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Insurance Certificates 2021/23 Placer Labs, IncTE ACC?R t)r CERTIFICATE OF LIABILITY INSURANCE DA11/07/20 2rr) 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: Christine Marciano Christine Marciano, Cyber Data Risk Managers LLC A/CONNo, EXt : 855.288.7475 (,//c No): 300 Carnegie Center, Suite 150 ADDRESS: Princeton, NJ 08540 Christine Data Privac Insurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER B :Travelers Casualty & Surety Company of America 19046 Placer Labs Inc. INSURER C : 440 N Barranca Avenue, #1277 INSURER D : Covina, CA 91723 INCI IRFR F lilr«ff]9 A -.?-,Tel y A Ci 91 d refill 9 :8.IIL1d-1 A: C7 WA 14116101.IIL41:1:I 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 ESL0339554754 11/01/2022 11/01/2023 EACH OCCURRENCE DAMAGE PREMISES TOoecurDrence $4,000 000 $ 250,000 X CLAIMS-MADE1:1 OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 4 000 000 GENERAL AGGREGATE $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4,000,000 X POLICY PRO LOC $ A AUTOMOBILE LIABILITY ESL0339554754 11/01/2022 11/01/2023 Eaacccid.n,) GLELIMIT 4,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X DAMAGE Per accident) s50,000 NON -OWNED HIRED AUTOS X AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N WC STATU- I JOTH- T RY LIMITS I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ A Technology Professional Liability, Cyber Data Breach & Privacy Liability ESL0339554754 11/01/2022 11/01/2023 $5,000,000 per claim/$5,000,000 aggregate B Commercial Crime Liability 107257824 11/01/2022 11/01/2023 $1,000,000 per claim/$1,000,000 aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) As required by a written agreement, The City of La Quinta, its officers, officials, employees and agents shall be named as additional insured. This Policy will be primary and non-contributory to the third party's own insurance, but only if you and the third party have entered into a contract that contains a provision requiring this. CFRTIFICATF Rini nFR CONCFI I OTInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of La Quinta, its officers, officials, employees ACCORDANCE WITH THE POLICY PROVISIONS. and agents 78495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quinta, California 92253 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURANCE REVIEW RE: Please list the Contracting Party / Vendor Name, type of agreement to be executed, including any change orders or amendments, and the type of services to be provided. Make sure to list any related Project No. and Project Name. Insurance certificates required per the Agreement: ACCORD Certificate dated 10-days prior or less _____________________________ enter ACCORD issue date Commercial General Liability Insurance: $1,000,000 per occurrence/$2,000,000 aggregate OR $2,000,000 per occurrence/$4,000,000 aggregate Additional Insured Endorsement naming City of La Quinta Primary and Non-Contributory Endorsement Automobile Liability: $1,000,000 combined single limit for bodily injury and property damage. Workers’ Compensation: Statutory Limits / Employer’s Liability $1,000,000 per accident or disease Workers’ Compensation Endorsement with Waiver of Subrogation Sole Proprietor Professional Liability (Errors and Omissions): Errors and Omissions Liability insurance with a limit of not less than $1,000,000 per claim Cyber Liability/Technology Errors and Omissions Liability Insurance: $1,000,000 per occurrence/loss Other: ________________________________________________________ List other insurance types such as – molestation, harassment, etc. Approved by: ________________________ Date: ________________________ and $2,000,000 Aggregate 10ZT CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/31/2022 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 endors ement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER AON RISK SERVICES SOUTH INC 3550 LENOX ROAD NORTHEAST SUITE 1700 ATLANTA GA 30326 CONTACT NAME: Aon Risk Services, Inc of Florida PHONE (A/C, No, Ext): 833-506-1544 FAX (A/C, No): EMAIL ADDRESS: work.comp@trinet.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : ACE American Insurance Company 22667 INSURED TriNet Group, Inc. L/C/F Placer Labs, Inc. 1 Park Place, Suite 600 Dublin, CA 94568-7983 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 15568538 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA MED 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 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC RETENTION $ A WORKERS COMPENSATION Y / N N AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X WLR_C71266618 07/01/2022 07/01/2023 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Waiver of subrogation in favor of The City of La Quinta, its officers, officials, employees and agents as required by written contract. Workers Compensation coverage is limited to worksite employees of Placer Labs, Inc. through a co -employment agreement with TriNet HR III, Inc.. CERTIFICATE HOLDER CANCELLATION The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured TriNet Group, Inc. L/C/F Placer Labs, Inc. 1 Park Place, Suite 600 Dublin, CA 94568-7983 Endorsement Number Policy Number Symbol: WLR Number: C71266618 Policy Period 07/01/2022 TO 07/01/2023 Effective Date of Endorsement 07/01/2022 Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( X ) Specific Waiver Name of person or organization: The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, CA 92253 ( ) Blanket Waiver 2. Operations: 3. Premium: Included 4. Minimum Premium: Included ___________________________________ Authorized Representative WC 90 03 75 (05/18) 10ZT CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 04/26/2022 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 endors ement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite #1100 Miami, FL 33131-4937 CONTACT NAME: Aon Risk Services, Inc of Florida PHONE (A/C, No, Ext): 833-506-1544 FAX (A/C, No): EMAIL ADDRESS: work.comp@trinet.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : ACE American Insurance Company 22667 INSURED TriNet Group, Inc. L/C/F Placer Labs, Inc. 9000 Town Center Parkway Bradenton, FL 34202 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 15524476 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA MED 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 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC RETENTION $ A WORKERS COMPENSATION Y / N N AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X WLR_C69080315 07/01/2021 07/01/2022 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers Compensation coverage is limited to worksite employees of Placer Labs, Inc. through a co -employment agreement with TriNet HR III, Inc.. Waiver of subrogation in favor of The City of La Quinta, its officers, officials, employees and agents as required by written contract. CERTIFICATE HOLDER CANCELLATION The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured TriNet Group, Inc. L/C/F Placer Labs, Inc. 9000 Town Center Parkway Bradenton, FL 34202 Endorsement Number Policy Number Symbol: WLR Number: C69080315 Policy Period 07/01/2021 TO 07/01/2022 Effective Date of Endorsement 04/26/2022 Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( X ) Specific Waiver Name of person or organization: The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, CA 92253 ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium: The premium charge for this endorsement shall be percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: ___________________________________ Authorized Representative WC 90 03 75 (05/18) Placer Labs Inc. 340 S Lemon Avenue, #1277 Walnut, CA 91789 11/01/2021 11/01/2021 11/01/2022 11/01/2022 Christine Marciano, Cyber Data Risk Managers LLC 300 Carnegie Center, Suite 150 Princeton, NJ 08540 Christine Marciano 855.288.7475 Christine@DataPrivacyInsurance.com A B Underwritten by certain underwriters at Lloyd's ESK0234051962 107257824 $5,000,000 per claim/$5,000,000 aggregate $1,000,000 per claim/$1,000,000 aggregate Technology Professional Liability, Cyber/ Data Breach & Privacy Liability Commercial Crime Liability X X X X X A A ESK0234051962 ESK0234051962 11/01/2021 11/01/2022 11/01/2021 11/01/2022 1,000,000 1,000,000 50,000 1,000,000 250,000 10,000 1,000,000 2,000,000 2,000,000 A X ESK0234051965 11/01/2021 11/01/2022 3,000,000 3,000,000 Travelers Casualty & Surety Company of America 19046 The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, California 92253 4/26/2022 As required by a written agreement, The City of La Quinta, its officers, officials, employees and agents shall be named as additional insured. This Policy will be primary and non-contributory to the third party's own insurance, but only if you and the third party have entered into a contract that contains a provision requiring this. Unique Market Reference No. B087521C9N5051, B087521C9N5053 ©2019 CFC Underwriting Ltd, All Rights Reserved ADDITIONAL INSURED ENDORSEMENT ATTACHING TO POLICY NUMBER: ESK0234051962 THE INSURED:Placer Labs Inc WITH EFFECT FROM:01 Nov 2021 It is understood and agreed that the following amendments are made to this Policy: 1. The following DEFINITION is added: "Additional insured" means The City of La Quinta, its officers, officials, employees and agents (Effective From: 27 May 2022) 78495 Calle Tampico La Quinta California 92253 US 2. Where an “Additional insureds” CONDITION exists in this Policy, additional insureds are included as a third party. 3. Where an “Additional insureds” CONDITION does not exist in this Policy, the following CONDITION is added: Additional insureds Additional insureds are indemnified under this Policy as if they were you, but only in respect of sums which they become legally obliged to pay (including liability for claimants' costs and expenses) as a result of any claim arising solely out of an act, error or omission committed by you or on your behalf, provided that had the claim been made against you, then you would be entitled to indemnity under this Policy. Before we indemnify any additional insured, they must prove to us that the claim arose solely out of an act, error or omission committed by you or on your behalf and fully comply with CONDITION 1 as if they were you. When this CONDITION applies, it will be primary and non- contributory to the additional insured's own insurance but only if you and the additional insured have entered into a contract that contains a provision requiring this. Whilst additional insureds are indemnified under this Policy, any claim made by additional insureds against you will be treated by us as if they were a third party and not as a named insured. 4. The following CONDITION is added: Notice of cancellation to additional insureds If we give you notice of cancellation in accordance with the “Cancellation” CONDITION, we will endeavour to provide the same Unique Market Reference No. B087521C9N5051, B087521C9N5053 ©2019 CFC Underwriting Ltd, All Rights Reserved notice of cancellation to additional insureds; however, not doing so will not place any additional liability upon us. SUBJECT OTHERWISE TO THE TERMS AND CONDITIONS OF THE POLICY Authorised Signatory CFC Underwriting Ltd 1 CFC Underwriting Ltd is Authorised and Regulated by the Financial Conduct Authority ©2018 CFC Underwriting Ltd, All Rights Reserved CERTIFICATE OF INSURANCE IMPORTANT: This Certificate is issued as a matter of information only and confers no rights upon the holder. It does not amend, extend or alter the coverage afforded by the Policy and it does not constitute a contract of insurance. If an ‘additional insured’ is stated below, the Policy must have an additional insured provision or be endorsed for this be valid. Should the Policy be cancelled before the expiry of insurance stated below, notice will be delivered in accordance with the Policy provisions. POLICY NUMBER: ESK0234051965 THE INSURED: PLACER LABS INC 340 South Lemon Avenue, #1277 Walnut, CA 91789 US ADDITIONAL INSURED: The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, California 92253 BUSINESS ACTIVITIES: Foot-Traffic Data Analytics Platform THE UNDERWRITERS: Underwritten by certain Underwriters at Lloyd’s INCEPTION OF INSURANCE: 00:01 Local Standard Time on 01 Nov 2021 EXPIRY OF INSURANCE: 00:01 Local Standard Time on 01 Nov 2022 LEGAL ACTION: Worldwide Limit of liability: USD3,000,000 each and every lawsuit, including defense costs and expenses Aggregate limit of liability: USD3,000,000 for all lawsuits, including defense costs and expenses Which is excess of your underlying insurance as detailed below: Underlying insurers: Policy No: Coverage part: Inception date: Expiry date: Type of insurance: Underlying limit of liability: CFC Underwriting Ltd ESK0234051962 INSURING CLAUSE 3: COMMERCIAL GENERAL LIABILITY 01 NOV 2021 01 NOV 2022 Commercial General Liability USD1,000,000 LIMITS OF LIABILITY 2 CFC Underwriting Ltd is Authorised and Regulated by the Financial Conduct Authority ©2018 CFC Underwriting Ltd, All Rights Reserved Authorised Signatory CFC Underwriting Ltd DATE: 30 May 2022 PLEASE REFER TO YOUR POLICY DOCUMENT FOR FULL TERMS AND CONDITIONS 3 CFC Underwriting Ltd is Authorised and Regulated by the Financial Conduct Authority ©2018 CFC Underwriting Ltd, All Rights Reserved ATTACHING TO POLICY NUMBER: ESK0234051965 THE INSURED: PLACER LABS INC WITH EFFECT FROM: 01 Nov 2021 It is understood and agreed that the “Cancellation” CONDITION is deleted in its entirety and replaced with the following: Cancellation This Policy may be cancelled: a) by you if you give us 15 days written notice; or b) by us if we give you 30 days written notice but only as a result of your non-payment of the Premium and Policy Administration Fee in accordance with the “Payment of premium and policy administration fee” CONDITION of this Policy. If you give us notice of cancellation in accordance with a) above, the earned Premium shall be pro rata to the number of days that the Policy is in effect SUBJECT OTHERWISE TO THE TERMS AND CONDITIONS OF THE POLICY Authorised Signatory Authorised Signatory CFC Underwriting Ltd CFC Underwriting Ltd CANCELLATION CONDITION AMENDATORY CLAUSE 4 CFC Underwriting Ltd is Authorised and Regulated by the Financial Conduct Authority ©2018 CFC Underwriting Ltd, All Rights Reserved ATTACHING TO POLICY NUMBER: ESK0234051965 THE INSURED: PLACER LABS INC WITH EFFECT FROM: 01 Nov 2021 It is understood and agreed that the following CONDITION is added this Policy: Waiver of subrogation Notwithstanding the “Our rights of recovery” CONDITION, we agree to waive our rights of recovery against any third party if, prior to the claim or incident which you reasonably expected to give rise to a claim, you entered into a contract that contains a provision requiring you to do this. SUBJECT OTHERWISE TO THE TERMS AND CONDITIONS OF THE POLICY WAIVER OF SUBROGATION CONDITION CLAUSE 10ZT ,41.. QRE' CERTIFICATE OF LIABILITY INSURANCE DATE jEHWDO/YYYY) 05/26/2023 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 endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions statement on this certificate does not confer rights to the certificate holder policy(ies) must have ADDITIONAL INSURED provisions or be of the policy, certain policies may require an endorsement. A in lieu of such endorsement(s). PRODUCER AON RISK SERVICES SOUTH INC 3550 LENOX ROAD NORTHEAST SUITE 1700 ATLANTA GA 30326 CONTACT NAME: Aon Risk Services, Inc of Florida PHONE FAX (NC, No, Ext): 833-506.1544 (NC, NO EMAIL ADDRESS: work.comp@trinet.com INSURER(S) AFFORDING COVERAGE NAIC /s INSURER A : ACE American Insurance Company 22667 INSURED TriNet Group, Inc. L/C/F Placer Labs, Inc. 1 Park Place, Suite 600 Dublin, CA 94568-7983 INSURER B: INSURER C INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 15668352 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY OCCUR EACH OCCURRENCE $ I CLAIMS -MADE DAMAGE TO D PREMISES Ee occurrence) $ MED EXP (Any one person) $ _ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: LOC GENERAL AGGREGATE $ POLICY PROJECT PRODUCTS - COMP/OPAGG $ OTHER $ AUTOMOBILE _ - — LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY — SCHEDULED AUTOS NON -OWNED AUTOS ONLY CO BINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ U UMBRELLA LIAB EXCESS LIAB ` OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEC RETENTION $ A 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 X WLR_C52609355 07/01/2023 07/01/2024 X PER { OTH- STATUTE I ER N E.L EACH ACCIDENT $ 2.000,000 below E.L- DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Waver of subrogation in favor of The City of La Quinta, its officers, off cials, employees and agents as required by written contract. Workers Compensation coverage is limited to worksite employees of Placer Labs, Inc. through a co -employment agreement with TriNet HR III, Inc.. CERTIFICATE HOLDER CANCELLATION The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE flon Ask 8etvices 5outli tine ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 'Y, 036129 90033090300 7 03 02 0 0000 0 000 1031965 Workers' Compensation and Employers' Liability Policy Named Insured TriNet Group, Inc. IJC/F Placer Labs, Inc. I Park Place, Suite 600 Dublin, CA 94568-7983 Endorsement Number Policy Number Symbol: WLR Number: C52609355 Policy Period 07/01/2023 TO 07/01/2024 Effective Date of Endorsement 07/01/2023 Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. (X) Specific Waiver Name of person or organization: The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, CA 92253 () Blanket Waiver 2. Operations: 3. Premium: Included 4. Minimum Premium: Included Authorized Representative WC 90 03 75 (05/18) Vilig 036124 90033090300 7 03 03 0 0000 0 000 1031965