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
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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 WVDADDL
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
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
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 EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER 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
8/23/2023
Woodruff-Sawyer & Co.
50 California Street, Floor 12
San Francisco CA 94111
WS Certificates 844-972-6326 [email protected] North American Capacity Insurance Company 25038 OPENINC-02 American Casualty Company of Reading 20427 OpenGov, Inc
PO Box 41340
San Jose, CA 95160
Valley Forge Insurance Company 20508 Continental Casualty Company 20443 4488731 C X 1,000,000 X 1,000,000 15,000 1,000,000 2,000,000 X
Y 6079220146 2/15/2023 2/15/2024
2,000,000
D 1,000,000 X XY 6079220132 2/15/2023 2/15/2024
B
B
WC 6 79220177
X
WC 6 79220163
2/15/2023
2/15/2023
2/15/2024
2/15/2024
1,000,000 1,000,000 1,000,000
A Tech Errors & Omissions/Cyber C4LPE040432CYBER2023 2/15/2023 2/15/2024 Per Claim/ Aggregate $1,000,000 The City of Redondo Beach, its officers, elected and appointed officials, employees, and volunteers are included as additional insured as respects General Liability and Automobile Liability to the extent provided in the attached forms.
Coverage is considered primary and Non-contributory to the extent provided in the attached form. City of Redondo Beach 415 Diamond Street
Redondo Beach, CA 90027
Business Auto Policy
Policy Endorsement
LESSOR - ADDITIONAL INSURED AND LOSS PAYEE
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: OPENGOV, INC.
Endorsement Effective Date:
SCHEDULE
Insurance Company: The Continental Insurance Company
Policy Number: 6079220132 Effective Date:
Expiration Date: 4
Named Insured: OPENGOV, INC.
Address: PO BOX 41340
SAN JOSE, CA 95160-1340
Additional Insured (Lessor):
Address:
Designation Or Description Of "Leased Autos":
Coverages Limit Of Insurance
Liability $1,000,000 Each"Accident"
Comprehensive Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Deductible For Each Covered "Leased Auto"
Collision Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Deductible For Each Covered "Leased Auto"
Specified Causes Of Loss Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Deductible For Each Covered "Leased Auto"
Endorsement No: 4; Page: 1 of 2
Policy No: BUA 6079220132
Policy Effective Date: 3
Policy Page: 35 of 68
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CA 20 01 10 13
Endorsement Effective Date: Endorsement Expiration Date:
© Copyright Insurance Services Office, Inc., 2011
Business Auto Policy
Policy Endorsement
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Coverage
1. Any "leased auto" designated or described in the Schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow.
2. For a "leased auto" designated or described in the Schedule, the Who Is An Insured provision under Covered Autos Liability Coverage is changed to include as an "insured" the lessor named in the Schedule. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by:
a. You;
b. Any of your "employees" or agents; or
c. Any person, except the lessor or any "employee" or agent of the lessor, operating a "leased auto" with the permission of any of the above.
3. The coverages provided under this endorsement apply to any "leased auto" described in the Schedule until the expiration date shown in the Schedule, or when the lessor or his or her agent takes possession of the "leased auto", whichever occurs first.
B. Loss Payable Clause
1. We will pay, as interest may appear, you and the lessor named in this endorsement for "loss" to a " leased auto".
2. The insurance covers the interest of the lessor unless the "loss" results from fraudulent acts or omissions on your part.
3. If we make any payment to the lessor, we will obtain his or her rights against any other party.
C. Cancellation
1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition.
2. If you cancel the policy, we will mail notice to the lessor.
3. Cancellation ends this agreement.
D. The lessor is not liable for payment of your premiums.
E. Additional Definition
As used in this endorsement:
"Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra " auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor.
Endorsement No: 4; Page: 2 of 2
Policy No: BUA 6079220132
Policy Effective Date: 3
Policy Page: 36 of 68
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CA 20 01 10 13
Endorsement Effective Date: Endorsement Expiration Date:
© Copyright Insurance Services Office, Inc., 2011
Business Auto Policy
Policy Endorsement
ADDITIONAL INSURED ENDORSEMENT - CONTRACTUAL OBLIGATION It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows:
SCHEDULE
Name of Additional Insured Person Or Organization
ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT TO NAME AS AN ADDITIONAL INSURED.
1. Paragraph A.1. Who Is An Insured of Section II - LIABILITY COVERAGE is amended to include as an additional insured the person or organization scheduled above, but only if you are required by “written contract” to make that person or organization an additional insured under this policy.
2. The insurance provided to the additional insured is limited as follows:
a. The person or organization is an additional insured only with respect to “bodily injury” or “property damage” arising out of a covered “auto” and caused by your negligent acts or omissions or the negligent acts or omissions of someone, other than the additional insured, for whom you are legally liable.
b. The person or organization is not an additional insured for the person or organization’s own acts or omissions, nor those of anyone, other than you, for whom the person or organization is legally liable. c. We will not provide the additional insured any broader coverage or any higher limit of liability than the least that is:
(1) Required by the “written contract”; or
(2) Afforded to you under this policy.
3. Condition 2. Duties In the Event of Accident, Claim, Suit or Loss of Section IV - BUSINESS AUTO CONDITIONS is amended to add the following conditions applicable to the additional insured:
An additional insured under this endorsement will as soon as practicable:
a. Give us written notice of an “accident” which may result in a claim or “suit” under this insurance, and of any claim or “suit” that does result;
b. Agree to make available any other insurance the additional insured has for a loss we cover under this policy;
c. Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or “suit”; and
d. Tender the defense and indemnity of any claim or “suit” to any other insurer or self insurer whose policy or program applies to a loss we cover under this policy. But if the “written contract” requires this insurance to be primary and non-contributory, this provision d. does not apply to insurance on which the additional insured is a Named Insured.
We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a “suit”.
4. Only for the purpose of the insurance provided by this endorsement, SECTION V DEFINITIONS is amended to add the following definition:
Endorsement No: 8; Page: 1 of 2
Policy No: BUA 6079220132
Policy Effective Date: 3
Policy Page: 41 of 68
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CNA71526XX (10-2012)
Endorsement Effective Date: Endorsement Expiration Date:
© Copyright CNA All Rights Reserved. Material used with permission of ISO Properties, Inc Business Auto Policy
Policy Endorsement
“Written contract” means a written contract or written agreement that requires you to make a person or organization an additional insured under this policy, provided the contract or agreement:
1. Is currently in effect or becomes effective during the term of this policy; and
2. Was executed prior to the accident for which the additional insured seeks coverage under this policy.
All other terms and conditions of the policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy.
Endorsement No: 8; Page: 2 of 2
Policy No: BUA 6079220132
Policy Effective Date: 3
Policy Page: 42 of 68
Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CNA71526XX (10-2012)
Endorsement Effective Date: Endorsement Expiration Date:
© Copyright CNA All Rights Reserved. Material used with permission of ISO Properties, Inc &1$ 3$5$02817
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