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Contract 50656-R2
CSC No. 50105( 11a FOP��Nn& RECEIVE JUN 14 2019 CITY OF FORT WORTH C!T OF FORT WORTH CITYSECRETARy CONTRACT RENEWAL NOTICE June 6, 2019 SRB Systems, Inc. Attn: Hemchand Bandreddy, 7901 Cameron Rd, Ste. 3-320 Austin, TX 78754 Re: Contract Renewal Notice Contract No. CSC No. 50656 (the "Contract") Renewal Term No.oo..��August 1, 2019 to August 2, 2020 / The above referenced Contract with the City of Fort Worth expires on August 1, 2019 (the "Expiration Date"). Pursuant to the Contract, contract renewals are at the sole option of the City. This letter is to inform you that the City is exercising its right to renew the Contract for an additional one (1) year period, which will begin immediately after the Expiration Date. All other terms and conditions of the Contract remain unchanged. Please return this signed acknowledgement letter, along with a copy of your current insurance certificate, to the address set forth below, acknowledging receipt of the Contract Renewal Notice. Failure to provide a signed acknowledgment does not affect the renewal. Please log onto PeopleSoft Purchasing at http://fortworthtexas.gov/purchasing to insure that your company information is correct and up-to-date. If you have any questions concerning this Contract Renewal Notice, please contact me at the telephone number listed below. Sincerely, Vickie L. Anderson Administrative Technician 200 Texas Street Fort Worth, TX 76102 Vickie.Anderson_,fortworthtexas.go 817-392-2788 OFFICIAL RECORD CITY SECRETARY Contract Renewal age df CSC No. ACCEPTED AND AGREED: CITY OF FORT WORTH CONTRACT COMPLIANCE MANAGER: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including By: ensuring all performance and reporting Name: Sus Alanis requirements. Title: ssistant City Manager By: 2a" (� 0 APPROVAL RECOMMENDED: Name„ 9teve Streiffe Title: Assistant Director,IT Solutions APPROVED AS TO FORM AND By: LEGALITY: Name: Title: ATTEST: By: Name: Jkn B. trong DST >, Title: Assistant Ci Attorney . �., By: CONTRACT AUTHORIZATION: Name. ary J. y er U M&C: C- 28636 Title: City Secretary = Date Approved: 3-27-2018 Form 1295 Certification No.: 2018-321483 S SRB Systems, Inc. By: —7f " Name: Hemchand Bandreddy Title: Director OFFICIAL RECORD CITY SECRETARY FT. WORTH,TX Contract Renewal Page 2 of 2 DATE(MM/DD/YYYY) aCoRH CERTIFICATE OF LIABILITY INSURANCE 12/04/18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If 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 endorsements. PRODUCER NOMEACTAmber Kinsey Carl Burton Insurance Agency PHONE 512-258-4197 FAX 512-258-6631 9410 B Anderson Mill Road E-MAIL A/C No. :a lnsey s cg o a .net Austin, Texas 78729 ADDRESS INSURERS AFFORDING COVERAGE NAICJI IN RERA: Hartford Lloyds Insurance INSURED SRB SYSTEMS INC INSURERB: Hartford Ins Co of the Midwest 7901 Cameron Road INSURER Austin, TX 78754 INSURERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONSOF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAID CLAIMS. INSR AUUL1bUbH POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICYNUMBER fMM/DD1YYYYI MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $2,000,000.00 X COMMERCIAL GENERAL LIABILITY PREMI E Ea occurrence s300,000.00 CLAIMS-MADE El OCCUR MEDEXP An one erson $ 10 000.00 A 65SBIL4853 1-3-19 1-3-20 PERSONAL&ADV INJURY $2,000,000.00 GENERAL AGGREGATE $4,000,000.00 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG $4,000,000.00 P LICY PRO LO $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000.00 Ea accident ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED 65SBIL4853 1-3-19 1-3-20 A AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS }( NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ REDEXCESS LIAB Id CLAIMS-MADE AGGREGATE $ RETENT N WORKERS COMPENSATION X I WCSTATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 65WBCIO2821 1-3-19 1-3-20 E.L.EACH ACCIDENT $1,000,000.00 A OFFICER/MEMBER EXCLUDED? �N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000.00 If yes,describe under 1,000,000.00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) DIR AND THE STATE OF TEXAS ARE NAMED AS AN ADDITIONAL INSUREDS UNDER THE GENERAL LIABILITY AND HIRED AND NON—OWNED AUTO COVERAGE. THERE IS A WAIVER OF SUBROGATION IN FAVOR OF DIR UNDER THE HIRED AND NON—OWNED AUTOMOBILE COVERAGE, AND GENERAL LIABILITY COVERAGES. 30 days notice of cancellation applies CERTIFICATE HOLDER CANCELLATION DEPARTMENT OF INFORMATON RESOURCES 300 W. 15TH STREET SUITE 1300 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AUSTIN, TEXAS 78701 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT E ©1988-2010 ACOR ORPORATION.ff rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD