HomeMy WebLinkAboutWESTERN ALLIED CORPORATION 1-2004
INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
1/-/ -OL!j
CLERK OF COUNCIL
DATE,.>-IO -0'/ CONSULTANT AGREEMENT
G: fJ'1:§ THIS AGREEMENT, made and entered into this S'flt day of ðJYI L- , 2004 by
(fl. &þ¡ ~1-1 ) and between Western Allied 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").
A-2004-054
. ~.
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
preventative repair and maintenance services.
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 consulting 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:
1.
SCOPE OF SERVICES
Consultant shall perform those services as set forth in Exhibit A (Proposal for
Qualifications for Providing Preventative Maintenance and Repair Services for the City of Santa
Ana Police Administration and Other City Equipment) to this Agreement.
2.
COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services,
the rates and charges identified in Exhibit A. The total sum to be expended under this
Agreement, shall not exceed $ 6S,gge.e8 during the term of this Agreement.
%.$,100. 01' ~M V '-
b. Payment by City shall be made within thirty (30) days following receipt of proper
invoice evidencing work performed, sgbject 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 April
30,2005, with the ability to extend at the City's option for 2 additional one year periods 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 Finance and Management
Services and the City Attorney.
4.
INDEPENDENT CONTRACTOR
Consultant shall, during the entire term ofthis Agreement, be construed to be an
independent contractor and not an employee ofthe 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, agents, volunteers, and employees 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 ITom 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 thereITom, 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.
2
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.
Certificates of insurance shall be furnished to the City upon execution of
this Agreement and shall be approved in form by the City Attorney.
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.
(ii)
(iii)
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 proofthat 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 effect 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 ITom 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 I of this Agreement; and (2) ITom 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 ITom 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 ITom this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding.
7.
CONFIDENTIALITY
If Consultant receives ITom 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 ofthis Agreement,
and further agrees to exercise the same degree of care it uses to protect its own information of
3
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 oflaw; 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 Finance and Management Services
City of Santa Ana
20 Civic Center Plaza (M-ll)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-5008
and,
4
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: J
LJ,¿s+(lt.-..J ~ie
t\ t(,J', Michael Gallagher
12046 E. Florence Ave,
Santa Fe Springs, CA 90670
~r p"r-...+¡' ð J
Attn:
Michael Gallagher
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 ITames, 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, that 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 ofthe City and any such assignment, transfer, delegation or subcontract without
5
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 ofthe 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.
6
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.
d?L ¡j~
---,Z¿ ,-<-j" --y
PATRICIA E. HEALY 0
Clerk ofthe Council
CITY OF SANTA ANA
t2412
DAVID N. ¡¡AM
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City AttO~ì r
B y: ~ LA-<-<.
Michael Vigtliotta
Deputy City Attorney
RECOMMENDED FOR APPROVAL:
CONSULTANT
0 CK. Coma
Executive Di ctor ofthe
Finance Ana Management
Services Agency
,U~~J1f-
-
(-'" E1=- qç- 2( 22-7- cr'Ç
Employer ID # or Individual SS #
7
Specifications: 01-2004-RFP I
PROPOSAL for QUALIFICATIONS for PROVIDING
PREVENTIVE MAINTENANCE AND REPAIR SERVICES
For the CITY of SANT A ANA
POLICE ADMINISTRATION and
OTHER CITY EQUIPMENT
PRIMARY CONTACT:
QUALIFICATIONS
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(-z-íYf0 f. F{p,N'.J~ AVe. I ~~~~fv4)f
L.AC(Oç:,-=ro
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NAME of FIRM:
PHONE NUMBER:
I
,
FAX NUMBER:
VENDOR ADDRESS:
INVOICE PROCESSING LOCATION:
CONTACT NAME:
Ç. '\. ~
PHONE NUMBER:
( (
FAX NUMBER:
l (
DESCRIBE YOUR MOST RELEVENT EXPERIENCE IN PROVII?ING SIMILAR -
RELATED SERVICE: ú'1"'Y 0+ cr-Jt/J1"\.¡'O) L(~ \)11 ~'I'f.~O
PLEASE PROVIDE INFORMATION DEMONSTRATING THE FINANCIAL
STABILITY OF YOUR FIRM: ::!:',.J 16 U>(.u.¿ ç,ç e ,Ç'AvVL(" Â-b'1>12.0).
Si0e.Q Iq(q[.
NUMBER OF YEARS YOUR FIRM HAS BEEN IN THE INDUSTRY:
~3
GENERAL SUMMARY OF YOUR FIRMS ORGANIZATION, OWNERSHIP AND
SERVICES:
5u~c4kr $'
6Rr,
tð PQJy~~(stœk~( æl'J.
7
Revised 01/14/04
¡EXHIBIT A
-
Specifications: 01-2004-RFP l
SCOPE OF SERVICES
1. Provide and replace one carrier 06EZZ0660 compressor with a carrier compressor, (1)
refrigerant dryer refill with additional refrigerant. Check, test and verity operation of
unit. (Location City Hall )
P¡ice $ {¡CtJ 8 <1,-
¡., f!r¡.J¡JJ'\L (,,0 \-k.<..\"",~(Ü~r-
2. Provide (4) quarterly inspections per year including filter and fan belts replaced as
needed:
QIY-
MODEL
SN
LIEBERT
VEZ45A-AAM
CDF308LA
307193-00 I
94009100
AIR CONDITIONING
LIEBERT CONDENSING UNIT
I
,
(Location Police Facility)
1- 11 -
Price $
3. Provide annual oil analysis for (2) York chillers model YTHIJ3E2CRG and (I) York
rotary chiller YSCBCAS l-CHA
Pri ce $
53) -
4. Provide annual vibration analysis for (2) York chillers YTHIJ3E2CRG and (I) York
rotary chiller YSCBCAS l-CHA
Price $
-
'Z21 c;
I
5. Repair Toshiba 200 I-P, 3600 RPM 460 volts, 228 amps 3 phase, 60 H2 SN 94Y
00526
Pri ce $
0 0 cfr; -
,0
,
6. Remove and repair (I) Marley cooling tower AlC motor Marathon
I VL25STIEN6542BB 460v, I 775RPM, 20 HP, 256 T ITame.
Price $~a 19 -
{
3
Revised 01/14/04
Specifications: 01-2004-RFP 1
7. Remove the purge from motor on York chiller and repair the purge unit.
Price $
( -¿.'"2..J-
)
(-<) ,u,¡w.(f,~r
8. Remove scale and rust on ê,~!,Oj"lu, coil heat exchanger and epoxy coat bundle and
end bells on York chiller model YTHIJ3E2CRG.
Pri ce $
2 J::¡- S-
f
9. Wrap over the existing insulation at the City Library with an fsk foil paper - tie foil in
place.
Pri ce $
37 So-
I
/
10, Provide annual Preventive Maintenance and inspection on (2) Brian boilers model
RV450-W-FDG-WXL 3,600,000 MBH (1995).
Pri ce $
Zß<rs--
/
11. Provide annual Preventive Maintenance and inspection on (1) Ajax Boiler model
WNGl250W SN 54579-30HP.
Price $
{( 7'5~ -
,
12. Provide annual Preventive Maintenance on (4) hot water boilers models
(2) 1250 N 600 ATP-PVI 1,000,000 BTUI HR, (2) 1500 N 1500 ATP -PVI 1,200,
000 BTUIHR.
Price $
I) Ca..y,;; -
13. Remove combustion chamber module ITom PVI water heater model #1250N600TP
serial number 129483821. Clean mounting surface and 0 ring surface, install new
combustion chamber module with new nuts, pressure test at nonnal operating
pressure and check for leaks. Install new five collectors and connect to existing five.
Reinstall existing burner, piping and electrical. Start burner, test all controls for
proper operation and put into service. Adjust burner for optimum efficiency.
Price $~{ qú-
,
9
Revised 01/14/04
Specifications: 01-2004-RFP 1
14, Perfonn a leak test on York chiller model YTHIJ3E2CRG.
Price S
7-:S()~
eplace filters and provide chiller controls coolant for (2) York chiller
THIJ3E2CRG.
Price $
16. Replace Copeland compressor model ERCI0200- T AD-400 460 volts on evidence
ITeezer unit. Provide refugerant as needed.
Price $
No 13Îb - F.1.€6:t£~
G:>"'^fN'SJ'" r
I
I
17. Annual Preventive Maintenance inspection of (3) evidence ITeezer models LAHA-
032E- T AD-l 00. I. Inspect controls for operations, 2. Verify compressor operation
and refugerant charge, and inspect for refugerant leaks. Inspect electrical connections
and adjust as needed.
Price $
(4')0 ~
,
18. Annual inspection of (4) ITeezer model Kolpak AE66280B cold zone.
Price $
~2 7S~
19. Replace compressor on freezer model 032E-T AD-l 00.
Price S No
,
íSl~ - 'F.¡o£¿Yr
G:":''''pr€SSc,r
20. Remove and replace main drive shaft on carrier model 39Cl20 Air handler 18,275
CFM, 20 HP 480V 3PH.
Price $ -1;J T- 7-- - ,
21. Replace cooling section on carrier model 39ClOO 12,000 CFM 10HP 480V 3HP.
Price $
1'2- -sq î -
)
10
Revised 0 I /14/04
Specifications: 01-2004-RFP 1
~,p¡'œ ",dœ,'" "," OM"" modd 3811DC4861 0 460V 3PH 60HZ
Price S
~heplace special purpose secondary heat exchanger model DRCV0334 SN 98-3067 A
"í' i tons compressor 460 volts 3 phase 60HZ.
Price S
24. Remove and replace 5 ton Tecumseh compressor model AGC556lEXG.
Price $
(G90-
I
I
25. RcpainefrigeffiftHettk-'-()n 5 ton Tecumseh compressor model AGC556lEXG.
Cf¡s--
Price $
26. Balance Air handler carrier model 39C 1 00.
Price $
~/ C;;S ~-
27. Replace compressor on Trane Intellipack SXHFC7540R7A9AD300IRT - SN
J98M74496.
Price $
to, <1 S-S- -
r
28. Repair Victory refrigerator I kitchen & grill .
Pri ce $ ----.-J J 0
þl't)
29. Repair cook - chill Useco model 94 101 c SP 1201208 volts.
Price $
¡J~
,
<j5/j)
II
Revised 01114/04
Specifications: 01-2004-RFP I
30. Replace compressor on ice machine Hoshizari model B 1200 SS.
Price S
Nò
\3,\.~
31. Replace compressors on Jewett refrigerator in Evidence model LF 17BBD-l B-O I.
Price S
No í3N':I
32. Repair domestic chest freezer, Whirlpool model EH220FXWNOO.
Price S Ni:J
/
Regular time technician cost:
Journeyman chiller mechanic:
Apprentice chiller mechanic:
Sheet metal fabricator:
12
~t&.
q '2. $ / HR
q 'i?,.. $ / HR
'1 ?- $ / HR
'18 $/HR
Re\"ised 01/14/04
EXHIBIT B
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 ITom 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
8
AroRQ. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
04/13/2004
PRODUCER (310)309 2268 FAX (310)309-2568 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Sander A. Kessler & Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2850 Ocean Park Boulevard, Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Santa Monica, CA 90405
ATTN; SHEILA GREEN INSURERS AFFORDING COVERAGE NAIC#
INSURED Western All ied Corporat10n INSURER A Travelers Indemnity Co. Of IL
12046 E. Florence Ave. INSURER B Great American Insurance Co.
Santa Fe Springs, CA 90670 INSURER C
INSURER 0
INSURER E
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR DO'
p~H.~~ EFFECTIVE POLICY EXPIRATION
11/01/2003 11/01/2004
EACH OCCURRENCE
DAMAGE TO RENTED
TYPE OF INSURANCE POLICY NUMBER
GENERAL LIABILITY Vl EJ-CO-2394A386 TIL-03
X COMMERCIAL GENERAL LIABILITY
~ ~ CLAIMS MADE [!] OCCUR
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
A
X
A
GEN'L AGGREGATE LIMIT APPLIES PER
I POLICY m j~g n LOC
~TOMOBILELlABILlTY Vl ]-CAP-2394A398-TIl-03
X ANY AUTO
-
-
X SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
cc;.
PRODUCTS - COMPIOP AGG $
11/01/2003
11/01/2004
COMBINED SINGLE LIMIT
(Eaaccident)
ALL OWNED AUTOS
BODILY INJURY
(Per person)
~()odo 1/3
-(I-:
BODILY INJURY
(Peraccidenl)
PROPERTY DAMAGE
(Peraccidenl)
~~GE LIABILITY
I ANY AUTO
AUTO ONLY - EA ACCIDENT $
EA ACC $
AGG $
,
,
,
,
,
OTHER THAN
AUTO ONLY
B
~~SSlUMBRELLA LIABILITY
~ OCCUR D CLAIMS MADE
TSU2533433 11/01/2003
EACH OCCURRENCE
AGGREGATE
11/01/2004
t DEDUCTIBLE
I RETENTION
,
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
A ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
II yes, describe under
SPECIAL PROVISIONS below
OTHER
VTRJ-UB-2394A374-03 11/01/2003
x wc STATU-
11/01/2004
E.L. EACH ACCIDENT $
EL DISEASE - EA EMPLOYE $
EL DISEASE - POLICY LIMIT $
LIMITS
,
,
,
,
,
10J.';'-
1,000,000
300 , ooe
5,OOe
1,000,00C
2,000,00e
2,000,000
,
1,000,000
,
,
,
5,000,000
5,000,000
1,000,000
1,000,000
1,000,000
...Dl'SCRIPTION pF OPERATION:; I LOCATIONS VEHICLES I EXÇLUSIONS ADDED BY SNDORSEMENT I SPEiCIAL PROVISIONS
~E: SerV1Ce - ThlS insurance applles separately to each lnsured against whom claim is made or suit is
,rought except with respect to the company's limits of liability. The inclusion of any person or
>rganization as an Insured shall not affect any right which such person or organization would have as a
:laimant if not included. Additional Insured endorsement attached.
Except 10 Days Notice of Cancellation for Non-Payment of Premium.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL~){ MAIL
*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
-JW(XiOOII6JOO(-J6JOO¡¡ fI61lJ6 (XiJOOI (XX
-)iJIi1i_JIII~-_XXXXXXXXX
~
City of Santa Ana
Building Maintenance Superintendent
20 Civic Center Plaza, M-11
Santa Ana, CA 92702
AUTHORIZED REPRESENTATIVE
Sheila Green SHEILA
@ACORDCORPORATION 1988
ACORD 25 (2001/08) FAX;
(714)647-5421
<'t
Western Allied Corporation
COMMERCIAL GENERAL LIABILITY
Policy #: VTEJ-CO-2394A386-TlL-03
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(CONTRACTORS OPERATIONS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY - CONTRACTORS COVERAGE PART
1.
WHO IS AN INSURED - (Section II) is amended to include any person or
organization you are required to include as an additional insured on this policy by
a written contract or written agreement in effect during this policy period and
signed and executed by you prior to the loss for which coverage is sought. The
person or organization does not qualify as an additional insured with respect to
the independent acts or omissions of such person or organization. The person or
organization is only an additional insured with respect to liability caused by "your
work" for that additional insured.
2.
The insurance provided to the additional insured is limited as follows:
a) In the event that the limits ofliability stated in the policy exceed the limits
ofliability required by a written contract or written agreement in effect
during this policy period and signed and executed by you prior to the loss
for which coverage is sought, this endorsement shall be limited to the
limits ofliability required by such contract or agreement This
endorsement shall not increase the limits stated in Section III - LIMITS OF
INSURANCE.
The insurance provided to the additional insured does not apply to "bodily
injury", "property damage", "personal injury" or "advertising injury"
arising out of an architect's, engineer's or surveyor's rendering of or failure
to render any professional services including:
I. The preparing, approving or failing to prepare or approve maps,
shop drawings, opinions, reports, surveys, field orders, change
orders, or drawings and specifications; and
Supervisory or inspection activities performed as part of any
related architectural or engineering activities.
This insurance does not apply to "bodily injury" or "property damage"
caused by "your work" included in the "products-completed operations
hazard" .
II.
c)
3.
Subpart (i)(a) of the Pollution exclusion under Paragraph 2., Exclusions of Bodily
Injury and Property Damage Liability Coverage (Section I - Coverages) does not
apply to you if the "bodily injury" or "property damage" arises out of "your work"
performed on premises which are owned or rented by the additional insured at the
time "your work" is perfonned.
CG D2 48 10 02
Copyright, The Travelers Indemnity Company, 2002
Page 10f2
.
Western Allied Corporation
COMMERCIAL GENERAL LIABILITY
Policy #: VTEJ-CO-2394A386-TlL-03
4.
Any coverage provided by this endorsement to an additional insured shall be
excess over any other valid and collectible insurance available to the additional
insured whether primary, excess, contingent or on any other basis unless a written
contract or written agreement in effect during this policy period and signed and
executed by you prior to the loss for which coverage is sought specifically
requires that this insurance apply on a primary or non-contributory basis. When
this insurance is primary and there is other insurance available to the additional
insured from any source, we will share with that other insurance by the method
described in the policy.
5.
As a condition of coverage, each additional insured must:
a.) Give us prompt written notice of any "occurrence" or offense which may
result in a claim and prompt written notice of "suit".
b.) Immediately forward all legal papers to us, cooperate in the defense of any
actions, and otherwise comply with policy conditions.
c.) Tender the defense and indemnity of any claim or "suit" to any other
insurer which also insures against a loss we cover under this endorsement.
This includes, but is not limited to, any insurer which has issued a policy
of insurance in which the additional insured qualifies as an insured. For
purposes of this requirement, the term "insures against" refers to any self-
insurance and to any insurer which issued a policy of insurance that may
provide coverage for the loss, regardless of whether the additional insured
has actually requested that the insurer provide the additional insured with
a defense and/or indemnity under that policy of insurance.
d.) Agree to make available any other insurance that the additional insured
has for a loss we cover under this endorsement.
~3I5
CG D2 48 10 02
Copyright, The Travelers Indemnity Company, 2002
Page 2 of2