HomeMy WebLinkAboutPREMIER VENDGROUP INC.City of Santa A
Clerk of the Council cotcoffice use- only
AGREEMENT TERMINATION FORM
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amendments (if any) are no longer in effect.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.
CM RK OF HE COUNCIL
Is the agreement(s) a permanent record? Yes NoAUG 2 + = F v32
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with -?Q�W',Q-9 V Q,4� l p _ :1 'L +
N-2017-263 U 1' � d`fi
No. was completed on and final payment has been made.
(List aft amendments. Use space below if needed.)
1j-aoI7—�(�3
Revised: 10-18-16
Department: P9L&4} ) Od Yi' ! k,-
Phone/Ext.: si
Signature: /V��u�l�l
Date: % / -YI ;;Z-1
N-2017-263-02
CV 12TiEN t
INSURANCE NOT ON FILE
WORK MAY NOT PROCEED
CLERK OF N I
O: PRCS ( '/ ) NOV i 4 201
Silvia Cuevas DATE:
SECOND AMENDMENT TO VENDING AGREEMENT WITH PREMIER VENDGROUP INC.
THIS SECOND AMENDMENT to the above -referenced agreement is entered into on October 30, 2019,
by and between Premier Vendgroup, Inc.; a California corporation ("Consultant"), and the City of Santa
Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of
the State of California ("City").
RECITALS
A. On December 16, 2017, the parties entered into Agreement No. N-2017-263 to provide beverage
and/or snack vending machines at various City -owned properties ("Agreement").
B. On September 18, 2018, the parties amended the Agreement through the First Amendment to add
provisions for a change machine at the Santa Ana Police Department at a cost of $120 per year. The
parties also agreed to exercise the first optional one-year extension of the term until November 30, 2019.
C. The parties now wish to amend the Agreement, as already amended, to add two additional
vending machines at the City's Work Center and to exercise the second of two, one-year renewals.
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The Parties therefore agree:
1. Section 1, TERM, will be revised to indicate that the City is exercising the second (of two) optional
one (1) year renewals. In addition, the term will be updated to reflect that the Agreement expires on
November 30, 2020, unless terminated by either party as provided in the Agreement.
,u>.l
2. Exhibit A to the Agreement will be replaced with the attached Exhibit Aadding two -additional
vending machines to the City's Work Center.
3. Except as modified by this Second Amendment, all terms and conditions of the Agreement, as
previously amended, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to the Agreement
on the date and year first written above.
ATTEST
/2�lerk of the Council
CITY OF SANTA ANA
[Signatures continue on the next page]
Page 1 of 2
N-2017-263-02
APPROVED AS TO FORM
SONIA R. CARVALHO
City Attorney
BY: . F.Ib 0 "1#.
LAURA A. ROSSINI
Senior Assistant City Attorney
RECOMMENDED FOR APPROVAL
C
L UDLOFF
Executive Director
Parks, Recreation and Community Services Agency
CONSULTANT
i
Title..
r.4o
Page 2 of 2
EXHIBIT A
PROPOSED SCOPE OF SERVICES/VENDOR RESPONSIBILITIES
1. Provide beverage and/or snack vending machines, approved locations.
2. Ensure that no less than 50 percent of the food and beverage provided in all vending machines
located at City -owned facilities are of a healthy variety.
3. Provide maintenance, service and cleaning of those machines at regular intervals and/or as needed.
4. The vending operation shall be nun in an efficient and courteous manner. Vending services staff
member(s) shall be clean and neatly dressed, presenting a positive image for City facilities. Special
consideration will be offered to bidders able to demonstrate superior customer service.
5. For the safety of the public patrons who utilize City facilities and/or maintenance concerns
regarding City facilities, restrictions may be necessary including items sold, packaging, etc. The
City must approve all menu items, packaging, and machines, and machine locations (or changes to
the above).
6. The vendor shall obtain a business license to operate within the City of Santa Ana and maintain
current liability insurance coverage.
7. The vendor(s) shall attend meetings with City staff as required.
8. The venclor(s) shall coordinate with other Agencies as required.
9. The vendor shall provide a revenue/expenditure report if requested by the City of Santa Ana.
10. The revenue to the City shall be $600 per month.
CITY RESPONSIBILITIES
The City will provide the following:
1. Electricity and electrical maintenance for approved vending machines to be installed.
2. Approval of sites and number and types of machines to be installed.
3, Staff liaison for communication and problem resolution.
4. Pay $120 year for one (1) change machine located at the Police Department.
EXHIBIT A
PRICING
Snacks
Pricing
Large Serving Size Chips 12oz
$1.00
Fresh Pastries
$1.50
Cookies
$1.00
Deluxe Bag Snacks
$1.00
Candy --Chocolate
$1.00
Energy Bars
$2.00
Gum/Mints
$1.00
Drinks
Pricing
20oz Soda/WaterBeverage
$1.25
12oz Soda Can
$1.00
Snapple
$1.50
20oz Gatorade Bottle
$1.75
Energy Drinks 16oz, Red Bull 8oz
$2.75
Juice Drinks
$2.00
Coffee
Pricing
8oz Cup
$0.75
12oz Cup
$1.00
EXHIBIT A
EXISTING SITES
PRCSA Park/Facility Sites
Address
Existing
Proposed Number/Type
Machines
Of Machines
El Salvador Park
1825 W. Civic Center
2
1 cold drink and 1 snack
Memorial Park
2102 S. Flower St.
2
1 drink and l snack
Rosita Park and Salgado
706 N. Newhope St.
2
1 drink and 1 snack
Recreation Center
Santa Ana. Public Library
26 Civic Center Plaza
2
1 cold drink and 1 snack
Santa Ana Senior Center (SASC)
434 W. 3`1 Street
1
I cold drink/snack combo
Southwest Senior Center SWSC)
2201 W. McFadden Ave.
2
1 cold drink and 1 snack
Santa Ana Regional
1000 East Santa Ana Blvd
3
2 cold drink and 1 snack
Transportation Center (SARTC)
Santa Ana Police Department,
60 Civic Center Plaza
4
2 cold drink, I hot drink,
Code 7 Cafe
and 1 snack
Santa Ana Police Department,
60 Civic Center Plaza
I
1 cold drink
I" Floor
1
Change Machine
Santa Ana City Hall
20 Civic Center Plaza
2
1 cold drink and 1 snack
Santa Ana City Yard,
220 S. Daisy Ave.
2
1 cold drink and 1 snack
Administrative Building
Santa Ana City Yard,
220 S. Daisy Ave.
2
1 cold drink and 1 snack
Fleet Maintenance
WORK Center
80l West Civic Center
2
1 cold drink and I snack
Drive, Suite 200
"`MCERTIFICATE
OF LIABILITY INSURANCE
DATE(MMIDOrr"
THIS CERTIFICATE IS ISSUED AS
CERTIFICATE DOES NOT AFFIRM
MA
rIVE1.1i
R OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH
11/6/2019
CERTIFICATE HOLDER. THIS
BELOW. THIS CERTIFICATE OF I
SURAI
OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE
CE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
AFFORDED BY THE POLICIES
REPRESENTATIVE OR PRODUCER,
kND Tli
ISSUING
E CERTIFICATE HOLDER.
INSURER(S), AUTHORIZED
IMPORTANT: If the certificate holds
is an
DDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED
provisions or be endorsed.
If SUBROGATION IS WAIVED, sublet
this certificate does
to th
terms and conditions of the Policy, certain policies may require an
endorsement. A statement on
not confer right
to the
ertificate holder in lieu of such endorsement(s).
PRODUCER
Arthur J. Gallagher & Co.
CONTAC Edka SOk011k
77
PNONE
818534-3558
FAx x . 818.316.0990
Insurance Brokers of CA, Inc. LIC
2629
21820 Burbank Blvd. Suite 175
EMAIL , Edka Sokolik a'
Woodland Hills CA 91367
.corn
INSURED
Downey Vendors
6814 Suva Street
Bell Gardens, CA 90201
COVERAGFS rebTrnrArc .rr r..rs,•... ..._.. .. _._
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IS TO CERTIFY THAT THE POLICI
NOTWITHSTANDING ANY
MAY BE ISSUED OR MA
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TYPE OF INSURANCE
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LIMITS SHOWN MAY HAVE BEEN
POLICY NUMBER
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THE POLICIES
REDUCED BY
PVUDCDYEFF
4/1/2019
THE INSURED
OTHER
DESCRIBED
PAID CLAIMS.
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ADV INJURY
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DESCRIPTION OFOPERATIONS ILOCATIONSIVEHI
City of Santa Ana, Risk Management, it's
General Liability coverage on a primary an
U:S'AC
fOcels,
non c
D 101,AddItlonal Remarks B .dule,rsaybeH .hedXrsoreapece lerago.d)
mployees, agents, representatives, and volunteers are included as Additio
ntdbUtory basis per attached form CG 88100413. 30 days Notice of Cancel
al Insureds with respect to
allon Applies.
R VIE
& APPROVED
CERTIFICATE HOLDER MAKISK
MANVIGEMENT
UIVISIUN --Z=.._.. -_.__.
V 13 2019 SHOULD ANY OF THE ABOVE DESCRIBED
THE EXPIRATION DATE THEREOF, Ni
City of Santa Ana ACCORDANCE WITH THE POLICY PROVISII
Risk Management M. LAMBERT
20 Civic Center PI AUTHGRIZEDREPRESENTATWE
Santa Ana CA 92702
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ACORD 25 (2016103) TheACORD name and logo are registered marks of ACORD
ES BE CANCELLED BEFORE
WILL BE DELIVERED IN
rights
c
a
a
COMMERCIAL GENERAL LIABILITY
CG 88 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CO MERCIAL GENERAL LIABILITY EXTENSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENEF AL LIABILITY COVERAGE PART
INDEX
SUBJECT
NON -OWNED AIRCRAFT
NON -OWNED WATERC"
PROPERTY DAMAGE LIAE
EXTENDED DAMAGE TO I
MEDICAL PAYMENTS EXl
EXTENSION OF SUPPLEM
ADDITIONAL INSUREDS -
PRIMARY AND NON-CONT
ADDITIONAL INSUREDS -
WHO IS AN INSURED - INC
INSURED - FELLOW EMPLI
NEWLY FORMED OR ADD[
FAILURE TO DISCLOSE HA
KNOWLEDGE OFOCCURR.
LIBERALIZATION CLAUSE
BODILY INJURY REDEFINE
EXTENDED PROPERTY DAI
WAIVER OF TRANSFER OF
WHEN REQUIRED IN A COI
CG 88 10 04 13
-,ELEVATORS
:RTY RENTED TO YOU (Tenant's Property Damage)
2Y PAYMENTS -COVERAGES A AND B
INTRACT, AGREEMENT OR PERMIT
ORY- ADDITIONAL INSURED EXTENSION
JDED PROTECTION OF YOUR "LIMITS OF INSURANCE"
'AL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN
EXTENSION -MANAGEMENT EMPLOYEES
LLY ACQUIRED ENTITIES
5, AND PRIOR OCCURRENCES
i
OFFENSE, CLAIM OR SUIT
OF RECOVERY AGAINST OTHERS TO US '�
OR AGREEMENT WITH YOU
® 2013 Liberty Mutual Insurance
yrlg led material of Insurance Services Office, Inc., with its permission.
PAGE
2
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2
2
3
3
3
5
6
6
7
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Page 1 of 8
With respect to coverage afforded by this endorsement, the provisions of the policy applN unless modified by
the endorsement.
A. NON -OWNED AIRCRAFT
Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Properly Damage Liability,
exclusion g. Aircraft, A ito Ot Watercraft does not apply to an aircraft provided:
1. It is not owned by ny insured;
2. It is hired, charterec or to 3ned with a trained paid crew;
3. The pilot in comma id hc Ids a currently effective certificate, issued by the duly cor stituted authority of
the United States o Ame ica or Canada, designating her or him a commercial or aii line pilot; and
4. It is not being used to car persons or property for a charge.
However, the insurance affonled by this provision does not apply if there is available to the insured other
valid and collectible ins rant , whether primary, excess (other than insurance written to apply specifically
e in excess of this policy) contingent or on any other basis, that would also apply to this loss covered under
this provision.
B. NON -OWNED WATERCRAFT
s
Under Paragraph 2. Exclusions of Section 1- Coverage A - Bodily Injury And Property D mage Liability,
Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following:
This exclusion does not apply to:
(2) A watercraft yo i do rot own that is:
(a) Less than 2 feet long; and
a (b) Not being i ised t carry persons or property for a charge.
C. PROPERTYDAMAGE LI BILI -ELEVATORS
1. Under Paragraph 2. Excit sions of Section I - Coverage A - Bodily Injury And Prop rty Damage Liabil-
ity, Subparagraphs (3), ( ) and (6) of exclusion j. Damage To Property do not appy if such "property
damage" results In: m th use of elevators. For the purpose of this provision, elevE tors do not include
vehicle lifts. Vehicle lifts re lifts or hoists used in automobile service or repair open Itions.
2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other
Insurance, Paragrap I b. Excess Insurance:
The insurance afforded by this provision of this endorsement is excess over any roperty insurance,
whether primary, a cess, contingent or on any other basis.
D. EXTENDED DAMAGE TO PRO ERTY RENTED TO YOU (Tenant's Property Damage)
C
If Damage To Premises I lentecTo You is not otherwise excluded from this Coverage Pa :
1. Under Paragraph 2. Exclusions of Section I -Coverage A -Bodily Injury and Property Damage Liability:
it
a. The fourth from the I at paragraph of exclusion j. Damage To Property is replaced by the follow-
ing:
Paragraphs (1), 3) an (4) of this exclusion do not apply to "property damage,, other than damage
by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to:
(i) Premises rented t 3 you for a period of 7 or fewer consecutive days; or
(11) Contents th 3t you rent or lease as part of a premises rental or lease agreen lent for a period of
more than days.
Paragraphs (1), (3) arid (4) of this exclusion do not apply to "property dame e" to contents of
premises rented to yoY for a p iod of 7 or fewer consecutive days.
A separate limil of isu nce pplies to this coverage as described in Sa ion III - Limits of
Insurance.
® 2013 Leert u al Insurance
CG 88 10 04 13 Includes pydgjtted material of Insurance services Office, Inc., with its permission. Page 2 of 8
I
b. The last paragi
aph c
f subsection 2. Exclusions is replaced by the following:
Exclusions c.
throug
i n. do not apply to damage by fire, lightning, explosio
, smoke or leakage
from automatic
fire
protection systems to premises while rented to you or tern
Jorarily occupied by
you with permission
of the owner. A separate limit of insurance applies to Damage
To Premises
Rented To You
as described
in Section III - Limits Of Insurance.
2. Paragraph 6. under
Secti
n III - Limits Of Insurance is replaced by the following:
6. Subject to Par
igrapt
5. above, the Damage To Premises Rented To You Until
is the most we will
pay under Cov,
rage
A for damages because of "property damage" to:
a. Any one pi
emis
(1) While
rentec
to you; or
(2) While
rented
to you or temporarily occupied by you with permission
of the owner for
damage
by
fire, lightning, explosion, smoke or leakage from automatic
protection sys-
tems;
or
b. Contents t
iat yo
i rent or lease as part of a premises rental or lease agreerr
ant.
3. As regards coveraC
a pro
Aded by this provision D. EXTENDED DAMAGE TO PROPERTY
RENTED TO
YOU (Tenant's Pro
ertyDamage)
- Paragraph 9.a. of Definitions is replaced with the
following:
9.a. A contract for
a lease
of premises. However, that portion of the contract for
a lease of premises
that Indemnified
any
person or organization for damage by fire, lightning, explosion,
smoke, or
leakage from Autorridtic
fire protection systems to premises while rented to
you or temporarily
occupied by y
u with
the permission of the owner, or for damage to contents
of such premises
that are include
in ybur
premises rental or lease agreement, is not an "insured
contract".
E. MEDICAL PAYMENTS I
If Coverage C Medical
are amended as follows:
Under Paragraph 1
(b) of Paragraph a.
(b) The expenses
F. EXTENSION OF SUPPLI
1. Under Supplementi
b. Up to $3,000 h
out of the use
to furnish these
2. Paragraph 1.d. Is re
d. All reasonable
defense of the
off from work.
G. ADDITIONAL INSURED;
1. Paragraph 2, under
organization whom
agreement or perm
liability for "bodily
or in part by:
a. Your acts or on
of your on going
written agreem
sonal and adve
written agreem)
CG 88 10 04 13 Includes
is not otherwise excluded, the Medical Payments
Agreement of Section I - Coverage C - Medical Pa
by the following:
I and reported within three years of the date of the
PAYMENTS -COVERAGES A AND B
- Coverages A and B, Paragraph 1.b. is replaced
costlof bail bonds required because of accidents or traffic
any ehicle to which the Bodily Injury Liability Coverage a
by the following:
incurred by the insured at our request to assist us in
"suit", including actual loss of earnings up to $500 a
BY CONTRACT, AGREEMENT OR PERMIT
ided by this policy
nits, Subparagraph
dent; and
the following:
violations arising
is. We do not have
he investigation or
ey because of time
iecticjn II - Who is An Insured is amended to include as an Ins red any person or
you (have agreed to add as an additional insured in a writ contract, written
Su h person or organization is an additional insured but o ly with respect to
)jury", "property damage" or "personal and advertising injury' caused in whole
or the acts or omissions of those acting on your behalf, in the performance
tons for the additional insured that are the subject of the written contract or
ivided that t 'bodily injury" or "property damage" occurs, or the "per -
injury" �s co itted, subsequent to the signing of such written contract or
'� si ® 2013 Libe utu I s rants
tied material of Insurance Services office, Inc., with Its permission. Page 3 of 8
b. Premises or facilities rented by you or used by you; or
c. The maintenan e, operation or use by you of equipment rented or leased to y u by such person or
organization; or
d. Operations performed by you or on your behalf for which the state or politcal subdivision has
issued a permii subject to the following additional provisions:
(1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad-
vertising i jury" arising out of the operations performed for the state or political subdivision;
(2) This insur nce oes not apply to "bodily injury" or "property damage" included within the
.completec ope tions hazard".
(3) Insurance appIle3 to premises you own, rent, or control but only with respect to the following
hazards:
(a) The existence, maintenance, repair, construction, erection, or reryoval of advertising
signs, awni gs, canopies, cellar entrances, coal holes, driveways, manholes, marquees,
hoist away openings, sidewalk vaults, street banners, or decorations and similar expo-
sures; or
(b) The c nstru ion, erection, or removal of elevators; or
a (c) Theo ners p, maintenance, or use of any elevators covered by this Insurance.
However:
1. The insurance afforded to such additional insured only applies to the extent peTnitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insur-
ance afforded o suc additional insured will not be broader than that which you are required by
c the contract or agreement to provide for such additional insured.
With respect to P rags h 1.a. above, a person's or organization's status as a additional insured
under this endorse ent Ends when:
(1) All work, i cludl materials, parts or equipment furnished in connection with such work, on
the project (oche than service, maintenance or repairs) to be performed b or on behalf of the
additional nsure (s) at the location of the covered operations has been roi ipleted; or
(2) That portio of 'your work" out of which the injury or damage arises ias been put to its
intended use by any person or organization other than another contract r or subcontractor
engaged in perfo ming operations for a principal as a part of the same proj ct.
With respect to Paragraph 1.b. above, a person's or organization's status as ar additional insured
under this enclorsei ent ends when their written contract or written agreement with you for such
c
premises or fadlitieE ends.
a With respects to P , graph 1.c. above, this insurance does not apply to any "occu once" which takes
place after the equif ment rental or lease agreement has expired or you have return ad such equipment
to the lessor.
a The insurance provi ad this endorsement applies only if the written contract oi written agreement
is signed prior to the "bodi y injury" or "property damage".
We have no duty t defend an additional insured under this endorsement until we receive written
notice of a "suit" b the additional insured as required in Paragraph b. of Conditi n 2. Duties In the
Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi-
tions.
/i�11�1I
CG 88 10 04 13 Includes copyri hted material ofInsurance ' Services office,
ff e, Inc., with its permission. Page 4 of 8
n
a
3
2. With respect to the insu�ance provided by this endorsement, the following are aided to Paragraph 2.
Exclusions under Section I -Coverage A -Bodily Injury And Property Damage Liability:
This insurance dos not apply to:
a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured.
b. "Bodily injuryor 'property damage" that occurs prior to you commencing operations at the
location where such "bodily injury" or "property damage" occurs.
c. "Bodily injury" "proerty damage" or "personal and advertising injury" arisi g out of the render-
ing of, or the allure to render, any professional architectural, engineering oi surveying services,
including:
(1) The preps ing, ipproving, or failing to prepare or approve, maps, shop drawings, opinions,
reports, s rveys, field orders, change orders or drawings and specifications; or
(2) Supervisorr, ins action, architectural or engineering activities.
This exclusion app !as ei an if the claims against any insured allege negligence or Aher wrongdoing in
the supervision, hi ing, amployment, training or monitoring of others by that insured, if the "occur-
rence" which caw ad th 3 "bodily injury" or "property damage", or the offenSE which caused the
"personal and adv rosin injury", involved the rendering of, or the failure to render, any professional
architectural, engin eying or surveying services.
d. "Bodily injury" or"pioperty damage" occurring after:
(1) All work, i cludi g materials, parts or equipment furnished in connection with such work, on
the project (other than service, maintenance or repairs) to be performed b or on behalf of the
additional insure (s) at the location of the covered operations has been coi npleted; 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 perfo ming operations for a principal as a part of the same prof ct.
e. Any person or rgani ation specifically designated as an additional insured for ongoing operations
by a separate kDDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is-
sued by us and made a part of this policy.
3. With respect to the nsuraiice afforded to these additional insureds, the following is added to Section III
-Limits Of Insuranc :
If coverage provided tote additional insured is required by a contract or agreement, the most we will
pay on behalf of the additi nal Insured is the amount of insurance:
a. Required by the contr ct or agreement; or
b. Available under the a plicable Limits of Insurance shown in the Declarations;
whichever is less.
This endorsement s all n t increase the applicable Limits of Insurance shown in th Declaratio ns.
H. PRIMARY AND NON -CO TRIBLITORY ADDITIONAL INSURED EXTENSION
This provision applies t any I arson or organization who qualifies as an additional insu ed under any form
or endorsement under It is pollcy.
Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CON ATIONS is amend-
ed as follows:
a. The following is add ad to Paragraph a. Primary Insurance:
If an additional insu ed's policy has an Other Insurance provision making its poll excess, and you
have agreed in a wri en c ntract or written agreement to provide the additional insured coverage on a
primary and noncontibutor t basis, this policy shall be primary and we will not seek contribution from
the additional insure 's pc Icy for damag we cover.
® zu'I ur 'iislIra,,,ce
CG 88 10 04 13 Includes opydg ted material of Insurance Services e, Inc., with Its permission. Page 5 of 8
g
t
b. The following is added t¢ Paragraph b. Excess Insurance:
When a written coi itract lor written agreement, other than a premises lease, facilibi is rental contract or
agreement, an equ Amen rental or lease contract or agreement, or permit issued Dy a state or political
subdivision betwe n . I and an additional insured does not require this insure to be primary or
primary and non- ntribytcry, this insurance is excess over any other insurance for which the addi-
tional insured is de ignattd as a Named Insured.
Regardless of the vritten agreement between you and an additional insured, this insurance is excess
over any other ins rant whether primary, excess, contingent or on any other basis for which the
additional insured as b an added as an additional insured on other policies.
ADDITIONAL INSURE[
This provision applies
or endorsement under
1. The following
An additional
a. Give writti
this insur®
b. Tender th,
insurance
c. Agree to r
cover unde
d. We have r
we receive
-EXTENDED PROTECTION OF YOUR "LIMITS OF
anylperson or organization who qualifies as an additional
d to Condition 2. Duties In The Event Of Occurrence, OI
under this endorsement will as soon as practicable:
;e of an "occurrence" or an offense that may result in a
us;
defense and indemnity of any claim or "suit" to all insure
,ailadle to the additional insured; and
ike vailable any other insurance which the additional insur
this overage Part.
d under any form
,a, Claim or Suit:
m or "suit" under
whom also have
has for a loss we
to defend or indemnify an additional insured under thig endorsement until
notice of a "suit" by the additional insured.
2. The limits of in ;uran applicable to the additional insured are those specified in a written contract
or written agreamers or the limits of Insurance as stated in the Declarations of this policy and
defined in Sec ion I 1 - Limits of Insurance of this policy, whichever are le s. These limits are
inclusive of anc not iri addition to the limits of insurance available under this PC licy.
J. WHO IS AN INSURED -1 MCIDENTAL MEDICAL ERRORS/MALPRACTICE
WHO IS AN INSURED - ELLC W EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEE
Paragraph 2.a.(1) of Sec ion II -Who Is An Insured is replaced with the following:
(1) "Bodily injury" or "personal and advertising injury":
(a) To you, to your partric is or members (if you are a partnership or joint venture), to your members (if
you are a limited liab lity company), to a co -"employee" while in the course o his or her employ-
ment or performing Julies related to the conduct of your business, or to your other "volunteer
workers" while perfor ing duties related to the conduct of your business;
(b) To the spouse, child, I parent, brother or sister of that co -"employee" or "volu teer worker" as a
consequence oil Paragraph (1) (a) above;
(c) For which therE is arty obligation to share damages with or repay someone else who must pay
damages becau 5e of the injury described in Paragraphs (1) (a) or (b) above; or
(d) Arising out of In s or her providing or failing to provide professional health care services. However,
if you are not in the business of providing professional health care services or providing profes-
sional health care personnel to others, or if coverage for providing profession I health care ser-
vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not
apply.
Paragraphs (a) and (b) a ova cc not apply to "bodily injury" or "personal and advertising injury" caused by
an "employee" who is a ting I i a supervisory capacity for you. Supervisory capacity as used herein means
the "employee's" job responsibilities ssign by you, includes the direct supervision of other "employ-
ees" of yours. However, non of thes "em to ees" 1a2re)' sureds for "bodily injury" or "personal and
® 3 L e tu$1 T"ns Inc
CG 88 10 04 13 Includes copyrighted material of Ins ante Services Office Inc., with Its permission. Page 6 of 8
a
advertising injury" arising
cause "bodily injury" or "
tion by liquor or controlled
The coverage provided by
your "employee".
K. NEWLY FORMED OR ADDI
Paragraph 3. of Section II
3. Any organization
interest, will cual
organization. lloA
a. Coverage urn
which the ant
b. Coverage A d
acquired crfc
c. Coverage B i
committed be
d. Records a d t
No person or organi
venture or limited I
as an insured under
L. FAILURE TO
Under Section IV -
sentations:
Your failure to disc) se
shall not prejudice he
prior "occurrences" is
M. KNOWLEDGE OF
Under Section IV -
In The Event of Occ
Knowledge of an '
insured shall not in
1. of Section II - WI
"occurrences", offe
"employee".
N. LIBERALIZATION
If we revise this Cam
additional premium cl
effective in your state.
O. BODILY INJURY
Under Section V -
3. "Bodily Injury"
mental anguist
ness or disease
CG 88 10 04 13 Includes
of their willful conduct, which is defined as the purpose�l or willful intent to
mal and advertising injury", or caused in whole or in art by their intoxica-
J. is excess over any other valid and collectable itjsurance available to
NALLY ACQUIRED ENTITIES
io Is An Insured is replaced by the following:
newly acquire or form and over which you maintain o nership or majority
as a Named Insured if there is no other similar insurer ce available to that
ler this provision is afforded only until the expiration of the policy period in
ty was acquired or formed by you;
oes not apply to "bodily injury" or "property damage" that occurred before you
rm d the organization; and
loss not apply to "personal and advertising injury" arising out of an offense
forg you acquired or formed the organization.
les riptions of operations must be maintained by the first Named Insured.
is On insured with respect to the conduct of any current or p st partnership, joint
co pany that is not shown as a Named Insured in the Deal rations or qualifies
wi ion.
ZA RDS AND PRIOR OCCURRENCES
rci 31 General Liability Conditions, the following is added to Condition 6. Repre-
a I hazards or prior "occurrences" existing as of the inceptic n date of the policy
cqq erage afforded by this policy provided such failure to disclose all hazards or
no intentional.
MN�E, OFFENSE, CLAIM OR SUIT
arci 0 General Liability Conditions, the following is added to Condition 2. Duties
Offense, Claim Or Suit:
:urr nce", offense, claim or "suit" by an agent, servant or "employee" of any
elf 3onstitute knowledge of the insured unless an insured listed under Paragraph
Is An Insured or a person who has been designated by them to receive reports of
ss, claims or "suits" shall have received such notice from the agent, servant or
feral Liability Extension Endorsement to provide n
policy will automatically provide the coverage as of
3. is replaced by the following:
physical injury, sickness or disease sustained by a
injury, shock, fright or death that results from such
® 2013 4ibrtyu yuallsu�r�ce
material of Insurance Services OM a nc., with its permission.
coverage without
day the revision is
This includes
I Injury, sick -
Page 7 of 8
P. EXTENDED PROPERI
Exclusion a. of COVI
following:
a. Expected Or
"Bodily injui)
This exclusion
reasonable fc
Q. WAIVER OF TRANSFI
CONTRACT OR AGRE
Under Section IV - Cc
far Of Rights Of Reco%
We waive any righ
make for injury <
x = contract with that
provided:
1. You and that
waive such ric
2. The injury or
ment.
CG 88 10 04 13
Includes i
i
)A GE
iGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the
Boded Injury
or 'property damage" expected or intended from the stand oint of the insured.
foe not apply to "bodily injury" or "property damage" resu ting from the use of
to protect persons or property.
OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A
ENT WITH YOU
mer'ial General Liability Conditions, the following is added t� Condition 8. Trans-
y A�ainst Others To Us:
of re�overy we may have against a person or organization be use of payments we
damage arising out of your ongoing operations or "your ork" done under a
erson or organization and included in the "products -completed operations hazard"
or organization have agreed in writing in a contract
nst that person or organization; and
occurs subsequent to the execution of the written c
�I� � .-��77��yyjjrr//
20 Lib�M�It)alsurance
Ited material of Insurance Services Office, Inc., with its permission.
agreement that you
or written agree -
Page 8 of 8
YYNEY VENDORA INC.
PEMIER VEND GROUP
6814 SUVA ST.
ELL GARDENS, CA 90201
PHONE: (562) c128-1801
FAX: (562) 9'rf, 8.5501
November 1
Re: City of Santo Ana
Please accept #his 4ocumentation that Downey Vendors, Inc. DB?,� is
Premier VendlGro D.
If you have a questions or need additional information, please der not
hesitate to contact tae.
Thank
fjFM CNT �}iViSIJN
2019
LAMBERT