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HomeMy WebLinkAboutExigis LLC; 2020-01-01;EXIGIS, LLC. STATEMENT OF SERVICE INSURANCE COMPLIANCE SERVICES v.2.0 This Statement of Services ("SOS") by and between Exigis, LLC., a New York Limited Liability Company of 12 E 46th Street, Suite 6E New York, NY 10017 ("Exigis") and City of Carlsbad, CA, located at 1200 Carlsbad Village Drive, Carlsbad, CA 92008 ("Client" or "Customer"); (collectively, the "Parties") is pursuant to the Master Customer Agreement (the "MCA") between the Parties dated January 1, 2020. Unless otherwise indicated herein, all capitalized terms contained in this SOS shall be defined in accordance with the MCA. I. EFFECTIVE DATE This SOS is effective on January 1, 2020 ("Effective Date"). II. TERM The initial term of this SOS is for a period of twenty-four (24) months commencing on the Effective Date and renewing annually through [December 31, 2021] (the "Term"). Ill. TITLE This project will be referred to as Insurance Compliance Services. IV. INTRODUCTION EXIGIS' insurance compliance services {"Services") are designed to assist Customer with the management of 3rd party risk (e.g., risk from vendors, franchises, leases, contractors, etc.) by tracking, monitoring and reporting the compliance of 3rd parties to their respective insurance obligations to Customer. Our standard compliance services ("Services") monitor, measure, and test a 3rd Party's submitted insurance information according to our proprietary multi-dimensional compliance framework r'Standard Compliance Framework" or "SCF" or "Framework"). The Framework includes the following standard components but can be extended in select areas as detailed below and in Standard Compliance Framework section: Based on Template v20190904.1 Page 11 Version 2.0 • A comprehensive compliance process with up to a maximum of Six (6) workflows • Ability to track of up to five (5) document types (can be extended) • Ability to track of up to seven (6) insurance coverage types (can be extended) • Ability to evaluate insurance information for compliance against up to a maximum of seven (7) risk tests measured across thirty (30) insurance questions V. OBJECTIVE The overall objective of the Service is to help Customer to more effectively manage the risk related to their 3rd Party populations. The metric to measure the success of our Service is the ratio of compliant 3rd parties over the entire target population measured on a monthly basis. VI. BACKGROUND The Customer is a municipality, with several departments that interact(s) with 465 active 3rd Parties. The Customer has been managing insurance information for their 3rd Parties by using the CSAC-EIA sponsored insurance compliance system (EXIGIS's platform) and now wishes to contract directly with EXIGIS. Given that the Customer has been using the EXIGIS system, there will not be any effort or cost related to migrating customer data. The customer however does want to add four (4) additional'departments and their respective vendors. VII. INVOICING AND FEES A. SERVICE FEES The fees for the services described in this SOS consist of one-time setup fees and recurring service fees. The following table details the related fees and cap in hours in support of this project. ·-------· -----Service ; Setup Fees Hours1 Annual Fees Hours1 Provisioning N/A N/A $8,980 N/a -----· -~~--, ·---------,,_ Services ~-! $6,230 20 $10,950 85 If the Customer chooses to amortize the Setup Fees over the course of the term, the annualized fee will be as follows: Annualized Fee: Based on Template v20190904.1 $23,045.00 Page I 2 Version 2.0 B. TRAVEL AND EXPENSE No fees related to Travel and Expense ("T&E") are expected and they are excluded from this SOS. In the event that a T&E situation should arise, the T&E must be set in writing and approved for payment by the Customer prior to incurring the T&E. 1 These hours represent the cap of hours allocated for each service. C. PREFERRED PARTNER DISCOUNT If Customer is a Member of CSAC-EIA, Customer will receive a fee discount of 10%. The discount will be applied to recurring fees and credited against the previous billing period throughout the duration of the MDA. D. BILLING AND PAYMENT TERMS Customer will be billed 1/12th of the Annual Recurring Fee on a monthly basis with term of Net 30. E. INVOICE SCHEDULE If setup fees will be paid separately, they will be due upon signing and monthly fees will commence on the 1st of the following month throughout the term of the SOS according to the following schedule. Please note that a Preferred Partner Discount of $170.42 will be applied to each monthly invoice throughout the term of the SOS. Invoice Due Amount 1 : Monthly Fee At Signing : --~------------~ s1,920.42 I 2 i Monthly Fee 1st of the Following Month I 3 ! Monthly Fee _______ ---+-----__ -#2 + 30 days i ___ _ 4 i Monthly Fee ---------+---------#3 + 30 days $1,920.42 $1,920.42 $1,920.42 5 ! Monthly Fe1:______ _ ___ ____ ____ #4_+ 30 days -------$1,920.42 . 6 • Monthly Fee _________ : ______ _ _1#5 + 30 days . $1,920.42 ,__1 ___ 1 _ Monthly Fee ____ #6 + 30 days • $1,920.42 --~-_ i Monthly Fee ---· ______ _ _ _________ #7_~ 30 days I _____ $1,920.42 : Monthly Fee J #8 + 30 days I $1,920.42 9 10 ! Monthly Fee ___ ----#9 + 30 days I $1,920.42 i 11 _J__iy,onthly Fee_____ -~ _ -_-_ _ ___ #10_+ 30 days r-----_ _ $1,920.4?J 12 13 Monthly Fee _______ _ #11 + 30 days : $1,920.42 i Mo~thly Fee ___ , ___ #12 + 30 days , $1,920.42 ~:-: ~:~:~~ ~:: · --"7= 1 -~ --. :;: : m:~: 1 H::~~::t 17 I Monthly Fee -----~--: ____ _ #16 + 30 days $~,920.42 : Based on Template v20190904.1 Page I 3 Version 2.0 ----- $1,920.421 18 _Monthly Fee I #17+ 30 days ---·--------------------r------------ $1,920.42 ) 19 Monthly Fee i #18 + 30 days 20 Monthly Fee I #19 + 30 days $1,920.42 i - - - 21 __ Mon!!:Jly Fee t #20 + 30 days $1,920.42 i -,.,. 22 ~-----Monthly Fee #21 + 30 days $1,920.42 i i Monthly Fee $1,920.42 I 23 #22 + 30 days I - 24 I Monthly Fee ~--~----- - #23 + 30 days s1.920.42 I F. ANNUAL ESCALATIONS For service that extends beyond its base term, unless otherwise notified, fees will escalate annually at a rate of 4%. G. REMITTANCE INSTRUCTIONS For payments via electronic transfer: Federal Employer ID: Bank Name: Bank Address: Account Name: Account Number: Routing Number: Swift Code: For payments via check: VIII. SCOPE OF SERVICE 31-1813780 Citibank, N.A. 1155 Avenue of the Americas, New York, NY 10036 Exigis Limited Liability Company 05386352 021000089 CITIUS33 Exigis, LLC. Accounts Receivable 12 E 46th Street, Suite 6E New York, NY 10017 The scope of this SOS includes a combination of services: for software subscriptions, for professional to configure platform and for on-going maintenance and support. The following sections will detail the parameters that define each of these specific aspects of this project. A. TARGET VOLUMES This section will provide the project with necessary context for on-going services; namely, volume details for the target 3rd Party population and for the number of documents that will be processed for insurance compliance purposes. 1 Customer is responsible for the payment or reimbursement of any bank fees associated with the wire transfer of funds. Based on Template v20190904.1 Page I 4 Version 2.0 Target Population The Customer's 3rd Party population that is has been identified and targeted for insurance compliance tracking and monitoring is as follows: --------·------~----------------------~--------~ I Volume 3rd Parties Reason for Compliance Tracking 1. Vendors : 550 Total! 550 3rd party populations grow and shrink at regular cycles. This "churn" needs to be identified in order to properly understand the effort involved in servicing a targeted population properly. The following table will detail that variability ("Churn Rate") and will serve as the factor in the sizing of the project. --- I 3rd Parties Volume Total Number of 3rd Parties (at this time) ' 1. 550 I --2. 3rd Parted added per Year 25 3. 3rd Pa~ies dropped per Year ___ 25 --- Churn Rate 9% Document Processing The following table details the expected number of documents that will be processed on an annual basis according to Document Type. Document Types 1. ACORD 25 2. ACORD 101 3. ISO CG 2010/37 ----------------- 4. ISO CG 24 04 5. California State Workers' Compensation Certificates ---------- 6. Other ----------- 7. ACORD 24/27 . -----·--·-----------------------~--- Based on Template v20190904.1 550 . TBD i [ 220 ; TBD I TBD ! ' i N/A / ------------------------ Volume ' ---1 Page I 5 Version 2.0 Total 770 Documents in Total B. PLATFORM PROVISIONING DETAILS The following section will detail the specific platform choices made by the Customer including: software edition, number of users, type of user access, and the infrastructure plan. Software Subscriptions Exigis grants a non-exclusive, non-assignable and non-transferable license for access to and defined limited use of the following EXIGIS applications ("Applications" or "Software") per Edition purchased. --------------------------·-·---------·--· -i Edition Purchased Yes No ____ i Enterprise f Essentials User Roles and Access Applications I EXIGIS RiskWorks (rmCompliance and rm.Reports) i EXIGIS Complianz Authorized Users (the "Users") shall refer to those individuals in the employ of Customer including employees, agents, and representatives to whom Exigis grants a non-exclusive, non-assignable and non- transferable license for access to and defined limited use of Applications. The following table outlines the combined number and types of User licenses included in this SOS per purchased Edition: ~ --· ----- I User Type Essentials 1. Administrator I Ability to manage users and i N/A system parameters ---------·--·----- 2. Reviewer User can approve exception N/A requests --··-·· 3. Requester Ability to add a 3rd Party, N/A request documentation and record determination . ··-----. •--•· Infrastructure The following infrastructure plan is included in this SOS per purchased Edition: ·------· -------------------- Essentials 1. Data Storage N/A ----- 2. Bandwidth N/A ----·-------· --------•-•------------- C. SERVICE FRAMEWORK CONFIGURATION DETAILS Enterprise : o' -------·---· 10 i : 88: j I _______ i Enterprise 20GB 40GB per Month The following section will detail how the Service will be designed for the Customer including how supporting workflows will be configured, which types of documents will be tracked, and what tests will be performed on the insurance documents supplied by 3rd Parties. · Based on Template v20190904.1 Page I 6 Version 2.0 Standard Compliance Workflows ("SCWs") The Framework includes a defined set of workflows that activate the requesting and tracking of specific insurance document types and the evaluation of their respective content tested against a defined set of insurance tests. The following section details the specific components that comprise the Framework provided under this SOS per Edition purchased. Please note that the Framework is limited to the maximum of six (6) workflows. 11. ·:::::: Req~~;, . · 1 lntroduc~=~~:~:: ::~ __ ]_--~~-s-:~-:-:-i:i-~--~---_-_ E~t:-:-~-se----~-.. ! request for evidence of Triggered Triggered i insurance. 2. Renewal R~quest i Upon i-nsurance expiration, a 3. Document Submission and Data Captllre 4. Information Audit series of requests are made for an updated evidentiary documentation such as renewal certificate . .. --· -·-· -·-- Document is secured and information is tracked and ~~~()rded di~taUy in sys!e_rn. I Evidentiary data from a 1 document is audited by staff i for accuracy. Manually Triggered X 5. Compliance Determination I --------------~---- j Data that is captured and, in Manually some cases, audited will be Triggered evaluated to determine whether the insurance complies with the requirements set by the Customer. 6. Exception Processing i Request(s)is/are routed to l Customer for further review I , and decis·--i-on (e.g., -r-e-qu_e_ st to waive a coverage or lower _ __ limits).____ _ _ __ __ __ i_ Standard Insurance Document Types ("SIDs") System Triggered X X System Triggered X A 3rd Party will be asked to provide proof of insurance. The proof must be supplied in a pre-approved industry standard set of document types (11Standard Insurance Document Types" or 11SIDs"). The library of supported document types is set to the five (5) following document types: I Document Types ~~--==~=~=~= i 1. ACORD 25 -·1 ·- ! ]c;rtific~te of Liability I I Insurance __ Based on Template v20190904.1 I I _L_ ~~Es=s=e=n~ti=a=ls~/=== ~nterprise I X X I __.J Page I 7 Version 2.0 2. ACORD 101 ----- -·-·---------- 3. ISO CG 20 10/37 4. ISO CG 24 04 5. California State Workers' Compensation Certificates Additional Remarks ---------· -· --- Additional Insured Endorsement Waiver of Transfer of Rights of Recovery Endorsement Non-Standard Insurance Documents {NS/O's) X X X X X In addition to the SIDs, the following non-standard insurance document types will also be supported. Please note that only the Enterprise edition can support document types beyond those included in the SID library. None. Standard Insurance Coverage Types ("SICs") Data from the insurance documents or SIDs will be recorded onto a maximum of 6 (six) insurance coverages ("Standard Insurance Coverage Types" or "SI Cs") as specified below: Insurance Coverage Types Essentials Enterprise ~~~--------~--c=--===~--""'=~~~~-~J 1. Com111~rdal Gen(!rc1IUability X ____________ ~ 1 2. Automobile Liability_____ X ~~---~or_!<ers' Coll!pensation_ _ X 4. _ Employer's Liability _ _ X 5. Professional Liability (Errors X __ and_ Omissions) 6. __ Excess/Umbrella Non-Standard Insurance Coverage Types ("NS/Cs") X X X X X X In addition to the SICs, the following non-standard insurance coverage types will also be supported. Please note that both Essentials and Enterprise edition support insurance coverage types beyond those included in the SIC library. The following non-standard insurance coverages will be supported and included in the scope of this project. [_-____ l_n_su!ance Coverage TyJ>es~---"-- 7. _ ~y__ber Liability 8. _ l'e>llution_Lic1bility __ 9. Garage Keeper's Liability ' L_ Based on Template v20190904.1 Essentials ____ ~_nterprlse __ _ N/A X N/A X N/A X Page I 8 Version 2.0 ---- 10. Sexual Abuse/Molestation Liability ----. -·· ---- 11. Builder's Risk ----------- -__ _!~-Fi_d~li_~_El<>nE 13. _!roperty Insurance __ 14. Standard Risk Tests ("SRTs") N/A N/A N/A --------------- N/A X X X X The 3rd Party's insurance will be tested against any number of the following seven {7) standard qualitative and quantitative risk tests ("Standard Risk Tests" or "SRTs") over the course of the 3rd Party's lifecycle. The Framework is limited to the following seven (7) tests. 1. ~~:~::s:~ Purchased -~ ~~~~ .-~--~-E~~e~ials ~~.=~= :~ · --Enter;rise 2. Required Coverages Purchased ! · -X ------;-------X ___ j i--Req~iredlimits __ Purcha·s~cf-~-~-=---J,__ --~ --£-~==~~=--1 ==-----~----~-=~---·· ·-··-·--· I 4. Additlor:iallnsure~Status j ----~--_____ _I_ _ ______ _x __________ --, :5__. _ Wcl_~'_ler of Subrogation ~tcl_!_~s__ _____ _ _ _ ___ _ ~--________ . '5'. _ _!i_l'lcl_".'C~ Rati_l'lg of Insurer __ _____ __ __ __ ___ __ _ ___ -~---___________ ' 7. F~n~11_~al Str:_en~!h of ln_s_lJr~r X Standard Risk Classifications ("SRCs") The target population of 3rd Parties can be segmented into one or more risk type. Each risk classification ¼'.ill indicate the level of risk posed by the 3rd Party relationship and can via the Compliance Matrix dictate the types of risk tests that will be used to evaluate each submitted document (e.g., certificate of insurance, etc.) to determine compliance status. The following table details the definition of the Standard Risk Classifications and the number of 3rd Parties that fall within that classification. Risk Classification Customer Definition 3rd Party Count i 1. High Risk [Enter Customer Definition [Enter# Volume in this Risk i Here or "N/ A"] Type] -·· ------------- 2. Medium Risk [Enter Customer Definition [Enter# Volume in this Risk Here or "N/A"] Type] -----.--------- 3. Low Risk I [Enter Customer Definition -[Enter# Volume in this Risk I Here or "N/A"] Type] -------------------------------~---. ---------------------~----· -----------·· Total [Enter Count Here] I I Non-Standard Risk Classifications In addition to the set number of SRC's, a Customer can additional classifications. These classifications can follow a different nomenclature (e.g., Contract Types, Vendor Type, etc.) but must relate back to a Based on Template v20190904.1 Page I 9 Version 2.0 type of risk posed to the Customer. The following table details the additional risk classifications for this customer. None. Standard Compliance Matrix ("SCM") The following table indicates, with an "X", the types of risk tests that will conducted across the various risk classifications. -! i Risk Classifications ! Risk Tests High Medium Low -·····--------1. Insurance Purchased X ! X X ----- 2. Required Coverages Purchased X I X ----------- 3. Required Limits Purchased X X ---------4. Additional Insured Status X 5. Waiver of Subrogation Status X 6. Financial Rating of Insurer X ' ------ 7. Financial Strength of Insurer ! X i Non-Standard Compliance Matrix In addition to the SCM, the following non-standard matrix will also be supported. Please note that both Essentials and Enterprise edition support this extended matrix. None. D. SERVICE SUPPORT DETAILS The following section will detail the various aspects of the plan to support Customer during configuration and after roll-out. Customer Training Exigis will coordinate and provide customized role-based training and continuing education services to acclimate Customer Users to Software and assigned role and task responsibilities. The following training Services are included in this SOS (by Edition purchased): ·-----·--. ,. .... ---··· ..... --· -1 ---·--Type of Training Essentials Enterprise Generic On:1:>emand "How t~" Videos (5 minutes in length) 5 .. _ I_ __ 5 --- Customized role-based/task-specific web training sessions None I 2 per year (60 Mins eac~) ----· --... ----·-I_ ···-- Support Resources The following table outlines Support Services and hours of operation included in this SOS: Resources Customer Advocate Based on Template v20190904.1 ' Description A dedicated insurance professional_ that will oversee Essentials Enterprise No Yes ----------···········-··--~------ Page I 10 Version 2.0 --------- service and facilitate strategic concerns. - Op timization Consultant To assist with optimizing the No Yes configuration of the service on an annual basis. ---I - Ac count Manager ! Day-to-Day contact that will Yes Yes i handle any operational issue j communicated from the ! Custo~er. --··---- Liv w ! An online service that will e Chat Support Yes Yes ! connect End-Users to help I --·--/ desk support staff. --- eh-to-Case Support Designed for End-Users, this Monday I I provides them with the I through Friday: 1 ability to submit service 8:00 am-8:00 ! requests via the web with an pm EST I email response from EXIGIS i staff. \ l - Te ! Designed for End-Users, this lephone Support i No Monday through i • provides them with the ' Friday: i I ! ability to speak with a live I 8:00 am-8:00 pm i help desk professional._ I EST -~--.----·- E. DATA MANAGEMENT AND SYSTEM INTEGRATION The following table shows which option is available by edition and the following section will detail the specifics of required system integration and data management work included in this SOS. Work Essentials Enterprise ---~I Managed Data Upload Included Included I Single Sign-on N/A Optional I I Data Exchange via FTP --1 N/A Optional --1 I I ! System Integration N/A Optional ------·--··--· ~-------~' Single Sign-on If required, the following will detail the specifics of any single-sign-on ("SSO") interface included in this sos. Managed Data Upload If required, the following will detail the specifics of any data uploads included in this SOS. It is typical to migrate data from previously used systems or export from other backend systems such as accounting packages or ERP systems. ~-------------------~ ·-------------------------~---------------------- i Task i Number of Records Based on Template v20190904.1 Details The expected number of records to be uploaded to initiate the service. ---- i Volume/Parameter 1 100 _ __j Page I 11 Version 2.0 ----------·---I TBD I Sources of Uploads The number and name of sources for the data upload included in the SOS. I i I ------ Frequency of Uploads Daily IN/A - 1 ----· ··--Weekly i N/A Monthly ------~-_ I r-1/A ---- Quarterly IN/A ----·----- Annually : N/A Record Types Included in the 3rd Parties (e.g., vendors, franchisees, 100 Upload(s) leases, etc.) Historical I --------------- 3rd Party Contact Email Addresses Risk 1100 Classification of 3rd Party (e.g., a flag, an I agreement, a contract, a lease, etc.) -~i~tor~al c;_ompliance Records N/A -----~ Historical COi Documents N/A Other Historical Documents N/A Data Exchange via FTP If required, the following will detail the specifics of any Data Exchange via File Transfer Protocol ("FTP") included in this SOS. None. System Integration If required, the following will detail the specifics of any system integration via a standard application protocol interface ("API") to be included in this SOS. None. F. REPORTING AND COMMUNl(f.lTON REQUIREMENTS Communication is a critical aspect to the success of any project. It is the expectation that all Parties will communicate sufficiently throughout the lifecycle of the project including: project status call and or meetings during the configuration phase of the project and then status meeting and or calls after the Service has been rolled-out to ensure the Service is performing according to stated objectives. .. ---------,--------- : Definition Essentials Enterprise -- 1. Kickoff iX I A call or meeting where all stakeholders i are present in order to set expectations. 2. Discovery --l One or-more me~"tl~gs or calls for the --+--! X-- purpose of documenting the exact requirements of the SOS by the EXIGIS I project team.___ __ ____ _ _ ____ l -1:···········~ -----------_J_ Based on Template v20190904.1 ---- Page I 12 Version 2.0 3. Requirement i Meeting where customer will review the X Review l final product for sign-off. 4. Project ! Meeting duri~g th~e~c_o_n_fi-gu_r_a-ti_o_n_p_h-as_e_t_o--+-N-o-! Twice a :x ! Updates ! communicate progress and/or solicit i Month, by •---------r decisions from Customer. ! EXIGIS Project ~ _____ ! Manager _ 5. Quarterly Post-Roll Out, calls to go over the progress No i Yes, by EXIGIS Check-in l of the on-going service. : Account [ Manager Stewardship success of project and service is reviewed, i Customer and any go-forward adjustment discussed i Advocate 6. Annual 1. In-person meeting preferred where overall No i Yes, by _________ ~~~ agreed. _________ ----~---------' ____ _ G. PROJECT MILESTONES AND ESTIMATED TIMELINE The following table documents the seven (7) major project milestones involved in this project and estimated delivery dates. The duration are estimates based implementing the Standard Framework for each edition. Please note that any additional requirements will affect the overall duration and schedule. ----------------- : Milestone ------ Essentials --T ---Enterprise _.!.....i Kickoff Signing+ 15 days I Signing+ 15 days j ?_ ___ Di~overy _ _#1+5days ____________ #1+1Q_days ___ _ 3 Requirements Documentation #2 + 5 days #2 + 15 days 4 Framework Configuration 1-------------~-----------#3 + 5 days ___ #3 + 60 days 5 , Customer Review and Acceptan~~-_____ ,_#_4_+_5_d_a~ys _________ #_4_+_10_d_ay~s ___ _j 6 Service Rollout #5 + 1 day ___ _ ___ #5 + 5 days ------- 7 ; Maintenance After #6 , After #6 ====i ===============T=o=t=al=E=s=ti=m=a=te=d=D=u=r_-a_ti_o_n~ ___ 3_6 __ D_a~y_s ___ ~i ____ l_l_S_D_a~y=s==--~-l H. CHANGE MANAGEMENT PROCEDURES Customer does not anticipate any changes to the requirements detailed in this SOS. However, if changes do arise, they must be done in writing by the EXIGIS, and an SOS amendment must be prepared to reflect these changes. I. PROJECT ROLES AND CONTACTS ----------· ·-----~--- Contact Role Project Sponsor Project Manager : At Customer ! Ed Garbo I Ed Garbo I Based on Template v20190904.1 At EXIGIS N/A Olga Moskatova Senior Associate, Fulfillment Services 12 E 46th Street, Suite 6E New York, NY 10017 Phone: (800) 928 1963 (ext. 2221) Emai~:_ olga.moskatova@exigis.com Page I 13 Version 2.0 Process Owner i idGarbo Account Manager I N/ A ·--- Custon,er Advocate I N/ A N/A Michell Dick -------1 Michelle Dick IX. AD-HOC SERVICE For requests that go beyond the parameters set in the standard Enterprise or Essentials editions (e.g., additional document types, coverages or risk factors, etc.), additional fees will be applied as defined below. Each custom request will be tracked and billed outside of the standard package pricing and billed on a monthly basis. A COMPLIANCE FRAMEWORK COMPONENT FEES: For requests that are outside the standard compliance framework, the following additional fees will apply for each component. --------·- Component Fee Document Types $25 per document processed beyond the SIDs defined above Insurance Coverages $2 per additional coverage beyond the SICs defined above Questions i $1 per additional question beyond_ the standard risk test questions B. USER ACCESS FEES: ! ' ! I i ! I If during the term of this SOS, the number of active Users exceeds the quantity of User licenses purchased, a per-user license fee will be assessed on a monthly basis in accordance the following fee schedule: User Type~----····----·-·· ---7---· Monthly Fee ____ ] __ 1_. Administrator $220.00 I 2. Manager/Overseer $45.00 I 3. Approver/Rev_i_e_w_e_r ____ -_----_---_--------____ ___ ___ _ --r-___ _ _______ $$5l'........____,. 0 0 0 0 ; _ __ 4. ___ Requestor_ _ _ __L_ C. INFRASTRUCTURE Type Allocation · · J Monthly Fee ______ _1_._ _ Data Storage --~~_dditional GB_o! Storage I ___ $100.00 --~ 2_'.__ Bandwl~t_!1_____ __ _ An add~)o_nal GB of Ban_dwidth/Mont~ ·--------$500.99_ Based on Template v20190904.1 Page I 14 Version 2.0 D. HOURLY RATES The table below outlines Exigis hourly service rates for the period of 2019-2020. These rates shall apply in the calculation of fees related to any expanded support, configuration, integration, engineering technical services which exceed the scope defined herein.2 ---- Role Hourly Rate Consultant I -- Consultant II Consultant Ill ---------------------· Representative I ---- Representative II Representative Ill -- Engineer I ------ Engineer II Engineer Ill Analyst I ---------------• . . --- Analyst II Analyst Ill --- _S~pport ----~---- ----·----__________ ..._ _________ ---- [Signature page to follow] 2 Hourly rates are subject to change following advance written notice from EX/G/5 to Customer. Based on Template v20190904.1 $ $ $ - $ ---- $ __ J $ $ $ -- $ $ $ $ -----~ 228.00 306.00 397.00 ------- 93.00 115.00 137.00 205.00 250.00, 363.00 i I 172.00 i 217.00 i 397.00 ! 93.oo I Page I 15 Version 2.0 x. Signatures Each party represents and warrants that on this date they understand and agree to the terms and conditions of this SOS and are duly authorized to bind their respective principals by their signatures. City of Carlsbad, CA Title: Human Resources Director December .t 1 . 2019 Exigis, LLC. Armand Alvarez Chief Executive Officer December _3_Q, 2019 Based on Template v20190904.1 APPROVED AS TO FORM Cella A. Brewer, Citr AttomeJ Br, jOe J.(d(f L Hlr ---Asst/OeputyCI Attorney City of Carlsbad, CA _ Page I 16 Version 2.0 EXIGLIM-01 CWILSON1 ACORD' CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYYJ ~· 12/18/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ij2ij!~cT Connie Wilson Hub International Northeast Limited r:ig,NJo,Ext): (717) 767-7862 I FAX 1805 Loucks Road, Suite 300 (AIC,No): York, PA 17408 i~o'M~ss: connie.wilson@hubinternational.com INSURER/SI AFFORDING COVERAGE NAIC# INSURER A: Hartford Fire Insurance Comoanv 19682 INSURED INSURER B: Hartford Insurance Grouo 914 EXIGIS Limited Liability Co. INSURER c: Westchester Surolus Lines Insurance Co. 10172 12 East 46th Street, Floor 6 INSURER D: Philadelohia lndemnitv Insurance Comoanv 18058 New York, NY 10017 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT V\,'ITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iN'i~ TYPE OF INSURANCE ~8.Pk ~~ POLICY NUMBER PO!J9_Y EFF _ _POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 -~ CLAIMS-MADE CK] OCCUR DAMAGE TO RENTED 300,000 39SBANW5936 3/31/2019 3/31/2020 PREMISES /Ea occurrence\ $ f---MED EXP /Anv one oersonl $ 10,000 f---PERSONAL & ADV INJURY $ 2,000,000 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ~ POLICY □ ~fc?r □ LOC PRODUCTS -COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY ~~~~b~~~llNGLE LIMIT $ 2,000,000 f--- ANY AUTO 39SBANW5936 3/31/2019 3/31/2020 BODILY INJURY /Per oersonl $ -OWNED ~ SCHEDULED -AUTOS ONLY f--AUTOS BODILY INJURY /Per accidentl $ X ~L';-'?s's ONLY X ~aro~~Jr.~ fROPERTY 1~AMAGE Per accident $ -f-- $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ -EXCESS UAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION $ $ B WORKERS COMPENSATION XI ~\%11TE I I OTH-AND EMPLOYERS' LIABILITY ER YIN 39WECT06251 3/31/2019 3/31/2020 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE []] E.L. EACH ACCIDENT $ Rl'FICER/MEMBER EXCLUDED? N/A 1,000,000 ( andatory In NH) E.L. DISEASE -EA EMPLOYEE $ ~~;~~ft~J~ 'c;'t6PERATIONS below E.L DISEASE -POLICY LIMIT $ 1,000,000 C Professional Liabili G2757791A005 3/31/2019 3/31/2020 Per Claim/Aggregate 3,000,000 D Cyber Liability PHSD1432282 3/31/2019 3/31/2020 Per Claim/Aggregate 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The certifcate holder is listed as additional insured as required by contract. Waiver of Subrogation for workers compensation as per form WC0003 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad/CMWD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1635 Faraday Ave Carlsbad, CA 92008 AUTHORIZED REPRESENTATIVE I c_q.w~ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number: 39 WEC TO6251 Endorsement Number: Effective Date: 03/31/19 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: EXIGIS LLC 12 E 46TH ST FL 6 NEW YORK NY 10017 -~ 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. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Any person or organization from whom you are required by contract or agreement to obtain this waiver from us. Endorsement is not applicable in KY, NH, NJ or for any MO construction risk Form WC 00 03 13 Printed in U.S.A. Process Date: 02/19/19 Countersigned by ___________________ _ Authorized Representative Policy Expiration Date: 03/31/20