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Insurance Certificates 2021/22 Triton Techonology SolutionsA!—� ® DATE(MM/DD/YYYY) L CERTIFICATE OF LIABILITY INSURANCE 12/22/21 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). PRODUCER CONT CT NAMEA BART A NUGEN NUGEN & ASSOCIATES INSURANCE SERV INC PHONE FAX A/c No Ext: 909/941-0167 A/C,No:909/941-9453 10722 ARROW RTE STE#116 E-MAIL Rancho Cucamonga, CA 91730 PRODUCER INSURED TRITON TECHNOLOGY SOLUTIONS, INC 32234 PASEO ADELANTO STEM SAN JUAN CAPISTRANO CA 92675 949 388-3919 CUSTOMER ID##OC17 30 4 INSURER(S) AFFORDING COVERAGE NAIL# INSURER A:OHIO SECURITY INSURANCE COMPANY 240e2 F INSURER B: UNITED-79—TATES LIABILITY INSURANCE COMPANY F INSURER C : STATE COMPENSATION INSURANCE FUND N R INSURER D : INSURER E INSURER F CnVFRAnFS (FRTIFIROTF All INARFR om%ncinni r.0 1—n— 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/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000.00 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7XI OCCUR PREMISES Ea occurrence $100 , 000 • 00 MED EXP (Any one person) $ 5,000.00 A BKS (22) 56399403 03/03/21 03/03/22 PERSONAL & ADV INJURY $2,000,000.00 GENERAL AGGREGATE $4 , 000 , 000 . 00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000.00 X POLICY 7JECT LOC JECT $ AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) $1 , 000 , 000 . 00 X BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ A SCHEDULED AUTOS HIRED AUTOS BAS (22) 56535798 05/24/21 05/24/22 X PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS X $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $2,000,000.00 A X EXCESS LAB CLAIMS -MADE ESA(22) 56399403 03/03/21 03/03/22 AGGREGATE $2,000,000.00 DEDUCTIBLE $ $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN � OFFICER/MEMBER EXCLUDED? )Mandatory in NH) N/A 9111099 21 09/12/21 09/12/22 WC STATU- OTH- X TORY LIMITS ER E.L. EACH E.L. DISEASE - EA EMPLOYEE $1,000,000.00 $1,000,000.00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000.00 $ B A E&O (Incl Cyber Liab) Property �BKS(22)56399403 TK1005569K 05/13/21 03/03/21 05/13/22 03/03/22 1000000occ/2000000agg $412,000 BBP of other DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF LA QUINTA IS ADDITIONAL INSURED, PRIMARY AND NON—CONTRIBUTORY PER THE ATTACHED UtK I IrIGA I L MULULK CANCELLATION CITY OF LA QUINTA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: MONIKA RADEVA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 78495 CALLE TAMPICO ACCORDANCE WITH THE POLICY PROVISIONS. LA QUINTA, CA. 92253 AUTHORI ES ATIVE I ©1988-2009 ACORD CORP rION. All rights reserved. ACORD25(2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BKS(22)56399403 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization's Location's) Of Covered Operations AS REQUIRED BY WRITTEN CONTRACT ALL AUDIO/VIDEO OPERATIONS OF SIGNED BY BOTH PARTIES TO THE LOSS THE NAMED INSURED I Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 COMMERCIAL GENERAL LIABILITY CG20010413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY -- OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Name Of Insured: TRITON TECHNOLOGY SOLUTIONS INC Policy#: BKS(22)56399403 CG 20 0104 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 AGAINSTWAIVER OF TRANSFER OF RIGHTS OF RECOVERY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Name of Insured: TRITRON TECHNOLOGY SOLUTIONS INC Policy#: BKS(22)56399403 CG 24 04 05 09 Copyright, Insurance Services Office, Inc., 2008 Page 1 of 1 INSURED cg2404a. fap