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HomeMy WebLinkAboutKIMLEY-HORN AND ASSOCIATES, INC. (2)City of Santa I a Clerk of the Council CO&6 Mice Use (&-'/ r AGREEMENT TERMINATION FORM i�Ct�y'A Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect.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 l"L Pv�' — 61�1 ''" No. el7 — was completed on Lj / and final payment has been made. r � (List all amendments. Use space below N needed.) C C _ Department: G'V /� — ee e-rt _ O Phone/Ext.: Signature: rfascll Cru r,�r Date: Revised: 10-18-16 / A-2017-108-02 !NSURANCE NOT ON FILE WORK IMAY NN T., PROCEED MAYOR CLERK OF COUNCIL Miguel A. Pulldo MAYOR PRO TEM DATE' APR 3 Juan Villages 0 2019 COUNCILMEMBERS Cecilia Iglesias David Pernaloza 01 \' Vacant Vicente Sarmiento Jose Solorio CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 www.santa-ana oro April 12, 2019 Kimley-Morn and Associates, Inc. 765 The City Drive South, Suite 200 Orange, CA 92868 Attn: Darren Adrian, Vice President Re: Extension of Consultant Agreement No. A-2017-108 ACTING CITY MANAGER Steven A. Mendoza CITY ATTORNEY Sonia R. Carvalho ACTING CLERK OF THE COUNCIL Norma Mitre -Ramirez Pursuant to Section 3 ("Term") of Agreement No. A-2017-108, entered into by Kimlcy-Ilorn and Associates, Inc. and the City of Santa Ana, dated May 2, 2017 and as previously extended, the time period of the Agreement is hereby extended for an additional one (1) year period, from May 2, 2019 through May 1, 2020. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Si r , Fuad S. Sweis PE, ES Executive Director, Public Works Agency CITY OF SANTA ANA Steven A. Mendoza Acting City Manager APPROVED AS TO FORM V�/ J M.Funk Assistant City Attorney ATTEST Nonna Mitre Acting Clerk of the Council KIMLEY-HORN AND ASSOCIATES, INC. (� Darren Adrian /U� } 2019.04.16 08:30:36-07'00' Name: Title: SANTA ANA CITY COUNCIL Migoal A. Pulido Juan Villegas Vicente Sannieoto David Penaioza Jose Solorio Vacant ced6a tglesin Mayor Mayor Pro Tom, Ward 5 Ward Ward Ward3 Ward Ward mpl d1doasanla-ana.om Ivillenas(olsaota-ana ore vna m enlo(alsanta-ana„grg daenaloza --ta-ana orn _ 'solor'o(olsanla-ana oro i ales'as(dsanfa-ana 919_. Client#: 25320 KIMLHORN DATE(MMIDDIYYYY) AUUKUIM CERTIFICATE OF LIABILITY INSURANCE 10/04/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER I NAMIA E: Jerry Noyola Greyling Ins. Brokerage/EPIC PHONE Eat, 770-552.4225 868350-4082 3780 Mansell Road, Suite 370 ^� "O Alpharetta, GA 30022 noosess: Jerry. noyola@greyling.com INSURER(S) AFFORDING COVERAGE NAIC0 INSURER A: National Union Fire Ins. C.O. 19445 INSURED INSURER B: ASpen AmBriCan lmNJ DOe Company Kimley-Horn and Associates, Inc. 43460 23841 New He 421 Fayetteville Street, Suite 600 INsuRERc: pahlrein'.Co. 085202 Raleigh, NC 27601 INSURER D: Lloyds of London INSURER E: INSURER F: RC V oIUIN INUML$H: 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 CONTRACTOR 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. INSLTRR TYPE OF INSURANCE ADOL SUER POUCYEFF POLICYyEXP INSR D POUCYNUMBER MMMD MWDD/YYYY UMITS A X COMMERCIAL GENERAL LIABILITY MA CLAIMS -OE L9 OCCUR Contractual Llab. 5268169 4/01/2019 04/01/202 $1 000000 �E�AAqcN�1mp CO�EECTCTURRENCE PREMISES EaERrw�ra r. s500 000 X MEDEXP(AnywePerson) $25000 PERSONAL &ADV INJURY $1,000000 A 448966g 4/01/2019 04/01/202 GEN'L AGGREGATE LIMIT APPLIES PER: PRC POLICY ELOC OTHER: AUTOMOBILE LIABILITY X ANYAUTO OWNED SCHEDULED AUTOS ONLY HIRED AUTOS X AUTOS ONLY X NON -OWNED AUTOS ONLY GENERAL AGGREGATE s2,000,000 PRODUCTS-COMPIOPAGG $2r000 OOQ Be dBINED SINGLE LIMIT $ 11,000,000 BODILY INJURY (Per Person) $ BODILY INJURY (Per acddent) $ PROPERTY DAMAGE Per acddanl $ EACH OCCURRENCE SS QQQ QQQ B C A D UMBRELLA Lim X OCCUR X EXCESS LAB CLAIMS -MADE NIA CX005FT19 015893685 (ADS) 015893686(CA) B0146LDUSA1904949 4101/201904/01/202 4/01/2019 4/01/201904/01/202 4/01/2019 04/01/2020 04/01/202 AGGREGATE $5 00Q 000 DED X RETENTION SO WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICERPEIMBEREXCLUDED>ECUTIVEFR (Mandatory in NH) Ir yes, describe under DESCRIPTION OF OPERATIONS be. Professional Liab X PER OTH- $ EL EACH ACCIDENT $1000000 E.L. DISEASE -EA EMPLOYEE $1000000 E.L. DISEASE -POLICY LIMIT Per Claim $2,000,000 $1,000 QQQ I Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be adached if mare space is required) Re: On -Call Agreements A-2015-171, A-2017.108, A-2016-344, A-2017-273,A-2017-025, A-2009-212, A-2018-159 01, A-2018-160-01 & A-2018-025. The City of Santa Ana, its officers, employees, agents & representatives are named as Additional Insureds with respects to General & Automobile Liability where required by written contract. The above referenced liability policies with the exception of workers compensation & professional liability are primary & non-contributory where required by written contract. Separation of Insureds applies (See Attached Descriptions) CERTIFICATE Hnl nPO City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th I Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN & APPn t/PiCCORDANCE WITH THE POLICY PROVISIONS. 1019 REPRESENTATIVE ACORD 25 (2016103) 1 of 2 The #S1815091/M1513917 ©1988-2015 ACORD CORPORATION. All rights reserved. of ACORD JNOY1 DESCRIPTIONS (Continued from Page 1) to the General Liability Policy. Umbrella Follows Form with respects to General, Automobile & Employers Liability Policies. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' written notice (except 10 days for nonpayment of premium) will be provided to the Certificate Holder. SAGITTA 25.3 (2016/03) 2 of 2 #51815091/M1513917 POLICY NUMBER: 5268169 COMMERCIAL GENERAL LIABILITY CC 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Lit Additional insured Person(s) Or Organization(s) Location And Descr iption Of Completed Operations ANY PERSON OR ORGANIZATION WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. PER THE CONTRACT OR AGREEMENT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included In the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agree- ment, the insurance afforded to such addi- tional insured will not be broader than that CG 20 37 04 13 Insurance Services /QI y which you are required by the contract or agreement to provide for such additional insured. S. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: I. Required by the contract or agreement; or 2, Available under the applicable Limits of Insu- rance shown in the Declarations; whichever is less. This endorsement shall not increase the appli- cable Limits of Insurance shown in the Decla- rations- Office, Inc., 2012 Page 1 of 1 0 This page has been left blank intentionally. ENDORSEMENT This endorsement, effective 12:01 A.M. 04101/2019 forms a part of Policy NO.4489sss issued to KIMLEY-HORN AND ASSOCIATES, INC. by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POUC`r. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following. BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: ANY PERSON OR ORGANIZATION TO WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT AS SUCH PERSON'S OR ORGANIZATIONS LIABILITY ARISING OUT OF USE OF A COVERED AUTO. I. SECTION II - COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. 87950 (9/14) /0 ,r AUTHORIZED REPRESENTATIVE information of Insurance Services Office, Inc., Page 1 of 1 with its permission. This page has been left blank intentionally.