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HomeMy WebLinkAboutA9004 - AVIATRIXCity Clerk Form Updated 7/21/2021 CONTRACT ABSTRACT Contract prepared by: ____________________________________________________ Submitted on: __________________ By: __________________________________ Note: _________________________________________________________________ Contract Compliance Exhibits: Yes Signatures: Yes Insurance: Yes Bonds: Yes Contract Approvals Council/ Community Redevelopment Agency Approval Date: __________________________ Agenda Item No./ Resolution No.: _______________________________________________ Agreement No: _____________________________________________________________ Contract Administration Lead Department: ___________________________________________________________ Contract Administrator: _______________________________________________________ Contract Company Name: __________________________________________________________ Company Contact: _________________________________________________________ Summary of Services: ______________________________________________________ Contract Price: ____________________________________________________________ Funding Source: ___________________________________________________________ Contract Term: ____________________________________________________________ Munis Contract Number: _____________________________________________________ No NoNo No Aviatrix Communications Katie Franco - 760 717 1888 katie@aviatrixcommunications.com Website Repairs and Maintenance $450/mo 4157020.50145 Extension from July 1st, 2022 to December 31, 2022 Vendor No. 103384 Aviation Harry Barrett / Daniel Meier N/A N/A A9004 Nadia. P. Seery 8/15/22 Christina Brown 4 4 4 4 DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED8/15/2022 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS AUTOSAUTOSNON-OWNEDHIRED AUTOS SCHEDULEDALL OWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD MTTU Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA 520 Madison Avenue 32nd Floor New York, New York 10022 (888) 202-3007 contact@hiscox.com Hiscox Insurance Company Inc 10200 Aviatrix Communications, LLC 11162 Caminito Vista Pacifica San Diego, CA 92131 City Of Palms Springs 3400 East Tahquitz Way Palm Springs, CA 92262 City Of Palms Springs are named as additional insured and this insurance is primary and non contributory subject to policy terms and conditions. 05/20/202305/20/2022P100.278.588.4Y X A X X Each Claim: $ 1,000,000 Aggregate: $ 1,000,000 Professional LiabilityA 05/20/202305/20/2022P100.276.953.4Y 1,000,000 100,000 5,000 0 2,000,000 2,000,000 04/05/2022 DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED Included Berkshire Hathaway Direct Insurance Company 10391 06/07/2022 The City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 X X X N9BP000312 07/14/2021 07/14/2022A 5,000 2,000,000 50,000 4,000,000 4,000,000 Aviatrix Communications 11162 Caminito Vista Pacifica San Diego, CA 92131-3301 BIBERK P.O. Box 113247 Stamford, CT 06911 Professional Liability (Errors & Omissions): Claims-Made Per Occurrence/ Aggregate 203-654-3613844-472-0967 customerservice@biBERK.com Primary and Non-Contributory endorsement is included on the general liability policy (see endorsement attached) The City of Palm Springs are listed under a blanket waiver of subrogation is included on the worker’s compensation policy (see endorsement attached) X 10,000 X X 3,000,000 3,000,000A N9UM000328 07/14/2021 07/14/2022 1,000,000 1,000,000 1,000,000 X A N X N9WC485649 05/25/2022 05/25/2023 X Primary and Non Contributory DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED 06/07/2022 Berkshire Hathaway Direct Insurance Company X X * * * ALS up to 12 months. 0 007/14/2021 07/14/2022 The City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 N9BP000312 Bldg #001: Public Relations (Office) - 6517107 Location: 11162 Caminito Vista PacificaSan Diego, CA 92131-3301 n/a n/a n/a Aviatrix Communications 11162 Caminito Vista Pacifica San Diego, CA 92131-3301 BIBERK P.O. Box 113247 Stamford, CT 06911 541820 250 (203) 654-3613 salessupport@biberk.com (844) 472-0967 DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED BUSINESSOWNERS BP 14 88 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BP 14 88 07 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM The following is added to Paragraph H. Other Insurance of Section III – Common Policy Conditions 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. DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED 1.00 Blanket Waiver - Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. All CA Operations N9WC485649 DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED DocuSign Envelope ID: 1BF35744-C41C-4C95-B0A9-7188956770ED