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HomeMy WebLinkAboutJOHN ROBINSON CONSULTING, INC. (2)N-2021-019-01 MAYOR Vicente Sanniento MAYOR PRO TEM Phil Bacerra COUNCILMEMBERS Johnathan Ryan Hernandez Jessie Lopez Nelida Mendoza David Penaloza Thai Viet Phan iNSURANCE ON FILE WORK MAY PROCEED UNIT m `I �`•�C o51ogfUvL CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza . P.O. Box 1988 Santa Ana, California 92702 wwW.santa-ana.om December 14, 2021 d, c� )c� ) il a� µ Z W John Robinson Consulting, Inc. 1055 East Colorado Blvd, Suite 500 Pasadena, CA 91106 Attn: Mr. John Robinson Re: Extension of Agreement No. N-2021-019 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by John Robinson Consulting, Inc., and the City of Santa Ana, dated January 18, 2021, the time period of the Agreement is hereby extended for an additional one-year period, from January 1, 2022 through December 31, 2022. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely 11,`II' C. Gy-L n Nabil Saba, P.E. Executive Director, Public Works Agency CITY OF SANTA ANA -�� Z44 Kristine Ridge City Manager APPROVED AS TO FORM Sonia R. Carvalho City Atto ey LBrAndon Salvatierra Deputy City Attorney ATTEST CONSULTANT SANTA ANA CITY COUNCIL Vicente 6armlento Phil Bacerra That Viet Phan David Penaloza Jessie Lopez JohneNan Ryan Nemandez Notice Mendoza Mayor Mayor Per Tam, Ward 4 Wadi Ward Wad Ward Wad6 veannientordlsanta-anaom ploacertsadeanlai am tph.onan laanaom doenalozaAsanta-ana am sielaoeadheirpta-,in,am nyinheraisp 615anta-ana am mendozadsanta-anaoro Francine K. Villareal vua,esl Dace:2021ns.2008:03:5 -07W A� �® CERTIFICATE OF LIABILITY INSURANCE DAM(MMI02 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 endorsements). PRODUCER AssuredPartners of Washington, LLC A/E Insurance Services CONTACT Allison Bar a CA Lic # OK93926 PNAME HONE Fax a Ert, 360-626-2007 aC No:360-598-3703 No. 19660 10th Ave NE ADDRESS: allison.barga@assuredpartners.com Poulsbo WA 98370 INSURER(S) AFFORDING COVERAGE NAIC9 INSURERA: Underwriters at Lloyd's, London/AEGIS INSURED 26221 John Robinson Consulting Inc 1055 East Colorado Blvd Suite 500 INSURER B: RLI INSURANCE COMPANY 13056 INSURERC: INSURER D: Pasadena CA 91106 INSURER E : _ INSURER F : COVERAGES CERTIFICATE NUMBER: 1340530486 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 ADDLSUBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR PSB0009419 5/9/2021 5/9/2022 EACH OCCURRENCE $1,000,000 DAMAGERENTED Ea PREMISESS occurrence $1,000,000 MED EXP (Any one person) $10,000 PERSONAL S ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: � JECOT1:1 LOG GENERAL AGGREGATE PRODUCTS-COMP/OP AGOOTHER: B AUTOMOSILELIABILITY PSBOOD9419 5/9/2021 5/9/2022 COMBINED SINGLE LIMIT Ea accidentANY BODILY INJURY(Per parson) rs2,000,000POLICY AUTO OWNED SCHEDULED ONLY AUTOS BODILY INJURY Per accidentAUTOS ( 1X HIRED X NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGEAUTOS Per accident B1-1 UMBRELLA LIAR X OCCUR PSE0004657 5/9/2021 5/9/2022 EACH OCCURRENCE $3,000,000 X AGGREGATE $3,000,000 EXCESS WAB CLAIMS -MADE IED I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED'! NIA PSW0005179 5/9/2021 5/9/2022 X SEATUTE EORH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatary in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 A Professional Lam: Claims Made 1525/20U10119/109 5/9/2021 5/9/2022 $2,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: Revision to the City's Recycled Water Master Plan Agreement #N-2021-019 the City, its officers, employees, agents, volunteers and representatives are an additional insured per the attached. 30 day notice of cancellation applies per the attached. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza, 4th Floor AUTHORIZED REPRESENTATME Santa Ana CA 92701 / Z 7_ 4 j% gs xWrMe,.ganaduMerwt (� Y"'^ F REVIEWED & APPROVED Br. ©1988-2015 ACORD Ci F4+� P, vt[uwl ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ®' Risk Management Analyst Policy Number: PSB0009419 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack° HIRED AUTO AND NON -OWNED AUTO LIABILITY This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Schedule Coverage Additional Premium Limit of Insurance A. Hired Auto Liability $ 100 $ 1,000,000 Per Occurrence B. Non -owned Auto Liability $ Included $ 1,000,000 Per Occurrence A. Insurance is provided only for those coverages for which a specific premium charge is shown in the Declarations or in the Schedule. 1. Hired Auto Liability The insurance provided under Paragraph A.1. Business Liability in SECTION II — LIABILITY applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. 2. Non -owned Auto Liability The insurance provided under Paragraph A.I. Business Liability in SECTION II — LIABILITY applies to "bodily injury" or "property damage" arising out of the use of any "non -owned auto" in your business by any person. B. For insurance provided by this endorsement only: 1. The exclusions under Paragraph B.1. Appli- cable To Business Liability Coverage in SECTION II — LIABILITY, other than Exclusions a., b., d., f. and I. and the Nuclear Energy Liability Exclusion, are deleted and replaced by the following: a. "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or PPB 321 11 10 (2) The spouse, child, parent, brother or sister of that "employee" as a conse- quence of Paragraph (1) above. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages because of injury. This exclusion does not apply to: (1) Liability assumed by the insured under an "insured contract"; or (2) "Bodily injury" arising out of and in the course of domestic employment by the insured unless benefits for such injury are in whole or in part either payable or required to be provided under any work- ers' compensation law. b. "Property damage" to: (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. 2. Paragraph C. Who Is An Insured in SECTION II — LIABILITY is replaced for the purposes of this endorsement by the following: 1. Each of the following is considered an insured to the extent that it is: a. You; EWWm Ai Rov®vieicn �'. - Rat Management Analyst Policy Number: PSB0009419 RLI Insurance Company b. Any other person using a "hired auto" C. Limit of Insurance with your permission; The Limit of Insurance under this endorsement is c. For a "non -owned auto": shown in the schedule above. The Limit of Insurance (1) Any partner or "executive officer" of will apply separately to each "occurrence" resulting from Hired Auto Liability or Non -owned Auto yours; or Liability. For Hired Auto Liability and Non -owned (2) Any "employee" of yours; Auto Liability covered by this endorsement, the Limit but only while such "non -owned auto" is of Insurance is the most we will pay for the total of all "occurrence" being used in your business; and damages resulting from any one regardless of the number of: d. Any other person or organization, but a. Insureds; only for their liability because of acts or omissions of an insured under a., b. or b. "Autos"; c. above. c. Claims that are made or "suits" that are brought; However, none of the following is an or insured: d. Persons or organizations making claims or a. Any person engaged in the business of bringing "suit". his or her employer for "bodily injury" to D. For the purposes of this endorsement only, Para - any co -"employee" such person in- graph H. Other Insurance in SECTION III — COM- thed in the course off employment, or to MON POLICY CONDITIONS is replaced by the. the spouse, child,parent, brother or sis- following: ter of that co -"employee" as a conse- quence of such "bodily injury", or for any This insurance is excess over any other valid and obligation to share damages with or re- collectible insurance, whether primary or excess, pay someone else who must pay dam- covering the "hired auto" or "non -owned auto". ages because of the injury; E. The following additional definitions apply: b. Any partner or "executive officer" for any 1. "Auto business" means the business or occu- "auto" owned by such partner or officer pation of selling, repairing, servicing, storing or or a member of his or her household; parking "autos". c. Any person while employed in or otherwise engaged in duties in y, "Hired auto" means any "auto" you lease, hire, connection with a"auto business", rent or borrow. This does not include any "auto" other than an "auto to business" you you lease, hire, rent or borrow from any of your operate; "employees", your partners or your "executive officers" or members of their households. d. The owner or lessee (of whom you are a sublessee) of a "hired auto" or the 3. "Non -owned auto" means any "auto" you do not owner of a "non -owned auto" or any own, lease, hire, rent or borrow which is used in agent or "employee" of any such owner connection with your business. This includes or lessee; or "autos" owned by your "employees", your partners or your "executive officers", or e. Any person or organization for the con- members of their households, but only while duct of any current or past partnership used in your business or your personal affairs. or joint venture that is not shown as a Named Insured in the Declarations. PPB 321 11 10 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Risk Mogment ern AePRov®)ft 't Risk Management Analyst WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Person or Organization Schedule Job Description All persons or organizations that are party to a contract that Jobs performed for any person or organization that you requires you to obtain this agreement, provided you executed have agreed with in a written contract to provide this the contract before the loss. agreement. 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 05/0e12021 Policy No. PSW0005179 Endorsement No. Insured John Robinson Insurance Company RLI Insurance Company Countersigned By ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Risk Visism REmEwED ® APPRov Fo� P1, V:LG'nal ® Ru k Management Analyst Policy Number: Pseoo094i9 RLI Insurance Company Named Insured: J.MR"bhnw THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack® FOR PROFESSIONALS BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM - SECTION II — LIABILITY C. WHO IS AN INSURED is amended to include as an additional insured any person or organization that you agree in a contract or agreement requiring insurance to include as an additional insured on this policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product -completed operations hazard". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this policy. b. This insurance does not apply to the rendering of or failure to render any "professional services". c. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. 3. The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION 11 — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an PPB 304 02 12 additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION III K. 2. Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO ONLY TO SECTION II — LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Ruk MvrgmwtDMdm LRtviE &A-PR,w By: �'. Ruk Management Malys[ Policy Number: Ps" 0009419 PSB0909419 PSW0005179 RLI Insurance Company Named Insured ohn R°bins^^ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack° NOTICE OF CANCELLATION OR NONRENEWAL — DESIGNATED PERSON OR ORGANIZATION Schedule Designated Person or Organization: City of Santa Ana Email Address: US Mail Address: Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 If we cancel or chose to nonrenew this policy for any reason other than nonpayment of premium we will provide written notice at least (3� days before the effective date of the cancellation or nonrenewal to the designated person or organization in the above schedule. Such notice will be sent via the US mail address or E-mail address listed above. Proof of mailing or e-mailing will be sufficient proof of notice. PPK 2108 05 11 Risk Meagamad y*I Milsr � Risk Management Analyst Ejhjubmmz!tjhofe!cz!Upsj!Qjfstpo! Ebuf;!3133/16/22!19;32;21! 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