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HomeMy WebLinkAboutECONOMIC & PLANNING SYSTEMS - INSURANCE CERTIFICATESHOULD 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-MAILADDRESS: 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 EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR 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 3/21/2024 Andreini &Company-San Mateo 220 West 20th Ave San Mateo CA 94403 Sara Alemayehu (650)378-4320 650-378-4361 salemayehu@andreini.com Continental Casualty Company 20443 ECONO-5 Sentinel Insurance Company Ltd 11000Economic&Planning Systems 455 Capitol Mall,Suite 701 Sacramento CA 95814 Hartford Casualty Ins.Company 29424 Lloyd's of London 442269102 B X 2,000,000 X 1,000,000 10,000 2,000,000 4,000,000 X X Y Y 51SBABA6144 4/1/2024 4/1/2025 4,000,000 B 2,000,000 X X Y Y 51SBABA6144 4/1/2024 4/1/2025 B X X 3,000,00051SBABA61444/1/2024 4/1/2025 3,000,000 X 10,000 C X N Y 51WECAK5W1H 4/1/2024 4/1/2025 1,000,000 1,000,000 1,000,000 A D Errors &Omissions Cyber/Privacy Liability 425343942 ESM0339912025 4/1/2024 4/1/2024 4/1/2025 4/1/2025 Per Claim/Aggregate Per Claim/Aggregate 2,000,000 1,000,000 30 days notice of cancellation except 10 days for non-payment of premium per policy provisions. Errors &Omissions Retro 1/1/83 Retention -$10,000 EPS #:193180,Fort Collins Harmony Gateway Economic Analysis City of Fort Collins its officers,and employees are additional insured on a primary and non-contributory basis under the Business Liability policy form for BOTH General and Auto Liability with respect to operations and work performed by the named insured as required by written contract.Waivers of Subrogation apply per attached policy provisions. City of Fort Collins Attn:Jerri Groves 408 Mason Ct. Fort Collins CO 80522 USA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Countersigned by Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date:02/01/24 Policy Expiration Date:04/01/25 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number:51 WEC AK5W1H Endorsement Number: Effective Date:04/01/24 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address:Economic & Planning Systems 455 CAPITOL MALL STE 701 SACRAMENTO CA 95814 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Any person or organization for whom you are required by contract or agreement to obtain this waiver from us. Endorsement is not applicable in KY, NH, NJ or for any MO construction risk BUSINESS LIABILITY COVERAGE FORM (b)b.Rented to,in the care,custody or Coverage under this provision does not control of,or over which physical apply to: control is being exercis ed for any (1)"Bodily injury"or "property damage" purpose by you,any of your that occurred;or "employees","volunteer workers", (2)"Personal and advertising injury" any partner or member (if you are arising out of an offense committedapartnershiporjointventure),or before you acquired or formed the any member (if you are a limited organization.liability company). 4.Operator Of Mobile Equipmentb.Real Estate Manager With respect to "mobile equipment"registered inAny person (other than your "employee"or your name under any motor vehicle registration"volunteer worker"),or any organization law,any person is an insured while driving suchwhileacting as your real estate manager. equipment along a public highway with yourc.Temporary Custodians Of Your permission.Any other person or organizationProperty responsible for the conduct of such person is Any person or organization having proper also an insured,but only with respect to liability temporary custody of your property if you arising out of the operation of the equipment,and die,but only:only if no other insurance of any kind is available (1)With respect to liability arising out of the to that person or organization for this liability. maintenance or use of that property;and However, no person or organization is an insured with respect to:(2)Until your legal representative has been appointed.a."Bodily injury"to a co-"employee"of the person driving the equipment;ord.Legal Representative If You Die b."Property damage"to property owned by, Your legal representative if you die,but rented to,in the charge of or occ upied byonlywithrespecttodutiesassuch.That you or the employer of any person who is representative will have all your rights and an insured under this provision.duties under this insurance. 5.Operator of Nonowned Watercrafte.Unnamed Subsidiary With respect to watercraft you do not own that Any subsidiary and subsidiary thereof,of is less than 51 feet long and is not being used yours which is a legally incorporat ed entity to carry pers ons for a charge, any person is an of which you own a financial interest of insured while operating such watercraft with more than 50%of the voting stock on the your permission.Any other person or effective date of this Coverage Part. organization responsible for the conduct of The insurance afforded herein for any such person is also an insured,but only with subsidiary not shown in the Declarations respect to liability arising out of the operation as a named insured does not apply to of the watercraft,and only if no other injury or damage with respect to which an insurance of any kind is available to that insured under this insurance is also an person or organization for this liability.insured under another policy or would be However,no person or organization is an an insured under such policy but for its insured with r espect to:termination or upon the exhaustion of its limits of insurance.a."Bodily injury"to a co-"employee"of the person operating the watercraft;or3.Newly Acquired Or Formed Organization b."Property damage"to property owned by,Any organization you newly acquire or form, rented to,in the charge of or occupied by other than a partnership,joint venture or you or the employer of any person who is limited liability company,and over which you an insured under this provision.maintain financial interest of more than 50%of the voting stock,will qualify as a Named 6.Additional Insureds When Required By Insured if there is no other similar insurance Written Contract,Written Agreement Or available to that organization. However:Permit a.Coverage under this provision is afforded The person(s)or organization(s)identified in only until the 180th day after you acquire a.f.Paragraphs through below are additional or form the organization or the end of the insureds when you have agreed,in a written policy period, whichever is earlier; and Form SS 00 08 04 05 Page 11 of 24 POLICY # 51SBABA6144 BUSINESS LIABILITY COVERAGE FORM (e)contract,written agreement or because of a Any failure to make such permit issued by a state or political inspections,adjustments,tests or subdivision,that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy,provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business,in connection agreement, or the issuance of the permit.with the distribution or sale of the products;A person or organization is an additional (f)Demonstration,installation, insured under this provision only for that servicing or repair operations, period of time required by the contract, except such operations performed agreement or permit. at the vendor's premises in However,no such person or organization is an connection with the sale of the additional insured under this provision if such product;person or organization is included as an (g)Products which,after distributionadditionalinsuredbyanendorsementissued or sale by you,have been labeled by us and made a part of this Coverage Part, or relabeled or used as a including all persons or organizations added container,part or ingredient of any as additional insureds under the specific other thing or substance by or for additional insured coverage grants in Section the vendor; orF.–Optional Additional Insured Coverages. (h)"Bodily injury"or "property a.Vendors damage"arising out of the sole Any person(s)or organization(s)(referred to negligence of the vendor for its below as vendor),but only with respect to own acts or omissions or those of "bodily injury"or "property damage"arising its employees or anyone else out of "your products"which are distributed acting on its b ehalf. However, thisorsoldintheregularcourseofthevendor's exclusion does not apply to:business and only if this Coverage Part (i)The exceptions contained in provides coverage for "bodily injury"or (d)(f)Subparagraphs or ;or"property damage"included within the (ii)"products-completed operations hazard".Such inspections,adjustments, tests or servicing as the vendor(1)The insurance afforded to the vendor has agreed to make or normallyissubjecttothefollowingadditional undertakes to make in the usualexclusions: course of business,inThisinsurancedoes not apply to:connection with the distribution (a)"Bodily injury"or "property or sale of the products. damage"for which the vendor is (2)This insurance does not apply to anyobligatedtopaydamagesby insured person or organization fromreasonoftheassumptionof whom you have acquired such products,liability in a contract or agreement. or any ingredient,part or container,This exclusion does not apply to entering into,accompanying orliabilityfordamagesthatthe containing such products.vendor would have in the absence b.Lessors Of Equipmentof the contract or agreement; (1)Any person or organization from (b)Any express warranty whom you lease equipment;but only unauthorized by you; with respect to their liability for "bodily (c)Any physical or chemical change injury","property damage"orintheproductmadeintentionally "personal and advertising injury"by the vendor;caused,in whole or in part,by your (d)Repackaging,except when maintenance,operation or use of unpacked solely for the purpose of equipment leased to you by such inspection,demonstration,testing,person or organization. or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 POLICY # 51SBABA6114 BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 13 of 24 (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to any "occurrence"which takes place after you cease to lease that equipment. c.Lessors Of Land Or Premises (1)Any person or organization from whom you lease land or premises,but only with respect to liability arising out of the ownership,maintenance or use of that part of the land or premises leased to you. (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to: (a)Any "occurrence"which takes place after you cease to lease that land or be a tenant in that premises;or (b)Structural alterations,new construction or demolition operations performed by or on behalf of such person or organization. d.Architects,Engineers Or Surveyors (1)Any architect,engineer,or surveyor,but only with respect to liability for "bodily injury","property damage"or "personal and advertising injury"caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: (a)In connection with your premises; or (b)In the performance of your ongoing operations performed by you or on your behalf. (2)With respect to the insurance afforded to these additional insureds,the following additional exclusion applies: This insurance does not apply to "bodily injury","property damage"or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you,including: (a)The preparing,approving,or failure to prepare or approve, maps,shop drawings,opinions, reports,surveys,field orders, change orders,designs or drawings and specifications;or (b)Supervisory,inspection, architectural or engineering activities. e.Permits Issued By State Or Political Subdivisions (1)Any state or political subdivision,but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to: (a)"Bodily injury","property damage" or "personal and advertising injury"arising out of operations performed for the state or municipality;or (b)"Bodily injury"or "property damage" included within the "products- completed operations hazard". f.Any Other Party (1)Any other person or organization who is not an insured under Paragraphs a. through e.above,but only with respect to liability for "bodily injury", "property damage"or "personal and advertising injury"caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: (a)In the performance of your ongoing operations; (b)In connection with your premises owned by or rented to you;or (c)In connection with "your work"and included within the "products- completed operations hazard",but only if (i)The written contract or written agreement requires you to provide such coverage to such additional insured;and (ii)This Coverage Part provides coverage for "bodily injury"or "property damage"included within the "products- completed operations hazard". (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to: "Bodily injury","property damage"or "personal and advertising injury" arising out of the rendering of,or the failure to render,any professional architectural,engineering or surveying services,including: Policy # 51SBABA6144 BUSINESS LIABILITY COVERAGE FORM (6)When You Are Added As An When this insurance is excess over other Additional Insured To Other insurance,we will pay only our share of Insurance the amount of the loss,if any,that exceeds the sum of:That is other insurance available to (1)you covering liability for damages The total amount that all such other arising out of the premises or insurance would pay for the loss in the operations,or products and completed absence of this insurance;and operations,for which you have been (2)The total of all deductible and self- added as an additional insured by that insured amounts under all that other insurance;or insurance. (7)When You Add Others As An We will share the remaining loss,if any, with Additional Insured To This any other insurance that is not described in Insurance this Excess Insurance provision and was not That is other insurance available to an bought specifically to apply in excess of the additional insured.Limits of Insurance shown in the Declarations of this Coverage Part.However,the following provisions c.Method Of Sharingapplytootherinsuranceavailableto any person or organization who is an If all the other insurance permits additional insured under this Coverage contribution by equal s hares, we will follow Part:this method also.Under this approach, (a)Primary Insurance When each insurer contributes equal amounts Required By Contract until it has paid its applicable limit of insurance or none of the loss remains, This insurance is primary if you whichever comes first.have agreed in a written contract, written agreement or permit that If any of the other insurance does not permit this insurance be primary.If other contribution by equal shares,we will insurance is also primary,we will contribute by limits.Under this method,each share with all that other insurance insurer’s share is based on the ratio of its c.by the method described in applicable limit of insurance to the total below.applicable limits of insurance of all insurers. (b)Primary And Non-Contributory 8.Transfer Of Rights Of Recovery Against To Other Insurance When Others To Us Required By Contract a.Transfer Of Rights Of Recovery If you have agreed in a written If the insured has rights to recover all or contract,written agreement or part of any payment,including permit that this insurance is Supplementary Payments,we have made primary and non-contributory with under this Coverage Part,those rights are the additional insured's own transferred to us.The insured must do insurance,this insurance is nothing after loss to impair them.At our primary and we will not seek request,the insured will bring "suit"or contribution from that other transfer those rights to us and help us insurance.enforce them.This condition does not (a)(b)Paragraphs and do not apply to apply to Medical Expenses Coverage. other insurance to which the additional b.Waiver Of Rights Of Recovery (Waiver insured has been added as an Of Subrogation) additional insured.If the insured has waived any rights of When this insurance is excess,we will recovery against any person or have no duty under this Coverage Part to organization for all or part of any payment, defend the insured against any "s uit" if any including Supplementary Payments,we other insurer has a duty to defend the have made under this Coverage Part,we insured against that "suit".If no other also waive that right,provided the insured insurer defends,we will undertake to do waived their rights of recovery against so,but we will be entitled to the insured's such person or organization in a contract, rights against all those other insurers.agreement or permit that was executed prior to the injury or damage. Form SS 00 08 04 05 Page 17 of 24 POLICY # 51SBABA6144 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date:02/01/24 Policy Expiration Date:04/01/25 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number:51 WEC AK5W1H Endorsement Number: Effective Date:04/01/24 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address:Economic & Planning Systems 455 CAPITOL MALL STE 701 SACRAMENTO CA 95814 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us