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HomeMy WebLinkAboutEAST END REALTY PARTNERSHIP, LP. AND WURSTHAUS, INC. (2)City of Santa is Clerk of the Council S� 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TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect.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 A-2020-213 No. was completed on (List all amendments. Use space below if needed.) i.lagreementslformeform - agreement termination form_goldenrod.doc COTC Office Use Only OF THE COUNCIL 28'23 PM-4:33 t ( t30 2\ and final payment has been made. Department: F—C'C h Phone/Ext.: LPIG Signature: Date: I �— 01 C0 >URANCE NOT ON FILE A-2020-213 *OA VORK MAY NOT PROCEED CLERK OF COUNCIL DATE: SECOND AMENDMENT TO TEMPORARY P IZ (NA �1)(Yl Ivi 0. Cie vc+L) l OUTDOOR DINING LICENSE AGREEMENT This SECOND AMENDMENT TO TEMPORARY OUTDOOR DINING LICENSE AGREEMENT ("Second Amendment to License Agreement") is entered into this 17th day of _ November , 2020, by and between the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California ("City"), East End Realty Partnership, LP, and Wursthaus, Inc. (collectively "Licensee"). RECITALS A. On May 7, 2019, the City and Licensee entered into the Temporary Outdoor Dining License Agreement No. A-2019-063 ("License Agreement") to allow temporary outdoor dining activities within a portion of Plaza Calle Cuatro ("Plaza"), adjacent to real property located at 301-305 East Fourth Street, Suite 106, Santa Ana. B. On November 30, 2019, the City and Licensee entered into a First Amendment to Temporary Outdoor Dining License Agreement No. A-2019-200 to extend the term of said License Agreement, increase the amount of the License Fee to cover the extended term, and clarify the type of fencing that may be installed on the Licensed Property. C. In accordance with the terms and conditions of said License Agreement, the parties desire to: amend said License Agreement to extend the term of said License Agreement for an additional one year, subject to the payment of an additional License Fee by Licensee; increase the amount of the License Fee to cover the extended term; and, allow a five (5) foot extension of the outdoor patio to align with the restaurant's front door. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions of said License Agreement, except as herein modified, the parties agree as follows: 1. Section 1, Term and Purpose of License, shall be amended to extend the term of the License Agreement from November 30, 2020, until November 30, 2021. 2. Section 1, Terms and Purpose of License, shall also be amended to increase the size of the Licensed Premises by extending the outdoor patio by an additional five (5) feet to the south to align with the restaurant's front door, thus increasing the size of the Licensed Premises, as depicted in Exhibit 1 attached hereto and incorporated herein by reference. 3. Section 2, Licensed Premises and Use, subsection (a), shall be amended to reference Exhibit 1 attached hereto to depict the expanded Licensed Premises under said License Agreement. 1 A-2020-213 4. Section 3, License Fee, shall be amended to reflect that, upon execution of this First Amendment to License Agreement, Licensee shall pay to the City a one-time non-refundable fee of Two -Thousand and Twenty -Eight dollars ($2,028) to cover this second extended term of the License. Except as hereinabove modified, the terms and conditions of said License Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to License Agreement the date and year first above written. ATTEST: DAIW GOME Clerk of the Codneil APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney Ryap1'0. dge Asst'8tant ity Attorney RECOMMENDED FOR APPROVAL: Q MINH THAI Executive Director Planning and Building Agency CITY OF SANTA ANA KRISTINE RIDGE CityManager EAST END REALTY PARTNERSHIP, LP Ryan Chase WURSTHAUS, INC. Signature on following page Gabriel Ruiz 4. Section 3, License Fee, shall be amended to reflect that, upon execution of this First Amendment to License Agreement, Licensee shall pay to the City a one-time non-refundable fee of Two -Thousand and Twenty -Eight dollars ($2,028) to cover this second extended term of the License. 5. Except as hereinabove modified, the terms and conditions of said License Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to License Agreement the date and year first above written. Signature on previous page DAISY GOMEZ Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney /X�V' R . dge Assn nt 'ity Attorney RECOMMENDED FOR APPROVAL: Signature on previous page MINH THAI Executive Director Planning and Building Agency CITY OF SANTA ANA Signature on previous page ERISTINE RIDGE City Manager EAST END REALTY PARTNERSHIP, LP Signature on previous page Ryan Chase WURSTHAUS, INC. Gabriel Ruiar EXHIBIT 1 EXPANDED LICENSED PREVHSES Exhibit 1 Expanded Licensed Premises Temporary Outdoor Dining Site Plan at Plaza Calle Cuatro for Wursthaus Restaurant S i d Plaza Calle Cuatro e Performing w Wursthaus Stage a Restuarant I k w p � u c a LL S' MORE idewalk 4th Street \\[;Apprmed Outdoor Dining �iftnal V requested Francine R. ,,9,bdbyra1a—a Villareal ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMI°D YVYY) 11 /20/2020 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(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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Risk Stratagles Company CONTACT NAME: Risk Strategies Company 2040 Main Street, Suite 450 Irvine, CA 92614 PHONE NNo Est: 949-242-9240 AIL No: E-MAIL ADDRESS: s oun risk -strata ies.com INSURER($) AFFORDING COVERAGE NAICM INSURERA: Sompo America Insurance Company 11126 wwwAsk-strategies.com CA DOI License No. OF06675 INSURED East End Real Partners LP 129 W. Wilson V Ste 100 INSURER B: Fireman's Fund Insurance Company 21873 INSURER C: Oak River Insurance Company 34630 INSURER D: Costa Mesa CA 92627 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 9R7nsRa1 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 LTR OF INSURANCE ADDLSUBRTYPE INSD W/D POLICYNUMBER EFF MMIDDPOLICYYYYY MMIDDPOLICY EXP YYYY LIMITS A �/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ✓ CPLS1033HO 3/1/2020 3/1/2021 EACH OCCURRENCE $1,000,000 -DAMAGE TO —RENTED PREMISES Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYjEa ✓ LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED AUTO$ONLY AUTOSULED HIRED NON -OWNED AUTO$ ONLY ✓ AUTO$ ONLY ACVS1325ZO 3/1/2020 3/1/2021 ECOINED [SINGLE LIMIT $1,000,000 ✓ BODI LV I NJURY(Per person) $ ✓ BODILY INJURY (Per accident)$ ✓ PROPERTYDAMAGE Per accident $ $ B ✓ UMBRELLA LIAB EXCESS LIAB ✓ OCCUR CLAIMS -MADE USLOO5062201 3/1/2020 3/1/2021 EACH OCCURRENCE $25,000,000 AGGREGATE $25,000,000 DED RETENTION$0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFIC RANYPROPMEMBEREXCLU ED9 ECUTIVE ] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A EAWC113725 2/1/2020 2/1/2021 �/ STATUTE ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1 0 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re: Outdoor Dining License Agreement, Adjacent to 301-305 E. 4th St., Ste 106, City of Santa Ana, CA. City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General Liability and Auto Liability perthe attached endorsements or as required by written contract. Insurance is Primary and Non -Contributory. - 30 Days' Notice of Cancellation with 10 Days' Notice for Non -Payment of Premium in accordance with the policy provisions. HOLDER City of Santa Ana Risk Management Division, 4th Floor 20 Civic Center Plaza Santa Ana CA 92701 ACORD 25 (2016/03) 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 REPRESENTATNE a Michael Christian ' The ACORD name and logo are registered marks of ACORD RISI2il itraganeddDiutsi°n ram. REVIEWED &{{A0PPRcyvED By., rgsi-Hr�e VsRRE/t¢afl. ® Risk Management Analyst 58705631 1 20-21 WC, 20-21 GL-AL-UL I Stacy Eickhoff 1 11/20/2020 8:21:55 AM (PST) I Page 1 of 12 POLICY NO.: CPLS1033HO COMMERCIAL GENERAL LIABILITY CG 82 24 05 12 PREMIER GENERAL LIABILITY COVERAGE EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. REASONABLE FORCE g. Aircraft, Auto Or Watercraft Paragraph 2.a. Expected or Intended Injury under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: a. Expected or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the in- sured. This exclusion does not apply to "bod- ily injury" or "property damage" resulting from the use of reasonable force to protect any person or property. B. CONTRACTUAL LIABILITY Paragraph 2.b. Contractual Liability under COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GEN- ERAL LIABILITY COVERAGE FORM is replaced by: b. Contractual Liability "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a con- tract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have had in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract', provided the "bo- dily injury" or "property damage" occurs subsequent to the execution of the con- tract or agreement. C. NON OWNED WATERCRAFT Paragraph 2.g.(2) in the Aircraft, Auto Or Wa- tercraft exclusion under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COM- MERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: (2) A watercraft you do not own that is: (a) less than 75 feet long; and (b) Not being used to carry persons or property for a charge. D. ELECTRONIC DATA LIABILITY 1. Paragraph 2.p. Electronic Data under COV- ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COV- ERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "elec- tronic data" that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of "bodily injury". 2. The following definition is added to SEC- TION V — DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 3. For purposes of the coverage provided for "Electronic Data", Paragraph 17. in SEC- TION V — DEFINITIONS is replaced by: 17. "Property damage" means a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or Includes copyrighted material of Insurance Services Office, Inc., CG 82 24 05 12 with its permission. Rime Management DMsian REVIEWED&APPROVED BY: ® Risk Management Analyst 58705631 120-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 111/20/2020 8:21:55 AM (PST) I Page 2 of 12 b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "elec- tronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For purposes of this insurance, "elec- tronic data" is not tangible property. E. DAMAGE TO PREMISES RENTED TO YOU 1. The last paragraph after the listed exclusions under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SEC- TION I — COVERAGES within the COM- MERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: Exclusions c. through n. do not apply to "property damage" by fire; smoke from a "hostile fire"; explosion; lightning; smoke re- sulting from such explosion or lightning; colli- sion by "mobile equipment" or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as de- scribed in SECTION III — LIMITS OF IN- SURANCE. 2. Paragraph 6. of SECTION III — LIMITS OF INSURANCE within the COMMERCIAL GENERAL LIABLITY COVERAGE FORM is replaced by: 6. Subject to Paragraph 5. above, the Dam- age To Premises Rented To You Limit is the most we will pay in any one event un- der COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE for damages because of "property damage" from fire; smoke from a "hostile fire"; explosion; lightning; smoke resulting from such ex- plosion or lightning; collision by "mobile equipment" or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with per- mission of the owner. F. MEDICAL PAYMENTS 1. Paragraph 1.a. under COVERAGE C. MEDICAL PAYMENTS of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 6 with its permission. 1. Insuring Agreement a. We will pay medical expenses as de- scribed below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations: Provided that: (a) The accident takes place in the "coverage territory" and during the policy period; (b) The expenses are incurred and reported to us within three years of the date of the accident; and (c) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonable require. G. SUPPLEMENTARY PAYMENTS SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 1. We will pay, with respect to any claim we investigate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to $5,000 for cost of bail bonds re- quired because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. c. The cost of bonds to release attach- ments, but only for bond amounts within the applicable limit of insurance. We do have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. e. All costs taxed against the "insured" in any "suit". f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the appli- cable limit of insurance, we will not pay any prejudgment interest based on that period of time afta Rime Management DMsian REVIEWED&APPROVED BY: Risk Management Analyst 58705631 120-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 111/20/2020 8:21:55 AM (PST) I Page 3 of 12 g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, of- fered to pay, or deposited in court the part of the judgment that is within the applica- ble limit of insurance. These payments will not reduce the limits of insurance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indem- nitee if all of the following conditions are met: a. The "suit" against the indemnitee seeks damages for which the insured has as- sumed the liability of the indemnitee in a contract or agreement that is an "insured contract"; b. This insurance applies to such liability as- sumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same "insured contract"; d. The allegations in the "suit" and the in- formation we know about the "occur- rence" are such that no conflict appears to exist between the interests of the in- sured and the interests of the indemnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that in- demnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investi- gation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, sum- monses or legal papers received in connection with the "suit": (c) Notify any other insurer whose coverage is available to the in- demnitee; and (d) Cooperate with us with respect to coordinating other applicable insurance available to the in- demnitee; and (2) Provides us with written authoriza- tion to: (a) Obtain records and other infor- mation related to the "suit"; and (b) Conduct and control the defense of the indemnitee in such "suit" Our obligation to defend an insured's in- demnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of in- surance in the payment of judgments or settlements or the conditions set forth above, or the terms of the agreement de- scribed in Paragraph f. above, are no longer met. H. FELLOW EMPLOYEE COVERAGE — SUPERVISOR OR HIGHER Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM does not apply to the following: Your supervisory or management "employees" for "bodily injury" only. Damages owed to an injured co -"employee" or "volunteer worker" will be reduced by any amount paid or available to the injured co -"employee" or "volunteer worker" under any other valid and collectible insurance. NEWLY ACQUIRED ORGANIZATIONS Paragraph 3.a. of SECTION II — WHO IS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: a. Coverage under this provision is afforded only until the end of the current policy period. 4t1-3:iHs1177e7:1 it,I I /shtil :I III I LI 6111:1:1 �7 The following is added to SECTION II — WHO IS AN INSURED within the COMMERCIAL GEN- ERAL LIABILITY COVERAGE FORM: Throughout this policy the words "you" and "your" refer to any corporation or other business organi- zation, other than a joint venture, in which the first Named Insured has or acquires during the policy period an ownership interest of more than 50% and is subject to the management control of the first Named Insured or its subsidiaries, and which is domiciled within the United States of America or its territories or possessions. K. AMENDMENT OF AGGREGATE LIMIT OF INSURANCE The General Aggregate Limit Of Insurance refer- enced in Paragraph 2. of SECTION III — LIMITS OF INSURANCE within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM applies separately to: 1. Each of your "locations" owned by or rented to you; and Includes copyrighted material of Insurance Services Office, Inc., CG 82 24 05 12 with its permission. Rime Management DMsion REVIEWED&APPROVED BY: !® ® Risk Management Analyst 58705631 120-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 111/20/2020 8:21:55 AM (PST) I Page 4 of 12 2. Each of your projects away from premises (iii) That is insurance to cover your owned by or rented to you. liability as a tenant for "prop - "Location" means premises involving the same or erty damage" to premises connecting lots, or premises whose connection is while rented to you or tempo - interrupted only by a street, roadway, waterway or rarily occupied by you with right-of-way of a railroad. permission of the owner; or L. KNOWLEDGE OF OCCURRENCE The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Knowledge of an "occurrence", offense, claim or "suit" by your agent, servant or "employee" shall not be considered knowledge by you unless you, your insurance manager or any other person you designate has received notice of the "occur- rence", offense, claim or "suit" from your agent, servant, or "employee." I� f:iy�.l �:il� f.111ET_Pte3 Paragraph 4.b.(1)(a) in the Other Insurance condition of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: 4. Other Insurance b. Excess Insurance (1) This insurance is excess over (a) any of the other insurance, whether primary, excess, contin- gent or on any other basis: (i) That is Fire, Extended Cov- erage, Builders Risk; Installa- tion Risk or similar coverage for "your work"; (ii) That is insurance covering Fire; smoke from a "hostile fire"; explosion; lightning; smoke resulting from such explosion or lightning; colli- sion by "mobile equipment" or leakage from fire protec- tion systems for premises while rented to you or tempo- rarily occupied by you with permission of the owner; or (iv) If the loss arises out of the maintenance or use of aircraft, "autos", or watercraft to the extent not subject to Para- graph 2.g. Aircraft, Auto Or Watercraft under COVER- AGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. N. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following is added to Paragraph 6. Representations of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Commercial General Liability Coverage Form or at any time during the policy period will not invali- date or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after the exposure or hazard is discovered. O. WAIVER OF SUBROGATION The following is added to Paragraph 6. Transfer Of Rights Of Recovery Against Others To Us of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMER- CIAL GENERAL LIABILITY COVERAGE FORM: This condition does not apply to any person or organization to which you waived this condition by written contract or agreement, but only to the extent that subrogation is waived prior to the "bodily injury" or "property damage" under a contract with that person or organization. P. LIMITED WORLDWIDE LIABILITY COVERAGE The following is added to SECTION IV — CON- DITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 6 with its permission. Rime Management Diaisian REVIEWED&APPROVED BY: '� Risk Management Analyst 58705631 120-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 111/20/2020 8:21:55 AM (PST) I Page 5 of 12 Expanded Coverage Territory 1. If a "suit" is brought in a part of the "coverage territory" that is outside the United States of America (including its territories and posses- sions), Puerto Rico or Canada, and we are prevented by law, or otherwise, from defend- ing the insured, the insured will initiate a de- fense of the "suit". We will reimburse the in- sured, under Supplementary Payments, for any reasonable and necessary expenses in- curred for the defense of a "suit" seeking damages to which this insurance applies, that we would have paid had we been able to ex- ercise our right and duty to defend. If the insured becomes legally obligated to pay sums because of damages to which this insurance applies in a part of the "coverage territory" that is outside the United States of America (including its territories and posses- sions), Puerto Rico or Canada, and we are prevented by law, or otherwise, from paying such sums on the insured's behalf, we will re- imburse the insured for such sums. 2. All payments or reimbursements we make for damages because of judgments or settle- ments will be made in U.S. currency at the prevailing exchange rate at the time the in- sured became legally obligated to pay such sums. All payments or reimbursements we make for expenses under Supplementary Payments will be made in U.S. currency at the prevailing exchange rate at the time the expenses were incurred. 3. Any disputes between you and us as to whether there is coverage under this policy must be filed in the courts of the United States of America (including its territories and possessions), Puerto Rico or Canada. 4. The insured must fully maintain any coverage required by law, regulation or other governmen- tal authority during the policy period, except for reduction of the aggregate limits due to pay- ments of claims, judgments or settlements. Failure to maintain such coverage required by law, regulation or other governmental author- ity will not invalidate this insurance. However, this insurance will apply as if the required coverage by law, regulation or other govern- mental authority was in full effect. For purposes of this coverage only, the following is added to Paragraph 4.b.(1)(a) under Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM: If the insured's liability to pay damages is deter- mined in a "suit" brought outside the United States of America (including its territories and possessions), Puerto Rico or Canada; or That is coverage required by law, regulation or other governmental authority in a part of the "coverage territory" that is outside the United States of America (including its territories and possessions), Puerto Rico or Canada. For purposes of this coverage only, Paragraph 4. of SECTION V — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: 4. "Coverage territory" means anywhere in the world with the exception of any country or ju- risdiction which is subject to trade or other economic sanction or embargo by the United States of America. O. BODILY INJURY REDEFINITION Paragraph 3. of SECTION V. — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, injury or illness or emotional distress and/or death resulting from any of these at any time. R. INSURED CONTRACT —LEASE OF PREMISES Paragraph 9.a. of SECTION V — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 9. "Insured contract" means: a. a contract for lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "property dam- age" by fire; smoke from a "hostile fire", explosion; lightning; smoke resulting from such explosion or lightning; collision by "mobile equipment" or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract". S. LIBERALIZATION If we revise this endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. Includes copyrighted material of Insurance Services Office, Inc., CG 82 24 05 12 with its permission. Rime Management DMsion REVIEWED&APPROVED BY: ® Risk Management Analyst 58705631 120-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 111/20/2020 8:21:55 AM (PST) I Page 6 of 12 T. GOOD SAMARITAN SERVICES 1. Under SECTION II —WHO IS AN INSURED, paragraph 2.d., the following is added: This exclusion does not apply to your em- ployees or volunteer workers, other than an employed or volunteer physician, rendering "Good Samaritan services". 2. The following definition is added to SECTION V — DEFINITIONS: "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 6 with its permission. Rime Management DMsion REVIEWED&APPROVED By: ® Risk Management Analyst 58705631 120-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 111/20/2020 8:21:55 AM (PST) I Page 7 of 12 This Endorsement Changes the Policy. Please Read It Carefully. COMMERCIAL AUTOMOBILE ENHANCEMENT This endorsement modifies coverage provided under the following: BUSINESS AUTO COVERAGE FORM f tl-I;Ivy-! Q=1 i'.I =1 ■] 1 Z I-ill104110i0lrl4;TAM 4 Under Section 11— COVERED AUTOS LIABILITY COVERAGE, the following changes are made: A. BROAD NAMED INSURED The following is added to A. Coverage, paragraph 1. Who Is An Insured: d. Any legally incorporated entity of which you own more than 50 % of the voting stock on the effective date of this coverage part Is an Insured. B. ADDITIONAL INSUREDS — BY CONTRACT, AGREEMENT OR PERMIT The following is added to A. Coverage,. paragraph 1. Who Is An Insured: e. Any person or organization, not otherwise identified as an "insured" in this coverage or by endorsement to this coverage, that you are required by written contract, written agreement or written permit to name as an "insured". However, such person or organization is an "insured" only: (1 ) With respect to the operation, maintenance or use of a covered "auto'; and (2) For "bodily injury" or "property damage' caused by an "accident" which takes place after: (a) You executed the written contract or written agreement; or (b) The permit has been issued to you. The insurance provided under item B. above applies on a primary basis if that is required by the written contract, written agreement or written permit. Coverage under this provision is limited to the minimum limits of liability stipulated in that written contract, written agreement or written permit or the amount of loss not to exceed the Limit of Liability shown in the Declarations, whichever is less. C. EMPLOYEES AS INSUREDS The following is added to A. Coverage, paragraph 1. Who Is An Insured: f. Any "employee" of yours is an "insured" while using a covered "auto' you don't own, hire or borrow in your business or your personal affairs- D. FELLOW EMPLOYEE COVERAGE B. Exclusions, paragraph 5. Fellow Employee is deleted and replaced with the following: D718 Includes copyrighted material of SCA01 002 (j Insurance Services Office, Inc. with its Permission, Rime Management DMsian REVIEWED&APPROVED BY: '� Risk Management Analyst 58705631 1 20-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 1 11/20/2020 8:21:55 AM (PST) I Page 8 of 12 "Bodily injury" to: a. Any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business„ or b. The spouse, child, parent, brother or sister of that fellow "employee" as a consequence of Paragraph a, above. However, we will cover "bodily injury caused by your "employee" to his or her fellow "employee" if the "bodily injury" results from the use of a covered "auto". 2. ADDITIONAL SUPPLEMENTARY PAYMENTS Section II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, paragraph 2.a, Coverage Extensions, Supplementary Payments, items (2) and (4) are deleted and replaced by the following: (2) Up to $5000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. 5= 1LlDF IR4rIH=F-ls?Irlk'[00I'll41 1@14 Section IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, paragraph 2. Duties In The Event Of Accident, Claim, Suit Or Loss, item a. is deleted and replaced by the following and item d. is added: a. In the event of an "accident", claim, "suit" or "loss" you must give us or our authorized representative prompt notice of the "accident" or "loss" when the "accident", claim, "suit" or "loss" is known to: (1) You, if you are an individual; (2) A partner, if you area partnership or joint venture; (3) An "executive officer" or director if you are an organization other than a partnership, joint venture or limited liability company; (4) A member, if you are a limited liability company; (5) A trustee if you are a trust; or (6) An "employee" designated by you to give us such a notice. This notice should include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. d. Your rights afforded under this policy will not be prejudiced if you fail to give us notice of an "accident", claim, "suit" or "loss", solely due to your reasonable and documented belief that the "bodily injury or "property damage" is not covered under this policy. D718 Includes copyrighted material of SCA01 002 () Insurance Services Office, Inc. with its permiss6on, Rime Mattagement Diuiaian REVIEWED&APPROVED By: '� Risk Management Analyst 58705631 1 20-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 1 11/20/2020 8:21:55 AM (PST) I Page 9 of 12 4. WAIVER OF SUBROGATION The following is added to Section IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, paragraph 5. Transfer of Rights of Recovery Against Other To Us: If the insured has waived those rights prior to the "accident" or "loss", our rights are waived also. 5. UNINTENTIONAL ERRORS AND OMISSIONS The following is added to Section IV - BUSINESS AUTO CONDITIONS, B. General Conditions, paragraph 2, Concealment, Misrepresentation Or Fraud: We will not disclaim coverage under this Coverage Part if you fail to disclose all hazards existing as of the inception date of the policy, provided such failure is not intentional and you report the (allure to us as soon as practicable after its discovery. However, we reserve the right to charge additional premium for any such hazard. 6. BROADENED PHYSICAL DAMAGE COVERAGE Under Section III — PHYSICAL DAMAGE COVERAGE, the following changes are made: A. WAIVER OF DEDUCTIBLE — GLASS REPAIR The following is added to D. Deductible: No deductible for a covered "auto' will apply to glass damage if the glass is repaired rather than replaced. Lie] Q 10[a]21a1 %11:7_1"I- i•]:ifAiII.Ial :1»L,61*--1 A. Coverage, 4. Coverage Extensions, paragraph a. Transportation Expenses is deleted and replaced by the following: We will pay up to $50 per day to a maximum of $1500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". C. ADDITIONAL LOSS OF USE EXPENSES A. Coverage, 4. Coverage Extensions, paragraph b. Loss Of Use Expenses is deleted and replaced by the following: For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1) Other than collision only if the Declarations indicates that Comprehensive Coverage is provided for any covered "auto'; (2) Specified Causes of Loss only if the Declarations indicates that Specified Causes of Lass Coverage is provided for any covered "auto"; or (3) Collision only if the Declarations indicates that Collision Coverage is provided for any covered "auto". 07f 8 Includes copyrighted material of SCA 01 i702 () Insurance Services Office, Inc. with its Permission, Rime Mattagement Disisian REVIEWED&APPROVED By: '� Risk Management Analyst 58705631 1 20-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 1 11/20/2020 8:21:55 AM (PST) I Page 10 of 12 However, the most we will pay for any expenses for loss of use Is $65 per day, to a maximum of $1500. D. COST TO RECOVER STOLEN AUTO The following is added to A. Coverage, 4. Coverage Extensions, We will pay reasonable and necessary expenses incurred by you to return a stolen, covered "auto" from the place where it is recovered to its usual garaging place. The most we will pay for such expenses is $1000. This Coverage Extension does not apply if your business is selling, servicing or repairing "autos". E. PERSONAL EFFECTS COVERAGE The following is added to A. Coverage, 4. Coverage Extensions. In the event of a total theft of a covered "auto", we will pay for personal effects owned by an "insured" and in or on the covered "auto" at the time of "loss". The most we will pay for such personal effects is $500 per "loss". No deductibles apply to this Personal Effects Coverage- F. AIRBAGS -ACCIDENTAL DISCHARGE COVERAGE The following is added to B. Exclusions, paragraph 3. This exclusion does nut apply to the accidental or unintended discharge of an airbag. The most we will pay for such "loss" is $1000. This coverage is excess over any other collectible insurance or warranty. €DTI =1 : I [d tl 471 J-11KO]TI =I;?Aq 14 The following is added to A. Coverage, 4. Coverage Extensions. In the event of a total "loss" to a covered "auto" and In addition to the actual cash value of the covered 'auto", we will pay up to $1000 to repair or replace vehicle wraps displayed on the "auto" at the time of'loss' The most we will pay under the Vehicle Wrap Coverage is $5000 for any one "loss", regardless of the number of covered "autos" deemed a total "Boss". For the purpose of this coverage, vehicle wraps are full color, graphic images printed on vinyl film and attached to an "auto". 7. ADDITIONAL DEFINITIONS The fallowing is added to Section V - DEFINITIONS: "Executive Officer means a person holding any of the officer positions created by your charter, constitution, by-laws or any similar governing document. 'Phis endorsement forces a part or Policy Number: ACV$132520 Enectivenate: 03-01-2020 Insurtd: 7 & 2A I"ANAGEMENT, LLC D718 Includesoapvrightedmaterial of SCA01 002 () Insurance Services Office, Inc. with its permission. Rime Management Division REVIEWED&APPROVED By: '� Risk Management Analyst 58705631 1 20-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 1 11/20/2020 8:21:55 AM (PST) I Page 11 of 12 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 0410B (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium All CA Operations 350.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective 02/01/2019 Policy No. EAWC010904 Insured Insurance Company Oak River Insurance Company Countersigned by WC 99 0410B (Ed. 9-14) Endorsement No. Premium $ Rime Mattagmient DMsinn REVIEWED&APPRDVEDBy., faaa.o:.r.e R. Mnebd '� Risk Management Analyst 58705631 1 20-21 NC, 20-21 GL-AL-UL I Stacy Eickhoff 1 11/20/2020 8:21:55 AM (PST) I Page 12 of 12 This Endorsement Changes the Policy. Please Read It Carefully. NOTICE TO CERTIFICATE HOLDER OR DESIGNATED ENTITY INDIVIDUAL This endorsement modifies all coverage parts included in this policy. SCHEDULE PERSON OR ORGANIZATION: CITY OF SANTA ANA Risk Management Division, 4th Floor ADDRESS: 20 CIVIC CENTER PLAZA SANTA ANA, CA 92702-1 8 Number of Days Notice of Cancellation: 30 (If left blank, no notice will be sent.) Number of Days Notice of Nonrenewal: (If left blank, no notice will be sent.) This endorsement forms a part of Policy Number: CPLS1033HO Effective Date: 03-01-2020 Insured: S&A MANAGEMENT, LLC SIL 02 022 0412 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Rime Management Divisian REVIEWED&APPRDVEDBy., faaa.o:.r.e R. Mnebd '� Risk Management Analyst A. If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, we will mail notice of cancellation to the Scheduled person or organization at the address shown in the Schedule above. We will mail this notice at least the number of days shown in the Schedule above for cancellation. However, failure to send such notice or send it within the specified time period will not rescind the cancellation. B. If we decide not to renew this policy for any statutorily permitted reason, we will mail notice of nonrenewal to the Scheduled person or organization at the address shown in the Schedule above. We will mail such notice at least the number of days shown in the Schedule above for nonrenewal. However, failure to send such notice or send it within the specified time period will not rescind the nonrenewal. This endorsement forms a part of Policy Number: CPLS1033HO Effective Date: 03-01-2020 Insured: S&A MANAGEMENT, LLC SIL 02 022 0412 Includes copyrighted material of Insurance services Office, Inc., with its permission. Rime Management Divisian REVIEWED&APPRDVEDBY: faaa.o:.r.e R. Mnebd '� Risk Management Analyst