreplaced by the following:a.You must see to it that weare notified assoon aspracticableofan"occur-rence"or an offense whichmayresult in a claim. Tothe extent possible, no-tice should include:(1)How, when andwherethe"oc-currence"or offense took place;(2)The namesand addresses of any injured persons and wit-nesses; and(3)The nature and location ofany injury or damage arising out of the"occurrence"or offense.Thisrequirement applies only whenthe "occurrence"or offenseisknownto an"authorized representative".12.Nonowned AircraftThe following isaddedtoExclusion2.g.Aircraft, Auto Or WatercraftunderSec-tionI -CoverageA-Bodily Injury AndProperty Damage Liability:
Thisexclusiondoes not apply toan air-craft you do not own, provided that:a.The pilot in command holdsa current effectivecertificate, issuedbya duly constituted authority ofthe United StatesofAmerica orCanada, desig-nating that person asa commercial or airline transport pilot;b.The aircraftisrented with a trained, paid crew; andc.The aircraftdoesnot transportper-sons or cargo for a charge.13.Bodily Injury RedefinedSectionV -Definitions, 4."Bodily injury"is replaced by the following:4."Bodily injury"meansbodily harmor injury, sickness, disease,disability,humiliation, shock, fright,mental an-guishor mental injury,including care,lossof servicesordeathresultingfrom any of these at any time.14.ExpectedOrIntended InjuryRedefinedThe last sentenceofExclusion2.a.Ex-pectedOrIntended InjuryunderSec-tionI -Coverage A-Bodily Injury AndProperty Damage Liability is replaced by the following:Thisexclusion doesnot apply to "bodily injury"or "property damage"resulting from theuse of reasonable forcetoprotect per-sons or property. 15.FormerEmployeesAs InsuredsThe following isadded to Paragraph 2.underSection II-Who Is An Insured:2.Each of the following is also anin-sured:Any of your former "employees", di-rectors, managers, members, part-ners or "executive officers", includingbutnot limitedto retired, disabledor thoseon leave of absence, butonly for actswithin the scope of theirem-ployment by you or for dutiesrelatedto the conduct ofyour business.
WLTR005
THE HARTFORD
BUSINESS SERVICE CENTER
3600 WISEMAN BLVD
SAN ANTONIO TX 78251 June 13, 2022
City of Cupertino
10300 TORRE AVE
CUPERTINO CA 95014
Account Information:
Policy Holder Details : CARAHSOFT TECHNOLOGY CORP
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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
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
06/13/2022
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 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
AUTOMATIC DATA PROCESSING INS AGCY
76250717
71 HANOVER ROAD
FLORHAM PARK NJ 07932
CONTACT NAME:
PHONE
(A/C, No, Ext):
(800) 524-7024 FAX
(A/C, No):
E-MAIL ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
INSURER A : Hartford Fire and Its P&C Affiliates 00914
INSURED
CARAHSOFT TECHNOLOGY CORP
11493 SUNSET HILLS RD STE 100
RESTON VA 20190-5230
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
SUBR
WVD
POLICY NUMBER POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/Y YYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
CLAIMS-MADE OCCUR DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE
POLICY PRO-
JECT
LOC PRODUCTS - COMP/OP AGG
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident)
ANY AUTO BODILY INJURY (Per person)
ALL OWNED
AUTOS
SCHEDULED
AUTOS BODILY INJURY (Per accident)
HIRED
AUTOS
NON-OWNED
AUTOS
PROPERTY DAMAGE
(Per accident)
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS-
MADE
EACH OCCURRENCE
AGGREGATE
DED 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
N/ A 76 WEG ZJ6798 04/19/2022 04/19/2023
X PER
STATUTE
OTH-
ER
Y/N E.L. EACH ACCIDENT $1,000,000
E.L. DISEASE -EA EMPLOYEE $1,000,000
E.L. DISEASE - POLICY LIMIT $1,000,000
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 Cupertino
10300 TORRE AVE
CUPERTINO CA 95014
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
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Form WC 00 03 13 Printed in U.S.A.
Process Date: 03/25/22 Policy Expiration Date: 04/19/23
WAIVER OF OUR RIGHT TO RECOVER
FROM OTHERS ENDORSEMENT
Policy Number: 76 WEG ZJ6798 Endorsement Number:
Effective Date: 04/19/22 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address: CARAHSOFT TECHNOLOGY CORP
11493 SUNSET HILLS RD STE 100
RESTON VA 20190
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 shall not operate directly or indirectly to benefit anyone not named in the Schedule.
SCHEDULE
Any person or organization for whom you are required by contract or agreement to obtain this waiver from us.
Endorsement is not applicable in KY, NH, NJ or for any MO construction risk