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Insurance Certificates 2021/22 Data TicketAcO "0 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/22/2021 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 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). PRODUCER CONTACTLynette (Lynn) NAME: Y (Y ) Eye PIA Select Insurance Solutions PHONE gp5-9?5-3531 A/c FAX No text : (A/C, No): ADDRESS: Iynn.eye�r�piaselect.com 1100 Industrial Rd., #3 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Amco Insurance Company 002014 San Carlos CA 94070 INSURED INSURER B : Employers Insurance Group 10346 Data Ticket, Inc. INSURER C : Continental Casualty Company 20443 DBA: Revenue Experts INSURER D : Scottsdale Insurance Company 41297 2603 Main Street, Ste. 300 INSURER E : Travelers Casualty and Surety Company of America 31 194 INSURER F : Irvine CA 92614-4200 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. LTR TYPE OF INSURANCE INSD NND POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE ® OCCUR PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 &A.DVINJURY $ 2,000,000 A Y ACP GLO 3079509589 11/01/2021 11/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: -PERSONAL GENERAL AGGREGATE S 4,000,000 POLICY ECT LOC PRODUCTS - COMPIOPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY (Ea accident) S 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS ACP GLO 3079509589 11/01/2021 11/01/2022 BODILY INJURY (Per accident) $ XHIRED NON -OWNED AUTOS ONLY A AUTOS ONLY FROPERTY DAMAGES (Per accident) S UMBRELLA LiABi OCCUR EACH OCCURRENCE $ 2,000,000 A X EXCESS LIA8 CLAIMS -MADE ACP CAA 3079509589 11/01/2021 11/01/2022 AGGREGATE $ 2,000,000 DED I I RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOP/PARTNER/EXECUTIVE FFICERIMEMBEREXCLUDED? I Y I NIA EIG4581764-02 I 11/01/2021 I 11/01/2022 v - /� STATUTE ER E.L. EACH ACCIDENT I $ 1,000,000B E.L. DISEASE - EA EMPLOYEE $ 1,000,000 Mandatory in NH) If ns, describe under E.L. DISEASE - POLICY LIMIT S 1,000,000 D_SCP,IPTION OF OPERATIONS below See attached Additional Remarks Schedule for additional policies DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) It is agreed the Certificate Holder listed below is included as Additional Insured including Waiver of Subrogation and Primary & Non -Contributory wording as required by written contract. Workers Compensation includes a blanket Waiver of Subrogation. CERTIFICATE HOLDER rAFJrFl I ATIC)M SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of La Quinta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 78495 Calle Tampico La Quinta CA 92253 AUTHOR REPRESENTATIVE --t 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ACC)R a ADDITIONAL REMARKS SCHEDULE Page of AGENCY PIA Select Insurance Solutions NAMED INSURED Data Ticket, Inc. DBA: Revenue Experts POLICY NUMBER Various policies -see below CARRIER Various carriers -see below NAIC CODE i EFFECTIVE DATE: Various dates THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: 25 FORM TITLE: Attachment to Certificate of insurance Insurer C: Continental Casualty Company Professional Liability/Errors & Omissions Policy #287188360 Policy period: 11/1/2021 to 11/1/2022 Limit: $2,000,000 $10,000 Retention per claim Insurer D: North American Capacity Insurance Company Cyber Liability Policy #C-4LPY-035907-CYBER-2022 Policy period: 3/24/2022 to 3/24/2023 Limit: $3,000,000 $5,000 Retention per claim Insurer E: Travelers Casualty and Surety Company of America Crime Policy #105702099 Policy period: 11/1/2021 to 11/1/2022 Limit: $1,000,000 $25,000 Retention per claim ACORD 101 (2008/01) V ZUU8 AGUKU GUKFUKAI IUN. All ngms reserves. The ACORD name and logo are registered marks of ACORD Policy #ACP GLO 3079609589 Policy period: 1111121-11l1122 COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. 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. However, the insurance afforded to such additional insured: 1, Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "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: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies ever, if the claims against any insured allege negligence or other wrongdoing in the supervislnn, hiring, employment; training nr monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render arty professional architectural, engineering or surveying services. CG 20 33 04 13 n Insurance Services Office, Inc.. 2012 Page 1 of 2 CG 20 33 0413 2. 'Bodily injury" or "property damage" occurring after: a. 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, of b. 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; 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. All terms and conditions apply unless modified by this endorsement. Page 2 of 2 © Insurance Services Office, Inc.. 2012 CG 20 33 04 13 POLICY NUMBER: ACP GL0 3079509589 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: As required by a written contract executed prior to 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. All terms and conditions of this policy apply unless modified by this endorsement. CG 24 04 05 09 : Insurance Services Office, Inc., 2008 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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 With respect to all employees subject to the workers' compensation laws of the state of California, any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 11 /01 /2021 Policy No. EIG 4581764 02 Issued to DATA TICKET, INC. Premium Countersigned at at 12:01 AM standard time, forms a part of Of the EMPLOYERS PREFERRED INS. CO. Carrier Code 00920 Endorsement No. on By: Authorized Representative WC 04 03 06 (Ed. 4-84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Policy #ACP GLO 3079509589 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 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 PRODUCT&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 Insurarce available to the additional insured. All terms and conditions of this policy apply unless modified by this endorsement. CG 20 01 04 13 C; Insurance Services Office, Inc.. 2012 Page 1 of 1