The URL can be used to link to this page

Home My WebLink About06. Auth PSA w HCA Asset Mgmt for Fixed Assets Physical Inventory Consultant SvcsItem No. APPROVED CITY MANAGER TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL FOFFICE F THE CITY MANAGER L H. GANDHY, DIRECTORFINANCE DATE: JULY 26,, 2022 PHYSICALSUBJECT: FIXED ASSETS RECOMMENDATION That the City Council authorize the City Manager to enter into a professional services agreement i Asset Management, LL ( CA) for Fixed Assets<Physical Inventory Consultant Services. DISCUSSION The City of Downeyrequested proposals from liie consulting firms for comprehensive Fixed Asset Physical Inventory and Valuation Services. The following objectives v been identified for this project; Financial R The City of Downey has a responsibility to maintainaccurate complete fixed asset records in order to properly report fixed assetinformation in financial reports issued o external reporting agenci s and the public. Specifically, fixed assetrecords should maintained in order to ensure that financial reports: 1. Comply withGenerally Accepted Accounting rich s ( ); Comply2. ith funded grant provisions; and 3. Meet the requirements 34 financial reporting. Accountability Control: The City of Downey also has a responsibility to establish systems, procedures and controls o safeguard assets from loss or theft. Therefore; Fixed asset records must be sufficient to control the movement and dispositionof fixed assets and to establish accountability for any loss or Fixed Assets Physical; Inventory Consultant Services JUNE 28, 2022 Project Outline` c+ olun ing/Co trot Policies In accordance with the City of Downey's capitalization (accounting and reporting) policy, all fixed assets with a unit cost of over $5,000 and a normal life of more than one year, will be included in the inventory. In addition, in accordance with the City of Downey's accountability and control objectives, all Information Technology and Federally Funded equipment with a unit cost over $500 and a normal life of more than one year will be included in the inventory and subject to placement of bar code tags as described below. BAL92dDLIM The consultant firm will be responsible for applying bar code tags to machinery and equipment, in accordance with the City of Downey's control policy and objectives, and including the tag numbers in the fixed asset accounting records. Placement of the tags will be applied in consistent locations with procedures formalized with the City of Downey prior to beginning the fieldwork. Ti Ln in eaeire eats The City of Downey expects that this project will be completed by the financial closing, FY 2021-22, in September of 2022. The consultant will set forth the proposed work schedule and plan to complete all phases of the work before the specified timeframe. On April 18, 2022, the City of Downey issued a Request for Proposals (RFP) for Fixed Assets Physical Inventory Consultant Services. The RFP was posted on the City's Planet Bids online bidding system. One hundred, ninety-one'(191) vendors were notified, and the City of Downey received five (4) proposals. W-111PRIMMIRM11I • /1 1t OHC Property A• • 11 1/ - .•- - '. 1 /1' A City of Downey panel of four finance department staff members reviewed and scored the submitted proposals and selected HCA. HCA is a responsive and responsible bidder that has completed two previous inventories for the city and is fully capable of undertaking the scope as outlined in the RFP. Therefore, staff is recommending that the City Council approve a professional services agreement (Attachment A) with HCA for Fixed Assets Physical Inventory Consultant Services, in the amount of $33,350.00, for services for FY 21/22, and authorize the Director of Finance to approve two renewal options for services for FY 23/24 and FY 25/26. 2 Fixed Assets Physical Inventory Consultant Services JUNE 28, 202 FISCAL IMPACT The total cost of services is This project is included in the finance department line item budget account no. 1 - -10-7. ATTACHMENTS Attachment A - ro ssion l Services Agreement Attachment sProposal 3 AGREEMENT FOR PROFESSIONAL SERVICES THIS AGREEMENT FOR PROFESSIONAL SERVICES ("Agreement") is entered into this t f July, 2022, by and between the CITYY, a Californiamunicipal corporation and charter city (hereinafter referred to as "CITY") t Management, a Florida, i r referred o "CONSULTANT"). NOW, THEREFORE, for and in consideration e mutual covenants and conditions herein contained, CITY and CONSULTANTagree s follows: SECTION This Agreement is made andentered into with respect to the following facts: () CITY has considered the r os 1, dated May 2 "d , 2022 (the "Proposal"), from CONSULTANT for professional services, including, t not limited , providing the services scribed below in Section 6 of this Agreement. () CITY desiresto have a highly qualified company to perform such services. () CONSULTANT represents an arr s that it is qualified to perform such services ands agreed to do so pursuant to this Agreement; and () CITY desires to contract it n the basis of the following r s and conditions. SECTION 2. RETENTION OF CONSULTANT. CITY hereby retains T LT T hereby accepts such retention, o perform thoseservices under this Agreement. CONSULTANT represents that it is fully qualified such services by virtue of its experiencen r inin education n expertise of its principals and employees, if any. SECTION. INDEPENDENT The partieshereby acknowledge that CONSULTANT i, and shall at all times remain as to CITY, a wholly independent contractor shall not be considered to be an employee of CITY. Neither CITY nor any of its agentsshall have control over the conduct of CONSULTANT r any o employees, except as set forth in this Agreement. CONSULTANT shall not represent at it is, or that any of its agents or employees are, in any manner employees of CITY. In the event that CONSULTANTor any employee, agent, or subcontractor of CONSULTANT providingices under this r nt claims or is determined by a court of competent jurisdiction or the CaliforniaPublic Employees Retirement System ( I ) to be eligible r enrollment in CalPERS as an employee of CITY,CONSULTANT shall indemnify, defend, and hold harmless CITY for the payment of any employe and/or employer contributions for CalPERS benefits on behalf of CONSULTANT or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise the responsibility of CITY. SECTION . PRINCIPAL REPRESENTATIVE The Downey Finance Director of CITY shall be the principal representative of CITY for 123959 purposes of this Agreement. a shall be the principal representative of CONSULTANT for purposes of this Agreement. SECTION 5. CONSULTANT NOT AGENT OF CITY. A. CONSULTANT shall have no authority, expressed or implied, to act on behalf o CITY in any capacity whatsoever as an agent. B. CONSULTANT shall have no authority, express or implied, pursuant to this Agreement o incur any debt or liability on behalf of CITY or otherwise bind CITY to any obligation whatsoever. SECTION 6. SCOPE OF CONSULTANT ill diligently perform the tasks, in a goodand workmanlike manner, which are morespecifically identified in the Proposal, attached hereto and incorporated herein by reference as Exhibit A, unless otherwise modified or waived in writing City Manager. SECTION CONSULTANT shall perform all services required pursuant to this Agreement in the manner and accordingto the standards observed by a competent practitioner of the profession in which CONSULTANT is engaged in the geographical area in which CONSULTANT practices his or her profession. SECTION A. CONSULTANT shall devote such time to the performance of services pursuant to the Agreement as may be reasonably necessary for satisfactory e or nc o C . SULTAN T's obligations pursuant to this Agreement. B. Neither party shall be considered in default of this Agreement to the extent performance is prevented or delayed by any cause, present or future, which is beyondthe reasonable control of the party. SECTIONII A. CONSULTANT represents and warrants to CITY that it has all necessary professional licenses and/or certificates to legally perform the services under this Agreement. B. CONSULTANT represents and warrants to CITY that CONSULTANT shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this Agreement all necessary licenses and certificates required of CONSULTANT to perform the services. TERM.SECTION 10. , The term of this Agreement shall commence on July 26th, 2022 and terminate on June , 2023, The term of this Agreement may be extended for two additional Fixed Asset Physical Inventory counts, performed every two years, by a written amendment to this Agreement signed by the Director of Finance and CONSULTANT. SECTION 1; COMPENSATION. A. CONSULTANT will perform those tasks and deliver the services described in this 2 Agreement, in accordance with the terms and provisions of this Agreement for a total contract price not to exceed thirty-three thousand, three hundred Dollars , unless specifically approved in advance and in writing by the City Manager. CONSULTANTB. shall be paidthe compensation at the payment intervals t forth in the Payment Schedule (Section }. Authorized o shall be in strict compliance wit r nisi f this Agreement. CONSULTANT shall provide all labor, materials and equipment, as necessary to performthe services under this Agreement without any additional charge or compensation. CONSULTANT shall not charge for travel time or break time. SECTION CONSULTANTA. Il submit o CITY a monthly itemized t t nt which indicates work completed curs of Servicesrendered by CONSUL . The statement shall describe the amount of Services and supplies provided since the initial commencement date, or sine the start of the subsequent illin periods, as appropriate, through the datef the statement. CITY shall, within thirty () days of receiving such statement, review the statement and y all approved charges r o. CONSULTANT shall be entitledto payment of the Compensation in those amounts and at the tires set forth herein: i. Due upon completion of the Services (s defined in Exhibit ) $33,350 TOTAL: Provided the Services have been rendered satisfactorily to CITY and in accordance i this Agreement, CITY shall tender payment to CONSULTANT not later than thirty (30) days following each of the milestonetimes set forth above. B. CITY shall make no payment for any extra, further, or additional services not expressly set forth in this Agreement unless such extra service n the pricethereof is agreed to in writing and executed by the City Manager prior to the time that such extra service is rendered. SECTION 13. COMPENSATION WITHHELD. A. m e CITY shall have reasonable grounds for believing that CONSULTANT will be unable to perform this Agreement fully and satisfactorily within the time fixed for performance; or a meritorious claim exists or will exist against CONSULTANT or CITY arising out of the negligence of CONSULTANT or LTA T's breach of any provision of this Agreement, then the CITY maywithhold payment of any amount otherwise due and payable to CONSULTANT under this Agreement. Any amount so withheld may be retained by CITY for that period as it may deem advisable to protect CITY against any loss and may, after written notice to CONSULTANT, be applied in satisfaction of any claim described here. C. This provision is intended solely for the benefit of CITY and no person shall have any right against the CITY or claim against CITY by reason of the CI 's failure or refusal to withhold monies. I interest shall be payable by CITY on any amounts withheld under this provision. e This provision is not intended to limit or in any way prejudice any other right of CITY SECTION CITY shall have the right to audit and inspect all books and records kept by CONSULTANT in connection it h operation n services e under this Agreement. CONSULTANTshall maintain full and accuraterecords i respect to all matters covered under this Agreement for a periodthree rs after the expiration or termination of this Agreement. [ shall have the right to access and examinesuch records urin normal business hours and to audit such records, to make transcripts therefrom an inspect all program dat, documents, proceedings and iviti . OWNERSHIPSECTION 15. 1 All reports, cu r other written material ("written products") developed CONSULTANTin the performance of this Agreement shall be andremain property of CITY without restriction r limitation upon its user dissemination by CITY.LT e e and retain copies f such writtenproducts as desired,but no such rit n products shall be the subject of a copyright application . To the extent applicable, CONSULTANT represents and warrants that CONSULTANT has the legal right to utilize all intellectual ro T T will utilize in the performance of its obligations pursu t tot is Agreement. CONSULTANT further represents CONSULTANT shall ensure CITYs the legal right to utilize ll intellectual property involve in and/or resulting r L 's performance of thisAgreement. All data,documents, discussion, or other information v lb r received CONSULTANT r provided for performance of this Agreement are deemed confidential and shall not be disclosedy CONSULTANT without prior written consent ITY. CITY shall grant consent if disclosure is legally required. I[ CITY datashall be returned to CITYupon the termination or expiration of this r SECTION ® RIGHT OF TERMINATION. A. This Agreement may be terminated by either party with or without cause, upon ten (10) days written notice tote other party. B. All work shall cease t the conclusion of the notice period andT shall be paidfor all services satisfactorily provi ed prior to termination in accordance with rates as provided in this Agreement. C. All CITY data, documents, objects, materials or other tangible things shall be returned to CITY upon termination or expiration of this Agreement. SECTION 17. INDEMNITY. A. General Indemnification. Except as provided in subdivision () below which i applicable to "design professionals" only, CONSULTANT shall defend (with counsel acceptable to CITY), indemnify nd hold the CITY, its officials, officers, employees, volunteers and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, 4 directly or indirectly, in whole or in part, from CC ULTA T's negligence, recklessness or willful misconduct. CONSULTANT'SSECTION 18. LIABILITY LIIC LIABILITY AND PROPERTY CONSULTANTll assume all responsibility for damages to property or injuries to persons, including cci tl death, which may be causedT's negligent performance aft is Agreement,whether such performancey themselves, or their agents, or whether such I ccru or be discoveredfore or after termination f this Agreement. SECTIONs LIABILITIES. A. CONSULTANT shall not assert any claim ri in out of any act or omission y any officer, agent, or employee of CITYin the executionr performance of this Agreement against that officer, agent or employee. B. Nothing in this re nt shall be construed to given r on other tn CITY and CONSULTANT ny legal or equitable rights, remedy or claim under this Agreement. INTEREST.SECTION 20. CONFLICT OF A. CONSULTANT covenants that neither it nor any officer of the corporation, or partnership, s the case may be, has any interest, nor shall they acquire any interest, directly or indirectly,is ul conflict in any manner with the performance of L T's services under this Agreement. B. CONSULTANT further agrees that in the performanceof this Agreement, no person having an interest of the abovenature II be employedy him or her. person contracts it I , either for the rendition of personal services shall n contribution to a CITYofficial or candidate for CITY office. NOTICES.SECTION 21. Any notices, bills, invoices or reports required y this r ent shall be deemed received : (1) the dateif deliveredy hand, facsimile r overnight overnight courier service during L or 's regular u in r ; or () on the third business day following osi in the United States mail if deliveredby mail, postage prepaid, to the addresses lists la (or such other addresses as the parties may, from time to time designate in writing): TO CITY. City of Downey 11111 Brookshire Avenue Downey, CA 90241 Attn: Director of Finance With courtesy dopy to: City of Downey City Attorneys' Office 11111 Brookshire Avenue Downey, CA 90241 TO CONSULTANT: HCA Asset Management 214 4th Ave Circle East Bradenton, FL 34208 Attn: Gregory P. Sheehan SECTION ® BINDING This Agreement shall be bindingupon the parties hereto and their successors in interest. SECTION 2. CONSULTANT shall not assign, transfer, convey, I r otherwise is os of its rights or obligations run r, except the payment of funds from CITY,it out prior written consent of CITY. Anyattempt by CONSULTANT to assign, transfer, convey, pledge or otherwise i os of its rights or obligations herun r without the City'sriot written consent shall make such assignment, transfer, conveyance, ! or other disposition null and void. B. The consent f CITY to an assignment shall not be unreasonably withheld, but prior to approving an ssi n ent involving the performanceof anyobligations ursu nt to this Agreement, CITY shall be satisfied y competent evi that the assigneeis financially able and tonically qualified to perform thoseservices proposed to be assigned. In the event of such ssi n, CITY may condition the same so as to ensure compliance with the provisions of this Agreement. D. I consent to one assignment shall not be deemedto constitute consent to future ssi n ent ckn 1 s that 's written consent must be first obtained prior to eachassignment, transfer, conveyance, I or other disposition, COMPLIANCESECTION 24. I CONSULTANT shall comply ith all applicable laws in performing its obligations under this Agreement. CONSULTANT shall be liable for all violations of such laws and regulations in connection i this Agreement. If the CONSULTANTany work knowingit to be contrary to such laws, rules regulations n it t giving written notice to the CITY, CONSULTANT shall be solely responsible for all costs arisingtherefrom. T shall defend, indemnify and holdCITY, its officials, directors, officers, loy s and agents free n harmless, pursuant to the applicableindemnification r vis! ns of thisAgreement, from ny claim or liability airising out of any failureor alleged failure to comply with such laws, rules or regulations. LT T's violation of such laws, rules and regulations shall also constitute a material breach of this Agreement. SECTION. INSURANCE, A. Time for CoMpliance. CONSULTANT shall not commence the Services or the Project under this Agreement until it has provided evidence satisfactory to the CITY that it has secured all insurance required under this section. In addition, CONSULTANT shall not allow any subcontractor to commence work on any subcontract until it has provided evidence satisfactory to the CITY that the subcontractor has secured all insurance required under this section. The CITY reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience with insurer, coverage or other special circumstances. 7 3 B. ini u euire ntso CONSULTANT II, at its expense, procure maintain for the duration of the Agreement insurance against claims for injuries to persons or damages to property hick may arise from or in connection with the performanceof the Agreement, the Services or the Projecty the CONSULTANT, its agents, representatives, employees or subcontractors. CONSULTANT shall also require II of its subcontractors to procure n i t in the same insurance for the duration of the Agreement. Such insurance shall meet at least the following mini u levels of coverage: (i) Minimum . Sgqpq f Insurance. ,(1) Commercial General Liability (C ): Insurance Services Office Form1 covering CGL on an"occurr n" basis including products and completed oper tion ro damage, bodily injury n rsonal and advertising injury; (2) Automobile Liability-. Insurance Servis s Office FormNumber CA 0001 covering o 1 (anyauto) or if CONSULTANT owns no autos, Code 8 (hired) and 9 (non -owned); and ()Workers' Compensation : Workers' Compensation insurance as required y the Stateof California withtut Limits; and () Employer's Liability Insurance. (ii) Minimum Limits of Insurance. CONSULTANT _shall maintain limits no"less n: (1) Commercial General Liability ( L)m No less than $2,000,000 r occurrence for products and completed oper tions, bodily injury, property damagen personal and advertisinginjury. If Commercial r i Liability Insurance r other form ith general agr t limit applies, either the general aggregate limit shall apply separately t o this Agreement/location (ISO CG 25 03 or 25 04) or the general aggregate limit sII be twice the required cc rr nc limit; () Automobile Liability. No less than $2,000,000 per accident for bodily injury and property damage; and()Workers' Compensation' Workers' Compensation limits as required y Labor o oft State f California it tut Limits; () Employers Liability: Employees Liability limits of no less than $2,000,000 per accident for bodily injury or disease. Employer's Liability coverage ive y the I if CITYreceives written verification that CONSULTANT has no employees. If the CONSULTANT in Ens broader coverage and/or higher limits than the minimumshown in this subdivision 3.2.10.2, the CITYrequires and shall be entitledto the broader coverage and/or the higher limits maintained by the CONSULTANT. Any available insurance proc e s in excess of the specifiedminimum limits of insurance and coverage shall be availableo the CITY. Professional i ilit (rror is� CONSULTANT shall procure and maintain, and require its sub -consultants o procure and maintain, for a periodof five (5) years following completion of the Services or the Project, errors and omissions liability insurance pro ri t to its profession. Such insurance ll be in an amount not less than $2,000,000 per occurrence or claim n 2, , in the aggregate, and shall be endorsed to include contractual liability. If the CONSULTANT i twins broader coverage and/or higher limits than the minimum shown in this subdivision ( ), the I requires and shall be entitled to the broader coverage and/or higher limits intain by the CONSULTANT. ny available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the CITY, SECTION 26. DISCRIMINATION. A. CONSULTANT re s that no person shall be excluded from employment in the performance of this Agreement on grounds of race, creed, color, sex, age, handicap or marital status, place of national origin or any other basis prohibited by local, State or Federal law. 8 B. CONSULTANT agrees to comply with all local, State and Federal laws relating to equal employment opportunity rights. ENTIRETYSECTION 27. This Agreement contains the entire Agreement of CITY andT i respect to the subject matter hereof, and no other agreement, statement, or promise made by any party, or to any employee, officer, r agent of any party, which is not contained in this Agreement shall be binding or valid. n ns or modifications to this Agreement shall be effective binding only if made in writing and executedt ie . SECTION In the event that any action or proceeding is instituted for the breach of this Agreement, the prevailing party shall be entitled to reasonable attorn s' fees. SECTIONI A is the intent n understanding of the partiesto this Agreement that every provision of law required e inserted in this Agreement is inserted here If through ist s or otherwise, anyof those rovisions are notinserted i correct form, then this r nt shall upon application of either, be amended insertion so as to comply strictly with the law andwithout prejudice to the rights of either party. C. If this Agreement contains any unlawful provisions, not an essential part of the Agreement and which appear nott have n a controlling or material inducement to the making oft is Agreement, those roisio s shall be deemed of no effect, and shall upon application of either party be stricken from the Agreement without affectingbinding rc of the Agreement as it shall remain r emitting those pr vision . SECTION In the event that suit shall be brought by either party to this contract, the parties agree that venue shalt be exclusively vested in the State courts of the County of Los Angeles or where appropriate, in the UnitedStates District Court, Central District of California, Los Angeles, California. SECTION This Agreement y be executed in counterparts, each of which shall be an original, but together shall constitute one and the same instrument. SECTIONaINTERNAL INCONSISTENCIES. If this Agreement contains any errors, inconsistencies with any attachments, ambiguities, r discrepancies, including typographical errors, CONSULTANT shall request a clarification of those items by writing to the City Manager whosedecision shall be binding upon the parties. SECTIONI The captions and headnotes or sections of this Agreement, and marginal notes are intended for convenience and reference purposes only and in no way define, limit or describe the scope or intent of this Agreement. SECTIONI In the n of any conflict, inconsistency, r incongruity between y provision oft is Agreement, any of its exhibits, attachments, purchase order, or notice to proceed, the provisions oft this r nt will govern andcontrol. SECTIONw CONSULTANT shall not subcontract ny portion of the work required y this r o nt, except as expressly stated r in, without prior written approval of CITY. CONSULTANTshall require and verify that all subcontractors maintain insurance meeti II of the requirements sot forthin this Agreement. CONSULTANT shall ensure that CITY is an additional insured n all insurance required from subcontractors. Subcontracts, if any, shall contain r visi kin them subject to all provisions stipulated in this Agreement. WITNESSIN , this r o t for Professional Services has been duly authorized n x cuff y the parties hereto on the y and year first herein above written. ,1 I f, CITY of Downey By ity Manager ATTEST: City Clerk APPROVE (y t orneyy "CONSULTANT" K a^ a - its: t ATTEST. r m i ecretary - 10 Page 1 of 1 A. Cover Letter : City of Downey Capital Assets Physical Inventory Consultant Services, The City of Downey (hereafter "City") is seeking to engage a qualified fixed asset management consulting firm,, Like HCA Asset Management LLC (hereafter "HCA"), to perform a Citywide physical inventory/audit reconciliation, tagging and valuation, of qualifying City owned assets. HCA understands that the engagement has two primary City objectives, financial reporting, and accountability control, as described in the RFP on page #3. HCA designed services will provide accounting reporting & valuation, financial reconciliation and audit support for assets currently maintained in the Fixed Assets module of EDEN from Tyler Technologies and Microsoft Excel schedules, supporting Property Control System thresholds and assets meeting The City's Capitalization Policies. HCA understands that The City of Downey has a responsibility to maintain accurate and complete capital asset records to ensure accurate financial reporting to external reporting agencies and the public. This is to acknowledge our understanding of capital asset accounting requirements supporting GASB Statement 3, ONIB A-21 & A-110, F&A Indirect Cost Recovery, Generally Accepted Accounting Principles (G ), and Government Accounting Auditing and Financial Reporting ( ) and our ability and experience to provide the required services. Our inventory methodology supports GAAP, GAAFR, A- 133, (now under the Uniform Guidance UG umbrella) audit standards. HCA is prepared to support e City and our engagement results upon State, Independent anda e l audit. On behalf of HCA Asset Management LLC, I will act as the City of Downey California engagement contact manager. With over 29 years of experience in providing inventory and valuation services to State and Local Governent(s), the Higher Education, Healthcare and Hospital Communities, it is my pleasure to work with and support The City in this important initiative. Please do not hesitate to contact me if we can provide further insight regarding the services proposed. On behalf of HCA, I am fully authorized to negotiate contracts with our clients. My contact information is as follows: HCA Asset Management Gregory P. Sheahan President 5214 4 h Ave Circle East Bradenton F1.3420 941.544.2369 direct 941.752.6330 office gsheahan@ ca .co Y lI e welcome and loo forweard to the opportunity to be of service to the City of Downey Better Data Means I. R tk,. ASS E 4 MAHa6E EHY Page 2 of 1 OEM==00= B. Company Description, Capability, and Experience HCA is a national full -service appraisal firm that specializes in providing asset inventory and valuation services to the public sector. HCA was established in 1985 with the primary focus on providing Building Component and Fixed Asset studies supporting Inventory Control, Financial and Federal cost reimbursement reporting, and accounting requirements. Since that time, our full time highly qualified team of professionals has increased in size and scope to provide asset valuation services to Federal, State and Local Governments, Public and Private School Systems, Colleges and Universities, Hospitals and Extended Care Facilities, Not for Profit Organizations, and the Hospitality and Insurance Industries. HCA possesses the financial stability and proven track record to assist your program today — and for many years to come. In 2022, we are celebrating 37 years of continuous service to our clients. Our experience working with Federal, State and Local Governments for the purpose of supporting Inventory Control, Financial and Federal Fixed Asset reporting requirements is second to none. Since our inception, we have assembled a team of valuation consultants with unparalleled experience in providing financial cost segregation (componentization), property and infrastructure valuation and appraisal conclusions and fixed and moveable equipment asset management services. With our extensive project management experience, we have the knowledge and expertise to establish consistent, reliable inventory and valuation conclusions. We are driven by a commitment to building and maintaininglong-ter relationships rather than short-term profits, and our clients will attest to this very basic.fact. Our professional services include the development and review of fixed asset policies and procedures, inventory and valuation of land, infrastructure, buildings, movable equipment, and the implementation of bar code equipment inventory systems, equipment re -verification studies and outsourcing of the property management function. Our engagement results are provided in a "far at that will intctface" with client supported fixed asset systems. HCA is a service -oriented business, dedicated to providing competitive quality solutions, and on time delivery of our engagement results. The HCA capital asset management services assist our clients with external audit requirements, financial and Federal reporting, and accountability and control of fixed assets. Our commitment to every client is complete satisfaction, from start to finis Our comprehensive capital asset management services include: Development and best practices assessment of asset management policies & procedures `Review of accounting/asset management systems GAS13 34, FASB and OMB A-21 (now uniform Guidance) capital asset consulting Compliance with OMB A-87, and A-133 Audit and Federal Cost Principals for State & Local Governments. OMB A-21 step down cost allocation services supporting our building component and movable equipment engagement results. Comprehensive asset inventory; Land, Infrastructure, Buildings, Movable Equipment Better Data Means ;, k, ,sk H CA Page 3 of l GE=E===N Space inventories/measurements, room use and data collection (i.e., building number, building description, room number, gross/assignable square foot, department (or), assignment of room type (HEGIS CODE) and Principal Investigator/Primary Occupant (I) etc. to support FA reporting Optimizing F&A rate calculations on capital equipment depreciation by allocation on room -to -room equipment match. Building Component Studies/Capital Cost Allocations supporting maximum Federal cost recovery benefits. RFID and Barcode tagging/use of optical Bluetooth scanners/re-verification studies Annual updating service (including on -site re -inventories and database outsourcing services) Calculation of depreciation supporting Financial & Federal reporting requirements Reports provided to meet financial reporting and insurance requirements Interface engagement results with Client supported fixed asset systems Contractor self -assessment services that address the requirements of Federal Acquisition Regulation (FAR) 52.245-1 KRPR Software and fixed asset systems integration Valuation conclusions on assets for insurance placement purpose of Replacement Cost New (RCN) under the appropriate premise of Fair Market Value (F ) A few things you should nu about our fig El We deliver what clients need/want, when we agree to do somissed delivery dates are unacceptable, both to you and HCA. We deliver only the highest quality product, after it has been thoroughly reviewed by Senior Management — we do things canoe and understand that your satisfaction is paramount to our continued success, e are not the largest valuation firm in the industry. and our clients enjoy the many benefits of this focus -- our goals do not include "top line' growth, but rather the emphasis is placed on long-term relationships, one client at a time. Multiyear update agreements are a staple or our fire, as evidenced by our client list and past project experience. El e are able to succeed with our "service first" approach due, in part, to the technology employed by us and effective use of software databases. We provide an optimum degree of client customization through the use of our proprietary "real time" data capture program, HITS and Microsoft Access database as well as Microsoft Excel spreadsheets. Using these popular programs allows us to import/export data into any system our clients work with. El Through our depth of experience, HCA has worked with many different government entities, counties, insurance groups, hospitals, and higher education institutes with project requirements identical in scope to those proposed by The City of Downey. Better Data Means JU'c, H CA ar paMx Page 4 of 1 C. Qualifications HCA offers unparalleled comparable project experience when measured against the City's requested services. With over 150 years of combined management experience, we have the knowledge and expertise to establish consistent, reliable inventory and valuation conclusions. _ Our senior staff includes members of the American Society of Appraisers (AA), Project Management Professional Accreditation ), ( A) and Engineering (PE) with backgrounds in accounting, engineering, construction management and finance/economics. We are affiliated with and support NACUBO, FRA, NCURA, NECA, SECA, NACCA, WECA, NPMA, AACC and many other regional and local business organizations. HCA prides itself on having attracted and retained some of the most skilled and experienced staff in the public -sector inventory, valuation & appraisal industry. We tackle assignments with a "one client at a time" approach, unique in a field where many firms focus on top -line (revenue) targets, and short-term growth. _ Our team has taken the opposite approach, focusing on delivering a quality report, on time and for a fair fee — one commensurate with our skill sets. Our staff has many years working with HCA and fully trained for this type of work, you will never find personnel who are unqualified on any of our engagements. As our client's will attest to, the challenging portion of this engagement is not necessarily the data collection and fixed asset tagging/inventory itself, although sizeable, but the reconciliation is by far the critical component to the successful completion and acceptance of the final reports and results. _HCA prides itself in the proven methodology, procedures and the level of detail that is taken by our staff to support an audit trail that will be acceptable to the City and your state, independent and Federal auditors. It is not uncommon to see Firms with less experience in this area to not properly anticipate the time and t ere ore the costs associated with this extremely important effort IT en you contact our clients and references of others, we recommend that you specifically address the qualifications of Firms in t is area. Completing this q fort right thefirst time can eliminate added cost and time to resolve post engagement issues. We work closely with the Institutions departments, and management staff to provide reports and recommendations that guarantee success. - HCA is a unique firm offering clients a national presence and capabilities, without losing that "small company" feel so often associated with the highest level of customer satisfaction. Although there are larger consulting practices, we feel we are appropriately sized to satisfy our clients. With the HCA Asset Management, focused approach, every client is important, regardless of project size or fee. HCA will coordinate the logistics of this engagement from its western Region Office with additional resources, as needed, from its Corporate Office. HCA Asset Management LLC., 13292 Alexis Drive, Kamas Utah 4036. HCA Asset Management is registered to do business in the State of California and over the last 5-years has/continues to perform capital asset inventory, tagging, valuation and appraisal projects, identical in scope to the services requested by the City of Downey, for hundreds of clients across the country and in the state of California. A partial client listing is included on the following page. Better Data. Means .t HI CA OEM===== Page 5 of l CA 17VVENTOR I IA UDITIVAL UAT I N CLIENTS f rticd : is in City of Lake Forest CA City of St Cairsvile Ohio University of California Los Angeles City of OxnardC Dekalb CountyCity of Palmetto Florida League of Raleigh NC Emory University City of Sarasota Florida Monroe County Ohio City of Flagstaff Arizona Hillsborough County FL California Institute of Technology (T) _University of Wisconsin City of Opa-locka FL BrowardCounty FL Edina County Minnesota Northwestern University City of BrianTexas Pennsylvania State University City of Newport Milwaukee Yale University Saint Joseph's University SUNY Downstate Medical r. SUNY Stony Brook SUNY Universityt Buffalo Met Council Minnesota - Columbia University SOC Community College District CA Ohio State University University of California San Diego Clark County, Las Vegas University of Chicago Brandies University University of Iowa U of Iowa — Hospital & Clinics Rutgers University University of Kansas San Diego Metropolitan Transit System University of North Carolina University of Pennsylvania City of Johnstown University of Southern California University of Tennessee City of Niles OH Wake Forest University Weill Cornell Medical College Manassas Park City Schools Minnesota City of Lake Wales FL Virginia Municipal League Kentucky League of Cities League of MinnesotaCities NCLM Members Kansas Counties Association League of RaleighC Ascension Health Care Systems Boston University University of Michigan University of Arizona Utah — UCIP Harris Health System Broward County, Florida Haywood Health System City of Santa Clara HHS CA Cal State Maritime CA HCA offers unparalleled comparable project experience when measured against the City's requested services. All 28 Plus )TCA staff are full-time, permanent staff members whose value to you will be quickly demonstrated by their complete -understanding of the research equipment, space, and engagement scope and their commitment to providing quality results. HCA Project Team have worked on numerous related engagements supporting specifications identical to that requested by The City. This experience, coupled with our consulting expertise, will provide The City with the professional services needed to achieve a successful seamless conclusion to this project. erData AleansBc H� inawncEnewr ........Page 6 of 1 G===MN= D. Technical Approach STRA TEGIES TO MEET THE CITYS GOALS HCA prides itself in the proven methodology, procedures and the level of detail that is taken by our staff to support an audit trail that will be acceptable to The City staff, management and your state, independent and federal auditors/negotiators. The "tribunal" knowledge and experience of City team members will be utilized by HCA throughout the inventory process. This interaction between HCA and key Stakeholders will ensure total project continuity and stewardship once our staff has completed our work, as HCA has demonstrated from previous project engagements performed with the City. PRE-FIELDIVORKPREPERATION Prior to our site visit, our project manager will: ➢ Review and confirm the scope and timing of the services to be provided with The City's designated Project Manager. ➢ Request electronic copies of all file and field layout documentation that will be used to support the engagement; The City's fixed asset and electronic space files (if available) and related accounting information etc. ➢ Coordinate project schedules and address any potential location accessibility limitations. Meet with The City's point of contact to determine best timing for inventory. ➢ Request any necessary client supplied data (e.g. accounting information, coding structures and definitions etc...), confirm with The City's staff representative(s) data collection information meets all required fields and field formats for successful upload into The City' fixed asset system. ➢ Confirm individual building, site and department contacts telephone numbers and email addresses. ONSITE FIELD P — INVENTOR YIDA TA COLLECTION All onsite fieldwork begins with a comprehensive kick-off meeting with our clients. We believe the most important elements to successfully completing your inventory project is adequate communication and proper planning. Once contacts have been established at all locations and adequate notification has been sent regarding the purpose of our project, HCA staff will conduct the physical inventory and tagging process. This effort will involve a site -by -site building -by -building room -by -roam Physical inspection and tagging effort to record ALL fixed assets subject to the engagement, t ASsE,CA Page 7 of 1 CIE===== Once contacts have been established at all locations and adequate notification has been sent regarding the purpose of our project, HCA staff will conduct the physical inventory, tagging and reconciliation process. This effort will involve a site -by -site, room -by -room inspection to record and tag all assets subject to the engagement. Throughout all phases of the engagement, HCA Staff will be respectful of City staff. HCA staff will leave areas as they found them, will not unplug any equipment and will be responsible and concise during the physical inventory. As the assets are inventoried and tagged, HCA will scan/record all equipment using HCA supplied Bluetooth optical scanners, tablets, and CA's proprietary " " asset inventory capture software. The e r software — pronounced keeper ( https://kepr.com/ ) allows us the ability to correct and capture missing pertinent data elements while in the field, standing in front of the item (i.e. description, serial #, model, manufacturer, location at the room level, etc.) and reconcile assets at the same time, thus greatly limiting City staff time and involvement. KPEPR will also provide HCA staff the ability to scan and search assets by location, department, serial numbers, description, etc. All data can be synced live with internet connection at various stages of the day to provide up to the minute accurate data. The inventory data captured is reviewed and matched against the ENTIRE City fixed asset database, providing the ability to identify matched assets, matched assets identified in different locations, items identified that match the City capital asset definition and to provide the inventory exception reports needed to support the inventory reconciliation requirements. HCA will conduct a follow-up secondary phase, final reconciliation, which includes HCA meeting with departments to reconcile the capital assets not located during phase one walk-through inventories. Assets not located during phase one may be due to reasons such as space inaccessible, stored out of sight, currently off -site, no way to identify unique identifier such as serial number, no tag, no serial number match, etc. The items not accounted for will be researched and identified immediately after initial inventories. We then set up meetings with the departments to physically verify and tag assets they were able to locate. This approach allows HCA to verify assets that have moved locations without returning to spaces multiple times with multiple departments. This will also minimize tying up City staff resources to verify assets. AIANA GEAIENT PLAN and TIAIETABLE HCA understands that "time is of the essence" for this inventory,' tagging and reconciliation project and we are prepared to begin the engagement shortly after award and contract execution. The anticipated timeframe for completion of the capital asset review, inventory, reconciliation, valuation and delivery of the final reports and electronic media is estimated to be 45 calendar days from receipt of the City's executed contract and commencement of the on -site field work. HCA shall perform onsite work during normal City business hours Monday through Friday, 8:00 am through 5:00 p, but is also prepared to inventory 24 hour facilities, such as Volunteer Fire/rescue stations, police vehicle(s) on shift changes etc. after hours as stipulated by the City. HCA has a proven record on engagements of this size and scope. ,Be ter Data Mean H<.,.kaA Page8 of 1 G=H==== HCA is prepared to work with The City to establish engagement ti era e that is suitable to The City of DowneyManagement and your reporting requirements. Please refer to the following work plan for a time -phased task list supporting the engagement. TASK 10 DAYS 3 BPS DAYS 1) Project Planning 2) HCA Asset Management System Setup 3) Review Staff Inventory & System Assessment Procedures 4) Complete Engagement Coordination 5)Complete Inventory & Data Collection Process 6) Inventory & Valuation Reconciliation 7) Complete Assessment Edits 8) Complete Final Review 9) Produce Draft Reports 10) Produce Final Reports 11) Final Inventory Electronic Interface QUALITY CONTROL PROCEDURES HCA is committed to timely delivery and high -quality services to all of our clients. Built-in quality control measures are integral to every project. We focus not only on thoroughness but on accuracy and consistency as well. Some of CA's quality control processes include: ➢ Our Project Managers verify that every site location has been visited by an HCA team member by reviewing maps, building and/or site plans, and monitoring the matched and unmatched asset list from the City database. Additionally, a listing of any locations unable to be accessed is provided to our clients for resolution. ➢ To ensure that all data collected by HCA staff is included in project deliverables, CA's project manager maintains daily logs of asset counts by building, department, buildings, rooms inventoried, etc. This electronic information (via client specific dashboard) is made available to City administrators/managers for specific job tracking and reporting capabilities. ➢ HCA will supply the necessary Bluetooth bar code optical scanner hardware and the HCA proprietary KRPR data capture software to manage the asset inventory and track the inventory results on an up to the minute basis. Inventory data captured on the optical scanners will be uploaded and reconciled against the entire City capital asset file. This process allows us to track the progress of the inventory and identify matched assets, matched assets transferred to different locations, and assets and locations not yet accounted for. ➢ HCA will provide City Management electronic weekly engagement progress reports, as is part of our standard operating procedures for asset inventory engagements. 1tealerData HCA Page 9 of 1 EPEE==== Our Project Managers review all inventory data for accurate and consistent: ➢Descriptions/Nomenclature Numbering/Coding ➢ CostsNalues At the conclusion of the comprehensive fixed asset inventory reconciliation HCA will provide the City complete set of reports including but not limited to: •'' Asset inventoried that match data fields currently in City's asset system • Asset data field corrections, (i.e., description, serial number, model, location etc.) • Asset deletions currently recorded in the City's asset system NOT located after follow-up reconciliation with departments ALL will have name of contact indicating disposition Accurate "baseline" of assets with recorded fields provided in template format as required for upload into the City's asset system Any unusual findings and best practice recommendations for prospective accounting CITY S TAFF EXPECTAI The successful execution of any fixed asset valuation, inventory and reconciliation requires a cooperative and coordinated relationship between the consultant and client. Our anticipated role as the selected vendor will be to perform the majority of all tasks associated with the execution of the engagement. However, the City's involvement will be critical in the following areas to ensure our overall success. Based on our vast project experience, the most critical step will be the assignment of a City employee as coordinator for the engagement. Having your coordinator involved in the assignment from start to finish is essential and helps ensure total project continuity and stewardship once our staff has completed our work. The City project coordinator should have a basic understanding of fixed asset cost accounting and full knowledge of your internal fixed asset accounting requirements. The coordinator should be available to: 1. Coordinate inventory staff requirements concerning: a. Access to sites, buildings, and space b. Security clearances c. , Requests from the fixed asset database, reports, and workspace. 2. Arrange introductions of HCA staff to appropriate personnel (i.e., Specific "Sensitive" Area Contacts, Accounting Staff, Building Security, etc.). 3. Notify appropriate City personnel concerning the nature of the project (i.e., Project Announcement Memo/Correspondence). Page 10 of 1 . Provide inteet access and a room to coordinate activity for HCA on -site staff, preferably near Project Management or Accounting Departments. 5. Provide HCA with all current and -to-date asset listings immediately upon award (or as soon thereafter as possible). Reconciliation: HCA will make every effortto find and account for all items subject to the 'inventory engagement. Any items not located during the initial blitz phase will be disseminated and emailed to department point of contact (PC) for resolution. Once department POC's have received email correspondence and have had sufficient time provided for review, HCA staff will schedule follow-up appointments to inventory remaining items located. For any assets the POC's are unable to locate a explanation as to why it cannot be found will be asked for, such as disposed, traded -in, off -site, etc. will be populated in the asset notes. HCA will contact department POC's at least twice via email and once b phone, if the phone number is available, to schedule the department reconciliation appointments. The PC will be flagged as unresponsive after three contact attempts have been made, and no response is received by HCA. HCA will inform City Project Coordinator/Manager and request them to reach out to the unresponsive POC and encourage participation. Procedures will be developed to account for capital assets that are received by The City during the inventory process. The HCA working file will be frozen as of a specific date, allowing us and The City to properly account for new assets. Per our inventory procedures, HCA will provide weekly status updates and meet with City management and stakeholders while on site to discuss progress and statistical analysis of the data. E. Project Team Outline HCA maintains a staff of full-time specialists who are totally committed to our asset inventory and valuation practice. We tackle assignments with a "one client at a time" approach, unique in a field where many firms focus on top -line (revenue) targets, and short-term growth. Our team has taken the opposite approach, focusing on delivering a quality report, on time and for a fair fee — one commensurate with our skill sets. Our staff has many years working with HCA and fully trained for this type of work, you will never find personnel who are unqualified on ANY of our engagements. HCA prides itself on having attracted and retained some of the most skilled and experienced staff in the public -sector inventory, valuation, consulting & appraisal industry. Our proposed team is well -qualified and extremely experienced on projects with similar scope and size. HCA is a unique firm offering clients a national presence and capabilities, without losing that "small company" feel so often associated with the highest level of customer satisfaction. Although there are larger consulting practices, we feel we are appropriately sized to satisfy our clients. With the HCA focused approach, every client is important, regardless of project size or fee. Lo esssio al Pro les fear° Key to Members Better Data Metrics ,tip, H CA 1 .4�AaaM Page 11 of 1 comm=MM Gregory e , President ay e o Ex erie cE' Greg has been associated with HCA for over 29 years. As President he is ultimately responsible for the overall operations of all contracts. He has been involved with coordination and oversight of a majority of governmental, higher education, hospital clinical and research institution projects that HCA has conducted in the past twenty-five years. _These projects include original building cost segregation (coponentizatio), historical, replacement cost and insurable valuation conclusions, capital equipment inventories audit and reconciliation services, annual updates and fixed asset accounting and reporting ftiriction outsourcing projects. Prior to working with HCA, Greg was in the construction industry. His construction knowledge was instrumental in the creation of HCA proprietary fixed asset database depreciation programs and building component cost allocation methodologies. Gre's consulting experience includes the development and implementation of complex capital asset management and depreciation solutions for numerous clients in government agencies, cities, and counties the higher education and health care environment. Engagement objectives have included the development of property management and financial accounting initiatives supporting client requirements. He has extensive expertise in establishing fixed asset property records for cost accounting, supporting GAS13 34, GAAP, UG requirements, and Facilities and Administration (F&A) cost recovery supporting OMB A-21 and -110 cost reimbursement regulations, now all under the U - Uniform Guidance umbrella, as well as assisting clients meet accountability regulations ,of internal/external audit and S-133 audit reviews. He has been asked to speak at numerous regional and national conferences on the subject of property and asset management reporting and over the past two years has conducted workshops on Asset Accountability for the State of Ohio Auditors group meetings and in addition has served as a national panel expert on these subjects for the SECA, FRA and NECA conferences. ey tc do n s1A ffIli do n s National Association of Cost Accountants State and Local Government Cost Accountants (GFA) Northeast Cost Accountants CA) National Property Managers Association ) rofessional Histen HCA Asset Management, President 1991 -Present Sheahan Construction -Owner/Operator ece t/ of L- ro'ects University of California -San Diego City of Oxnard CA - University of California (UCLA) California Institute of Technology (CIT) Mike Fister, NIBA, ?V Better Data Means, H,C.EME a Page 12 of 1 OEM==== Chief Operations Officer an e oL&vperlence Mike serves HCA Asset Management LLC. ("HCA") as the COO, leading more complex appraisal and capitalization assignments. His project management skills and consulting expertise have been crafted through many successful capital asset management engagements for a variety of public entities, including cities, counties, schools, and colleges/universities. Through direct consulting interface with the various contributors, users, auditors, controllers, and accountants Mike has acquired the knowledge of the reporting and reconciliation needs of the many parts of any single higher education institute. He honed many of his analytical and leadership skills while working for the Boeing Company as a Financial Analyst and Contracts Administrator. These roles included leading a team to implement new software systems as part of introducing LEAN Manufacturing practices to the business and financial processes. Through a regular execution of City, county, and college/university projects, Mike has developed the skills necessary to manage n execute of large capital equipment inventories, space inventories, and Building Componentization projects. Throughout his career Mike has worked with many state and local government clients to ensure consistency and compliance for 2-year inventory cycle count mandates. These clients include, but are not limited to: City of Oxnard CA, Dekalb County GA, Monroe County OH, City of Niles OH, City of St. Clairsville O, City of Opa-loca FL, City of Lake Wales FL eta roessioal HistoLT HCA Asset Management, LLC., COO 10/07 -Present Boeing, Contract Administration 06/2006-09/2007 Boeing, Business Analyst 06/2004-06/2006 Education Project Management Professional — Project Management Institute Masters- Business Administration, Webster University S — Administrative Management/Marketing, Missouri State University Recent / On --ohm roieci DeKalb County GA South Orange County CC District CA City of Niles OH San Diego Metropolitan Transit System Mariana Traetta, MBA VP of CAM Operations Range, 2LExperience effer Data a Means ,` , .e� 01 w,: ,. ...........Page 13 of 1 OEM==== Mariana is the HCA Asset Management VP of CAM Operations and K6pr Software Director. Mariana has more than 15 years of professional experience in Higher Education, including the development of FA (Facilities and Administrative) Cost Rate Proposals, space surveys, and asset management. Mariana has a significant understanding of cost, space, and asset data in accordance with federal guidelines. She has assisted colleges and universities with F A proposal development, and the implementation of well - documented and defensible costing methodologies in accordance with the OMB Uniform Guidance, 2 CFR Part 200. During her career, Mariana has conducted several room inventory and space utilization studies. She has trained academic departments and research unit space coordinators on how to categorize results obtained from faculty interviews into 2 CFR Part 200 functional definitions. Mariana has substantial experience working with complex data sets, including the compilation, analysis and reporting of information relevant to Higher Education clients. At HCA she has managed projects related to capital asset inventories, including the implementation of RFID technology, building componentization studies, and asset management consulting best practices at large Higher Education institutions. Mariana has also been involved in Peoleoft and Oracle Cloud financial systems implementation projects. Pro essional isto HCA Asset Management, Director, 07/201-Present MAXIMUS Higher Education Practice, Manager, 01/2017-07/201 University of Kansas, Financial Analyst, 03/2005-01/2017 Education Master of Accounting and Information Systems, University of Kansas, 2009 Bachelor of Business Administration and Accounting, University of Kansas, 2004 RecentlOiwoine FixedAsset Proiects Cal State Maritime College CAWeill-Cornell Medical College City of Lake Forest CA City of Downey CA *** A anticipates utilizing the same staff members who have previously worked on and completed th e City of Downey comprehensive inventory, and fine cil reconciliation efforts F. References 1) Reference Name: California State Univer-siij Maritime AcaAM Contact: Mr. abi Joseph CPA, University Controller and Director Financial Services Address: Cal Maritime, 200 Maritime Academy Dr. Vallejo CA 94590 Phone #: (707) 654-1782 E-mail address rioseph@csum.edu Cal Maritime — HCA was awarded a competitive bid RFP award of a comprehensive capital equipment inventory, tagging and financial reconciliation for the Cal Maritime in 2017. In 2020 the Cal Maritime Better Data Means Page 14 of l GEME=MM added an addendum to the original agreement and HCA performed an updated physical inventory and financial reconciliation of qualifying assets for G , GAS13 3, and funded grant provision inventory compliance requirements. The services performed are identical to those requested by the City of Downey and the results of these inventories have provided Cal Maritime with audit compliance, and ongoing equipment stewardship. HCA is due to update the inventory for Cal Maritime in FY2023. 2) Reference Name; Ccn cif aata Clara Valev CA Contact: Mr. Vinod Sharma CPA Controller and Director Financial Services Address: SCVHHS 2325 Edberg Lane #306 San Jose, CA 95134 Phone #: (408) 793-1943 E-mail address Vinod.Sharma@hhs.sccgov.org Santa Clara Valley County — HCA was awarded a competitive bid RFP award of a comprehensive capital equipment inventory, tagging and financial reconciliation for the Santa Clara Valley County in 2016. Since that time HCA has performed annual inventory update services and added additional hospital inventory services. The services performed are identical to those requested by the City of Downey and the results of these inventories have provided Santa Clara Valley County with audit compliance, and ongoing equipment stewardship. _HCA remains under contract with Santa Clara Valley County. 3) Reference Name: City ofDc�°ny CA Contact: Ms. Kathleen J. van Ragy, Purchasing Coordinator Phone #: (562) 904-7257 E-mail address Kvanraay@downeyca.org City of Downey CA - HCA was awarded a competitive bid RFP award of a comprehensive capital equipment inventory, tagging and financial reconciliation for the City of Downey in 2017. In 2020 the City added an addendum to the original agreement and HCA performed an updated physical inventory and financial reconciliation of qualifying assets for GAAP, GAS13 3, and funded grant provision - inventory compliance requirements. The results of these inventories have provided the City with audit compliance, and ongoing equipment stewardship. CA's familiarity with City buildings, departments, and reporting requirements will ensure that all City management objectives are met or exceed for this engagement, 4) Reference Name: Ci cif nand CA Contact # 1: Ms. Eden Casareno, Attestation Auditor and Partner, Eadie and Payne Phone #:.(951) 241-7800 E-mail address ecasareno@eadiepgynellp.com Contact #2: Ms. Deanna Purcell CPA; Director currently working at Groover Beach CA Phone : (805) 473-4555 E-mail address dpurcell@groverbeach.org City of Oxnard CA — The City's financial statements were audit by Eadie and Payne and as a result the City's assets were given a qualified audit opinion. HCA was awarded a competitive bid RFP award of a comprehensive capital equipment inventory, tagging, building, and infrastructure valuation and financial reconciliation for the City. The results of this engagement were successfully audited, with the qualified opinion removed. Better Data Means H, CA Page 15 of l (OEM==== 4/2/2022 HCA capital asset inventory projects in process, State of California: 1) South Orange County Community College District — identical in scope to services requested by the City. Engagement in process. Project Contact -- Nick Newkirk, Purchasing and Contracts Manager, phone : (99) 52.4375 E-mail address: nnewkirk@socccd.edu 2) San Diego Metropolitan Transit System (MTS) —Project just getting started, capital cost segregation in conjunction with capital equipment inventory, tagging, valuation and financial reconciliation. e strongly encourage the City to contact ANY of the HCA clients identified in this proposal response, to gain a first-hand perspective of HCA knowledge and experience in providing the fixed asset services requested. G. Cost Commitment To the extent that information regarding the assets to be inventoried exists currently, access to all such information should be made available to HCA staff. This information may include current fixed asset listings, financial statements containing current capital asset totals, auditor comments/findings/concerns related to capital asset reporting at The City, and any other relevant data. HCA will maintain copies of our backup and field notes, all relevant correspondence, and the final reports and electronic data in our possession and files for a period of not less than five (5) years from the date of the engagement. Based on our understanding of The City of owney's requirements and the level of professional skills necessary to complete the engagement to support the specifications described in our proposal response, HCA is pleased to submit the following professional fees and expenses supporting the proposed services: Perform "wall to wall" physical inventory & financial reconciliation of City's assets to meet the two primary objectives: (1) Financial Reporting and (2) Accountability and Control. Out -of -at pocket administrative, travel and living expenses are included in our fixed fee costs —1-year term with (2) 1-year renewal options, outlined below. ACCEPTED Inventory/Reconciliation $29,000 + Travel Fees $4,350 = $33,350 - 2022 OPTION I (CYCLE TINT RENEWAL 2024) ➢ Inventory/Reconciliation $29,000 + Travel Fees $4,350 = $33,350 2024 OPTION 2 (CYCLOE COUNTRENEWAL 2026) A Inventory/Reconciliation $29,000 + Travel Fees $4,350 = $33,350 2026 OPTION3 (BARCODE TAGS IFREQUIRED) A Barcode tag stock 3,000 item count consistent /existing = $1,000 Thank you for this opportunity to submit our proposal to provide capital asset physical inventory consultant services to the City of Downey. To indicate acceptance of the 1-year term fixed price described, Befter Data Means nill HCA Ass I ....... E 1 Page 16 of 1 and any service options stated, please place your initials in the space provided, execute the signature line and email return to: gsheahan@hcamgt.co Accepted y City of Downey: (Name, Title) (Date) Proposed _ . Paymentc e le HCA will invoice The City of Downey for services rendered throughout the progress of our work. HCA reserves the right to charge interest calculated based on one and one-half percent per month if payment is not received within 40 days of The City's receipt of our invoice. 14. Conclusion This is to acknowledge our understanding of capital asset accounting requirements supporting GAS Statement 34, 42 & 51, 2 CFR Part 200 (Uniform Guidance) F A Cost Principles, Generally Accepted Accounting Principles ( ), Government Accounting Auditing and Financial Reporting (G ) as well as our ability and experience to provide the required services. HCA anticipates working with City of Downey staff accessing their "tribunalknowledge" of City assets, throughout the engagement. The rational for selecting HCA is embedded in the company DNA, Core Values and Promise. HCA Core Values Clients Are Our Friends - We genuinely cage about our clients and the services they receive. Fiercely Protect OurReputation - We act professionally at all tires; deliver value; and do sat we say® Obsessed with utcomes - We're conitnitt d to complete company and client satisfaction. fleeArea Team -We set' port each other through umility, trust, and collaboration. CAGuarantee: We promise to deliver value and accurate, defensible data Please do not hesitate to contact me if 1 can answer any questions regarding the proposed services. Offered y: HCA Asset Management LLC Date June 20th, 2022 Gregory P. Sheahan President. HCA Asset Management LLC Direct 941.544.2369 Email gsheahan(a%hca co Office 941.752.6330 etter Data Means 1 ASSE,CA Coverage Is Provided 7h: Pollc Number: Ohio Security Insurance Company ) 58 17 88 67 Policy Period: 176 Berkeley St., Boston, NSA 02116 From 08124)'1 To 08[24/2022 12:01 am Standard Time at Insured Mailing Location Common olicy Declarations Named Insured Agent CA ASSET MANAGEMENT, LLC (727) 526-5707 5214 4th Avenue Cir E SAN OF FLORIDA Bradenton, FL 34208 1 BEACH DR SE STE 230 ST PETERSBURG, FL 33701-3972 POLICY FORMS AND ENDORSEMENTS- CONTINUED This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBERTITS CG 26 81 12 04 Minnesota Changes - Duties Condition 0 ®_ CG 84 99 08 09 Non -Cumulation Liability Limits Same Occurrence CO 85 00 04 12 Florida Changes - Non -Cumulation Of Liability Limits Same Occurrence C , RS_U3 04 13 Blanket Additional Insured Contractors - Products - Completed Operations CG 88 10 04 13 Commercial General Liability Extension CG 88 76 12 08 Exclusion - Earth Movement - Products/Completed Operations Hazard CG 88 77 12 08 Medical Expense At Your Request Endorsement CG 88 86 12 08 Exclusion - Asbestos Liability IL 00 17 11 98 Common Policy Conditions IL 00 21 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 02 45 09 08 Minnesota Changes - Cancellation and Nonrenewal IL 02 58 04 21 Arizona Changes - Cancellation and Nonrenewal IL 02 83 11 18 Wisconsin Changes - Cancellation and Nonrenewal IL 88 39 05 20 Florida Agent Countersignature Endorsement NP 74 26 04 13 Notice to Policyholder Fully Earned Minimum Premium Endorsements ' _n To report a claim, call your Agent or 1.844-326.2467 S 70 21 11 16 06/20/21 50178867 POLSVCS 425 MCXFPPNO INSURED COPY 001055 PACE 23 OF 96 COMMERCIAL GENERAL LIABILITY CO13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE 1T CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS - PROD UCTSICOMPLETED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph 2. under Section 11 - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract or written agreement. Such person or organization is an additional insured but only with respect to liability for "bodily injury" or "property damage": 1. Caused by "your work" performed for that additional insured that is the subject of the written contract or written agreement; and . Included in the "products -completed operationshazard". However. a) The insurance afforded to such additional insured only applies to the extent permitted by law; and ) ,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 The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b, of Condition 2. Duties In The Event Of Occurrence, Offense, Claim r Suit under Section I -Commercial General Liability Conditions. B. With respect to the insurance provided by this endorsement, _ the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: 9 1. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. 2. °"Bodily 'injury" or "property ' damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services including: a. The preparing, _ approving - or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawing and specifications, and . Supervisory, inspection,- architectural or engineering activities.___ 2013 LIberty Mutual Insurance 3 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission . Page 1 of 2 C. With respect to the Insurance afforded by this endorsement, exclusion I. Damage To Your Work of Paragraph 2. Exclusions under Section 1 - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: 1. Damage To Your Work "Propertydamage" to "your work" arising out of it or any part of it and included in the "products® completed operations hazard MEN D. With 'respect to the insurance afforded to these additional insureds, the following is added to Section II - 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 contract or agreement; or . Available under the applicable Limits of insurance shown in the Deciaration. whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. E. With 'respect to the insurance afforded by this endorsement, Section IV Commercial General Liability $ Conditions is amended as follows: 1, The following _ is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claims OrSuit: An additional Insured under this endorsement will as soon as practicable: , --Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and . c. _,Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. . We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. Paragraph 4, of Section IV - Commercial General Liability Conditions is amended as follows: a. The following is added to Paragraph a. Primary Insurance: f an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. . The following is added to Paragraph b.'Ecss Insurance; When a written contract or written "agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insur- ance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. © 2013 Liberty Mutual Insurance CG 85.83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission . Page 2 of 4 COMMERCIAL GENERAL LIABILITY CG 88 10 04 1 THIS T CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIALL This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT NON -OWNED T G FT 2 PROPERTY A:...A LIABILITY -ELEVATORS 2 EXTENDEDA A TO PROPERTY T TO YOU (Tenant's PropertyDamage) - EXTENSION MEDICAL PAYMENTS EXTENSION U _T Y PAYMENTS -C V A ADDITIONAL INSUREDS - BY CONTRACT, E T OR PERMIT -' PRIMARY AND NON -CONTRIBUTORY- ADDITIONAL INSURED NSI ADDITIONAL I -EXTENDED PROT CTI F YOUR "LIMITS OF INSURANCE" 6 WHO IS AN I -INCIDENTAL EDCAL ERRORSIMALPRACTICE AND WHOIS AN INSURED - FELLOW L YE EXTENSION - MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLYC UI E NTIIE 7 FAILURE T -. DISCLOSE _ HAZARDS AND PRIORCC 7 KNOWLEDGE OF CCUR C , OFFENSE, CLAIM SUIT 7 s LIBERALIZATION CLAUSE 7 nBODILY INJURY FIN 7 EXTENDED PROPERTY DAMAGE WAIVER F TRANSFER OF RI HT F RECOVERY AGAINST OTHERS TO U -' WHEN REQUIREDIN CONTRACT OR AGREEME T WITH YOU p 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Pago 1 of With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. .. NON -OWNED IRO AFT Under Paragraph "2.'Exclusions of Section I overageBodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. - It is hired, chartered or loaned with a trained paid crew; . , The pilot in command holds a currently effective certificate, Issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this 'provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically In excess of this policy), contingent or on any other basis, that would also apply to the loss covered under — this provision. S.NON-OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) -A watercraft you do not own that is (a) Less than 52 feet long® and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section l - Coverage ABodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion J. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph In. Excess Insurance: - The insurance afforded by this provision ,of this endorsement is excess over any property -insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY T (Tenant's PropertyDamage) s 1f Damage To'Premises Rented To You is not otherwise excluded from this Coverage Part: 4 1. Under Paragraph 2, Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: . The fourth from the last paragraph of exclusion j.`Damage To Property is replaced by the follow- ing: Paragraphs (1), O and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (1) Premises rented to you for a period of 7 or fewer consecutive days; or (I!) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. .Paragraphs -(1),'(3) and O of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit ' of insurance applies - to this coverage as described in Section IiI - Limits o ; Insurance. O 2013Liberty Mutual Insurance CO8 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, -smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance. applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. . Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: . Subject to Paragraph 6. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: . Any one premise, -(1) While rented to you; or (2) While rented to you or 'temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, - smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement, 3. As regards coverage provided by this provision D. EXTENDEDAGE TO PROPERTYT T YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, Is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical 'Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as -follows: Under Paragraph 1. Insuring Agreement of Section 1 - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: O The expenses are Incurred and reported within three years of the date of the accident; and F. EXTENSION SUPPLEMENTARY PAYMENTS COVERAGES A AND 1. - Under Supplementary Payments - Coverages A and B, Paragraph I.b. is replaced by the following: b. -Up to $,00 for cost of ball bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1..'Is replaced by the following. s d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. ADDITIONAL -INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section 11Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, ,or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 3 of 8 b; Premises or facilities rented by you or used by you, or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has Issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising Injury" arising out of the operations performed for the state or political subdivision; () This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". O Insurance applies to premises you own, rent, or control but only :with respect to the following hazards: O The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, " hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or O The construction, erection, or removal of elevators; or o s (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional Insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by 4 the contract or agreement to provide for such additional Insured. With respect to Paragraph 1.e. above, a person's - or organization"s status as an additional insured under this endorsement ends when: (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 () 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. With respect to Paragraph 1., above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such m premises or facilities ends. m With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". j e have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions, 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. . "Bodily injury" or "property damage that occurs prior to you commencing operations _ at the location where such "bodily injury" or "property damage" occurs. c. "Bodily Injury", "property damage" or "personal and advertising injury' arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications or O Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering ,of, or the failure to render, any professional architectural, engineering or surveying services. . "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 O 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. . Any person or organization specifically" designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3.. 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: . Required by the contract or agreement; or b. 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 Declaratio ns. N, PRIMARY AND NON-CONTRIBUTORYADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is end- ed as follows: a. The following is added to Paragraph a. Primary insurance: If an additional insured°s policy has an Other Insurance provision making its policy excess,and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured°s policy for damages we cover. © 2013 Liberty Mutual Insurance CC 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc,, with Its permission. Page 5 of b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, - other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional Insured is designated as a Named Insured. ' Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. 1, ADDITIONAL I r U EDS -EXTENDED PROTECTION OF YOUR "LIMITS INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1.-- The following is added to Condition 2, Duties In The Event Of Occurrence, Offense, Claim or Stilt: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an' occurrence" ,or an offense that may result in a claim or "suit" under n this insurance to us; Tender the defense and Indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c, Agree to make available any other insurance which the additional Insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. . The limits of insurance 'applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL' ERRORS/ MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES Paragraph .a.(1) of Section Ii - Who is An Insured is replaced with the following: (1) "Bodilyinjury" or "personal and advertising injury (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- s€onal health care personnel to others, or if coverage for providing professional health care ser- vices Is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs O and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory ,capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and © 2013 Liberty Mutual Insurance CG 88 10 04 1 _ includes copyrighted material of Insurance Services Ofce, Inc., with its permission. Page 6 of advertising Injury" arising out of their Willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverageprovided by provision J. is excess over any other valid and collectable insurance' available to your "employee". K. NEWLY FORMED ITI LL ACQUIRED TITIES Paragraph 3. of Section 11 • Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However. a. Coverage under this provision is afforded only 'until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily Injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injuryarising out of an offense committed before you acquired or formed the organization. . Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that Is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES, Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences" is not intentional M. KNOWLEDGE F OCCURRENCE, OFFENSE, CLAIM SUIT Under Section IV =Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim OrSuit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section 11 ®'Who Is An Insured or a person who has been designated by them to receive reports of "occurrences"', offenses, claims or "suits" shall have received such notice from the agent, servant or „employee", s N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective In your state. . BODILY INJURY DEFI Under SectionDefinitions, Definition 3. Is replaced by the following: 3. "Bodily "Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. 20131.1berty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 7 of 8 EXTENDEDP. TY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following; a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury' or "property damage" resulting from the use of reasonable force to protect persons or property. 0. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TWHEN REQUIRED CONTRACT IENT WITH YOU Under Section I - Commercial General Liability Conditions, the following is added to Condition -8."Trans- fer Of Rights Of Recovery Against Others To Us: e waive any right of recovery we may have against aperson or organization 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" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and Q 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. O 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of insurance Services Office, Inc., with its permission. Page 8 of 8 AGWI TRAVELERS WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERSLIABILITY LJ Y HARTFORD CT 06183 ENDORSEMENT WC 00 00 01t a POLICY R:-4J375621-21-42- LISTING EXTENSIONINFO e agree that the following listed endorsements form a part of this policy on its effective date. WC 00 00 01 A - -001 INFORMATION PAGE WC 00 00 01 A - 01 INFORMATION AGE 2 WC 00 00 01 A - 001 EXTENSION OF''INFORMATION PAGE - SCHEDULE WC 00 '00 01 A - 001 ENDORSEMENT LISTING WC 99 06 07 00 - 001 PARTICIPATING ENDORSEMENT C 09 06 07 A - 001 FL ETC INS GUARANTY ASSOC SURCH NOTIFIC WC 24 04 0 - 001 MISSOUI EMPLOYER PAID MEDICAL ENiT WC 00 03 13 00 -;01 WAIVER OF OUR RIGHT TOR COVER WC 00 04 14 A - 001 NOTIFICATION=F CiO IN OWNR ZNDT WC 00 04 22 ' C - 001 TERRORISM RISK INS PROD REAUTH ACT ENDT WC 00 04 24 00 - 001 AUDIT NONCOMPLIANCE CHARGE ENDORSEMENT WC 04 03 01 B - '001 POLICY AMENDATORY ENDORSEMENT-CALIFORNIA WC 09 04 03 C - 001 FL TRIPRA ENDORSEMENT WC 99 '03 76 A - 001 WAIVER OF OUR RIGHTS TO RECOVER -CA WC 99 03 99 00 - 001 CA WORKERS' COMP NOTICE OF NON-REN WC 99 03 C3 00 - 001 SPECIAL PROVISIONS ENDT C 99 03 F3 00 - 001 C` LIMITS OF LIABILITY HNDT WC 00 04 21 9 - 001 CATASTROPHE t /T CERT ACTS OF j ENDT WC 99 04 10 00 - 001 PREXIUM ADJ. FROM 'EFFECTIVE ELATE E, T. C 00 03 08 00 -"001 PARTNERS OFFICERS AND OTHERS EXCL ENDT WC 00 04 19 00 - 001 PREMIUM DUN .DATE ENDORSEMENT WC 02 04 01 C - 01 AZ ALCOHOL & DRUG FREE WK PLACE PERM END C 02 06 01 B - 001 AZ CANCELLAT16N AM NONRUNEWAL ENDT WC 02 06 03 00 - 001 AZ AME14DATORY INDORSEMENT WC 04 03 17 B - 001 EMPLOYEE IN9D BY ORNERL EMPLYER EXCLUDED WC 04 03 45 A - 001 COMPREHENSIVE PERSONAL LIAB POL EXCL WC 04 03 60 B - 001 E FLQYRRS' LIAB COV AMENDATORY E -CA WC 04 04 21`00 - 001 OPTIONAL PREMIUM INCREASE ENDORSEMENT - CALIFORNIA C 04 04 22 00 - 001 CALIFORNIA SHORT -RATE C' CELATION ENDT WC 04 06 01 01 CA CANCELATION ENDT WC 04 06 04 00 -'001 COVID-19 REPORTING REQUIREMENT END -C WC 09 03 03 00 -'001 FL EMPLRS LIAB COVERAGE ENDT WC 09 04 02 A - 001 FL EXP RATING NOD FACTOR ENDORSENE14T ATE OF ISSUE: 06-0-21 ST ASSIGN: Page 1 Of 2 WORKERSTRAVELERSJ COMPENSATION AND ONE TOWER SQUARE EMPLOYERSLIABILITY LICY HARTFORD CT 0613 ENDORSEMENT WC 00 00 01( ) POLICY UM -4 375621-21-4 «E LISTING Ni EXTENSION INFO PAGE We agree that the following listed endorsements form a part of this policy on Its effective date.-- WC 09 04 07 00 ® 001 FL NON -COOPERATION WITH PREM AUDIT ENDT C 09 06 06 00 -'01 FL EMPLOYMENT AND WAGE INFORMATION REL., WC 12 06 01 F ® 001 'IL AMENDATORY ENDT WC 12 06 03 00 - 001 ILLINOIS RENEWAL ENDORSEMENT WC 19 06 01 G - 001 MD CANCELLATION AND NONRENEWAL ENDT WC 22 00 00 A - 001 MN AMENDATORY ENDT WC 22 03 01 00 - 001 MN COMPLIANCE WITH APPLICABLE TRADE LAW WC 22 06 01 D - 001 MINNESOTA CANC AND NON RENEWAL ENDT C 24 03 02 00 - 001 MO NOTIFIC OF ADD MESOTHELIOMA BEN ENDT C 24 06 01 B ® 001 MO CANCELATION AND NOW -RENEWAL ENDT. WC 24 06 02 B d 001 MO PROPERTY & CASUALTY OUARANTY ASSOC. WC 24 06 04 C - 001 MIS OURI AMENDATORY ENDORSEMENT WC 37 06 01 00 - 001 SPECIAL PA ENDT « INSPECTION OF MANUALS C 37 06 02 00 --002 NOTICE INS CONSULTATION SERVICE EXEMPT. WC 37 06 03 A --001 PA ACT 6-1986 ENDORSEMENT WC 37 06 04 00 - 001 PA EMPLOYER ASSESSMENT ENDORSEMENT WC 48 06 01 C - 001 WISCO SIN LAW ENDORSEMENT WC 48 06 06 B - 001 WISCO SIN CANCELLATION O RENEWAL WC 99 06 46 00 ® 001 ILLNOIS AMENDATORY ENDORSEMENT DATE OF ISSUE: 6-30-21 ST ASSIGN: Page 2 Of 2 Coverage is Provided In: Policy Plumber: Ohio Security Insurance Company BAS () 58 17 88 67 Policy Period: 175 Berkeley St., Poston, MA 02116 From 08124/2021 To 08/2412022 12:1 am Standard Time at Insured Mailing Location Common Policy Declarations Natined insuredAgent CA ASSET MANAGEMENT, LLC (727) 526-5707 5214 4th Avenue Cir E SAN OF FLORIDA Bradenton, FL 34208 1 BEACH DR SE STE 230 ST PETERSBURG, FL 33701-3972 POLICY FORMS AND ENDORSEMENTS This section Iists all the Fornis and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. NUMBERFORM Ti ATE($) Applicable AC 00 31 01 14 Changes In Your Policy FL CA 00 01 03 06 Business Auto Coverage Form FL CA 01 28 0121 Florida Changes FL CA 02 67 01 21 Florida Changes - Cancellation and Nonrenewal FL CA 05 04 08 18 Florida Public or Livery Passenger Conveyance, Transportation Network and FL On -Demand Delivery Services Exclusion CA 87 63 06 09 Exclusion - Asbestos Liability FL CA 88 62 01 13 Waiver Of Transfer Of Rights Of Recovery Against Others To Us W1 MN FL AZ CA 99 33 02 99 Employees as insureds FL IL 00 17 11 98 Common Policy Conditions FL IL 00 21 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) FL IL 88 39 05 20 Florida Agent Countersignature Endorsement FL fn witness whereof, we have caused this policy to be signed by our authorized officers. Mark Touhey David Long Secretary President To report a claim, call your Agent or 1-844-325-2467 DS 702111G 9817BB67 POLSVCS -- 425 AGENT COPY 001388 PAGE 4 OF 20 Coverage Is Provided In: Policy Number: Ohio Security Insurance Company HAS ( 8 17 8 Policy Period: From 01 12 21 T08/24/2022 Business Automobile 12:01 am Standard Time Policy Declarationsat Insured Mailing Location ITEM ONE: Named Insured Agent CA ASSET MANAGEMENT, LLC (727) 526-5707 SAN OF FLORIDA ITEM TWO: SCHEDULE OF COVERAGES AUTOS This policy p1°ovides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the COVERED AUTO Section of the Business Auto Coverage Form next to the name of the coverage. "See Business Auto Coverage Form CA 00 01 for Covered Auto Symbol Descriptions COVERAGES LIMIT I Liability Insurance $1,000,000 each accident $5,677.00 Covered Auto Symbol(s) 08, 09* Terrorism Coverage $28.00 Total Provisional Clrrrtg es: $5,705.00 Note: This is not a bill ITEM FOUR, HIRED AUTO Estimated Annual Rate Per Each Cost of Hire $100Annual Cost of Hire Liability $55,000.00 7.638 $4,201.00 Cost of Hire means the total amount you incur for the hire o "autos" youdon't own (not Including "autos" you borrow or rent from your partners or employees or their family or their fancily members). Cost of hire does not include charges for services performed by motor carriers of propertyor passengers. To report a claim; call your Agent or 1-844-326.2467 DS 70 43 010 58178867 POLSVCS 425" AGENT COPY 001128 PAGE 6 OF 20 Coverage Is Provided in Policy Number: Ohio Security Insurance Company BAS (17 88 67 Policy period. From/2 10812412022. Business Automobile 12:01 am Standard Time Policy Declarations at insurod Mailing Location Na�med Insured en FICA ASSET MANAGEMENT, LLC (727) 526-5707 SAN OF FLORIDA ITEM I . 0 -)WNERSHIP LIABILITY 1® i� ' 'seinnec Ratit�a Racig Other than Garage Service Number of Employees 20 $1,181.00 Operations and Other Than Social Service Agencies Employees as Insureds Number of Employees 20 $295.00 To report a claim, call your Agent or 1-844-35-2467 DS 70 43 01 0 58178867 POLSVCS 425 AGENT COPY 001398 PAGE 6 OF 20 AW __ WORKERS COMPENSATION TRAVELERSJ AND ONE TOWER SQUARE EMPLOYERS LIABILITY LIC RTFO D CT 06183 ENDORSEMENT WC 99 03 C3 (0) POLICY NUMBER, UB-4J'37561-1-42- SPECIAL PROVISIONS ENDORSEMENT STATE APPLICABILITY The listed endorsements are only applicable in the following states: C 00 03 0 (00)-001 PARTNERS OFFICERS AND OTHERS EXCL ENDT APPLIES TO TATE(S): AZ FL IN MD MN'MO WI C 00 03 13 (00)-001 WAIVER OF OUR RIGHT TO RECOVER APPLIES TO STAT (S): AZ FL IL IN MD MN MO PA WI WC 00 04 14 ( )-001 NOTIFICATION OF CHG IN OWNR ENDT APPLIES TO STATE(S): AZ FL IL IN MD MN MO WI WC 00 04 14 (00)-001 NOTIFICATION OF CHANGE IN OWNERSHIP ENDT APPLIES TO STTE(S): PA WC 00 04 19 (00)-001 PREMIUM DUE DATE ENDORSEMENT APPLIES TO STAT (S): FL IL IN MD MN MO PA WI WC 00 04 21 ( D)-001 CATASTROPHE (O/T CERT. ACTS OF TERR)ENDT APPLIES TO STATE(S): AZ CA IL IN MD PA WI WC 00 04 22 ( B)-001 TERRORISM RISK INS PROG REAUTH ,ACT ENDT APPLIES TO TATE(S). AZ CA IL IN MD MR MO PA WI WC 00 04 24 (00)-001 AUDIT NONCOMPLIANCE CHARGE ENDORSEMENT APPLIES TO STAT (S): AZ IL MD MN WI C 02 04 01 ( C)-001 AZ ALCOHOL & DRUG FREE WK PLACE PREM END APPLIES TO TATE(S): AZ C 02 06 01 ( A)-001 AZ CANCELLATION AND NONRENE AL ENDT APPLIES TO STE(S): A WC 04 03 01 ( )-001 POLICY AMENDATORY ENDORSEMENT-CALIFORNI APPLIES TO STAT (S): CA WC 04 03 17 ( )-001 EMPLOYEE INSD' Y GENERL EMPLYER EXCLUDED APPLIES TO STATE(S). CA C 04 03 45 ( )-001 COMPREHENSIVE PERSONAL LIAB P L EXCL APPLIES TO STAT (S): CA WC 04 03 60 ( )-001 EMPLOYERS' LIB COV AMENDATORY E T-C APPLIES TO STATE(S): CA C 04 04 21 (00)-001 OPTIONAL PREMIUM INCREASE ENDORSEMENT - CALIFORNIA APPLIES TO STTE(S): CA C 04 04 22 (00)-001 CALIFORNIA SHORT -RATE CANCELATION ENDT APPLIES TO STAT(S): CA C 04 06 01 ( )-001 CA CANCELATION ENDT APPLIES TO STT(S): C C 09 03 03 (00)-001 FL EMPLRS LIAB COVERAGE ENDT APPLIES TO STAT(S): FL C 09 04 02 ( A)-001 FL EXP RATING MOD FACTOR ENDORSEMENT This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement is issued subsequent to preparation o the polio.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 08-29-19 ST ASSIGN: Page I of 3 WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 C (0) — POLICY NUMBER: U-4J375621-19- 2- SPECIAL PROVISIONS ENDORSEMENT STATE APPLICABILITY The listed endorsements are only applicable in the following states: APPLIES TO STATE(S): FL WC 09 04 03 (13)-001 FL TRIPRA ENDORSEMENT APPLIES TO STTE(S): FL WC 09 04 07 (00)-001 FL NON -COOPERATION WITH PREM AUDIT ENDT APPLIES TO STATE(S): FL WC 09 06 06 (00)-001 FL EMPLOYMENT AND WAGE INFORMATION REL® APPLIES TO ST(S): FL WC 09 06 07 ( A)-001 FL WC INS "GUARANTY ASSOC SURCH NOTIFC APPLIES TO STATE(S): FL WC 12 06 01 ( F)-001 IL AMENDATORY 9NDT APPLIES TO STATE(S); IL WC 12 06 03 (00)-001 ILLI OIS RENEWAL ENDORSEMENT APPLIES TO STAT (S); -I C 19 06 01 ( G)-001 MD CANCELLATION ONREEWAL ENDT APPLIES TO STAT(S): MD WC 22 00 00 ( A)-001 HN AMENDATORY ENDT APPLIES TO STE(S); WC 22 03 01 (00)-001 COMPLIANCE WITH APPLICABLE TRADE LAW APPLIES TO STATE(S): MN WC 22 06 01 ( D)-001 MINNESOTA CANC AND NON RENEWAL ENDT APPLIES TO STATE(S); MN C 24 03 02 (00)-001 MO NOTIFIC OF ADD MESOTHELIOMA BEN ENDT APPLIES TO STATE(): MO C 24 04 06 ( )-001 MISOUI EMPLOYER PAID MEDICAL ENDT APPLIES TO TAT(S): MO C 24 06 01 ( B)-001 MO CANCELATION AND NON -RENEWAL ENDT. APPLIES TO STATE(S); MO WC 24 06 02 ( ) -001 MO PROPERTY & CASUALTY GUARANTY ASSOC. APPLIES TO STAE(S): MO WC 24 06 04 ( )-001 MISSOURI AMENDATORY ENDORSEMENT APPLIES TO STATE(S): MO WC 37 04 01 (00)-001 PA AUDIT NONCOMPLIANCE CHARGE ENDT APPLIES TO STTEO: PA WC 37 06 01 (00)-001 SPECIAL PA ENDT - INSPECTION OF MANUALS APPLIES TO TATE(S): PA C 37 06 02 ,(00)-001 NOTICE INS CONSULTATION SERVICE EXEMPT. APPLIES TO STATE(S): P C 37 06 03 ( )-001 PA ACT 86-1986 ENDORSEMENT APPLIES TO STAT(S); P WC 37 06 04 (00)-001 PA EMPLOYER ASSESSMENT ENDORSEMENT APPLIES TO STATE(S): PA WC 48 06 01 ( C)-001 WISCONSIN LAW ENDORSEMENT APPLIES TO TTE(S): WI WC 48 06 06 ( B)-001 WI CO SIN CANCELLATION AND NON RENEWAL APPLIES TO STAT (S): WI WC 99 03 76 ( A)-001 WAIVER OF OUR RIGHTS TO RECOVER -CA APPLIES TO STTE(S): CA DATE OF ISSUE: "08-29-19 ST ASSIGN® Page 2 of 3 WORKERS COMPENSATION TRAVELERS AND ONE TOWER SQUARE EMPLOYERS LIABILITY- POLICY HARTFORD CT 0613 EN DORSEMT WC 99 03 C3 O — POLICY NUMBER: UB-4,'375 21.-19-4 - SPECIAL PROVISIONS ENDORSEMENT STATE APPLICABILITY The listed endorsements are only applicable in the following states; C 99 03 99 (00)-001 CA WORKERS' COMP NOTICE F NON -RENEWAL APPLIES TO STAT(S): CA WC 99 03 F (00)-001 CA LIMITS OF LIABILITY ENDT APPLIES TO STTO: CA C 99 04 10 ( 0) -001 PREMIUM J. FROM EFFECTIVE DATE EMT. APPLIES TO SITE(): CA WC 99 06 04 (00)-001 PARTICIPATING ENDORSEMENT - WISCONSIN APPLIES TO STTE(S): W WC 99 06 07 (00)-001 PARTICIPATING ENDORSEMENT APPLIES TO STT(): AZ FL IL IN MD MN MO P WC 99 06 46 (00)-001 ILLINOIS AMENDATORY ENDORSEMENT APPLIES TO TATE(S): IL DATE O ISSUE: 8-29-19 ST ASSIGN: Page 3 of 3 WORKERS COMPENSATION TRAVELERS1,41, AND ONE TOWER SQUARE EMPLOYERS LIABILITY LILY HARTFORD CT 06183 ENDORSEMENT WC 99 03 7 ( )a 001 POLICY : U -4J37 6 1-21-42- CALIFORNIAWAIVER OF OUR RIGHT TO RECOVER. FROM OTHERS ENDORSEMENT — (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR A. M NT CONSULTANTS WHICHHE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation o the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by T r tJ : ;06-30-27 ST SIGN: Page 1 of 1