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HomeMy WebLinkAboutCOMMUNITY SENIORSERV INC. (2)INSURANCE NOT ON FILE WORK MAY NQT PROCEED CLERK OF COUNCIL ® DATE: JUN 2 5 2019 AGREEMENT BETWEEN THE CITY OF SANTA ANA AND ®'. Tf -Cj A `0 COMMUNITY SENIORSERV, INC. FOR THE PROVISION OF HOME DELIVERED 5 t\v 1 & CW0 k> MEALS PROGRAM SERVICES THIS AGREEMENT is hereby made and entered into this 1811 day of June, 2019, by and between the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and taws of the State of California ("City"), and Community SemmServ, Inc., a California nonprofit corporation ("Provider"). RECITALS A, The City desires to retain Provider to participate in delivering meals to homebound senior residents and providing meals for senior residents at City senior centers. C. In undertaking the performance of this Agreement, Provider represents that it is knowledgeable in its field and that any services performed by Provider under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional firm in the held. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Provider shall deliver once a day, two meals to City senior residents at City Senior Centers ("Congregate Lunch Program"). Provider shall also deliver once a day, three meals to the homes of City senior residents that are homebound C'Home Delivered Meal Program"). Pursuant to these two programs, Provider will serve a minimum of 750 total unduplicated Santa Ana participants. All participants in the program will be enrolled through the City of Santa Ana Parks, Recreation and Community Services Agency. Programs shall operate as outlined in the attached Exhibit A. 2. COMPENSATION a. City agrees to pay, and Provider agrees to accept as total payment for its services, the sum of $90,290,00. The total sum to be expended under this Agreement shall not exceed this amount during the term of this Agreement. Each quarterly payment pursuant to this Agreement shall be $22,572.50 and paid pursuant to the quarterly invoice schedule set forth in the attached Exhibit A. b, City will be invoiced by Provider on a quarterly basis. Payment will be made within forty-five (45) days of the date of the invoice. Page I of 9 3. TERM The term of this Agreement shall commence on July 1, 2019 and terminate on June 30, 2020, unless terminated earlier in accordance with Section 13, below. 4. INDEPENDENT CONTRACTOR Provider shall, during the entire tern of this AlFcomeny 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 Provider performs the services which are the subject matter of this Agreement; however, the services to be provided by Provider shall be provided in a manner consistent with all applicable standards and regulations governing such services. Provider shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to its employees and shall be responsible for all applicable withholding taxes. S. INSURANCE Prior to undertaking performance of work under this Agreement, Provider shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Provider 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 Provider's negligent 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 and $2,000,000 in the aggregate, 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 insured provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. r,. Worker's Compensation Insurance. In accordance with California State law, Provider, if Provider 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, Provider agrees to obtain and maintain any employer's liability insurance with limits not less than S 1,000,000 per accident. d. If Provider is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. Page 2 of 9 e. The following requirements apply to the insurance to be provided by Provider pursuant to this section: (i) Provider shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement, (H) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. (iv) Provider shall supply City with fully executed additional insured endorsement. E If Provider 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 terminate this Agreement. Such termination shall not affect Provider's right to be paid for its time and materials expanded prior to notification of termination, Provider waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. d. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section I of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief flue to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to die extent required by Page 3 of 9 Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 7. RECORDS Provider shall keep records and invoices in connection with the work to be performed under this Agreement. Provider shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Provider under this Agreement. All such records and invoices shall be clearly identifiable. Provider shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Provider shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Provider under this Agreement. 8. CONFIDENTIALITY If Provider received from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Provider 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 information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party 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 the Provider disclosed in a publicly available source; (c) is in rightful possession of the Provider and disclosed without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Provider without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Provider covenants that it presently has no interest 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, tender, 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 first class or certified mail, postage prepaid, sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: Page 4 of 9 To City: City of Santa Ana City Clerk (M-30) 20 Civic Center Plaza P.Q. Box 1988 Santa Ana, California 92702 With copy to: Executive Director of Parks, Recreation and Community Services City of Santa Ana 20 Civic Center Plaza (M-23) P.Q. Box 1988 Santa Ana, California 92702 Fax (714) 571-421 I And: City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.Q. Box 1988 Santa Ana, California 92702 Fax (714) 647-6515 To Provider: Community SeniorServ, Inc. 1200 N. Knollwood Circle Anaheim, CA 92801 Fax (714) 220-1374 A paarty 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 facsimile, 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 This Agreement represents the complete and exclusive statement between the City and Provider regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In the event of conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail and will serve to fully supersede existing Agreement. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Provider. 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 or conditions hereof, shall not bind or obligate Provider nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or Pate 5 of 9 agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any parties, which are not embodied herein. 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Provider, Provider 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 that are the subject to this Agreement performed by City personnel or by other Providers retained by City. 13. TERMINATION This Agreement may be terminated by the City with thirty (30) days written notice of termination to the Provider. a. As a condition of such payment, the City may require Provider to deliver to the City all the 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 Provider 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. FINGERPRINTS AND BACKGROUND CHECK Provider, and any employees, subcontractors or volunteers, shall arrange for and submit their fingerprints for a criminal background check through the Department of Justice through the City's Human Resources Department process. Provider shall be responsible for all charges associated with fingerprinting. Provider shall not perform any services pursuant to this Agreement until clearance is received and Consultant is notified by the City's Parks, Recreation and Community Services Department, 15. NON-DISCRIMINATION Provider shall not discriminate because of race, color, creed, relation, 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 or any activities under this Agreement. Provider affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. Page 6 of 9 16, 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. 17. PROFESSIONAL LICENSES Provider 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 United Sates, the State of California, the City of Santa Ana and all other governmental agencies. Provider shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. t8. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and tight to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney'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 1f fully set forth in die body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: (/ua''_t NORMA MITRE Acting Clerk of the Council APPROVED AS TO FORM: SOMA R. CARVALHO City Attorney By: LAURA A.A. ROSSINI Senior Assistant City Attorney CITY OF SANTA ANA ANNE City Manager [Signatures contirwe on the next page) Page 7 of RECOMMENDED FOR APPROVAL: Ex c&yKe Director of Parks, Recreation and Community Services Agency COMMUNITY SENIORSERV, INC. By: Name: Gc j El Title: Page 8 of 9 EXHIBIT A SCOPE OF SERVICES AN FEE Co TS Page 9 ON City of Santa Ana Scope of Work Name of Organization Community SeniorSery Name of Funded Program Home Delivered and Congregate Meals Program Annual Accorn Ig ishment Goal I. Total number of unduplicated Participants (Santa Ana and Non -Santa Ana participants) anticipated to be served by the funded program, named above, during the 12-month contract period. 5,500 Participants II, Number of ONLY unduplicated San An Participants to be served by the funded program, named above, during the 12-month contract pedcd 750 Participants Program and Funding Descrimion III. Description of Work - In the space below, describe the program to be funded during the 12-month contract period. What specific activities will be undertaken during the contract period. Please be concise in your response. Only the viewable space will print. For Fiscal Year 19-20, Santa Ana discretionary funds in the amount of $50,290 will be utilized to help fund the raw food costs of meals on wheels and congregate lunch meals to Santa Ana older adult participants from July 1, 2019-June 30, 2020, Home Delivered Meal Program: Participants in the Home Delivered Meals program will receive a total of 3 nutritious meals daily for 5 days a week delivered to their home and case management services, Meals will be delivered by paid and volunteer drivers, Eligibility and case mangement services will be provided by CSS Case Managers, Participants will also have access to other services at no charge including in -home services, respite services, home safety equipment, and other resources. Congregate lunch Program: Participants in the Congregate Lunch program will be provided with a nutritional lunch five days a week at 2 sites in Santa Ana: Southwest Senior Center Santa Ana Senior Center Schedule of Performance Estimate the number of ONLY unduplicated Santa Ana participants to be served by the funded program during the 12- month contract period per quarter. (Enter number of new Santa Ana Participants served each quarter, If they were served in quarter 1 do not count them again iElTotal Quarter 1: July 1 - September 30 ParticipantsQuarter 2: October 1 - December 31 Participants Quarter 3: January 1 - March 31 Participants Quarter 4: April 1 -June 30 Participants Schedule of Invoicing unduplicated Santa Ana Participants to be served. Estimate the amount of grant funds to be requested durin the 12-month contract period on a quarterly basis. Quarter 1: July 1 -September 30 $ 22,572.50 Quarter 2: October 1 - December 31 $ 22,572.50 Quarter 3: January 1 - March 31 $ 22,572.50 Quarter 4: April 1 -June 30 $ 22,572.50 $ 90,290A0 Total Grant Exhibit A Page 1 of 1 AcoRDF CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYri) �a..�'' 7/1/2019 71 1 O'n 8 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 INSURERS), 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 LOCkton insurance Brokers, LLC CONTACT 725 S. Figueroa Street, 35th FI. PHONE-- -- PAX CA License MOF15767 _IA1C.INo Exit. Los Angeles CA 90017 AADMDARESS: (213)689.0065 INSURRIS) AFFORDING COVERAGE NAICp _ INSURERA Philadelphia Indemnity Insurance CD. _ 18058 INSURED Community SeniorServ, Inc, f _wsuRERB. Redwood Fire and Casualty Insurance Co 11fi73 1448916 Vk--&0)UR'- I iPL® 1200 N. Knolhvood Cir, IrvsuREa c: _ Anaheim CA 92801 _._ INSURER O: INSURERS: ..-. _.._.... __.. INSURER F : COVFRAGFR COMSFOI CFRTIPICATF NIIIMRFR. IkAaloln oevlelnu ul uaoco. __ __. ____. _._.__._.__... ............I. 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. LTR CE INBO. WVD POLICYNUMBER R! �� POLICYEFF POUCYE7(P i (MMiDDNYYVI (MMIDDIYYYY ! LIMITS - - --_- COMMERCIALOGENERA6 LIABILITY A X, _ Y N.. YFIYKI$46706 7/I/2018 7/I/2019 EACH OCCURRENCE ,S_.1,000,000 ! CLAIMS MADE }(I OCCUR I - DAMAGE TO RENTED PREMISCSiEsoccuttence) ,8 1,000,000 MEDEXP(Any Ono person) ... _,$ 20,000 PERSONAL BADVINJURY y5. J,000,00Q GEN'LAGGREGATE LIMITAPPLIESPER: 'I !I GENERAL AGGREGATE $.3,000,000 POLICY JECT', 1.03 ! PRODUCTS - COMPIOPAGG -- S.3,000,000 OTHER: $ A AUTOMOBILE UABIUTY N N PFIPKI846706 !7/112018 7/t/2019 COMBINED ISINGLE LIMIT X ANY AUTO !. BODILY INJURY (Per person) sXXXXXXX__. OWNED SCHEDULED OWNS ONLY X AUTOS `-_ BODILY INJURY (Per accident) $ XXXXXXX. .. HIRED NON ONLY AUTOS ONLY _jPeaacclCYDAMAGE ent5 _ _ XXXXXXX Coarp /Coll Ded s 1,000 A X_' UMBRELLA LIAB N N Ii PHUIB637625 7/1/2018 7/1/2019 EACH OCCURRENCE $ 10,000,900 E%LESS LIAR CLAIMS -MADE II AGGREGATE $ ,10,000,000 EN101000I $ XXXX IWORRERS COMPENSATION N iYIN COWC927987 TryR 7/1/T018 7/1/2019 STATUTE, ER .,- _ 'ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA L,EL EACH ACCIDENT $ 1 OOO,OOO (Mandatary In NH) !. EL DISEASE EA EMPLOYEE $ 1,000a0Q0 If yes, dI under DESCRIPTION OF OPERATIONS below IE.L. DISEASE POLICY UNIT $ 1000000 DESCRIPTION OF OPERATIONS/LOCATIONS) VEHICLES (ACORD 101,Additt... I Remarks Sehedule,. may be atleehed If more apace Is mquiretl ej The City of Santa Ana, its o(iicers, employees, agents, Additional Insured and representatives am an endorsement issued or approved by the insurance carrier. Insurance provided to Additional Insured(s) to the extent provided�by~�(Rt�fiolicy la ge or is primary and r{co9C' Yk )but a3t t is a ed endorsements or policy language. e t AIY4CLLH I JUN JCG ALLEUTIRlenl 15476274 The City Of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2O CIVIC Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS. CORPORATION, All AC IRD 25 (2016103) The ACORD name and logo are registered marks of ACORD Attachment Code: D551101 Certificate 1D: 15,176274 POLICY NUMBER; PHPK1846706 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): The City of Santa Ana, its officers, employees, 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" "property damage" or "personal and advertising in1'ury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. 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: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 © Insurance Services Office, Inc., 2012 Page 8 of 18 a DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 7/1/2020 7I1/20I9 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 Lockton Insurance Brokers, LLC CONTACT NAME: 777 S. Figueroa Street, 52nd Fl. PHONE FAX CA License #OF15767 E-MAIL IAIC. Nat: Los Angeles CA 90017 ADDRESS: (213) 689-0065 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Insurance Co. 18058 INSURED Community SeniorServ, Inc. INSURER B : Redwood Fire and Casual Insurance Co 11673 1448916 1200 N. Knollwood Cir. INSURER C : Anaheim CA 92801 INSURER D : INSURER E : INSURER F : COVFRAr.FS f'i MV1Ff11 nFRTIFI/'ATF NIIMRI=R• 1 9A7A17A RFVICInKI NI IMRFR• YYX3IXYX 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 ADDL SUeR POLICY EFF FLICY EEXP TR TYPE OF INSURANCE INSD VI1VQ POLICY NUMBER IMMIDWYYYY1 (MMIDDrAYY)LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y N PHPK2005119 7/]/2019 7/1/2020 EACH OCCURRENCE PRE,MIS—E$,Aaff.tEB ocRENau an" $ 1000,000 $ 1 000 000 $ 20 0-00. MED EXP (Any one person _ PERSONAL & ADV INJURY $ 1-000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO- {� JECT 1� LOC PRODUCTS - COMP/OP AGG $ 3,000,000 A AUTOMOBILE LIABILITY N N PHPK2005119 7/1/2019 7/l/2020 '.O OINFIBtSINra MIT $ 1,.000QQQ. BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED SCHED AUTOS ONLY AUTOSULED I BODILY INJURY (Per accident) $ XXXXXXX _ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAM4GE Pgr accl n $ XXXXXXX $ 1,000 A UMBRELLA LIAB X OCCUR N N PHUB683732 7/1/2019 7/l/2020 EACH OCCURRENCE $ 10 000 OOO JX AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 10.000 $ B WORKERS COMP LI TIOIN YIN AND ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F_N] (Mandatory in NH) N / A N COWC034033 7/l/2019 7/1/2020 PER O- X � TH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED_ The City of Santa Ana, its officers, employees, aganN, roprcyentutives and volunteers are an Additional Insured to the extent provided by the policy language or endorsement issued or approved by the insulunee apl � yr trp rirll il3t1p]�lyhtSurcd(z) is primary and non-contributory as per the attached endorsements or policy language. ��i�CtVy �j� OlR �JlGLI By Ri$k MANAGEMENT Divi$iON A_ L 17 2019 L;R=K I II-It;A I L HULut_K NC:t=LLA I IUN Nee Attachment 15476274 AM NTHA M. LAMBE The City of Santa Ana, Risk Management SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR n 14RR.7n14,7lCr317r) CORPORATION_ All rinhtw rPCPrvPd_ ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Attachment Code: D566170 Certificate ID: 15476274 POLICY NUMBER: PHPK2005119 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): The City of Santa Ana; it officers, employees, agents and representatives and volunteers are named as additional insureds ("additional insureds' with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds." 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", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. 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: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 © Insurance Services Office, Inc., 2012 Page 8 of 18