HomeMy WebLinkAboutDEVORA LEMUS (3)INSURANCE ON FILE
WORK MAY PROCEED N-2021-010-02
o UNTIL INSURANCE EXPIRES
o CLERK OF COUNCIL SECOND AMENDMENT TO UTILITY BOX ART PROGRAM
DATE: ARTIST AGREEMENT
THIS SECOND AMENDMENT TO UTILITY BOX ART PROGRAM ARTIST AGREEMENT is
made and entered into this 231d day of March, 2021, by and between the City of Santa Ana, a
charter city and municipal corporation, organized and existing under the Constitution and laws
rn of the State of California ("City"), and Devora Lemus ("Grantee").
L-M) co) 3,-" RECITALS
A. City and Grantee entered into Arts and Culture Artist Grant Program Agreement
number N-2021-010, dated November 6, 2020, for the purpose of providing grant
funding pursuant to the Utility Box Art Program ("said Agreement').
B. City and Grantee entered into a First Amendment to said Agreement dated
Janurary 15, 2021, for the purpose of extending the Term of said Agreement until
June 30, 2021
C. In accordance with the terms and conditions of said Agreement, the parties
desire to amend Section C — Project, Subsection 1, to extend said Agreement
until June 30, 2022.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terms and conditions of said Agreement, except as herein modified, the parties agree as
follows:
Section C, Project, Subsection 1, shall be amended to read as follows:
"Artist will paint the utility box assigned to them by the City, and nothing more.
Painting of the box must be completed by June 30, 2022. Painting may only
occur during the hours of 7 a.m. to 7 p.m. A minimum sidewalk clearance of four
(4) feet must be adhered to at all times."
2. Except as hereinabove modified, all terms and conditions of said Agreement
shall remain in full force and effect.
Page 1 of 2
N-2021-010-02
IN WITNESS WHEREOF, the Parties have executed this Second Amendment to Utility Box
Art Program Artist Agreement the date and year first above written.
ATTEST:
DAISY GOMEZ
Clerk of the Council
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By. V ✓��,
Ryan,0. Hodge
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
STE�NDO A
Executive Director
Community Development Agency
CITY OF SANTA ANA
KRISTINE RIDGE
City Manager
t4V
Page 2 of 2
Burns &
Wilcox
Francine R uigltallyslgneaby
Francine R. Villareal
Villareal Date: 2021.04.15
17:28:21-07'00'
101 California Street, Suite 975, San Francisco, CA 94111
Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620
DATE:4/7/2021 INSURANCE BINDER Pagel of
THIS BINDER IS ATEMPORARY INSURANCE CONTRACT, SUBJECTTO THE CONDITIONS SHOWN BELOW.
INSURED: City of Santa Ana B&W PRODUCER: Richard L Gobler
AGENT: MERRIWETHER & WILLIAMS INS
20 Civic Center Plaza 550 Montgomery St Ste 550
Santa Ana, CA 92701 San Francisco, CA 94111
LOCATION(S) OF RISK:
1. Bristol and Santa Clara Ave, Santa Ana, CA 92706
2. Bristol Street and 19th Street, Santa Ana, CA 92704
3. Bristol Street and Washington Avenue, Santa Ana, CA 92706
4. Bristol Street and Civic Center Drive, Santa Ana, CA 92703
5. Bristol and St Andrew PI, Santa Ana, CA 92704
6. Bristol Street and McFadden Avenue, Santa Ana, CA 92707
7. Bristol Street and Wilshire Avenue, Santa Ana, CA 92704
8. Bristol Street and Edinger Avenue, Santa Ana, CA 92704
9. Main Street and Civic Center Drive, Santa Ana, CA 92701
10. Flower Street and Alton Avenue, Lillie King Park, Santa Ana, CA 92707
11. First & Main, Santa Ana, CA 92701
12, 3rd & Main, Santa Ana, CA 92701
13, 4th & Main, Santa Ana, CA 92701
14. 3rd & Broadway, Santa Ana, CA 92701
15. 4th & Broadway, Santa Ana, CA 92701
16. 5th & Broadway, Santa Ana, CA 92701
17. 4th & Bush, Santa Ana, CA 92701
18. Grand & Dyer, Santa Ana, CA 92705
19. Main & McFadden, Santa Ana, CA 92707
20. 17th & Centre on 17th, Santa Ana, CA 92705
21. Bristol & 17th, Santa Ana, CA 92706
22. Main St and St. Gertrude PI, Santa Ana, CA 92704
23, Bristol & 1st, Santa Ana, CA 92703
24. Harbor & McFadden, Santa Ana, CA 92704
25. 1st & Downtown Plaza, Santa Ana, CA 92704
26. Main St & Washington, Santa Ana, CA 92704
27. Raitt& MacArthur, Santa Ana, CA 92704
28. Flower St & Bishop, Santa Ana, CA 92704
29. Greenville & Alton, Santa Ana, CA 92704
POLICY EFFECTIVE FROM: 04/12/2021 AT 12:01 AM TO 12/01/2021 AT 12:01 AM STD TIME AT RISK LOCATION.
FORM OF COVERAGE: COMMERCIAL GENERAL LIABILITY OCCURRENCE
POLICY NO: CIP423636
INSURER(S):
Line Of Business Supplier(s) Agreement Number Participation
Commercial General Liability Alain Specialty Insurance Company 100.00 %
-kz "MunegementDl AIM
REVIEWED & APPROVED BY:
Ii:4F,rnaaF
MMEW RBk Management Analyst
Burns&
Wilcox
DATE: 4/7/2021
101 California Street, Suite 975, San Francisco, CA 94111
Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620
INSURANCE BINDER Page 2 of 4
LIMITS / DEDUCTIBLES:
Loc Sub Coverage
1 General Aggregate
1 Products and Completed Operations
1 Each Occurrence
1 Personal and Advertising Injury
1 Medical Expense / Any One Person
1 Damage to Premises Rented to You / Each Occurrence
TOTAL CHARGES:
Premium: $
Fee: $
Tax: $
Tax: $
TOTAL: $
EXCLUSIONS:
600.00 Commercial General Liability
200.00 Brokerage Fee (Fully Earned)
1.50 Stamping Tax
18.00 Surplus Lines Tax - GenLiab
819.50
SEE "ENDORSEMENTS' SECTION BELOW / NEXT PAGE
ENDORSEMENTS:
Limit(s) Deduct!
$2,000,000
$2,000,000
$1,000,000 $500
$1,000,000
$5,000
$100,000
Per Claim BI/PD
100% MINIMUM & DEPOSIT
MINIMUM RETAINED PREMIUM:
100.00 % EARNED
MINIMUM PREMIUM = $600.00
Co Ins
&s c RlekMamge LDW!un
t? GREVIEWED&APPROVED BY:
��� pI �oa+.rM.a P1, V1.4�tnas,E
45=- Risk Management Analyst
Burns &
Wilcox
101 California Street, Suite 975, San Francisco, CA 94111
Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620
DATE: 4/7/2021 INSURANCE BINDER Page 3 of 4
**ENDORSEMENTS & EXCLUSIONS:
UNLPFD1 - COMMON POLICY DECLARATIONS.
AF001772 -CLAIM REPORTING INFORMATION.
AF100 - POLICY JACKET.
AF3380 - FRAUD & MISREPRESENTATION ENDORSEMENT.
AF3550 - MINIMUM EARNED PREMIUM & CANCELLATION CLAUSE.
AF900 - SERVICE OF SUIT.
IL0017 - COMMON POLICY CONDITIONS.
SOFAE -SCHEDULE OF FORMS & ENDORSEMENTS.
AF000839 -INJURY TO EMPLOYEES, SUBCONTRACTORS, INDEPENDENT CONTRACTORS, TEMPORARY WORKERS,
LEASED WORKERS OR VOLUNTEERS EXCLUSION.
AF001007 - COMBINED COVERAGE & EXCLUSION ENDORSEMENT: ASBESTOS EXCLUSION; LEAD EXCLUSION;
CONTRACTOR'S SPECIAL CONDITIONS; EMPLOYMENT RELATED PRACTICES EXCLUSION; NUCLEAR ENERGY LIABILITY
EXCLUSION; PROFESSIONAL SERVICES AND MALPRACTICE EXCLUSION; SEXUAL / PHYSICAL ABUSE EXCLUSION;
TOTAL POLLUTION EXCLUSION WITH HOSTILE FIRE EXCEPTION; ASSAULT & BATTERY EXCLUSION; ANTI -STACKING
AND NONDUPLICATION OF LIMITS OF INSURANCE; TENDERING OF APPLICABLE LIMIT OF INSURANCE.
AF001396 -INFRINGEMENT, MISAPPROPRIATION AND UNFAIR COMPETITION EXCLUSION.
AF001707 -AMENDMENT OF NONPAYMENT CANCELLATION CONDITION.
AF001729 -CONDITIONAL EXCLUSION OF LIABILITY/CLAIMS IN THE STATE OF MISSOURI -ONLY APPLIES IF MISSOURI
IS PRINCIPLE PLACE OF BUSINESS OR RISK CONDUCTS MORE THAN 10% OF OPERATIONS IN MISSOURI.
AF001752 -AMERICANS WITH DISABILITIES ACT AND DISCRIMINATION EXCLUSION.
AF3378 - AMENDATORY ENDORSEMENTS: CANCELLATION, CANCELLATION OF FINANCED POLICY, AUDIT
CONDITIONS.
AF3400 - SILICAOR SILICARELATED DUST EXCLUSION.
UNLPFSD1L -COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS.
AF001788 -TOTAL CANNABIS AND RELATED PRODUCTS EXCLUSION.
CG0001 - COMMERCIAL GENERAL LIABILITY COVERAGE FORM - CG0001 04-13.
CG2107 -ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY
EXCLUSION.
CG2167 -FUNGI OR BACTERIA EXCLUSION ((DOES NOT APPLY TO GOODS OR PRODUCTS INTENDED FOR BODILY
CONSUMPTION).
CG2426 -AMENDMENT OF INSURED CONTRACT DEFINITION.
AF001401 -DAMAGE TO PREMISES RENTED TO YOU LIMITATION -FIRE LEGAL LIABILITY COVERAGE.
AF000873 -KNOWN INJURY OR DAMAGE EXCLUSION FOR PERSONAL & ADVERTISING INJURY.
AF000899 -CLARIFICATION AMENDMENT TO POLICY AIRCRAFT, AUTO OR WATERCRAFT EXCLUSION.
D2 -CALIFORNIA SURPLUS LINES NOTICE.
CAPRNOTICE -CALIFORNIA PREMIUM REFUNDS NOTICE -POLICIES CANCELED BY INSURED MAY INCUR A 10%
SHORT RATE PENALTY.
CG3234-CACHANGES.
AF001740 -DESIGNATED OPERATIONS- STATE OF NEW YORK EXCLUSION.
AF001741 -DESIGNATED OPERATIONS -STATE OF WASHINGTON EXCLUSION.
AF33509 - ASSAULT & BATTERY EXCLUSION REMOVAL (ENDORSEMENT TO REMOVE A&B EXCLUSION).
AF33510 -CLASSIFICATION LIMITATION.
AF33515A - NEW RESIDENTIAL CONSTRUCTION EXCLUSION.
AF33530 -SUBSIDENCE EXCLUSION.
AF3397 - EIFS EXCLUSION & DRYWALL EMISSION EXCLUSION.
CG0300 -DEDUCTIBLE LIABILITY.
"CG2144 -LIMITATION OF COVERAGE TO A DESIGNATED PREMISES / PROJECT
PROJECT: ELECTRICAL / UTILITY BOX PAINTING FOR CITY OF SANTA ANA """
CG2154 - OCIP/WRAP-UP EXCLUSION.
CG2503 -PER PROJECT AGGREGATE:*** TYPIST INCLUDE THE FOLLOWING WORDING: "LOCATIONS AS REQUIRED
BY SPECIFIC WRITTEN CONTRACT" ***
AF001397 -BLANKET PRIMARY & NON CONTRIBUTORY WORDINGJYPING -ADD THE FOLLOWING WORDING TO
FORM: "ANY PARTY FOR WHOM THE INSURED IS PERFORMING SERVICES, AT A SPECIFIED PROJECT SET FORTH IN A
WRITTEN CONTRACT, THAT: (1) HAS BEEN SIGNED BY ALL PARTIES, INCLUDING THE NAMED INSURED AND THE PARTY
SEEKING COVERAGE UNDER THIS ENDORSEMENT: AND (2) HAS BEEN ENTERED INTO BEF Q JAc
Risk Mawgan�enL Division
REVIEWED& APPROVED By.
Risk Managelmnt Analyst
Burns &
Wilcox
101 California Street, Suite 975, San Francisco, CA 94111
Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620
DATE: 4/7/2021 INSURANCE BINDER Page 4 of 4
OCCURRED."]
"CG2010 -ADDITIONAL INSURED OWNER, LESSEES OR CONTRACTOR.
ENTITY NAMES AS All: "" ALL ARTISTS PAINTING ELECTCIAL / UTILITY BOXES FOR CITY OF SANTA ANA
CG2033 - BLANKET ADDITIONAL INSURED - WHEN REQUIRED BY AGREEMENT - DO NOT USE WITH CG2139.
CG2404 -BLANKET WAIVER OF SUBROGATION (ADD THE FOLLOWING WORDING TO FORM) "ANY PERSON OR
ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH
AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS ").
CONDITIONS:
QUOTE BASED ON ONE MULTI BOX PROJECT AT A FLAT RATE OF $600.00 - MINIMUM PREMIUM APPLIES.
1 All INCLUDED FOR THE CONTRACTORS.
PLEASE REVIEW THIS BINDER CAREFULLYAS IT MAY DIFFER FROM COVERAGES AND LIMITS REQUESTED.
THIS COMPANY BINDS THE KIND(S) OF INSURANCE STIPULATED HEREIN. THE ABOVE COVERAGES ARE THE ONLY COVERAGES BOUND.
ANY COVERAGE REQUESTED IN THE APPLICATION THAT DIFFERS FROM THE ABOVE IS NOT INCLUDED. THE INSURANCE IS SUBJECT TO
THE TERMS, CONDITIONS, LIMITATIONS, AND FORMS OF THE POLICY(S) IN CURRENT USE BY THE COMPANY. THIS BINDER IS
CANCELLED SIXTY (60) DAYS FROM THE EFFECTIVE DATE OR WHEN REPLACED BYA POLICY, WHICHEVER COMES FIRST.
THEAGENT MUST READ THIS CERTIFICATEAND IF NOT CORRECT RETURN IT IMMEDIATELY TO BURNS & WILCOX, LTD.
BY: Harvey Goldenberg, Authorized Representative (CA INS LIC # 0828615)
rtmtDhisim
_AR R �D&APaeovm Br.
` Risk Management Analyst
101 California Street, Suite 975, San Franolsoo, CA 94111
Phase: (415) 421.4244 OR (800) 759-4865 Fax; (415) 421.0620
DATE: 11119/2020 NSURA]NCE BINDER Page 4 of 4
QUOTE BASED ON ONE MULTI BOX PROJECT AT FLAT RATE
MINIMUM PREMIUM APPLIES
NO ARS INCLUDED,
PLEASE REVIEW THIS BINDER CAREFULLYAS IT MAY DIFFER FROM COVERAGES AND LIMITS REQUESTED,
THIS COMPANY BINDS THE KIND(S) OF INSURANCE STIPULATED HENEIN, THE ABOVE COVERAGES ARE THE ONLY COVERAGES BOUND,
ANY COVERAGE REQUESTED IN THE APPLICATION THAT DIPPERS FROM THE ABOVE IS NOT INCLUDED, THE INSURANCE IS SUBJECT TO
THE TERMS, CONDITIONS, LIMITATIONS, AND FORMS OF THE POLICY($) IN CURRENT USE BY THE COMPANY. THIS BINDER IS
CANCELLED SIXTY (60) DAYS FROM THE EPPECTIVE DATE OR WHEN REPLACED BY A POLICY, WHICHEVER COMES FIRST,
THEAGENT MUST READ THIS CBRTIFICATEANOIF NOT CORRECT RETURN IT IMMEDIATELY TO BURNS & WILCOX, LTD.
BY: Harvey Goldenberg, Authorized Representative (CA INS LIC # 0628615)
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