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HomeMy WebLinkAboutAP Triton LLC - PSA for Ground Emergency Medical Transportation Consultingf l PROFFF SSIONAL SERVICES AGREEMENT AP TRITON CONSULTING LLC TffiS A REEMENT is made and entered into between the City of Pasco,a Washington Municipel Corpor rion,hereinaf er referred to as"City",and A,p T}iton LLC,he refen d to as"Consultan#,"on the 25 day of Octob r .2021. RECITALS WHEREAS,the City desires to have certain services aad/or tasks p rfonned as set foith below reyuiring spec elized skills,training,e9uip nent,and other supportive capabilities;aad WSEREAS,the Consultant represents tbat it is qualifi d and ossesses snffcient skills, e cperieace equiP ment,and necessaty capabilities,including:t echnical and professionai expe rtise, when r quired,to perform the services and/or tasks as set forth in this Agreement upon which the City is relying. N W, THEREFORE, in conside atioa of the mutual covenaats, and performances contained herein,the part es agree as foltows: 1. Scooe of Serv cea. The Consultant shall perform such sezvices and accomplish such tasks, including the fium hing of all labor,materials,facilities a d equipme t nece,ss y for futl pe,i formance thereo as ide antified aad designated as Consultaat's Responsi'bilities throughout t ris Agreeme at,and as more particularly described in Scope of ork detailed in[Exht'bit A],atta hed hereto and inoorporated hereia(the"Project". Z• T This Project sball begin on the execution date listed above and promptly be compl ted by the cost report de dline of November 30,2021. The contract term extends through June 30,2022 should th+e be any HCA extensions or additional needs.. 3. Com pea stion and Psvmen 3.1 Paymeat for s rrvices provided h der shsll be made following the pe forniance of such semrice.s. Such payment shall be fuZl oompensation for work p rformed or s ces rendered,and for all labor,materials,supplies,equipmeat,aad incidentals necessary to coinplete the Pr+oject. 3.2 No payment sh,all be made for any se rvices rendered by the Consultant exoept for services identified and set forth in this Agreement waless authorized by a written supplanental agreement approved by the City. 3.3 The Ci#y shall pay the Consultarit for work perfornaed under tbis Agr ement upon timely submitted invoic,es detailing work perfurmed and exp nses for which reimbursement is soughk The City sha11 approve all invoices before payrnent is PY+fes imaal Se vices Ag eemerrt—AP Triton LLC GM'f Cost Rsgort FY2020/2021 Page 1 of i I issued. Payment shall occu c within thirty(30)days of receipt and approvai of an invoice. 3.4 T`he City sha21 pay the Consuttant for all work performed and expenses iacutred unde r this Agree nent,as follows. Othet: Ses Exhibit B 4. Re rts and Ins i ons. 4.1 The Consultant at such times and in such forms as the City may require, sball furnish to the City such statemaats, reoords, studies, surveys, r ports, date, and information as the City may request pertaining to matters covered by thisAgreemen 4.2 The Con lt nt shall,at my time during nom al business howrs and as of en as the City or the Washington State Auditor may reasonably dee nevessary, make available for e;Kamina#ion all of its records aud data, with re.4pect to a l matters cov red,directly or indirectly,by this Agreement and shall pernait the City,or its designated authorized r rp esentafiive to audit and inspec;t other deta relafing to a11 matters covered by this Ag nent. The City shall receive a copy of all audit reports made by the agency or firm as to the Consultant's activities, The City may at its cliscr tion,ooaduct an audit at it expense,usin,g its own or outside auditors, of the Consultant s activ ttes wluch relate,direc ly or uulirectly,to this A,gr me Consultant shall be provided a copy of such r ports. 4.3 The Consuhaa dvring the term of t is Agr+eement, shall obtain all penni#s and on documents necessary for the perfonnance of its wark and for the executioa of services at its own exgense, and shall maintain its validity. Upon recluest,the Consultant shall deliver to the City vopies ofthese licenses,registration documents,and p rmits or praof of their issuance or reRnewal. 4.4 Consuttant shaU maintain books, records and documents, which suffiaently and P P IY reflect a11 direct and indirect costs relat d tn the performance of this Agre at,and shall maint in such accounting pmeed,u es and practices as may be nece,ssary to assure pmger acxountiag of aU funds paid pursuant to this A reemeat. These reoords sh all he subject, at aU reasonable times, to inspection, rev iew, or audit as provided above. 4.5 The Consultant shall retain all books,records,documaents or oth r material relevant to tlus A neesnent for three(3)years aRer iLs expiration. Consultant agrces thst the City, or it designe, shall bave full access and right to examine any of said materials at all reasonable times during this p riod. Prnf sional Services Agr ment—AP Triton LLC GMT Cost R eport FY2020f2021 Page 2 af 11 5. Ownershio aad Use of Docunients. 5.1 All research,tests,sutveys,prel'aainary dat a,information,drawiags and documents made,collected,or prepared by the Consultant for performing the se vices subject to this Agreement, as weu as any fnal produc,collectively referred to as "work product,"sha11 be deemed es the exc usive property of the City,including copyright as secu red thereon. Consu tant may not use them except in connec ioa with the perfonmance of the services under this Agreement or with the prior written consent of the City. Any prior copyrig,ht d materials owned by the Consultant and utilized in the performance of the services und r this Agreement,or embedded in with the materials,products and serv7ices provided thereunder, shal]remaen the progerty of the Consultaut sabject to a license graated to the City for their coatinued use of the products and services provided under this Agreement. A,ny work product used by the Consultant in the performance of these services which it deems as confidentia,"`roprietary,'°or a°`irade secret"sha l be conspicuously designated as such. 5.2 In the event of Consultant's defaul or in the event that this Agre ment is tarnainated prior to its completion,the work product of the Consultant,along with a summary ofthe services performed to da#e of defaul ortenaination,shall become the prope ty of the City, and tender of the work prQduat and swmrnary shall be a prerequisite to final payment under this Agreement. The summary of services provided shall be prepsred at no addifiional cost, if the Agre ment is terminated thmugh default by the Consultant. If the Agreement is terminated throu h convenience by the City,the City agrees to pay Consultant for the pre,paration of the summary of services pmvided. 6. Public Record. b.1 Consultant acknowledges that the City is an agency subject tio Chapter 42.56 RCW Public Records Act." All preluninary draf s or notes pr pared or gathered by the Consultant, and recommendations of the Consultant are exempt prior to the acceptauce by the City or public citation by the City in connection with City action. 6.2 If the Consultant becomes a custodian of public records of the iiy and request for such records is received by the Ci#y,the Consultant shall respond to the request by the City for such records within five (S) business days by either providing the records,or by identifying in writing the additional t me neoe sary to provide the records with a deseription of#he reasons why additional time is needed. Such add.itional time shall not exceed twen y (20}business days ualess traordinary good cause is shown. 6.3 In the event the City receives a public records request for protected work pmduct of the Consultant within its possession, the City shall,prior to the release of any protected work product or as a result of a public records request or subpoena, provide Consultant at least ten{I O)business days prior written norice of the pendin$ Professianal Seavices Agreemant—AP Tritotl LLC GMT Cost Report FY2024/2021 Page 3 of 11 release ead to reasonably coop e with any legai action which may be inidated by the Consultant to njoin or otherwise prevent sucd release, 7. Indeaendent Contractor Relat onslua. 7.1 The parties int nd that an indeg ndent contractor relationship is created by tbis Agree nent. The City is u tere.sted primarily in the resutts to be arclueved;subject to the scope of services and the specific requirem nts of this Agreemen the impl mentation of services will lie solely with the discretion of the Consultan No agent,employee,ofCcer ar representative of tbe Constiltant sh a11 be deemed to be an employee,ag nt,officer,or represeatative of the Citty for any puxpose,and the employee.s of the Consultant are aot entitled to any of the benefits or privileges the City provides for its employees. The Consultant will be solely and entirelyresponsibleforitsac and for he acts of i s agents, employees, offxcers, subcontr actoxs or representatives during the performance of tb is Ageement. 7.2 In the performance of the services provided in this Agreement, Consultent is an independent ooahraactor with fi ll authonty to control and duect the performance of the details of the work,how er,the resvlts of the work eontemplated herein must meet the approvat of the City and shall be subject to the City's general rights of inspeCtion and review to secure the satisfactory completion thereo 3 The Consultant shall comply with all State and Federal laws including, but not limited to: 7.3.1 The definition requirements of RCW 50.04.140(Employsnent Sec,rnity). 3.2 RC hT 51.08.195(Industrial In,Ice). 7.3.3 Obtain a City of Pasco busin ss lic nse. 7.4 The Ci#y may,at its sole discretion,require the Consultant to remove any mployce, ageat or s rvant from mploymeat on this Projeet who,in the City's sole discretion, may be detrimeatal to the City's urteresk 8. IndemniScat on. 8.1 The Consultant shaU defend, indemnify, and hold haru e.ss the City, its officers, officials, employees, and volun#eers harmless from any and alI claims, injuries, damages,losses or suits iacluding attorney fees,arising out of or resulting from the acts, ernors or orniss ons of the Consultant in performance of tlus Agreement, except for injuries and dannages caused by the sole negligence of the City. 8.2 However, should a vourt of conagetent jurisdiction determine that this Agreement is subject to RCW 4.24.1 I5,then,in the ev nt of liability for dainages arising out of bodily injury to persons or d mages to properiy caused by or resulting€rom the Professian8l Services Agrcea ent—AP Triton LLC GMT Cost Report FY2020/Z021 P ge 4 of l 1 concurrent negligence of the Consultant, and the City, its o cers, offcials, einployees, and voiunteers,the Consultant's liability,including the duty and oost to defead,hereunder shall be only to the extent of the Consu tant's negligence.It is fiuther specifically and expressly uaderstood that the indemmific,ation provided herein constitutes the Consultant's waiver of immunity under Industrial Ynsurance, Title 51 RCW,solely for Fu goses of this indem nification. Tbis waiver has been mutually negotiated by the parties.The provisions of ttvs section shall survive#he expira ion or termination of this Agre nent. 8.3 No li ' 'ty sha11 attach to the City by resson of entering into this Agreement except as expressly provided herein. 8.4 Tb is indemnifica ion sball include damages,pe alties aad attorney fees sustain d as a result of Consultant's delayed or failed gerform mce of Sec ion 6 above. 9. La uraace, The Consultant shall proa re and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to pr+operiy whicd may arisefromorinconnectionwiththepeformaaceoftheworkherevndrbytheConsultt,its ageats, rePres tatives, employees, or suboontrac;tors. The Consultant's maintenance of insurance as required by the Agreement shall not be cons rued to limit the liability of the Consultant to the coverage provided by such insuranoe, or atherwise limit the City's rec;ourse to aay remedy available at law or ia equity. 9.1 Min Scope of Insu3raace. Consultant shall obtain insurance of the types and coverage descnbed below: 9.I.1 Automobile Liability insurance covering all owned,non-owned,hired and leased vehiclees. Coverage shall be at least es broad as Insvrance Services Offce(ISO)form CA 00 l. 9.1.2 Conunercial General Liabi ity insuraace shall be at lesst as broad as ISO occ nrence form C{00 Ul and shaU vover liability arising from premises, opera.tions, stop-ap independent contractors and personal injury and advertising injury.The City shall be named as en a+dditional insured uader the Cotisul t's Commercial General Liability insurance policy with respect to tlie work p rrfonmed for the City using an additional ins d endorsement at least as br+oad as ISp endorsem nt form CG 20 26, 9.1.3 R orkers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington, 9.1.4 Professionat Liability insurance appropriate to the Consultant's profe.ssion. 9.2 Mu imum Amounts of Ins oe. Consultant shall maint in the following insuraaoe linrits: Professia al Seivic.es Agre ment—AP Triton LLC C3M'I'Cost Repart FY20201202I Page S of 11 9.2.1 Automobile Liebilifiy insuranoe with a minimum combined sing e limit for bodily injury and propea[y dmmage of$1,U00,Q U per accident. 9.2.2 Commercial General Liability inst ance shall be written with Iirnits no less than: 1,000,000 each ocq rrence;and I $2,00,000 general aggreg te; 9.2.3 Professional Liabilifiy insurance shall Ue wri,tt n with limits no less than: 1,040,Q00 per ctaim;and 1,4Q0,000 policy aggregate limit; 9•3 Othe Insu ance ro'vision• The Consultant's Automobile Liability and Comm ciai Ge,s eral Liability insurance policies are to contain,or be endorsed to contain that they shaU be primary insurance withrespect to the City.Any insttrance self-insurance,or self-insured pool ooverage maintained by the City shall be excess of the Consiiltant's insurance and shall not conbribute with it. 9.3.1 The Consultsnt's insurance shall be endoised to state that voverage shall not be caacelled by either Party,except af thirty(30)days prior arittea notioe by c.ertified mail,retura receipt requested,has be n given to the City. 9.4 ,ccep . .ty of Inswrers. Insura nce is to be placed with insurers with a curnent A.1VI.B st rating of not Iess than A:VII. 9.5 V nification of Cove e. Consultant shall fin aish the City with origiaal certificate and a copy of the ameadatory eadorsements, inciuding, but not necessarily Iimited to,the additional insured endorsement,videncing the insurance requir ments of the Agreement before commencement of the work. 9.b No ice of Canceilation. The Consultaat sha1l provide the City with wriften notice of amy policy cancellation withiu two (2) business days of their receipt of such nohce. 9.7 Citv Full Avaiiabititv of Consultant Limits. If the Consultant m,aintains bigher insurence limits than the minimiuns shown above,the City shall be insured for the fuU available limits of Commercial G neral and g,xcess or Umbrella liability rnaintained by the Consultant,imespective of whether such Iirnits maintained by the Consultant are greater th ui those requirecl by tbis Agree nent or wh ther any oertificate of i.nsurance furnished to the City evidences lunits of liability lower then those mai.ntained by the Consultenk 9.8 Failwre to Maintain nsurance,Failure on the pert of the Consultant to maintain the insurance as required sha11 oonstitute a matezial breach of contract,ulson which the Professional Sarvioes Agreement—AP Triton LLC GMT Cost Report FY2020f2021 Page 6 of i l City may,after giving five(5)business days notice to the Consultant to c omect the breach,im mediately termiaate the Agre ment or:at its disaretion,proctue or renew such insurance and pay eay and all prem ums m connection thereantb,with any stmns so expended to be repaid to the City on demand,or at the sole discretion of the City,offset against fuuds due the Consultant from the City. 10. Noad scriminaf on. In the performance of this Agrreement, the Consultant will not discriminate against any e ployee or applicant for employment on the grounds of racey creed,color,national orig,nn,sex,marital status,age ar the presence of any sensory,m nta,t or physical handicap;prov ded that the pr lu ition against discnimination in employment because of handicap shaU not apply if the perticuIar dis b ity prevents the proper perfor aQance ofthe particular workermvolved. The Consult t shall ensure that applicamts are ea ployed, and that employees are t eated during employment in the perfonn ce of tbis Agreemeat without discrimination because of their race,c+eed,color,nation,al origin, sex, marital status, age or the presence of any sensory, mental or physical handic p. Consult nt shall take such action with respect to tbis Agreement as may Ue required to nsure fnll compliance with local, State and Federal laws prolu iting disc:rimination in employment 11. Covenant.A ainst Cont ngent Fees. The Consultant wan ants that it has not employed nor retained any company, fYr m, or person, other thaa a bona fide employee working exclusively for the Consultant,to solicit or se.cure t ris Agreem nt;and that it has not paid or a reed to pay any company,pe son or fu m,other thaa a bona fide e nployee warldng exclusively for the Consultant, eny fee, commission, p rcent ge, bmkerage fee, gift, or other consideration contengent upon or resulting n the award or making of this Agreernent. For breach or violation of this wananty, the City shall have the right to tenainate this Agreemeat. 12. Assf uneat and Snbrontractin$. 12.1 The City has awarded this Agreement to the Consultant due to its unique qua ifications to perform these s rvices. The Consultant shall not assign {or subcont rract other than as specifically ideatified in Exhibit A)its perform pnce und r this Agreement or any portions of this Agtreme t without the prior written oonsent of the City,whieh consent must lie sought at least thirty(30)days prior o the date of any progosed assignment. • 12.2 Any work or services assigned or subcontracted hereunder shall be sub ect to each provision of this Agreement includ;ng Section 6, Public Records; Section 10, Nondiscrimination;proper bidding prcx dures where applieable;aad all local,State and Federal statutes,ordinances and guidelines. 12.3 Any tecbnieal or professional service subcontract not listed in this Agreemeat,must have prior written approval by the C ity. Ps fessiaaal Se vices Agiremeat—AP T non LLC GMT Cost Report FY2020/2021 Page?of 11 13. Termuina ion. 13.1 Tenmination foar Convea nieace. Either patty may terminate tbis Agreement for any resson upon giving#he oth rparty no less than ten(]0}business days writtea notice in advance of the effeative date of such termiaa ion. I3.2 Teraunation for Cawse. If the Consultent fails to perform in the inaaner caUed for in tlus Agreemeat,or if the Consuttaat fails to comply with aay other provisions of tbis Agre ment and fails to oon ect such noacompliance within,five {5)business days of writtea notice thereo the City may terminate this Agreement for cause. Tezmination shall be effecctive by serving a notice of tenninatioa on the Consultant setti ng forth the manaer ia which fhe Consultant is in defaul The Consultaat will only bepaid forservices and expe comp yiag with the te ms ofthis Agreanent, inCurred prior to tenmination. 14. General Provisions. 14.1 For the purpose of this Agreement,tune is of the esseace. 14.2 N_otice. Notice provided for in this Agrcement sha11 be sent by: 14.2.1 Personal se vice upon the Project Administrators;or 14.2.2 CertiBed mail to the physical address of the parties, or by elec c+onic mission to the mail ddresses designated for the parties below. 14.3 The Projeat Administrator for the pwpose of this Agreemeat shall be: 14.3,1 For the City: Richa Sigdel,or his/her designee Finance Director 525 N 3 Ave Pasco,WA 99301 si dek asco-wa. ov 14.3.2 For the Consultant: Kurt H nke,or his/her designee 1309 Coffeen Avenne,Suite 3178 Sheridan WY 82801 info,cr aptniton,com 15. Disnnte Resolut on. 15.1 This Agreement has been and sball be cons rued as having been made and entered into and delive red within the State of Washington aad it is agreed by each pariy hereto tb at this Agreement shall be govesned by the laws of the State of Wsshingtoa Professional Services Agreem t—AP Trfton L!C GM'T Cost Repart FY2020/2021 Pege 8 of 11 1.Z In tdl event ol a dispute re arcling tlie enforceme t, breach, def ult, or interpl etaiion of f is Agrccment, the P['oject rlc rj inisErators, OC Cll li' C eSlailCCS shall first rneet in a ood faith ef iort to z'esQlve sucl c is ute. n the event thc dispute caE not be resa vcd hy a reement of thc parties, said disp Ee shal be resolved by arbiNatio pursuant to CW 7,44A,as amec cied, vith ro l parti s wai ing the ri;lit of a jury t-ia uE on [rial de no o, vitl venuc placcd in Pasco; Franklin County, Washin ton. 7'Ite substantially revailing party shal! b entitled to its reasonable attortley fees a d costs as additiona! awarc and jud 3ne«t against the other. 16. Nanwaiver. Waiver by tiic City of any provision of tlus A eement or any time lin itation provided for in t is Agrcerne t sl all not canstitute a ty ivcr af any other similar event or ot3 er pro ision of this Agree nent. 17. Intc ration. This .•ec mcn het vee tlte pattics consists ii its entirety tif this docwn i and any eahibits,scl edules or attachinents. Atly mc dificat on of t iis A•eement or chan,e order affecting tJ is r grecm nt shall be in writing a ld signed by both parties_ 1$. Authorization. By si ature below, each party wa3rrants tliat they are authorized ai c eir po vered to execute ihis A-cen ent binding t c Ciry and thc Coy st ltant respectively. IN VIT IESS tiVH REOF, the arties f3ave caiised ti3is A eement to be zxecuted on the date first «-ritien above, C1TY OF PA$C, ASHING`Oti CO SULTAI`'I' 0 t ---- -_ .......-----------._ Ri Iia Sigdcl, Fint i ce Dircctnr Kurt P. Henkc,Principle/Ianaging Partncr ATTEST: c . Debr t C. Barham, City Clerk APPROV;D AS TO rOR Vi: Keir 1=ex aw, PLLC, C:ity Atiorriey Profcsssa[i11 S rvi e,A wrccanenF—AP Triton LLC GMT Coy Rrpon F1'3D20r2021 Paqe 9 of 13 EXSIB A Scope of Services GR UND EN RGENCY MEDICAL TRANSgORTA'T t)N CUNSULTING RESP(?NS BII S C4NSULTANT sball provide cansulting servi ces t o t e CLIBNI'as follows: CONSULTANT ghall annually prepare the cost report t CLIL NT submits to the State of Washington in order for the CLIENT to participate in the State's GEMT Program.CANSULTANT shall prepare the cost reports in accor ance with all federal,stste,or maaicipal laws or regnlations. CONS`ULTANT sball provide CLIEI]TT wit]the cost report aa.d all supportiag documentation ta the agreed upon email address. Tt shall be the CLIENr'S responsibility to file#he cost reFort with the State of Vashington. CLIENT sh ll meet CONSULTANT's established deadlines for data submissioa and do ument reviews. There shall be a cap of 30 hrnn s per month on all services provided,u,nless exbended by mutual agreement of the parties. As part of the fee set forth ia this F.hibit,CONSULTANT shall provide CLIEN'r wrth four(4) hours of audit assistance,either in pe rson(if the audit is conducted onsite)or thraugh telephonele.mail if the andit is a desk audit). Travel expenses will be billed to CLIENT as set fortli ia gxhi'brt B. Any pragra ns,projects or additional work beyond the 30-hour moathly cap can be ttegoti ted an a project basis cost by the party's or at 4Q0.0 per hour. Professi ai Services Agrecmeat—AP Triton LLC GMT Cost Report FY2020/2021 Page 10 of 11 t Y Payntent Terms A. SCSEDULE Seivices to be performed under this Agreesneat will begin at the time the Agreeme nt is executed. B i Related ttavel expenses such as airfare,hotel, and m eals will i e billed at actuel cost and will l e approved by the CLIENT prior to tr vel. C. TUTAL PAYMEN'.A,,MQUNT Services unaer the contract provi@ed by the CONSULTANT shall be compl ted for a fee of 7,SQ0 plus 3%of gross pmfits ger year,for a ter a of one l)year. The fee sch dule refer aced he rein hall remaia unchanged for the ferin of the contract. Invoices for payment will bc provided to the CLIENT ugon the campletion of the cost nport,to the address pro ided under the contract. Paym nt will be due within thirty(30)days of invoice p stmark. It will be the CLTENT'S responsibility to notify CONSULTANT of any changes to th,e name and/or address on recard for the purposes of invoicing. D. PAXMEN''COVERAGE If a monthlY I Ym schedule is requested by the CLIENT and agreed to in writing,the monthly PaYment hall be payment fvr all services as described in Fxlv.bit A and any apgmved c osts,iacluding unlimited teleghone and/or videoconferenciag.Personal conference as ae essary for cvmpletion of the repart sball be included op to fow(4)times per mantlL E. anDrrxo v.,s v c s Any requests for services beyond the soope of sernices set farth in Fxlu'bit A shall be billed at the rate of Fow Hundred dollars($400.00)pe hour or a negotiated fxed cost for special pro3ects,performing any services unc er this pr vision r+equines prior writt n approval of hoth parties. Contact iaformation for b'illing purposes is as follows: CLIBNI': City of Pasco Atta:Richa Sigdel,Finance Director 525 N 3nd Avenue Pasco,VfIA 99301 Phone number:(509)544 3Q65 Email address:sigdelr@pasco-wa.gov CONSULTANT:AP Triton,LLC Attn:Va2erie Frwia 1309 Coffeen Avenue,Suite 3178 Sheridan WY 82801 Phone nwo ber:916.2I7.2499 Email address:ve rwin@aptriton.com Professional Services Agreemeat—AP Triton LLC G ZQ 021 Page 11 of 11 WLTR005 THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 March 29, 2021 FOR INFORMATIONAL PURPOSES ONLY 1851 HERITAGE LN STE 138 SACRAMENTO CA 95815-4996 Account Information: Policy Holder Details :AP TRITON CONSULTING LLC Contact Us Business Service Center Business Hours: Monday - Friday (7AM - 7PM Central Standard Time) Phone:(866) 467-8730 Fax:(877) 905-2772 Email:nutmegins@thehartford.com Website:www.thehartford.com Enclosed please find a Certificate Of Insurance for the above referenced Policyholder.Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/29/2021 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 SUBROGATIONIS 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 USI INSURANCE SERVICES LLC/PHS 41715154 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251 CONTACT NAME: PHONE (A/C, No, Ext): (866) 467-8730 FAX (A/C, No): (877) 905-2772 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED AP TRITON CONSULTING LLC 1851 HERITAGE LN STE 138 SACRAMENTO CA 95815-4996 INSURER A :Atain Speciality Insurance Company 17159 INSURER B :Starstone National Insurance Company INSURER C : 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/Y YYY)LIMITS A X COMMERCIAL GENERAL LIABILITY CIP422266 03/27/2021 03/27/2022 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence)$100,000 MED EXP (Any one person)$5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) B UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS- MADE 78295D210ALI 03/27/2021 03/27/2022 EACH OCCURRENCE $1,000,000 x AGGREGATE $1,000,000 DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/ A PER STATUTE OTH- ER Y/N E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. For Informational Purposes Only. CERTIFICATE HOLDER CANCELLATION FOR INFORMATIONAL PURPOSES ONLY 1851 HERITAGE LN STE 138 SACRAMENTO CA 95815-4996 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD