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Insurance - CU Technology LLC dba Acorn Technology Services - 2024-06-24ACORl..7® CERTIFICATE OF LIABILITY INSURANCE 16w..,,,. ' DATE(MM/DD/YYY10 06/24/2024 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 techru Technology Risk Underwriting Group 596-600 Enterprise Drive Lewis Center, Ohio 43035 CONTACT Katie Baughan PHONEWCExt): 614-842-6686 (A/C, No): 614-888-2739 EMAIL tech btieru ADDRESS: ka@ 9•com INSURERS A FORDING COVERAGE NAIC # INSURER A: RLI INS CO 13056 EACH OCCURRENCE $ 2,000,000 INSURED CU Technology LLC dba Acorn Technology Services INSURER B: Hamilton Insurance DAC ' A0765 1960 Chicago Ave. Suite E9 and Suite C3 Riverside, CA 92507 INSURER C: GEN'L AGGREGATE LIMIT APPLIES PER: ✓ POLICY PRO- JECT LOC OTHER: GENERAL AGGREGATE $ 4,000,000 INSURER D: INSURER E: A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS ✓ HIRED ✓ NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED RETENTION $ INSURER F: i Y ( COVERAGES CERTIFICATE NUMBER: RFVISION NUMRFR- 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 I LTR TYPE OF INSURANCE ADDL SUBR IWD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DDY LIMITS A COMMERCIAL GENERAL LIABILITYY CLAIMS -MADE ✓ OCCUR Y PTB0001949 06/01/2024 06/01/2025 j EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1000,000 MED EXP (Any one person)$ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ✓ POLICY PRO- JECT LOC OTHER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS ✓ HIRED ✓ NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED RETENTION $ Y i Y ( PTA0001217 06/01/2024 06/01/2025 COMBINED SINGLE LIMIT Ea accident)$ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY Per accident $ ( ) PROPERTY DAMAGE $ Per accident Y Y EACH OCCURRENCE $ AGGREGATE $ $ ✓ STATUTE ERH A WORKERS COMPENSATIONPTW0001346 AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN N1,000,000 OFFICER/MEMBEREXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A I 06/01/2024 06/01/2025 E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Errors and Omissions Insurance B1 180D221573/038 06/01/2023 06/01/2024 Each Claim $2,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) See ACORD 101 CERTIFICATE HOLDER CANCFLLATInN ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District ACCORDANCE WITH THE POLICY PROVISIONS. 290 Paularino Avenue Costa Mesa, CA 92626 AUTHORIZED REPRESENTATIVE 01 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: AC220418114040117 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY McCormick & Reinmuth Insurance Agency Inc. NAMED INSURED CU Technology LLC dba Acorn Technology Services 1960 Chicago Ave. Suite E9 and Suite C3 Riverside, CA 92507 POLICY NUMBER CARRIER NAIC CODE 13056 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: Certificate issued as evidence of insurance per policy terms, conditions and exclusions. Cost Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers and employees are additional insured per the terms of the written contract with respect to the General and Automobile coverages (Form PPB 304G 04) (PPB 321 11 10) . The General, Automobile (Form PPB 304G 04) and Umbrella (Form PPU 304G 01 12) insurance policies shall be primary and non-contributory with any coverage held by the additional insureds. A waiver of subrogation in favor of the additional insureds applies to the General, Automobile Policies (Form PPB 304G 04) per written contract. The Errors & Omissions Insurance has insuring agreements for Tech & Professional Services Wrongful Act, Media Wrongful Act, Data & Network Wrongful Act and Breach Response. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: PTB0001949 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack° CHANGE ENDORSEMENT Policy Number: PTB0001949 Named Insured: CU Technology LLC Endorsement Effective Date (12:01 a.m.): 06/24/2024 RI Additional Premium: $ 26 ❑ Return Premium: $_ ❑ No Premium Change Premium change from taxes, fees and/or surcharges: $0.00 It is understood and agreed that this policy is amended as follows: Add PPK 2108 05 11 RLIPack Notice Of Cancellation Or Nonrenewal - Designated Person Or Organization per attached. Add PPB 313 02 12 RLIPack For Professionals Scheduled Additional Insured Endorsement per attached. Premium change noted on this form is for this policy term only. Any attached documents may include premium amounts that are annualized. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. PPK 2103 06 10 Page 1 of 1 Policy Number: PTB0001949 RLI Insurance Company Named Insured: CU Technology LLC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack® FOR PROFESSIONALS SCHEDULED ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM — SECTION II — LIABILITY Schedule Name of Person(s) or Organization (s): Cost Mesa Sanitary District 1. SECTION II C. Who Is An Insured is amended to include as an additional insured the person or organization shown in the schedule above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product -completed operations hazard". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply to the rendering of or failure to render any professional services. b. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. 3. The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION III K.2 Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO SECTION I — PROPERTY AND SECTION 11— LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury' arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. PPB 313G 04 13 Page 1 of 1 Policy Number: PTB0001949 RLI Insurance Company Named Insured: CU Technology LLC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack® NOTICE OF CANCELLATION OR NONRENEWAL — DESIGNATED PERSON OR ORGANIZATION Schedule Designated Person or Organization: Cost Mesa Sanitary District Email Address: US Mail Address: 290 Paularino Avenue Cost Mesa, CA 92626 If we cancel or chose to nonrenew this policy for any reason other than nonpayment of premium we will provide written notice at least �) days before the effective date of the cancellation or nonrenewal to the designated person or organization in the above schedule. Such notice will be sent via the US mail address or E-mail address listed above. Proof of mailing or e -mailing will be sufficient proof of notice. PPK 2108 05 11 Page 1 of 1