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HomeMy WebLinkAboutHERITAGE MUSEUM OF ORANGE COUNTY (6)INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES 1 I IZ02o CLERK OF COUNCIL D E N-2019-185 EP 2 5 2019TARTS AND CULTURE ARTIST GRANT PROGRAM AGREEMENT BETWEEN HE CITY OF SANTA ANA AND HERITAGE MUSEUM OF ORANGE COUNTY T W This Artist Grant Agreement ("Agreement") is made and entered this 201h day of August, 2019, by and between the City of Santa Ana, a charter City and municipal corporation organized and existing under the Constitution and laws of the State of California ("City'), and Heritage Museum of Orange County ("Grantee") for the purpose of providing grant funding pursuant to the Investing in the Artist Grant Program. City and Grantee may herein individually be referred to as a "Party" and collectively be referred to as the "Parties" to the Agreement. RECITALS: A. On July 18, 2019, the Arts and Culture Commission reviewed all applicants and recommended that Grantee be awarded an artist grant based on its Application for its artwork ("Project"). A true and correct copy of Grantee's Application is attached hereto as Exhibit A and incorporated herein by reference. B. In undertaking the performance pursuant to this Agreement, Grantee represents that it is skilled and knowledgeable in the arts and culture arena and that the Project created or performed hereunder will be created or performed in compliance with such standards as may reasonably be expected from an artist. 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. Term. This Agreement shall be effective upon signature by both Parties and shall expire one year from the date first written above, unless terminated earlier in accordance with this Agreement. 2. Fundin . 2.1. Subject to Grantee's performance of all required actions under this Agreement, City shall provide funding, in two disbursements, as detailed below, of an amount not to exceed Six Thousand Dollars ($6,000.00) ("Grant Amount" or "Grant"). 2.2. Grantee will be paid in two (2) installments. First payment will be one-half of the funding amount provided above or $3,000.00 and will be provided within thirty (30) days of the full execution of the Agreement by the parties along with a complete invoice submitted by Grantee. The second and final payment will include the remaining amount of $3,000.00 and will be issued within thirty (30) days after the Grantee submits to the City all the proper receipts, invoices and final report for the Project. 2.3. Appropriate performance of the Grantee will be determined by City in its sole discretion. City reserves the right to cease funding after the first disbursement detailed above, and to be reimbursed the initial payment, if Grantee's performance is determined to be insufficient or unacceptable in the City's sole discretion. 2.3. City represents that there is no correlation or connection between its selection of institutions or organizations for grant awards and an institution or organization's business relationship or potential business relationship with City. 3. Grant Activities. Grantee agrees: #2658v2 3.1. To perform the activities described in the Grant Application and Timeline submitted to City for consideration dated May 31, 2019, a copy of which is attached as Exhibit A and incorporated into this Agreement as if set out in full. 3.2. To submit all reports (each, a "Report"), which shall include, at a minimum, the items set forth as required by the Application. No personally identifiable information shall be included in any of the Reports, except where specifically requested. The Reports shall be in a format that is reasonably acceptable to City. City may request additional information as City, in its sole discretion, determines is necessary to monitor performance of this Agreement. City shall have the right to use any Reports submitted by Grantee, or any portion thereof, for any reason. 3.3. Grantee shall maintain all pertinent financial and accounting records pertaining to this Agreement in accordance with generally accepted accounting principles and other procedures reasonably specified by City. Upon termination or expiration of this Agreement or request by City, Grantee shall provide, at its expense, copies of all financial and accounting records produced by it arising out of this Agreement. 3.4. Grantee shall allow audits, compliance or special reviews and inspections, including on -site inspection, with or without prior notice, of Grantee's facilities by City or by third parties designated by City, or their authorized representatives. Grantee shall provide its full cooperation for any such audit, review or inspection, including providing timely access, for examination and copying of records (including computerized records) pertinent books, documents, papers, computer programs and records and reasonable access to its personnel. 3.5. Grantee shall ensure that any areas utilized for the Project are maintained and restored to a well -maintained, safe, sanitary, and clean condition, and kept free of any hazardous waste at all times. All equipment associated with the installation of the artwork, trash and debris shall be removed and cleaned up on a daily basis. Grantee shall place a drop cloth or similar barrier on the ground below the artwork while installation is underway, which barrier shall be removed each day upon completion of an installation session. 3.6. The Project may not contain advertising, religious art, sexual content, negative or violent imagery, convey political partisanship or include any hidden, subliminal or camouflaged messages or statements of any kind or nature. Appropriateness of the content of the Project will be determined by City in its sole discretion. 3.7. The Project may not include any breach of intellectual property, trademarks, brands, or images of illegal activity, and the Grantee must be the copyright holder for the Project. 4. Termination. 4.1. City may immediately terminate this Agreement upon one or more of the following: 4.1.1. Grantee's violation of any federal, state or local law or regulation. 4.1.2. Grantee's breach of any of the terms or conditions of this Agreement, including the Application and Timeline, or any unapproved deviation from said documents that has not been cured within 30 days of written notice of such breach. 4.2. In the event the Agreement is terminated under Section 4.1, City reserves the right to require Grantee to refund any or all grant funds awarded to Grantee under this Agreement, and Grantee agrees to refund to City any or all grant funds awarded under this Agreement. #2658v2 5. Limitation of Liabilit 5.1. IN NO EVENT SHALL CITY BE LIABLE FOR ANY INDIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES OR EXPENSES FOR ANY NEGLIGENCE, BREACH OF CONTRACT OR ANY OTHER ACT ARISING OUT OF OR RELATING TO THIS AGREEMENT OR THE ACTIVITIES COVERED HEREUNDER. 5.2. Section 5 and Section 6 do not limit Grantee's rights, including its ability to seek recovery, against anyone other than City, its directors, officers, employees, agents, successors and assigns. 6. Indemnification. 6.1. Grantee shall defend, indemnify, protect and hold harmless the City, and its elected and appointed officers, employees, members or agents from and against all claims for damages, liability, cost and expense (including without limitation attorney's fees) arising out of or alleged by third parties to be the result of the negligent acts, errors or omissions or the willful misconduct of the Grantee, and Grantee's employees, subcontractors or other persons, agencies or firms for whom Grantee is legally responsible in connection with -the execution of the work covered by this Agreement. Grantee shall have no duty to indemnify or hold harmless the City if claims, damages, liability, costs, expenses (including without limitation, attorney's fees) arise from the sole negligence or sole willful misconduct of the City subsequent to declaration by the Grantee. Grantee's obligations shall survive the termination of this Agreement. 6.2. Grantee agrees to hereby fully release and forever discharge the City from any and all claims, demands, damages, losses, and liabilities (hereinafter collectively referred to as "claims"), which are or may be related to or in any way connected with the negligence or willful misconduct of its officers, officials, employees, or agents in connection with the creation, painting, performance or installation of the Project hereunder. 6.3. Grantee further agrees that City may in good faith and on reasonable terms settle any such claims and that City's right to indemnification shall extend to any such settlement, provided City has given notice of such claim and its intent to settle. City's right to indemnification is in addition to, and may be exercised independently of, any remedy held by City under this Agreement, at law or in equity. The indemnity provision set forth in this Agreement shall survive the termination or expiration of this Agreement indefinitely. 7. Insurance 7.1 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 naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and 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 e .11-5 % damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, 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. 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. C. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 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. d. 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 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. Where the amounts or coverage provided by the certificates of insurance provides coverage greater than those listed by this Agreement, the amounts provided by the certificates of insurance shall be incorporated by reference into the Agreement. V. Consultant shall supply City with a fully executed additional insured endorsement. e. 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 terminate 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. 8. General Provisions. 8.1. Grantee shall acquire prior written permission from City for any use of the City name or logo in association with its Project. 8.2. If any parts of this Agreement are held to be invalid or unenforceable, the remaining parts of the Agreement shall continue to be valid and enforceable. #2658v2 8.3. Grantee shall comply with all governmental requirements that may now or in the future become applicable to its activities under this Agreement. 8.4. This Agreement, including Exhibit A, Application, and any amendments or schedules hereto, contain the full understanding and agreement of the Parties with respect to its subject matter, and no waiver, alteration or modification of any of the provisions to this Agreement shall be binding unless in writing and signed by an authorized officer of both Parties. 8.5. No waiver by either Party or any breach, default, or series of breaches or defaults, and no failure, refusal, or neglect of either Party to exercise any right, power, or option given to it under this Agreement or to insist upon strict compliance with the terms of this Agreement shall constitute a waiver of these provisions with respect to any subsequent breach or waiver by either Party or its right at any time thereafter to require exact and strict compliance with provisions of this Agreement. 8.6. Any notice or other communication required or permitted to be made or given by either Party pursuant to this Agreement will be in writing and will be deemed to have been duly given: (i) five (5) business days after the date of mailing if sent by registered or certified U.S. mail, postage prepaid, with return receipt requested; (ii) when transmitted if sent by facsimile, provided a confirmation of transmission is produced by the sending machine; or (iii) when delivered if delivered personally or sent by express courier service. All notices to City shall include a reference to the Project title. All notices will be sent to the other Party at its address as set forth below or at such other address as such Party will have specified in app notice given in accordance with this section: Grantee: 6 VAJy'0Vt'(in�1 � c��� City: City of Santa Ana Clerk of the Council (M-30) 20 Civic Center Plaza P.O. Box 1988 Santa Ana, CA 92702 FAX (714) 647-6956 8.7. This Agreement is subject to all applicable local, State and Federal laws. 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. 8.8. Grantee agrees to comply with all applicable equal opportunity and affirmative action laws as appropriate, Grantee 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 #2658v2 employment related activities. Grantee affirms that it is an equal opportunity employer (if applicable) and shall comply with all applicable federal, state and local laws and regulations. 8.9. Any funds provided under this Agreement that are not expended, obligated or otherwise committed by the termination or expiration of this Agreement shall be immediately returned to City. 8.10. Grantee grants to City a non-exclusive, irrevocable, transferable, royalty free, worldwide license to use, reproduce, display, distribute, and prepare derivative works, in any form or media at the discretion of the City for the Project conceived, performed or created as a result of this Agreement. 8.11. Grantee and any of the Grantee's agents, employees or representatives are, for all purposes under this Agreement, an independent contractor and shall not be deemed to be an employee of the City, and none of them shall be entitled to any benefits to which City employees are entitled including but not limited to, overtime, retirement benefits, work's compensation benefits, injury leave or other leave benefits. 8.12. Neither Party shall assign any rights or obligations under this Agreement. 8.13. Each Party 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. 8.14. Each Party warrants that they have executed this Agreement knowingly, freely and voluntarily and with full knowledge of its legal consequences. All parties involved warrant and represent that, prior to executing this Agreement, each Party has had the opportunity to review and consider this matter with legal counsel, and that the terms of this Agreement, and its consequences, are fully understood by each Party. 8.15. This Agreement represents the entire agreement and understanding between the parties, and supersedes any and all prior agreements and understandings between the parties, whether oral or written. 8.16. 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 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. #2658v2 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. J APPROVED AS TO FORM: SONIA R.-CARVALHO City RECOMMENDED FOR APPROVAL: STEVEN A. MENDOZA Executive Director Community Development Agency #2658v2 CITY OF SANTA ANA KRISTINE RIDG City Manager GRANTEE: 4 V v Name:QViv� Title: EXHIBIT A INVESTING IN THE ARTS GRANT PROGRAM APPLICATION #2658v2 INVESTING IN THE ARTIST LINE ITEM BUDGET Personnel Description of Personnel, Contracted instructors, lecturer honorarium, artist stipend Total Compensation Grant Funded Request OC Fine Arts Studio artists stipend $6000 $3500 Project Administrator $1500 $0 Community Partner Stipends $750 $500 Equipment, Materials, Supplies Item Quantity Unit Cost Total Cost Grant (equipment, material, supplies) Funds Requested Paint: Primary coat, red, blue, 60 gallons $33 $2000 $500 yellow, magenta, purple, violets, White, titanium, mate, Painting supplies: Rollers, pads, N/A N/A $1000 $780 Extension, handles, brushes, yardsticks, construction paper, tarps, buckets, palettes, trays, metals scrapers, masking tape, drawing supplies Office expenses (copies, folders, $250 $0 paper clips, miscellaneous) Mural Panels 8 $120 $960 $720 Special Events Description Total Cost Grants Funded (fees, permits, facility rental) Ribbon cutting, opening public $1250 $0 reception, appetizers, drinks, invites) Enter budget categories and projected expenditures Category Expenditures Expenditures Total Total Funded by Santa Funded by Other Program Organization Ana Grant Sources (including Budget Budget In -kind) Administrative salary $1500 $1500 staff and benefits Contractual/professional $4000 $2750 $6750 services/stipends Equipment, materials, $2000 $2710 $4710 supplies Special Events $0 $1250 $1250 Production Total $6000 $8210 $14210 $607,988.00 Total Program Revenue Funding Source Amount: Santa Ana Artist Grant $6000 Santa Ana Unified School District $1720 Heritage Museum of Orange Comity $6490 Total Program Budget $14210 Timeline Date Action Outcome Listening sessions, workshops, Complete first mural depicting September 2019 design and mural Buddhist Vietnamese stories implementation with Minh Dang Quang Temple and recruit high school art students Listening sessions, workshops, Complete second mural October 2019 design and mural depicting Punjabi history and implementation with The Sikh stories Center of OC Listening sessions, workshops, Complete third mural depicting November 2019 design and mural Cambodian history and stories implementation with The Cambodian Family Listening sessions, workshops, Complete fourth mural depicting December 2019 design and mural Chinese history and stories implementation with Asian American Senior Citizens Service Center (not confirmed yet) Opening receptions and public Celebrate our Unknown Histories January or February 2020 unveiling Murals '�' CERTIFICATE OF LIABILITY IN sl1RANCE OATEIM..0DIYYYY) o6/27nQ1s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANtl 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 ihs ctirtlliopEe holder la an ADgITIOIJAL INSUREp; tho policy(les) must.M1avo ApDITEONA INSUREtl provisions or 6«r endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies mayrequire an endorsement. A statement on this certiflcate does not Confer nights to the certificate holder In Ileu of such endoraamant(sj. PRODUCER .'..NAME Mary POJaf ISU- Dunlap Agency 1pHDNE %, (914)038-3168 (714J 922-6157 700 West 1st St" suite 6 A AtG No: ._ __� marvnd stasis. nnm Tustin INSURED Heritage Museum of Orange County 3101 W. Harvard Street CA 92780 Santa Ana CA JVEKAGES CERTIFICATE NUMBER; OL1962403963 REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOC INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIE& LIMITS SHOWN MAY -HAVE -BEEN REDUCED BY PAID CLAIMS TYPE OF INSURANCE -, ,,- POLICY NUMBER (,iMI00mYVl (IMF OhrWYZ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE a OCCUR y�®per— Fi$E$iE g A x POLICY L JECOT OTHER: _ AUTOMOBILE LIABILITY ANY AUIO A OWNED AUTOS ONLY HIRED AUTOS ONLY LIAR EMPLOYERS' LIABILITY B 11111101116 SCHEDULED AUTOS NON -OWNED AUTOS ONLY OCCUR CLAIMS -MADE I$ YlN XECUTIVE ❑ NI PAC 4296301-04 1 07/01/2019 1 Q7/01/2020 PAC 4296301-04 ' 07/01/2019 i 07/OV2020 IJUB-OG54216-8-19 1 07/01/2019 1 07/01/2020 Liquor Liability i $ 1,000,000 1,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS ( VEHICLES (ACORD 101, Additional Remark. Schedule, may be aeachad if more space Is mqulmd) Thirty (30) days noitice of cancellation required The City of Santa Ana, It's officers• amployses, agents, and representative are named as additional Insured r� in regards to General Liability per attached G2015 11 68 Addtonal Insured Form REVIEWED & APPROVED By Risk MANACIEMENT I)iViSiON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN -City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS, Risk Management Division 20 Civic Center Plaza 4th FI. AUTHORIZED REPRESENTATIVE Santa Ana CA 92702, ©1988-2015 ACORD CORPORATION, All rights reser AC ORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:eAc 4296301-04 COMMERCIAL GENEaA.LIA811:rrY CG 20 15 11188 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, 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) Or Organlzation(s) (Vendor) City of Santa Ana, it's officers, agents and employees 20 Civic Center Plaza Santa .Ana,, CA 92701 Information required to complete this Schedule, if not shown above, will be shown In the Declarations. A. Section II -Who Is An Ins urod Is amended to include as an insured any persons) or organlzatlon(s) (referred to below as vendor) shown In the schedule, but only with respects to "bodily Injury" or "property damage" arising out of "your products' shown In the schedule which are distributed or sold in the regular course of the vendor's buslness, subject to the following additional exclusions: 1. The Insurance afforded the vendor door not apply to; a. "Bodily Injury" or "property damage" for which the vendor Is obligated to pay damages by reason of the assumption of liability In a contract or agreement, This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made Intentionally by the vendor; d, Repackaging, unless unpacked solely for the purpose of Inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any fallures to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; I. Demonstration, Installation, servicing or repair operations, except such operations performed at the vendor's prernises In connection with the sale of the product; g. products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or Ingredient of any other thing or substance by or for the vendor; or h. "Bodily Injury" or "property damage" arising out of the sole negligence of the vendor for Its own acts or omissions or those of Its employees or anyone else acting on Its behalf. However, this exclusion does not apply to: (1) The exceptions contained In Subparagraphs d. or f.; or {2) Such Inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make In the usual course of business, In connection with the distribution or sale of the products. 2. This Insurance does not apply to any Insured person or organization, from whom you have acquired such products, or any Ingredient, pan or container, entering into, accampanying or containing such products. REV IIEW�ED & AMPP ROVED ' Q1 CG 2015 11188 ISO Properties, Inc., 2004 EiZAhJt>INI~ R. VILI.AREAL Page 1 of 1 ADDITIONAL INSURED ENDORSEMENT Insurance Company—,U j Ekhis endorsement modifies such insurance as is offered by the provisions of Policy Number: &e—�oK3on -Oy _relating to the following: 1, The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative 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 prirnary and is not additional to or contributing with any other Insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each Insured against whom claim is made or suit is brought except with respect to the company's limits of liability, The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant If not so included. 4, With respect the materially reduced has been given to 92701. additional insureds, this Insurance shall not be cancelled, or in coverage or limits except after thirty (30) days written notice the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California (Completio%bf.the following, Including countersignature, is required to make this endorsement effectiva) Effective -7/11 -t , this endorsement form part of Rory# Issued to (Name insuredy*ri�ISP[i+tir Countersigned, VIEWED & APPROVED Risk MANMIEMENT DIVISION