Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
WILLDAN HOMELAND SOLUTIONS
INSURANCE ON FILE ' VORK MAY PROCEED UNTft INSURANCE EXPIRES CLE KI EWU CIL. DATE: UGl U Z 2010 5 p, q (I ) L -,Lo 1^carV,NU2.- PROFESSIONAL. SERVICES AG42LLMENT TO PROVIDE GRANTPROTECT R FISCAL COORDINATOR SERVICES `[THIS AGREEMENT, tirade and entered into this 21" day of August, 2018 by and between WILLDAN HOMELAND SOLUTIONS, an operating division of WILLDAN GROUP, Inc., a California corporation (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hnereniziter "City"). RECITALS A. City, acting through the Santa Ana Police Department in its capacity as a Core City and lend agency for the Anaheim J Santa Ana Urban Area under the Urban Areas Security Initiative ("UASI"), has applied for, received and accepted a grant from the federal Department of Homeland Security, Office of Domestic Preparedness, through the State of California, Office of" Emergency Services, to enhance countywide emergency preparedness, hereinafter referred to as "the Grant". B. The City desires to contract with an expert in providing Project and Fiscal Coordinator - Grant Management Services. C. Consultant represents that it has the necessary skills and experience to provide assistance in developing in applications, invoicing and processing payment documents in compliance with grant policies, and maintaining guidelines and polices required by grant providers. D, In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services perfonned by Consultant tinder this Agreement will be performed in compliance with such standards astray reasonably be expected train a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the teens and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SE12V10ES Consultant shall develop and provide grant management services asset forth in Exhibit A, attached hereto and incorporated by this reference. All services required hereunder shall conform in all respects to standards and regulations for funding by the U.S. Department of Homeland Security, and the California Office of Emergency Services. Consultant will be responsible for continued training to remain current on the management and reporting obligations required of die various Homeland Security Grant funds. 2. COMPENSATION It. City agrees to pay, and Consultant agrees to accept as total payment for its services as hourly rate of $68,92, effective September 1, 2018, Additionally, Consultant shall be reimbursed for training and travel which has been pre -approved, in writing, by City. The total sum that can be expended during the teen of this Agreement (September 1, 2018 through August 31, 2019) shall not exceed $144,840 annually. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. USE AND OWNERSHIP OR DOCUMENTS It is understood by and agreed to between the parties that all written papers or materials prepared pursuant to this Agreement, paid for with Grant funds, or composed utilizing information provided by Santa Ana, shall be the property of Santa Ana and shall be delivered to Santa Ana upon completion of the services hereunder. A. TERM This Agreement shall continence on September 1, 2018 and terminate on August 31, 2019, unless terminated earlier pursuant to Section 13, below. 5. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of tins Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance which shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. c. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be canceled without thirty (30) days prior written notice to the City. Ten (10) days notice if cancellation is due to non-payment of premium. d. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terninate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 7. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, and special counsel from liability for personal injury, or just compensation, arising out of claims for personal injury, including death, and claims for property damage, to the extent they arise from the negligent or willful misconduct in the performance of operations or errors or omissions of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section t of thus Agreement. 8. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably wuterstood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic inlmnation. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either patty by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of [lie Consultant disclosed in a publicly available source; (e) is in rightful possession of the Consultant without an obligation of confidentiality (d) is required to be disclosed by operation of law, or (e) is independently developed by the Consultant without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 10. NOTICE Any notice, leader, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by fust class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic communication in [)to manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Telefacsimile (714) 647-6956 With courtesy copies to: Santa Ana Police Department City Attorney UASI / Homeland Security Division City of Santa Ana 60 Civic Center Plaza 20 Civic Center Plaza (M-29) P.O. Box 1981 (M-97) P.O. Box 1988 Santa Ana, California 92702 Santa Ana, California 92702 Attn: Kanan Blake Telefacsimile (714) 647-6515 Email: kblakc@santa-aiia.org santa-ana.org Telefacsimile (714) 245-8098 To Consultant: Mike Hooper Willdan Homeland Solutions 2401 East Ratella Avenue, Suite 300 Anaheim, California 92806 Office (714)940-6389 Email: mhoopercrwilldan.com A party may change its address by giving notice in writing to the other- party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 11, EXCLUSIVITY AND AMENDMENT ]'his Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, that terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each patty to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 13. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of tenvination. In the event that grant funding is not secured, City has the right to terminate the Agreement inunediately upon exhaustion of the grant funds. Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice oftennination, subject to the following conditions; a. As a condition of such payment, the Chief of Police may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. 14. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affunus that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 15. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 16. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the Unitech States, the State of California, the City of Santa Ana and all other govertntental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of thus Agreement. 17. CONSULTANT CERTIFICATIONS a. Debarment and Suspension — Contractor will comply, and all its contractors will comply, with applicable federal suspension and debarment regulations including, but not limited to, Executive Orders 12549 and 12689, and 2 Code of Federal Regulations (CFR) §200.212 and codified in 2 CFR Part 200. b, Section 504 of the Rehabilitation Act of 1973 (Handicapped) - All recipients of federal funds must comply with Section 504 of the Rehabilitation Act of 1973 (The Act). Therefore, the federal funds recipient pursuant to the requirements of The Act hereby gives assurance that no otherwise qualified handicapped person shall, solely by reason of handicap be excluded from the participation in, be denied the benefits of or be subject to discrimination, including discrimination in employment, in any program or activity that receives or benefits from federal financial assistance. The Contractor agrees it will ensure that requirements of The Act shall be included in the agreements with and be binding on all of its contractors, subcontractors, assignees or successors. C. Americans with Disabilities Act of 1990 - (ADA) Contractor must comply with all requirements of the Americans with Disabilities Act of 1990 (ADA), as applicable. d. Lobbying and Political Activity - None of the funds, materials, property, or services provided directly or indirectly under this agreement shall be used for any partisan political activity, or to further the election or defeat of any candidate for public office, or otherwise in violation of the provisions of the "Ilatch Act". e. Contractor will comply with all applicable lobbying prohibitions and laws, including those found in United States Code Title 31, § 1352, el seq., and agrees that none of the funds provided under this award may be expended by the Contractor to pay any person to influence, or attempt to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with any federal action concerning the award orrenewal of any federal contract, grant, loan, or cooperative agreement. f, Contractor will comply, and all its contractors will comply, with all requirements of the Byrd Anti -Lobbying Amendment (31 U.S.C. 1352), as applicable. g. Non -Discrimination and Equal Opportunity - Contractor will comply, and all its contractors will comply, with Title Vl of the Civil Rights Act of 1964, as amended; Section 504 of the Rehabilitation Act of 1964, as amended; Subtitle A, Title 11 of the Amcricans with Disabilities Act (ADA) (1990); Title DC of the Education Amendments of t972; the Age Discrimination Act of 1975, as amended; Drug Abuse Office and 'treatment Act of 1972, as amended; Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970, as amended; Section 523 and 527 of the Public Health Service Act of 1912, as amended; Title VIII of the Civil Rights Act of 1968, as amended; Department of Justice Non-Discrttnination Regulations, 28 CFR Part 42, Subparts C, D, E, and G; and Department of Justice regulations on disability discrimination, 28 CFR Part 35 and 39. In the event a Federal or State court, Federal or State administrative agency, or the Contractor makes a finding of discrimination after a due process hearing on the grounds of race, color, religion, national origin, sex, or disability against a recipient of funds, the Contractor will forward a copy of the findings to CITY which will, lin turn, submit the findings to the Office of Civil Rights, Office of Justice Programs, U.S. Department Of Justice. K Contractor will comply, and all its contractors will comply, with all requirements of the Executive Order 11246 of September 24, 1965, entitled "Equal Employment Opportunity," as amended by Executive Order 11375 of October 13, 1967, and as supplemented in Department of Labor regulations 141 CPR chapter 60), as applicable. i. Contractor will comply, and all its contractors will comply, with all requirements of the California Public Contract Code Section 10295.3, as applicable. j. Contractor will comply, and all its contractors will comply, with all requirements of the Copeland "Anti -Kickback" Act (18 U.S.C. 874) as supplemented in Department of Labor regulations (29 CFR Part 3), as applicable. k. Contractor will comply, and all its contractors will comply, with all requirements of the Davis -Bacon Act (40 U.S.C, 276a to 276a-7) as supplemented by Department of Labor regulations (29 CFR Pail 5), as applicable. 1. Contractor will comply, and all its contractors will comply, with all requirements of Sections 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708) as supplemented by Department of Labor regulations (29 CFR Part 5), as applicable. In. Contractor will comply, and all its contractors will comply, with all applicable standards, orders or requirements issued under Section 306 of the Clean Air Act (42 U.S.C. 1857(h)), Section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738, and the Environmental Protection Agency regulations (40 CPR pail 15), as applicable. n. Contractor will comply, and all its contractors will comply, with all requirements of the Energy Policy and Conservation Act (Pub. L. 94-163, 89 Stat. 871), (53 FR 8078, 8087, Mar. 11, 1988, as amended at 60 FR 19639, 1964.5, Apr. 19, 1995), as applicable. o. Contractor will comply, and all its contractors will comply, with all requirements of Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, as applicable. P. Contractor will comply with the Federal Water Pollution Control Act (33 U.S.C. 1251- 1387) as applicable. q. Contractor agrees that the Department of Homeland Security shall have the authority to seek patent rights for any process, product, invention or discovery developed and paid for with finding through this Agreement based on the requirements of 37 CPR§ 401, as applicable. r. Pursuant to 2 CPR section 200.315, Contractor may copyright any work that is subject to copyright and was developed, or for which ownership was acquired, under a Federal award. The Federal awarding agency reserves a royalty -free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work for Federal purposes, and to authorize others to do so. The Federal government has the right to: (1) Obtain, reproduce, publish or otherwise use the data produced under a Federal award; and (2) Authorize others to receive, reproduce, publish, or otherwise use such data for Federal purposes. Contractor will provide int'onnation pursuant to 2 CPR section 200315(e) for response to a Freedom of Infomiation Request when applicable. s. Contractor will comply with the provisions of 2 C.F.R. section 200.315 regarding the use of intangible property. t. Contractor will comply with all applicable local, state and federal statutes, codes and regulations regarding the use of state or federal grant funds and properly acquired with those grant funds. U. If the product is detective, does not function as represented or advertised, City is entitled to either a full refund of the purchase price or replacement of the product for a new product at the City's election. 18. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnity City [idly, including reasonable costs and attomey's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA, a municipal Corporation of the State of Califomia IV? MARIA D. IIUIZAR _ RAUL GODINEZ II Clerk of the Council City Manager APPROVED AS TO FORM: SONIA R. CARVALHO City t -n ly 13y 1' A to GOSIAN Assistant City Attorney RECOMMENDED FOR APPRO AL: (—D VALENTIN Chief of Police WILLDAN HOMELAND SOLUTIONS MIKE HOOIt President and CEO EXHIBIT A JOB DESCRIPTION GRANT PROJECT & FISCAL COORDINATOR Anaheim/ Santa Ana UASI Grant Office lob title: Grant project & Coordinator Oopartment/Group vroiacl rnana amFm wra; granCa & Audit 4n t Santo'kni Police oaparlo-cm Job riewiption Reporting Relationships/Supervision iota category- lob ategory lob Code U;UIDO3 Deports to the JAii Grant CovIlonatcr and Adrrirutra:or. y'lgrks in Jole conrdinabor n;ith Project CooYdinatera, SLb Rccpents, Gty Finance, and Lnc C, bioinia pfficr of Cm^rgcrl Soria;. Galsor to the JA;I Working Group iJAWC1,UASIWerlrgContfnittcc,UAs}GSutCcrrn•dtct•s. andOrirgcCourcymellIlA cssrnrntCcater iCCIAQ %sten Center Basic Function the Gran* Ploiect S Fisea.:cordin3tor pans, 3r11anrans, manages, anddrests an, sires related to prclecl management and the imancto and Audit Un t. Ensures successf Jl rn:e lrat: on of all aspens of p•o;ecii, IrclAirg tecrri.al, gran^a!, legal, and poi rtcar, in ersu:e that pretecta aisrRnud stay on tiudget ono no e.neduie Lnsures grant Iir4rl are in compliance sobrnrt; cash advances{request; in a tr•taoi.y marner, t.rac?s e(PsrdLtures and cudgel,. crgcesses sub reciplerl •e n•tunern2nt regscsts, any managei del3red reco'tlkeeping Responsibilities ar 1 ::1 Isa to 4FI'!4pt And C i:,gjlrAlinr • R,%Fonvbi.. Ir the raanad+m.•rI m•ti oar, siahl ,J z'i ""d "d pita ret n:Yrvid e, induulme h J 11,11 1 wt=d la and artgenwv 1rmw mar .i n- ile.ra: ilr n : g rw r,ingJirn-glia ur .vill', a I acfd cAI r n.l�•, anC reg.dAliors,, 114""Ei�g,a.dbrt. emu rgfarliripal ion e'd.I ,rgonalFu911r rafeln eke •urs andngnlnr rwnnrhny, + P• udde rev m of plulert 3ppilca: um ensuring nuthw,rad Etl_dpr^rer:l Vat tA3} compliance • Supports tha cporolg4Ii)r and rmp�eniegtaton o` trn cnntrarttnp process sd;h Request fcr sr7po.a IRthj &urlopmpn; and crna- il, rrray., ann procnss+rg rf Agreemeris • flvticipatc3 �n 8rrt 3ppnca: cn and iYrvediment jail baton at rgirl, ,tate ann fnJeral Ic.•el • pwil updates or proleot,flusand/or program goal:;rmbatrre;. • Provsim bnehw; to the UA}I %%o•, rg G! 3.p, JAS1 3tr::rmk Ceanruttce, and UAM, b+ ji bwnr•srt tCes, anC UUAL Cer'tcr. • A;it5P:ithcntr{atnq. errCnt ltfmi inky VAsebatk In+rrtU'X 55`tEt^. lCnYph n`Cr'%.aY'y doeumentatcn fcr ai:ach-ricrt la each Peru r >rtom • Revrco,ofrequire?docvTentahon uabmatcd Ly;tarterdsl.b rrcrplcrts to rnclgdc pecjrct!apphcarcm E F, GI UES tape 3ecls fir. uding but not I wdvd to Suit taurtc. Velar le Appro ro , [norgcr. e✓ Weration Canter apPrgVal e, and AI:cra ftAVoItaaait Aapucva1), q ar lc ty reonrIi. an 3'0 V0 oc do21s • Revir'r, al'r.,b recipi int train, ig t, nib Ur,^mort Icquo I is. tC n_r 5a re aide cu men tail on ho •, been comoleted, eft required b"k up has b^.n. ,abmittcd, and tm rd4wes and up cenectiy Contact sub recipient in order to a;k fcr caritcatice, o, reque,t nrui ,ng documentation m •seeded. Entar in al ait, d .".nd sit Crna� tea nlr�g rCrLlnt s IIfI :ar.^I :prcad;ncct Iov rcpurUng, tracking, and rc`.n+taur.cnaCnt pur,^.oic. • ,bets as inj an toOCIAC rusicn Cenfr • Attend, poi ning and updatr meet ng; a; requc;ted or dc_,—n -tl nccessar,, Anaheim/ Santa Ana UASI Grant Office __ __ —- _ is F It ctde, prtrgle nn a is der!^i til Ndei,;,w, hv: 41c, m ulh y,ntl ii dtlnlr, l-. I'w r1AS nn,dmit or an^ nr.r,f ❑ retia• Financml and Ant ii, htagar;emeat C ore Finarroa' urocedi es • JOOil tokeq) l of Plan: a,v and ill na: ionto oa ele d«FI u P,n lig '. ad,uvta cul for at ta.hmtit l Io Ii,e reuuev fur caincll api;i i'I pr,^,el lo* nest, giant accoart ryn'betrti dud budge) alltRaLWl6 lLf" abject code. • Cmmn'rtf tawson entry nP Prn,erts and ArlivlFfi in nr$,r 0: ri PatP hudyel al -a Turns by p"t^rt, dod acste Activity' nimb en 1n51: icentvfy a - alact and Ia!uIt er area as an accounting rnecha msat. • FIOIe)'. purchaseo: JnsanJ At tact ,app.,ring kirolmutaton, ac It as nrvati an d parking Opp Pro'Cct d:4uu n_i ng inf+.lrl i Minn a t8 m ant Iti ur CI'al god. CU'Atr Irl nr dur m nsen; pArt pl. did %e wl t0 C•Iq Fin4l'A r^ for Iendnr OaYncn!. Pr;;frss 111 Yawing rnroi[+•s for rrnbdrt "necrs a•tdtl, ,u ppmting nuul m.. ddtio I, inl crew )for a# III .eu Pit, ri l re uchors• create �almbit serlert ^ccQ1, a it aid send ?cl I. I, ri,Cdl for pdymce I. Pr., r,s ad: air l{:ienl -emdnn sem enl pnr N w s 1,I rherk f , -MF IIre. ra,an dl Caper A'ctt and ttlmplet , I pr.:er,a lit, Iecipie it i -voice , Crdte rt•P nha nrnirw pat'.krl al d�rnd fn Fol Ie ,Flsral for pdYIII ell! is F m in til rtGnth y if h-eF for g -ant :L•I e;u net, r,ohc+ct uvwllo' cliiu• A,II itln Inn', Prd ca F'fA int ls,bti id RrvM.v t ..ntLly I'l r Ci„riovh, 1 , l urt,, d'; a:4ng dnpeclp, »lr nmrsh,wro. rhils and r,� P7N Pay,ol'I prug,mn 1•: prwi l All 0n,t li it ds rcJui • 7:nll h-te hudt+ t Pi ,j,tl'nn im rdth oi'+-n Wwwid',t1 5-uuilY Or.mt. u_ cd,t f apCn rid ,nu51'I>, ,,, Al (I Ili III rN 141'r tivf�at to Pill, N Fit Al is, in it, , , 10 r'I"f,ly nud"rt fill ..,'I nl•N f6idl Yea' • upon deco- of gran', rum p!e:r 1+:c ml a'.iao of Cl:y 61t,rel IxQirr and all Frani -4fl roil a-ttc. ,at'A'.1 gn r,.,•es.nyjou'net s, ,, 11.4 l u ha au ,.+ if"rk,pnnde, Is P n,AJ, i Ayl i'd'w'infI , t 1I I ,,I K•• ,, C'a,'t manage,, All g dot adminnt•4W+ is reedN LefrjcmC O;i':f d( knirrgrn Cl SON".'s 'Ca QL5J r'"'A'.iPUre f. • insure f-nancla ran rl All_ Ail, tl- gaRt an.^, u,y &ran, a rl •.:'Sear cwt Ir ! it II, Pte r -I - rot, .d 0fi,, oI `c n,n�pej g Scrpcea ;pl the Office ai laarelard Seturit-r ane the Cepartma!t of rtnn,wla td S-mwi Union pith Iota), state and fad?ra ager tiFi resa'9ina $5ao6al olpttcrs lelatt- to lAc admnatrat on oFtl•e Honeda ac Semn:Y Gran Fs • PartuJitrsm grdnl dpplI_dhma 411_1won'nr.-,Ij,ntifi_4hon%, r rpin'•at q rr" and fird'.4' 1,,"I • A,, It and to,rplrI grdd 'n:r'i'rf, .v rJ grin) mn LL -obon rrqu-.h ma Ing CA'ir"'lin nttl,e W rmeg�nty Sr r+e, nvwN;upk. "cci !,tg It IAdbun+1a Ihr ivlrc,i' pute•:I nr4 ,x III,,,e t,c, e.ea se r['Al aPPI a, ed pro "t a_phha:IQ ns arc Pit' itad_acr•ptiom me refilled 1 t h,•'n:3 1II0 is f dry 1-1- e -a,1 r4,., nYj,a•,I. and ndvi if Ir r - I, ba'k'1gOt r,t1t, r Wapllelt I t411 Uu t Sr n' f til pdtkrl, I,iri.Ila Il a, kt,is I"Ipm,.nl 1111&'1, a l Cit, fl, nr,d I.nitun vid IAWSOA Prgarst r':y •I vo.. u• ,II It v.nrkbnnN, a"n send to inP ."affarnia 5frlre rl Fm=� g�nry SwvIIac iii rci inhur,?rnt-tit • Once c1,"k, I,4vN `s^in t«ail•"o(..niter,Srir.a9rltIth,µ,a,hrvq.,,,'ile,. ica- I n,t I�tr +'.I, it vo re, de in rrl ren h I'rralw q F:r&IcsiI • Al irk Arte CII, A : it,n!am it in1t, LII- n,we,l rrnuvI un t.• fb edvarcr), udtd.Iil ve'iciwj.ub lei irwrI pnyneni, fon,,] ,fcd 1,i d,pra ne it eu d n i If dole Frtrr e,1 :leis to 01- Fad,Mdl IAgr,,,It 41 ui yea it drrl Human S,,-, le,, hu ab .nirn•st ea!m,i or grant ad"nit,, r miao,in ac1tioteJ'Iafnba.a of al 6 narnld' poul, of c ultd. i .t tt.v, ta, l In.,, da an Not rnaa 14 it wrc, Il Lf Hina and Se: drIY lira.' ehi rkipi-:,t, I r rddel 1014nt4,d ..nd b I'll," dty .•,,411y N, of i..I, iii it Ied✓,rt Fri pt,I ani Arm it kl,oi - , RN nnarl,alw Avpo•', .nr R,•mnitw lane„, up,r' I pre -la ro:, 4'a s,. bmn. it .am aal progra;c lrpn':{ (i'd n) I'C"n,= Fpnpr al ligan) eepornnp )Col WSI Anaheim/ Santa Ana UASM Grant Office UASt Grort c[f ec proced..2s Attend Urhan Area ;eCuri'y h'iriali're'NJri n& Cf:up a'tu nearing "Irniltcr rr't.el I gs as prvgia'I a:L and Irtanchl point of contact I Lpdatr acrd evar Utter Arra, S,;,ally 11 if illi,- 5rb-Rech vis G.udrl:ne, ana polis ,,. In a -pude mw lasts, full" and ICpu'IPIne01v flan, O.M and Cal OFS A, wrp n, asdalAil 111,40 Orlifor crcj[tt managed a -d sub reeiprcoti. • kpdnfa lily Anilteirn ,r °ants Ana LWSI furl", V, (h oa+.h ores grant yru, ind,ding ,eirnI U 'IAT n,l Fors", orcje[tdppl eaticr9, prolert n'ud Geatimis, nlDri:axing furans, train -ng Icro'v, n'pwI ng (^rm,, asd nthwt, <vvp r t:of) v nl core ri:If' it d ion vi lh grrnt fel siert tndnagr+ri to envtr- app'aIt' dte fide -,Il, heir And 'oca r»qurtr n•n•n1s =.til Llef'g milt angel 1i,V meet grant dnullines a S,rd eat ewnnd"I, vrin•n III. Qt,alterlV Pvfje<l Staw, Reps'!+ me del-, reu:ew in, enmpte7er,,i, and Ell y.Ard k 11, apptaIs- At,,ff, sfalf lar r,v:va + +vrrwine5 111011.1 11 114 1( dn•i final stilus IUUoII, ib-en,,kly, mmtlnly and rauartwbtt to Ury ,,ASI Gia n Coad:ndvi Knowledge, Skills, and Abilitles Ful' unde itandimg of Fe;lerl and CalwES Sncmgs' G'a'd Gutdance ari! lull .arae: slnnrit, of lbe fuvaneiri,+Santa X -a UPS Sub-rebp•ent Gtarit Guidance Gx-ure at ko.wvpdge of gavvmfir en, con trac tIrip/ vocUrell eel or;:cPs±e5 Anility to if ie if are YrojccL bucg^tf ALility lu faLrhtdt.' g`:idp wvfiig,. Al; i'iIV to research tapics urfar,i'.iar to !he I n.onral arec5 A eal:ettrse a rad exper rli re ravithm Homefdrd 5ecunt9 Gran', r At,,,rcrI asa der^loo Frc6tait,p. 4':!. plyy Knowb]cIc of grant bnarml mal gcn'ent rngt it m of,. nrd ahiity to read thrcu�n the at.plictgle clad of fedva, regJatiarti. OMP oculars Envlroncien.al A. If,strric prciervdtirr reflurcn^cnts Gal �G S•tatcg e Goal, $ Ob eeby_�, Core C^pabilitics. P,a:urerrc,l and %chaa,rg faun;, and have{ Pel ci]S for the Urtan 'arca Security Iritiawo i--�fl gter tL and -4o•ncland repu•ity Erant Frograw (r,5Ur). Atli ity to rvra_ pr71e':.', biclgeti. Abl'tty to 100dltt? group wv CtmgS, Ahlht'y to research took: nriawilmr, to t^Cir ^crr-al treat c' cxp^'t ;c end expe'enco (,%afro Bono ant SC[ut ty Gram re�cva9cv) Ind cave rap p-::t;rrm(proctf plar<.. CbiIts to n4ant3tn Food 'so'i. rg rcdabo^,rh.lp5 w1h all atakercl.",ee wdhm the C,ysl, state or att ids agen:.es, cther tcan, riernber„ aIvt and the Ccaim,mli+cesed stak?,older-. 5no+vle�pe and abitc Io a;a t AVVCS Pt I naaoa fJanleeri >y;iPnl lot -.wow, P.:K p_yroll 5'r;:ctrl So'nvarc, :hr Frd^ra Grant OFwtrrg lopl ,and PAItr0;C1: pragrzws such it; Wera, Excel, G+uUook, I'Dwol,orrt pab ishur, rid WE Wisetrack I^centa,y Sycttm'. Krov.ladge of rnartc;pa: gevrar d',t "Crgtlon;, C•ty'iranoJI J:countrK tach" uu�s. r inrurn•nnnr h,t^.ferry prsrc5sng ynd c'ntrgl5 AOl'Jn;9c tvrbt aid wooer' comrrjriLat'-0n S?,fls, AD Ih' tc cnlYn p ]^Inm: chn e 1 rr:.fp ponyca Lf trn-r r t v G_.. App'o�w"C fly. s .� '-�' Dale. :-jy/t .. ✓ ;.. l la,t U,,knrr,l Ry,. _ Pit -tri ot- WILLDAN HOMELAND SECUIRTY PRICING PROPOSAL WI LLDAN I extending your Homeland Solutions reach July 25, 2018 Kanan Blake, Sergeant UASI Grant Coordinator Homeland Security Division Santa Ana Police Department Office (714) 245-8720 Cell (714) 471-2039 b h ad I ey@sa nta-a n a. o rg RE: Price quote for services for the position of Grant Project & Fiscal Coordinator Sgt. Blake: Willdan Homeland Solutions (Willdan) appreciates the opportunity to provide the City of Santa Ana with our price proposal for services for the position of Grant Project & Fiscal Coordinator. Please see the proposal for a detailed description of the associated costs. Willdan Homeland Solutions appreciates the opportunity to be of service to the City of Santa Ana. Please do not hesitate to contact me at 714-403-1397 or mhooper@willdan.com if you have any questions pertaining to this proposal. Respectfully Submitted, Mike Hooper President/CEO Willdan Homeland Solutions Engineering I Geotechnical 1 Environmental 1 Financial I Homeland Security 714.940.6300 1 800.424.9144 1 fax: 714.940.4920 1 2401 East Katella Avenue, Suite 300, Anaheim, CA 92806-6073 1 www.willdan.com Price Proposal to Perform Grant Management Services For the City o/Santa Ann, Cal/orntn CITY OF SANT ANA Grant Project and Fiscal Coordinator Services COST PRICE PROPOSAL Performance Period p1 — (Months 1-12) September 01, 2018 through August 31, 2019 LABOR CATEGORY RATE HOURS TOTAL Labor Grant Project & Fiscal Coordinator $ 68.92 2,000 $ 137,840 Subtotal Time & Materials IT&M) Labor OTHER DIRECT COSTS Estimated Trawl and Training Subtotal Cost Reimbursable GRANDTOTAL W I LLDAN Homeland Solutions 2,000 $ 137,840 $ 7,000 $ 144,840.00 2 1 P a g e ��. as CERTIFICATE OF LIABILITY INSURANCE DAT 1013112017VVY) 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 pohcy(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($). PRODUCER ADD Risk Insurance services West, Inc. LOS AM19eles CA Office CONTACT NAME: INC. NNo. Ext): (866) 283-7122 ac. No.: (800) 363-0105 707 Wll shire Boulevard Suite 2600 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC At LOS Angeles CA 90017-0460 USA INSURED INSURERA: Travelers Property Cas CO Of America 25674 Willdan Homeland Solutions 2401 E. Katella Avenue, Ste. 220 INSURER B: Lexington Insurance Company 19437 INSURER C: Anaheim CA 92806 USA INSRER UD: /y"a �a1G NSURER E: 92701 USA INSURER F: PREMISES Es ocavenca $1,000,000 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. Limits shown are as requested LTR TYPE OF INSURANCE IVSD ME POLICY NUMBER MMIODIVYYY MMIDOIYVYY LIMITS A M MERCIAL GENERAL LIABILITY AUTHORIZED REPRESENTATIVE TTL of the City Council EACH OCCURRENCE $1,000,000 20 Civic Center PO Box 1988 CLAIMS -MADE ❑X OCCUR #CO �•'r �rsaaW /y"a �a1G Santa Ana CA 92701 USA t/G�faAYla PREMISES Es ocavenca $1,000,000 MED EXP (Any one person) $15,000 mployee Benefits Liability PERSONAL a ADV INJURY $1,000,000 GEWL AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ❑ PRO ❑ LOC ECT PRODUCTS -CONFIDE AGO $2,000,000 OTHER. A AUTOMOBILE LIABILITY BA -7]365332 -TIL -17 11/09/201711/09/2018 COMBINED SINGLE LIMIT $1,000,000 Ea accitlem BODILY INJURY( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per acatlenf UMBREL-ni OCCUR EACH OCCURRENCE AGGREGATE EXCESS UAB CLAIMS -MADE DED RETENTION A WORKERS EMPLOYERS' ION AND Y N ANY PROPRIETOR/ PARTNER I EXECUTIVE U69]$58819TI L17 11/09/2017 11/09/2018 X STATUTE ETH E.L. EACH ACCIDENT $1,000,000 OF I GERIMEMBER EXCLUDED] N (Mandatory in NH) NIA E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 B Archit&Eng Prof 028174912 11/09/2017 11/09/2018 Aggregate $2,000,000 SIR applies per policy ter s & condi'lons Per Claim $1,000,000 SIR $250,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is requlrad) RE: Grant Management Services. City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insured with respect to the General Liability and Automobile Liability policies; and the General Liability policy evidenced herein is Primary and Nan -Contributory to other insurance available, in accordance with the policy provisions. Severability of Interests coverage is included within the General Liability policy, CERTIFICATE HOLDER CANCELLATION ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016105) The ACORD name and to o are registered marks of ACORD 0 to 0 er o 0 SP O 2 dl u Y m O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Santa Ana AUTHORIZED REPRESENTATIVE Attn:Clerk of the City Council 20 Civic Center PO Box 1988 P1 aza(M-30) �•'r �rsaaW /y"a �a1G Santa Ana CA 92701 USA t/G�faAYla ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016105) The ACORD name and to o are registered marks of ACORD 0 to 0 er o 0 SP O 2 dl u Y m O Policy Number: 6307J366586TIL17 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is limited as follows: plies only to such "bodily injury" or "property damage" that occurs before the end of the pe- riod of time for which the "written contract re- quiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SEC- TION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: c. In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement shall not increase the limits of insurance described in Section III — Limits Oflnsurance. d. This insurance does not apply to the render- ing of or failure to render any "professional 3. services" or construction management errors or omissions. e. This insurance does not apply to "bodily in- jury" or "property damage" caused by "your work" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifi- cally requires you to provide such coverage for that additional insured, and then the insur- ance provided to the additional insured ap- The insurance provided to the additional insured is excess over any valid and collectible 'other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the ad- ditional insured under this Coverage Part must apply on a primary basis or a primary and non- contributory basis, this insurance is primary to "other insurance" available to the additional in- sured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But this insur- ance provided to the additional insured still is ex- cess over any valid and collectible "other insur- ance", whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any "other insurance". The following is added to SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS: Duties Of An Additional Insured As a condition of coverage provided to the addi- tional insured: a. The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CGp D,4 14 04 08 <0 Zoos Th✓e�Travpiers Companies, Inc, Page 1 of 2 VWCu�� 'sr a fJ COMMERCIAL GENERAL LIABILITY I. How, when and where the 'occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the 'occurrence" or offense. b. If a claim is made or "suit' is brought against the additional insured, the additional insured must: I. Immediately record the specifics of the claim or "suit' and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c. The additional insured must immediately send us copies of all legal papers received in con- nection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and oth- erwise comply with all policy conditions, d. The additional insured must tender the de- fense and indemnity of any claim or "suit' to any provider of other insurance which would cover the additional insured for a loss we cover. However, this condition does not affect whether this insurance provided to the addi- tional insured is primary to that other insur- ance available to the additional insured which covers that person or organization as a named insured. 4. The following is added to the DEFINITIONS Sec- tion: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or or- ganization as an additional insured on this Cover- age Part, provided that the "bodily injury" and "property damage" occurs and the "personal in- jury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period Page 22 of 2y''y 2008 The TraA s Companies, Inc. CG D4 14 04 08 POLICY NUMBER: BA7J365332TIL17 ISSUE DATE: 11/09/2017 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 Days PERSON OR ORGANIZATION: AS Per Written Contract or Agreement ADDRESS: PROVISIONS: If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, and a number of days is shown for cancellation in the schedule above, we will mail notice of cancellation to the person or organization shown in the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. �IL T4 05 03 11 © 2011 The Travelers In emnity Company. All rights reserved. Page 1 of 1 POLICY NUMBER: 6307J366586TIL17 ISSUE DATE: 11/09/2017 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY — NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 Das PERSON OR ORGANIZATION: AS Per Written Contract or Agreement ADDRESS: PROVISIONS: If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, and a number of days is shown for cancellation in the schedule above, we will mail notice of cancellation to the person or organization shown in the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. IL T4 05 03 11 © 2011 The Travelers Indemnity Company, All rights reserved. I MI -11 Kyf'M"'D P� /�, 01 Page 1 of 1 C) to r POLICY NUMBER: UB9J558819TIL17 ISSUE DATE: 11/09/2017 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 Days PERSON OR ORGANIZATION: AS Per Written Contract or Agreement ADDRESS: PROVISIONS: If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, and a numberof days is shown for cancellation in the schedule above, we will mail notice of cancellation to the person or organization shown in the schedule IL T4 05 03 11 above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 �1 ® .`off zo CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 1OM2D,9 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(les) 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 Aon Risk insurance Services West, Inc. Los Angeles CA Office 707 Wilshire Boulevard Suite 2600 CONTACT PHONE FAX AR,. W.Eel; 0866) 2113-7122 AIC. No.: (800) 361-0105 E-MAIL ADDRESS: INBURERIB)AFFOROING COVERAGE NAICa Los Angeles CA 90017-0460 USA INSURED INSURERA: Travelers Property Cas Co of America 25674 willdan Homeland Solutions INSURER a: Lexington Insurance Company 19437 2401 E. Katella Avenue, Ste. 220 Anaheim CA 92806 USA INSURER C: NSURER D: INSURER E: EACHOCCURRENCt $1,000,000 INSURER F: PREMISES Ea occurrence) E1, 000, 000 COVERAGES CERTIFICATE NUMBER: b(UUr4U(tb43 NCVIJIUN NumooH: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown am as requested TIM LTR TYPE OF INSURANCE 5 POUCYNUMBER MUUOUGTLFF PULICYtAP UNITS X I COMMERCU LGEMERALUABIUTY P63073366586TIL EACHOCCURRENCt $1,000,000 PREMISES Ea occurrence) E1, 000, 000 -MADE X❑ OCCUR MED EXP (Any due Farina) $15,000 TCLAVAS .E.X EmPbyee Benerds Liabary PERSONAL& ADV INJURY $1,000,000 X radual Liabary Included GEN'LAGGREGATE LIMIT APPLIES PER. GENERALAGGREGATE $2,000,000 X POLICY [:]PRCT E]LOC PRODUCTS -COMPIOPAGG $2,000,000 e 0 OTHER A AUTOMOBILE LWBIUTY P -810 -7]36$332 -TIL -18 11/09/2018 11/09/2019 COMBINED BINDLE LIMIT $1,000,000 E acddem BODILY INJURY (Per person) X ANYAUTO 2 BODILY INJURY(Peracdden0 OWNED SCHEDULED m AUTOS ONLY AUTOS R PeOPERTYDAMAGE NIFEOAVIOS NON.OWNED acmdenl ONLY AUTOS ONLY Y m UMBRELLA LIAR OCCUR EACH OCCURRENCE U AGGREGATE EXCESS LU1B H CLAIMS -MADE DED1 IRETENTION A WORKERSGOMPENSAMONAND PIUS9155881918 11/09/2 18 1 0 19/ O1 PER DTH. STATUTE EMPLOYERS' UABIUTYX YIN E.L. EACH ACCIDENT $1,000,000 My PROPRIETOR/ PARTNER I EXECUTIVE N OFMCEWMEMBER E%CUAEOt (Mendamryin N1) NIA E.L.DISEASE-EAEMPLOYEE $1,000,000 OESCRITION under OESCRIPRON un OPERATIONS below —_ EL. D(SEASE.POLICY LIMIT $1,000,000 B ArchitBEng Prof028174912 11/09/2018 11/09/2019 Aggregate $2,000,000 _ SIR applies per policy ter s 6 Condi ions Per claim $1,000,000 DESCRIPTION Of OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addifienal Panama Schedule, Ivy W stashed 11 mon space u required) RE: Grant Management. City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability and 7i1� Automobile Liability policies evidenced herein are Primary and Non -Contributory t0 other insurance available to an Additional insured, but only in accordance with the policy's provisions. A waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability and workers' compensation policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Santa Ana AUTHORIZED REPRESENTATIVE Attn: Clerk of the Council 20 civic Center P1 dao (M-30) Santa Ana CA 92701 USA W_ . Ae.X✓C'tap.s. Y� fQ JL ©1988.2015 ACORD CORPO Olights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Policy Number: P6307J366586TIL18 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is limited as follows: c. In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement shall not increase the limits of insurance described in Section III — Limits Oflnsurance. d. This insurance does not apply to the render- ing of or failure to render any "professional services" or construction management errors or omissions. e. This insurance does not apply to "bodily in- jury" or "property damage" caused by "your work" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifi- cally requires you to provide such coverage for that additional insured, and then the insur- ance provided to the additional insured ap- plies only to such "bodily injury" or "property damage" that occurs before the end of the pe- riod of time for which the "written contract re- quiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SEC- TION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured for a loss we cover. However, If you specifically agree in the "written contract requiring insurance" that this insurance provided to the ad- ditional insured under this Coverage Part must apply on a primary basis or a primary and non- contributory basis, this insurance is primary to "other insurance" available to the additional in- sured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But this insur- ance provided to the additional insured still is ex- cess over any valid and collectible "other insur- ance", whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any "other insurance". 3. The following is added to SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS: Duties Of An Additional Insured As a condition of coverage provided to the addi- tional insured: a. The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D4 14 04 08 0 2008 The Travelers Companies. Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY I. How, when and where the 'occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit' is brought against the additional insured, the additional insured must: I. Immediately record the specifics of the claim or "suit' and the date received; and if. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c. The additional insured must immediately send us copies of all legal papers received in con- nection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and oth- erwise comply with all policy conditions. d. The additional insured must tender the de- fense and indemnity of any claim or "suit' to any provider of other insurance which would cover the additional insured for a loss we cover. However, this condition does not affect whether this insurance provided to the addi- tional insured is primary to that other insur- ance available to the additional insured which covers that person or organization as a named insured. 4. The following is added to the DEFINITIONS Sec- tion: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or or- ganization as an additional insured on this Cover- age Part, provided that the "bodily injury" and "property damage" occurs and the "personal in- jury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 0 2008 The Travelers Companies.. Inc. CG D4 14 04 08 Policy Number: P8107J365332TIL18 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE —This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION If — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION 11 — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in - D. EMPLOYEES AS INSURED sured" against, and investigate or set- tle any such claim or "suit" and keep The following is added to Paragraph A.1., Who Is us advised of all proceedings and ac - An Insured, of SECTION 11 — COVERED AUTOS tions. LIABILITY COVERAGE: (ii) Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs, (iii) may, at our discretion, participate E. SUPPLEMENTARY PAYMENTS — INCREASED in defending the "insured" against, or in LIMITS n the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION 11— COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITYCOVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in - we cover. We do not have to furnish sured" pays with our consent, but these bonds, only up to the limit described in Para - 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION 11 — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense the "insured" against any such I HIRED AUTO — LIMITED WORLDWIDE COV- "s "suit", but only up tand included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph 8.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (S) Anywhere in the worid, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is nota substitute for and that is not an "auto" you lease, hire, rent or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - count partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 02015 The Travelers Indemnfty Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. LCM11,71101.1 X31 is141Loi 1L14=MC3 A_F�l The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION 111— PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph AA.a., Transportation Expenses, of SECTION 111 — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags In a covered "auto" you own that in- flate due to a cause other than a cause of"loss" set forth in Paragraphs A.t.b. and A.t.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph A.4., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex - We will a u to $400 for "loss" to wearing a - tent required of you by a written contract pay P 9 P signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 62 15 ® 2015 The Travelers indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How - N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 ® 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO POLICY NUMBER: P8107J365332TIL18 ISSUE DATE: 11/09/2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR LIABILITY COVERAGE - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided underthe following: BUSINESS AUTO COVERAGE FORM SCHEDULE OF ADDITIONAL INSURED PERSONS OR ORGANIZATIONS AS PER WRITTEN CONTRACT OR AGREEMENT PROVISIONS 1. The following is added to Paragraph c, in A.1., Who Is An Insured, of SECTION If — LIABILITY COVERAGE: This includes any person or organization designated in the Schedule Of Additional Insured Persons Or Organizations who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Liability Coverage, but only for damages to which this insurance applies and only to the extent of that designated person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph 5., Other Insurance, in B., General Conditions, of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which the person or organization designated in the Schedule Of Additional Insured Persons Or Organizations is the first named insured when the written contract or agreement between you and that designated person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CA T4 42 08 17 C 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance services Office, Inc. with its permission. TRAVELERS JJ WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (00) - POLICY NUMBER: PJU139J55881918 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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 applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FUNISH THIS WAIVER. DATE OF ISSUE: - - ST ASSIGN: TRAVELERS JW WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — POLICY NUMBER: PiUB9J55881918 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (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 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FUNISH 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 of the policy.) Endorsement Effective 11/09/2018 Policy No, PJUB9J55881918 Endorsement No. Insured Premium Insurance Company Countersigned by Travelers Property Casualty Company of America DATE OF ISSUE: ST ASSIGN: Page 1 of 1