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Home My WebLink AboutOVERLAND, PACIFIC & CUTLER 4A s ' ' '.".'" c.._ City of Santa Ana Clerk of the Council AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Clerk of the Council Office (M-30). Call 647-5237 if you have any questions. C 1 T '; . , , 1"\/ r-,\ .~A ===============================================================~bJ==========~~~fir======== 7m3 HAY 12 AM 9: lIO The agreement with Overland, Pacific & Cutler, Inc. (Previously Overland Resources) ,......., Q~wnelt-(jL A -cX003 -D~O.J -- 0/ No. A-2003-040-02 was completed on 3/31/06 and final payment has been made. -- Department: Design Engineering - ROW Phone/Ext. : 5067 - Kent Jorgensen/Cindy Gomez ~,CLtA/J~ Signature: Date: 4/29/08 Revised 07-23-07 ~.c' ., City of Santa Ana Clerk of the Council AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Clerk of the Council Office (M-30). Call 647-5237 if you have any questions. 2fJJp. fl.1! r I ,. j'cil 2 'n AN CI-, ,f; Overland, Pacific & Cutler, Inc. (Previously OverlanB~sOurce. s) ""Ie. 9: ftf) The agreement with No. '\ ;\ VA ~ 1., . H, JNCIL A-2003-040-0 1 was completed on 3/31/05 & was amended on 2/10/05 and final payment has been made. Continuous Department: Design Engineering - ROW 5067 - Kent Jorgensen/Cindy Gomez Phone/Ext. : Signature: ~l/V'. ~l~~ Date: 4/29/08 Revised 07-23-07 . . A--~3 -o<!O-o / FIRST AMENDMENT TO AGREEMENT THIS FIRST AMENDMENT TO AGREEMENT is entered into on ¡1J A 2.vH ~ 1-, 2004, by and between Overland, Pacific & Cutler, Inc., a California corporation ("Consultant") and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). Recitals: A. The City and Cutler & Associates, Inc. entered into Agreement A-2003-040, dated March 3, 2003, (hereinafter "said Agreement") by which Consultant has provided right of way services to the City. B. On August 13, 2003, Overland Resources, Inc. was purchased by Consultant, which assumed the rights, liabilities and obligations of Cutler & Associates, Inc. under said Agreement. C. In accordance with the terms and conditions of said Agreement, the parties wish to extend the term for an additional one-year period. Wherefore, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this First Amendment to Consultant Agreement, the parties agree as follows: Pursuant to Section 3 of said Agreement, Consultant and City agree to extend the term of said Agreement for one year, beginning April I, 2004 and ending March 31, 2005. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Consultant Agreement on the date and year first written above. BARRY McDA IEL Chief Executive Officer APPROVED AS TO FORM: K:IWPDOCSIDOO4IPOOIIOOOI1655.DOC DATE (MM/DD/VY) 02 27 04 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 CE OF LIABILITY INSU A CORD- PRbDUCER AICHER INSURANCE AGENCY 1255 PROSPECT AVENUE HERMOSA BEACH, CA 90254 (310)798-1650 (310)798-1654 FAX OVERLAND PACIFIC & 100 W. Broadway Long Beach, CA INSURED CUTLER, #500 90802 INC INSURER A: ILLINOIS UNION INSURANCB COMPANY INSURER S" INSURER C. INSURER D. 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, IN.f: TYPE OF INSURANCE POLICY NUMBER POL.ICY EFFECTIVE POLICY EXPIRATION 10 DAYS FOR NON-PAYMENT OF PREMIUMS ADDITIONAL. INSURED; INSURER !.ETTER: CANCELlATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BECAHCElLED BEFORETHEEXPlRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE 0 THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAllURETO DO SO SHALL IMPOSE 00 ION OR llABIUTY OF ANY KIND UPON THE NSURER, ITS AGENTS OR GENERAL L.IABllITY COMMERCIAL GENERAll~BlllTY ClAIMS MADE 0 OCCUR EACH OCCURRENCE FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRO- e AUTOMOBILE LIABILITY ANY AUTO PRODUCTS - COMPIOP AGG Loe ALL OWNED AUTOS SCHEDULED AUTOS COMBINEO SINGLE LIMIT $ (Eaaccident) ßODILY INJURY $ (per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANYAVTO AUTO ONLY - EA ACCIDENT $ EAACC $ AGG $ OTHER THAN AUTO ONLY. EXCESS LIABILITY OCCUR D CLAIMS MADE EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION $ E.L. DISEASE - EA EMPLOYEE :$ E.L DISEASE - POLICY LIMIT :$ t¡y $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A OTHER ROFESSIONAL RRORS & OMISSIO 11/15/03 11/01/04 $2,000,000 2,000,000 BMI 20010437 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *30 DAYS EXCEPT CERTIFICATE HOLDER CITY OF SANTA ANA PUBLIC !lORKS DBPARnœNT 20 CIVIC CBNTBR PLAZA SANTA ANA, CA 92701 H-36 t ACORD 25-S fl/97) i LIMITS $ $-.- $ $ $ $ -- $ $ $ $ $ OTH- R EACH CLAIM AGGREGATE DATE (MMJDDIYY) 02 27 04 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 OF LIABILITY INSU CE AeORD- CERTIFIC PRODUCER AICHER INSURANCE AGENCY 1255 PROSPECT AVENUE HERMOSA BEACH, CA 90254 (310) 798-1650 (310)798-1654/FAX OVERLAND PACIFIC & CUTLER, 100 W. Broadway #500 Long Beach, CA 90802 ft,.- ~o03-03g A'JOO3--o1D INC INSURED INSURER A: GREA'l' AMERICAN E&S INSURANCE COMPANY INSURER B: 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 PAJD CLAIMS. I~.f: TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POL~CYEXPIRATION A GENERAl LIABILITY PL 5574310 06/24/03 06/24/04 X COMMERCIAL GENERAL LIABILITY Cl.AJMS MADE 00 OCCUR A LIMITS EACH OCCURRENCE $ RAE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ PERSONAL & ADV INJURY $ GENERAl AGGREGATE $ PRODUCTS - COMPIOP AGG $ LOC 06/24/03 06/24/04 PL 5574310 COMBINED SINGLE LIMIT (Eaaooident) ANY AUTO ALL OWNED AUTOS 80DIL Y INJURY (Per person) SCHEDULED AUTOS X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY (per accident) PROPERTY DAMAGE (Per accident) GARAGE lIABIUTY ANY AUTO AUTO ONl V - EA ACCIDENT $ EA ACC $ AGG $ $ $ $ $ $ OTHER THAN AUTO ONL V: EXCESS lIABIUTY OCCUR D ClAIMS MADE ~,~ ,tj I EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LlABIUTY $ E.l. DISEASE - EA EMPLOYEE $ E.L DISEASE. POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/lOCATIONSNEHIClES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS THE CITY, ITS OFFICERS, AGENTSW, EMPLOYEES, CONSULTANTS, SPECIAL COUNSEL & REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED PER ATTACHED CG8225 1000000 100000 exclude 1000000 2000000 exclude $ 1000000 $ $ $ *30 DAYS EXCEPT 10 DAYS FOR NON-PAYMENT OF PREMIUMS CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LfTIER: CANCELLATION SHOULD ANYOFTHEABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO HE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAlLURETO DO SO SHALL IMPOSE NO 8l~ON OR UABILlpn:>F"ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENT TIVES. . AUTHORI REPRES ATI I CITY OF SANTA ANA PUBLIC IIORKS DEPARTMENT 20 CIVIC CENTER PLAZA M-36 SANTA ANA, CA 92701 ACORD 2S-S (T /97) RPORA TION 1988 Iii,,! , l"¡. L~ ,;.. .,. . OV£~lAND PACIFIC & CUTlER, INC. PolIcy HPl5574310 Effective: 06/24/2003 to 06/24'2004 JLGUA'" M8II1C1Wf ,,,,,,,.,,, OOWAIIIIII ...... .. "-I"" r:...-... e 1;:"'......" If". .'''''-n. ==. . CGUZII re... 07 981 THIS Ø4D0RIliMENT CHANOa ". I'OLICV. I'U!AII! IeIAD IT CARl!l'UU- V. COMMIIICiW. GEN!MI. UAMJTY IItMIIŒT ADDmONAL INI&IIEÐ ~-\"ÐIT COMMIifICIAI. GENaIAL ~iNJII.m COV\!AAGE PART TIll. ..dDr.- modif,a. in_-- prcwidad ........ Ihe fOUcwMW .. WHO 18 AN INSURED IS8odon 10 /. - 10 ÍI1CIud8 II an rn- an, panon or or- It1inDon ICIIlftI ...-1ioMI ln8uraa¡ ../10111 yo.. .a requo,ed to ..-d .. It1 81fØ1ane/ ~ on -po"", -. 1. . ..rman comrlCJ or agr- or; 2. an or., "0fW8Ct or agra_r whera a ,,_fleara of "'-- IIIIOwlII If8t !>Wi sonor~lIan__...,. ...-eeI 111' be8n i88u1llt but 1118 wti~ Of or" _lCr ~ Þa / 3. .......enay in affeee or ÞaCOlntl\8 affecriva á"''''8 1118 - of 1hio poIic,: Mil , ... "'Kulftl prIor to 1118 "ÞocIi1, in,....,: 'propWt, d8m1p.' or 'pwlOllll and ad- ve"",ong "'J'IY' WIIicrI f'-It _fa.. on or after 1118 111118 of 1118 incl>JlOn of II1IS poIic, poriO<I. .. -.... In ... ~ lionS Paøeo af 1118 poIIcr bur pnor to 1118 '1I'1I8r 0' 1118 - of 8JCpIr1lClOn or øan- CeI- of CIlia poÞcy. 8. Wo1l1 rel>8Cf to 1118 .nsurance .ff~ a""" -'1l1li0110111/ III..,. !he fOl_1II8 84Øiliol1ll pl'ØYÌ8I11n8 apply: 1. "' pe,.o" or orll1tZlfÏOll.. only an AQ- CII1i- I/1aIrIld ",,81 r...cr 10 lilbility II'I8In OUI ..f: .. ",,_HI Ot eqwopmarw ro.. own. rent 1-. cr. 0C!aIp/: cr b. ,- CIOCIIII aper- petf- for tI18J AdCIi1iOnaI ~ Þ, or for yau. The Í/1IOIance prO\/l- CO - AddItIonal In- ....811 - ncn apply to "IIOGIly Inll'ý" or "prcpany CIIfIIII" IIICIUIIIId wiIhIrI - "1""- cIUCt8-comp-" "P8'8ti1lllll ........ 2. Th8 l.omitS of --- appIicaÞl. 10 .., - -- _lid .,.. ...... a¡>tI",- f'-'l In 1118 wtoØ8n eonlnlCl cr ""ea.,.,1 or In 1IJ8 Dec:"- fM 1111. po"",. whic:I18V81' .. 1811 - .. 811b8CC to 1118 _a "'" COI'dotIon' of "". -1118 forlR Thu8 LIIM8 of Inaur- are inclU- sive of ancI not '" -- fO IIIØ ~wnit$ of In......,'" 811""," 111 'Ch8 Decl8rltlOll' ~ " per_a or orllliUdon'a 818M a, IIf1 ,,- III8IOrlld ...... 1I1í. ..- Ind8 30 CII,. .fter yO&" op...IIOIIS or .- ,..,. th8& ^,*,.IÎOIIII ......... It. eompl...., or - or 1/8 e¡cpntlOll 0' 1110. polICy. WlllCll8ver la _Þer C. The onaur..,. ptovr- 10 an, -'\ddI_1 In- lur." _I not oppIJ 1D "þOCj1, ",,....,; "prop- erry ~. or "PW-..! ancI -ritong In- jury- "'8Ì'1II - of ... Ifchlrao::r.. lInQinM(e. 0( -..ey..,.. ~Inu ot or f8ilur.. to r- an, prOfllMionll _VI"" IIICI&ICIII1g: ,. 'Ch8 prIp8I'ona IIpprov.~ 01" ..."'" 1D pt'- per. or 1f>pr0lll IIIIW. Cll'1W1~ ~ r~ -,.. -. ore"',... elloign or 8p8Cific:ation.. ..., CG 82 25 ~ 07l1H11 XS Capyrihl ..,..,.,. S8rY1ce. Off..... h:.. 1898 "88. 1 of 21 " ...." ............,'. 'II, ~. r7j¡:~U7 d/r ,'" ~"'''A'''"''~1.t!l.lIWI1.~F''' .~\'- .>,,~~.t'..,'-Q. .----;'J: ;"A..~Þ. .. , . a. """'1IOr,. 1n8p8Ction. Of 8I1N8'1IIQ IIII'\IÍIIH. Covonoge prOVoCllld 118r8in _I - I. .,.- - OIl' Illy 01IIfII' V*, 8IICI c:CIIIactiÞIa in- --- availlble U) an, ~ "-"'I . wI181hIr 1118 OIlIer ins<I'81e11 .1 prilfllrv. a- -.. CCIIItInIIIt 0( on Illy 01I1fII' lI8Ii. 11'118.. . wih\8ft -- -- Ipaciflelll, no""".. ... .......-.- be prman, J '. ~¿~7 3/1 CG 82 26 lEd 071l1l3I XS Copynllh\ IrIN1I1co $....,- Off,ce. Inc:. 1888 11'. :a of 21 - "''''''I''-~'''''''''ÌI i.... ,~\.e4J;),.....",,\~~,. ~.U,.!.. -J J. p. , - AèoRt>", CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDJYYYY) 7/20/2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Venbrook Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 22801 Ventura Blvd, Third Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Woodland Hills, CA 91364 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone 818-225-8200 Fax 818-225-8210 INSURERS AFFORDING COVERAGE NAIC# INSURED Overland, Pacific & Cutler, Inc. INSURER" Great American E & S Company 100 West Broadway INSURER., The Hartford Insurance Company Suite SOO INSURER c: Everest National Insurance Long Beach, CA 90802 INSURER'" illinois Union Insurance Company , INSURER E, RSUllndemnltv ComDanv 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' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION GENERAL LIABIUTY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 00 OCCUR PL 5574310-01 6/24/2004 6/1/2005 EACH OCCURRENCE N PREMISES Ea occurence MED EXP (An one person PERSONAL & ADV INJURY LIMITS $ 1,000,000 $ 50,000 $ Excluded $ 1,000,000 $ 2,000,000 PRODUCTS. COMPfOP AGG $ Excluded A GENERAL AGGREGATE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO 72 UECUM6536 6/24/2004 6/24/2005 (Eaaccidenl) ALL OWNED AUTOS BODILY INJURY B (Per person) $ SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY X $ NON.QWNEO AUTOS (Per accident) PROPERTY DAMAGE $ {Per accident) GARAGE UABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESsnJMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 X OCCUR D CLAIMS MADE NHA212256 1/9/2004 6/1/2005 $ 1,000,000 AGGREGATE E $ üE:.uu¡,;ïiBU::. $ RETENTION $ $ WORKERS COMPENSATION AND 3900048305-041 6/1/2004 6/1/2005 X we STATU- OTH- EMPLOYERS' UABILlTY $ 1,000,000 C ANY PROPRIETORlPARTNERlEXECUTIVE E.L. EACH ACCIDENT OFFICERlMEMBER EXCLUDED? YES E.L. DISEASE - EA EMPLOYEE $ 1,000,000 g~~I~tS~~~~I~':óNS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 ~THE~ BMI20010437 6/24/2004 6/1/2005 EPL: $1,000,000 - $15,000 Retention D mp oyment Practices Liab & E & 0: $2,000,000 - $50,000 Retention Errors & Omissions Prof Llab AS TO FORM DESCRIPTION Of OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PR "10 Days Notice of Cancellation for Non-Payment of Premium" CERTIFICATE HOLDER City of Santa Ana Public Works Department Altn: Taig Higgins 20 Civic Center Plaza Santa Ana, CA 92701- Ad Itlonallnsured CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEfORE THE EXPtRATION DATE THEREOf, THE tSSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTifiCATE HOLDER NAMED TO THE LEFT, BUT FAlWRE TO DO SO SHALL IMPOSE NO QBUGATtON OR LIABILITY Of ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHQRUEDREPRESENTATNE \..-{ 1-1. ACORD 25 (2001/08) e 0 e @ACORDCORPORATION 1988 . ..---" POLICY NUMBER: PL 5574310-01 POLICY TERM: 06/24/2004 - 06/01/2005 COMMERCIAL GENERAL LIABILITY ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Name of Person or Organization: City of Santa Ana, its officers, agents, employees, consultants, special counsel & representatives. WHO IS AN INSURED (SECTION II) is amended to include as an insured the person or organization shown in the schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. For: Overland, Pacific & Cutler, Inc. CG 20 10 11 85 Copyright, Insurance services office Inc. 1984 Ai'!''?, \i I¡. -, A Y ,-,',Ll... q . '.,., T() FORNI ~~~èc,?,L- AS::'lSlaJl'" Y , Lily AUün;cy ~ ; ACORO,. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/OO/YYYYj 6/9/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Venbrook Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 22801 Ventura Blvd. Third Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Woodland Hills, CA 91364 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone 813-225-6200 Fax 818-225..Q210 -- ri/llSURERS AFFORDING COVERAGE NAIC# INSURED Overland, Pacific & Cutler, Inc. A- ~Oo5.ID^ INSURER A: Great American E & S Comoanv 100 West Broadway INSURER B Hartford Casuat~l"$u;ance Co. Suite 500 INSURER C RSUllndemnitv Company Long Beach, CA 90802 INSURER D' National Liabilitv & Fire Co. I INSUR.ER 6: Illinois Union Insurance Comnanv COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE lNSURE:D NAMED ASOVE FOR THE POLICY PERIOD INDICA TED. 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 ~iES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS POUCY EXPIRATION ~ AD POlICY NUMBER I PRH-~'l" EFFECTIVE UMITS ~NERAL UABlUTY EACH OCCURRENCE S 1 000 000 ~ ==rMERClAl GENERAL LlA!lll)'T'( PL 5574310-02 6/1/2005 6/112006 gREMISES Ea oceureoce\ S 50 OOD A - CLAIMS WOE [!] OCCUR MED EXP (Anyone ""rsoo) S Excluded "~ Contractual Liabmtv PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2 000 000 rlL .ll.GG~E.nE LIMIT A?PlS ?ER: PRODUCTS - COMPIOP AGG s Excluded POLICY ~~RT lOC ~roNOBa.E UA8IUTY COMBINED SINGLE LIMIT s 1,OOO,DOO f- ANY AUTO 72UECTQ3952 6/1/2005 6/1/2006 {Eaaccideol) f- ALL OWNED AuTOS BODilY INJURY S 9 ,.x SCHEDULED AUTOS (Per person) ~. H:REO AUTOS BDDll Y INJURY S ~ NON-OWNED AUTOS (Peracc:idenl) e----. ~ $1,000 Comp Oed PROPERlY DAMAGE X $1,000 Coli Oed (Pefaccidef\ll s ;=rE ~.OJTY AUTO ONLY. EA ACCIDENT S ANY AUTO OTHER THAN EA Ace s AUTO ONLY: AGG S EJlCnSlUM9REUA UABlUlY EACH OCCURRENCE S 1 000,000 ~""OCCUR 0 CLAIMS MACE NHA214302 6/1/2005 6/1/2006 AGGREGATE s 1 000 000 C s R DEDUCTIBLE S RETENTION S S WORKERS COMPENSATJOH AND 530303 6/1/2005 6/1/2006 X I 'T~S,~T~r,~;. I IOJ'!:!- EMPLOYERS' LIABILITY D ANi PROPF!:IETORIF'ARTNERlEXECUTlVE E.L. EACH ACCIDENT S $1 000 000 OF"FICERlMEMBER EXCLUOl:D? YES E.L. DISEASE - EA EMPLOYEE S $1,000000 ~tEt~~:O~;rtiS be\QW E.L. DISEASE. POLlCY LIMIT S $1 000 000 OTHER BMI20022998 6/1/2005 6/1/2006 E & 0 $2,000,000 SIR: $100,000 E Errors & Omissions Prof Liab DESCRIP1lQNOfOPERA11OHSll.OCA.~SJV~HJCLESICXClUSlONS"DDEDBYENDORSEMENTlSPECIALPROVlSIONS ' ;'~:::'C': \1, ~ ' p.' rr) ~... Th' SA' ffi I ", I. \.' ' dtt e City of anta na, Its 0 Icers, agents, employees, consu tants, special counsel & reperesen~tives are named' a Ad lonal Insured as their interests may appear in the operations of the Named Insured. ~.x- , . 'c. t /Ij *10 Days Notice of Cancellation for Non*Paymentof Premium / ~ ;,-,,- _ ~~ '" , / , , CERTIFICATE HOLDER Add,lIonallnsured City of Santa Ana Public Works Department Attn: Taig Higgins 20 Civic Center Plaza Santa Ana, CA 92701- CANCELLA nON SHOUUl "NY OF ~E ABOVE OESCRIBED POUClfS BE CANCEllED BEFORE TfIE EXPlRATJON DATE THEREOF, THE ISSUING INSURER Will. ENDEAVOR TO MAIL ~ DAYS WRlTTEN NO't1CE TO 'THE C:ERT1FICATE HOLDER NAMED TO THE LEFT, BUT fAILURE TO bO so SHAll IMPOSE NO OBUGAnON OR l.JABIUTY OF ANY KIND UPON nlE INSURER, ITS AGENTS OR REPRESENTATlVE&. AU'JlfORlZED REPRES ACORD 25 (2001108) OVER1 CertJI 2 Holder# 10B , THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE PART A. WHO IS AN INSURED (Section II) is amended to include as an Insured any person or. organization (called additional Insured) whom you are required to add as an additional Insured on this policy under: 1. a written contract or agreement or; 2. an oral contract or agreement where a certificate of insurance showing that person or organization as an additional Insured has been issued; but the written or oral contract must be: 3. currently in effect or becoming effective during the term of this policy; and 4. executed prior to the "bodily injury," "property damage," "personal injury," or "advertising injury" which first manifests on or after the date of the inception of this policy period, as shown in the Declarations Page of the policy but prior to the earlier of the date of expiration or cancellation of this policy. B. With respect to the insurance afforded such Additional Insured, the following additional prov,isions apply: 1. that person or organization is only an Additional Insured with respect to liability arising out of: a. premises or equipment you own, rent. lease, or occupy; or b. your ongoing operations performed for that Additional Insured by or for you. The insurance provided to such Additional Insured does not apply to "bodily injury" or "property damage" included within the "products-completed operations hazard." 2. The Limits of Insurance applicable to any such Additional Insured are those specified in the written contract or agreement or in the Declarations for this policy, whichever are less and are subject to the terms and conditions of this coverage form. These Limits of Insurance are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. 3. A person's or organization's status as an Additional Insured under this endorsement ends 30 days after your operations or agreement for that Additional Insured are completed or cease, or the expiration of this policy, whichever is earlier. ''\-01_'1 '...) "/ ~,~ ') I- JU ;,"'i.. ',', ..' 'i ~ eLL, .._~,.,~~ _m~~. ./'. <" -" .' L: '; . ~ "','_l I C. The insurance provided to any Additional Insured does not apply to "bodily injury," "property damage," "personal injury," or "advertising injury" arising out of an architect's, engineer's, or surveyors' rendering of or failure to render any professional services including: 1. the preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, design or specifications; and 2. supervisory, inspection, or engineering services. It is further agreed that this insurance shall be primary and noncontributory but only in the event of the Named Insured's sole negligence. '. I ,--', ( q~' ~ ,- t .1. i. / '/-/.)7 _.' ) .:::;,z) j / ) " d"._.. ...;'.........-.'-_....___._._'e,__.