Beazley Security -City of SSF Services Agreement FINAL — South San Francisco City Council, May 8, 2024

Short Form Services Agreement
[Rev:11/14/2016]
1 SOUTH SAN FRANCISCO SERVICES AGREEMENT
This Services Agreement (this “Agreement”) is made and entered into between the City of South San Francisco, a municipal corporation (“City”) and Beazley Security LLC (formerly known as Lodestone Security LLC), (“Consultant”) effective as of April 15, 2024, (the “Effective Date”). City and Consultant are hereinafter collectively referred to as (the “Parties”). In consideration of their mutual covenants, the Parties hereby agree as follows:

1. Scope of Services. Consultant shall provide the following services and/or materials (“the Work”): Attack Surface Monitoring and Managed Threat Detection for two years, as more specifically described in the Scope of Services, attached hereto as Exhibit A. The Work shall commence on June 2, 2024 and shall be completed to the satisfaction of the City by June 1, 2026 unless such date is extended or otherwise modified by the City in writing. In the event of a conflict or inconsistency between the text of the main body of this Agreement and Exhibit A, the text of the main body of this Agreement shall prevail.

A. Security Breach Notification and Reporting. Consultant shall have policies and procedures in place for the effective management of Security Breaches, as defined below, which shall be made available to the City upon request. In the event of any actual security breach or reasonable belief of an actual security breach the Consultant either suffers or learns of that either compromises or could compromise the City’s data (a “Security Breach”), Consultant shall notify the City within 48 hours of its discovery.

Consultant shall immediately determine the nature and extent of the Security Breach, contain the incident by stopping the unauthorized practice, recover records, shut down the system that was breached, revoke access and/or correct weaknesses in physical security. Consultant shall report to the City:
(i) the nature of the Security Breach;
(ii) the City data used or disclosed;
(iii) who made the unauthorized use or received the unauthorized disclosure; (iv) what the Consultant has done or shall do to mitigate any deleterious effect of the unauthorized use or disclosure; and
(v) what corrective action the Consultant has taken or shall take to prevent future similar unauthorized use or disclosure. Consultant shall provide such other information, including a written report, as reasonably requested by the City. Consultant shall analyze and document the incident and provide all notices required by applicable law.

2. Payment. City shall pay Consultant an amount not to exceed: Two Hundred Sixty-Four Thousand Dollars ($264,000.00) for the Work, to be completed in accordance with the terms and conditions of this Agreement. The calculation of payment for the Work shall be set forth as follows:

Lodestone Security will invoice the City $132,000.00 in May 2024 for Year 1 and $132,000.00 in May 2025 for Year 2. The amount stated above is the entire compensation payable to Consultant for the Work performed hereunder, including all labor, materials, tools and equipment furnished by Consultant.

City shall make payments, based on invoices received for the Work to be performed in accordance with the terms and conditions of this Agreement. City shall have thirty (30) days from the receipt of an invoice to pay Consultant.

3. Independent Contractor. It is understood and agreed that this Agreement is not a contract of employment and does not create an employer-employee relationship between the City and Consultant.

At all times Consultant shall be an independent contractor and City shall not control the manner of Short Form Services Agreement
[Rev:11/14/2016]
2 Consultant accomplishing the Work. Consultant is not authorized to bind the City to any contracts or other obligations without the express written consent of the City.

4. Indemnification. To the fullest extent permitted by law, Consultant shall indemnify, defend (with counsel acceptable to the City), and hold harmless the City and its elected and appointed officers, officials, employees, agents, contractors and consultants (collectively, the “City Indemnitees”) from and against any and all liability, loss, damage, claims, expenses and costs (including, without limitation, attorneys’ fees and costs of litigation) (collectively, “Liability”) of every nature arising out of or in connection with Consultant’s performance of the Work or Consultant’s failure to comply with this Agreement, except such Liability caused by the gross negligence or willful misconduct of the City Indemnitees.

5. Insurance. Prior to beginning the Work and continuing throughout the term of this Agreement, Consultant (and any subcontractors) shall, at Consultant’s (or subcontractor’s) sole cost and expense, furnish the City with certificates of insurance evidencing that Consultant has obtained and maintains insurance in the following amounts:

A. Workers’ Compensation that satisfies the minimum statutory limits.

B. Commercial General Liability and Property Damage Insurance in an amount not less than ONE MILLION DOLLARS ($1,000,000) combined single limit per occurrence, TWO MILLION DOLLARS ($2,000,000) annual aggregate, for bodily injury, property damage, products, completed operations and contractual liability coverage. The policy shall also include coverage for liability arising out of the use and operation of any City-owned or City-furnished equipment used or operated by the Consultant, its personnel, agents or subcontractors.

C. Comprehensive automobile insurance in an amount not less than ONE MILLION DOLLARS ($1,000,000) per occurrence for bodily injury and property damage including coverage for owned, if any, and non-owned vehicles.

D. Professional Liability Insurance in an amount not less than ONE MILLION DOLLARS ($1,000,000) covering the licensed professionals’ errors and omissions.

E. Cybersecurity/Liability Insurance coverage in an amount not less than ONE MILLION DOLLARS ($1,000,000) per occurrence / aggregate. Coverage shall be sufficiently broad to respond to the duties and obligations as is undertaken by Consultant in this Agreement and shall include, but not be limited to, claims involving infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, alteration of electronic information, extortion and network security. The policy shall provide coverage for liabilities for financial loss resulting or arising from acts, errors, or omissions, in rendering technology services, as follows:
i. Violation or infringement of any right of privacy, including breach of security and breach of security/privacy laws, rules or regulations globally, now or hereinafter constituted or amended;
ii. Data theft, damage, unauthorized disclosure, destructions, or corruption, including without limitation, unauthorized access, unauthorized use, identity theft, theft of personally identifiable information or confidential City information in whatever form, transmission of a computer virus or other type of malicious code; and participation in a denial of service attack on third party computer systems;
Short Form Services Agreement
[Rev:11/14/2016]
3 iii. Loss or denial of service; and
iv. The policy shall not contain a cyber terrorism exclusion.

The cybersecurity/liability insurance coverage required in this subsection (E) must include technology/professional liability including breach of contract, privacy and security liability, privacy regulatory defense and payment of civil fines, payment of credit card provider penalties, and breach response costs, including without limitation, notification costs, forensics, credit protection services, call center services, identity theft protection services, and crisis management/public relations services.

All insurance policies required under this Section 5 shall be written on an occurrence basis and shall name the City Indemnitees as additional insureds with any City insurance shall be secondary and in excess to Consultant’s insurance. If the Consultant’s insurance policy includes a self-insured retention that must be paid by a named insured as a precondition of the insurer’s liability, or which has the effect of providing that payments of the self-insured retention by others, including additional insureds or insurers do not serve to satisfy the self-insured retention, such provisions must be modified by special endorsement so as to not apply to the additional insured coverage required by this agreement so as to not prevent any of the parties to this agreement from satisfying or paying the self-insured retention required to be paid as a precondition to the insurer’s liability. Additionally, the certificates of insurance must note whether the policy does or does not include any self-insured retention and also must disclose the deductible. The certificates shall contain a statement of obligation on the part of the carrier to notify City of any material change, cancellation, termination or non-renewal of the coverage at least thirty (30) days in advance of the effective date of any such material change, cancellation, termination or non-renewal.

The City’s Risk Manager may waive or modify any of the insurance requirements of this section.

6. Compliance with all Applicable Laws; Nondiscrimination. Consultant shall comply with all applicable local, state and federal laws, regulations and ordinances in the performance of this Agreement. Consultant shall not discriminate in the provision of service or in the employment of persons engaged in the performance of this Agreement on account of race, color, national origin, ancestry, religion, gender, marital status, sexual orientation, age, physical or mental disability in violation of any applicable local, state or federal laws or regulations.

7. Termination. City may terminate or suspend this Agreement at any time and without cause upon written notification to Consultant. Upon receipt of notice of termination or suspension, Consultant shall immediately stop all work in progress under this Agreement. The City's right of termination shall be in addition to all other remedies available under law to the City.

8. Prevailing Wage. Where applicable, the wages to be paid for a day's work to all classes of laborers, workmen, or mechanics on the work contemplated by this Purchase Agreement, shall be not less than the prevailing rate for a day’s work in the same trade or occupation in the locality within the state where the work hereby contemplates to be performed as determined by the Director of Industrial Relations pursuant to the Director’s authority under Labor Code Section 1770, et seq. Each laborer, worker or mechanic employed by Consultant or by any subcontractor shall receive the wages herein provided for. The Consultant shall pay two hundred dollars ($200), or whatever amount may be set by Labor Code Section 1775, as may be amended, per day penalty for each worker paid less than prevailing rate of per diem wages. The difference between the prevailing rate of per diem wages and the wage paid to each worker shall be paid by the Consultant to each worker.

An error on the part of an awarding body does not relieve the Consultant from responsibility for payment of the prevailing rate of per diem wages and penalties pursuant to Labor Code Sections 1770-1775. The City will not recognize any claim for additional compensation because of the payment by the Consultant for any wage rate in excess of prevailing wage rate set forth. The possibility of wage increases is one of Short Form Services Agreement
[Rev:11/14/2016]
4 the elements to be considered by the Consultant.
(A) Posting of Schedule of Prevailing Wage Rates and Deductions. If the schedule of prevailing wage rates is not attached hereto pursuant to Labor Code Section 1773.2, the Consultant shall post at appropriate conspicuous points at the site of the project a schedule showing all determined prevailing wage rates for the various classes of laborers and mechanics to be engaged in work on the project under this contract and all deductions, if any, required by law to be made from unpaid wages actually earned by the laborers and mechanics so engaged. (B) Payroll Records. Each Consultant and subcontractor shall keep an accurate payroll record, showing the name, address, social security number, work week, and the actual per diem wages paid to each journeyman, apprentice, worker, or other employee employed by the Consultant in connection with the public work. Such records shall be certified and submitted weekly as required by Labor Code Section 1776.

9. Payment of Taxes; Tax Withholding. Consultant is solely responsible for the payment of employment taxes incurred under this Agreement and any similar federal or state taxes. To be exempt from tax withholding, Consultant must provide City with a valid California Franchise Tax Board form 590 (“Form 590”). Unless Consultant provides City with a valid Form 590 or other valid, written evidence of an exemption or waiver from withholding, City may withhold California taxes from payments to Consultant as required by law. Consultant shall obtain, and maintain on file for three (3) years after the termination of this Agreement, Form 590s (or other written evidence of exemptions or waivers) from all subcontractors. Consultant accepts sole responsibility for withholding taxes from any non-California resident subcontractor and shall submit written documentation of compliance with Consultant’s withholding duty to City upon request.

10. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect.

11. Entire Agreement. This Agreement represents the entire and integrated agreement between the Parties. This Agreement may be modified or amended only by a subsequent written agreement signed by both Parties.

12. Non-Liability of Officials, Employees and Agents. No officer, official, employee or agent of City shall be personally liable to Consultant in the event of any default or breach by City or for any amount which may become due to Consultant pursuant to this Agreement.

13. Prevailing Party. In the event that either party to this Agreement commences any legal action or proceeding (including but not limited to arbitration) to interpret the terms of this Agreement, the prevailing party in such a proceeding shall be entitled to recover its reasonable attorney’s fees associated with that legal action or proceeding.

14. Notice. All notices and other communications which are required or may be given under this Agreement shall be in writing and shall be deemed to have been duly given (i) when received if personally delivered; (ii) when received if transmitted by telecopy, if received during normal business hours on a business day (or if not, the next business day after delivery) provided that such facsimile is legible and that at the time such facsimile is sent the sending Party receives written confirmation of receipt; (iii) if sent for next day delivery to a domestic address by recognized overnight delivery service (e.g., Federal Express); and (iv) upon receipt, if sent by certified or registered mail, return receipt requested. In each case notice shall be sent to the respective Parties as follows:

Short Form Services Agreement
[Rev:11/14/2016]
5 Consultant:

Lodestone Security, LLC
320 E. Main Street
Lewisville, TX 75057
City:

City Clerk
City of South San Francisco
400 Grand Avenue
South San Francisco, CA 94080

15. Execution in Counterpart. This Agreement may be executed in counterparts and/or by facsimile or other electronic means, and when each Party has signed and delivered at least one such counterpart, each counterpart shall be deemed an original, and, when taken together with other signed counterpart, shall constitute one Agreement, which shall be binding upon and effective as to all Parties.

16. Assignment, Governing Law. The Consultant may not assign any of Consultant’s obligations under this Agreement without the City’s prior written approval. This Agreement is governed by California law. The jurisdiction for any litigation arising from this Agreement shall be in the state of California, and shall be venued in the County of San Mateo.

IN WITNESS WHEREOF, the Parties have executed this Agreement as of the date written above.

CITY: CONSULTANT:

By: _____________________________ By:__________________________ Sharon Ranals, City Manager
Print Name: ___________________
Title: ________________________
APPROVED AS TO FORM: Company: ____________________
____________________________
City Attorney
2729961.1
5380725.1

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
04/17/2024
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

USI INSURANCE SERVICES LLC/PHS
01215796
The Hartford Business Service Center
3600 Wiseman Blvd
San Antonio, TX 78251

CONTACT
NAME:

PHONE
(A/C, No, Ext):
(866) 467-8730 FAX
(A/C, No):

E-MAIL
ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC#

INSURED
Beazley Security LLC
180 SAUGATUCK AVE
WESTPORT CT 06880-5818
INSURER A : Twin City Fire Insurance Company 29459
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
A

COMMERCIAL GENERAL LIABILITY
X X 01 SBA IK8803 06/01/2023 06/01/2024
EACH OCCURRENCE $2,000,000

CLAIMS-MADE X OCCUR DAMAGE TO RENTED
PREMISES (Ea occurrence)
$1,000,000
X General Liability MED EXP (Any one person) $10,000
PERSONAL & ADV INJURY $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY PROJECT X LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER:

AUTOMOBILE LIABILITY
01 SBA IK8803 06/01/2023 06/01/2024

COMBINED SINGLE LIMIT
(Ea accident)
$2,000,000
ANY AUTO BODILY INJURY (Per person)

ALL OWNED
AUTOS

SCHEDULED
AUTOS BODILY INJURY (Per accident)
X
HIRED

AUTOS X

NON-OWNED
AUTOS

PROPERTY DAMAGE
(Per accident)

UMBRELLA LIAB

EXCESS LIAB
OCCUR
CLAIMSMADE

EACH OCCURRENCE

AGGREGATE
DED RETENTION $

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
PER

STATUTE
OTHER
Y/N E.L. EACH ACCIDENT
E.L. DISEASE -EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
A

EMPLOYMENT PRACTICES

LIABILITY
01 SBA IK8803 06/01/2023 06/01/2024 Each Claim Limit
Aggregate Limit
$10,000
$10,000
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 South San Francisco
400 GRAND AVE
SOUTH SAN FRANCISCO CA 94080-3634

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.

The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:

LOC# :

ADDITIONAL REMARKS SCHEDULE Page 2 of 2
AGENCY

USI INSURANCE SERVICES LLC/PHS

NAMED INSURED

BEAZLEY SECURITY LLC
180 SAUGATUCK AVE
WESTPORT CT 06880-5818

POLICY NUMBER
SEE ACORD 25

CARRIER
SEE ACORD 25

NAIC CODE
EFFECTIVE DATE: SEE ACORD 25

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Notice of Cancellation will be provided in accordance with Form SS1224, attached to this policy. Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008, attached to this policy. RE: State job is performed in: CA 301 WOODS PARK DRIVE
CLINTON NY 13323
(866) 467-8730
(866) 467-8730
[email protected]
(866) 467-8730
(866) 467-8730

USI INSURANCE SERVICES LLC/PHS
The Hartford
Hartford Fire Insurance Company and its Affiliates
One Hartford Plaza, Hartford, Connecticut 06155
Select Customer Insurance Center
Policyholder, please call us at:

Agent, please call us at:

INSURANCE ENDORSEMENT

ATTACHED
*** PLEASE REVIEW THE CHANGE ***
Enclosed is an endorsement for your business insurance policy. Please review it at your convenience. If you have questions or need to make further changes:

Policyholder, please call us at:

Agent, please call us at: between 7 A.M. and 7 P.M. CST .

The premium billing will be mailed to you separately. You can expect to receive it soon.

Thank you for allowing us to service your business needs.

THE HARTFORD SELECT CUSTOMER INSURANCE CENTER
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

Form SS 12 24 06 11 Page 1 of 1
© 2011, The Hartford

NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S)
This policy is subject to the following additional Conditions:

A. If this policy is cancelled by the Company, other
than for non-payment of premium, notice of such
cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the
certificate holder(s) with mailing addresses on file
with the agent of record or the Company.

B. If this policy is cancelled by the company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within ten (10)
days of the cancellation effective date to the
certificate holder(s) with mailing addresses on file
with the agent of record or the Company.

Any notification rights provided by this endorsement
apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy’s term.

If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient
proof of notice.
001
03/15/24 06/01/23
06/01/24
01 SBA IK8803 DW

LODE STONE SECURITY LLC
180 SAUGATUCK AVE
WESTPORT CT 06880
03/15/24
001

USI INSURANCE SERVICES LLC/PHS
215796

TWIN CITY FIRE INSURANCE COMPANY

ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS.

THIS IS NOT A BILL.

NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE

PROPERTY OPTIONAL COVERAGES APPLICABLE TO ALL LOCATIONS ARE ADDED

COMPUTERS AND MEDIA COVERAGE
FORM SS 04 41
DEDUCTIBLE: $ 1,000
FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT ISSUE:

FS00H900001016 SS 12 24 06 11
PRO RATA FACTOR: 1.000
THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN.

Form SS 12 11 04 05 T Page
Process Date: Policy Effective Date:

Policy Expiration Date:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

POLICY CHANGE
This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated below:

Policy Number:

Named Insured and Mailing Address;
Policy Change Effective Date: Effective hour is the same as stated in the Declarations Page of the Policy.

Policy Change Number:

Agent Name:

Code:

POLICY CHANGES:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

FS 00 H900 00 1016 FailSafe® Page 1 of 2
© 2016, The Hartford
(Includes copyrighted material of Insurance Services Office, Inc., with its permission.)

WAR, HOSTILE LOSS OR TERRORISM EXCLUSION
You and we agree that:

Section II - Definitions is changed to add the following:

Hostile loss means:

1. confiscation, nationalization, requisition, seizure, destruction of or damage to property of any nature, tangible or intangible, infrastructure or service;

2. interruption or termination of services; or

3. use of military or usurped power or the imposition of martial law by or under the order of any governmental or other authority; terrorist; or military or armed person or group
Terrorism means any act against any person, organization or property of any nature, tangible or intangible, infrastructure or service:

1. that involve the following or preparation for the following:
a. use or threat of force or violence; or
b. commission or threat of a dangerous act; or
c. commission or threat of an act that interferes with or disrupts an electronic, communication, information or mechanical system; and

2. when one or both of the following applies:
a. the effect is to intimidate or coerce a government or the civilian population or any segment thereof, or to disrupt any segment of the economy; or b. it appears that the intent is to intimidate or coerce a government, or to further political, ideological, religious, social or economic objectives or to express (or express opposition to) a philosophy or ideology.

B. The following exclusion is added:

Section III - Exclusions, Subsection A is changed to add the following:

We will not pay for damages, first party expenses, or claim expenses or defend any of you for any wrongful act or claim arising out of or in any way related to any actual or alleged:

1. war, including undeclared or civil war; or

2. warlike action, including action in hindering or defending against an actual, threatened or expected attack, by a military force, any government, sovereign or other authority using military personnel or other agents; or

3. insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these;

4. hostile loss, including any action taken in hindering or defending against an actual or expected hostile loss; or

5. terrorism, including any action taken in hindering or defending against an actual, or expected incident of terrorism regardless of any other cause or event that contributes concurrently or in any sequence to the wrongful act or claim.

FS 00 H900 00 1016 FailSafe® Page 2 of 2
© 2016, The Hartford
(Includes copyrighted material of Insurance Services Office, Inc., with its permission.) However, with respect to terrorism, this exclusion only applies to claims arising from activities:
(a) determined by any government body or government official to be an act of terrorism; or (b) that We reasonably believe to be committed on behalf of, in concert with or at the behest of an organization, group, cell or network listed in Executive Order 13224 or any addition thereto or replacement thereof; including an organization, group, cell or network which is added to such order as a result of the act of terrorism.

All other terms and conditions remain unchanged.
1 Dawson, Joanna
From: Susan McIntosh <[email protected]>
Sent: Friday, April 19, 2024 5:56 AM
To: Dawson, Joanna
Cc: Chase Bollinger
Subject: RE: Vendor Form and Gen'l COI
[NOTICE: This message originated outside of City of South San Francisco -- DO NOT CLICK on links or open attachments unless you are sure the content is safe.] Hi, Joanna.

The company does not own any vehicles and won’t in the future. We are happy to sign something to that effect.

The finance team is getting the COI updated with the 30-day language.

Best,
Susan
From: Dawson, Joanna <[email protected]>
Sent: Thursday, April 18, 2024 7:22 PM
To: Susan McIntosh <[email protected]>
Subject: RE: Vendor Form and Gen'l COI
Hi Suan,
Thank you, sorry to be a bug but the only things missing on the COI are highlighted. Regarding #5, it mentions cancellation policy is attached but it’s not.

1. City of SSF shall be named as additional insured.

2. The auto liability must include owned autos (or request a waiver from City’s Risk Manager)

3. COIs must include statement of waiver of subrogation

4. COIs must include statement that the coverage is primary and non-contributory

5. COIs must include statement of 30-day notice of change or cancellation in coverage Joanna
From: Susan McIntosh <[email protected]>
Sent: Thursday, April 18, 2024 3:16 PM
To: Dawson, Joanna <[email protected]>; Chase Bollinger <[email protected]> Subject: Vendor Form and Gen'l COI
[NOTICE: This message originated outside of City of South San Francisco -- DO NOT CLICK on links or open attachments unless you are sure the content is safe.] Hi, Joanna.

Thank you for your patience. Attached is the COI and the Vendor Verification Form.

Let me know if you need anything more.

ACORD 25 (2014/01)

AUTHORIZED REPRESENTATIVE

CANCELLATION

CERTIFICATE OF LIABILITY INSURANCE

JECT LOC PRO- POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:

CLAIMS-MADE OCCUR

COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $

DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
DED RETENTION $

CLAIMS-MADE
OCCUR
$
AGGREGATE $
UMBRELLA LIAB EACH OCCURRENCE $

EXCESS LIAB
INSR

LTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF
(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYYY) LIMITS
PER

STATUTE
OTHER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$

ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under
DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

ALL OWNED SCHEDULED

HIRED AUTOS

NON-OWNED

AUTOS AUTOS
AUTOS

COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
$
$
$

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

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

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 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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

PHONE
(A/C, No, Ext):

PRODUCER
ADDRESS:

E-MAIL
FAX
(A/C, No):

CONTACT
NAME:

NAIC #
INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

Charles Bellingrath
A:

ARC Excess & Surplus of Massachusetts LLC
495 Old Connecticut Path, Suite 220
Framingham, MA 01701
8572395051
Technology Errors & Omissions &
Cyber Liability
A: $1M/$3M Each Claim/Aggregate
Crum & Forster Specialty Insurance Company 44520
A:TCM-103221 6/29/2023 6/29/2024

INSURED
Beazley Security, LLC
320 E. Main Street
Lewisville, TX 75057

DATE (MM/DD/YYYY)
04/22/2024
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage is in full force and effect and strictly subject to the terms, conditions, and exclusions of the policy.

CERTIFICATE HOLDER
Form W-9
(Rev. March 2024)
Request for Taxpayer
Identification Number and Certification
Department of the Treasury
Internal Revenue Service Go to www.irs.gov/FormW9 for instructions and the latest information.

Give form to the
requester. Do not
send to the IRS.

Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below. Print or type. See Specific Instructions on page 3. 1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded entity’s name on line 2.)
2 Business name/disregarded entity name, if different from above. 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes.

Individual/sole proprietor C corporation S corporation Partnership Trust/estate LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) ....

Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner.

Other (see instructions)
3b If on line 3a you checked “Partnership” or “Trust/estate,” or checked “LLC” and entered “P” as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See instructions ......... 4 Exemptions (codes apply only to
certain entities, not individuals;
see instructions on page 3):

Exempt payee code (if any)
Exemption from Foreign Account Tax
Compliance Act (FATCA) reporting
code (if any)
(Applies to accounts maintained
outside the United States.)
5 Address (number, street, and apt. or suite no.). See instructions. 6 City, state, and ZIP code
Requester’s name and address (optional)
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.

Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter.

Social security number
––
or
Employer identification number
–
Part II Certification
Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.

Sign
Here
Signature of
U.S. person Date
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

What’s New
Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the “LLC” box and enter its appropriate tax classification.

New line 3b has been added to this form. A flow-through entity is required to complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065).

Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they Cat. No. 10231X Form W-9 (Rev. 3-2024)
Beazley Security, LLC
✔ C
65 Memorial Road, Suite 320
West Hartford, CT 06107
81 4655829

South San Francisco City CouncilMay 8, 2024

South San Francisco City Council
May 8, 2024