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HomeMy WebLinkAboutSILVER & WRIGHT, LLP (2)o INSURANCE NOT ON FILE N-2021-035-01 N N WORK MAY NOT PROCEED CLERK OF COUNCIL a DATE: Q FIRST AMENDMENT TO PROVIDE ADMINISTATIVE HEARING SERVICES WITH SILVER & WRIGHT LLP THIS FIRST AMENDMENT to the above -referenced agreement is entered into on April 9, 2021, by and between Silver & Wright, LLP, a California limited liability partnership ("Contractor"), 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. The parties entered into Agreement No. N-2021-035, dated February 18, 2021, by which Contractor agreed to serve as a neutral administrative hearing officer and provide on -call professional administrative hearing services for the City ("Agreement'). B. The Agreement is current, and in effect, and continues through February 17, 2022. C. The parties now wish to augment the overall amount of compensation related to an increase in services to be provided by the Contractor during the term of the Agreement. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terns and conditions of said Agreement, except as herein modified, the parties agree as follows: Section 2.a., Compensation, is amended to increase the overall compensation in the amount of $15,000. The total amount to be expended during the term of the Agreement shall not exceed $20,000. 2. Except as modified by this First Amendment, all terms and conditions of the Agreement shall remain in full force and effect. [signature page to follow] Page 1 of 2 N-2021-035-01 IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first written above. APPROVED AS TO FORM Sonia R. Carvalho City Attorney By: Rya dge Assistant ity Attorney RECOMMENDED FOR APPROVAL ci Minh Thai Executive Director, Planning and Building Agency CITY OF SANTA ANA Krfstine Ridge f� City Manager SILVER & WRIGHT LLP Curtis R. Wright, Partner Page 2 of 2 Ejhjubmmz!tjhofe!cz!Upsj!Qjfstpo! Upsj!Qjfstpo Ebuf;!3133/12/37!22;12;25!.19(11( DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 01/19/2022 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). CONTACT PRODUCER Aleen Maldjian NAME: FAX PHONE Brown & Brown(714)221-1800(714)221-4196 (A/C, No): (A/C, No, Ext): E-MAIL 2401 E. Katella Ave.aleen.maldjian@bbrown.com ADDRESS: Suite 550 INSURER(S) AFFORDING COVERAGENAIC # AnaheimCA92806Chicago Insurance Company22810A INSURER A : INSURED INSURER B : Silver & Wright LLP INSURER C : 3 Corporate Park INSURER D : Suite 100 INSURER E : IrvineCA92606 INSURER F : 22/23 Master COVERAGESCERTIFICATE NUMBER: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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 10,000 MED EXP (Any one person)$ AYYABA20210019040102/06/202202/06/2023Excluded PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- Included POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY 1,000,000 $ (Ea accident) ANY AUTOBODILY INJURY (Per person)$ OWNEDSCHEDULED AABA20210019040102/06/202202/06/2023 BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS HIREDNON-OWNEDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB 2,000,000 OCCUREACH OCCURRENCE$ A EXCESS LIAB ABA20210019040102/06/202202/06/20232,000,000 CLAIMS-MADEAGGREGATE$ DEDRETENTION$$ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, agents, employees, and volunteers are named as Additional Insured as respects to General Liability in regards to the operations of the Named Insured per endt SB9189 04-17. Primary and Non-Contributory per endt SB9189 04-17. Waiver of Subrogation applies per endt SB9189 04-17. 30 Day Notice of Cancellation applies per endt MAN BP 06 04 20. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana; Risk Management Division 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa AnaCA92702 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD BOP MultiCover - SB 91 89 04 17 Policy Amendment This Endorsement modifies insurance provided under the Businessowners Coverage Form. Your policy is broadened and clarified as follows: 1.Non Employment Discrimination Liability Unless “personal and advertising injury” is excluded from this policy the following applies: A.Section II – Liability, F. Liability and Medical Expenses Definitions, Item 14. is amended to include the following: h.“Discrimination” B.Section II – Liability, F. Liability and Medical Expenses Definitions is amended to include the following: 23.“Discrimination” means the violation of a person’s civil rights with respect to such person’s race, color, national origin, religion, gender, marital status, age, or sexual orientation or preference, physical or mental condition, or any other protected class or characteristic established by any federal, state or local statutes, rules or regulations. C.Section II – Liability, B. Exclusions, 1. Applicable to Business Liability Coverage, p. Personal and Advertising Injury is amended to include the following: (14)Arising out of “discrimination” directly or indirectly related to the past employment, employment or prospective employment of any person or class of persons by any insured; (15)Arising out of “discrimination” directly or indirectly related to the sale, rental, lease or sub- lease or prospective sale, rental, lease or sub-lease of any dwelling or permanent lodging by or at the direction of any insured; (16)Arising out of “discrimination”, if insurance thereof is prohibited by law; or (17)Fines, penalties, specific performance, or injunctions levied or imposed by a governmental entity, or governmental code, law, or statute because of “discrimination”. 2.Additional Insured If an Additional Insured endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 2. Additional Insured does not apply to such person or organization. Section II - Liability Coverage, C. Who Is An Insured, Item 2. is amended to include the following: e.Any person or organization is included as an additional insured, but only to the extent such person or organization is legally obligated to pay for “bodily injury”, “property damage” or “personal and advertising injury” caused by your acts or omissions. With respect to the insurance afforded to such additional insured, all of the following additional provisions apply: SB9189 04-17 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved.Page 1 of 8 (1)You have agreed in a written “insured contract” that such person or organization be added as an additional insured under this policy; (2)The “bodily injury”, “property damage” or “personal and advertising injury” for which said person or organization is legally obligated to pay occurs subsequent to the execution of such “insured contract”; (3)The most we will pay is the lesser of either the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the “insured contract”; (4)The insurance afforded to such additional insured only applies to the extent permitted by law; (5)Such person or organization is an additional insured only with respect to: (a)Their ownership, maintenance, or use of that part of the premises, or land, owned by, rented to, or leased to you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (b)Your ongoing operations performed for that insured; (c)Their financial control of you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (d)The maintenance, operation or use by you of equipment leased to you by such person or organization; (e)Operations performed by you or on your behalf and for which a state or political subdivision has issued a permit, provided such operations are not performed for such state or political subdivision, and are not included within the “products-completed operations hazard”; or (f)Their liability as a grantor of a franchise to you. (6)This insurance does not apply to “bodily injury”, “property damage”, “personal and advertising injury”, “occurrence” or offense: (a)Which takes place at a particular premises after you cease to be a tenant of that premises; (b)Which takes place after all work, including materials, parts or equipment furnished in connection with such work to be performed by or on behalf of the additional insured at the site of the covered operations, has been completed; (c)Which takes place after that portion of “your work” out of which the injury or damage arises has been put to its intended use by any other person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project; or (d)Which takes place after the expiration of any equipment lease to which (5) (d) above applies; (7)With respect to architects, engineers or surveyors, coverage does not apply to “bodily injury”, “property damage” or “personal and advertising injury” arising out of the rendering or failure to SB9189 04-17 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved.Page 2 of 8 render any professional services by or for you, including: (a)The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; or (b)Supervisory, inspection, architectural, or engineering services. These exclusions apply even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the “occurrence” which caused the “bodily injury” or “property damage”, or the offense which caused the “personal or advertising injury” involved the rendering of or the failure to render any professional services by or for you. 3.Additional Insured –Vendors If an Additional Insured Vendors endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 3. Additional Insured – Vendors does not apply to that person or organization. Unless the “products-completed operations hazard” is excluded from this policy, Section II – Liability Coverage, C. Who Is an Insured, Item 2. is amended to include the following: f.Any vendor of yours is included as an additional insured, but only with respect to “Bodily Injury” or “Property Damage” caused by “your products” which are distributed or sold in the regular course of the vendor’s business, subject to the following additional exclusions: (1)The insurance afforded the vendor does not apply to: (a)“Bodily injury” or “property damage” for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b)Any express warranty unauthorized by you; (c)Any physical or chemical change in the product made intentionally by the vendor; (d)Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f)Demonstration, installation, servicing or repair operations, except such operations performed by the vendor in full compliance with the manufacturer’s written instructions at the vendor’s premises in connection with the sale of the product; (g)Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h)“Bodily injury” or “property damage” arising out of the liability of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. (2)This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or SB9189 04-17 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved.Page 3 of 8 containing such products; (3)The most we will pay is the lesser of either the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the contract or agreement; and (4)The insurance afforded to such vendor only applies to the extent permitted by law. 4.Additional Insured - Limited Primary and Noncontributory Provision Section III – Common Policy Conditions (Applicable to Section I – Property and Section II – Liability), H.Other Insurance, is amended to include the following: 4.With respect to Section II – Liability: However, if you have added any person, organization or vendor of yours as an additional insured to this policy by way of this MultiCover endorsement and have agreed in a written “insured contract” that this insurance is primary and non-contributory with other insurance available to that additional insured, this insurance is primary and we will not seek contribution from such additional insured’s other insurance, provided that the additional insured is a Named Insured under such other insurance. 5.Blanket Waiver of Subrogation Section III Common Policy Conditions (Applicable to Section I – Property and Section II – Liability, K.Transfer of Rights of Recovery Against Others to Us, 2., is deleted and replaced with the following: 2.Applicable to Businessowners Liability Coverage a.If the insured has rights to recover all or part of any payment we have made under this policy, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring “suit” or transfer those rights to us and help us enforce them. This condition does not apply to Medical Expenses Coverage. b.If required by a written “insured contract” executed prior to the “occurrence” or offense, we waive any right of recovery we may have against any person or organization named in such “insured contract” because of payments we make for injury or damage arising out of your operations or “your work” for that person or organization. 6.Broadened Named Insured A.Section II - Liability Coverage, C. Who Is An Insured, is amended to include the following: 3.Any organization that you own at the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the policy period majority ownership or majority interest, will qualify as a Named Insured if: a.There is no other similar insurance available to that organization; and b.The first Named Insured shown in the Declarations has the responsibility of placing insurance for that organization; and c.That organization is incorporated or organized under the laws of the United States of America. However: SB9189 04-17 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved.Page 4 of 8 (1)Coverage under this provision 3 is afforded only until the next occurring annual anniversary of the beginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier; and (2)Coverage A does not apply to “bodily injury” or “property damage” that occurred before you acquired or formed the organization; and (3)Coverage B does not apply to “personal and advertising injury” arising out of an offense committed before you acquired or formed the organization. B.Section II - Liability Coverage, C. Who Is An Insured, the last paragraph, is deleted and replaced with the following: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture, or limited liability company that is not shown as a Named Insured in the Declarations. However, this does not apply to a limited liability company that meets all of the conditions in Section II - Who Is An Insured, provision 3., above. 7.Medical Payments Unless Medical Expenses Coverage is excluded from this policy: A.Section II - Liability, B. Exclusions, 2. Applicable to Medical Expenses Coverage, f. is deleted and replaced with the following: f.Included within the “products-completed operations hazard”. However, this exclusion does not apply to expenses for dental services. B.Section II - Liability, D. Liability and Medical Expenses Limits of Insurance, is amended to include the following: 5.Medical Expenses Coverage is primary and not contributing with any other insurance, even if that other insurance is primary also. 8.Liberalization Section III – Common Policy Conditions (Applicable to Section I – Property and Section II – Liability), G.Liberalization, is deleted and replaced with the following: G.Liberalization If we adopt a change in our forms or rules which would broaden the coverage provided by any form that is a part of this policy without an extra premium charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. 9.Damage to Premises Rented to You A.Section III – Liability Coverage, B. Exclusions, 1. Applicable to Business Liability Coverage, the last paragraph is deleted and replaced with the following: Exclusions c., d., e., f., g., h., i., k., l., m., n. and o. in Section II – Liability do not apply to damage by fire to premises while rented to you, temporarily occupied by you with permission of the owner or managed by you under a written agreement with the owner. A separate Damage To Premises Rented To You Limit of Insurance applies to this coverage as described in Paragraph D. Liability And Medical Expenses Limits of Insurance in Section II – Liability. SB9189 04-17 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved.Page 5 of 8 B.Section III - Liability Coverage, D. Liability and Medical Expenses Limits of Insurance, Item 3. is deleted and replaced with the following: 3.The most we will pay under Business Liability for damages because of “property damage” to a premises while rented to you, or in the case of fire, while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, is the greater of: a.$1,000,000 Any One Premises; or b.The Damage to Premises Rented To You Limit shown in the Declarations. 10.Chartered Aircraft Section II - Liability, B. Exclusions, 1.Applicable to Business Liability Coverage, g. Aircraft, Auto or Watercraft, is amended to include the following: (6)An aircraft in which you have no ownership interest and that you have chartered with crew. 11.Coverage Territory Broadened Section II – Liability Coverage, F. Liability and Medical Expenses Definitions, Item 4.a. is deleted and replaced with the following: a.The United States of America (including its territories and possessions), Puerto Rico, Canada, Bermuda, the Bahamas, the Cayman Islands and the British Virgin Islands. 12.Personal or Advertising Injury - Contractual Unless “Personal and Advertising Injury” is excluded from this policy, Section II – Liability Coverage, B.Exclusions, 1. Applicable to Business Liability, p. Personal and Advertising Injury, (4) is deleted in its entirety. 13.Fellow Employees Coverage Section II - Liability Coverage, C. Who Is an Insured, Item 2.a.(1) is deleted and replaced with the following: (1)“Personal and advertising injury”: However, subsections (a), (b), (c) and (d) of item (1) remain unchanged. 14.Bodily Injury Definition - Broadened Section II – Liability Coverage, F. Liability and Medical Expenses Definitions, Item 3. is deleted and replaced with the following: 3.“Bodily injury” means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. 15.Unintentional Failure to Disclose Hazards Section II - Liability Coverage, E. Liability and Medical Payments General Conditions, is amended to include the following: SB9189 04-17 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved.Page 6 of 8 6.Unintentional Failure to Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. 16.Supplementary Payments, Increase Limits Section II – Liability, A. Coverages, 1. Business Liability, f. Coverage Extension – Supplementary Payments, (1) (b) and (d) are deleted and replaced with the following: (b)The cost of bail bonds required 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 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 substantiated loss of earnings up to $500 a day because of time off work. 17.Amended Duties in the Event of an Occurrence, Offense Claim or Suit Section II - Liability Coverage, E. Liability and Medical Payments General Conditions, 2. Duties in the Event of Occurrence, Claim or Suit, a. and b. are deleted and replaced with the following: a.You must see to it that we or any licensed agent of ours are notified of a General Liability “occurrence” or offense which may result in a claim as soon as practicable after it becomes known to: (1)You, if you are an individual; (2)Your partner or member, if you are a partnership or joint venture; (3)Your member, if you are a limited liability company; (4)Your executive officer if you are an organization other than a partnership, joint venture or limited liability company; or (5)Your authorized representative or insurance manager. Knowledge of an “occurrence” or offense by persons other than those listed above does not imply that those listed above also have such knowledge. To the extent possible, notice to us should include: (1)How, when and where the “occurrence” or offense took place; (2)The names, addresses, and telephone numbers of any injured persons and witnesses; and (3)The nature and location of any injury or damage arising out of the occurrence, offense, claim, or “suit". 18.Section III - Common Policy Conditions (Applicable to Section I – Property and Section II – Liability), H.Other Insurance, 2. is deleted and replaced with the following: 2.Business Liability Coverage SB9189 04-17 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved.Page 7 of 8 If other valid and collectible insurance is available to any insured for a loss we cover under Business Liability Coverage, our obligations are limited as follows: a.The insurance provided under this policy is primary if you are required by a written “insured contract” to include any person or organization as an insured, but only with respect to that insured’s liability arising out of the ownership, maintenance, or use of that part of the premises owned by or rented to you, or “your work” for that insured by or for you. Any other insurance available to that person or organization is excess and noncontributory with this insurance, or; b.Except for the circumstance described in 2.a., above, the insurance provided under this policy is excess over any other liability insurance available to any insured whether such other insurance is written as primary, excess, contingent or any other basis. An exception applies when any insured specifically has purchased excess insurance to apply in excess of the limits of insurance shown in the Declarations for Business Liability Coverage. 19.Damage to Invitees’ Automobiles from Falling Trees or Tree Limbs - Limited Coverage The policy applies to direct physical damage to automobiles owned by invitees subject to all of the following: 1.Provided such damage originates from premises owned, managed, leased or rented by an insured; 2.Coverage applies only to invitees of an insured or an insured’s tenant; 3.Such damage is directly caused by wind-driven falling trees or tree limbs; 4.The most we will pay for any one loss is the lowest of: a.the actual cash value of the damaged automobile as of the time of the loss; or b.the cost of repairing the damaged automobile; or c.the cost of replacing the damaged automobile with another automobile of like kind and quality. Regardless of the number of occurrences, losses or claims, this coverage is subject to a limit of $25,000 in any one policy period; 5.This coverage is not subject to the General Liability General Aggregate Limit; and 6.We will make payments under this coverage without regard to fault. 20.Section II – Liability, B. Exclusions, 1. Applicable to Business Liability Coverage, a. Expected or Intended Injury, is deleted and replaced with the following: a.Expected or Intended Injury “Bodily injury” or “property damage” expected or intended from the standpoint of the insured. This exclusion does not apply to “bodily injury” or “property damage” resulting from the use of reasonable force to protect persons or property. All other terms and conditions of this policy shall remain unchanged. SB9189 04-17 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved.Page 8 of 8 Courtesy Notice of Cancellation for Other Than Nonpayment of Premium toDesignated Entities MAN BP 06 04 20 Policy Amendment Schedule Name and Address of Person(s) or OrganizationsNumber of Days Notice if other than 10 days: City of Sana Ana30 Days Information required to complete this Schedule, if not shown above, will be shown in the Declarations. This policy is amended as follows: A.If We cancel this policy prior to expiration for any reason other than non payment of premium or at Your request, and we have been notified that You are required under a current contractual obligation to notify a certificate of insurance holder or holders when this policy is canceled, then We will endeavor to mail or deliver a copy of such written notice of cancellation to the certificate holder(s) shown in the Schedule above, as follows: 1.To the name and address corresponding to each certificate of insurance holder indicated in the Schedule above; and 2.At least 10 days prior to the effective date of the cancellation, as shown in our notice to the first Named Insured, or, if indicated, the longer number of days notice shown in the Schedule above. B.Notwithstanding the foregoing, such notice of cancellation is provided on an informational basis and solely to assist You in informing the certificate of insurance holder(s) in advance of pending cancellation in coverage to assist you in meeting Your contractual notice requirements to such parties. Our failure to provide such advance notification to the certificate of insurance holder(s) shown in the Schedule of this endorsement will not extend any policy cancellation date, negate any cancellation of the policy, or grant, alter or extend any rights or obligations under this policy and we shall have no liability for any failure to provide the notice(s) as provided herein. All other terms and conditions of this policy remain unchanged. MAN BP 06 04 20 Page 1 of 1 EBUF!)NN0EE0ZZZZ* DFSUJGJDBUF!PG!MJBCJMJUZ!JOTVSBODF 1202:03133 UIJTDFSUJGJDBUFJTJTTVFEBTBNBUUFSPGJOGPSNBUJPOPOMZBOEDPOGFSTOPSJHIUTVQPOUIFDFSUJGJDBUF IPMEFS/UIJTDFSUJGJDBUFEPFTOPUBGGJSNBUJWFMZPSOFHBUJWFMZBNFOE-FYUFOEPSBMUFSUIFDPWFSBHF BGGPSEFECZUIFQPMJDJFTCFMPX/UIJTDFSUJGJDBUFPGJOTVSBODFEPFTOPUDPOTUJUVUFBDPOUSBDUCFUXFFOUIF JTTVJOH!JOTVSFS)T*-!BVUIPSJ\[FE!SFQSFTFOUBUJWF!PS!QSPEVDFS-!BOE!UIF!DFSUJGJDBUF!IPMEFS/ JNQPSUBOU;JguifdfsujgjdbufipmefsjtboBEEJUJPOBMJOTVSFE-uifqpmjdz)jft*nvtucffoepstfe/JgTVCSPHBUJPOJTXBJWFE- tvckfduupuifufsntboedpoejujpotpguifqpmjdz-dfsubjoqpmjdjftnbzsfrvjsfbofoepstfnfou/Btubufnfoupouijtdfsujgjdbufepft opu!dpogfs!sjhiut!up!uif!dfsujgjdbuf!ipmefs!jo!mjfv!pg!tvdi!foepstfnfou)t*/ QSPEVDFS DPOUBDU!OBNF; BVUPNBUJD!EBUB!QSPDFTTJOH!JOT!BHDZ QIPOFGBY )911*635.8135)911*635.5124 87361828 )B0D-!Op*; )B0D-!Op-!Fyu*; 82!IBOPWFS!SPBE F.NBJM!BEESFTT; GMPSIBN!QBSLOK18:43 JOTVSFS)T*!BGGPSEJOH!DPWFSBHFOBJD$ 11:25 JOTVSFS!B!;!Ibsugpse!Gjsf!boe!Jut!Q'D!Bggjmjbuft JOTVSFE JOTVSFS!C!; TJMWFS!'!XSJHIU!MMQ JOTVSFS!D!; 4!DPSQPSBUF!QBSL!TUF!211 JOTVSFS!E!; JSWJOFDB:3717.626: JOTVSFS!F!; JOTVSFS!G!; DPWFSBHFTDFSUJGJDBUF!OVNCFS;SFWJTJPO!OVNCFS; UIJTJTUPDFSUJGZUIBUUIFQPMJDJFTPGJOTVSBODFMJTUFECFMPXIBWFCFFOJTTVFEUPUIFJOTVSFEOBNFEBCPWFGPSUIFQPMJDZQFSJPE JOEJDBUFE/OPUXJUITUBOEJOHBOZSFRVJSFNFOU-UFSNPSDPOEJUJPOPGBOZDPOUSBDUPSPUIFSEPDVNFOUXJUISFTQFDUUPXIJDIUIJT DFSUJGJDBUFNBZCFJTTVFEPSNBZQFSUBJO-UIFJOTVSBODFBGGPSEFECZUIFQPMJDJFTEFTDSJCFEIFSFJOJTTVCKFDUUPBMMUIF UFSNT-!FYDMVTJPOT!BOE!DPOEJUJPOT!PG!TVDI!QPMJDJFT/!MJNJUT!TIPXO!NBZ!IBWF!CFFO!SFEVDFE!CZ!QBJE!DMBJNT/ JOTSBEEMTVCSQPMJDZ!FGGQPMJDZ!FYQ QPMJDZ!OVNCFS UZQF!PG!JOTVSBODFMJNJUT MUSJOTSXWE)NN0EE0ZZZZ*)NN0EE0Z!ZZZ* FBDI!PDDVSSFODF DPNNFSDJBM!HFOFSBM!MJBCJMJUZ EBNBHF!UP!SFOUFE DMBJNT.NBEFPDDVS QSFNJTFT!)Fb!pddvssfodf* NFE!FYQ!)Boz!pof!qfstpo* QFSTPOBM!'!BEW!JOKVSZ HFOFSBM!BHHSFHBUF HFO(M!BHHSFHBUF!MJNJU!BQQMJFT!QFS; QSP. 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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 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). CONTACT PRODUCER Sean Hayes NAME: PHONE FAX First Indemnity Insurance Agency, Inc. 781-581-2519781-595-2293 (A/C, No, Ext): (A/C, No, Ext): 87 Oxford Street E-MAIL shayes@firstindemnity.net ADDRESS: Lynn, MA 01901 INSURERS AFFORDING COVERAGE NAIC # General Security National Insurance Company INSURER A: INSURED INSURER B: Silver & Wright LLP INSURER C: 3 Corporate Park INSURER D: Suite 100 INSURER E: Irvine, CA 92606 INSURER F: COVERAGESCERTIFICATE NUMBER: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. INSRADD'LSUBR TYPE OF INSURANCEPOLICY NUMBERPOLICY EFFPOLICY EXPLIMITS LTRINSRDWVD EACH OCCURANCE GENERAL LIABILITY DAMAGE TO RENTED PREMISES COMMERCIAL GENERAL LIABILITY (Ea occurance) CLAIMS MADEOCCUR MED EXP (Any one person) PERSONAL & AND INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG GEN'L AGGREGATE LIMIT APPLIES PER: POLICYPROJECTLOC COMBINED SINGLE LIMIT (Ea AUTOMOBILE LIABILITY accident) BODILY INJURY (Per person) ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident) AUTOSAUTOS NON-OWNED PROPERTY DAMAGE (Per accident) HIRED AUTOS AUTOS UMBRELLA LIAB EACH OCCURANCE OCCUR AGGREGATE EXCESS LIAB CLAIMS MADE DEDRETENTION $ WC STATU- WORKERS COMPENSATION OTHER TORY LIMITS AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT OFFICE/MEMBER EXCLUDED? N/A Y/N E.L. DISESAE - EA (Mandatory in NH) EMPLOYEE If yes, describe under DESCRIPTION OF E.L. DISEASE - POLICY LIMIT OPERATIONS below Each Claim: $ 2,000,000 3924000000800 Lawyers Professional07/01/2107/01/22 A -00 General Aggregate: $ 4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACCORD 101, Additional Remarks Schedule, if more space is required) Claims made Coverage, Covering 10 Attorney, Retro-Date: 03/01/2013. Deductible is per claim and applies to loss and defense. Claim Expenses are Inside the Limits of Liability. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVED DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSUREER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND TO THE INSURER, IT'S AGENTS OR REPRESENTITIVES AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) The ACCORD name and logo are registered marks of ACCORD