HomeMy WebLinkAboutO.C. DEPARTMENT OF EDUCATION 3_ . +~,-.
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AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Sr. Deputy Clerk of the Council (M-30). Ca1164'7-5238 if you have any
questions.
~` The agreement with /L~u!/ '
was completed on `>~ J 1"fl ~ ,and final1 payment has been made.
Department: ~ t~
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Signature: `~Y l
Date: ~ ~~
City of Santa Ana
Revised 8-7-03 Clerk of the Council
'IÑSU~ANCE ON fllf,
YORK MAY PR'oCŒD .
UN IlL II~SURANCE EXPIRES
.1{--I-05
CLERK OF. COUNCIL
DATE: IQ -;).-0'/
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F,'5Cf!rL-
AGREEMENT NUMBER:
27083
N-2004-056
AGREEMENT FOR THE PROVISION OF SUPPORT
SERVICES FOR THE GED TESTING PROGRAM
THIS AGREEMENT, made and entered into this 26th day of March, 2004 by and
between thlOrange County Department of Education, maintaining the Alternative and
Correctional Education Schools and Services (ACCESS), hereinafter "Educator", 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') Educator and City shall
collectively be referred to as the "Parties".
RECITALS
A. Educator wishes to provide GED testing for the benefit of adult inmates housed in
the Santa Ana Police Department Jail Facility, hereinafter referred to as "Jail",
B. Educator is specially trained, experienced and competent to conduct the GED
Testing Program, hereinafter referred to as "Program".
C. City is agreeable to allowing Educator access to inmates in order to administer the
Program,
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.
A.
DUTIES AND RESPONSIBILITIES
Educator shall perform the following duties and responsibilities with regard to
providing GED testing to inmates at the Santa Ana Jail Facility:
I.
2.
Administer GED testing to inmates housed in the Jail.
Provide GED testing materials, equipment and supplies necessary to
administer the GED testing,
Administer one (I) session of GED testing as needed, when a minimum of ten
new examinees desire to take the test, which shall consist of two (2)
consecutive days of testing from 8:30 a.m. through 2:30 p.m.
In addition to the ten new examinees, additional examinees that need to retake
any of the five tests may also be scheduled to test during the examine period,
Provide examinees' GED test scores within two (2) working days after they
have been received from the state GED office,
Examinees will be charged the following rates for the GED Testing:
3,
4,
5,
6.
Initial GED - 5 Sections
$75.00
B.
2.
TERM
Retesting fees:
Test # I - Writing Skills
Test #2 - Social Studies
Test #3 - Science
Test #4 - Reading Skills
Test #5 - Mathematics
$15,00
$10.00
$10,00
$10.00
$10.00
City shall perform the following duties and responsibilities:
I.
2.
Schedule the test administration with Nancy Rice, Educator's GED Examiner
Compensate Educator at the rate of$350,00 per ten hour/two day examine
period
Provide a secure testing room with adequate space and testing stations, i,e"
desks, tables, chalkboard, clock or other means of displaying written
directions for Educator to conduct GED testing prior to each scheduled
testing.
Make certain that examinees arrive on time for each scheduled testing in order
for the testing to operate on schedule,
Assign one (I) detention officer to remain inside the testing room when the
GED testing is being administered, for safety purposes.
Provide and validate parking spaces for Educator's employees to conduct the
GED testing,
Provide lunches for examinees in the testing room,
Provide breaks when necessary for Educator's staff to use the restroom
facilities,
3,
4,
5,
6.
7.
8.
This Agreement shall commence on April I , 2004 and terminate on March 31, 2005,
unless terminated earlier in accordance with Section 12, below, The term of this Agreement
may be extended upon a writing executed by the Chief of Police and the City Attorney.
3.
INDEPENDENT CONTRACTOR
Educator 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 Educator performs the services which are the subject matter of this
Agreement; however, the services to be provided by Educator shall be provided in a manner
consistent with all applicable standards and regulations governing such services. Educator
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.
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4.
PERSONNEL
Educator and City shall retain complete and absolute authority over their respective
staff members assigned to the Program. Neither party has the authority to discipline, suspend
or terminate from employment, or take action against the other party's officers, agents or
employees.
The Parties shall at times enforce appropriate discipline and good order among their
employees and shall not knowingly employ any unfit person or anyone not skilled in
providing the services required under this Agreement.
5.
INSURANCE
Prior to undertaking performance of work under this Agreement, Educator shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Educator 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 Educator'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. Educator shall
supply City with a fully executed additional insured endorsement in substantially the form
attached hereto as Exhibit A upon execution of this Agreement and shall be approved in form
by the City Attorney,
b, Worker's Compensation Insurance, In accordance with the provisions of Section
3300 of the Labor Code, Educator, if Educator 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, Educator agrees to obtain
and maintain any employer's liability insurance with limits not less than $1,000,000 per
accident.
c. The following requirements apply to the insurance to be provided by Educator
pursuant to this section:
(i)
Educator shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement.
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(iii)
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)
d, If Educator 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 effect Educator's right to be
paid for its time and materials expended prior to notification of termination, Educator 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
a. Educator agrees to and shall indemnify, hold harmless and defend the City, its
officers, agents, employees and representatives from every claim or demand made and every
liability, loss, damage or expense, of any nature whatsoever, which may be incurred by
reason ofliability for (I) death or personal injury, (2) injury to, loss or theft of property, or
(3) any other loss, damage or expense arising out of (I) or (2) above, sustained by the
Educator or any person, firm or corporation employed by the Educator, either directly or by
independent contract, upon or in connection with the services called for in this Agreement,
however caused, but only in proportion to, and to the extent such liability, loss, damage or
expense is caused by, or results from, the negligent or intentional acts or omissions of
Educator, its officers, agents or employees.
b. City agrees to and shall indemnify, hold harmless and defend Educator, the Orange
County Board of Education and its officers, agents and employees from every claim or
demand made and every liability, loss, damage or expense, of any nature whatsoever, which
may be incurred by reason ofliability for (I) death or personal injury, (2) injury to, loss or
theft of property, or (3) any other loss, damage or expense arising out of (I) or (2) above,
sustained by the City or any person, firm or corporation employed by the City, either directly
or by independent contract, upon or in connection with the services called for in this
Agreement, however caused, but only in proportion to, and to the extent such liability, loss,
damage or expense is caused by, or results from, the negligent or intentional acts or
omissions of City, its officers, agents, employees or representatives,
c. Neither party hereto may assert against the other party any claim in connection
with this Agreement unless the asserting party has given the other party written notice of the
claim within six (6) months after the asserting party first knew or should have known of the
facts giving rise to such claim.
7.
EMERGENCIES
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Any emergency situation affecting the welfare of Educator's employees or the
examinees, including but not limited to riot, fire, flood and natural disaster, shall be
immediately communicated between the Parties.
8.
CONFIDENTIALITY
Educator and City shall maintain confidentiality of their respective records and
information, concerning the examinees served pursuant to all applicable federal and/or state
laws or regulations as each may exist or be hereafter amended or enacted.
9.
CONFLICT OF INTEREST CLAUSE
Educator 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.
10.
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:
To Educator:
Clerk ofthe City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P .0, Box 1988
Santa Ana, CA 92702-1988
telefacsimile 714/647-6956
Orange County Department of Education
200 Kalmus Drive
P.O. Box 9050
Costa Mesa, California 92628-9050
telefacsimile 741/662-3570
Attn: Susie Kegel
With courtesy copies to:
Chief of Police
City of Santa Ana
60 Civic Center Plaza (M-97)
P.O. Box 1981
Santa Ana, California 92702
telefacsimile 714/ 245-8007
and,
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P,O, Box 1988
Santa Ana, California 92702
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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.
11.
EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City
and Educator, 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
Educator. 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 Educator 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.
12. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of
Educator, Educator 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
Educators retained by City,
13.
TERMINATION
This Agreement may be terminated by either Party upon thirty days written notice of
termination delivered to the other party.
14.
DISCRIMINATION
Educator 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. Educator affirms that it is an equal
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opportunity employer and shall comply with all applicable federal, state and local laws and
regulations.
15.
JURISDICTION - VENUE
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.
16.
PROFESSIONAL LICENSES
Educator 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. Educator 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.
17.
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 indenmify 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.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written,
ATTEST:
CITY OF SANTA ANA
,
~~
City Manager
A TRICIA E. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By: ','.
Laura Sheedy
Assistant City Attorn
RECOMMENDED FOR APPROVAL:
*
ORANGE COUNTY
DEPARTMENT OF EDUCATION
~J~\~
PAULM. WALTERS
Chief of Police
~
(TITLE) Executive Director
Tax ID#
95-6000943
*Legal Name: Orange County Superintenent of Schools
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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:
I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 9270 I;
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 9270 I.
(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
9
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EVIDENCE OF COVERAGE
Orange County Department of Education
MEMORANDUM NUMBER: 74
This Evidence of Coverage is used as a matter of information only and confers no rights upon the Certificate Holder. This Evidence of Coverage
does not amend, extend, or alter the coverage afforded by the memoranda listed below.
CERTIFICATE HOLDER INFORMATION
City of Santa Ana
Attn: Donna Estrada
20 Civic Center Plaza
Santa Ana, CA 92701
Covera!!e Period: Effective: 4-1-04 Expires 12:01 a.m.: 4-1-05
This is to certify that lhe Alliance of Schools for Cooperative Insurance Programs (ASCIP) Memorandum of Coverages on insurance listed below
have been issued to the Covered Party named above for the period indicated. Notwithstanding any requirement, term, or condition of any contract
or other document with respect to which this Evidence of Coverage may be used or may pertain, the coverages afforded by the Memorandum of
Coverages described herein are subject to all the terms, exclusions, and conditions of such Memorandum of Coverages.
TYPE OF COVERAGE
LIMIT OF LIABILITY/COVERAGE
General Liability
$1,000,000 Combined Single Limit Per Occurrence
Should any of the above coverages for the Covered Party be changed or withdrawn prior to the expiration date issued above, ASCIP will mail 30
days written notice to the Certificate Holder, but failure to mail such notice shall impose no obligation or liability of any kind upon ASCIP, its agents,
or representatives. If you have any questions, contact:
Ms. Paula Chu Tanguay, Chief Administrative Officer
ASCIP . 12750 Center Court Drive' Suite 205 . Cerritos, CA 90703 . (562) 403-4640
flfrr
* ASCIP is ajoint powers authority pursuant to Article 1 (commencing with Section 6500) of Chapter 5 of Division 7 of Title 1 of the Government
Code and Sections 39603 and 81603 of the Education Code.
Rev 5-97
74-03/04-64C
Authorized Representative:
Date Issued: 5-4-04
(fVAJfJ-W~)cdy / b
I
I 1\ lliance of Schools for Cooperative Insurance Programs
1112750 Cm'" COO" D,iw. Suit< 205, Cmi'o" CA 90703 (562) 403,4640
.
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Additional Covered Party Endorsement
District: Orange County Department of Education
Endorsement No.
74-03/04-64A
Additional Covered Party:
Description of Operations, Vehicle, or Property:
City of Santa Ana, its officers, employees, agents,
volunteers and representatives
As respects use of facility to conduct GED testing for adult inmates
housed in the Santa Ana Police Department Jail Facility
Covera e Period:
Effective: 4.1.04
Ex ires 12:01 a.m.: 4-1-05
The coverage provided to the Covered Party is hereby extended by this endorsement to the Additional Covered Party named above in
accordance with the provisions contained in the Memorandum of Coverage (MOC), The coverage extended hereby applies only with
respect to liability arising out of activities in the Description of Operations, Vehicle, or Property noted above. It is intended by
ASCIP in issuing this endorsement to defend and/or indemnify the Additional Covered Party only if the District is solely negligent
In issuing this endorsement, ASCIP intends and agrees to extend coverage pursuant to the terms and conditions of the MOC to the
Additional Covered Party named above only to the extent that the Additional Covered Party faces liability arising out of claims,
demands, or lawsuits claiming money damages on account of bodily injury or property damage as defined and limited in the ASCIP
MOC The limits of liability extended to the Additional Covered Party listed above is $1,000,000 per occurrence for liability,
Authorized Representative:
Date Issued: 5-4-04
(ffh-
ASCIP is a joint powers authority pursuant to Article 1 (commencing with Section 6500) of Chapter 5 of Division 7 of Title 1 of the Government
Code and Sections 39603 and 81603 of the Education Code.
Rev 5/97
~J;t
7 /7
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/ 1\ lliance of Schools for Cooperative Insurance Programs
1112750 Cent" Cou" D,iv<. Sui" 205. C'ITit", CA 90703 (562) 403,4640
,
EVIDENCE OF COVERAGE
Orange County Department of Education
MEMORANDUM NUMBER: 74
This Evidence of Coverage is used as a matter of information only and confers no rights upon the Certificate Holder. This Evidence of Coverage
does not amend, extend, or alter the coverage afforded by the memoranda listed below.
CERTIFICATE HOLDER INFORMATION
City of Santa Ana A - ;J.OOtj- I q3
JJ - ;)/)0 '-1- os/¡;
Attn: Clerk of the Council
20 Civic Center Plaza (M-30)
Santa Ana, CA 92702-1988
Coverage Period: Effective: 7-1-04 Expires 12:01 a.m.: 7-1-05
This is to certify that the Alliance of Schools for Cooperative Insurance Programs (ASCI?) Memorandum of Coverages on insurance listed below
have been issued to the Covered Party named above for the period indicated. Notwithstanding any requirement, term, or condition of any contract
or other document with respect to which this Evidence of Coverage may be used or may pertain, the coverages afforded by the Memorandum of
Coverages described herein are subject to all the tenns, exclusions, and conditions of such Memorandum of Coverages.
TYPE OF COVERAGE
LIMIT OF LIABILITY/COVERAGE
General Liability
$1,000,000 Combined Single Limit Per Occurrence
Should any of the above coverages for the Covered Party be changed or withdrawn prior to the expiration date issued above, ASCIP will mail 30
days written notice to the Certificate Holder, but failure to mail such notice shall impose no obligation or liability of any kind upon ASCIP, its agents,
or representatives. If you have any questions, contact:
Ms. Paula Chu Tanguay, Chief Executive Officer
ASCIP . 12750 Center Court Drive. Suite 205 . Cerritos, CA 90703 . (562) 4034640
Authorized Representative:
Date Issued: 10-29-04
#¿;Ç
-
* ASCIP is ajoint powers authority pursuant to Article 1 (commencing with Section 6500) of Chapter 5 of Division 7 of Title 1 of the Government
Code and Sections 39603 and 81603 of the Education Code.
Rev 5-97
74-04/05-25C
A::'ROVED AS TO f<uKM:
.I
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/I! \ lliance of Schools for Cooperative Insuran ograms S ; t Shedy
II ^. t City Attorc.ey
12750 Center Court Drive, Suite 205, Cerritos, CA 90703 (562) 403.4640 SSlstan.
.,
Additional Covered Party Endorsement
District: Orange County Department of Education Endorsement No.
74-04/05-25A
Additional Covered Party: Description of Operations, VehicIe, or Property:
City of Santa Ana, its officers, agents and employees As respects to provide a One-Stop Liason, Carol Iffland, to the Santa
Ana WORK Center for the Instructional Services Program
Agreement #28344
COVerage Period: Effective: 7-1-04 Expires 12:01 a.m.: 7-1-05
The coverage provided to the Covered Party is hereby extended by this endorsement to the Additional Covered Party named above in
accordance with the provisions contained in the Memorandum of Coverage (MOC), The coverage extended hereby applies only with
respect to liability arising out of activities in the Description of Operations, Vehicle, or Property noted above. It is intended by
ASCIP in issuing this endorsement to defend and/or indemnify the Additional Covered Party only if the District is solely negligent.
In issuing this endorsement, ASCIP intends and agrees to extend coverage pursuant to the terms and conditions of the MOC to the
Additional Covered Party named above only to the extent that the Additional Covered Party faces liability arising out of claims,
demands, or lawsuits claiming money damages on account of bodily injury or property damage as defined and limited in the ASCIP
MOC The limits of liability extended to the Additional Covered Party listed above is $1,000,000 per occurrence for liability.
APPROVED AS TO FORM
?./z.
~
'Laura Stitt Sheedy
Assistant City Attorney
Authorized Representative:
Date Issued: 10-29-04
~~
-
ASCI? is ajoint powers authority pursuant to Article 1 (commencing with Section 6500) of Chapter 5 of Division 7 of Tille 1 of the Government
Code and Sections 39603 and 81603 of the Education Code.
Rev 5/97
.
111.\ lliance of Schools for Cooperative Insurance Programs
1112750 Crnte, Coo,, Drive, Suite 205, C,m"" CA 90703 (562) 403,4640
l'IRr,-06-2007 15: 29
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P.02/03
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Orange County Department of Educatio":
:MEM... "O~" .:n..... .'
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rbi' Evidence of Covetage is used as a maller of infDmUltion only and eonfers no rights upon the Certificate Holder. This Evidence of Coverage
do., not amend. extend. or alter the coverage afforded by the mel\lorande listed below.
0 an 4- d.005- :2...) 9
Attn: Donna Estrada
20 Civic Center Plaza A -J...ODl., - :2.10
Santa Ana, CA 92701
... ..
Cove!:!.ge Period: Effective: 7-1-06 Expires 12:01 a.m.: 7-1-07 '.
This is tn certify that the Alliance of Schools for Cooperative Insurance ProgJ:8llls (ASCIP) Memorandum of Coverages on insurance listed below
have been i.sued to the Covered Party nomed above for the period indicated. Notwithstanding any requirement, term, or condillon of any conlnlct
or orher document with respect to which this Evidence of Coverage may be used or may perta.in. tho coverages afforded by the Memorandum of
C {. ~.erage& described herein are $Ubject to all the tenns, exclusions, and conditions of such Memorandum of Covef2g~s.
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TYPROF COVERAGE LIMIT OF LIABILITY/COVERAGE
-~
General Liability $1,000,000 Combined Single Limit Pet Occurrence
L_..___
"ould any of the above coverages for the Covered Potty be changed or withdrawn prior to the e.pil'lltion date issued. .bove. ASClP will mail 30
day' wrinen notice to the Certificate Holder, but failure to mail such notice shall impose no obligation or liability of any I:Jnd upon ASClP, its agents.
or represental:ives, If you have any questions, contact:
Ms. Paula Chu Tangnay, ChiefExeculive Officer
ASCIP . 12750 CenICr Court Drive . Suite 205 . Cerritos, CA 90703 . (562) 4034640
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Authoriled Representative: \7/VI"(~71 Z-
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Date Issued: 8-21-06 i
. ....SCII' is a joint powers authority pursuant to Article I (commencing witb Se<tion 6500) of Chapter 5 of Division 7 of Title 1 of the Govomment
Code .nd Seclions 39603 and g 1603 of tho Education Code.
ReV $-97
74 -06/07'04C
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llUane.of Schoo" foe Coope""v.'"."~nc. ~a",!
12150 Cmw Coun om.... SMite 205', c.m~"" CA 9070.3 (S62J 403.4640
CER11FICATEHOLDERINFORMATION
Al - ;;;.tj:)'f - D5/.p
City f S
ta Ana
i11'1R-"06-2007 15: 29
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~da.it~'J1~;Coyere'd;.Party Endorsement
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istrict: Orange County Department of Education Endorsement No.
74-06/07.04A
- Description of Operations, Vehicle, orPro~rty:
dditiortal,CoveredParty:
lty of Santa Ana, its officers, agents, volunteers and As respects OED testing prOgram for adult inmates housed in the Santa
presentatives Ana Polic:e Deputm.ent Jail Facility
Agreement #29586
,overal!e Period: Effective: 7.1.06 ExDiI'es 12:01 a.m.: 7.1-07
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The coverage provided 10 the Covered Party is hereby extended by this endorsement 10 the Additional Covered Party named above in
accordance with the provisions contained in the Memorandum of Coverage (MOC). The coverage extended hereby applies only with
'cspect to liability arising out of activities in the Description of Operations, Vehicle, or Property noted above. It is intended by
ASCIP in issuing this endorsement 10 defend andlor indemnify the Additional Covered Party only if the District is solely negligent.
I" issuing this endorsement, ASCIP intentb and agrees to extend covetage pursuant to the terms and conditions of the MOC to the
Additional Covered Party narned above oniy to the elltent that the Additional Covered Party faces liability arising out of claiJlls,
d~nland., or lawsuits claiming money damages on account of bodily injury or property damage as defined and limited in the ASCIP
MOC. The limits of liability extended to the Additional Covered Party listed above is $1,000,000 per ""currence for liability.
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Authorized Representative:
Date Issued: 8-21-06
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A5CIP is ajoinl powers authority pursuant to Article 1 (commencing with Section 65(0) of Chapter S of Division 7 of Title 1 of the Government
Code ",,,I Sections 39603 and 81600 of tho Education Cod..
1l.,5/97
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f~lIiance of Schools for Cooperative Insurance Programs
II 12750 c..,r.. Cm<" VrWr. $..... 205. Cm1tos. CA 00703 (562) 403-4640
TOTRL P.03
MRR-05-2007 15:29
P.01/03
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FAX TRANSMlTT AL
WIl.LIAM M. HABERMEHL
county Stlperll'ltl!lndent of Scl'lOClI~
Date: March 5, 2007
To: Donna Estrada
Santa Ana Jail
Fax#: 711/ p.2f1S - ~ I / b
Subject: W-9
Pages: 3 (including coversheet)
See attached certificate of insurance for contract #29586 with the Orange County Department of
Education.~c:.-bve.. 7/1 /ot - 7.h/o 7-
Thank you.
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From the desk of:
Bevelyn Eubany
Administrative Technician
Purchasing/Contracts Unit
Orange Connty Department of Education
200 Kalmus Drive
P.O. Box: 9050
Costa Mesa, CA 92628-9050
Phone (714) 966-4100 Fax: (714) 549-4807
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