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Fourth Amendment, Signature & Insurance - ChargePoint, Inc.

Redondo Beach City Council
August 18, 2026

Document
Fourth Amendment, Signature & Insurance - ChargePoint, Inc.
Meeting
August 18, 2026
Body
Redondo Beach City Council
Original file
4.4 MB
Text extracted from the city's file for reading and search. Open the original on redondo.legistar1.com. That file is the official record.

FOURTH AMENDMENT TO THE MASTER SERVICES AND SUBSCRIPTION

AGREEMENT BETWEEN THE CITY OF REDONDO BEACH
AND CHARGEPOINT, INC.

THIS FOURTH AMENDMENT TO THE MASTER SERVICES AND SUBSCRIPTION AGREEMENT (“Fourth Amendment”) is made between the City of Redondo Beach, a chartered municipal corporation (“Subscriber”), and ChargePoint Inc, a Delaware corporation (“CPI”).

WHEREAS, on May 2, 2017 the parties entered into the Master Services and Subscription Agreement between the Subscriber and CPI (the “Agreement”); WHEREAS, on August 14, 2018, the parties entered into a First Amendment to the Agreement ("First Amendment") to extend the term of the Agreement and increase the amount paid to CPI by $1,014;
WHEREAS, on April 13, 2021, the parties entered into a Second Amendment to the Agreement ("Second Amendment") to extend the term of the Agreement to August 29, 2026, and increase the amount paid to CPI by $25,881;
WHEREAS, on October 17, 2023, the parties entered into a Third Amendment to the Agreement ("Third Amendment") to add charging station services and increase the amount paid to CPI by $9,331.02;
WHEREAS, Section 1.2 of the Agreement provides for the incorporation of certain exhibits, including a Price Quotation setting forth the pricing terms applicable to the ChargePoint Services; and
WHEREAS, the parties desire to amend the Agreement.

NOW THEREFORE, in consideration of the promises and mutual covenants contained herein, and intending to be legally bound, the parties hereby agree to make the following amendments to the Agreement:

1. SECTION 1.2 EXHIBITS AND PRIVACY POLICY. Section 1.2 of the Agreement is amended to add the CPI quotation attached hereto as Exhibit “A-4” (Additional Price Quotation”), which is incorporated into and made a part of the Agreement. CPI shall provide the services described in Exhibit “A-4”, in an amount not to exceed $15,380, in accordance with the Agreement, as amended.

2. SECTION 9.1 - TERM OF THE AGREEMENT. Section 9.1 of the Agreement, as previously amended, is hereby amended and restated in its entirety as follows:

The term of the Agreement shall continue through the expiration of all Service Plans purchased by Subscriber under the Agreement, including any Service Plans and other services purchased or renewed by Subscriber under the Agreement, including those purchased or renewed pursuant to this Fourth Amendment, unless earlier terminated in accordance with the Agreement.

3. NO OTHER AMENDMENTS. Except as expressly stated herein, the Agreement shall remain unchanged and in full force and effect. The Agreement, the First Amendment, Second Amendment, Third Amendment, and this Fourth Amendment, constitute the entire agreement between the parties and supersede any previous oral or written agreements with respect to the subject matter hereof. In the event of any inconsistency between the terms of the Agreement, First Amendment, Second Amendment, Third Amendment, and Fourth Amendment, the terms of this Fourth Amendment shall govern.

SIGNATURES ON NEXT PAGE
IN WITNESS WHEREOF, the parties have executed this Fourth Amendment in Redondo Beach, California, as of this 18th day of August, 2026.

CITY OF REDONDO BEACH, CHARGEPOINT, INC.,
a chartered municipal corporation a Delaware Corporation __________________________ By: _______________________
James A. Light, Mayor Name: _______________________
Title: _______________________

ATTEST: APPROVED:
__________________________ __________________________
Eleanor Manzano, City Clerk Diane Strickfaden, Risk Manager APPROVED AS TO FORM:
__________________________
Joy A. Ford, City Attorney
8/13/2026 | 11:45 AM PDT
Mansi Khetani
CFO
EXHIBIT “A-4”

CHARGEPOINT QUOTATION
See attached.

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
8/12/2026
Gallagher Brokerage & Insurance Solutions, Inc.
50 California St Floor 12
San Francisco CA 94111
WS Certificates 415-391-2141 [email protected] License#: 0329598 Federal Insurance Company 20281 COULTEC-01 Beazley Excess and Surplus Insurance, Inc. 17520 ChargePoint Holdings, Inc.

Chargepoint, Inc.
254 E. Hacienda Avenue
Campbell, CA 95008
Endurance Risk Solutions Assurance Co. 43630 925103931
A X 1,000,000 X 1,000,000 10,000 1,000,000 2,000,000 X
Y 36085989 5/1/2026 5/1/2027
2,000,000
A 1,000,000 XY 73641612 5/1/2026 5/1/2027
A
C
X X 10,000,000 X
56721371
XSC30058809301
5/1/2026
5/1/2026
5/1/2027
5/1/2027
10,000,000
A 71844212 5/1/2026 5/1/2027
X
1,000,000 1,000,000 1,000,000
B Technology E&O / Cyber
(Professional Liability)
D252B9260801 5/1/2026 5/1/2027 Per Claim/ Aggregate $5,000,000 The City of Redondo Beach, its officers, elected and appointed officials, employees, and volunteers are included as additional insured as respects General Liability and Auto Liability are included as Additional Insured as respects General liability, Automobile Liability, on a Primary and Non-contributory basis to the extent provided in the attached forms.

Notice of Cancellation applies with respects General Liability, Auto Liability and Workers Compensation to the extent provided in the attached forms. City of Redondo Beach 415 Diamond St.

Redondo Beach, CA 90277
Form: 16-02-0292 (Rev. 11-16) Page 1 of 3
"Includes copyrighted material of Insurance Services Office, Inc. with its permission"

COMMERCIAL AUTOMOBILE
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM
This endorsement modifies the Business Auto Coverage Form.

1. EXTENDED CANCELLATION CONDITION
Paragraph A.2.b. – CANCELLATION - of the
COMMON POLICY CONDITIONS form IL 00 17 is
deleted and replaced with the following:
b. 60 days before the effective date of cancellation if we cancel for any other reason.

2. BROAD FORM INSURED
A. Subsidiaries and Newly Acquired or Formed
Organizations As Insureds
The Named Insured shown in the Declarations is
amended to include:

1. Any legally incorporated subsidiary in which
you own more than 50% of the voting stock on
the effective date of the Coverage Form.

However, the Named Insured does not include
any subsidiary that is an “insured” under any
other automobile policy or would be an
“insured” under such a policy but for its
termination or the exhaustion of its Limit of
Insurance.

2. Any organization that is acquired or formed by
you and over which you maintain majority
ownership. However, the Named Insured
does not include any newly formed or acquired
organization:
(a) That is an “insured” under any other
automobile policy;
(b) That has exhausted its Limit of Insurance
under any other policy; or
(c) 180 days or more after its acquisition or
formation by you, unless you have given
us written notice of the acquisition or
formation.

Coverage does not apply to “bodily injury” or
“property damage” that results from an “accident”
that occurred before you formed or acquired the
organization.

B. Employees as Insureds
Paragraph A.1. – WHO IS AN INSURED – of
SECTION II – LIABILITY COVERAGE is amended to
add the following:
d. Any “employee” of yours while using a
covered “auto” you don’t own, hire or
borrow in your business or your personal
affairs.

C. Lessors as Insureds
Paragraph A.1. – WHO IS AN INSURED – of
SECTION II – LIABILITY COVERAGE is
amended to add the following:
e. The lessor of a covered “auto” while the
“auto” is leased to you under a written
agreement if:
(1) The agreement requires you to
provide direct primary insurance for
the lessor; and
(2) The “auto” is leased without a driver.

Such leased “auto” will be considered a
covered “auto” you own and not a covered
“auto” you hire.

However, the lessor is an “insured” only
for “bodily injury” or “property damage”
resulting from the acts or omissions by:

1. You;

2. Any of your “employees” or agents;
or

3. Any person, except the lessor or
any “employee” or agent of the
lessor, operating an “auto” with the
permission of any of 1. and/or 2.
above.

D. Persons And Organizations As Insureds
Under A Written Insured Contract
Paragraph A.1 – WHO IS AN INSURED – of
SECTION II – LIABILITY COVERAGE is
amended to add the following:
f. Any person or organization with respect to
the operation, maintenance or use of a
covered “auto”, provided that you and
such person or organization have agreed
under an express provision in a written
“insured contract”, written agreement or a
written permit issued to you by a
governmental or public authority to add
such person or organization to this policy
as an “insured”.

However, such person or organization is
an “insured” only:

Policy Number: 73641612
Form: 16-02-0292 (Rev. 11-16) Page 2 of 3
"Includes copyrighted material of Insurance Services Office, Inc. with its permission" (1) with respect to the operation,
maintenance or use of a covered
“auto”; and
(2) for “bodily injury” or “property damage”
caused by an “accident” which takes
place after:
(a) You executed the “insured
contract” or written agreement; or
(b) The permit has been issued to
you.

3. FELLOW EMPLOYEE COVERAGE
EXCLUSION B.5. - FELLOW EMPLOYEE – of
SECTION II – LIABILITY COVERAGE does not apply.

4. PHYSICAL DAMAGE – ADDITIONAL TEMPORARY

TRANSPORTATION EXPENSE COVERAGE
Paragraph A.4.a. – TRANSPORTATION EXPENSES
– of SECTION III – PHYSICAL DAMAGE
COVERAGE is amended to provide a limit of $50 per
day for temporary transportation expense, subject to a
maximum limit of $1,000.

5. AUTO LOAN/LEASE GAP COVERAGE
Paragraph A. 4. – COVERAGE EXTENSIONS - of
SECTION III – PHYSICAL DAMAGE COVERAGE is
amended to add the following:
c. Unpaid Loan or Lease Amounts
In the event of a total “loss” to a covered “auto”, we will pay any unpaid amount due on the loan or lease for a
covered “auto” minus:

1. The amount paid under the Physical Damage
Coverage Section of the policy; and

2. Any:
a. Overdue loan/lease payments at the time of
the “loss”;
b. Financial penalties imposed under a lease for
excessive use, abnormal wear and tear or
high mileage;
c. Security deposits not returned by the lessor:
d. Costs for extended warranties, Credit Life
Insurance, Health, Accident or Disability
Insurance purchased with the loan or lease;
and
e. Carry-over balances from previous loans or
leases.

We will pay for any unpaid amount due on the loan or
lease if caused by:

1. Other than Collision Coverage only if the
Declarations indicate that Comprehensive
Coverage is provided for any covered “auto”;

2. Specified Causes of Loss Coverage only if the
Declarations indicate that Specified Causes of
Loss Coverage is provided for any covered “auto”;
or

3. Collision Coverage only if the Declarations indicate that Collision Coverage is provided for any
covered “auto.

6. RENTAL AGENCY EXPENSE
Paragraph A. 4. – COVERAGE EXTENSIONS – of
SECTION III – PHYSICAL DAMAGE COVERAGE
is amended to add the following:
d. Rental Expense
We will pay the following expenses that you or
any of your “employees” are legally obligated
to pay because of a written contract or
agreement entered into for use of a rental
vehicle in the conduct of your business:

MAXIMUM WE WILL PAY FOR ANY ONE
CONTRACT OR AGREEMENT:

1. $2,500 for loss of income incurred by the
rental agency during the period of time that
vehicle is out of use because of actual
damage to, or “loss” of, that vehicle, including
income lost due to absence of that vehicle for
use as a replacement;

2. $2,500 for decrease in trade-in value of the
rental vehicle because of actual damage to
that vehicle arising out of a covered “loss”; and

3. $2,500 for administrative expenses incurred
by the rental agency, as stated in the contract
or agreement.

4. $7,500 maximum total amount for paragraphs

1., 2. and 3. combined.

7. EXTRA EXPENSE – BROADENED COVERAGE
Paragraph A.4. – COVERAGE EXTENSIONS – of
SECTION III – PHYSICAL DAMAGE COVERAGE
is amended to add the following:
e. Recovery Expense
We will pay for the expense of returning a
stolen covered “auto” to you.

8. AIRBAG COVERAGE
Paragraph B.3.a. - EXCLUSIONS – of SECTION
III – PHYSICAL DAMAGE COVERAGE does not
apply to the accidental or unintended discharge of
an airbag. Coverage is excess over any other
collectible insurance or warranty specifically
designed to provide this coverage.

9. AUDIO, VISUAL AND DATA ELECTRONIC

EQUIPMENT - BROADENED COVERAGE
Paragraph C.1.b. – LIMIT OF INSURANCE - of
SECTION III - PHYSICAL DAMAGE is deleted
and replaced with the following:
b. $2,000 is the most we will pay for "loss" in any
one "accident" to all electronic equipment that
reproduces, receives or transmits audio, visual
or data signals which, at the time of "loss", is:
(1) Permanently installed in or upon the
covered "auto" in a housing, opening or
other location that is not normally used by
the "auto" manufacturer for the installation
of such equipment;
(2) Removable from a permanently installed
housing unit as described in Paragraph

2.a. above or is an integral part of that
equipment; or
(3) An integral part of such equipment.

10. GLASS REPAIR – WAIVER OF DEDUCTIBLE
Policy Number: 73641612
Form: 16-02-0292 (Rev. 11-16) Page 3 of 3
"Includes copyrighted material of Insurance Services Office, Inc. with its permission" Under Paragraph D. - DEDUCTIBLE – of
SECTION III – PHYSICAL DAMAGE COVERAGE
the following is added:

No deductible applies to glass damage if the glass
is repaired rather than replaced.

11. TWO OR MORE DEDUCTIBLES
Paragraph D.- DEDUCTIBLE – of SECTION III –
PHYSICAL DAMAGE COVERAGE is amended to
add the following:

If this Coverage Form and any other Coverage
Form or policy issued to you by us that is not an
automobile policy or Coverage Form applies to the
same “accident”, the following applies:

1. If the deductible under this Business Auto
Coverage Form is the smaller (or smallest)
deductible, it will be waived; or

2. If the deductible under this Business Auto
Coverage Form is not the smaller (or smallest)
deductible, it will be reduced by the amount of
the smaller (or smallest) deductible.

12. AMENDED DUTIES IN THE EVENT OF

ACCIDENT, CLAIM, SUIT OR LOSS
Paragraph A.2.a. - DUTIES IN THE EVENT OF
AN ACCIDENT, CLAIM, SUIT OR LOSS of
SECTION IV - BUSINESS AUTO CONDITIONS is
deleted and replaced with the following:
a. In the event of “accident”, claim, “suit” or
“loss”, you must promptly notify us when the
“accident” is known to:
(1) You or your authorized representative, if
you are an individual;
(2) A partner, or any authorized
representative, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive officer, insurance manager,
or authorized representative, if you are an
organization other than a partnership or
limited liability company.

Knowledge of an “accident”, claim, “suit” or
“loss” by other persons does not imply that the
persons listed above have such knowledge.

Notice to us should include:
(1) How, when and where the “accident” or
“loss” occurred;
(2) The “insured’s” name and address; and
(3) To the extent possible, the names and
addresses of any injured persons or
witnesses.

13. WAIVER OF SUBROGATION
Paragraph A.5. - TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US of
SECTION IV – BUSINESS AUTO CONDITIONS is
deleted and replaced with the following:

5. We will waive the right of recovery we would
otherwise have against another person or
organization for “loss” to which this insurance
applies, provided the “insured” has waived
their rights of recovery against such person or
organization under a contract or agreement
that is entered into before such “loss”.

To the extent that the “insured’s” rights to
recover damages for all or part of any
payment made under this insurance has not
been waived, those rights are transferred to
us. That person or organization must do
everything necessary to secure our rights and
must do nothing after “accident” or “loss” to
impair them. At our request, the insured will
bring suit or transfer those rights to us and
help us enforce them.

14. UNINTENTIONAL FAILURE TO DISCLOSE

HAZARDS
Paragraph B.2. – CONCEALMENT,
MISREPRESENTATION or FRAUD of SECTION
IV – BUSINESS AUTO CONDITIONS - is deleted
and replaced with the following:

If you unintentionally fail to disclose any hazards
existing at the inception date of your policy, we will
not void coverage under this Coverage Form
because of such failure.

15. AUTOS RENTED BY EMPLOYEES
Paragraph B.5. - OTHER INSURANCE of
SECTION IV – BUSINESS AUTO CONDITIONS -
is amended to add the following:
e. Any “auto” hired or rented by your “employee”
on your behalf and at your direction will be
considered an “auto” you hire. If an
“employee’s” personal insurance also applies
on an excess basis to a covered “auto” hired
or rented by your “employee” on your behalf
and at your direction, this insurance will be
primary to the “employee’s” personal
insurance.

16. HIRED AUTO – COVERAGE TERRITORY
Paragraph B.7.b.(5). - POLICY PERIOD,
COVERAGE TERRITORY of SECTION IV –
BUSINESS AUTO CONDITIONS is deleted and
replaced with the following:
(5) A covered “auto” of the private passenger
type is leased, hired, rented or borrowed
without a driver for a period of 45 days or
less; and

17. RESULTANT MENTAL ANGUISH COVERAGE
Paragraph C. of - SECTION V – DEFINITIONS is
deleted and replaced by the following:
“Bodily injury” means bodily injury, sickness or
disease sustained by any person, including
mental anguish or death as a result of the “bodily
injury” sustained by that person.

Policy Number: 73641612
Policy #73641612

SCHEDULE
Name of Person(s) or Organization(s):

IF YOU ARE OBLIGATED, PURSUANT TO A WRITTEN CONTRACT OR AGREEMENT, TO

PROVIDE PERSON(S) OR ORGANIZATION(S) WITH NOTICE OF CANCELLATION,

THEN WE WILL NOTIFY SUCH PERSON(S) OR ORGANIZATION(S) PROVIDED THAT WITHIN 30 DAYS OF THE DATE WE SEND NOTICE OF CANCELLATION TO THE FIRST

NAMED INSURED, THE FIRST NAMED INSURED OR PRODUCER OF RECORD PROVIDES

US WITH A SPREADSHEET CONTAINING THE NAME, MAILING ADDRESS AND, IF AVAILABLE, E-MAIL ADDRESS OF THE PERSON(S) OR ORGANIZATION(S). 16-02-0316 Ed. 10 14 Page 1 of 1
POLICY NUMBER: 73641612 COMMERCIAL AUTO
16-02-0316 Ed. 10 14
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIMARY AND NON-CONTRIBUTORY LIABILITY

INSURANCE
This endorsement modifies insurance provided under the following:

BUSINESS AUTO 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: CHARGEPOINT HOLDINGS, INC.

Endorsement Effective Date: 05/01/2026

SCHEDULE
Name(s) Of Person(s) Or Organization(s):

PERSONS OR ORGANIZATIONS THAT YOU ARE OBLIGATED, PURSUANT TO A

CONTRACT OR AGREEMENT BETWEEN YOU AND SUCH PERSON OR

ORGANIZATION, TO PROVIDE PRIMARY AND NON-CONTRIBUTORY INSURANCE Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following is added to Item 5. – “Other
Insurance” of Item B. – “General Conditions” under
Section IV – “Business Auto Conditions”:
e. Regardless of the provisions of Paragraph 5.a.
through d. above, for any liability arising out of the
ownership, maintenance, use, rental, lease, loan, hire
or borrowing by an ”insured” of a covered “auto” for
which an “insured” is contractually obligated to
provide primary insurance coverage to a client, this
Coverage Form will be primary and non-contributory
with respect to the Persons or Organizations in the
schedule, regardless of the availability or existence of other collectible insurance under any other Coverage
Form or policy that applies on a primary basis.

WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 99 06 43 (Ed. 6-11)

NOTICE OF CANCELLATION

SCHEDULED PERSON(S) OR ORGANIZATION(S)
This endorsement effective on 10/02/26
Policy No. 71844212
Issued to CHARGEPOINT HOLDINGS, INC.

Chubb National Insurance Company
(NAME OF INSURANCE COMPANY)
Under Part Six - Conditions of the policy, the following is added:

Notice of Cancellation - Scheduled Person(s) or Organization(s) When we cancel this policy we will notify the person(s) or organization(s) described in the SCHEDULE at least 30 days (10 days in the event of nonpayment of premium) in advance of the cancellation date.

Any failure by us to notify such person(s) or organization(s) will not:
• Impose any liability or obligation of any kind upon us; or • Invalidate such cancellation.

SCHEDULE
Name of Person(s) or Organization(s):

IF YOU ARE OBLIGATED, PURSUANT TO A WRITTEN CONTRACT OR AGREEMENT, TO

PROVIDE PERSON(S) OR ORGANIZATION(S) WITH NOTICE OF CANCELLATION,

THEN WE WILL NOTIFY SUCH PERSON(S) OR ORGANIZATION(S) PROVIDED THAT WITHIN 30 DAYS OF THE DATE WE SEND NOTICE OF CANCELLATION TO THE FIRST

NAMED INSURED, THE FIRST NAMED INSURED OR PRODUCER OF RECORD PROVIDES

US WITH A SPREADSHEET CONTAINING THE NAME, MAILING ADDRESS AND, IF AVAILABLE, E-MAIL ADDRESS OF THE PERSON(S) OR ORGANIZATION(S).

WC 99 06 43 (Ed. 6-11)
Producer Copy

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