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Insurance Certificates 2023/24 Triton Techonology SolutionsACCPRO, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 02/27/23 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 eeNgTACTBART A NUGEN PHONE 909/941-0167 fAiG. No. EXti: E-MAIL ADDRESS: I VAc,H 909/941-9453 PRODUCER CUSTOMER ID#.#OC17 30 4 INSURER(S) AFFORDING COVERAGE NAICS TRITON TECHNOLOGY SOLUTIONS, INC 32234 PASEO ADELANTO STE#E1 SAN JUAN CAPISTRANO CA 92675 949 388-3919 INSURER A:OHIO SECURITY INSURANCE COMPANY UNITES STATES LIABILITY INSURANCE COMPANY INSURER B : INSURER C : STATE COMPENSATION INSURANCE FUND 24082 FSCXV 25895 FSCX 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 INSR TYPE OF INSURANCE ADDL AMR SR s1BR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DDJYYYY) A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR Y Y BKS (24) 56399403 03/03/23 03/03/24 EACH OCCURRENCE $2,000,000.00 X DAMAGE 10 REM ED PREMISES (Ea occurrence) $100, 000 . 00 CLAIMS -MADE n MED EXP (Any one person) $ 5,000.00 PERSONAL 8. 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 PRO- JECT LOC $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Y Y BAS (23) 56535798 05/24/22 05/24/23 COMBINEDSINGLEINGLE LIMIT accident) $1, 000, 000 . 00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ $2 i 600,000.00 A UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE ESA (24) 56399403 03/03/23 03/03/24 EACH OCCURRENCE X AGGREGATE .$2 r 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 Y 9111099 22 09/12/22 09/12/23 X WRTTTS OR - E.LEACH ACCIDENT $1,000,000.00 EL DISEASE - EA EMPLOYEE $1, 000,000.00 below EL DISEASE - POLICY LIMIT 1 000 000.00 $ B A E&O (Inc1 Cyber Liab) Property J TK1005569L BKS (24) 56399403 05/13/22 03/03/23 05/13/23 03/03/24 1000000occ/2000000agg $412,000 BBP of other DESCRIPTION OF OPERATIONS I 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 BEING NAMED AS ADDITIONAL INSURED PER FORM CG2010 04/13, PRIMARY PER FORM CG2001 04/13 AND WAIVER OF SUB PER FORM CG2404 05/09 ON GL,AUTO AND W/C CERTIFICATE HOLDER CITY OF LA QUINTA 78495 CALLE TAMPICO LA QUINTA, CA. 92253 CANCELLATION SHOULD ANY OF THE A THE EXPIRATION I► ACCORDANCE WI ©198 ACORD25(2009/09) The ACORD name and logo are registered marks of AC E DESCRIBED FOLIC! E HEREOF, NOT) WILL HE PS ICY PROVES! • 'S. CANCELLED BEFORE BE DELIVERED IN ACORD CORP,CfRATION. All rights reserved POLICY NUMBER: BKS(24)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) rlr Chnani7ntinn/cl ALL PERSONS OR ORGANIZATIONS AS REQUIRED BY WRITTEN CONTRACT WITH THE NAMED INSURED Location(s) v #V ere 1 VpGra tISJI 1j ALL AUDI/VIDEO OPERATIONS OF 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: 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(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; arid 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. CG20100413 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. © 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 Page 2 of 2 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. © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER#: BKS(24)56399403 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 CG20010413 (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. © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER#: BKS(24)56399403 COMMERCIAL GENERAL LIABILITY CG24040509 WAVER 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 B Y WRITTEN CONTRACT T 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 MO T OK CARKIEK CO VEKAUE 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 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: SEPTEMBER 14, 2022 2572 4 AUTHORIZED REPRESENT SCIF FORM 10217 (REV.7-2014y 12/ IVE PRESIDENT AND CEO nl n np 917