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Home My WebLink AboutA8586-COCHELLART FIDLEITYqC R� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY) 05/30/2026 1 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 Aon Risk xnsurance services West, Inc. Denver CO Office CONTACT NAME: PHONE (AC. Ho. F.,): (866) 283-7122 FA C800) 363-0105 E-MAIL ADDRESS: 200 Clayton Street, Suite 800 Denver CO 80206 USA INSURER(S) AFFORDING COVERAGE NAIC R INSURED INSURERA: QBE Insurance Corporation 39217 Fidelity National Information Serv. Inc. and all subsidiaries 347 Riverside Ave INSURER B: National Fire & Marine Ins Cc 20079 INSURER C: Continental Casualty Company 20443 Jacksonville FL 32202 USA INSURER O: American Casualty Co. of Reading PA 20427 INSURER E: Transportation Insurance Co. 135289 20494 INSURER F: The Continental Insurance Company COVERAGES CERTIFICATE NUMBER: 570112891582 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MWDDIYYYY IOLIT "I MWDDIYYY LIMITS X COMMEACIALGENERAL LIABILRY EACH OCCURRENCE $2,000,000 CLAIMS -MADE �X OCCUR PREMISES Ea occurrence $2, 000, 000 MED EXP(Any one person) $10,000 PERSONAL& ADV INJURY $2,000,000 GENLAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $4,000,000 POLICY ❑ PROECT E LOC J PRODUCTS-COMP/CPAGG $4,000,000 OTHER: C AUTOMOBILE LIABILITY SUA 7036257962 04/01/202504/01/2026 COMBINED SINGLE LIMB E $2,000,000 BODILY INJURY (Per Parson) X ANYAUTO BODILY INJURY (Per accWerd) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED PROPERTY DAMAGE MY AUTOS ONLY Per accident F X UMBRELLAUM X OCCUR 4 EACHOCCURRENCE 25, 0, AGGREGATE $25,000,000 EXCESS LIMB CLAIMS -MADE OEO I % RETENTION S10, 000 D WORKERS COMPENSATION AND WC76TUT" 04/01/210 "64=2026X PER STATUTE TH- EMPLOYERS'LIABILITY YIN ADS except CA E. L. EACH ACCIDENT S1,000,000 E ANY PROPRIETOR I PARTNER I EXECUTIVE N/A WC7036292615 04/01/2025 04/01/2026 OFFICERMEMBER EXCLUDED? (Mandatory In HH) AZ,MA,OR,WI E.L. DISEASE -EA EMPLOYEE $1,000,000 II yee, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POUCY LIMIT $1,000,000 A Cyber Liability QPL 4151 9 02/51 2025 02/01/2026 Cy er/E&O/Aggregate ID, 00, 000 Claims Made SIR applies per policy terms & condi ions DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD tot, Addifi.ei Remark. Schedule, may W attached If more space p required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. umbrella Liability follows form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE JUN 0 9 2025 POLICY PROVISIONS. CITY OF PALM SPRINGS AUTHORIZED REPRESENTATIVE Attn: CITY CLERK O�� PALM°SPRINGS CA 92263-27Q froe of the City Clerk r� 9,41) � JL r Aaamtsdaes •ta4Mliard 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD d 1E AGENCY CUSTOMER57 098 " ID: 0000 648„ , _ - - LOC #: `4 ADDITIONAL REMARKS SCHEDULE ' Page _ of - AGENCY - - 'R,-, NAMED INSURED 1 qon Risk Insurance 'SerVl ceS. WeSt,`ffic., f' Fidelity�National; information serv. Inc. . ,POUCYNUMBER .. - .. - _.. .. : - :. L•. '; 'See certificate Number: 570112891582 - -' CARRIER - - NAIC CODE' - see' Certificate Number: 57,0112891582 - EFFECTIVE DATE: ADDITIONAL REMARKS- - THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, _ FORM NUMBER:, ACORD'25 FORMTITLE: Certificate of Liability Insurance - tlucnecc/ci ecGnoniidr rnvcoer_'o weir «' INSURER G: Great American Spi,Ht Ins Co .33723 - INSURER H : Everest National', Insurance Co ., 10120 INSURER. - INSURER ADDITIONALPOLICIES If a policy below does not include'limit infolmation,'iefer tothecorresponding policy or! the ACORD , - certificate form for policy limits." INSR - pDOL DOL SUBR POLICY NUMBER POLICY EFFECTIVE. POLICY EXPIRATION LIMITS LTR TYPE OF INSURANCE INSD�DATE`. WVD DATE _ ' - (MM/DD/YYYY) RI (MMD/YYYY)' , EXCESS LIABILITY - -- G - EXC5867053 - 04/01/2025 04/01/202.6: Aggregate $12,500,000 • 12.5pox25x25. - H ,, .^ . xc4E(00550251; .- 04/01/2025 04/01/2026 Aggregate �- $12,500,0010. _' - .. 12.Spox25x25 - .,.. .. Each .. S12,500,000 occurrence WORKERS, COMPENSATION, -. - D - - .. ." - N/A,; WC7036292601.- 04/01/2025 04/01/2026' - - - - " CA , _ -� C N/A WCE7036298219 04/01/2025:04/01/2026 ' ON - SIR applies per policy to ms"& tdn'dit ons OTHER... B. Cyber Liability - Excess 42EPP15308102'. 02/01/2025 02/01/2026. Cyber/E&O/Ag - $10,000,000' Claims Made 10 x16 gregate 0200E ACOF The ACORD name and logo ere registered marks o1 AC611M AGENCY CUSTOMER ID; 570000098648 ADDITIONAL REMARKS SCHEDULE 'Page —',of AGENCY ' I . .. I �1 I . I - Aon Risk,ansu'rance Services',West, Inc. NAMED INSURED - I Fidelity National information sere. Inc. 70-LIFY75-MBER See Certificatti.NUmber: 5701128915812 58 1 2 CARRIER � I see Certificate Number:'570112891582' CODE EFFECTIVE DATE: mmu, a JWIMM6 nmlvlmnma THIS ADDITIONAL REMARKS, FORM ORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: R: ACORD 25 FORM TITLE: Certificate of Liability Insurance Excess E&O, Cyber— 2/1/2025 2/1/2026 All Policies are Claims made Underwriting company P611CY,Number - Aggregate Limit(5) 02 Indian Harbor Insurance company - MTE003915712 $10m x $26M 03 Lloyd"s.underwriter Syndicate No. 4711 ASP.- FSCE02502015 $10M x $30M 04 Columbia Casualty Company -768772491-:$10M x $40M ACORD 101 (2008101) 02008 ACORD CORPORATION. All rights reserved. 1W_1 Ing IIIII!W! Certificate No: 570112891582 AON CITY OF PALM SPRINGS Attn: CITY CLERK PO Box 2743 PALM SPRINGS CA 92263-2743 USA Friday, May 30, 2025 To whom it may concern: Following a concentrated effort to reduce our environmental footprint and provide timely certificate delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format. Please utilize one of the following methods to ensure you will receive the electronic copy of your Certificate (Certificate No: 570112891582) for future renewals: - Visit aon.com/e-cert; or - Utilize the QR Code below to enter/validate your information. If your email address has changed or will be changing in the future, or you no longer require this certificate, please let us know using one of the methods above. Thank you for your cooperation and willingness to help us reduce our impact to the environment. Aon Risk Services 5801 Postal Road PO Box 818037 Cleveland, Ohio 44181-9600 AMENDMENT NO. 1 TO CONTRACT SERVICES AGREEMENT BETWEEN THE CITY OF PALM SPRINGS AND COACHELLART This Amendment No. 1 to the Contract Services Agreement with Coachellart is made and entered into as of this 1st day of January, 2021, by and between the City of Palm Springs ("City") and Coachellart, a non-profit organization ("Contractor"). City and Contractor are individually referred to as "Party" and collectively as "Parties." RECITALS A. City and Contractor previously entered into an Agreement (No. 8586) for Consulting Artistic Services for the Palm Springs Public Arts Commission as Artist -in -Residence for the Department of Parks & Recreation, to plan and execute projects that restore and add artwork in Parks facilities. Under this Agreement, compensation and reimbursement to Contractor was not to exceed ten thousand dollars ($10,000). B. City and Contractor desire to amend the Agreement to allow for the continuation of services by Contractor through June 30, 2021, with compensation and reimbursement not to exceed an additional ten thousand dollars ($10,000), with the total compensation and reimbursement payable to Contractor being twenty thousand dollars ($20,000). NOW, THEREFORE, in consideration of the promises and mutual obligations, covenants, and conditions contained herein, and other valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows: AGREEMENT 1. The true and correct recitals above are incorporated by this reference herein as the basis for and a material part of this First Amendment. 2. Section 3.1 of the Agreement is hereby amended in its entirety to read as follows: "3.1. Compensation of Contractor. Contractor shall be compensated and reimbursed for services rendered under this agreement in accordance with the schedule of fees set forth in Exhibit "A1". Contractor's total compensation under this agreement as amended, including reimbursement for costs and expenses, shall not exceed twenty thousand dollars ($20,000)". 3. Section 4.4 of the Agreement is hereby amended in its entirety to read as follows: "4.4. Term. Unless earlier terminated in accordance with Section 4.5 of this Agreement, this Agreement shall continue in full force and effect for a period of eleven (11) months, commencing on August 1, 2020, and ending on June 30, 2021". Page 1 of 4 Revised: May 2020 55575.18165\32972087.1 4. Continuing Effect of Agreement. Except as amended by this Amendment No. 1, all other provisions of the Agreement remain in full force and effect and shall govern the actions of the parties under this Amendment No. 1. From and after the date of this Amendment No. 1, whenever the term "Agreement" or "Contract" appears in the Agreement, it shall mean the Agreement as amended by this Amendment No. 1. 5. Adequate Consideration. The Parties hereto irrevocably stipulate and agree that they have each received adequate and independent consideration for the performance of the obligations they have undertaken pursuant to this Amendment No. 1. 6. Severability. If any portion of this Amendment No. 1 is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect. 7. Counterparts. This Amendment No. 1 may be executed in duplicate originals, each of which is deemed to be an original, but when taken together shall constitute but one and the same instrument. [SIGNATURES ON FOLLOWING PAGE] Page 2 of 4 5 5575.18165\32972087.1 Revised: May 2020 SIGNATURE PAGE FOR AMENDMENT NO.1 TO CONTRACT SERVICES AGREEMENT BETWEEN THE CITY OF PALM SPRINGS AND COACHEIILART IN WITNESS WHEREOF, the Parties have entered into this Amendment No. 1 to the Contract Services Agreement as of the day and year first above written. CITY OF PALM SPRINGS Approved By: David H. Ready, Esq., P City Manager D e Attested By: Approved as to Form: Jef&Y allin r City Attorney COA�CHELLART lval wnvE7 b1Ltgj Title . �a N `7, 0 1 Date If 5711V-1-4 Ile 1/0 1� APPROVED BY CITY MANAGER A Page 3 of 4 Revised: May 2020 55575.18165\32972087.1 Exhibit Al Coachellart Scope of Services/Work This is an agreement with Patrick Sheehan of Coachellart, for a pilot project as Artist -in - Residence for the Department of Parks and Recreation from through January 1 - June 30, 2021. The Artist -in -Residence will work with the Director of the Parks Department, with the assistance of the Public Arts Commission, to plan and execute projects that restore and add artwork in Parks facilities, with a goal of offering opportunities for young people to participate. Specific responsibilities include: 1. Identify locations in City parks facilities where art could be added or repaired/restored, in coordination with Director of Parks and Recreation. 2. Involve other artists in projects where possible, to ensure diversity. 3. Plan/Schedule times when young people can participate in painting - engaging young people in the community and enrolled in Parks programs (in coordination with Director of Parks and Recreation.) 4. Assemble all materials and support equipment. 5. Provide materials to publicize projects on social media, through the Public Arts Commission and the Parks and Recreation Department. 6. Report monthly to both the Public Arts and Parks and Recreation Commissions. 7. Submit detailed invoices for Coachellart activities monthly, including a breakdown of all work performed. Payment 1. Contractor will be paid $50/hour for Consulting Artistic Services as Artist -in -Residence for the Parks and Recreation Department, as billed each month, in an amount not to exceed $10,000, including materials and supplies. 2. All invoices for time and materials must be reviewed by the Director of Parks and Recreation and the Chair of the Public Arts Commission. Coachellart PO Box 414 Palm Springs, CA 92263 Tax EIN 84-3425677 A 501(c)(3) non-profit organization PERSONAL AUTOMOBI(E POLICY w" i�a(�/q/lieSq AMENDED DECLARATION AmendeD� 23, 2020Declaration effective �..�; Supersedes any previous declaration bearing "•7 the same policy number for thil policy term. INSUREDNAMED ADDRESS OFFICE PATRICK SHEEHAN DANAE LYNETTE SHE=EHAN 1257 GRANVIA VALMONTE PALM SPRINGS CA 92262 WAWANESA INSURANCE PO BOX 82867 SAN DIEGO CA 92138-9492 Telephone: 1-800-M-2920 Policy Number Account Number Policy Period 12:01 A.M. standard time at the address of the 21235000 From Sep 27, 2020 to Mar27, 2021 Named Insured as stated herein Important Information - Consumer Services - California Because of the complicated nature of the insurance business, there may be times when you will have questions regarding your coverage or the premium charged, or a problem may arise with your policy. If this occurs we urge you to contact our Customer Service Department to answer your questions or resolve your problem. If after this you are still not satisfied, you may contact the following state agency: California Department of Insurance, Consumer Services Division, 300 South Spring Street, South Tower, Los Angeles, California 90013 Toll free number: 1-800-927-HELP Website: www.insurance-ca.gov YOUR PRIVACY RIGHTS. We use information about you to provide you with insurance and adjust claims. We collect this information from you as well as from other sources. In certain circumstances, we may disclose this information to third parties without your consent. You have the right to access and corr;,ct any information about you that we collect. For more details about our privacy practices, please visit us at www.wawanesa.com. To receive a copy of our full privacy notice, please visit us in person, call us toll -free at 1-800-640-2920, or write to us at the address shown above. Please contact Customer Service if you have questions or require more information from Wawanesa Insurance. Phone: (858) 874-5300 Telephone Hours Fax: (619) 285-2711 Email: service. us(dwawanesa.com Monday - Friday 7:30am to 7:30pm Toll Free: (800) 640-2920 Online: wawanesa.com Saturday 8:00am to 4:30pm Dec 23, 2020 16:29 CT "Wawanesa Insurance" is a trademark of Wawariesa General Insurance Company PERSONAL AUTOMOBILE POLICY w Amended Declaration effective aaranesa AMENDED DECLARjATION Dec 23, 2020 'AL-v Supersedes any previous dedalration bearing nsVA' ' the same policy number for this policy term. PATRICK SHEEHAN DANAE LYNETTE SHEEHAN 1257 GRANVIA VALMONTE PALM SPRINGS CA 92262 WAWANESA INSURANCE PO BOX 82867 SAN DIEGO CA 92138-9492 Telephone: 1-800-640-2920 Policy Number Account Number Policy Period 12:01 A.M. standard time at the address of the 21235000 1 From Sep 27, 2020 to Mar 27, 2021 Named Insured as stated herein Named Insured's Phone Number: 760-636-8172 Named Insured's Email Address: reddotps@g mail, com Your previous 6 month premium was $1,560.68. Your amended 6 month premium is $1,631.38. Refer to the breakdown of premiums below. The change in premium for the remainder of the policy period is $36.69 (pro rated). I Description of Owned Vehicle(s) Vehicle Year Make Model Vehicle Identification Number Premium per Vehicle ($) 2 2015 Kia SOUL PLUS KNDJP�A57F7778076 773.36 3 2005 Dodge DAKOTA CLUB CAB SLT 1D7HE42K45S145232 267.29 4 2021 Mazda CX-9 GRAND TOURING JM3TCADY4M0506521 690.73 Premium Subtotal for Vehicles 1631.38 Insurance is provided only with respect to the coverage's for which a Premium is stated, subject to all conditions of the policy. Coverage and Limits of Liability See Policy for Coverage Details Bodily Injury Liability $100,000 per person/$300,000 each occurrence Property Damage Liability $50,000 each occurrence Medical Payments $1,000 each person Comprehensive $500 deductible Collision $500 deductible Roadside Assistance Rental Expense $30 day/$900 max each covered loss Uninsured/Underinsured Motorists Protection $100,000 per person/$300,000 each occurrence Uninsured Motorists Collision Deductible Waiver Total Premium per Vehicle ($) All Premiums listed are for the full 6 month term. Premiums per Vehicle ($) 2 !3 4 253.21 83.35 133.50 143.26 47.76 84.23 9.84 3.39 5.78 32.87 17.00 47.62 229.19 67.82 224.75 4.88 3.66 24.91 12.89 29.20 73.59 33.47 60.38 1.61 1.61 1.61 773.36 267.29 590.73 Dec 23, 2020 16:29 CT "Wawanesa Insurance" is a trademark of Wawanesa General Insurance Company PERSONAL AUTOMOBILE POLICY Amended Declaration effective 1ffiff1#10nesa AMENDED DECLARATION Dec 23, 2020 �ns•V�an ► ► Supersedes any previous declaration bearing the same policy number for thi� policy term. NAMED - • • • DD OFFICE PATRICK SHEEHAN DANAE LYNETTE SHEEHAN 1257 GRANVIA VALMONTE PALM SPRINGS CA 92262 WAWANESA INSURANCE PO BOX 82867 SAN DIEGO CA 92138-9492 Telephone: 1-800.640-2920 Policy Number I Policy Period 12:01 A.M. standard time at the address of the 21235000 Account Number From Sep 27, 2020 to Maf 27, 2021 Named Insured as stated herein Vehicle Rating Information Chart Vehicle Description Estimated Primary Vehicle Zip Code Discounts # of Traffic # of Chargeable Annual Rated Usage Applied convictions at -fault accidents Mileage Driver No. (See code for driver for driver rated Used for of Years definitions rated on this on this vehicle Rating Licensed below) vehicle 2015 Kia 8,000 8 Pleasure 92262 1, 2, 4 0 1 2005 Dodge 3,000 39 Pleasure 92262 1, 2, 3, 4 0 0 2021 Mazda 15,000 34 Commuting 92262 1, 2, 4 0 0 Discount Codes: 1. Good Driver 2. Multi -Vehicle 3. mature unver 4. Loyally Information affecting your insurance premium was obtained from a Motor Vehicle Record/CLUE report supplied by LexisNexisO Consumer Service Center and not LexisNeAsO made the decision to use this information. A free copy of this report is available to you if requested within 60 days. You have the legal right to dispute the accuracy and/or completeness of the information contained in the report by contacting LexisNexis® at LexisNexisO Consumer Service Center, P.O. Box 105108, Atlanta, GA 303485108 or call 1-800-456-6004. Applicable Forms Vehicle Identification Cards (VID 1), California Roadside Assistance Identity Card (RAIC 1) Driver(s) Driver Name Principal Operator of Vehicle Number Occasional Operator of Vehicle Number Patrick Sheehan 3 2 Danae Lynette Sheehan 4 Madison E Sheehan 2 Additional Interest(s) Lienholder(s) Vehicle 2 Sun Community FCU PO Box 4210 El Centro, CA 92244 Vehicle 4 TOYOTA FINANCIAL SERVICES PO BOX 105386 ATLANTA, GA 30348 Dec23, 202016:29 CT "Wawanesa Insurance" is a trademark of Wawanesa General Insurance Company Ag5s/(, ,— A'.6 � CERTIFICATE OF LIABILITY INSURANCE DATE(MhVODrYVVV) „/„l2D22 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 CONTACT NAME' Aon Risk Services Central, Inc. PA Office 100 North 18th street 15th Floor PHONEPhiladelphia INC. N. E,): (866) 283-7122 FAX (800) 363-0105 EaAAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAK:4 Philadelphia PA 19103 USA INSURED INSURER A: ACE American Insurance Company 22667 Fidelity National Information Serv. Inc. subsidiaries and al and Ave alldAari es rsid i A INSURER B: Indemnity Insurance CO of North America 43575 INSURERC: ACE Fire Underwriters Insurance CO. 20702 Jacksonville FL 32204-2946 USA INSURERD: The continental Insurance Company 35289 INSURER E: Axis insurance company 37273 INSURER F: COVERAGES CERTIFICATE NUMBER: 570096468559 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. Limits shown are as requested TYPE OF INSURANCE INSD WD POLICY NUMBER y y LIMITS X COMMERCIAL GENERAL LMBILITV HDOG EACH OCCURRENCE $2,000,000 CLAIMS -MADE ❑X OCCUR PREMISES Ea occurrence S1,0001000 MED EXP(My .0 person) EXCluded PERSONAL& AOV INJURY S1,000,000 GENLAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE 2,000,000 % POLICY ElJECT LOC PRODUCTS - COMPIOP AGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY Y ISA H25551901 01/01/202201/01/2023 COMBINED SINGLE LIMIT (Ea accident) 52,000,000 BODILY INJURY ( Per parson) % ANYAUTO BODILY INJURY IPer acc!) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON OWNED PROPERTY DAMAGE ONLY AUTOS ONLY (Peraal8ent D X UMBRELLA LIAR X OCCUR 7018146359 Ol 017M M771-771M EACH OCCURRENCE S1010001000 EXCESS LIM CLAIMS -NUDE AGGREGATE S10,000,000 DED I X RETENTION 410, 000 B WORKERS COMPENSATION AND wLRC X PER STATUTE OTI+ EMPLOYERS' UASILTTY YIN WC ADS E.L. EACH ACCIDENT $1,000,000 C ANY PROPRIETOR I PARTNER I EXECUTIVE N NIA SCFC68921752 01/01/2022 01/01/2023 OFFICERMEMBER EXCLUDED? (Mwxl ry in NNO wC wI E.L. DISEASE -EA EMPLOYEE S1,000,000 X 964 tl =be and r DESCRIPTION OF OPERATIONS Iml. E.L. DISEASE POLICY LIMIT S1,000,000 E Cyber Liability P OIOOO 4790 5 11/09/2022 11/09/2023 E80/Cyber 15,000,000 Edo/Cyber/Prof Liab SIR applies per policy terms & condi ions DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Atltl 0tl 1 Ra dts SCMtlulc m W altseMtl R m,xe space N rw irixt) Additional Named Insured: SUNGARD DATA SYSTEMS INC., SUNGARD CAPITAL CORP. ( Its Companies & subsidiaries. Certificate Holder is included as an additional insured for General Liability and Automobile Liability coverage if required by contract, but only with respect to activities or obligations performed under the contract and only to the limits required by the contract per the terms and conditions of the policies. umbrella coverage is follow form of the General Liability, Automobile Liability and Workers Compensation policies per the terms and conditions of the policies. CERTIFICATE HOLDER CANCELLATION KLCEIVED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WTH THE POLICY PROVISIONS. NOV AUTHORRED REPRESENTATIVE CITY OF PALM SPRINGS 2 2 2022 Attn: CITY CLERK PO Box 2743 PALM SPRING$ CA 92263-2743 USA Cdy Hall ^ ^ � C(/)!a/�raG16 Reception peck e.: kt7 y 4JL m 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD _ f AGENCY CUSTOMERID:1 )00080055 LOC#: ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY - - NAMEDINSURED _ Aon Risk Servi Ces,Central, Inc.' _ 'Fidelity National Information Serv. Inc. . POLICYNUMBER See Certificate Number: 570096468559 CARRIER - NAIC CODE See Certificate Number: 570096468559 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS.A SCHEDULE TO ACORD FORM, - FORM- NUMBER: ACORD25 FORM TITLE: Certificate of Liability Insurance ,INSURER(S) AFFORDING COVERAGE NAIC# INSR LTR TYPE OEINSUMNCE" ' ADDL {NSD SUBR WVD POLICYNUMBER POLICY EFTn?C+'IVE. DATE (MNUDD/YYYY) POLICYCY EXPIRATION DATE (mawun•YYY) LIDIrIS WORKERS COMPENSATION A - N/A WCUC6692179A WC Ohio 01/01/2022 Q1./Q1/ZQ23 A N/A WLRC68921715 - WC CA, MA 01/01/2022 01/01/2023 . the ACORD name and logo are registered marks of ACORD �: R Certificate No: 57009646o0j9 AON CITY OF PALM SPRINGS Attn: CITY CLERK PO Box 2743 PALM SPRINGS CA 92263-2743 USA Monday, November 14, 2022 To whom it may concern: Following a concentrated effort to reduce our environmental footprint and provide timely certificate delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format. Please utilize one of the following methods to ensure you will receive the electronic copy of your Certificate (Certificate No: 570096468559) for future renewals: - Visit aon.com/e-cert; or - Utilize the OR Code below to enter/validate your information. If your email address has changed or will be changing in the future, or you no longer require this certificate, please let us know using one of the methods above. Thank you for your cooperation and willingness to help us reduce our impact to the environment. MSC# 17755 1 Aon P.O. Box 1447 Lincolnshire, IL 60069 RECEIVED NOV 222022 Cty Hall Reception Desk