CITY OF RICHMOND
CONTRACT AMENDMENT
Department: Project Manager:
Project Manager E-mail:
Project Manager Phone No:
P.R. No: Vendor No: P.O./Contract No:
Description of Services:
Amendment No. ___ modifies the: (2nd or subsequent amendments attach Amendment History page)
Term, Payment Limit and Service Plan
Payment Limit and Service Plan
Term and Service Plan
Service Plan
The parties to this Contract Amendment do mutually agree and promise as follows:
1. Parties. The parties to this Contract Amendment are the City of Richmond, California, a municipal corporation (City), and the following named Contractor:
Company Name:
Street Address:
City, State, Zip Code:
Contact Person:
Telephone: Email:
Business License No: / Expiration Date:
A California [ ] corporation, [ ] limited liability corporation [ ] general partnership, [ ] limited partnership, [ ] individual, [ ] non-profit corporation, [ ] individual dba as [specify:]
[ ] other [specify:]
2. Purpose. This Contract Amendment is being entered into to amend the Contract between City and Contractor which was approved by the City Council of the City of Richmond or executed by the City Manager on , which original term commenced on and terminates with an original contract payment limit of $ . Said contract shall hereinafter be referred to as the "Original Contract" and is incorporated herein by reference.
3. Original Contract Provisions. The parties hereto agree to continue to abide by those terms and conditions of the Original Contract, and any amendments thereto, which are unaffected by this Contract Amendment.
Contract Amendment/EJ/TE 09-26-07
4. Amendment Provisions. This Contract Amendment is subject to the Amendment Provisions attached hereto, which are incorporated herein by reference, and which control over any conflicting provisions of the Original Contract, or any amendment thereto.
5. City of Richmond Business License Active Status Maintained. Pursuant to Municipal Code Section 7.04.030, the Contractor must maintain its City of Richmond business license for this Contract Amendment to be deemed to be in effect.
6. Insurance Coverage Updated and Maintained. Pursuant to the Original Contract, the Contractor shall provide the City with updated insurance certificates, and the Contractor shall maintain insurance coverage, for this Contract Amendment to be deemed to be in effect.
7. Signatures. These signatures attest the parties’ agreement hereto:
CITY OF RICHMOND, CALIFORNIA
a municipal corporation
By _______________________
Title:
I hereby certify that the Original Contract
and this Amendment have been approved
by the City Council or executed by the City
Manager.
By _______________________
City Clerk
Approved as to form:
By_______________________
City Attorney
List of Attachments:
1. Amendment Provisions
2. Updated Insurance Certificates
CONTRACTOR:
______________________________
(*The Corporation Chairperson of the Board, President or Vice-President should sign on the line below.)
By____________________________
Title:________________________
(*The Corporation Chief Financial Officer, Secretary or Assistant Secretary should sign on the line below.)
By:___________________________
Title:________________________
(NOTE: Pursuant to California Corporations
Code Section 313, if Contractor is a
corporation or nonprofit organization, this
Contract (1) should be signed by the
Chairperson of the Board, President or
Vice-President
and the Chief Financial
Officer, Secretary or Assistant Secretary; (2)
should have both signatures conform to
designated representative groups pursuant
to Corporations Code Section 313.
Contract Amendment between the City of Richmond and
Amendme
nt No. P.O./Contract No.
AMENDMENT PROVISIONS (TERM, PAYMENT LIMIT AND SERVICE PLAN)
1. Paragraph 2 (Term) of the Original Contract is hereby amended to extend the Contract term. Paragra
ph 2 of the Original Contract is amended to read as
follows:
"2. Term. The effective date of this Contract is
____________________________________________________________ (Insert original contract commencement date)
and it terminates
___________________________________________________.
(Insert new contract termination date)
unless sooner terminated as provided herein."
2. Paragraph 3 (Payment Limit) of the Original Contract is hereby amended to increase the
payment limit by $ . Paragraph 3 of the Original Contract is
amended to read as follows:
"3. Payment Limit. City's total payments to Contractor under this Contract shall not exceed $
including expenses."
“The City of Richmond shall not pay for services that exceed the Contract Payment Limit without the prior written approval of the City Manager if the total Contract amount does not exceed $10,000 or without the prior approval of the City Council if the total Contract amount is over $10,000.”
3. The Service Plan (Exhibit A) of the Original Contract is hereby amended to include the f
ollowing tasks and/or services:
Contract Amendment/EJ/TE 9-26-07
Contract Amendment between the City of Richmond and
Amendment No. P.O./Contract No.
AMENDMENT PROVISIONS (PAYMENT LIMIT AND SERVICE PLAN)
1. Paragraph 3 (Payment Limit) of the Original Contract is hereby amended to increase the payment limit by $ . Paragraph 3 of the Original Contract is amended to read as follows:
"3. Payment Limit. City's total payments to Contractor under this Contract Amendment shall not exceed $ including expenses."
“The City of Richmond shall not pay for services that exceed the Contract Payment Limit without the prior written approval of the City Manager if the total Contract amount does not exceed $10,000 or without the prior approval of the City Council if the total Contract amount is over $10,000.”
2. The Service Plan (Exhibit A) of the Original Contract is hereby amended to include the following tasks and/or services:
Contract Amendment/EJ/TE 9-26-07
Contract Amendment between the City of Richmond and
Amendment No. P.O./Contract No.
AMENDMENT PROVISIONS (TERM AND SERVICE PLAN)
1. Paragraph 2 (Term) of the Original Contract is hereby amended to extend the Contract term. Paragraph 2 of the Original Contract is amended to read as follows:
"2. Term . The effective date of this Contract is
_____________________________________________________________ (Insert original contract commencement date)
and it terminates
_____________________________________________________________. (Insert new contract termination date)
unless sooner terminated as provided herein."
2. The Service Plan (Exhibit A) of the Original Contract is hereby amended to include the following tasks and/or services:
Contract Amendment/EJ/TE 9-26-07
Contract Amendment between the City of Richmond and
Amendment No. P.O./Contract No.
AMENDMENT PROVISIONS (SERVICE PLAN)
(CONTRACTOR’S OBLIGATION’S)
The Service Plan (Exhibit A) of the Original Contract is hereby amended to include the following tasks and/or services:
Contract Amendment/EJ/TE 9-26-07
Contract Amendment between the City of Richmond and
Amendment No. P.O./Contract No.
AMENDMENT PROVISIONS (AMENDMENT HISTORY)
The first Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
The second Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
The third Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
The fourth Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
The fifth Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
Contract Amendment between the City of Richmond and
Amendment No. P.O./Contract No.
The sixth Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
The seventh Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
The eighth Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
The ninth Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
The tenth Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on for one or more of the following provisions (check those that apply):
Increased contract payment limit by $ ________________for a payment limit not to exceed $ _________________________.
Term Amendment (insert new termination date):________________________
Service Plan
Contract Amendment/EJ/TE 11-30-07
Version 20220501
SUPPORT QUOTE
CITY OF RICHMOND
ATTN:
450 CIVIC CENTER PLAZA
RICHMOND, CA 94804
I. This Support Quote is based on the hardware and software configuration set forth in Exhibit A – Schedule of Equipment (“Equipment”), including any improved features and models of such equipment purchased from Packet Fusion during any support term for all locations set forth in Exhibit B – Customer Locations.
II. Hourly Time and Material Billing Rates (“T&M Rates”) for the support Term are set forth in Exhibit C of this Support Quote.
III. Length of Support (“Term”) – Special support term length listed in the customer reference below.
Quote Number: QUO-03360-S9N5D3
Effective Start Date: 01 July 2023
Support Type and Term Options
Term Length
Support - No Phone
Coverage Term Length
With Optional
Phone Coverage Discount End Date
6 Term Month $ 20,109.60 Special Term $ 0.00 0% 31 December 2023 Amount selected will be due in full upon invoicing by Packet Fusion Please select your support type and term
from the table abo .ve
Quote Expires: 30 June 2023
IMPORTANT: After the renewal date, if not fully executed, Mitel’s Corporate Policy imposes a reinstatement fee beginning at 40% of the contract value. Depending on the amount of time lapse from renewal date, the fee increases to a maximum of 100% at month 8.
Version 20220501
Customer Purchase Orders referencing the Quote # and Contract Amount are acceptable in lieu of a Customer Signature.
Invoices are due net 30 from the date of invoice from Packet Fusion, Inc.
Make checks payable to Packet Fusion, Inc., PO Box 888055, Los Angeles, CA 90088-8055 Customer Reference
6 month extension on support agreement RS052118COR709692. Option for additional extensions in 3 month increments up to 4 10,054.80$ . total will extension month 3 optional Each times.
Accepted:
CITY OF RICHMOND
Name:
Date:
Title:
PO Number:
Version 20220501
Exhibit A
Hourly Time and Material Billing Rates (“T&M Rates”)
Hourly Rates
• Non-Support Customers 7$1 5.00 an hour
• Support Customer within California 2$1 5.00 an hour
• Support Customers outside California 7$1 5.00 an hour Overtime Hourly Rates
• Non-Support Customers 6$2 2.50 an hour
• Support Customer within California 187$ .50 an hour
• Support Customers outside California 6$2 2.50 an hour
Version 20220501
6 month extension on support agreement RS052118COR709692. Option for additional extensions in 3 month increments up to 4 times.
Version 20220501
___ Exhibit F
___ Section 8
City of Richmond - Insurance Requirements - Type 2:
Professional Services
Type 2 – Page 1 of 3
Revised: June 2011
In all instances where CONTRACTOR or its representatives will provide professional services (architects, engineers, construction management, counselors, medical professionals, hospitals, clinics, attorneys, consultants, accountants, etc.) to the City of Richmond (City), the City requires the following MINIMUM insurance requirements and limits.
CONTRACTOR shall procure and maintain for the duration of the contract, agreement, or other order for work, services or supplies, insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder and the results of that work by the CONTRACTOR, its agents, representatives, employees or subcontractors. Maintenance of proper insurance coverage is a material element of the contract. Failure to maintain or renew coverage or to provide evidence of renewal may be treated by the City as a material breach of contract.
CONTRACTOR agrees that in the event of loss due to any of the perils for which it has agreed to provide Commercial General Liability insurance, CONTRACTOR shall look solely to its insurance for recovery.
CONTRACTOR hereby grants to CITY, on behalf of any insurer providing Commercial General Liability insurance to either CONTRACTOR or CITY with respect to the services of CONSULTANT herein, a waiver of any right to subrogation which any such insurer of said CONTRACTOR may acquire against the CITY by virtue of the payment of any loss under such insurance.
Original, signed certificates and original, separate policy endorsements, naming the City as an additional insured for general liability coverage, as well as a waiver of subrogation for Workers’ Compensation insurance, shall be received and approved by the City before any work may begin. However, failure to do so shall not operate as a waiver of these insurance requirements.
City reserves the right to modify or require additional coverages for specific risk exposures depending on scope of CONTRACTORS work.
Minimum coverage is detailed below. The policy limits of coverage shall be made available to the full limits of the policy. The minimum limits stated herein shall not serve to reduce the policy limits of coverage of CONTRACTOR.
Minimum Scope of Insurance – the following forms shall be provided and coverage shall be at least as broad as the following:
1. Insurance Services Office Commercial General Liability coverage (ISO Occurrence Form CG 0001), and including coverage for bodily and personal injury, property damage, and products and completed operations (if applicable).
2. Insurance Services Office Automobile Liability coverage (ISO Form CA 0001, Code 1, Any Auto).
3. Original and Separate Additional Insured Endorsement for General Liability (ISO Form CG 20 10 11/85 or its equivalent) with primary and non-contributory language.
4. Workers’ Compensation Insurance as required by the State of California including Employer’s Liability coverage.
5. Original and Separate Waiver of Subrogation for Workers’ Compensation insurance.
6. Professional Liability or Errors & Omissions Liability Insurance appropriate to the CONTRACTOR’s profession (if required.)
Required Coverage Minimum Limits
Workers’ Compensation and
Employers’ Liability
Statutory limits as required by the State of California including $1 million Employers’ Liability per accident, per employee for bodily injury or disease.
If CONTRACTOR is self-insured, provide a certificate of Permission to Self- Insure, signed by the California Department of Industrial Relations and Self- Insurance. If contractor is a sole proprietor (has no employees) than contractor must sign “Contractor Release of Liability” found at:
http://www.ci.richmond.ca.us/index.aspx?nid=61
.
General Liability
(primary and excess limits
combined)
$2,000,000 per occurrence for bodily injury, personal injury and property damage. If the policy includes a general aggregate, either the general aggregate shall apply separately to this project, service or location or the minimum required aggregate limit shall be twice the per occurrence limit.
Policy shall be endorsed to name the City of Richmond as an additional insured per the conditions detailed below.
___ Exhibit F
___ Section 8
City of Richmond - Insurance Requirements - Type 2:
Professional Services
Type 2 – Page 2 of 3
Revised: June 2011
Automobile Liability $1,000,000 per occurrence for bodily injury and property damage.
PROJECT COST R EQUIRED LIMIT
$0 - $1 million $1 million p/o
$1 million - $5 million $2 million p/o
Over $5 million $5 million p/o
Professional Liability or Errors &
Omissions Liability –
Required for all professionals
including architects, engineers,
consultants, construction
management, counselors, medical
professionals, hospitals, clinics,
attorneys and accountants, & other
consultants as may be required by
the City.
Required Policy Conditions
Additional Insured Endorsement Applic able to General Liability coverage.
The City of Richmond, its officers, officials, employees, agents and volunteers are to be named as additional insureds for all liability arising out of the operations by or on behalf of the named insured including bodily injury, deaths and property damage or destruction arising in any respect directly or indirectly in the performance of this contract.
ISO form CG 20 10 (11/85) or its equivalent is required. If the Contractor is supplying their product or providing a service then the endorsement must not
exclude products and completed operations
coverage. If it does, then CG 20 37 (10/01) is also required.
SAMPLE Endorsements can be found at
http://www.ci.richmond.ca.us/index.aspx?nid=61
.
Primary and Noncontributory The contractor’s insurance coverage must be primary coverage as it pertains to the City, its officers, officials, employees, agents and volunteers. Any insurance or self insurance maintained by the City is wholly separate from the insurance of the contractor and in no way relieves the contractor from its responsibility to provide insurance.
Waiver of Subrogation
Endorsement Form
Contractor’s insurer will provide a Waiver of Subrogation in favor of the City for Workers’ Compensation Insurance during the life of this contract.
SAMPLE Endorsements can be found at
http://www.ci.richmond.ca.us/index.aspx?nid=61
.
Deductibles and Self-Insured
Retentions
Any deductible or self-insured retention must be declared to and approved by the City. At the option of the City either the insurer shall reduce or eliminate such deductibles or self-insured retention as respects the City or the CONTRACTOR shall procure a financial guarantee in an amount equal to the deductible or self-insured retention guaranteeing payment of losses and related investigations, claims administration and defense expenses.
Contractor is responsible for satisfaction of the deductible and/or self-insured retention for each loss.
A. M. Best Rating A:VII or Better. If the A.M. Best Rating falls below the required rating, CONTRACTOR must replace coverage immediately and provide notice to City.
Umbrella/Excess Liability Policies
If an Umbrella or Excess Liability Policy is used to meet the liability limits, coverage shall be as broad as specified for underlying coverage’s and cover those insured in the underlying policies.
Claims-Made Policies
___ Exhibit F
___ Section 8
City of Richmond - Insurance Requirements - Type 2:
Professional Services
Type 2 – Page 3 of 3
Revised: June 2011
If any insurance policy is written on a claims-made form: 1) the retroactive date must be shown, and must be before the date of the contract or the beginning of contract work. 2) Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work. 3) If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a retroactive date prior to the contract effective date, the Contractor must purchase an extended period coverage for a minimum of five (5) years after completion of contract work.
Subcontractors
CONTRACTOR shall include all subcontractors as insured under its policies or shall furnish to the City for review and approval, separate certificates and endorsements for each subcontractor. All coverage for subcontractors shall be subject to all of the requirements stated herein.
CONTRACTOR agrees to defend and indemnify the City of Richmond for any damage resulting to it from failure of either CONTRACTOR or any subcontractor to take out or maintain the required insurance policies. The fact that insurance is obtained by CONTRACTOR, and/or CONTRACTOR’s subcontractors, will not be deemed to release or diminish the liability of CONTRACTOR, including, without limitation, liability under the indemnity provisions of this contract. Damages recoverable by CITY from CONTRACTOR or any third party will not be limited by the amount of the required insurance coverage.
Verification of Coverage
All original certificates and endorsements shall be received and approved by the City before work may begin .
The City of Richmond reserves the right to require complete, certified copies of all required insurance policies including endorsements affecting the coverage at any time.
Original insurance certificates and required policy endorsements shall be mailed or delivered to the Designated Project Manager for the City of Richmond.
Insurance certificates and endorsements may be faxed to the Designated Project Manger. However, CONTRACTOR must mail the original certificates and endorsements to Designated Project Manager once faxed.
Continuous Coverage
CONTRACTOR shall maintain the required insurance for the life of the contract. Should the CONTRACTOR cease to have insurance as required during this time, all work by the CONTRACTOR pursuant to this agreement shall cease until insurance acceptable to the City is provided. In the event that CONTRACTOR fails to comply with the City’s insurance requirements, the City may take such action as it deems necessary to protect the City’s interests. Such action may include but is not limited to termination of the contract, withholding of payments, or other actions as the City deems appropriate.
If services or the scope of work extend beyond the expiration dates of the required insurance policies initially approved by the City, CONTRACTOR must provide updated certificates and endorsements indicating that the required coverage, terms and conditions are still in place. Renewal certificates and updated endorsements shall be mailed to the Designated Project Manager.
Cancellation
CONTRACTOR shall ensure that coverage shall not be cancelled, reduced or otherwise materially changed except after thirty (30) days’ prior written notice has been given to the City.
Reporting Requirements
Any failure to comply with reporting or other provisions of the policies including breaches of warranties shall not affect coverage provided to the City, its officers, officials, employees or volunteers.
Consistent with Public Policy
The insuring provisions, insofar as they may be judged to be against public policy shall be void and unenforceable only to the minimum extent necessary so that the remaining terms and provisions herein may be consistent with public policy and thus enforceable.
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
3/7/2023
Edgewood Partners Insurance Center
P.O Box 2110
Rancho Cordova CA 95670
Brianna Orchekowski
[email protected]
Travelers Property Casualty Co of Amer
25674
PACKFUSI
Packet Fusion Inc
4301 Hacienda Dr., Suite #400
Pleasanton CA 94588
1812773781
A
X
1,000,000
X
300,000
10,000
1,000,000
2,000,000
X
ZLP71M52139
3/7/2023
3/7/2024
2,000,000
A
1,000,000
X
BA8L430908
3/7/2023
3/7/2024
A
X
5,000,000
X
CUP0N049565
3/7/2023
3/7/2024
5,000,000
X
0 A
X
N
UB9K623585
3/7/2023
3/7/2024
1,000,000
1,000,000
1,000,000
A
Errors & Omissions
Claims-Made
Retro Date: 2/7/07
ZPL91M53691
3/7/2023
3/7/2024
Each Wrongful Act
Aggregate Limit
Deductible
$2,000,000
$2,000,000
$10,000
Re: All Contracts/Written Agreements between the Certificate Holder and the Insured.
Additional Insured: City of Richmond. When required by written contract, additional insured status with primary coverage applies to General Liability and Automobile Liability and waiver of subrogation applies to General Liability, Automobile Liability and Workers' Compensation, all per the attached endorsements.
City of Richmond
450 Civic Center Plaza
Richmond, CA 94804
Policy No.: ZLP71M52139
Policy No.: ZLP71M52139
Do not add this form to a policy. It is for informational purposes only.
COMMERCIAL AUTO
THIS ENDORSE MENT CHANGES THE POLICY. PLE A SE RE A D IT CAR EFULLY.
BUSINESS A UTO EXTENSIO N ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE – This endorsement broadens coverage. However, coverage for any injury, damage or medical expense s described in any of the provisions of this endorsement may be excluded or limited by another endor sement to the Coverage Part, and the se coverage broadening provisions do not appl y to the extent that coverage is excluded or limited by such an endor sement. The following listing is a general cover- age de scription only. Limitations an d exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
H. HIRED AUTO PHYSICAL DAM AGE – LOSS OF
USE – INCREASED LIMIT
A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
I. PHYSICAL DAMAGE – TRANSPORTATION
EXPENSES – INCREASED LIMITC. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY
E. SUPPLEMENTARY PAYMENTS – INCREASED
LIMITS
K. AIRB AGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSSF. HIRED AUTO – LIMITED WORLDWIDE COV-
ERAGE – INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE – GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS
PROVISIONS
A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section II.
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II – COVERED AUTOS
LIABILITY COVERAGE:
C. EMPLOYEE HIRED AUTOAny organization you newly acquire or form dur- ing the policy period over which you maintain
50% or more o wner ship interest and that is not
separately insured for Business Auto Coverage.
Coverage under this provision is afforded only un-
til the 180th day after you acquire or form the or-
ganization or the end of the policy period, which-
ever is earlier.
1. The following is add ed to Paragrap h A.1.,
Who Is An Insured, of SECTION II – COV-
ERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "in sured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name, with your permission, while performing
duties related to the conduct of your busi-
nes s.B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II – COVERED
AUTOS LIABILITY COVERAGE:
2. The following replaces Paragraph b. in B.5.,
Other Insurance, of SECTION IV – BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "autos" you own:
Any person or organization who is required under
a written contract or agreement between you a nd
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to w hich
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
an "employee's" name, with your
CA T3 53 02 15 ú 2 01 5 Th e Tr a v e l e rs I nd e m n it y C o m p a n y . A ll r ig hts r es e r v e d. Page 1 of 4 Inclu d es c o p y ri gh t e d m a t er i al of I nsur a nc e S er v ic es Offic e, I nc. w ith i ts p er m issi on .
Policy #BA8L430908
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COMMERCIAL AUTO
permission, while performing duties
related to the conduct of your busi-
nes s.
(a) With respect to any claim made or "suit"
brought outside the United States of
America, the territories and po s se ssion s
of the United States of America, Puerto
Rico and Canada:How ever, any "auto" that is leased, hired, rented or borrowed with a driver is not a
covered "auto". (i) You must arrange to defend the "in- sured" again st, and investigate or set-
tle any such claim or "suit" and keep
us advised of all proceedings an d ac-
tions.
D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II – COVERED AUTOS
LIABILITY COVERAGE:
(ii) Neither you nor any other involved
"insured" will make any settlement
without our consent.
Any "employee" of yours is an "insured" w hile us-
ing a covered "auto" you don't own, hire or borrow
in your business or your personal affairs.
(iii) We may, at our discretion, participate
in defending the "insured" against, or
in the settlement of, any claim or
"suit".
E. SUPPLEMENTARY PAYMENTS – INCREASED
LIMITS
1. The following replaces Paragr aph A.2.a.(2),
of SECTION II – COVERED AUTOS LIABIL-
ITY COVERAGE: (iv) We will reimburse the "insured" for
sums that the "ins ured" legally must
pay as damages becau se of "bodily
injury" or "property damage" to which
this insurance applies, that the "in-
sured" pays with our con sent, but
only up to the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II – COVERED AUTOS
LIABILITY COVERAGE.
(2) Up to $3,000 for cost of bail bonds (in-
cluding bonds for related traffic law viola-
tions) required becaus e of an "accident"
we cover. We do not have to furnish
these bond s.
2. The following replaces Paragr aph A.2.a.(4),
of SECTION II – COVERED AUTOS LIABIL-
ITY COVERAGE:
(v) We will reimburse the "insured" for
the reaso nable expense s incurred
with our con sent for your investiga-
tion of such claims and your defense
of the "insured" against any such
"suit", but only up to and included
within the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II – COVERED AUTOS
LIABILITY COVERAGE, and not in
addition to such limit. Our duty to
make such payments ends whe n we
have used up the applicable limit of
insurance in payments for damages,
settlements or defense expenses.
(4) All reasonable expense s incurred by the
"insured" at our requ est, including actual
loss of earnings up to $500 a day be-
cause of time off from work.
F. HIRED AUTO – LIMITED WORLDWIDE COV-
ERAGE – INDEMNITY BASIS
The following replaces Subparagraph (5) in Para-
graph B.7., Policy Period, Coverage Territory,
of SECTION IV – BUSINESS AUTO CONDI-
TIONS:
(5) Anywhere in the world, except any country or
jurisdiction while any trade sanction, em-
bargo, or similar regulation imposed by the
United States of America applies to and pro-
hibits the transaction of busines s with or
within such country or jurisdiction, for Cov-
ered Autos Liability Coverage for any covered
"auto" that you lease, hire, rent or borrow
without a driver for a period of 30 days or les s
and that is not an "auto" you lease, hire, rent
or borro w from any of your "employees",
partners (if you are a partnership), members
(if you are a limited liability company) or
members of their households.
(b) This insurance is exces s over any valid
and collectible other insurance available
to the "insured" whether primary, excess,
contingent or on any other basis.
(c) This insurance is not a sub stitute for re-
quired or compulsory insurance in any
country outside the United States, its ter-
ritories and pos se s sions, Puerto Rico and
Canada.
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COMMERCIAL AUTO
(2) In or on your covered "auto".You agree to maintain all required or compulsory insurance in any such coun-
try up to the minimum limits required by
local law. Your failure to comply with
compulsory insurance re quirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in-
surance requirements.
This coverage applies only in the event of a total
theft of your covered "auto".
No deductibles apply to this Personal Property
coverage.
K. AIRB AGS
The following is added to Paragraph B.3., Exclu-
sions, of SECTION III – PHYSICAL DAM AGE
COVERAGE:
Exclusion 3.a. does not ap ply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., but
only:
(d) It is understood that we are not an admit-
ted or authorized insurer outside the
United States of America, its territories
and pos se s sions, Puerto Rico and Can-
ada. We assume no respo nsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; andG. WAIVER OF DEDUCTIBLE – GLASS
c. The airbags were not intentionally inflated.The following is added to Paragraph D., Deducti- ble, of SECTION III – PHYSICAL DAM AGE
COVERAGE:
We will pay up to a maximum of $1,000 for any
one "loss".
No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV – BUSINESS AUTO CONDITIONS:H. HIRED AUTO PHYSICAL DAM AGE – LOSS OF USE – INCREASED LIMIT Your duty to give us or our authorized repre senta- tive prompt notice of the "accident" or "loss" ap-
plies only when the "accident" or "loss" is kno wn
to:
The following replaces the last sentence of Para-
graph A.4.b., Loss Of Use Expenses, of SEC-
TION III – PHYSICAL DAMAGE COVERAGE:
(a) You (if you are an individual);How ever, the most we will pay for any expense s for loss of use is $65 per day, to a maximum of
$750 for any one "accident".
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability com-
pany);I. PHYSICAL DAMAGE – TRANSPORTATION
EXPENSES – INCREASED LIMIT (d) An executive officer, director or insurance manager (if you are a corporation or other or-
ganization); or
The following replaces the first sentence in Para-
graph A.4.a., Transportation Expenses, of
SECTION III – PHYSICAL DAMAGE COVER-
AGE:
(e) Any "employee" authorized by you to give no-
tice of the "accident" or "loss".
We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.5., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV – BUSINESS AUTO CONDI-
TIONS:J. PERSONAL PROPERTY
5. Transfer Of Rights Of Recovery Against
Others To Us
The following is added to Paragraph A.4., Cover-
age Extensions, of SECTION III – PHYSICAL
DAM AGE COVERAGE: We waive any right of recovery we may have against any per son or org anization to the ex-
tent required of you by a written contract
signed and executed prior to any "accident"
or "loss", provided that the "accident" or "loss"
arises out of operations contemplated by
Personal Property
We will pay up to $400 for "loss" to wearing ap-
parel and other personal property which is:
(1) Owned by an "insured"; and
CA T3 53 02 15 ú 2 01 5 Th e Tr a v e l e rs I nd e m n it y C o m p a n y . A ll r ig hts r es e r v e d. Page 3 of 4 Inclu d es c o p y ri gh t e d m a t er i al of I nsur a nc e S er v ic es Offic e, I nc. w ith i ts p er m issi on .
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COMMERCIAL AUTO
such co ntract. The waiver applies only to the
person or organization designated in such
contract.
The unintentional omission of, or unintentional
error in, any information given by you shall not
prejudice your rights under this insurance. How-
ever this provision does not affect our right to col-
lect additional premium or exercise our right of
cancellation or non-renewal.
N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph B.2., Con-
cealment, Misrepresentation, Or Fraud, of
SECTION IV – BUSINESS AUTO CONDITIONS:
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Do not add this form to a policy. It is for informational purposes only.
COMMERCIAL AUTO
4. Loss Payment
Physical Damage Cover- son or organization holding, storing or trans- ages porting property for a fee regardless of any
other provision of this Coverage Form.At our option, we may:
5. Other Insurancea. Pay for, repair or replace damaged or sto- a. For any covered "auto" you own, thislen property;
Coverage Form provides primary insur-b. Return the stolen property, at our ex- ance. For any covered "auto" you don'tpense. We will pay for any damage that own, the insurance provided by this Cov-results to the "auto" from the theft; or erage Form is excess over any other col-c. Take all or any part of the damaged or lectible insurance. However, while a cov-stolen property at an agreed or appraised ered "auto" which is a "trailer" is con- value. nected to another vehicle, the Covered
Autos Liability Coverage this CoverageIf we pay for the "loss", our payment will in- Form provides for the "trailer" is:clude the applicable sales tax for the dam- aged or stolen property. (1) Excess while it is connected to a mo- tor vehicle you do not own; or5. Transfer Of Rights Of Recovery Against Others To Us (2) Primary while it is connected to a
covered "auto" you own.If any person or organization to or for whom we make payment under this Coverage Form b. For Hired Auto Physical Damage Cover- has rights to recover damages from another, age, any covered "auto" you lease, hire,those rights are transferred to us. That person rent or borrow is deemed to be a coveredor organization must do everything necessary "auto" you own. However, any "auto" that to secure our rights and must do nothing after is leased, hired, rented or borrowed with "accident" or "loss" to impair them. a driver is not a covered "auto".
B. General Conditions c. Regardless of the provisions of Para- graph a. above, this Coverage Form's1. Bankruptcy
Covered Autos Liability Coverage is pri-Bankruptcy or insolvency of the "insured" or mary for any liability assumed under anthe "insured's" estate will not relieve us of any "insured contract".obligations under this Coverage Form. d. When this Coverage Form and any other2. Concealment, Misrepresentation Or Fraud Coverage Form or policy covers on the This Coverage Form is void in any case of same basis, either excess or primary, we fraud by you at any time as it relates to this will pay only our share. Our share is the Coverage Form. It is also void if you or any proportion that the Limit of Insurance of other "insured", at any time, intentionally con- our Coverage Form bears to the total of ceals or misrepresents a material fact con- the limits of all the Coverage Forms and cerning: policies covering on the same basis.
a. This Coverage Form; 6. Premium Audit
b. The covered "auto"; a. The estimated premium for this Coverage Form is based on the exposures you toldc. Your interest in the covered "auto"; or us you would have when this policy be-d. A claim under this Coverage Form. gan. We will compute the final premium
3. Liberalization due when we determine your actual ex- posures. The estimated total premium willIf we revise this Coverage Form to provide be credited against the final premium duemore coverage without additional premium and the first Named Insured will be billedcharge, your policy will automatically provide for the balance, if any. The due date forthe additional coverage as of the day the re- the final premium or retrospective pre-vision is effective in your state. mium is the date shown as the due date4. No Benefit To Bailee Physical Damage on the bill. If the estimated total premiumCoverages exceeds the final premium due, the first We will not recognize any assignment or Named Insured will get a refund. grant any coverage for the benefit of any per-
CA 00 01 10 13
Insurance Services Office, Inc., 2011 Page 9 of 12
UB-9K623585
UB-9K623585
Packet Fusion, Inc.
Travelers Property Casualty Company
of America