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Insurance Certificates 2017/18 ViaTRON Systems, IncCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) INSURER(S) AFFORDING COVERAGE NAIC # PRODUCER INSURED INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : COVERAGES TYPE OF INSURANCE POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: LOCPOLICY OTHER: EACH OCCURRENCE MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ $ $ $ $ $ AUTOMOBILE LIABILITY ANY AUTO HIRED AUTOS $ $ $ $ OCCUR CLAIMS-MADE DED RETENTION $ EACH OCCURRENCE AGGREGATE E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION $ $ $ $ $ Y/N CONTACTNAME: PHONE(A/C, No, Ext): E-MAIL ADDRESS: FAX(A/C, No): CERTIFICATE NUMBER:REVISION NUMBER: $ UMBRELLA LIAB EXCESS LIAB AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01)The ACORD name and logo are registered marks of ACORD $ INSURER F : $ N/A SCHEDULEDAUTOS NON-OWNED AUTOS ALL OWNED AUTOS 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 ADDL INSD POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) PRO- JECT DAMAGE TO RENTED PREMISES (Ea occurrence) COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE(Per accident) WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below PERSTATUTE OTH-ER SUBR WVD 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). SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 08/17/2017 AUTOMATIC DATA PROCESSING INSURANCE AGCY INC 1 ADP BLVD MS 625 ROSELAND, NJ 07068 (877) 677-0428 (877) 677-0428 (877) 677-0430 spcbicadp@travelers.com VIATRON SYSTEMS INC 18233 HOOVER ST GARDENA, CA 90248 TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA 090017014451922 A X UB-6H27048A-17 09/08/2017 09/08/2018 X 1,000,000 1,000,000 1,000,000 AS RESPECTS TO WORKERS COMPENSATION COVERAGE, WC 04 03 06 - WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA HAS BEEN ATTACHED TO THE POLICY. CITY OF LA QUINTA IS LISTED IN THE ENDORSEMENT SCHEDULE AS A DESIGNATED PERSON OR ORGANIZATION. CITY OF LA QUINTA 78495 CALLE TAMPICO LA QUINTA, CA 92253 RevisedMay2017 M E M O R A N D U M TO: Frank J. Spevacek, City Manager FROM: Monika Radeva, Deputy City Clerk DATE: August 22, 2017 RE: Agreement for Contract Services (ACS) with ViaTRON Systems, Inc. for City records scanning and quality control services Attached for your signature is an ACS with Matrix Imaging Products, Inc. for City records scanning and quality control services for a three-year term expiring on June 30, 2020, for a maximum compensation not to exceed $40,000. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: X Contract payments will be charged to account number: 101-1005-60103 X Amount of Agreement, Amendment, Change Order, etc.: $40,000 N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with _____ no reportable interests in LQ or ____ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: X Approved by the City Council on AUGUST 1, 2017 N/A City Manager’s signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less. This expenditure is $____________and authorized by contract approved by ________ N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on 08/22/07 by Pam Nieto) N/A Performance bonds as required by the agreement (originals) X City of La Quinta Business License number LIC-0111332; Expires: 12/31/2017 X A requisition for a Purchase Order has been prepared (amounts over $5,000) X A copy of this Cover Memo has been emailed to Finance (Sandra)