HomeMy WebLinkAboutCOOPERATIVE PERSONNEL SERVICES 2 - 2004
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WORK MAY NPT PROCEED
CLERK OF COUNCIL
DATE: \0 ..-~2-o4 CONSULTANT AGREEMENT
THIS AGREEMENT made and entered into this 1-r/t day of ([}f!.l.obe€ , 2004 by
and between Cooperative Personnel Services, a California Joint Powers Authority (hereinafter
"Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and
existing under the Constitution and laws ofthe State of California (hereinafter "City").
N-2004-128
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
developing written examinations for Fire department personnel.
B. Consultant is experienced, knowledgeable, and has the personnel capable of providing
the written examination required.
C. City desires to rent a written examination for Fire Engineer, prepared and developed by
consultant. Consultant agrees to furnish the City a multiple-choice custom examination
for the position of Fire Engineer, to be administered by the City at a time and date to be
determined.
NOW THEREFORE, in consideration ofthe mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
1.
SCOPE OF SERVICES
a. Consultant agrees to develop a written examination for the position of Fire Engineer,
based on specific subject matter and course material from International Fire Service
Training Association.
b. The City will select and, if necessary, edit specific questions after reviewing the
certification examinations.
c. Consultant will compile the selected exam questions and provide the City with exam
booklets.
d. Consultant is not responsible for exam validation or candidate qualification and ranking.
e. Related inquiries will be referred to the City's authorized representative.
2.
COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as payment for the services, the
rates and charges specified in Exhibit A. The total sum to be expended under this
Agreement shall not exceed $5,000.00 during the term of this Agreement.
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b. Payment by City shall be made within thirty (30) days following receipt of proper
invoice evidencing work performed, subject to City accounting procedures. Payment
need not be made for work which fails to meet the standards of performance set forth
in the Recitals which may reasonably be expected by City.
c. Any breach of examination material security by City will compromise the
certification system, and will result in an assessment to the City of a $500.00 security
penalty fee.
3.
TERM
This Agreement shall commence on the date first written above and terminate on June,
30,2005, 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 the Personnel
Services Agency and the City Attorney.
4.
INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee 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. 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.
6.
INDEMNIFICATION
Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents,
employees, consultants, special counsel, and representatives from liability: (1) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims
for personal injury, including health, and claims for property damage, which may arise from the
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direct or indirect operations of the Consultant or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates to the services described in
section 1 of this Agreement; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects
arising from this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to
have been suffered, by reason of the events referred to in this Section or by reason of the terms
of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold
harmless, and pay all costs for the defense ofthe City, including fees and costs for special
counsel to be selected by the City, regarding any action by a third party challenging the validity
of this Agreement, or asserting that personal injury, damages, just compensation, restitution,
judicial or equitable relief due to personal or property rights arises by reason of the terms of, or
effects arising from this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding.
7.
CONFIDENTIALITY
If Consultant receives from the City, or if City receives from Consultant information
which due to the nature of such information is reasonably understood to be confidential and/or
proprietary, Consultant and City mutually agree that it shall not use or disclose such information
except in the performance of this Agreement, and further agrees to exercise the same degree of
care it uses to protect its own information of like importance, but in no event less than reasonable
care. The City agrees that all exam questions and contents shall be reasonably understood to be
confidential. City shall not use or disclose such information except in the performance of this
agreement. "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 City or Consultant is
disclosed in a publicly available source; (c) is in rightful possession of the City or Consultant
without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or
(e) is independently developed by the City or Consultant without reference to information
disclosed by the other party.
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
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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:
Personnel Services Agency
City of Santa Ana
20 Civic Center Plaza, M-24
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-6930
and
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:
Cooperative Personnel Services
Attn: Ms. Coleen Gomez
191 Lathrop Way, Suite A
Sacramento, California 95815
telfacsimile (916) 263-3613
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.
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10.
EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, and supersedes any and all other agreements, oral or written, between the parties. In
the event of a conflict between the terms of this Agreement and any attachments hereto, the
terms of this Agreement shall prevail. This Agreement may not be modified except by written
instrument signed by the City and by an authorized representative of Consultant. The parties
agree that any terms or conditions of any purchase order or other instrument that are inconsistent
with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without
the City's prior written consent shall be considered null and void. Nothing in this Agreement
shall be construed to limit the City's ability to have any of the services which are the subject to
this Agreement performed by City personnel or by other consultants retained by City.
12.
TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of termination,
subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to deliver
to the City all work product completed as of such date, and in such case such work product shall be
the property of the City unless prohibited by law, and Consultant consents to the City's use thereof
for such purposes as the City deems appropriate.
b. Payment need not be made for work which fails to meet the standard of performance
specified in the Recitals of this Agreement.
13.
DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital
status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited
by applicable law, in the recruitment, selection, training, utilization, promotion, termination or
other employment related activities. Consultant affirms that it is an equal opportunity employer
and shall comply with all applicable federal, state and local laws and regulations.
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14.
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.
15.
PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United States, the State of California,
the City of Santa Ana and all other governmental agencies. Consultant shall notify the City
immediately and in writing of her inability to obtain or maintain such permits, licenses,
approvals, waivers, and exemptions. Said inability shall be cause for termination of this
Agreement.
16.
MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to
City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set
forth in the body of this Agreement.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST:
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PATRICIA E. HEALY
Clerk of the Council
CITY OF SANTA ANA
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City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
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Assistant City Attorney
RECOMMENDED FOR APPROVAL:
CONSULTANT:
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.-=ffi Hurnatl Resource Services
September 13, 2004
Waldo Barela
City of Santa Ana
20 Civic Center Plaza
Santa Ana, CA 92702
Dear Mr. Barela:
As we discussed earlier, the exam for Fire Engineer that you wish to administer on September 28,
2004, will be billed as follows: Base Fee for a semi-stock exam - $415.00; Per Candidate - 1-100
candidates - $10.00 per-candidate, 101 - 500 candidates - $9.50 per candidate; Shipping charge - % 10
of the total.
Should you have additional questions or comments, please f;;.el free to contact us at (916) 263- t 800 or
] -866-867-5272. We greatly appreciate the opportunity to provide '.Hiuen tests for your examination
needs.
Sincerely,
(!~ 4c4
Coleen Gomez
Test Rental
EXHIBIT
241 Lathrop Way
Sacramento. CA 95815
91 6.263.3600
BOO.822.4277 (outside CA)
916.263.3613 fax
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Offices In:
Califorr\ia
Wis:ons.n
Washington, D.C.
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pftO~I~ (916)443-0200 FAX (916)443-0251
owen' Dunn Insurance Services . .
L icens8 NUIDer': 0670.161
2831 G Street Suite 200
-:"""'cramentD, CA 95816-3721
'<..c!f) operat ve Personnel e ces
241 Lathrop Way
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Slcramen~o CA 95815
CERTIFICATE OF LIABILITY INSURANCE ~ii:;)
THIS CERTFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY-AND CONFERS NO RIGHTS UPÖNTHECERTFICATE. ...
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER TH C V ORDE BY THE POLICIES
INSURERS AFFORDING COVERAGE
~~Rk TRAVELERS
INSURER B:
INSURER c:
INSURER 0:
NAIe .
INSURER E:
, '
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN
AN'( REQUIREMENT. TERM OR CONJITION OF ANY CONTRACT OR OTHE~ 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.
- TYJOI OF INSIJIIt.I,NCE : POLICY NUMMR POUCY EFFECTIVE POLICY EXPI ATION UMITS
GENERAL LIAIIIL.ITY I 6607704A197 07/01/2004 07/01/2005 ~ OCCURRENCE $ 1,000,
~ COMMERCIAL GENERAl. UA8ILITY DAMf\GE TO RENTED S 500.1
~ :J ClAIMS WADE rn OCCUR I MEO ÐlP (AnyOl18 ØtI'8<1n) S 10,
A X I PERSONAl. & M:N INJURY $ Exc1 u£
I GEN!ML AGGREGATE S 2 000.[
. GEN'l AGGRtGA1'E LWIT APP1JES PER: I I'ROOUc;TS'. co...op AGO' s 2.000.0
I POI.ICY n ~R8i n LOC i
~TOMOBlLI LIABILITY 8l07704A197 07/01/2004 07/01/2005 COr.ABINED SINGLe LI...IT
S
NffAUTO (Ea IOtId8nt) 1.000.00Di
-
- AU. OWNED AUTOS I eoOILY INJURY
$
SCHEDùLEC AUTOS (Pw pnon)
A X -
~ HIÆD AUTCS . BODILY INJURY !
i (Per accld8n\) $
.!. NON-ov.NeD AUTOS ,
I PROPERTY DAlMGE $
/.':., , i ("'" 8cc11MnU I
,. ~~E LIAIILITY I AUTO OM. Y . EA ~CDENT I :
ANY AUTO' I OTHER THAN I!AACC S
i AUTO OM.Y: ,,00 $
ijllSlUMlIIIlLLA LIABILITY I EX7704A197 07/01/2004 07/01/2005 EACH OCCURReNCE I 5.0oo,OOQI
X OCCUR 0 CLAIMS w.œ I AGGREGATE $ 5.000,oo~
A X 8
=i OEDUCna.E ' $
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RI!T!NTION S j $
WOItIlIIU COMPENSATION ANO UB1176A220 07/01/2004 07/01/2005 I X I~~~~I l°.,W' 1
EMPl..OYERr L...IIUTY 1,000,000
A N(Y PI'IOPRIETORIPARTNER/EXECUTIVE . E.l. EACH ACCIDENT S
DFF1CZRl..,W!!I!fI EXClUœ07 U. DiseASe. I!A EMPLO'fEE 8 1.000.000
w~~une.
5 VISIONS belgW E.L DISEASE . POLICY Ur.A1T S 1.000000
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J'.,i'CØTlOf ~ OP~RATIONS I LOC,,! TlONSI VEI'ICLES II!KCLUSIONS ADDED BY !!NOOIlSEMIHT / SPICIAL PROVISIONS
e: e.l orn1a Operatlons
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~nera 1 Liability Additional Insured as per attached endorsement CC D2 48 IO()2 wI priEr)' wording
Upon non-payment of premium, 10 day notice of cancellation app1ies. I
,
,
City of Santa Ana
Attn: Thien-Vu Ngo
2Ð Civic Center Plaza
Santa Ana, eA 92702
~OULO ANY OF THE AlOIIE DESCRIBED POUCIIS IE CANC!!LUD 11I'0IUi TNI
E~IRATlON DAn THEREOF, T~ ISSUING INBURIR 'MLlUMX~ MAIL
30* OAn -TIEN NOTICE TO T~ CUTlI'ICATe HOLD!R NAilED TO THE L£FT,
~~ (~øøx~}QiWl~..-x8XX
~KIKM.:ftXIHIIJ(XØ¥IIIeOOIIJØXXXXXXXXX
MJTHOR~D IUPR~I\ITATM; . Ji1 --- c ;1,....,....t..
~ar anne Novak/LLR
ACORD 25 (2001108)
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MCORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL NSURED. the pOIicy(ies) must be endorsed. A statement
on this certificate does not cqnfe~ rights to the certificate holder in lieu of such endorsement(s).
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If SUBROGATION IS WAIVED, subject to the terms and conditions c:lthe policy, certain poleies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorse,ment(s).
DISCLAIMER
The CertifICate of Insurance on the reverse side of thia ~orm does not constitute a contract between
the Issuing Insurei'(s); authorIzed representetll18 or prodúcer, end the certificate holder, nor does I!'
affirmatively or negatively amend, ex-.encl or alter the coverage afforded by the poßcies listed thereon.
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ACORD 25 (2OÐ1101)
City of Santa Ana
Certificate issued to City of Santa Ana'
Owen Dunn Insuranc. Serv;ces
06/17/2004
20 26 11 85 COMMERCIAL GENERAL LIABILITY
\ . .~ED INSURED: Cooperative Personnel Serv; ces
FOllCY NUMBER: 3MG70480510
INSUR~NCE CO~PANY: I American Manuf. Mutual Ins Co
EFFECTIVE DATE: 07/01/2004
06/16/20001
This endorse~ent changes the policy.
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Please read it carefully.
ADDITIONAL INSURED--DESIG~ATED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GE~ERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization:
The Community Redevelopment ~gency of the City of Santa Ana, and the City of Santa Ana, their
respective officers, employees. agents, volunteers and representatives.
, ? no entry appears above, information required to complete this endorsement ~11 be shown in the
'Dêclarations as applicable to this endorsement.)
WHO IS AN I~SURED (Section II) is amended to incl~de as an insured the person or organization shown in
the Schedule as an insured but only with respect to liabi1ity arising out of your operations or premises
owned by or rented to you.
CG 20 26 11 85
Copyright, Insurance Services Office. Inc., 1984
06/17/2D04
CG D2 48 10 02
COMMERCIAL GENERAL LIABILITY
Customer Name: Cooperative Personnel Services
Insurance Car~ier: TRAVELERS
Policy Number: 6607704A197:
Policy Period: 07/01/2003 to 07101(2004
THIS ENDORSEMENT CHANGES THE POLICY.
PLEASE REAO IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(CONTRACTORS OPERATIONS)
~ERCIAL GENERAL lIABILITY COVERAGE PART
L~~ER(IAL GENERAL LIABILITY - CONTRACTORS COVERACE PART
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. City of Sant~ Ana
. Certificate--iss8Iect to'Cit~"ofSantIAna
Owen Dunn Insurance Services '
Ofj/161.200~
WHO IS AN INSURED - (Secti~n II) ;,s amended to include any person or òrganization you are required
. include as an additional ;nsuned on this policy by a written contract or written agreement ;~ effect
during this policy period and signed and executed by you prior to'the loss for which coverage ;5 sought.
The person or organization does not qua1ify as an additional in~ured with respect to the independent acts
or omissions of such person or organization \ The person or organization is only an additiona' insured
with respect to liability caused by I'your w~rk" for t,hat additional insured.
I
The insurance provided to the' additipnal insuréd is limited,as follows:
2.
a) In the event that the limits of liability stated in the policy exceed the limits of liability
, required by a written contract or written agreement in effect during this policy period and sigr.ed and
executed by you prior to the lòss for which coverage is sought, the insurance provided by this
erdorsement shall be limited to the li~its of liability.required by such contract or agreement. This
erdorsement shall not increase 'the limits stated in Section III ~ LIMITS OF INSURANCE.
b) The insurance provided to th@ additiona' insured does not apply to "bodily injury", "property
damage", "personal injury" or "advertising injury" arising out of an architect's, engineer's or
s~rveyor's rendering of or ~ailur~ t~ render any p~ofe~sional.ser~ices includ~~g:
I. The preparing, approving or failing to prepare or approve naps, shop drawings, opinions, reports,
s~rveys, field orders, change orders, or drawing and specifitations; and
]1. Supervisory or inspection activities performe,d as part of any related architectural or engineering
activities.
c) This insl.lrance does not apply to "bodily injury". or "property damage" caused by "your work",
included in the "products-completed o::lerations hazard".
3. Subpart (l)(a) of the pollution exclusion under Paragraph Z., 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 pramises which are owned or rented by the
additional insured at the time "your work" is performed.
4. Any coverages 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 a~ree~ent 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 bases. 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 "suit".
b) Immediately forward all legal papers to us, cooperate in the investigation or settlement of the
claim or defense against the "suit", 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 'Hh;ch 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
~~sured has actually requested that the insurer provide the additional insured ~th a defense and/or
jemnity under that policy of insurance.
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City of Santa Ana
"Cèrtïfïënë i!isÜëdtõ'Clty of'Sañta"Ar,.':"" ...... ...dP
Owen Dunn Insurance Services
d) Agree to make available any other insurance that the additional insured has for a 10S5 we cover
.r~'1er this endorsement.
06/16/Z00
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CG D2 48 10 Q2
Copyright, The Travelers Indemnity Company, 2000
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.te: 911/2005
Time: 9:21 AM To: City of Santa Ana @ 9,1-714-647-6930
page-,-~~____
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I 'oeDUCER (916)443-0200 ~AX (916)443-0251
I' Owen Dunn Insu~ance Services
License Number: 0670167
! 2831 G Street Suite 200
I Sacramento, CA 95&16-3721
I""uo., ~~~e~~i~~m:~r~~::~~c;e~~~~~~e:-- n __n_
I 241 lathrop Way . .
I Sacramento, CA 95815 N_;?,oo'l-I<JS .
. N. iNJ01-fJ-.Y-OI
----~ATE(*Ci:;~)-i
09(01(2005
THIS CERTI~ICATE IS ISSUEDASA MATTER OF JN~ORMATION I
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
'L HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR I
ALTER THE COVERAGE AFFORDED BY THE POLICIES BelOW. ~
, INSURERS A~FORDING COVERAGE ! NAIC N I
-~;~~:~r~.:7::=!!,~ve fers Ind~.!x~Co~any ---+---=_~~=-~~~=-~i
':Sl;~:::"l; Travelers Propel"'ty & Casualty--rnfCol
Ir~CiU<;-~~. Travelers Indemnity Co of IL: .~
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CERTIFICATE OF LIABILITY INSURANCE
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Exn04A197' 07/01(2005 , 07(01/2006
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I WORKERS COMF'ENSATION AND
: EMPLOYERS' llABIlIT{
I C 'I' .:.,1"1 ~OF'O::;IET(;Rfi='ll,R"'-I~ERIE~ECP' <'10
C:F=IC:::;;>I;~Ei~3c;< f)<CL;_'[:E~'"
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tII;~CII:IP1ION OF' OPE'UllON$ I LOC~nONS I VEHICLES I EXCLl,;SONS ADD~ ev EN;'O I, ~rMiI~~s
e. Test ~en~a~ Servlces .. A" ISUiiH.~ity Atl()l':l(~\
eneral Llablllty Blanket Add,tlonal Insured en~orsement per attached
UB1176AOiOiOl 07/01(2005 ' 07(01/2006
ABlHW-M#l,> ~" 'iW' ~('rltW
CG0246 1002
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upon nonpayment of pnemium, 10 days notice of cancellation will be given.
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C!;RTIFlCATI; 1-401 n~R
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City of Santa Ana
Pe~sonnel Se~vices, M-24
Attn: Waldo Barela
P.O. Box 1988
Santa Ana, CA 92702-1988
l1CE" ATION
SI-lOULD ANY ,:iF THE ABOVE' :JESCRI8ED POLICiES BE CANCELLED BEFORE THE
e~p:FlAT'ON DATE THEREOF, T"lE ISSClING INSURER WLl ~~ M,lOIL
30"~ DAYS "':R;TTEN NO"lce TO THE: ceR"nFICATE I-lQt.OIiR Nl>,MiD TO Tf1E L;,-n
KOOlllI~_JIIOOII(~JllIO:llll~I0;~XXX
~-'liJiA\Xitlil(__ltl_~__XXXXXXXXX
AUTHORI2EO REP~ESENTA-IVE ','i~",,~~...,..._ C /Zr-'I>"~__
~an:!I!~_~o~ak/LLR :j
,l)ACORD CORPORATION 1';88
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ACORD 25 (2001f08) FAX:
(714)647-6930
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~..t-e: t:l/J./~UU~ Time: 8:;l1 AM To: L;11;Y 0.1- ~ant.a Ana ~ ~,1.-11lli.'oq/-6S.30
Page: 003
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IMPORTANT
if the certificatEt holder is an AOD,TtON.o.,L INSIj~EC, the poLcy(ies) must be endo-"Sed. A statement
on this certificate does not confer rights :c the certificate helder in lieu :)f such er;dorsement(s)
f SL.;8ROG.~ TlON IS WAIVED, subject to the terms and conditio:1s of the policy, certain policies ma}'
:equire an endo,sement. A 'Statement on this certificate does not conter rights to the certificate
'Foider in lieu of such endorsement(s)
DISCLAIMER
The Ce:Hicate of Insurance or. the re\erse siue Gf this flJrm does nQt constitute a cortract between
the issuing !ns.urer(s), authonzed representative or prOdl'cer, and the certificate holder, nor does it
affirmatively or negatively ?mend, e){teno or alter the coverage aftcrdeo by the policies listed therecn.
APPROVED AS TU F01\M
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~CORD 25 (2001/08)
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ete: SfllZ005 Time: ~:Zl AM To: City 0.1: Santa Ana (!I 9,1-n4-647-6S30
Page: 004
City of Santa Ana
:ertificate ;ssued to City of Santa Ana
~en Dunn Insurance Serv;ces
'9/01/2005
lamed Insured: Cooperative Personnel Se~"J;ces
arrier; Travelers Indemnlty Com~any
ffective Date: C7/01/2005
'ch cy Number: P6307704A197TIL05
ommer::lal General Liao'.llty
09/01/2005
COMMERCIAL GENERAL LIABILITY
HIS ENDORSEMENT CHANGES THE POLICY. P_EASE Rt:AD IT:ARtFULlY
LANKET ADDITIONAL INSURED
CONTRACTORS)
his endorsemert rnodifH!!S lnsurance pr::rt,,,ded under t~!' folloVJ~f"1g:
OMMERCIAL GENERAL LIA3ILITv COVERAGE PART
OMMERCIAL GENERAL LIA3ILI7v - CONTRACTORS COVEeAGE PART
w~o IS AN INSURED - (section II) is amended to i~::lLlde any per""so.'1 01" organization you are requlred
c include as an additional 'nsured on this policy I::-y 3. wl"itter ccntra<:t or written agreement ~r. effect
luring this policy perlod and signed and executed by y.:)u ~r'"or tc. the loss "::;or whieh covel~age is sought.
he person or organizati on does not qua 11 fy as an addl ti ona ~ i nSL.I~ed w~ th respect to the i ndepet'loent act::.
.I~ omiss1ons of such person or organization. He pel~S:J1 or orgun"izatiDn 15 Conly an add1tional 1nsured
.ith respect to 1 ;3.bil ity caused by "y,~.;;", work" fer that add~ tional insured"
Tr,e insured pro...'lded to the additiona: "inst,;red is lin"ted as follows:
) In ~he event that the limits of 1iabi",ty stated ln the policy ex;:eeds the limits of ;'abl1ity
equired by a wr,tten ::ontl~act 0:'" written agreenlent in effect durlng this pol"lcy period and signed and
xecuted by you prier to the loss for which coverage is sought, the insu~ance prcvided by th1s
.ndorselnent shall be 1 imi red to the 1; :ni ts of 1 iab. 1 i ty -equ" red by SU:;'1 contract or a;reement. Thi 5
'ndorSEment shall not herease the limits stated in Se::t;oil II - LIMITS OF H15URANCE.
) The; nsurance prlJvi ded to the add; t1 ona 1 insured does t)ot appl y co "bodi 1 y i njur'l", "propetty
'amage", "'perso(1al injlJ:~/" or "aavertis~ng injury" aris1ng out of an ar,:h1tec~ls, engineer's or
urvey::>;""s rendering of or fai'lure to I~ender an)' J;rofe:ssional services inc"uding:
r"E:: prepar'i ng, ap_::;~ovl ng or fai 11"9 to p)"epare or approve maps I snop drawi ngs, 0::>1 ni ons I '"eports I
urveys, fie:d orders, ~hange orders, 0- drawings and soec~~"at1ons; and
I. Supervisory or -i"\spectior' acti'Jities performed as part of arc)' related arc:hitect~,"al or ergineeri"g
ctlvitles.
,C 02461002 COP'Ir1ght, The irave"iers Inderr:rllty ':ompany, 2002 Page:' of 2
) This 'nsurance does not apply to "bodily inJur:)'" 0" "property damage" caused by "your work"
ncluded 1n the ""products-completed oper-a":ions ba:Zard"~nless YOk..: :Ire required 1:C provide such cGven,ge
~r the addltioral ins~,ed by a writte, contract or written ag~eement i1 ef~ect Guring this policy period
nd sig'1ed and e>.ecut~d by you prior t:J the ":055 for Whl.::h cov'~rage is sought arc then onl/ 'ro:"" the
ler'10d of t~me required by suer contract or agreement a....ci In no event beyond the expiration date o~ tn,?
oliey.
S;;bpart (l)(a) of the PollLtion exclu5~or l.<nder Pa!~agrapl- 2., Exclusions of Bodily InJury and
roperty Damage Liability (overage (Section I - Caver;;lg,?s) doe!: net ap:?lf to YOu if the "'bod,ly injl,.;ry.'
r "pl-ope!~ty damage" ~.rises out of "Y:Ju'~ wor"k" perfCr1led on prem.;ses w:'ich are (owned or rent~d b)' the
dd,tic1al l"lsur"ed at the til11e "ycur,"':F(" ~s performed.
A.'1Y coverage provided by this endOi"Semet1t to an adcht-onal 'insured shall be excess over any oth.:::,~
alia a"d co;lectible insurance ava"ila.,le to tre additicllal ""'lsLred wh<:ther prin'ary, ex::ess. contingent
r 0:1 ar.y other basis ;,J,11ess CJ. written ::ontl"act or written agreement in ef'::ect curing tlis policy pei'll)d
nd signed ar,ci executed by you pr-10r t:> -:he 'oss for ;,vhich coverage ls sought specifically requir'es that
ris ","1surance apply on a primary at" ~lOn-contr'~butory .::.as,s. When 1:1115 lnsurance 15 ;J'rHlary arc thel~~
s ot:bei ~ nsur-ance avai 1 abl e to the addi ti ana I 'i rsu:~ed f'~on an}' scurce, we v.i'11 share '.vi th that ctl"1er'
n5ura~ce by the rnethod clesui be:d in t"le pOi - cy_
,""s a condit"lon of coverage, each addlt-onal ~n.s~I~ed t"i1u~h:
APPROVED /\S 10 fORM
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,te: 9/1/2005 Time: 9:21 AM To: City of Santa Ana @ 9,1-714-647-6930
Page: 005
City of Santa Ana
:ertificate issued to City of Santa Ana 09/01/2005
Men Dunn Insurance Serv;ces
.) Give LIS prompt written rotice of any "occl...rrence" or offense Vlrt;id may resu"lt in a claim and
'rompt w....'tten rotic.e ':If "s.u~t".
:.) Immed'ately rorward all legal papers to ws, coone~ate In the inves~;gation or settlement of the
laim o~ defensE against the "sl;it", and other...:~se comply w~th peliey :::ond;t~ons.
.) Tender the aefense and irdemnity of any clalm ::;r "su..t" tc any other ~nSl..irer wt-rich a;so insures
gainst a "lOSS we cover under tris endo"'sement, This hch.des bL.!t is not hr.lited to, any insi.Jrer whic,
as issJed a polley of insurance in ~~ich the addltionai lnsurea qualifies as an insured. For purposes
f th'is "'eqU1rement, t:"1@ term II 'insures aga~nst" refers ~i) any self-'insu:,ance and to any insurer which
ssued a po~ ~ cy c,f i nsu""ance that may prov; de coverage fOI~ the less I regal~di ess cf whether the additi :j"'td 1
nsured has aetuaily requested that the insur'et' prov-Jde -:he additional insured with a defense ancjcr
ndemnity under that polley of insurance.
.) Agree to make ava;lab~e any othe"" insurarce that ,:he additlQl'1al lr:sul'ed has for a loss we covet
nder t'1is endorSEment.
age 2 of 2
Copyrlght. The Travele""s Indemnity (.:)ll1pany, 2(,02
CG D2 40 10 02
APPROVED AS TO FORivl
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