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HomeMy WebLinkAboutPROTECTION AMERICA, INC. (5)INSURANCE NOT ON FIL WORK MAY NOT PROCEEI MAYOR CLERK OF COUNCIL Vicente Sanniento MAYOR PRO TEM DATE: Phil Bacerra COUNCILMEMBERS Johnathan Ryan Hernandez Jessie Lopez Nelida Mendoza David Penaloza Thai Viet Phan CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY MAY 0 3 2022 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 wvew.santa-ana.ora p : WA (TewA C) (Av) fif March 29, 2022 Protection America, Inc. Attn: Ed Clay 21350 Nordhoff Street, #104C Chatsworth, CA 91311 Re: Extension of Agreement #A-2021-080 Dear Mr. Clay: A-2021-080-02 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez Pursuant to Section 3 ("Term") of Agreement No. A-2021-080 ("Agreement'), entered into by Protection America, Inc. and the City of Santa Ana dated June 1, 2021, the parties hereby agree to extend the potential end date of the Term of the Agreement out to June 30, 2022. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. Sincerely, PROTECTION AMERICA, INC. Steven Mendoza Ahmed Ali Executive Director, Chief Executive Officer Community Development Agency CITY OF SANTA ANA: stine Ridge City Manager APPROVED AS TO FORM: Sonia R. Carvalho CityAttorney Ryau'�01 14odge Assistant City Attorney Vicente Sommers Phil Became Thai Viet Phan Mayor Mayor Pm Tom, Wool 4 Want 1 ,earanienloseasame-amore mramma(otambeamere Whanadsanle-ana.ore Clerk of the Council SANTA ANA CITY COUNCIL Dowd Penaloza Jessie Lopez JohnaNan Ryan Hernandez Nation Mendoza Wad Ward Word Wed doenabzeraamoteamose IessielooeaIDsanW-ana om INonhemandez®sans-ana.om tl to 1 oiga ly munm by mn Tori Pierson M'W" xoxz0a.xa /- N PROTE24 OP ID: RR '4`� CERTIFICATE OF LIABILITY INSURANCE DATE 022 oan 5nozz 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 endorsemen s . PRODUCER 877-242-9600 Central Insurance Agency, Inc. 93 East Main Street Smithtown, NY 11787 George Gavaris CONTACT Central Insurance Agency, Inc PHONE 877-'lag-9600 FAX 877-243-8995 A/C, No, EXt : AIC, No E-p AIL INSURERS) AFFORDING COVERAGE NAIC N INSURER A: Employers Compensation Ins. 11512 JNSURED "isPPO#11PO#1. ion America Inc.20313 P INSURERB; PeleusInsurance Company 34118 INSURER C: Sentinel Insurance Company11000 21350 Nordhoff St # 104C Chatsworth, CA 91311 United Financial Casualty INSURER 0: Y 11770 NSUREft E: NSURER F: COVERAGES CERTIFICATE NUMBER- RFVIRlnN MIIMRPR- 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 TYPE OF INSURANCE DOL NSD UBR Mn POLICY NUMBER POLICY EFF 09119/2021 POLICY EXPIJJL 09/1912022 LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR Errors & Omission X X GLV0001152 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED Ea occurrence) 100,00PREMISES $ X X GEN'LAGGREGATE MEO EXP An one erson 5,000 Assault & Battery PERSONAL 8 AOV INJURY 1,000,000 LIMITAPPLIES PER: POLICY JELQT LOC OTHER: GENERALAGGREGATE 2,000.000 PRODUCTS-COMP/OP AGO 2,000,000 D AUTOMOBILE X X LIABILITY ANY TO OWNED OWNED SCHEDULED AUTOS ONLY AUTOS U����OppWN pp ONLY 041698621 04108/2022 10/08/2022 COMBINED SINGLE LIMIT 1 000 000 BODILY INJURY Per erson BODILY INJURY Per accitlenl QAMAGE IOaciiATOS UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED F I RETENTION$ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE YIN Wan'SERIMEMggEqq E%CLUDEDP �Y (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA EIG2562084-04 11/06/2021 11/0612022 X PERTUTE OTH- E.L EACH ACCIDENT 1,000,000 E.1- DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMITC 1,000,000 Property 91SBAVL2993 04/26/2021 0412612022 Contents 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS [VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) See page 2 for additional information CTYSTAN City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 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 REPRESENTATIVE n"'s, RbrkMeugenvdIXWdon L7Jf i.., `g RenLv�eAmeax�8r. ACORD 25 (2016103) ©1988-2015 ACORD CC"----"�-" The ACORD name and logo are registered marks of ACORD NOTEPAD: HOLDER CODE CTYSTAN PROTE24 PAGE u INSURED'S NAME Protection America Inc. OP ID: RB Data 04/15/2022 City of Santa Ana, officers, agents, employees, and volunteers are included as an additional insured on a primary and non- contributory basis under the general liability with respect to the liability created by the negligent acts, errors and omissions of the named insured herein as required by written contract. The General Liability includes a waiver of subrogation as required by written contract. Rbkmw%g dDvhlm RenEwFn i AmS'NeJ Sr. -` ' h %ti �icwarc POLICY NUMBER: GLV0001152 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Automatic Status Included Where Required by Written Automatic Status Included Where Required by Written Contract. Contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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" or "property dam- age" caused, in whole or in part, by "your work' at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". Rhk Glo gm avian Ren 4Arrawm ' %a+L l%rtweK 9 Ulmrsxxrt,,,see„e,.am�iaae . CG 20 37 07 04 © ISO Properties, Inc., 2004 POLICY NUMBER: GLV0001152 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any Person or Organization for whom the insured, prior to a claim, occurrence or incident for which the insured could reasonably expect a claim or occurrence to arise, was required via written agreement or contractual obligation, to waive such rights. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Pt.k�togm�ea.®� (�, I�+neym6 NrkwmBr: %u �!iGsaan Ruk Maru9emm[Clmcal Patle CG 24 04 05 09 © Insurance Services Office, Inc., 2008 POLICY NUMBER: GLV0001152 COMMERCIAL GENERAL LIABILITY CIGL 79 03 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 6'Z04*11l111= Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Automatic Status Included Where Required by Written Contract. Automatic Status Included Where Required by Written Contract. Additional Information: 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 or organization shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your operations for the additional insured at the location shown in the Schedule. However: a. The insurance afforded to such additional insured only applies to the extent pern IN Md'4 fi b. If coverage provided to the additional insured is required by a contract or at. 1 'j-y _, =ns== CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc 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; and c. Regardless of the date of occurrence or when the injury or damage first occurs or is first discovered, a person's or organization's status as an additional insured under this endorsement ends upon the earliest of: (1) The completion or termination of the contract or agreement between you and the additional insured for the location shown in the Schedule; (2) The date you cease actively performing operations for the additional insured at the location shown in the Schedule; or (3) The expiration or termination date of the policy or this endorsement. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to liability or damages for "bodily injury", "property damage', or "personal and advertising injury": 1. Caused by, arising from, or included in the "products -completed operations hazard"; 2. Arising out of the additional insured's sole negligence; 3. Arising out of work or operations performed by you that were completed prior to the effective date of this endorsement; or 4. Which continues or progressively deteriorates after you cease actively performing operations for the additional insured at the location shown in the Schedule, even if the injury or damage first occurred, or is alleged to have first occurred, during the course of your operations for the additional injured. C. Solely for purposes of this endorsement, the following definition is deleted in its entirety and replaced by the following: 1. ""Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed; (b) When all of the work to be done at the location shown in the Schedule has been completed if your contract calls for work at more than one location; or (c) When that part of the work done at the location shown in the Schedule has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. D. 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 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. xskwogR,�onm�R I�+nenm6 Mrxw®Bv: Risk Mnw tUffl PIA e CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. 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. Schedule Person or Organization Job Description With respect to all employees subject to the workers' compensation laws of the state of California, any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation 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.) This endorsement, effective 11/06/2021 Policy No. EIG 2562084 04 Issued to PROTECTION AMERICA INC at 12:01 AM standard time, forms a part of Of the EMPLOYERS COMPENSATION INS. CO Carrier Code 00441 Endorsement No. Premium Countersigned at on By: Authorizt (',�' 3�1 „J�• %u �rrWex WC 04 03 06 GWR RkkMa qe lamr ll de (Ed. 4-84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights re: _ _