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HomeMy WebLinkAboutAIMTD LLC (2)MAYOR Miguel A. Pulido MAYOR PRO TEM Juan Villages COUNCILMEMBERS Cecilia Iglesias David Penaloza Vacant Vicente Sarmiento Jose Solorio O). pt"ulll zPw x-e4vJ4 `� INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES u W 1301 Zo2 () CLERK OF COUNCIL DATE: 9AN 1, 4 2020 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza ar P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.om November 12, 2019 AimTD LLC 751 S. Weir Canyon Rd, Suite 157-158 Anaheim, CA 92808 Attn: Olga Polunin, President and CEO Re: Extension of Agreement No. A-2017-329 Dear Ms. Polunin: A-2017-329-02 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez Pursuant to Section 3 of Agreement No. A-2017-329, entered into by AimTD LLC and the City of Santa Ana, dated December 5, 2017, the term of the Agreement is hereby extended for an additional one (1) year period, from December 5, 2019 through December 4, 2020. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms apill) Qnditions of the Agreement remain unchanged and in full force and effect. veils, PE, PLS Director, Public Works Agency SANTA ANA ATTEST Krist ne Ridge Daisy Gomez City Manager Clerk of the Council APPROVED AS TO FORM A& M.Funk Assistant City Attorney AimTD LLC AtL Name: /Olga Polunin Title: President and CEO SANTA ANA CITY COUNCIL Miguel A. Pulido Juan Villages Vicente Sarmiento David Peneloza Jose Solorio Vacant Cecilia Iglesias Mayer Mayor Pro Tern, Ward 5 Ward i Ward 2 Ward 3 Ward 4 Ward 6 moulao0caula-ana.om "villevasidsanla-ans.wa vsarmienlo(Wsanla-ana.vry dyenaloza(�sanla-an...,v "soloriv(alsanla-anaory civlesias(vlsanta-ana.om CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDONYM 11116/2019 THIS CERTIFICATE IS ISSUED A$ 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 riahts to the cantflcata holder In UAU at eurh oorfinreomeufral Hisaox Inc. diblal Miscox Insurance Agency in CA PxoNe FAX 9 cY I: (888) 202 3007 F,' Nog_. 520 Madison Avenue SNAIL -- -- 32nd Floor .EAM"El , contact@hlscoxcom Now York, NY 10022 INSURCRIS)ArFORDINOCOVER_AOE NNCP INSURED AImTD LLC 751 S Weir Canyon rd, SIR 157.158 Anaheim, CA 92808 COVERAGES CERTIFICATE NIIMRFR• RcvleinM •n lane crs. - --- - 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. INSLTR AM NCE 80. U POLICY P IOD 6XP TYPE OF INSURA POLICY NUMBER MMIDD DDlYY LIMITS ____f COMMERCIAL GENERAL LIABILITY _ _. EACH OCCURRENCE $ CLAIMS LJ q'tlMAD � �1 -MADE OCCUR PR E otzurrence $ I �.�._.....�..�._...____. MED EXP An w.a parson 3 _ � PERSONAL A AOV INJURY S �-...�— GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRO- ❑ POLICY L_._1 JECT LLOGI PRbDUGTG-COMPlOP AGG $ OTHER' i $ — AUTbMODILELIADILITY GMBINED SINGLELIMIT S IEa axaaen0 __,4_ mm ANY AUTO BODILY INJURY (Per percent $ OWNED _........Y ._.._,.. _._-. _..,.,......_...� AUTOSSCHEDULED W .AUTOa (Perarz BODILY INJURY Pmarcldenn $ HIREDAUIOSONLY HIRED iAUTOSNOWOWNEDLY PROPERTY DAMA '— __.. AUTOSONLY i' 1 AUTOS ONLY a�F. p r c Jd ni $ UMBRELLA UAB 'OCCUREACH OCCURRENLE $excess H_G�OT r- ..__I .__IqL S-NIAOE LIAR AGGREGATERETENTIONS WORKERS COMPENSATION STATUTE_y, tlTH- r� AND EMPLOYERS' LIABILRY YIN __... ANYPR4PRIETORIPARTNEFV XEOUTIYE OFFIGEPIMEMREREXCLUORD? E NIA E.L., EACH ACCIDENT Is (Mandatary to NH) E.L. DISEASE, E'A EMPLOYEE( S (Ecnhe unde OSCRIPT14N OF OPERATIONS bnlaw _ E.L DISEASE - ISEASE- POLICY S A Professional Liability N UDC-1827497-E0.19 09/30/2019 03012020 Each Claim: 2.000,000 Aggregate: $ 2,000,000 DESCRIPTION OF OPERATION SILOCAI IONS I VEHICLES (ACORD 101. Addltlonat Remarks Sehadula, may be attached It more space is tequimd) 20 Civic Center Plaza CA 02702 ( YR(sk NAUEMENTEtivisiom SHOULD ANY OF THE ABOVE DESCRIBED POLICIES DE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL DE DELIVERED IN 0, LAM2019 ACCORDANCE. WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE —�� MBERT ' ©1988-2018 ACORD CORPORATION. All riahts rnsn"Arl ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD a � ot>-1-411 CERTIFICATE OF LIABILITY INSURANCE 11roTr2Dlg THtS CERTIFICATE IS ISSUER AS A MATTER OF INFQRfdATi4N QNLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDM 7HES CERTIFICATE ROES NQT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTENR QR ALTER THE CQVERAOE AFF4RRER 8Y THE PQLICtEB SELQW. TFIIS CERTIFICATE dF INSURANCE OdE3 NdT CQNS7RUTE A CONTRACT SETWEEN THE ISSUING INSURER($}> AUTNdR1xEQ REPRESENYATPIE QR PRdQUCER, AND THE CERTIFtCATE.NdLQER, IMPQRTANT; If the cartHlcata hnldar is all ADQITtQNAL INSURED, tha patloylioa}emeHainhaollGas m dNre uira8an oDdoTsetmenG A statomant on If SUSRQGA71QN IS WANED, sub}eCt to Ute terms and tandHtait9 Of tha pa11CrtY R��nanttsY. � � __ ROY JEFFERSON, AGENT 115 $ CHAPARRAL COURT, SUITE 250 ANAHEIM HILLS. CA 02808 AIMTD LLC 751 WEIR CANYON RD STE 157-158 ANAHEIM, CA WEDS __.-...._---�------. POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN OLD NAMW SO 3 ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL I i PR M ,S'F mmvAO@I CLAMASHdAS L.-.,,,; OCf,UR I I-ME�E%R pvry wePmsenl S S Y I Y 02-CX-Mt79.0 02I28f2019 i 0212612020 PERSONALSADVINJUW $ GENERALAGGREGA78 3 GEN'LAOOREGATE LIMIT APPUES PER' _ 1 OBODUCTS.COh!PA)OAGO $ POLICY ST 0 Loc f 4 TH R: OM&NEB LE $ AuTOMOME UAaIUTY Y Y 6158448-COO-7a 0310=010'031tl812020�{Ea,� NM AUTO I—DOINLY IN.t V(Pk We ) 5 840371ft-S28-75 62/28/2014, 02/2512020 4..._. I �� A _ bCPEDN.ED i BOQILY INJURY {Per bcc'•p $ _ AUSOS0NLY AUTOS PRO?c M1i*�G $ HIRED N,IR W ED ar �e'den1�,--------- AIITOS ONLY •AU'(O$ONLY $ UNaRXL ALWa OCCUR ' I EACH L�;GURRENCE ,� 3 G ANY iPROPREMBER�TTHERD)(FCUTIVE Y iN/AI Y I 92-GA-DIIS0.8 02l2812019I0'2/28/2020 I )ESCRIPTION OROPERATIONS'�Ctaa IACORD iPi, AtltliNenal Remake SeheduM, nwy 0. altac ed If mac >Wue SD DAY NOTICE OF CANCELLATION, EXCEPT FOR 10 DAYS NON PAYMFNT OF PREMIUM WILL BE PROVIDED SUBJECT TO POLICY TERMS, CONDITIONS & EXCLUSIONS. City of Santa Ana Risk Management Division, Ah 20 civic Cantor Plaza Santa Ana, CA 92702 ACORD 26 t2018103) FA i I' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED DEFORE THE EXPIRATION DATE THKRCOF NOTICE WILL BE DELIVERED IN WITH THE POLICY PROVISIONS. marks of 1. All tights D)SOV/00. 1001AW 132842.12 W64010 W POLICY NUMBER: 640 3716-1328-75 NAMED INSURED: AIMTD LLC POLICY PERIOD: a2/x$Ixo1s Oxlx&/2oza This endorsement is part of te policy. Except for the changes th his endorsement nd erne t nt makes, all other provisions of the policyremain the same and apply arations Page as an red provided 1. A person or organization shown on the Liability Coverage, but only to the extent thlat person or organization tquallifiesuas ansinsured as defined In Liability Coverage. 2. An Additional insured has the same right of recovery under Liability Coverage as if they had not been shown on the Declarations page as an Additional insured. 3. If Liability Coverage is changed or terminated as to the interest of the Additional Insured, unless another number of days is shown on the Declarations Page, We will provide the Additional Insured: a. 10 days notice of such change or termination if the policy is nonrenewed or the cancellation is for nonpayment of premium; and b. 20 days notice of such change or termination if the cancellation is for any reason other than nonpayment of prerniutn. Name of Person or organization: City of Santa. Ana, Rs officers, emplayees an agents and representatives are additional insured's with respect to general liability and auto liability per the attached endorsements or as required hywritren contract, dreary and Non -Contributory, insurancersp coverage Is primary and non -contributor, Waiver of Subrogation Applies to General Liability. & APPROVED WEMENT DiVISiON It M. LAMBERT a POLICY NUMBER: 640 3716-B28-75 NAMED INSURED: AIMTD LLC POLICY PERIOD: 02/28/2019-02/28/2020 6196U WAIVER OF sUBRQGATION UNDER THE LIABILITY COVERAGE This endorsement is part of the policy. Except for the changes this endorsement makes, all other provisions of the policy remain the same and apply to this endorsement. It is agreed that we will not exercise our right of subrogation under Liability Coverage as respects The name shown immediately following the title of this endorsement of the Declaration Page, Name of Person or Organization: City of Santa Ana, Its officers, employees an agents and representatives are additional insured's with respect to general liability and auto liability per the attached endorsements or as required by written contract. Insurance is primary and Non -Contributory. Waiver of Subrogation Applies to General Uauujty. Coverage is primary and non -contributor REVIEWED & APPROVED AAMA ANAGEMENT DIVISION C 20 2019 HAM, LAMBERT 13 POLICY NUMBER: 515 6448-008-75 POLICY PERIOD: 02/28/2019-02/28/2020 NAMED INSURED: AIMTD LLC 6b28t3U ARDITIONAI INSURED ENDORSEMENT (Prior notice of 7erminationl This endorsement is part of the policy. Except for the changes this endorsement makes, all other provisions of the policy remain the same and apply to this endorsement 1. A person or organization shown on the Declarations Page as an Additional insured is provided Liability Coverage, but only to the extent that person or organization qualifies as an insured as defined in Liability Coverage. 2. An Additional Insured has the same right of recovery under Liability Coverage as If they had not been shown on the Declarations page as an Additional Insured. 1 If Liability Coverage is changed or terminated as to the interest of the Additional Insured, unless another number of days is shown on the Declarations Page, we will provide the Additional Insured: a, 10 days notice of such change or termination if the policy is nonrenewed or the cancellation is for nonpayment of premium; and b. 20 days notice of such change or termination if the cancellation is for any reason other than nonpayment of premium. Name of Person or Organization: city of Santa Ana, its officers, employees an agents and representatives are additional insured's with respectto general liability and auto liability per the attached endorsements or as required by written contract. insurance is primary and Non-Contrlbutory. Coverage is primary and non -contributor. Waiver of Subrogation Applies to General Liability, & APPROVED %CEMENT DivisioN M, LAMBERT POLICY NUMBER: 515 6448-008-75 POLICY PERIOD: 02/28/2019-02/28/2020 NAMED INSURED: AIMTD LLC 6196U WAIVER OF SUBROGATION UNDER THE LIABILITY COVERAGE This endorsement is part of the policy. Except for the changes this endorsement makes, all other provisions of the policy remain the same and apply to this endorsement. It is agreed that we will not exercise our right of subrogation under Liability Coverage as respects The name shown immediately following the title of this endorsement of the Declaration Page. Name of Person or Organization: City of santa Ana, its officers, employees an agents and representatives are additional Insured's with respect to general liability and auto liability per the attached endorsements Of as required by written Contract, Insurance is primary and Non -Contributory. Coverage is primary and non -contributor. Waiver of Subrogation Applies to General Liability. REVIE!'KED & APPROVED 6196U By Risk ANAQF.MFNT DiViSiON 20 2019 M. LAMBERT WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT 70 RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy, We will notenforca our right against the person or organization named in the Sohedute. (This agreement applies only to tire extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation premium otherwise due on such remuneration. Scnedule 129=11.01-0=017AW ,Job Descriotton City of Santa Ana, Its officers, employees an agents and representatives are additional insureds with respect to general liability and auto tlabtity per TRAFFIC DATA the attached endorsements or as required by written contract. Insurance Is primary and Non•Corrtrlbutory. This endorsement changes the policy to which it Is attached and is effective on the date issued unless ohenwise stated.. (rile information below is required only wdien this endorsement is Issued subsequent In preparation or the policy.) Endorsement Effective Policy No, 92-GA-D960-8 Eneorsmnent No. Insurod insuranos Company Stare Farm General insurance Company AIMTD, LLC 7515 WEIR CANYON RD STE 157-158 ANAHEIM, CA 97=8 q� r-tl,t�r� $ C;<xin�trerrsiigned{Bry'�----- WC 04 03 06 RE Y � t_LL+ iY Ae" r" rSiJV1..Lt Ptin:c`tt in l! 3.A. (Ed. 4.84) $Y Risk ANAGEMENT D 4`ISION 11' M. LAMBERT eMp-e Ta5.1 Policy No. 92-CX-M179_0 Page 1 at?, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CMP-4786.1 ADDITIONAL fNSU RED —OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: SCHEDULE Pollcy Number. 92•CX-Mila-0 Namcadlnsuree. AIMTDU.0 75 t 5 WHR CANYUN RD STE 157-158 ANAHEIM, CA 92808 Name And Address Of Additional Insured Person Or Organization: City of Santa Ana, its officers, employees an agents and representatives are additional Insured's with respect to general liability and auto liability per the attached endorsements or as required by written contract. Insurance Is primary and Non -Contributory, SECTION Ili— LIABILITY 13 s amendedtoinn cludo, as an additional insured, any person or organization shown in the Schedule, but only with respect to liability for "bodily injury , innproperty injury' caused, in whor ole or In parrsonal t, by en s- a. Ongoing Operations (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing opera- tions for that addhionat insured; or It, products — Computed Operations 'Your work" performed for that additional Insured and included in the 'products - completed operations hazard". However, Paragraph I. above Is subject to the following: a. The insurance afforded to the additional insured only applies to vie extent permit - lad by law; b. if coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance provided to the additional insured will not be broader Van that which you are required by the contract or agreement to provide for such addition- al Insured; and e. II tine contract or agreement between you and the additional insured is governed by Calfomia Civil Code Section 2782 or 2782.05, the insurance provided to the additional Insured is the tosser Of that which: (1) Is allowed for the satisfaction of a de- fense or Indemnity obligation b Cali• ferrite Civil Code Section 2782 or 2782.05 for your sole Ilablfily; or (2) You are required by contract or egreernent to provide for such addi- iional insured. We have no duty to defend or Indemnify the additional insured under this ondorsomeni un- til a claim or "suit" is tendered to us. 1. COp1?Ighl, State F,. itluwai &140,40lla IaS MAW company, zeta Inds,,$OOyngnlod matei101 Of Irv00`nT1 Seeps Oflnce. Inc., wnh its pmmlanan. & APPROVED ICEMENT DIVIsiON 20 2019 M, LAMBERT WC Od 03 08 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY (CO.4-EA) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce your riht against the ou perforrm work underrson or organization named in a written contract the, requiresthe Schedule. yo to obtain hislagreement from unt sies -) you only to the extant that you must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. s °l� premium The additional premium for this endorsement shall be or the California workers' compensation ._� otherwise due on such remuneration. Schedule P�75.229L9t9a ,14t!p1191i City of Santa Ana, its officers, employees an agents and representatives are additional tnsurad's with respect to general lability and auto liability per TRAFFIC DATA the attached endorsements or as required by written contract. Insurance is primary and Nan -Contributory. This andorsement chantias the policy to which It is attached and is effective on the date issued unless 01118rensa stated (The Information below Is required only where tills endorsement is issued subsequentto preparation of the policy.) EA00rsomontEffective po;icvNo.92-CH-M1790 Endorsement No. Insured Insurance Company State Farm General Insurance Company AIMTD, U.0 751 S WEIR CANYON RD STE 157.158 ANAHEIM, CA 97808 Countersigned 6y WC Od 03 00 R V'C. / k /� `a[{{�� Pmwd h u.S.A (Ed. 4-84) n.. n:,.l.l'AAAmAnvMENT DivistON t M, LAMBERT