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Insurance Certificates 2022/23 Triton Techonology SolutionsACQ a' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/12/22 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 NUGEN & ASSOCIATES INSURANCE SERV INC 10722 ARROW RTE STE#116 Rancho Cucamonga, CA 91730 INSURED TRITON TECHNOLOGY SOLUTIONS, INC 32234 PASEO ADELANTO STE#E1 SAN JUAN CAPISTRANO CA 92675 949 388-3919 !woe BART A NUGEN PHONE 909/941-0167 (A/C, No. EX1)- E-MAIL ADDRESS. PRODUCER CUSTOMER ID ## OC 17 3 0 4 f CC,No(909/941-9453 INSURER A INSURER(S) AFFORDING COVERAGE OHIO SECURITY INSURANCE COMPANY NAIL# 24082 FSCXV UNITED STATES LIABILITY INSURANCE COMIDANY INSURER B 25895 FSCX INSURER C.STATE COMPENSATION INSURANCE FUND N/R INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT INDICATED. NOTWITHSTANDING CERTIFICATE MAY BE ISSUED EXCLUSIONS AND CONDITIONS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE . ADDL INSR :SUER wva I POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP JMM/DD/YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR BKS (23) 56399403 03/03/22 03/03/23 EACH OCCURRENCE $2 , 000 , 000 . 00 X UAMAGt 10 Heil ftLt PREMISES (Ea occurrence) $100 , 000 - 00 CLAIMS -MADE X MED EXP (Any one person) $ 5,000.00 PERSONAL BADVINJURY $2,000,000.00 GENERAL AGGREGATE $4,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4 , 000,000.00 TIC POLICY n JECT 7LOG $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAS (23) 56535798 05/24/22 05/24/23 COMBINED SINGLE LIMIT (Ea accident) $1, 000, 000 .00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A UMBRELLA LIAB EXCESS LIAB r OCCUR CLAIMS -MADE ESA(23) 56399403 03/03/22 03/03/23 EACH OCCURRENCE $2,000,000.00 x AGGREGATE $2,000,000.00 DEDUCTIBLE RETENTION $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y/N N/A 9111099 22 09/12/22 09/12/23 WC STATU- OTH- X TORYLIiuj!TS ER ELEACH ACCIDENT $1, 000, 000. 00 E.L. DISEASE - EA EMPLOYEE $1 , 000,000.00 below E L. DISEASE - POLICY LIMIT 1 000000.00 , $ , B A E&O (Incl Cyber Liab) Property TK1005569L 05/13/22 05/13/23 BKS (23) 56399403 03/03/22 03/03/23 1000000occ/2000000agg $412 , 000 BBP of other DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ALL AUDIO/VIDEO OPERATIIONS OF THE NAMED INSURED CITY OF LA QUINTA IS ADDITIONAL INSURED PER FORM CG2010 04/13, PRIMARY AND NON-CONTRIBUTORY PER FORM CG2001 04/13 CERTIFICATE HOLDER CITY OF LA QUINTA ATTN: MONIKA RADEVA 78495 CALLE TAMPICO LA QUINTA, CA. 92253 CANCELLATION SHOULD ANY OF THE EXPIRA ACCORDAN AUTHORIZED R HE AB%VE DESCRIBED POLE *NI ' TTHEREOF, NOTICE WIT HE POLICY PROVISIONS. ti 1988- IES BE CANCELLED BEFORE WILL B —DELIVERED IN CORPORATION. All rights reserved. ACORD25(2009/09) The ACORD name and logo are registered marks of ACORD AC� I \ DATE(MM/DD/YYYY) t;5RTIFICATE OF LIABILITY INSURANCE 05/16/22 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 CONTACT NAME: BART A NUGEN NUGEN & ASSOCIATES INSURANCE SERV INC PHCNa g09/941-0167 wCNo909/941-9453 10722 ARROW RTE STE#116 E•MAtL ADDRESS: Rancho Cucamonga, CA 91730 PRODUCER 1USTDMERID##OC17304 INSURED TRITON TECHNOLOGY SOLUTIONS, INC 32234 PASEO ADELANTO STE#E1 SAN JUAN CAPISTRANO CA 92675 949 388-3919 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A:OHIO SECURITY INSURANCE COMPANY 24082 FSCXV UNITED STATES LIABILITY IN E ANY INSURER B INSURER C : STATE COMPENSATION INSURANCE FUND N/R 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. tivsR TYPE OF INSURANCE ADDL SUBR POLICY EFF P LI Y EX LIMITS LTR INSR ywn POLICY NUMBER MM/DD/YYYY MWD❑ A GENERAL LIABILITY COMMERCIAL$100 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx7 OCCUR BKS(23)56399403 03/03/22 03/03/23 EACH OCCURRENCE $ 2,000,000.00 PREM SES It , 000 . 00 MED EXP (Any one person) $ 5,000.00 PERSONAL BADVINJURY $ r0 0,000.0 GENERAL AGGREGATE $4,000,000.0 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY P"Co LOC PRODUCTS - COMP/OP AGG $ 4 , 001000.06 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAS (23) 56535798 OS/24/22 05/24/23 CO BINED(SINGLE LIMIT(Ea $1, 000, 000.00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ A UMBRELLA LIAB EXCESS LIAB CLAIMS -MADE ESA(23) 56399403 03/03/22 03/03/23 EACH OCCURRENCE $ 2,000,000. X HOCCUR AGGREGATE $2,000,000. DEDUCTIBLE RETENTION $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, de scribe under DESCRIPTION OF OPERATIONS below NIA 9111099 21 09/12/21 09/12/22 X WCSTATII- OTH- RYLIMITS ER E.L EACH ACCIDENT 1,000,000. $ E.L. DISEASE - EA EMPLOYEE $1 ,000,000.00 E.L DISEASE -POLICY LIMIT 1 0 0 0. 0 $ 1 B A E&O (Incl Cyber Liab) Property TK1005569L �BKS(23)56399403 05/13/22 03/03/22 05/13/23 03/03/23 1000000occ/2000000agg $412,000 BBP of other DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ALL AUDIO/VIDEO OPERATIIONS OF THE NAMED INSURED CITY OF LA QUINTA IS ADDITIONAL INSURED PER FORM CG2010 04/13, PRIMARY AND NON-CONTRIBUTORY PER FORM CG2001 04/13 CERTIFICATE HOLDER •CANCELLATION CITY OF LA QUINTA SHOU4CE E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN : MONIKA RADEVA THE DA THEREO NOTICELi BE 'DELIVERED IN 78495 CALLE TAMPICO ACCOE OILA QUINTA, CA. 92253AUTHORI ©1988-100'9 ACORD25(2009/09) The ACORD name and logo are registered marks of ACORD TION. All rights reserved. DATE (MM/DD/YYYY) AC40R" CERTIFICATE OF LIABILITY INSURANCE 02/22/22 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 COINT CT NAME: BART A NUGEN NUGEN & ASSOCIATES INSURANCE SERV INC PHONE NoEXt:909/941-0167 a No909/941-9453 10722 ARROW RTE STE#116 -MAIL ADDRESS: Rancho Cucamonga, CA 91730 DU ER #OC17304 INSURED TRITON TECHNOLOGY SOLUTIONS, INC 32234 PASEO ADELANTO STEM SAN JUAN CAPISTRANO CA 92675 949 388-3919 CUSTOMER ID #. INSURER(S) AFFORDING COVERAGE INSURER A : OHIO SECURITY INSURANCE COMPANY INSURER C : INSURER D : INSURER E INSURER F : COVFRAGFS CFRTIFICATF Nl IMRFR- aGvicinni kit IR/irmo. NAIC# N/R 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 A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR BKS (23) 56399403 03/03/22 03/03/23 EACH OCCURRENCE $ 2 000 000.00 PREMISES Ea occurrence _ $100 , 000 . 00 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 2,0' GENERAL AGGREGATE $4 , 0 0 , 0 0 . GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO 'T LOC PRODUCTS - COMP/OP AGG $4,000,000.00 $ A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAS (22) 56535798 OS/24/21 05/29/22 COMBINED SINGLE LIMIT (Ea accident) $1 , OOO , 000 . 00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) — $ PROPERTY DAMAGE (Per accident) $ X X $ $ A UMBRELLA LIAB EXCESS LIAB H OCCUR CLAIMS -MADE ESA(23)56399403 03/03/22 03/03/23 EACH OCCURRENCE 2,000,000. $r x, AGGREGATE $2,000,000.00 DEDUCTIBLE RETENTION $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 9111099 21 09/12/21 09/12/22 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000.00 E.L. DISEASE - EA EMPLOYEE $1, 000 , 00.00 E.L. DISEASE - POLICY LIMIT 1 , 000 , 000 . 00 $ B A E&O(Incl Cyber Liab) Property �BKS(23)56399403 TK1005569K 05/13/21 03/03/22 05/13/22 03/03/23 10000000cc/2000000agg $412 , 000 BBP of other DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ALL AUDIO/VIDEO OPERATIIONS OF THE NAMED INSURED CITY OF LA QUINTA IS ADDITIONAL INSURED PER FORM CG2010 04/13, PRIMARY AND NON-CONTRIBUTORY PER FORM CG2001 04/13 CITY OF LA QUINTA SHOULD ANY OF THE ABO DESCRIBED P0_L_1t'IESmBE CANCELLED BEFORE ATTN: MONIKA RADEVA THE EXPIRATION D EEREO ,� NOTICE WILL BE DELIVERED IN 78495 CALLE TAMPICO ACCORDANCE WIT HE POLICY R; VISIONS. .. LA QUINTA, CA. 92253 AUTHORIZED REPRES TIVE fr j, ©1988-2009 AC0ftIb'CORPORAJJGltf All rights reserved. ACORD25(2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BKS(23)56399403 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 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 Persore(sl Or Groanization(sl Of Covered AS REQUIRED BY WRITTEN CONTRACT ALL AUDIOAADEO OPERATIONS OF SIGNED BY BOTH PARTIES TO THE LOSS THE NAMED INSURED Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — 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 2010 0413 0 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 tJ COMMERCIAL GENERAL LIABILITY CG 20 010413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION This endorsement modines insurance provided under the following: COMMERCIAL. GENERAL LIABILITY COVERAGE PART PRO DUCTSICOMPLETED 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 contractor agreement that this insurance would he Primary and would not seek contribution horn any other insurance available td the additional insured. Name Of Insured: TRITON TECHNOLOGY SOLUTIONS INC POiicy#: BKS(23)56399403 CG 20 01 0413 Q Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: BKS(23)56399403 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 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. CG 24 04 05 09 Copyright, Insurance Services Office, Inc., 2008 INSURED Page 1 of 1 cg2404a.fap Name of Insured: TRITON TECHNOLOGY SOLUTIONS INC Policy Number: BAS(23)56535798 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement). Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to an extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 2048 02 99 Copyright Insurance Services Office, Inc 1998 Insured: TRITON TECHNOLOGY SOLUTIONS INC Policy Number: BAS(23)56535798 COMMERCIAL AUTO LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following: COMMERCIAL AUTO LIABILITY COVERAGE PART SCHEDULE Name of Person Or Organization: ANY PERSON OR ORGANIZATION FOR WHOM THE INSURED HAS AGREED BY WRITTEN CONTRACT WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization required by contract (written or oral), but only as respect to liability arising out of or result of ownership maintenance or us of a covered auto. This insurance is primary with respect to the Additional Insured(s). Any other insurance available to the Additional Insured(s) will be excess only and non-contributing as respects claims or liability arising out or resulting from the acts or omissions of the named insured or of others performed on behalf of the named insured. Commercial AUTO Liability INSURED: TRITON TECHNOLOGY SOLUTIONS INC POLICY NUMBER: BAS(23)56535798 THIS ENDORSEMENT CHANGES THE POLICY.READ IT CAREFULLY. WAIVER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM TRUCKERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident", provided that the "accident" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. SCHEDULE Name of Person or Organization: ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER CA T 3 40 02 9 STATE. i:COMPENSATION ..1 INS.U:RANCE'= FUND N HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS BROKER COPY EFFECTIVE SEPTEMBER 12, 2022 AT 12.01 A.M. AND EXPIRING SEPTEMBER 12, 2023 AT 12.01 A.M. TRITON TECHNOLOGY SOLUTIONS INC 32234 PASEO ADELANTO STE El SAN JUAN CAPISTRANO, CA 92675 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION 9111099-22 RENEWAL SP 5-24-28-01 PAGE 1 OF 1 NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: 2572 AUTHORIZED REPRESENTFIfIVE PRESIDENT AND CEO SCIF FORM 10217 (REV.7-2014) SEPTEMBER 14, 2022