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HomeMy WebLinkAboutVan Dorpe Chou Associates 1�2 AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Deputy Clerk of the Council (M-30). Call 647-6520 if you have any questions. -------------------------------------------------- ------ The agreement with ValA cl jQ �Qc1� — 6�3 � t` / Gft was completed on //t000 LV �_, and final payment has been made. R - 200 3 - 213 (IQ) Department Signature: Date: Revised 4-16-87 City of Santa Ana Clerk of the Council I/ NOTICE OF ASSUMPTION Re: Consultant Agreement A-2003-213 for Construction Inspection Services including building, mechanical, electrical and plumbing inspections. NOTICE IS HEREBY GIVEN by VCA Code Group to the CITY OF SANTA ANA (hereinafter referred to as the "City") as follows: I. Van Dorpe Chou Associates entered into Consultant Agreement N-2003-093, dated September 22, 2003, which was amended to increase compensation and renumbered A- 2003-213, dated October 6, 2003, to provide construction inspection services to the City; and 2. Said company formed VCA Code Group, with Dan Van Dorpe acting as the company's President. Service of Process will be to: VCA Code Group 295 N. Rampart Street, Suite A Orange, California 92868 facsimile 714/ 978-9788; and 3. VCA Code Group hereby agrees to honor the terms of the "Consultant Agreement A-2003- 213" dated October 6, 2003, described in Exhibit "A" attached hereto and by this reference made a part hereof; and 4. VCA Code Group hereby accepts and assumes the rights, liabilities and obligations of Van Dorpe Chou Associates under said Agreement, from and after the effective date of April 1, 2004; and 5. All required insurance documents and bonds shall be issued in the name VCA Code Group, and all payments by the City shall be made in the name of the corporation. DATED: VCA Code Group BY: , DAN VAN DORPE President TAX ID #02-0697917 The City of Santa Ana hereby acknowledges and accepts the terms outlined in this "Notice of Assumption" agreement. APPROVED TO FORM Joseph W. Fletcher CITY OF SANTA ANA City Attorney dztLp� `' ,a �� r z oY aura Sheedy STEVE HARD* 104 ON DAT Assistant City Attorney Executive Director of Planning c: Mfi c ZoeiwJ rid INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES 7-1-0 CLERK OF COUNCIL N-2003-093 rAn- 9 a 03 CONSULTANT AGREEMENT ( THIS AGREEMENT, made and entered into this A,�,2cday of 6 ( ek, 2003 by and between Van Dorpe Chou Associates, a California Corporation (hereinafter "Consultant"), 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 (hereinafter "City"). RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of construction inspections including building, electrical, mechanical and plumbing inspection. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SERVICES Consultant shall provide those services of a building, electrical, mechanical and/or plumbing inspector, all of who shall be employees of the Consultant and shall perform construction inspections and related duties. All work shall be in conformance with City policies and procedures. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services an hourly rate of $45.00. The total sum to be expended under this Agreement, shall not exceed $10,000.00 during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on June 30, 2004, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of Planning and Building Agency and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Consultant shall supply City with a fully executed additional insured endorsement in substantially the form attached hereto as Exhibit B upon execution of this Agreement and shall be approved in form by the City Attorney. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. f. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 telefacsimile (714) 647-6956 With courtesy copies to: Executive Director of Planning & Building Agency City of Santa Ana 20 Civic Center Plaza (M-20) and, P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 973-1461 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6515 To Consultant: VanDorpe Chou Associates, Inc. 295 N. Rampart Street, Suite A Orange, CA 92868 telefacsimile (714) 978-9788 Attn: Dan VanDorpe A party may change its address by giving notice in writing to the other party. Thereafter, any notice, tender, demand, delivery, or other communication shall be addressed and transmitted to the new address. If sent by mail, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement and all questions relating to its validity, interpretation, performance, and enforcement shall be government and construed in accordance with the laws of the State of California. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: PATRICIA E. HEALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorne1 i Assistant CiTy Attorney REC "MENDED FOR APPROVAL: CYN HIA J. N SON Deputy City Manager CITY OF SANTA ANA DAVID N. REAM City Manager CONSULTANT: Dan VanDorpe President 95--3S- 03►9 Employer ID # or Individual SS # _ VCA CODE GROUP 295 Rampart Street. Suite A Orange, California 92868 (714) 979.9780. FAX 978-9799 August 7, 2003 Mr. Steve Gutmann Planning & Building Agency CITY OF SANTA ANA P. O. Box 1988 Santa Ana, California 92702 Subject: Contract Building Inspector Dear Mr. Gutmann: In response to your stated need for a temporary Building Inspector, we propose to provide a qualified person, Mr. Roger Banowetz for this service. Mr. Banowetz has over twenty years of experience as a building inspector. Our fee for Mr. Banowetz's service is $ 45.00 per hour based upon an eight -hour per day, five days a week schedule. Work in excess of the normal hours will be billed at time and one-half in accordance with State labor laws. We understand that the City will provide a vehicle for Mr. Banowetz to perform inspections. However, if the City does not provide a vehicle, he will be reimbursed at a rate of $0.36 per mile. Attached for your information is the resume of Mr. Banowetz. If this proposal is acceptable to you, please advise as of when Mr. Banowetz, should report to work. Please let me know if you require any additional information or if we can be of any further assistance. Yours very truly, VCA CODE GROUP Dan Van Dorpe, PE, CBO (/ President Attachment 41HIBIT A EXHIBIT A ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy # Issued to this endorsement form as a part of Named Insured Countersigned by Authorized Representative -ACCORP. CERTIFICATE OF LIABILITY INSURANCE 09ioa%zoo ) PRODUCER (949)263-0606 FAX (949)263-0906 Complete Insurance, Inc. California DOI #0437762 19000 MacArthur Blvd., PH Flr Irvine, CA 92612-1447 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Van orpe Chou Associates, Inc. 295 North Rampart Street, Suite A Orange, CA 92869 INSURERA: Fidelity and Guarantee Ins. Co. INSURERS Fidelty & Guaranty Ins Co INSURERC: St. Paul Fire & Marine Ins Co INSURERD: (c/o St. Paul) INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR Lm DD' JimGENERAL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LIABILITY BKO1510223 07/01/2003 07/01/2004 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 500,00 CLAIMS MADE O OCCUR $ 10,00 MED EXP (Any one Person) A PERSONAL S ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY X JECTPRO- LOG AUTOMOBILE LIABILITY ANY AUTO BA01464SOO 07/01/2003 07/01/2004 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X B ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS APPROVED AS C0(i Y TO FORM BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X Deputy City Att TIOy PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY. AGO $ ANY AUTO $ EXCESS/UMBRELLA LIABILITY BKO1510223 07/01/2003 07/01/2004 EACH OCCURRENCE $ 1,000,00 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,0001 A $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WVA800469S 07/01/2003 07/01/2004 X I MySTA,,TUTS I OTH- C EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICERR.IEMBEREXCLUDED? If Yee. crifte under SPECIALS PROVISIONS below E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E. L. DISEASE -POLICY LIMIT $ 1,000,00 OTHER 10-day notice applies to non-payment and/or non -reporting DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ertificate holder is additional insured as respects general liability but only if required by written contract with the named insured prior to an occurence and as per coverage form CL/BF21810401. Waiver of Subrogation endt. WC040306 included as respects Work Comp only. Coverage subject to all policy terms, conditions and limitations. City of Santa Ana, and employees & volunteers Office of City Attorney P.O. Box 1988 Santa Ana, CA 92702 SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL its officers, agents, 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Alicia Igram/MICHMA /�_�`i�•• ``fQ'" ACORD 26 (2001108) ©ACORD CORPORATION 1988 w 0 O N (� OA'7 >4 a 00 Z .b N W � � .w O _ W O 0 ~ A P d y N r_ i B �'r y 79 Cu. bORQ C y p 3 o � � U O O O u q O C O a+ Wa OU O w b u u e p 0 R O �vOi! J F ' a° � W 0O .� A W R O y 3 a ° B o 4j u h O 0 w U"73 cd o y WO Op rl R a V a4J w r u Q R o V o a a� t h L W q u C U o a O R V a p ti R oa '0 V y y y H 0'A O O L a O q O '0 A O 0 Z ++ « + H W O u.n O. O N O Y O K i3 9.4 O I YO a 0 w 0 iV 0 'yam' 0. w 'O YJ C cRi ,A 'O p r� pv r.Nd m a O as ° 5 ud pOp 'O O %. C 'bto o V] o iy v ?E 0,U 'O R O 0 pp O O a O T.0 R O d b ° ° N° p9Tp P g 0.0 o '� « C O11 'O 00 O 0 ^« b O A CC sv.� FvCy a ORq T F T R d N N 'D w 7 ^Op0 i O 0 o a. m a� a. A 0. 09 -00 'R O p d 0 b .� WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA This endorsement changes the policy to which it is attached and is effective on the data Issued unless otherwise stated. This endorsement, effective on 7/1/03 at 12:01 A.M. standard time, fors a part of: Policy No. WVA8004695 Endorsement Notice of the St. Paul Fire and Marine Insurance Company NCCI Carrier Code 13706 Issued to: Vandorpe Chou Associates, Inc. Premium: Policy Expiration Date: 7/1/04 Authorized Representative 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 3% of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Anyone for whom the Named insured has agreed to furnish this waiver. Minimum Premium: $100.00 The premium for this coverage will be determined and billed at Audit. AI'i'I20VED AS 1() CORM i_Yhra Sheedy {)epoty City Attorney WC 04 03 08 (Ed. 04 84) Printed in U.S.A. t 'd HEM 906049Z (6t6) H)MflSNI d127dwu WVS�:6 HH '0I 'M IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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 tights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing Insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORO 25 (20011011) 9 'd 0869 'ON 9060-CK (R6) dONNNf1SNf dd,d'IAN ➢vs9 :6 HH '0I 'ddS $�eQa CERTIFICATE OF LIABILITY INSURANCE 09/04/200 ' PRODUCER (949)263-0606 FAX (949)263-0906 Complete Insurance, Inc. California D0I #0437762 19000 MacArthur Blvd., PH Flr Irvine, CA 92612-1447 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Van orpe Chou Associates, Inc. 295 North Rampart Street, Suite A Orange, CA 92668 INSURERA: Greenwich Insurance Company INSURERS: (c/o XL Insurance) INSURER C: NSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR kDD'L TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE IMMIDDMI POLICY EXPIRATION DATE (MM/ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE O OCCUR MED EXP (Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGO $ POLICY 7 PRO- LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident)$ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) $ BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS Ai E"`'W Y.)!` *� PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY _ -_-_..._- AUTO ONLY-EAACCIDENT $ ANY AUTO La it Ji1C dy OTHER THAN EA ACC $ $ )iC LLI CJ All fl l'llr,Y AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WCSTATULIM - OTH- FIR EMPLOYERS' LIABIDTY ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICERMIEMBER EXCLUDED? V yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ A ro essional Liability PECO012128 07/01/2003 07/01/2004 $2,000,000 Per Claim Limit $2,000,000 Annual Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 0 day notice applies to non-payment City of Santa Ana, and employees & volunteers Office of City Attorney P.O. Box 1988 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL its officers, agents, 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE /j_ C-'� /J ACORD 25 (2001108) ®ACORD CORPORATION 1988