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HomeMy WebLinkAboutEPIC LAND SOLUTIONSCity of Santa Ana _ Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes _ No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with �1 c r! ^T)' .56ZL0716 N A-2015-161-01 No. _ was completed on (List all amendments. Use space below it needed.) Revised: 1 Q 18-16 5 D and final payment has been made. Department: l�� - L✓� �y�E Phone/Ext.: Signature: �� V C� `✓ i Date: INSURANCE NO"I" ON FILE WORK MAY NOT PROCEED MA LERK OF COUNCIL Miguigu el A. Pulido T MAYOR PRO TEM DA1:.E: AUG 2 9 201E Michele Martinez 9 COUNCILMEMBERS P. David Banavides Vicente Sanniento Jose Solono Sal Tinalero UY Juan Villegas .vz-- July 25, 2018 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza, M36 a P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.ora Epic Land Solutions, Inc. Attn: James L. Overcamp, Jr., SR/WA Vice President 2601 Airport Drive, Suite 115 Torrance, CA 90505 A-2015-161-01 CITY MANAGER Raul Godinez 11 CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar Re: Extension of Consultant Agreement No. A-2015-161 for Acquisition and Relocation Services Dear Mr. Overcamp: Pursuant to Section 3 ("Term") of Agreement No. A-2015-161 entered into by Epic Land Solutions, Inc. and the City of Santa Ana, dated August 5, 2015, which was amended on December 16, 2015 (#A-2016-009), the time period of said Agreement is hereby extended for an additional one (1) year period from August 6, 2018 to August 5, 2019. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of said Agreement unchanged and in full force and effect. Fua S Sweiss, PE, PLS Execut ve Director, Public Works Agency CITY OF SANTA ANA Raul Godinez 1I a ar/8 City Manager APPROVED AS TO FORM J�Funk 16wL Assistant City Attorney ATTEST Maria D. Huizar Clerk of the Council SANTA ANA CITY COUNCIL Mgaef A. Nhdo McolIa Manioex vlcanle sarmienrm .lase sWmo P. Dwd aanatides Juao Villages Sai Tioaiaro Mayor Mayor Pro rem. Ward ] Ward i Ward 3 Ward 4 Ward 5 Ward 6 mJyyIIQ9 jWj,-aneor, moMMae'z&—L.6anda0 a a a rmlaolaR6eamaananm m,Norro(aasantaarra9r9 tl0 'tl FY1' 1 3 i^L�tA has 1 d s,inaiero(¢lsa 1a-ana om EPICLAN-01 AUSTINA ACORN CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 9/25/225/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # OE67768 CONTACT Dana Schwartz NAME: IOA Insurance Services PHONE FAX 4370 La Jolla Village Drive (A/C, No, Ext): (619) 574-6223 50203 (A/C No):(619) 574-6288 Suite 600 Aoo IIEss• Dana.Schwartz@ioausa.com San Diego, CA 92122 INSURED Epic Land Solutions, Inc. 2601 Airport Drive Suite 115 Torrance, CA 90505 INSURER F : rnVFRA(.FS (_FRTIFI(`ATF NIIMRFR• RFVICInN m IMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AWL SUBR POLICY NUMBER ! POLICY EFF POLICY EXP LIMITS LT A X COMMERCIAL GENERAL LIABILITY ,EACH OCCURRENCE : $ 2,000,000 CLAIMS -MADE X OCCUR ❑ X 4031022253 10/01/2018 10/01/2019 DAMAGE TO RENTED 1,000,000 PREM�SES1Ea�.ur_r_en0) $ X Cont Liab/Sev OT Int 10,000 MED EXP (Any one nersonL _ _ I 2,000,000 PERSONAL 6 ADV INJURY_! 3_ _ _ _ AGGREGATE LIMIT APPLIES PER: GEN'L GENERAL AGGREGATE $ 4,000,000 POLICY jpT l LOC PRODUCTS COMP/OP AGG $ 4,000,000 OTHER: HNOA $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 ' $ ANY AUTO 14031022253 10/01/2018 ---(EAlccidept) -___- 10/01 /2019 BODILY INJURY (Per person) ! $ OWNED SCHEDULED i AUTOS ONLY AUTOS - i BODILY INJURY (Per- X NN E AUTOS X__ AUOTOS ONLIY � (Pe0acEciRde tDAMAGE $ X ONLY Autos . Owned - -- - B X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS -MADE 6014253989 i 10/01/2018 10/01/2019 AGGREGATE $ 10,000,000 DED I X I RETENTION $ 0 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER OTH- T ASUTE i --ER— YIN ANYPROPRIETOR/PARTNER/EXECUTIVE _. WC 5 94617867 10/01/2018 10/01/2019 1,000,000 L. EACH ACCIDENT - OFFICER/MEMBER EXCLUDED? 1 (Mandatory In NH) - NIA _E _._-__. ,_ __ E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Prof Liab/Clms Made PGIARK06632-02 10/01/2018 10/01/2019 Per Claim 3,000,000 C Ded.: $25K Per Claim PGIARK06632-02 10/01/2018 10/01/2019 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations City of Santa Ana, its offciers, employees, agents, volunteers and representativs are Additional Insureds with respect to General Liability per the attached endorsement as required by written contract. Insurance is Primary and Non -Contributory. 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions. REVIEWED BY: EUNICE HEREDIA (PG OF �) City of Santa Ana 20 Civic Center Plaza (M-36) P.O. Box 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C�A Policy Number: 4031022253 �r Named Insured: Epic Land Solutions, Inc. SB-146968-A (Ed. 01 /06 ) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C., OF THIS ENDORSEMENT FOR THESE DUTIES. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS -COMPLETED OPERATIONS COVERAGE BLANKET WAIVER OF SUBROGATION Architects, Engineers and Surveyors This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A. WHO IS AN INSURED (Section C.) of the 4. Businessowners Liability Coverage Form is amended to include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury," B. The insurance provided to the additional insured is limited as follows: That person or organization is an additional insured solely for liability due to your negligence specifically resulting from "your work" for the additional insured which is the subject of the 5 written contract or written agreement. No coverage applies to liability resulting from the sole negligence of the additional insured. The Limits of Insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy, whichever is less. These Limits of Insurance are inclusive of, and not C. in addition to, the Limits of Insurance shown in the Declarations. 3. The coverage provided to the additional insured within this endorsement and section titled LIABILITY AND MEDICAL EXPENSE DEFINITIONS — "Insured Contract" (Section F.9.) within the Businessowners Liability Coverage Form, does not apply to "bodily injury' or "property damage" arising out of the "products -completed operations hazard" unless required by the written contract or written agreement. SB-146968-A (Ed. 01 /06) The insurance provided to the additional insured does not apply to "bodily injury," "property damage," "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications by any architect, engineer or surveyor performing services on a project of which you serve as construction manager; or b. Inspection, supervision, quality control, engineering or architectural services done by you on a project of which you serve as construction manager. This insurance does not apply to "bodily injury," "property damage," or "personal and advertising injury' arising out of: a. The construction or demolition work while you are acting as a construction or demolition contractor. This exclusion does not apply to work done for or by you at your premises. BUSINESSOWNERS GENERAL LIABILITY CONDITIONS — Duties In The Event of Occurrence, Offense, Claim or Suit (Section E.2.) of the Businessowners Liability Coverage Form Is amended to add the following: An additional insured under this endorsement will as soon as practicable: 1. Give written notice of an occurrence or an offense to us which may result in a claim or "suit" under this insurance; Page 1 of 2 REVIEWED BY: EUNICE HEREDIA (PGZOF ?� ) 2. Tender the defense and indemnity of any claim or "suit" to us for a loss we cover under this Coverage Part; 3. Tender the defense and indemnity of any claim or "suit" to any other insurer which also has insurance for a loss we cover under this Coverage Part; and 4. 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 claim or "suit" from the additional insured. D. OTHER INSURANCE (Section H. 2. & 3.) of the Businessowners Common Policy Conditions are deleted and replaced with the following: 2. This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing to the additional insured's own coverage. This insurance is excess over any other insurance to which the additional insured has been added as an additional insured by endorsement. 3. When this insurance Is excess, we will have no duty under Coverages A or B to defend the additional insured against any "suit" if any other insurer has a duty to defend the additional insured SB-146968-A (Ed. 01/06) SB-146968-A (Ed. 01/06) against that "suit" If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. E. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Section K.2.) of the Businessowners Common Policy Conditions is deleted and replaced with the following: 2. We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement 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 within the "products -completed operations hazard." Page 2 of 2 REVIEWED BY: EUNICE HEREDIA (P OF `j)