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HomeMy WebLinkAboutPSOMAS, INC. (4)A-zo14-224-oz MAYOR ,�1SURANCE NOT ON FILE Miguel A. Pulido WORK MAY NOT PROCEED MAYOR PRO TEM Juan Villages CLERK OF COUNCIL COUNCILMEMBERS Cecilia Iglesias DATE:SLP 0 9 2019 David Penaloza /n Vacant 117 �,j Vicente Sannienlo O - V A, (,\ 7 Jose 3DI°d° �, r v Oo ���'" t rITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza a P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.orD August 26, 2019 Psomas, Inc. Attn: Joseph L. Boyle, Vice President 3 Hutton Centre Drive, Suite 200 Santa Ana, CA 92707 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez Re: Extension of Consultant Agreement for En2ineerina Services, No. A-2014-224 Pursuant to Section 4 ("Term") of the above -referenced Agreement, entered into by Psomas, Inc. and the City of Santa Ana, dated September 16, 2014, as previously amended and extended, the term of the Agreement is hereby extended for an additional one-year period, from September 1, 2019 through August 31, 2020 to complete ongoing projects. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the^i %ement, as amended, remain unchanged and in full force and effect. Fuad eiss, PE, PLS Executive irector, Public Works Agency CITY OF $ANTA ANA Kristine Ridge 7 /Sl City Manager APPROVED AS TO FORM ATTEST ` Daisy Gomez, MMC Clerk of the Council PSOMAS, INC -Mz. J66n M. Funk a :Joe Boy Assistant City Attorney Tit : Vice President SANTA ANA CITY COUNCIL Miguel A Pulido Juan Kllegas %n"nte sarmiento David Penalou Jane Salado Vannl Mayor Mayor Pro Tam. Ward 5 WI i Ward 2 Ward 3 Wa:d d nmlido0santa-ana.am Mlieaasd@sentaana.ov nrtlentcasanta-ana om doanalo.0uuuta-ana.aa holoda(®sanm-ana.ora Cecilia lgleslas Ward 6 ddeela30aanla-ana.om 7 0 DATE (MMIDDNYYY) acaKo CERTIFICATE OF LIABILITY INSURANCE ��. 9/19/2019 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 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 CONTACT Dealey, Renton & Associates PHONE —1 FAX Lic. #0020739 tac. Nn. ExtI. 714 427-6810 1 IAIC, No): 714 427-6818 600 Anton Blvd., Suite 100 ADDRESS: -- Costa Mesa CA 92626 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: XL SDecialty Insurance Co. 37885 INSURED PSOMAS PSOMAS 555 South Flower Street, Suite 4300 Los Angeles CA 90071 INSURER B : INSURER C : INSURERD: INSURER E : INSURERF: !`A►IGRAf.RC rFRTIPIrATF NIIMRFR• 1RA9RAR77 RFVIRI(iN NIIMRFR' 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. NSR TR TYPE OF INSURANCE INSD SUER POLICY NUMBER MWDDIYY IYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑ OCCUR 1GIAE TO RIENTED PREMISES Ea acurrenc $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ QEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ PRO- POLICY l.1 JE C LOC $ OTHER; AUTOMOBILE LIABILITY COMBINEDINGLE MI a +7CCk1 t $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS I PROPERTY J)X GE d $ _(PoLac UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ PER OTH- T T E-L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ E.L_ DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below Professional Liability Claims Made DPR9932582 10115/2011 11115/2019 Per Claim $1,000,000 Annual Aggregate $2.000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) 2SAN410111; Walnut Pump Station Upgrade Project / Agreement No.= A-2014-224 REVIEWED & APPROVED By RISC MANAGEMENT DIVISION ULK I II-IUA It HULUtK f I ■ h r,) I ) I/A A r � 01 ll t-ANUrL.L.A 1 IUN au UaY INOUCe DI UanCellailOrl FI2ANC:INE R. VILLAREAL City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD This endorsement, effective 12:01 a.m., 10/15/2018 forms apart of Policy No. DPR9932582 Issued to PSOMAS by XL SpecialtySpecia[ty insurance Com an . THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CANCELLATION — NOTICE TO DESIGNATED ENTITIES This endorsement modifies insurance provided under the following: PROFESSIONAL, ENVIRONMENTAL AND NETWORK SECURITY LIABILITY POLICY— ARCHITECTS, CONSULTANTS AND ENGINEERS Section XI. OTHER CONDITIONS, Paragraph A. Cancellation is amended by the addition of the following: In the event that the Company cancels this Policy for any statutorily permitted reason other than non- payment of premium, the Company agrees to provide thirty (30) days' notice of cancellation of this Policy to any entity with whom the NAMED INSURED agreed in a written contract or agreement would be provided with notice of cancellation of this Policy, provided that: The Company receives, at least fifteen (15) days prior to the date of cancellation, a written request from the NAMED INSURED to provide notice of cancellation to entities designated by the NAMED INSURED to receive such notice and; 2. The written request includes the name and address of each person or entity designated by the NAMED INSURED to receive such notice. This endorsement does not apply to non -renewal of the Policy, cancellation at the INSURED'S request, or to cancellation of the Policy for non-payment of premium to the Company or to a premium finance company authorized to cancel the Policy. Furthermore, nothing contained in this endorsement shall be construed to provide any rights under the Policy to the entities receiving notice of cancellation pursuant to this endorsement, nor shall this endorsement amend or alter the effective date of cancellation stated in the cancellation notice issued to the NAMED INSURED. All other terms and conditions of the Policy remain unchanged. REVIEWED & APPROVED By RISK MANAGEMENT DIVISION S 19 2019 FRANCA E R. L.LAREAL LDD 452 1116 Page 1 of 1 © 2016 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Client#: 25181 PSOMAS DATE (MMIDD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 9/10/2019 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 CONTACT -NAME: Katie Kresner 11 Greyling Ins. Brokerage/EPIC PHONE 770.552.4225 AIX Nd; 866.550.4082 A/C No Ext 3780 Mansell Road, Suite 370 E-0AIL ae.reser re IIn ADDRESS; Katie. Kn@g y g•tom Alpharetta, GA 30022 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins. Co. 119445 INSURED INSURER B : Psomas INSURER C 555 South Flower Street; Suite 4300 INSURER D Los Angeles, CA 90071 INSURER E INSURER F : rnvconr_oc L`CRTIGICATF MIIMRFR• is -in REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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. INSR LTR TYPE OF INSURANCE ADD N UB WVp POLICY NUMBER POLICY EFF DIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 5268212 4/0112019 04/01/202C EACH OCCURRENCE $1 00O 000 PREMISES Ea occur ante $ 500 000 CLAIMS -MADE � OCCUR MED EXP (Any one person) $ 25 000 PERSONAL & ADV INJURY $1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 PRO- LOC JECT POLICY X $ OTHER: A AUTOMOBILE LIABILITY 4489706 4/01/2019 04/01/2020 Co 881 SO$INGLE"LIMIT 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ AUTOS ONLY X SCHEDULED AUTOS X AUTOS ONLY AUTOS ONLY D PROPERTY DAM GE (Per aoladenll _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ H AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A A WORKERS COMPENSATION ANDEMPLOYERS'EMPLOYERS' LIABILITY ANY PR( YI N OFFICO MEMBER EXCLUDED? NJ (Mandatory In NH) N / A 015893764 (AOS) 015893765 (CA) 4I01/2019 4/01/2019 04/01/202 04101/202 X PER T Ea— E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE $1 000,000 E,. DISEASE- POLICY LIMIT L $1 OOO OOO If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) 2SAN410111; Agreement No. A-2014-224; Walnut Pump Station Upgrade Project. The City of Santa Ana, its officers, employees, agents, volunteers & representatives are named as Additional Insureds with respects to General Liability where required by written contract. The above referenced liability policies are primary & non-contributory where required by written contract. Separation of Insureds applies to the General Liability Policy. Waiver of Subrogation is applicable where required by written contract & allowed by law. Should any (See Attached Descriptions) CERTIFICATE HOLDER V1 CV Cx !i+ I +■v�J�n+veLLH1I�Iv By Risk ANACtEMENT DIWISION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division S 19 2019 AC gRDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza, 4th flo Santa Ana, CA 92702-0000 IZEDREPRESENTATIVE FRANCINE R. VILLA E ,64,6! ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1778000/M1464737 KKRE1 DESCRIPTIONS (Continued from Page 1) 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 named below. REVIEWED & APPROVED By RISk MANAGEMENT MWON 19 � FRANCINE R. VILLAREAL SAGITTA 25.3 (2016/03) 2 of 2 #S1778000/M1464737 POLICY NUMBER, 5268212 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED 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) ANY PERSON OR ORGANIZATION WHOM YOU Locationfs) Of Covered Operations PER THE CONTRACT OR AGREEMENT. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO, Information required to complete this Schedule, it 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: 1. Your acts or omissions; or 2, The acts or omissions of those acting on Your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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 CG 20 10 04 13 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 additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2, That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project, REVIEWED & APPROVED 0 Insurance Services CAfycl?j%tes,NlM'f gMENT DiVISiON 5E �;9 &2019 FRANCINE R. VILLAREAL Page 1 of 2 0 C, 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. REVIEWED & APPROVED By Risk MANACj MENT DIVISION 9 Q19 Page 2 of 2 Insurance Semi 1 FRANCINE R. VILLAREAL CG 20 10 04 13 ❑ POLICY NUMBER: 5268212 COMMERCIAL GENERAL LIABILITY CG 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 Name Of Additional Insured Person(s) Or Organizations# ANY PERSON -OR. ORGAN I ZAT l ON WHO YOU BECOME':OSI:I:GATED JO INCLUDE" AS AN ADDITIONAL INSURED AS 'A. RESULT OF ANY CONTRACT OR,AGREEMENT YOU HAVE ENTERED INTO SCHEDULE Location And Description Of Completed Operations) 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 organizationls) 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 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: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insu- rance shove in the Declarations; whichever is less. This endorsement shall not increase the appli- cable Limits of Insurance shown in the Decla- rations. REVIEWED & APPROVED By Risk MANAGEMENT DIVISION CG 20 37 04 13 a Insurance Servic �0 14.9 Q F3 V FRANCINE R. VILLAREAL Page 1 of 1 BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy) This endorsement, effective 12:01 AM 04/01 /2019 forms a part of Policy No. 015-89-3765 Issued to PSOMAS By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2. 00 % of the total estimated workers compensation premium for this policy. REVIEWED & APPROVEL, By RISk MANAGEMENT DiviSiON EP 19 2 1 ocm FRANCINE R. VILLAREAL WC 04 03 61 Countersigned by _ �'✓�`� �.t --'— "` (Ed. 11 /90) Authorized Representative Client#: 25181 PSOMAS DATE (MMIDD/YYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1 9/10/2019 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 CONTACT NAME: Katie Kresner Greyling Ins. Brokerage/EPIC PHONE FAX J. 866.550.4082 AIC, No, Extj; 770.552.4225 3780 Mansell Road, Suite 370 E-MAIL Katie.Kner re com ADDRESS: res@g Y .iln g• Alpharetta, GA 30022 INSURERS AFFORDING COVERAGE NAIC p INSURER A: National Union Fire Ins. Co. 19445 INSURED INSURER B : Psomas INSURER C : 555 South Flower Street; Suite 4300 INSURER D ; Los Angeles, CA 90071 INSURER E INSURER F : rnvGOAr-Ge CFRTIFICATF IdI1MRFR• IQ-9n RFVIRIAN N1IMRFR- 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 L_& TYPE OF INSURANCE ADDL Ii�iSR U6 WVD POLICY NUMBER POLICY /DD/YY F MM/DD/YYYY POLIffM/DD/ XP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 5268212 4489706 4/01 /2019 0410112020 EEpAApCCMHHp OCCURRENCE $1 OOO 000 PREIy}f E EoNwwum,rcW $500 000 MED EXP (Any one person) s25,000 PERSONAL & ADV INJURY $1 00O 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY FX JECTLOC OTHFR: AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS HIRED NON -OWNED X AUTOS ONLY AUTOS ONLY GENERAL AGGREGATE s2,000,000 PRODUCTS - COMP/OP AGG s2,000,000 $ A _ 4/01/2019 04/01/202 COA'IBINEDSINGLELIMI7dent Ea acc 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ FROP RTY DAMAGE Per accident) $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION$ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVEYIN ❑FFICE.RIMEM8ER EXCLUDED? FNI (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 015893764 (AOS) 015893765(CA) 4/01/2019 4/01/2019 04/011202a 04/01/2020 ER OTH- X I P;TATLITE ER E.L EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1 00O 000 E.L. DISEASE - POLICY LIMIT $1,000 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) 2SAN051200; Engineering Design Services for Rehabilitation of City Well 29, Agreement No. A-2017-338. The City of Santa Ana, officers, employees, agents & representatives are named as Additional Insureds with respects to General Liability where required by written contract. The above referenced liability policies with the exception of workers compensation are primary & non-contributory where required by written contract. Should any of the above described policies be cancelled by the issuing insurer before the (See Attached Descriptions) [a}galtl:111[WsrlM:L■31111 • By RISK MANAgEMENT UIVI I(OOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division p ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza,4th f1oOy4,EF 9 2019 Santa Ana, CA 92702-0000�211u R}"E❑ REPRESENTATIVE FRANCINE R. VILLAREi��_f� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1778001 /M 1464737 KKRE1 SAGITTA 25.3 (2016/03) 2 of 2 #S1778001/M1464737 POLICY NUMBER: 5268212 COMMERCIAL GENERAL LIABILITY CG 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 Of Additional Insured Person(s) Location And Description Of Completed Operations Or Organizations} AKY PERSON OR ORGANIZATION WHO YOU PER THE CONTRACT OR AGREEMENT BECOME OBL I GATEIYAT0?'INCLUDE AS' AN ADDITIONAL INSURED -'AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO l�M:+���\•7�1 CS�1rF:i�[�4 W1�1C.'.._.R;�::ii���--��iA. Mi. 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 personls) 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". Mich 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 Ill - 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: However: 1. Required by the contract or agreement; or 1. The insurance afforded to such additional 2. Available under the applicable Limits of Insu- insured only applies to the extent permitted rance shown in the Declarations; by law; and whichever is less. 2. If coverage provided to the additional insured is required by a contract or agree- This endorsement shall not increase the appli- ment, the insurance afforded to such addi- cable Limits of Insurance shown in the Decla- tional insured will not be broader than that rations. REVIEWED & APPROVED By RISK MANAGEMENT DIViSiON SE 19 2019 CG 20 37 04 13 0Insurance Sei VILLAREAL Page 1 of 1 Im POLICY NUMBER; 5268212 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED 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) 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, Location(s) Of Covered Operatic PER THE CONTRACT OR AGREEMENT, I Information required to complete this Schedule, it not shown above, will be shown in the Declarations. I A. Section iE - 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: 1. Your acts or omissions; or 2, The acts or omissions of those acting on Your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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 additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2, That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project, REVIEWED & APPROVED By Risk: MANAgEMENT DivisiON CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 SEP 9� 019 FRANCINE R. VILLAREAL Page 1 of 2 0 C, With respect to the insurance afforded to these additional insureds, the following is added to Section Ill - 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 D"larations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ,&VIEWED & APPROVED By Risk MANAUMENT MISION EP 19 2019 .i FRANCINE R. VILLAREAL Page 2 of 2 0 insurance Services Office, Inc., 2012 CG 20 10 04 13 0 POLICY NUMBER: 5268212 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance policy provided that: Condition and supersedes any provision to the 11) The additional insured is a Named Insured contrary: under such other insurance; and Primary And Noncontributory Insurance (2) You have agreed in writing in a contract This insurance is primary to and will not or agreement that this insurance would seek contribution from any other insurance be primary and would not seek contribu- available to an additional insured under your tion from any other insurance available to the additional insured, .zE'VdtVVED & APPROVED By Risk MANAGEMENT DIVISION SEP 19 2019 _­1, FRANCINE R. VILLAREAL CG 20 01 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1