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Insurance Certificates 2022/23 Data Ticket`'� LACERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/2/2022 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 endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER PIA Select Insurance Solutions 1100 Industrial Rd., #3 San Carlos CA 94070 CON IACT NAME: Lynette (Lynn) Eye PHONE 805-975-3531 FAX (A/C NoExt): (A/C, No): ADDRESS: lynn. eye@piase lect. com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Amco Insurance Company 002014 INSURED Data Ticket, Inc. DBA: Revenue Experts 2603 Main Street, Ste. 300 Irvine CA 92614-4200 rrnvCDAr-CC ......�....Aft .••._ ...... ___ INSURER B : Employers Assurance Co. 10346 INSURER C : Continental Casualty Company 20443 INSURER D : North American Capacity Insurance Company 41297 INSURER E : Travelers Casualty and Surety Company of America 31194 INSURER F : THIS INDICATED. CERTIFICATE EXCLUSIONS INblt ---- __-'—" rtWVIAIUINNUMt3tK: IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE NSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE AUULSUBK INSD WVD POLICY NUMBER YUUCY LI-I- (MM/DD/YYYY) POLICY WO' (MM/DD/YYYY) UMITS X COMMERCIAL GENERAL UABIUTY Y ACP GLO 3089509589 11/01/2022 11/01/2023 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR UAMA(,t I U KtN I tU PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 A PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PECOT- PER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ A AUTOMOBILE XHIRED UABIUTY ANY AUTO OWNED y X S SCHEDULED AUTOS NON -OWNED AUTOS ONLY ACP GLO 3089509589 11/01/2022 11/01/2023 COMBINED NhLE LIMI I (Ea accident)SI $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERIYDAMAGE (Per accident) $ $ A X UMBRELLA LIAR EXCESS UAB _ OCCUR CLAIMS -MADE ACP CAA 3089509589 11/01/2022 11/01/2023 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? ECUTIVE (Mandatory in NH) ANY PROPRIETOR/PARTNER/EX If yes, describe under DESCRIPTION OF OPERATIONS below Y / N 1, N / A EIG4581764-03 11/01/2022 11/01/2023 X _ STATUTE ER H E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 See attached Additional Remarks Schedule for additional policies DESCRIPTION OF OPERATIONS / LOCATIONS / 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. City of La Quinta 78495 Calle Tampico La Quinta CA 92253 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ACORO® ADDITIONAL REMARKS SCHEDULE AGENCY PIA Select Insurance Solutions POLICY NUMBER Various policies -see below CARRIER Various carriers -see below NAIC CODE Page of NAMED INSURED Data Ticket, Inc. DBA: Revenue Experts EFFECTIVE DATE: Various dates ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Attachment to Certificate of insurance Insurer C: Continental Casualty Company Professional Liability/Errors & Omissions Policy #287188360 Policy period: 11/1/2022 to 11/1/2023 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: 11/1/2022 to 11/1/2023 Limit: $1,000,000 $25,000 Retention per claim ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy #ACP GL03089509589 COMMERCIAL GENERAL LIABILITY CG 20 33 0413 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 even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or 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 any professional architectural, engineering or surveying services. CG 20 33 04 13 © Insurance Services Office; Inc.. 2012 LC5R R 20328 INSURED COPY Page 1 of 2 47 0004660 CG 20 33 04 13 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; or 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 LC5R R 20328 INSURED COPY CG 20 33 04 13 47 0004661 Policy #ACP GL03089509589 COMMERCIAL GENERAL LIABILITY CG 72 12 12 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY COVERAGE ENHANCEMENT ENDORSEMENT INCLUDING MEDICAL PAYMENTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION 1 — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions is amended as follows: 1. Paragraph (2)(a) of Exclusion g. Aircraft, Auto Or Watercraft is replaced with: (a) Less than 51 feet long; and 2. The following is added to Exclusion j. Damage To Property: (a) Paragraphs (3) and (4) does not apply to "property damage" to borrowed equipment while not in use, while at the insured's premises or a job site; or (b) Paragraph (4) does not apply "property damage" to customers goods while on the insured's premises for the purpose of being worked on or used in a manufacturing process. Limit of Insurance - The most we will pay for damages for "property damage" coverage provided by this coverage in any one "occurrence" is $10,000. Deductible - Our obligation to pay for a covered loss applies only to the amount of loss in excess of $500. We will pay the deductible amount to effect settlement of any claim or "suit" and, upon notification of this action having been taken, you shall promptly reimburse us for the deductible as has been paid by us. This insurance is excess over any other valid and collectible insurance. 3. The last paragraph of 2. Exclusions is replaced with: If Damage To Premises Rented To You is not otherwise excluded, exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or sprinkler leakage to premises while rented to you or temporarily occupied by you rented to you or temporarily occupied by you CG 7212 12 16 with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as follows: 1. Paragraph 1. b. is replaced with: b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1. d. is replaced with: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or `'suit", including actual loss of earnings up to $500 a day because of time off from work. SECTION II — WHO IS AN INSURED is amended as follows: 1. Paragraph 3. a. is replaced with: a. Coverage under this provision is afforded only until the 180t'' day after you acquire or form the organization or the end of the policy period. whichever is earlier; 2. The following is added: 4. Additional Insured — Automatic Status When Required In An Agreement With You Who Is An Insured includes person(s) or organization(s) described in Paragraphs a. — i. below with whom you have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. a. Co -Owners Of Insured Premises — with respect to their liability as co-owner of the premises. Includes copyrighted material of ISO Properties, Inc., with its Page 1 of 5 permission. LC5R R 20328 INSURED COPY 47 0004675 CG72121216 With respect to the insurance afforded to such additional insureds a. — d. described above the following is added to the 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. However, this insurance afforded to such additional insureds a. — i. described above: 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. SECTION III — LIMITS OF INSURANCE 1. The following is added to Paragraph 2: The General Aggregate Limit applies separately to each of your "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. 2. Paragraph 6. is replaced with: 6. Subject to 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or sprinkler leakage, while rented to or temporarily occupied by you with permission of the owner. The limit is increased to $1,000,000. 3. Paragraph 7. is replaced with: 7. Subject to 5. above, the higher of: a. $10,000: or b. The amount shown in the Declarations for Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by one person. Page 4 of 5 This coverage does not apply if Coverage C - Medical Payments is excluded either by the provisions of any coverage forms attached to the policy or by endorsement. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit is amended to include: e. Knowledge of an "occurrence". offense. claim or `suit" by an agent or employee of any insured shall not in itself constitute knowledge of the insured unless you, a partner, if you are a partnership; or an executive officer or insurance manager, if you are a corporation receives such notice of an "occurrence", offense, claim or "suit" from the agent or employee. 2. Paragraph b. Excess Insurance (1) (b) (ii) of condition 4. Other Insurance is replaced with: (ii) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; 3. Condition 6. Representations is amended to include: d. Your failure to disclose all hazards or prior "occurrences" or offenses existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" or offenses is not intentional. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non - renewal. 4. Condition 8. Transfer Of Rights Of Recovery Against Others To Us is amended to include: If required by a written contract executed prior to loss, we waive any right of subrogation we may have against the contracting person or organization 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". 5. The following condition is added: 10. Liberalization If we revise this coverage form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. Includes copyrighted material of ISO Properties, Inc., with its CG 72 12 12 16 permission. LC5R R 20328 INSURED COPY 47 0004678 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 11/01/2022 at 12:01 AM standard time, forms a part of Policy No. EIG 4581764 03 Of the EMPLOYERS ASSURANCE CO. Carrier Code 00919 Issued to DATA TICKET, INC. Premium Countersigned at on B Endorsement No. Authorized Representative WC 04 03 06 (Ed. 4-84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Policy #ACP GL03089509589 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 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. All terms and conditions of this policy apply unless modified by this endorsement. CG 20 01 04 13 © Insurance Services Office. Inc.. 2012 LC5R R 20328 INSURED COPY Page 1 of 1 47 0004659