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HomeMy WebLinkAboutNILA, INC DBA NILA SPORTSCity of Santa A 1 Clerk of the Council 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TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect.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. Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with COTC Office Use Only City of Santa Ana ti,+1O 0 2 2621 Clerk of the CouncJ No. A-2020-138 was completed on �� 31 LA) and final payment has been made. (List all amendments. Use space below if needed.) ✓� /1 Department: �'Y—t--�c 'Pr I Ad Vie (VA Phone/Ext.: 5�� Jr1+ Signature: a )1`11(k , ("LlfA —0 Date: -71 1bi iaagreementsVormsVorrn - agreement termination form_goldenred.doc INSURANCE NOT ON FILE WORK MAY NQT PROCEED CLERK OF COUNCIL DATE: A-2020-138 Q: PRCSA{p) FIRST AMENDMENT TO AGREEMENT WITH NILA, INC. DBA NILA SPORTS C Lla �) RN THIS FIRST AMENDMENT to the above -referenced Agreement is entered into on July 7, 2020, by and between Nila'-Inc.,. a California Corporation doing business as Nita Sports ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the N Constitution and laws of the State of California ("City"). 0 N o RECITALS (V A. The parties entered into Agreement No. N-2019-186 dated October 1, 2019 to provide for the purchase and installation of retrofit LED lighting at Jerome Park through On Board Financing ("OBF") with Southern California Edison ("Agreement"). B. The consultant has been unable to obtain the necessary parts and materials due to COVID-19. The parties therefore agree to amend the Agreement to extend the termination date from September 30, 2020 to December 31, 2020 to allow additional time to complete the services. The Parties therefore agree: 1. Section 3, TERM, is amended to extend the termination date from September 30, 2020 to December 31.2020. 2. Except as modified by this First Amendment, all terms and conditions of the Agreement as extended shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first written above. ATTEST V( DAIS GO E Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Attorney By:CJa-'w. A. Rtllylr� LAURA A. ROSSINI Acting Chief Assistant City Attorney CITY OF SANTA ANA KRISTINE RIDGE City Manager CONSULTANT Mr. Jim Sanfilippo President Nila, Inc. Page 1 of 2 RECOMMENDED FOR APPROVAL L A RUDLOFF Executive Director, Parks, Recreation and Community Services Agency [First Amendment -Agreement with Nila, Inc.] Page 2 of 2 �Is CERTIFICATE OF LIABILITY INSURANCE DATEIMMADYVVY) 2/19/2020 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(tes) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Risk Strata [as Company 700 Airport Boulevard Suite 300 Burlingame, CA 94016 CONTACT Tiffanychino PHONE 650-782-0400 FA Ac "°: EMAIL ADDRESS- tchinn risk-stmt ies.com INSURERS AFFORDING COVERAGE NAG 9 INSURER A; Federal Insurance Company INSURER 8: 20281 INSURED NiIA INSURER C: 723 West Woodbury Road AltadenaCA 91001 INSURERD: INSURER E : INSURER F ----------^ wNIv1Y Nuf91Dcm; 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 TYPE OF INSURANCE DD We U POLICY NUMBER POLICYEFF MMIDDIYYYY) POLICYEXP IMMMDNYYYI LIMITS A �/ COMMERCIALGENERALLIABILITY CLAIMS -MADE ❑✓ OCCUR ✓ 35892515 12/27/2019 12/27/2020 EACH OCCURRENCE $1000000 AMA E PREMISES Ea eccumence $1 00O 000 $10 000 MED EXP (Any one person) PERSONAL& ADV INJURY $1,000,000 GEHL AGGREGATE LIMIT APPLIES PER: POLICY ❑ JRO PRO- ❑OC GENERALAGGREGATE $2,000,000 PRODUCTS - COMP/OPAGG $2,000 000 OTHER: A AUTOMOBILELIABILITY ✓ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS ONLY ✓ AUTOS ONLY 73588466 12/27/2019 12/27/2020 COMBINED SINGLE LIMIT Ee aaklen $1 000,000 BODILY INJURY (Par person) $ BODILY IWURY(Perac,,dd) $ Px arccid DAMAGE $ACV $ A �/ UMBRELLA LIAR EXCESS LIAR pCCUR CLAIMS -MADE 78182245 6/30/2019 6/30/2020 EACH OCCURRENCE $1 Ogg 000 AGGREGATE $1.000,000 PER OTH- STATUTE ER $ DEB RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICEMMEMBEREXCWDED? NIA E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE -EA EMPLOYE $ E.L.DISEASE-POUCYLIMIT $ Dyes, RIPTIOdescribeentler DEBCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule. maybe attached if more space is required) City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are named Additional Insured per attached Form 80029020. This insurance is primary and non-contributory with respect to insurance or self-insurance maintained by the City. Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation. REVIEWED & APPROVED ...-.,r.�,...r� .,,.. ._�., v Ic _ City of Santa Ana Risk Management Div 20 Civic Center Plaza, 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 Mike W U AGVKU ZO (ZU1DI03) 5 ACORD CORPORATION. All rinhtc roccn,o.J the ACORD name and logo are registered marks of ACORD 54173002 119-20 GWAL 5 UNA I Lucy falaofa 1 2/19/2020 9.19:37 AM IP531 I Page 1 of 5 CH U B B' Liability Insurance Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: GENERAL LIABILITY Who Is An Insured DECEMBER 27, 2019 TO DECEMBER 27, 2020 DECEMBER 27, 2019 3589-25-15 WCE NiLA, INC. FEDERALINSURANCL+COMPANY OCA)BER 9, 2019 Under Who Is An Insured, the following provision is added. Additional Insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by Or Organization this policy. However, the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; • to the extent such contractor agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur, in whole or in part, before the execution of the contract or agreement and • with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: • that is more specifically identified under any other provision of the Who Is An Insured section (regardless of any limitation applicable thereto). • with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. Liability Insurance Additional Insured - Scheduled Person or organization continued Form 60-02-2367(Rev. 5-07) Endorsement Page I 54173002 1 19-20 GL/AL & Mel I Lucy Feleota 1 2!19/2020 9:19:37 M PST) I Page 2 of 5 cHUBB� LiaBihty Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other Insurance. Conditions Other Insurance — If you are obligated pursuant to a contract or agreement, to provide the person or organization Primary, Noncontributory shown is the Schedule with primary insurance such as is afforded by this policy, then in such case Insurance — Scheduled this insurance Li primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. Liability Insurance uu-ue-zyui lrrev. b-ull Schedule CITY OF SANTA ANA, RISK MANAGEMENT IT'S OFFICERS, EMPLOYEES, AGENTS, REPRESENTATIVES, AND VOLUNTEERS 20 CIVIC CENTER PLAZA, 4TII FLOOR SANTA ANA, CA 92702 All other terms and conditions remain unchanged. Authorized Representative Additional Insured - Scheduled Person Or Organization last page Page 2 54173002 1 19-20 ec/nL 5 MM I Lucy FaleoEa 1 2/19/2020 9:19:19 AN )PST) I Page 3 of 5 C H U B BPolicy Conditions Endorsement Policy Period DECEMBER 27, 2019 TO DECEMBER 27.2020 Effective Date DECEMBER 27, 2019 Policy Number 3589-25-15 WCE Insured NILA, INC. Name of Company FEDERAL INSURANCE COMPANY Date Issued OC`fOBER 9, 2019 This Endorsement applies to the fallowing forms: COMMON POLICY CONDITIONS :«, sa axss�wxx�uexww,u marsmaa.�aw;,ww:a«. - �-a4 _ c n,:.rei-ram .rx';attcas,»xweaa mx. s. :.wrovu�n:er:,.xaxiw.I Under Conditions, the following condition is added. Conditions Notice Of Cancellation When we cancel this policy for any reason, other than non-payment of prenmmn, we will notify To Scheduled Persons person(s) or organizaticn(s) shown in the Schedule at least 30 days in advance of the cancellation Or Organizations When date. We Cancel Any failure by us to notify such person(s) or organization(s) will not: • impose any liability or obligation of any kind upon us; or • invalidate such canccBation. Schedule Person(s)orOrgaoization(s): GBCINTERNATIONAL BANK ISAOA Address: 5670 WILSHIRE.BLVD SUITE 1780 LOS ANGELES, CA 90036 Person(s) or Organization(s): CIl'Y OF SANTA ANA, RISK MANAGEMENT, rl"S OFFICERS, EMPLOYEES, AGENTS, REPRESENTATIVES, AND VOLUNTEERS Address: 20 CIVIC CENTER PLAZA, 4Ttl 1LOOR SANTA ANA, CA 92702 Notice 01 Cancellation To Scheduled Persons Or Organizations Policy Conditions (Except Non -Payment Of Premium) Form 80-02-9779 (Ed. 3-11) Endorsement continued Page 1 san3M 119-20 cWFL 6 OMB I Lucy F.Ie fa 1 2/1912020 9:19:11 AM IPST) I eag2 1 oe 1 Conditions (continued) All other terms and conditions remain unchanged. Authorized Representative NOtice Of Cancellation To Scheduled Persons Or Organizations Policy Conditions (Except Non -Payment Of Premium) Form 90-02-9779(Ed. 3-11) Endorsement CA;Page 54173002 1 19-20 ec/Ac 4 00 1 Lucy Paleoea I V19/2020 9:19:17 AM IPSTJ I Page 5 of 5 THE A[ HARTFORD THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 City of Santa Ana Risk Management Division 20 CIVIC CENTER PLZ FL 4 SANTA ANA CA 92701-4058 Account Information: Policy Holder Details : INILA INC. February 17, 2020 vQ Contact Us Business Service Center Business Hours: Monday - Friday (7AM - 7PM Central Standard Time) Phone: (877) 287-1312 Fax: (888) 443-6112 Email: agencv.services &thehartford com Website: httos:Hbusiness.thehar-tford.com Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team A CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDr/YYY) 02l17l2020 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 SUBROGATIONIS 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 NAME: PAYCHEX INSURANCE AGENCY INC PHONE (877)266-6850 FAX (585)389-7894 76210705 150 SAWGRASS DRIVE (AM, No, EXt): WC, No): E-MAIL ADDRESS: ROCHESTER NY 14620 INSURER(S) AFFORDING COVERAGE NAiCN INSURER A: Hartford Fire and Its P&C Affiliates 00914 INSURED INSURER B : NILA INC. INSURER C: 723 W WOODBURY RD INSURER D: ALTADENA CA 91001-5310 INSURER E: INSURER F: ERTIFICATF THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR L R TYPE OF INSURANCE ADDL SURR POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDD YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE❑ OCCUR DAMAGE TO RENTED PREMISES Me ce MED EXP (Any one person) PERSONAL & ADV INJURY GENT AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECT ❑ LOC GENERAL AGGREGATE PRODUCTS-COMPIOP AGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Me accident) ANY AUTO BODILY INJURY (Per Person) ALL OWNED SCHEDULED BODILY INJURY Per accitlenl ( ) AUTOS AUTOS HIRED NON -OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- M AGGREGATE OEO RETENTION $ADE A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY YIN PROPRIETORIPARTNEWEXECUTIVE OFFICEWMEMBER EXCLUDED? NIA 76 WEG DS8068 01/16/2020 OV16/2021 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $1.000,000 E.L. DISEASE -EA EMPLOYEE $1,0O0,000 (Mandatory In NH) E.L. DISEASE -POLICY LIMIT $1,000,000 H yes, tlescdba under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Those usual to the Insured's Operations. Notice of Cancellation will be provided in accordance with Form WC990394, attached to this policy. Risk Management Division BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 20 CIVIC CENTER PLZ FL 4 IN ACCORDANCE WITH THE POLICY PROVISIONS. SANTA ANA CA 92701-4058 AUTHORIZED REPRESENTATIVE d'ueo,� -3� Cam,_ pVED ©1988.2015 ACORDQC}q�p� '§SY$ servr ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACOr;lr a15k MANA4E 13y fa N"", 0 d THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) Policy Number: Endorsement Number: Effective Date: Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: This policy is subject to the following additional Conditions: ra 91 If this policy is cancelled by the Company, other than for non-payment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If this policy is cancelled by the Company for non-payment of premium, or by the insured, notice of such cancellation will be provided within ten (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. Form WC 99 03 94 Printed in U.S.A. Process Date: If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. © 2011, The Hartford Policy Expiration Date: Silvia Cuevas City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4t" floor Santa Ana, CA 92702 February 20, 2020 Subject: Professional Liability (Errors and Omissions) Silvia Cuevas, As part of the contract awarded to Nila for the Jerome Park Lighting Retrofit, Nile Inc. will not employ a licensed professional (architect or engineer). Since no licensed professional will be employed we will not be providing Professional Liability E&O insurance (errors and omissions). Please let me know if you have any questions or need any clarification on this subject. Kind Regards Jim Sanfilippo Nila Inc. 310.245.2208 cell 723 West Woodbury Road Altadena, CA 91001 626.529.2856 info@nila.ty www.nilasports.cpg�O