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HomeMy WebLinkAboutORANGE COUNTY CONSERVATION CORPS (5)r:r 0 N r+: N Q_ B INSURANCE ON FILE WORK MAY PROCEED MAYOR UNTIL INSURANCE EXPIRES In. �'Y1 Vicente Sanniento CLERI MAYOR PRO TEM DATE: David Penaloza COUNCILMEMBERS Phil Baoerra Johnathan Ryan Hernandez Jessie Lopez Nelida Mendoza Thai Viet Phan �. (UA) (0k%rmH March 15, 2021 Katharyn O. Mudiz O.C. Conservation Corps 1853 N. Raymond Ave. Anaheim, CA 92801 CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 (714)647-5360 www.santa-ana.ora Re: Extension of Agreement A-2020-142 Dear Mrs. Mufiiz: A-2020-142-01 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez Pursuant to Section 3 ("Term") of the Agreement under the Workforce Innovation And Opportunity Act, No. A-2020-142, entered into by and between Orange County Conservation Corps and the City of Santa Ana, dated July 7, 2020, the time -period for said Agreement is hereby extended from July 1, 2021, through December 31, 2021. All other terms and conditions of said Agreement remain unchanged and in full force and effect. If you have any question regarding this matter, please contact Sandy Barba in the Community Development Agency at 714-565-2611. Sincerely, CITY OF SANTA ANA Kristine Ridge City Manager APPROVED AS TO FORM: Sonia R. Carvalho City ttorney Ry O Hodge Assistant City Attorney Vicente Sanniento oavitl Panel.. The Viet Phan Mayor Meyer Pm Tam, Wand!2 Wand ienl.Z0.nta-ana.ora tloenaloza0santaananro tohanfotoodaana.oro ATTEST: "aisy uomez Clerk of the Council RECOMMENDED FOR APPROVAL: Steven Mendoza, Executive Director Community Development Agency SANTA ANA CITY COUNCIL Jessie Lopaz Phil Bawna JahnaNan Ryan Hemantlez Nelitla Mendoza Ward Ward Ward Wartlfi sielooez(alsanta-ana or ab.ce.0heu ii-inidne aniemandezfolsanta-ana om meadozaratsanta-aneom o�suany oe-d by aandne It Francine R.Villareal VIII.—i mrc zort.m.is raea:os ueva A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MMID lY ) 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 Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc. 505 N Brand Blvd, Suite 600 Glendale CA 91203 CONTACT Annie Lee PHONE FAx D Na Eat. 8'8.539.8601 IJC No:818.539.8701 aoliaEss: Annie Lee a' .com INSURE S AFFORDING COVERAGE NAIC If INSURER A: Great American Alliance Insurance Company 26832 License#: 0726293 INSURED ORANC011-19 Orange County Conservation Corps 1853 N. Raymond Ave. INSURER B: Great American Insurance Company Of NY 22136 INSURERC: INSURERD: Anaheim, CA 92801 NSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 802897524 REVISION NUMRPR- 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. ILTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMIDOIYYW POLICY UP MM/DDIYYYY LIMITS A X COMMERCIALGENERAL LIABILITY CLAIMS -MADE � OCCUR Y PAC 515468016 10/1/2020 10/1/2021 EACH OCCURRENCE $1,000,000 DA MIST RENTED PREES Ea occurrexe $100,000 MED UP (Any am person) $ 5,000 PERSONAL &ADV INJURY $1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER:. POLICY ❑JECT LOG GENERAL AGGREGATE $3,000,000 PRODUCTS - COMP/OP AGO $3,000,000 $ OTHER: B AUTOMOSILELIABILITY CAP 099124907 10/1/2020 10/1/2021 COEaMBIaccitlEenfNDSINGLE LIMIT $1,000,000 X ANY AUTO BODI LV INJURY Per person) $ OWNED SCHEOOULEO AUTOS ONLY AUTS ( ) BODILY INJURY Per acgtlent $ HIRED X NIPROPERTY—DAMAGE AUTOS ONLY AUTOS ONLY X Per accident)$ Comp & Collision $ 5004$500 A X UMBRELLALIAB X OCCUR UMB 560379516 10/1/2020 10/1/2021 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESSLIAB CLAIMS -MADE DED X RETENTION$ in nnn $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUTIVE ❑ OFFICERIMEMBEREXCLUDED? NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ (Mandatory in NH) If yes, describe under EL.DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Abuse and molestation PAC 5154680 16 101112021 10/1/2021 Per Claim $1,000,000 Aggregate $3,000.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Policy: Professional Liability Policylit: PPAC 5154680 16 Carder :Great American Alliance Insurance Company Policy Term: 10/01/2020-10101/2021 Per Claim: $1,000,000 /Aggregate: $3,000,000 The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as named additional insured with respect to the operations of the named insured. Workers Compensation coverage is evidence only. Written notice shall be provided at least ten It 0) days in advance of cancellation for non-payment of premium and thirty (30) days in advance for any other cancellation or policy change. City of Santa Ana Risk Management Division, 20 Civic Center Plaza, 4th floor Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. A'UT11HORIZEDREI UT' 1-\4601 © 1988-2015 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 41yp1.-AsT" [CREVIEWED & D APPROVED BI q ' rMUhYiNa[ >Q, VilliNSGf4 Risk Management Analyst Named Insured: Orange County Conservation Corps Policy number: PAC 515468016 Effective date:10/1/2020 CG 20 26 (Ed. 04 13) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name of Additional Insured Person(s) or Organization(s): The City of Santa Ana, its officers, employees, agents, volunteers and representatives Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. in the performance of your ongoing operations; or 2. in connection with your premises owned by or rented to you. However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III - LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: 1. required by the contract or agreement; or Copyright, ISO Properties, Inc., 2012 CG 20 26 (Ed. 04/13) (Page 1 of 2) RiskMouganadElMsWn RentwED&AR ayscl Rr: ice+. ® Risk Management Analyst 2. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Copyright, ISO Properties, Inc., 2012 CG 20 26 (Ed. 04/13) (Page 2 of 2) Risk Mmugeme tDMsm REV EWER & APPROVED BY. `� R6k Manzg,m,MAnzlyal A o� CERTIFICATE OF LIABILITY INSURANCE DAM IMMI2020Y() 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 entlorsement(s). PRODUCER Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. LIC# 0726293 1255 Battery Street #450 San Francisco CA 94111 CONTACT PHONE FAX c a ac Na: ADDRESS: INSUREMS AFFORDING COVERAGE NAIC# INSURERA: NonProfts' United Workers' Com ensation Group INSURED NONPUNI-01 Orange County Conservation Corps 1853 North Raymond Avenue INSURERS: SafetyNational CasualtyCorporation 15105 INSURERC: Response IndernMy Company of California 10970 INSURER D : Anaheim, CA 92801 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1153230747 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 TYPE OF INSURANCE AOOL SUBR POLICYNUMBER POLICY EFF MMIDD/YYYY POLICY UP MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY E71OCCUR EACH OCCURRENCE $ DA N ED CLAIMS -MADE PREMISES Ea commerce) $ MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GENT AGGREGATE U MIT APPLIES PER: POLICY E PRO- ECT ❑ LOC GENERALAGGREGATE $ PRODUCTS-COMP/OPAGG $ $ OTHER: AUTOMOBILELIBWTY COMBINED SINGLE LIMIT Ea assistant $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS (Per accident) BODILY INJURY (P$ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Falsest ent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DEAD RETENTION$ $ A WORKERS ANDEMPLOYERS-LIABI,ON LIITY YIN NPU-WCG 001-2021 V7/2021 1/1/2022 X STATUTE OERH- E.L. EACH ACCIDENT $500,000 ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED4 NIA E.L. DISEASE - EA EMPLOYEE $500,000 (Mandatary in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $500.000 DESCRIPTION OF OPERATIONS helm C B XSWC - Buffer Layer XSWC ABL1000013-00 SP4064079 1/1/2021 1/1/2021 1/1/2022 1/1/2022 XS of$50g000 XS of$75g000 XS of $75g000 $250,000(EL B WC) $2,000,000(EL) Statutory (WC) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space is required) City of Santa Ana 20 Civic Center Plaza 4th Floor Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE ©1988-2015 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD _ e Risk ManagealterdDilvion i�rYv^iN k% REVIEWp SppAPtPIRO�V�ED By. FU4.&n �r r'. V�i,ci✓trA.c `® Risk Management Analyst 01