HomeMy WebLinkAboutBASILIO ASSOCIATES INC. 1A - 2002
AMENDMENT TO AGREEMENT
0'1
THIS AMENDMENT, made and entered into this 19th day of June 2001, by and between Basilio
Associates, Inc.,("Consultant") and the City of Santa Ana, a charter city and municipal corporation duly
organized and existing under the Constitution and laws of the State of California ("City"), collectively
referred to herein as "the Parties".
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c 'l'~yY A. The Parties entered into that certain agreement entitled "Consultant Agreement" dated September
L-- _c, 13,2001, hereinafter referred to as "said Agreement", for providing architecture services.
RECIIALS
B. The Parties hereto now desire to amend the Compensation, and Term of said Agreement in order to
in order to provide continuous uninterrupted service under the Agreement.
WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter
contained and made, and subject to all of the terms and conditions of said Agreement as hereby amended,
the parties hereto do hereby agree as follows:
1. Section 2, of said agreement, pertaining to "Compensation" term of said Agreement is hereby
amended to reflect an increase in compensation of an amount not to exceed $10,000.00 due to an
unexpected increase in the City's need for the Consultant's services under said Agreement.
2. Section 3, of said Agreement, pertaining to Term of said Agreement is hereby amended to change
the termination date of September 13, 2002, to September 30 2003, in order to provide necessary
continuous uninterrupted service to the Agency.
3. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged
and in full force and effect.
1N WITNESS WHEREOF, the parties hereto have executed this Amendment to said Agreement the
date and year first above written.
A'I"rEST. :i:J-
~
PATRIClAE.HEAL/ ~
Clerk ofthe Council
CITY OF SANTA AN
(signatures continued on next page)
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APPROVED AS TO FORM:
FOR APPROVAL:
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Executive Dir or of the
Finance and Management
Services Agency
Tax ID#
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Da~.e, 1/2~/2004 Time, 9,02 AM To,
-.. 'U.Ma
Ar{)Rn CERTIFICATE OF LIABILITY INSURANCE I DATE ¡MM/DD!YV¡
01/21(04
PRODUCeR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P. O. Box 10550 ALTER THE COVERAGE AH'ORDED BY THE POLICIES BELOW.
Santa Ana, CA 92711-0550
714427-6810 INSURERS AFFORDING COVERAGE
IN"'RED ",,-.).003-13/P 1'>,JRaR A. United States Fidelity & Guaranty
Basilio Associates, Inc. ¡V-J..bO,J.-143 IN>URER B, SI. Paul Fire & Marine Ins. Co.
71 Stoney Pointe INSURER 0, Security Ins. Co- of Hartford
Laguna Nlguel, CA 92677 N-dOQ/ -Ig,;... INSURBRD,
INSURBRB
@ 17146475421
1-510-4"-2193
Paoe, 002-003
COVERAGES
THE POLICIES OF INSURA.~ΠLISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THHOLICY PERIOD INDICATED NOlWITHSTANDIN
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACf OR OTHER DOCUMENT WITH RESPECf TO WHICH THIS ŒRTIFICATE MAY BE ISSUED a
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBIECf TO ALL THE TERMS, EXCLUSIONS AND CONDmONS OF SU
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUŒD BY PAID CLAIMS
&~ TYPE OF INS"RANC' POLICY NUMBER PO¡~CYEFPECTlVf POLICYEXPJ~T>ON
A GENERAL UAmUTY
BK01473871
09/13/03
09/13(04
EACH (œ,-,RRBNCH
PlRBDAMAGB':M,"",""
MBO BXC (AI, ,,' "'"",)
Ij 000000
1300000
110000
11 000 000
12000000
12000000
"RSONAL & ADV INJURY
GENBRAL AGGRBGATB
PRODUcrSCOMP¡C'P AOJ
A Al~OMOBlLEUABIUTY
BK01473871
09/13/03
09/13(04
COMBINEDSlNGLHLlM"
(Eo"""",
'1,000,000
'"V AUTO
m OWNeD AUF,S
"OILY INJURY
~"F""")
"HBDUlED A'IT':,S
X HIPPO Am,-,s
X N,"":,WNBOA<mÆ
BODIIX INJURY
~"."'""':
FR)PBRTY DAMAGE
""'"'~"','
AUTOONLY-EAACCIDBNT ,
,'THBRTHAN
AUTODNLY,
RA Ace 1
AGG ,
EA':H OOCURRBNDB
AGGRBGA"
B WORKE", COM'"""TlON AND
B EMPLOYERS' UAmUTY
WVA7734752
11/13/03
11/13/04
C OTHER Professional
iabillty
SAE0232768
09/13/03
09/13(04
BL.EAOHA:"'DBNT ,1000000
B.L.DISEASilBABMPLOYEE ¡1 000000
B.L,DISBASilPOLlITLIMII .1000000
$1,000,000 por claim
$1,000,000 ann I aggr.
O""CRlmDN OF OPERAT>ON'ILOCATIDNS/VEHICLB'IEXcLUSIONS ADDED BY eNOO",EMENT/S,"CIAL PROVISIONS
City of Santa Ana, Ms officers, agents, Yolunteers and representatives
are named as an addMlonallnsured as respects general liability for claims ,-,~j, {o .J) b', .
arising from the operations of the named Insured. ~~L~ : (
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CERTIFICATE HOLDER
ADDITJONALINSURED-INSURERLETIERI
CANCELLATION
City of Santa Ana
Marlo Ghlzzl;Bulkilng Maintenance Division
20 Civic Center Plaza, M-11
Santa Ana, CA 927P2
SHOlILD ANYOFTHEABOVE DESCRIBED POUCŒS BE CANCELLED BEFC«ETHE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL"""""""'MAI>.'!O..-DAYS WRIITEN
NOTICE TOTHE CERI1F1CATE HOLDeRNAMEOTOTHE LH"-. B
ACORD 25,S (7/911 1
of1
HS98124¡M98123
MAF
@ ACORD CORPORATION 1988
Da~e, 1/2./2004 Time, 9,02 AM To,
@ 17146475421
1-510-452-2193
pag.. 003-003
Policy Number: BKO1473871
OwnersÒLessees or Contractors (Form B)
ADDITI NAL INSURED
Change(s) Effective: 01/21/04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY. This endorsement modifies insurance policy under the following:
LIABILITY COVERAGE PART:
Schedule
Name of Person or Organization:
City of Santa Ana
Mario Ghizzi;Building Maintenance Division
20 Civic Center Plaza, M-ll
Santa Ana, CA 92702
SECTION II - WHO is AN iNSURED is amended to include as an insured the
person or organization shown in the Schedule, but only with respect to liability
arising out of "your work" for that insured by or for you.
City of Santa Ana, its officers, agents, volunteers and
representatives are named as an additional insured as respects general
liability for claims arising from the operations of the named insured.
PRIMARY INSURANCE:
IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY
AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED
SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS
INSURANCE.
SEVERABILITY OF INTEREST:
IT IS AGREED THAT EXCEPT WITH RESPECT TO THE LIMIT OF INSURANCE, THIS
COVERAGE SHALL APPLY AS IF EACH ADDITIONAL INSURED WERE THE ONLY INSURED
AND SEPARATELY TO EACH INSURED AGAINST WHOM CLAIM IS MADE OR SUIT IS
BROUGHT.
WAIVER OF SUBROGATION:
IT IS UNDERSTOOD AND AGREED THAT THE COMPANY WAIVES THE RIGHT OF
SUBROGATION AGAINST THE ABOVE ADDITIONAL INSURED(S) , BUT ONLY AS RESPECTS
THE JOB OR PREMISES DESCRIBED IN THE CERTIFICATE ATTACHED HERETO.
CL/BF 22400395
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D~tel
3/27/2006
..
Tim81 4109 PM
TOI Ghi::zi, Mario Ii 17146475421
1- 510 - 452 - 2193
Paqel 002.:,( I
!:...!W!J . BASILASSO
ACO&.D~ CERTIFICA'lrE OF LIABILITY INSURANCE
N
rJ
N .'
N-
N-
..tL:... '_"
COVERAGES /V.- ._
THE POLICIES OF INSURANCE LISTED BEW~E BEEN ISSUED TO THE INSURED NAMED ABOVE FOl<THE POliCY PERIOD INDICATED. NOTWITH:TANDM
ANY REQUIREME:::NT. TERM OR CONDInO~1 OF nfY CONTRACT OR OTHER DOCUMENT WITH RESPECl TO WHICH THIS CERTIFICATE MAY BE If tiUED ()~
MAY PERTA..." THE INSURANCE AFFORDED BY TH ~ POliCIES DESCRIBED HEREIN lS SUBJECT TO ALL THE TERrIotS. EXClUSIONS AND CONDITION) OF SU:'
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BE EN REDUCED BY PAID CLAIMS.
NSR TYPE Of INSURANCE PC UCY NUMBER LI Y EffE TlVe
Basilio Associates, Inc.
12 "J" Mauchly, Suite 100'
Irvine, CA 92618
THIS CERTIFICATE Iii ISSUED AS A MATTER OF INFORI
ONLY AND CONFE I~S NO RIGHTS UPON THE CERTI
HOLDER. THIS CE =:nFICATE DOES NOT AMEND, EXTI'
ALTER THE COVEI!'GE AFFORDED BY THE POLICIES I
INSll ~ERS AFFORDING COVERAGE
:",;wOI-18?. INSURER A United Stall;, Fidelity & Guaranty
.,),Do;;' - 14-3 INSURER B St. Paul Fi..: & Marine Ins. Co.
::\003-13-"' INSURER C
?ooo"- 0;;'::>- INSURER 0;
~(X}1-i,(p
;'o05-/.A? INSURER E; .
?'OO(c-O:JD .
DA 11: (Mft"OOfVV)
03127/1"1
'IATIOI~-
FICATE
.ND OR
IELOV!.
PRODUCER
Dealey, Renton & Associates
199 S Los Robles Ave Ste 540
Pasadene, CA 91101
626 844-3070
INSURED
A GENERAL LIABILITY
X COMMERCiAL GENERAl LlAB LlTV
CLAiMS MADE ~ OCCUR
BKO'I8958!'2
09/13/05
P L YEXPIR
.
09113106
~,&.I~IN --
UIIIrTS
EACH OCCURRENCE .100011
FIRE DAMAGE {Any Me t1M) .300 00
~~P{Anroneplt(l!lon) .10000
PERSONAL & ADV INJURY '10001/
GENERAL AGGREGATE .200011
PRODUCTS -COMPJOP AGG .20001
~,
COMBINED SINQLE LIMIT $1,000,1
(EaBccldBnt)
BODILY 'NJURY I
(PBrpe15~)
_.
BODILY INJURY '.
fPerdc~enl)
PROpERTY DAMAGE .
(PBfBi::cldsnl)
AUTO ONLY .EAACCICENT .
OTHER THAN EAACC .
AUTOO~Y: AGG .
EACH OCCURRENCE .
~GATE I
.
--
.
.
ilX~~Tf~;, I 10JIt
E.L EACH ACCIDENT .
~~ASE .EAEMPLOYEE $
E,L. DISEASE. POUCY LIMIT I $
$1,000,000 par claim
$1,000,000 annl aggr.
"
.1L-_
!_-.
GEN'L AGGREGATE LIMIT APPLIES PER
; PRO.
loe
!1L-_
I~-
~~-
A AUTOMOBILE UAEULITV
ANY AUTO
ALL OWNED AUTOS
~ SCHEDULED AUTOS
X HIRED AUTOS
,X NON.QWNED AUTOS
BK011895892
09/13105
09/13106
flI0
B OTHER Professional
lability
QP03B0922i
I
I 09113/05 09/13106
. GARAGE LIABILITY
"
, ANY AUTO
EXCESS lJABILITY
OCCUR 0 CLAIMS MADE
tlESCRIPTION Of OPERA110NSILOCA110NBIVEHfCLE8IEXCUSi JNS ADDED BV ENDORSEMENTI8PEClAL PROVISIONS
City of Santa Ana, its officers, agents, volun':eer8 and representatfves
are named as en additional Insured as raSIl8cts general liability for claims
arising from the operations of the named "'ourad.
\i;
CERTIFICATE HOLDER
/~7-/P.
ADDITIONAL INStIll SE 'INSUReftLETTER:
CA CELLAnON
City of Santa Ana
Building Maintenance Dlvh,ion
All": Mr. Mario Ghlzzi
20 Civic Center Piau, M.11I
PO Box 1988
SHOULD ANl'OfTHEABOYE DES::RIBED POLICES BE CANCELLED BEFORE THE EX 'IRAn:>>
DATE THEREOF, THE I8SUfN(llfISURER WI~ TOMAlL3IL-DA.'8\WRfITIC~
NOTICETOTHE CERTFICATI: to.DERNMtED TOTHELEFT,XIU(JU8 rJOUIctClIMI8:fl
:0I"~1tlII.-"l~Ka... .-laJlOIIQf
#S1S~1219IM138542
---j
<;) ACORD CORPOR'TION II IE
ACORD 25-8 (7/97)1 of 1
-
AAF
1..., ~'''''I~uutJ 'J.'lmel 4109 PM TOI Chiz-:i, Mario Ii 171464754:U
.
1.510.452.2193
Pa<:el 003 003
,
Policy Number: BK0189589:,
OwnersbLessees or Contractors (Form B)
ADDITI NAL INSURED
Change(s) Effective: 03/27/1'6
THIS ENDORSEMENT CliAN'3ES THE POLICY. PLEASE REAl) IT
CAREFULLY. This endorneml;nt modifies insurance policy under Ihe following:
LIABILITY COVERAGE PART:
Name of Person or Orgal1lzalion:
City of Santa Ana
Building MaintenancE! D:_ vision
Attn: Mr. Mario Ghizzi
20 Civic Center Plaza, ~-11
PO Box 1988
Santa Ana, CA 9270:;!
Schedule
SECTION" - WHO IS AN INSURED is amended to include as an il1sured the
person or organization shown 'r! the Schedule, but only with respect to liability
arising out of "your work" for thet insured by or for you.
City of Santa Ana, its officers, agents, volunteers and
representatives are nar~ed as an additional insured as respects gener,,]
liability for claims aJc:lsing from the operations of the named insurec..
PRIMARY INSURANCE:
IT IS UNDERSTOOD AND Am~EED THAT THIS INSURANCE 11:, PRIMARY
AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIOl'iAL INSURED
SHALL BE EXCESS ONLY AUD NOT CONTRIBUTING WITH THIS
INSURANCE.
SEVERABILITY OF INTEJ:<.Et;T:
IT IS AGREED THAT EXCEPT WITH RESPECT TO THE LIMIT OF INSURANCE, THH;
COVERAGE SHALL APPLY A1l IF EACH ADDITIONAL INSURf;D WERE THE ONLY INSUR;:D
AND SEPARATELY TO EACH INSURED AGAINST WHOM CLAn! IS MADE OR SUIT IS
BROUGHT.
WAIVER OF SUBROGATION:
IT IS UNDERSTOOD AND AGRSED THAT THE COMPANY WAIVE,3 THE RIGHT OF
SUBROGATION AGAINST THE l\BOVE ADDITIONAL INSURED '.S I, BUT ONLY AS RESPECTS
THE JOB OR PREMISES DEt;C:<.IBED IN THE CERTIFICATE ATTACHED HERETO.
CUBF 22 40 03 95
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_._". /0(/
Date: 10/30/2006 Time: 1202 PM To: Gonzales, Griselda @ 17146475421
' 1-~10-452-2193 Page: 002
-
ACORD," CERTIFICATE OF L1AB~L1TY INSURANCE I DATE fMMIDOI'fYY'f)
10/3012006
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dealey, Renton & Associates ONLY AND CONFERS NI) RIGHTS UPON THE CERTIFICATE
199 S Los Robles Ave Ste S40 HOLDER. THIS CERTIFIC:ATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW.
Pasadena, CA 91101
626 844-3070 INSURERS AFFORDING C')VERAGE NAIC#
INSURED INSURER A:. United States I:idelity & Guaranty
Basilio Associates, Inc. INSURER B:
12 "J" Mauchly, Suite 100 INSURER c:
Irvine, CA 92616 INSURER 0:
INSURER E:
Client#" 8210
B ~SILASSO
COVERAGES
THE POliCIES OF INSURANCE LISTED BELOW HA \IE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO JCY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR. CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHJC~ THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY T'-lE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERJ.. S. EXCLUSIONS AND CONDITIONS OF SUCH
POlICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUceD BY PAID CLAIMS.
~ = TYPE OF INSURANce POLICY NUMBER POLICY EFFECTIVE POLICY EXP1RA nON LIMns
A GENERAL LIABILITY BKfJ1895892 09/13106 09/13107 EACH OCCURRENCE '1 000 000
r::- DAMAGE TO RENTED '300 000
X p~ERCIAL GENERAL LIABILITY
I CLAIMS MADE ~ OCCUR MED EXP (Anyone pelllon) .10000
r- .1 000 000
- PERSONAL & ADV INJURY
GENERAL AGGREGATE .2 000 000
- .2 000 000
~'LAGG~nE LIMIT APFlS PER: PRODUCTS - COM PlOP AGG
POLICY rC8i LOC
A ~TOMOBII..E LIABILITY BK01895892 09113106 09/13107 COMBINED SINGLE LIMIT '1,000,000
ANY AUTO (EsflccidIlJlt)
-
t- ALL OWNED AUTOS BOorLYINJURY
(perpellion) .
SCHEDULED AUTOS
rx HIRED AUTOS BODilY INJURY
t)( .
NON-OWNED AUTOS (Pllraccidenl)
-
- PROPERTY DAMAGE .
(per 8~cidenl)
3MG' '~BI"'Y AUTO ONLY. EA ACCIDENT .
ANY AUTO OTHER THAN EA ACC .
AUTO ONLY: AGG .
EXCeSSlUMBRELLA LIABILITY EACH OCCURRENCE .
:J OCCUR 0 CLAIMS MADE AGGREGATE .
.
R ~EDUCTIBlE .
RETENTION . .
WORKERS COMPENSATION AND we STATU. 10~~.
EMPLOYERS' LIABILITY .
ANY PROPRIETORIPARTNERlEXECUTlVE E.L. EACH ACCIDENT
OFFICERIMEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $
Ifyss,dllBcribllurlller .
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT
OTHER
i\PPf>,
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDeD BY ENDORSEMENT I SPECIAL PROVISIONS .~ , , " I
City of Santa Ana, its officers, agents, volunteers and representatives are named as an ~~ (
additional Insured as respects general liability for claims arising from the operations of ------r ,/~ L/
the named insured.
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CERTIFICATE HOLDER
CANCELLATION
City 01 Santa Ana
Account Clerk 1
Attn: Griselda Gonzales
20 Civic Center Plaza, M~11, PO Box 1988
Santa Ana, CA 92702
SHOULD ANY OF THE ABOVE DES':RIBED POLICIES BE CANCELLED BEFORE THE EXPlRA110N
DATE THEREOF, THE ISSUING INSIIRER WILL ENDEAVOR TO MAIL ....3ll.... DAYS WRmEN
NOTice TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LlABI_ITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
ACORD 2S (2001/08) 1 of 1
#S1765631MI74867
AAF
@ ACORD CORPORATION 1988
lD-3D"2Dpa 13:13
.
FROM-PROFESSIONAL PRACTICE INSURANCE BROKERS
+
T-273 P.DD2/DD3 F-252
ACORb..
Cllenll: 8ll1W2 SASIASO
CERTIFICATE OF'LlABILITY INSU~NCE I f:::"IYYY"f.-
TItIS CERllFlCA'l151$ Ill8UED AS A MATTEIl Of INfORMATION . -
DIU.'" AND CONFEIIS NO Il/GlITlI UPON TItE CEllllF1CATE
HOLPEIl. TItIS CERTlfICA'l15 DDI'15 NOT AlIIENO, EXTEND 011
ALTEIlTItE COVERAGE AFfORDED BvTItE POUClES BEJ..OW.
,-
-
HIlH Professional Practice
Insurance Broke",. Inc,
10 California Street
Redwood City, CA ~151a
IMSu~
Basilio A5sac:iatn. Inc.
12 J Mauchly, Suite 100
Irvine, CA 92&18
INIIURERS AFFORDIIIG COVERAGE
_R'" US S,,"iany Insurance COllIpany
INSIJRfR B:
INSlJRER c:
INSURER D:
__e.
HAle #
29599
.-
COVERAGES
T"'f'O~lCln OF'~~/"",VC llfI!>IfS$Ul:P ""THI!.tlllllUll<O.llAI4Ell_nl PQl.\Ql! I!I'.IlIOQ 1lIPJC.\=, NQlWITHSTANQIN!l
AI'ly Rl!Qu,~IONT. TEIlM OR Com>ITION OF ANY CONTllACT OR OTMER DO<:ur.IENT WIT!< ~~CT TO W"1C>l nus CERTIFlCA~ l4AY ll1' ,SSuEt> OR
~y feFlTAIN. THE INSUPANCt:: AfFOfIDEt) BY1'H1! POJ..fell!S OUCRleED HEREIN IS SUaJecr TO ALl. THIi 'TERMS. EXCLUSIONS AND CONgrnop,jS OF SUCH
pouc,a AGGReGAlli UMtTS SI<OWN MAY I1I\VE Il<EN REPuCl!P IN PAID CLAI..S.
T\'PEOFI~1L\NCf! JWM8IR
GElrtERAl. UAau..m
COMMERCIAI..~~~I-l""
CLNMS ~E 0 OCCUR
. -
'-
-
UIIInl
.
$
QIM.~"DA'O::UMrT~t::f~
F'Ol.teY LOC
AUTOII08q.E /...tAaIUJY
ANY'I<Jt(l
AU., OWNED AuTOS
SC/1,ipuUiP ,Al,l'TOS
I1IA~AUTOS
hOIIl.QWNEP AUTOS
~~An )
~'ArN~'f $
Gi!NEAAa.~TE 5
PROPuC'f1S . (:QMP'IOP AGG s
GAR.we: UAaIUlY
_AUTO
COMB.INSO StNOl.E l-IWT $
(101_
1'0011- Y IN-Jul\l .
(~fp8/lOr!)
aooll..Y INJURy $
IPwacctl8N.)
~- $.
Ol'H&RTtfAN
AUTOOt<<.r:
ALlTOONl-y.It.\ACClDEHT S
EA""" .
N:;G $
$
.
.
$
.. EXCtEI:SIUMlftaL..\ UItIUUTY
OCCIJR 0 CLAIMS MAPfi
EACh OCCU~C;f!:
AGGflSGATll
DED\ICTJaLt:
Il&TE .
WQfltCeRG C0IIPENU.11ON AND
--'1JAllIUTY
"'" PflOl'I>ISYOAiPART>E""""""'T'''''
OFFlCE~RExO.uDED'1
1fv..~kIKlDr
P ROvfStONS belli,.
A OTHER
Profus./onal US0tl1242301 09/22106 011122/07
L/ablll
DES'CRIPllO.,OF OPERATI~'I.ClCATfONS'v&HICLE8/~~PY~'~1lJfT/1PIiClAL PRa~
All Operallon$ <If the Named In8~r8d, P"'feHionllll.iabilily only.
.
WCITAl\j: OTtf.
E+.~ACQgm,rr $
E.L. DISSASe . J
fl'.I.. $&ASE - POlJCt ur.DT $
$1.000,000 Per Claim
$1.000 000 ale
\ '. p~V
FORM
!,
CERTlFlc.o.TI; HOLDER
Mr. Mar;o Ghtm
B~lIdlng Mallllenen"" Manager
Bllildlng Malm-nonCll DIYl$lon 20
Civic Cenler Plaza. M.1
PClS! Office Box 1988
S 2
ACORD 2S (20111/06) 1 of 2 #8368767/M3Il1l78li
i\
. CANCeLLATION Dav NnticA mr Non.payment of P.....iI'Ilum
'1 SftOlJLD ANY' OF T1tIi oUIOVf ~ua POYCJIiIU CANCELi.ED PEF~ Ttao. ~MTIC:I I
: ;,1.; oX.1E~.THliIS$UlNOINSuR&JcWK.L'U 1ItQ:M4JI.. -3JL. DAY5Wf11TlEN
MOTICE C~Tl! TOTHEI.EFT..lIIJltMllfte..,t- r~~
l<
.. ACOIlP CORPORATION 1t IS
,
10-30-1026 13:13
.
FROM-PROFESSIONAL PRACTICE INSURANCE BROKERS +
T-273 P.003/003 F-252
IMPORTANT
II llIe certifil"lte holder i. an ADDITIONAL INSURED, the pOllcy(i...) must be en<lOrsold. A statemen'
on thi. certifiCate aces not confar rigl118 to the certifica", holder in lieu "F sueh endorsement(.).
-If. SUIlROGA-TION 1$ -WAIVEO...lIIIbject -">-the lelms anq lODnd/licOll.of"1ll pcI/QX. ClII'llIin..P\lIll(l~ 1710&.
require an endorsement. A _men! cn this certifjarte does no, confer righllS 10 the cetli~cale
holder in lit:lu 01 .uch endorsemenl(s).
DISCLAIMER
The Certifiarte of Insulilnce on !he reverse Si<le 01 tnis form does not constiMe a COnlraCl lle1Wllel1
the "",uing In"'f8f(sl. O_ri=<l rcp......,"'...e or prc<f"""" and the comlflcme 1)01_, nor aoes h
affirmatively or neglllively emend, eXlend or llllar !he coverage afforQ",j by the policies listed thereon.
ACORP 25-6 12001/P8l 2 of 2
tl$36S7671M369768
12/12/2007 15:25
9497274210
BASILO ASSOC INC
PAGE 01/02
f:lient#: R0042 BASIASO
A,CORDT" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDIlIYY)
12/03/07
PRODUCER THIS CERTIFICATf' IS ISSUED AS A MATTER OF INfORMATION
HRH PrOfessional Practice ONLY AND CONFERS NO RIGHTS UPON THE cERTIF.ICATE
100 Marine Parl(way, #200 HOLDER.. lHIS CERTIFICATE DOES NOT AMEND, ~ENO OR
ALTER THE COVERAGE AFFORDED BY THE F'OLlCIES B~lOW.
Redwood City, CA 94065-1517
650 369-5900 INSURERS AFFORDING COVERAGE
INliVRED INSURER A, US Specialty In8uraoc~ Company
Basilio Associates, Inc. INSURER B:
12 J Mauchly, Suite 100 INSURER c:
hVine, C/\ 92618 INSUReR D:
I INSURER E:
COVERAGES
THE POLICIES OF INSURA!'JCE LISTED BEI,.DW HAVE 8~EN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I!'JOlep-TED. NOTWlTti5TANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACt OR OTHeR DOCUMENT WITH RESPECT TO WHICH Tl'lIS CERTIFICATE MAY BE ISSUEO OR
MAY PEfl.T AIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUElJIiOCt TO ALL THE TERMS, EXCI,.USIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN ReDuCED BY PAlO ClAIMS.
INJ!R TYPE OF INSURANCE POLICY JWI.IMBIOR POLICY S'FI!~ POUt:YEXPlRATION l.-IMITS
L"fA
~NEML LIABILITY EA,CH OCGURRENCE $
f-- COMM ERCIAL l:;;l;NERAL LIABILITY FIRE OAMAGE (AnY OM 1I~\ $ --
f-- o CLAIMS MADE 0 OCCUR MED EXP (AnY one ~1$OIl) $
f-- PERSONAlll. APV INJURY $
A-2006-033 Ge.lERI'J.. A(;G~EG:ATi: $
f--
n'L AGGR.EA LIMIT APnF'ER: N-2000-155 PRODUCTS -COM~OPAGG $
POLICY ~~g: LOC
~TOMoeILE LIABILITY N-2001-182
N-2002-143 CDMBINEib SlNGLE LIMIT $
ANY AUTO (Ee aoold&nl)
- N-2003-136
ALL OWNED AUT05 BOOIL Y INJURY
- $
SCHEDULED AUT OS N-2004-022 {F'erp..'Bon}
-
- HIRED AUTOS N-2004-156 BODilY INJURY
(Per ..ecldent) $
- NON-oWNED ALlTOS N-2005-129
- -. N-2007-045 pROPERTY DAMAI3E $
{F'''rlO<Oid"n~1
~I;ll' LIABILITY AUTO ONI Y - Ell ACCIDENT $
A,'1VA,UTO OTHER THAN EAACC $
AUTO ONl.. Y: AGG $
EXCESS LIAI3IUTY EACH oCCURRENCE $
:::rOCCUR 0 CLA,IMS MADE AGGREGATE $
$
=i DEDUCTIBLE $
RETENTION $ $
WORKEIl$ eOMPENSA now. AND ~~~T~:~... r TOJ~
EMPLQnRS' l-lABlUTY
E.L EIICI-l ACCIDENT $
E.L. DISEASE - EA E;MPL DYEE $
i:.L DISEASE - POLICY LIMIT $
A OTHER
Professional US071242302 09/22107 09/22108 $1,000,000 Per Claim
lability $1,000.000 Aaareaate
D~IPTlON OF OPERA'IlONSlLOCATlONSIVEHICLESlEXCLUSIONS ADDEtl BY ENDORSEMENT/$PEClAL PROVISIONS
All operations of the Named Insured. ;f!5hp:!JL
/ //
CERTIFICATE HOLDER I I ADDlTl(lNAL INSURl:O 'INSURER L~R; CANCELLAtiON Tan n..u /
.
stl OIJ I.P ANY 01' THE Aa~ D ESCREED POLICIES Be CAllCEL~EiiP BEFORI! THE EXPIftAllON
CIty Of Santa Ana DAn; THE~OF, THE ISSUING INl;I,JR;!::R W1~ TOI\WL30...-lJ.\YSWRlTTEN
Attn: Mr. Mario Ghizzl, Facility Manager NOllCEiiTOTHE r;I!PmfICATE HOLD I!RNAMED TOTHE LEF1'~
20 Civic: Center Plaza, M-11
PO Box 1988
Santa Ana, CA 92702 AUTIOOIa1;::~TNE
I ~
ACORD 25-5 (7197) 1 of 2
#S398953/M396952
AXC
@ ACORD CORPORA liON 1988
12/12/2007 15:25
9497274210
BASILO ASSOC INC
PAGE 02/02
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED. the policy(les) 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 rights to the osrtlficate
holder in lieu of such endorsen'lant(s).
DISCLAIMER
The CElrtificate 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.
ACORD 25-$ (71il712 of 2 #S396953/M396952