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Home My WebLink AboutSOUTHLAND CAR COUNTERS 4A - 2004 /r: - ;;20°3 -/3 9 -D~ FIRST AMENDMENT TO CONSULTANT AGREEMENT THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into on June ~, 2004, by and between Southland Car Counters, 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 parties entered into Agreement #A-2003-139, dated July 7, 2003 (hereinafter "said Agreement") by which Consultant has provided traffic counting services. B. In accordance with the terms and conditions of said Agreement, the parties wish to extend said Agreement 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: I. Section 3, TERM, shall be amended to extend the termination date from June 30, 2004 to June 30, 2005. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Consultant Agreement on the date and year first written above. APPROVED AS TO FORM: ¡J{Ü/1~ Of ~ ð"OSEPH W. FLETC R City Attorney ACORD. CERTIFICATEOFLIABILITY INSURANCl;,u~~~~ ~ DATE IMMlDOIYY) 10/31/03 PRODUCER A- - ;;2./X'3 -139 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Consolidated Orange Co. Inc>. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1920 E. seventeenth St., *130 ALTER THE COVERAGE AFFORDEO BY THE POLICIES BELOW. Santa Ana CA 92705 INSURERS AFFORDING COVERAGE Phon..: 714-558-1334 Fax:Lic #0559854 "'UREO INSURER A. BAFECO/American States Ins Co Southland Commun~cations Markel American Insurance Co 0; Data Inc. 'NSURER B, DBA: SOUTHLAND CAR COUNTERS INSURERC' DBA: PHOENIX DATA SERVICES 1407 N. Ba§avia St. Suite 107 'NSURER 0' ~range CA 2867 INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSlJEOTO THE INSURED NAMED ABOVE FOR THE POlICV PERIOD INDICATEO. N01WlTHSTANDING ANV REaUIREMENT. TERM ORCONDIT10N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAV PERTAIN. THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE '!ERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN RECUCED BV PAID CLAIMS. LrR 'TYPE OF INSURANCE GENERAL LIABILITY paucy NUMBER P LI OAT M""'O DATE MMIDOIYY A X COMMERÐlALGENERALLIABILITY 01-CD-677669-0 CLAIMS w.DE 0 OCCUR 09/30/03 EACH OCCURRENCE 09/30/04 FIRE "'MAGE{Aoyooo',,) MED EXP (Any """ ..~on) PERSONAl.&ADVINJURV GENERAL ADGREGA TE PRODUC'!S - CaMP/OP AGG lOC 09/30/03 COMBINED SINGLE LIMIT 09/30/04 (E."""",,) A ANY'UTO AlL OWNED AUTOS SCHEOULEaAUTaB 01-CC-677669-0 BODILY INJURY (P""""O") X HIRED AU'!OS X NON.QWNEOAUTOS OODILYINJURV (P"""""') .. .. .. PROPERTYOAMAGE IP".""",,{) AU'TOONLV-EAACCIDEN'! , EAAce I AGG , I I EACH OCCURRENCE AGGREGATE ----". ANV AUTO OTHER THAN AUTOONLV. EXCESS LlABlUTY OCCUR 0 CLAIMS MACE DEDUCTIBLE RETENTIONS WORKERS COMPENSATION ANO EMPLaVERS" LIABILITY , E.L. DISEASE. EA EMPLOVE I E.L. DISEASE. POLICY LIMIT' OTHER 03/01/03 03/01/04 EA CLAIM AGGREGATE B PROF LIAB INS MG-817294 "CLAIMS MADE" PRIOR ACTS: 03-01-00 DESCRlPTI"" OF OPERAT10NSlLOCAT10NSNEHICLESlEXCLUSIONS ADDED BV"DORSEMENTISPECIAL PROVlSi""S -CANCELLATION - EXCEPT 10 DAYS NOTICE FOR NON PAnŒNT OE' PREMIUM. THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS & VOLUNTEERS AIŒ NAMED AS ADDITIONAL INSURED BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS CONTRACT ARE CONCERNED PER FORM iCG7635 10/01. RE; TRAFFIC COUNTING CONTRACT -PROJECT 5512 CERTIFICATE HOLDER Y ADornO"^, 'NSUREO; INSURER LETTER; A CANCELLATION UMmi $ 1 000,000 $ 200 000 $ 10 000 . 1 000 000 '2 000 000 .2 000 000 .1,000,000 $1,000,000 $1 000 000 6ANTO13 SHOULD ANY OF THE AIIOYE DESCRISEO POUCIES B. CANCELLEI> BEFORE THE "",PIRAT10 OATE THEREOF. THE 'SSUING INSURER WlLL- MAIL ..1Q!. DAYS WMTEN NOTICE TO TH! CERTIFICATE HOLDER "AM.o 'TO THE LEF'T,~ THE CITY OF SANTA ANA, ITS OFFICERS, EMl?LOYEES, AGENTS ATTN: ZED KEI<ULA 20 CIVIC CENTER M-21 SANTA ANA CA 92702 _. AIITHORIZED REPRESEN'TATI '10_- - () f::. Leonarei Ii Free n;;r-"~ @ACORD ACORD 25-8 (7/97) 88 , Named Insured; Southland Communications, Inc. Policy No; 01-CD"677669-0 DBA: SOlITHLAND CAR COUNTERS Policy Period: 09130/03 to 09/30/04 DBA; PHOENIX DATA SERVICES THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FlI SAFEC:O" LIABILITY PLUS ENDORSEMENT CG.76 35 1001 COMMERCIAL GENERAL LlABILIlY This endorsement mDdilies insurance prov\cled under the follOwing: COMMERCIAL GENERAL LIABILllY COVERAGE PART Sc,HEDULE Haml 01 Person Dr Organization: THE CITY OF SANTA ANA ITS OFFICERS, EMPLOYEES, AGENTS 20 CIVIC CENTER, M-2l SANTAANA,CA 92702 ADDITIONAL INSURED. BY WRmEN CONTRACt, AGREEMENT OR PERMf'. OR SCHEDULE The fDllowing paragraph is added to WHO IS AN INSURED (Section II): 5. MY person or Drg",izatlon ShDwn in the Schedule or for whDm you 8/e required by written contract, agreement' or perm. to provide insurance Is an insured, subject to ¡the following add~lonal provisions: a. The contract,: agreement or permft must be in enect during i the policy period shown In the Declarations, ~ must have been executed priOr tD the -bodily Injury," "property damage,. "personal and advertising injury," b. The person 01 organization added as an insured by this endDrsement is an insured only tD the e>Ctent you are held liable due to: (1) The ownership, maintenance Dr use of that part of premises you Dwn, rent, lease Dr occupy, &ubect tD the following add~lon81 provisions: (8) This: Insurance does not apply to any "DCéUrrence. which takes place after you cease to be a tenant in any premises leased to or rented to you; (h) This insurance does not apply to any structural afterations, new construction or demol~lon operations pertonned by or Dn behaW of the person or organization added as an insured; Includes Copyriahl~ MalllrIa) '" Insurance Servic8s Dna. Inc., withal pennlalion. ".-..'-"' ~..__.......... NI'- '- 0.., ..... 1 "" ;IJi~v1r 7-/s (2) YDur DngDing operations for that insured, whether the WOI1I is performed by rou or for you; (3) The maintenance, operation or use by you of eQulpmenlleued to you by such persDn or Drganlzation, subject to the following additional provisions: (8) This insurance does not apply 10 any "Dccurrence" which takes place after the equipment lease expires; (b) This Insurance does not apply 10 "bodily Injury" or .propelty damage" arising out of the sole neGligence 01 such person or organization; (4) Permits issued by any state Dr pol~ical subdivision with respect to operations performed by you or on 'your behan, subject to the following additional provision: This insurance does not apply to "bDdiiy Injury; "property damage," "personal and advertising injury" arising DUt of operations performed tor the state or munièlpallly: Co The insurance with respect to any architect, engineer, or surveyor added as an insured by this endorsement does not apply to "bodily injury," "property damage; . persDna I and advertising injury" arising out of the rendering of or the failure tD render any professional services by or for you, including: (1) The preparing, approving, or lailing ID prepare or approve maps, drawings, opinions, repDrts, surveys, change Dnlers, designs Dr specifications; and (2) Supervisory, inspection or engineering services. . II. This insurance does not apply ID "bodily injury" Dr .property damage" included within the .products-completed operations hazarD," . A person's or Drganlzation's statu's as an Insured under this endorsement ends when your operations for that insured are completed. No coverage will be provided II, In the absence of this endDrsement, no liability would be Imposed by law on yotJ. Coverage shall be limited to the extent of your negligence or lault aCCDrDing to the applicable principles of comparatiVe faull NON-OWNED WATERCRAn AND NON.OWMED AIRCRAFT LIABILITY Exclusion g, of COVERAGE A (Section I) Is replaced by the following: g. "Bodily Injury" or "property damage" arising out 01 the Dwnershlp, maintenance, use or entrustmenl to others DI any aircraft, "aulD" or watercraft owned or operated by Dr rented or . loaned to any insured. Use Includes operation and "loading or unloading." This exclusion applies even II the claims against any insured allege negligence or other wrongdoing in the supervision, hIrIng, employment, training or monliDring DI others by that insured. if the "occurrence" which caused the "bodily Injury" Dr "property damage" Involved the Dwnershlp, maintenance, use or entrustment to others of any aircraft, "auto" Dr watercraft that Is owned or operated by or rented or loaned to any Insured. This exclusion does nol apply to: . (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not Dwn that Is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property lor e charge; (3) Parking an "auto" on, or Dn the ways next to, premises you own or rent. provided the "auto" is not owned by or rented or loaned to you D'r the Insured; .. Inc!udel Copyrighted Malo<lal 01 lnauranee Servlc8a Dffico, lOt.. w;!h ~. p.rm~.<on. Ccllwrlaht. lnaurance Services Offici. 100.. ZOOI CG 76 3510 01 COMMERCIAL GENERAL lIABILITY (oC) LIability assumed under any" insured contract" for the ownership, mainlenance or use of aircraft Dr watercraft; or (6) "Bodily injury" or "property damage" arising out DI the Dperation of any of the equipment listed In paragraph 1.(2) or 1.(3) of the definRlon of "mobile equipment" (B) An aircraft you do not own provided II is not operated by any Insured. TENANTS' PROPERTY DAMAGE LIABILITY When a Damage to Pl1Imlses Rented to you limtt Is ShDwn In the Declarations, Exclusion J. of Coverage A, Section I is replaced by the following: . ~ Damage To PropertJ "Property damage" tD: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, Drganizatlon or entlly, for repair, replacement, enhancement, restoration or maintenance of such property for eny reason, inCluding prevention Df Injury to a person or damage to another's property, (2) Premises you sell, give away Dr a.bandon, " the .property damage" arises out of any part of those premises; (3) Property loaned to you; (4) PersDnal property In the care, custody or control of the Insured; (5) That particular part Df real property on which you or any contractors or subcontractors working directly or Indirectly on your behall are performing operations, If the "property damage" arises Dut of those operations, or (8) That particular part of any property that must bt restored. repaired or replaced because "your work" was incorrectly performed on It Paragraphs (1), (3) and (oC) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the CDntenlS of such premises, rented ID you. A separate limll of insurance applies tD Dama.ge To Premises Rented. TD You a.s described in Section III . lIm~s Of Insurance. Paragraph (2) of this exclusion does not apply If the premises ere "your wo¡(' and were never Dccupled rented or held lor rental by you. ' Paragraphs (3), (oC), (6) and (6) of this exclusion dD not apply 10 liability assumed under a sidetrack agreement. ~.v'~ P...ZoI3 " Paragraph (6) of this exclusion does not apply to "property damage" included in the "products-completed operations hazard." Paragraph 6. Df Section III Is replaced by the following: 6. Subject to S. above, the Damage To Property Limit Is the most we will pay under Coverage A for damages because Df "property damage" to anyone premIses, while rented to you, or In the case Df damage by fire, while rented to you Dr temporarily Dccupied by you w~h permission of the Dwner. The Tenants' Property Damage to Premises Rented tD YDU lim~ is the higher Df $200,000 or the amount shown in the Declarations as Damage to Premises Rented to You limit. WHO IS AN INSURED. MANAGERS The following is added to Paragraph 2.1. 01 WHO IS AN INSURED (Section II): Paragraph (1) does not applY to executive officers, or tD managers at the supervisory level or above. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B . BAIL BDNDS . Paragraph 1.b. of SUPPLEMENTARY PAYMENTS - COVERAGES A AND B Is replaced by the following: b. Up to $2,000 for cost Df bail bonds required because of accidents Dr traffic law violations arising out of the use Df any vehicle tD which the BodilY Injury Liability Coverage applies. We do not have to furnish these bonds. EMPLOYEES AS fNSUREDS. HEAlTH CARE SERVICES Provision 2.a.(1) d. of WHO IS AN INSURED (Section II) Is delet8Ø, unless excluded by separate endorsement. EXTENDED CDVERAGE FOR NEWLY ACQUIRED ORGANIZATIONS Provision 4.a. of WHO IS AN INSURED (Section II) Is repl1c8Ø by the following: I. Coverage under this provision is afforaed only until the end 01 the policy period. Includa Copyrighlecl Material 01 !!,'U~.~ ~..iCB'- ~~~:,!~c.~~~~ ~!",~~~ion. CO 76 36 1001 COMMERCIAL GENERAL LIABILItY EXTENDED "PROPERTY DAMAGE" Exclusion t. of COVERAGE A. (Section I) is amended to read: . .. "Bodily injury" or "property damage" expected or intended from the standpoint 01 the Insured. This exclusion does not apply tD "bodily injury" or "property damage" resulting from the use 01 reasonable force to protect persons Dr property. INCREASED MEDICAL EXPENSE LIMIT The medical expense limk Is amended to $10,000. KNOWLEDGE OF OCCURRENCE The following is added to Paragraph 2. Duties In The Event Of Occurrence. Offense, Claim Or Suk of COMMERCIAL GENERAL LlABILIlY CONDITIONS (Section IV): KnDwledge of an "occurrence," claim or "suit" by your agent, servant or employee shall not in itsell constitute knowledge of the named Insured unless an officer 01 the nam8Ø Insured has received such notice from the agent, SSlVlnt or employee. UNINTENTIONAL FAILURE TO DISCLOSE ALL HAZARDS The following Is add8Ø tD Paragraph 6. Representations Df COMMERCIAL GENERAL LlABILIlY CONDITIONS (Section IV): If you unintentionally fall to disclose any hazaras existing at the inception date of your pDlicY, we will not deny coverage under this Coveraoe Form because of such tailure. However. thIs provision does not affect our righl to collect addklDnal premium Dr exercise our right 01 cancellation or non-renewal. LIBERALIZATION CLAUSE The following paragraph is added to COMMERCiAL GENERAL LlABILIlY CONDITIONS (Section IV): 1D. " a revision to this Coverage Part, which would provide more coverage with nD additional premium, becomes effective during the pDlicY period in the state ShD\Vn in the Declarations, your pOliCY will automatically provide this addkional coverage on the effective date of the revision. ~. t{ (.>' DEC B2 2003 09:.:11"1< L.U.L.I."', ,>~ ~~> ~~-, 'u u-._-~- THIS ENDDRSDIEIIT CllAllUI TIlE POLICf. PLEASE READ IT tAREFULLY. ~ SA". c: '" ADDITIONAL INSURED PRIMARY co 76 81110 00 COVERAGE COMMeRCIAL GEHEAAL UABIUTY This endoneme/II mod- nsuranœ pruvIded u- till tlllllWinG; COMMERCIAl GENERAL LIAIIU1Y COVEMGE PAAT SCHEDULE NIII. 01 pem.. Of OIIIIID- crTY OF SANTA ANA 20 CIVIC CENTER PLAZA - M43 SANTA ANA, CA 92701 (If no entry IIØ8II1 IboVI. Inrcrmlliln IlQUIlld 111 comøe18 thl. endonement will be atIawn In 1118 Dec/lllllons as çplicabIe 10 11111 endOllIlllllll). WHO IS AN INSURED (SlClIoI1 U) II amendId III Incluœ a III insurad tne person or 0I'QII1JUIb1 Mown In tile Sclledule subject III tne1llllDWi1g pIIIY1alanl. 1. This insurance aøøi8S ant¡ 10 tile øIInt ,au 111 held liable lor. L Your gl1lIing OIII1IØIs for IIIat InIUIIII by or !Dr you; or .. The general MIIII'IÎI1Dn of JØangoi\g gperatlonl by ... pnon or I81IDUDn shIIwn In Ihe Schedu... 2. ThIS Insuranœ doU noIlIIPIY to: .. "ØadIlY Injury" or"IIDIeftY dImIe" ~ DIll Of IIIe sole neaJVenœ or wilful mI8conduct af, . or lor directs n daløn aJrnlSllld bY, the III1DII or orvanlzaliln SIIownln lie ScIIedule; or II. "BQØiJr 11jury" or "IIDpIIIty GamII" InCIUIIeII wlllin II1e ")IIdUCIS-mmpWd DIIIIItiJnS hl:rard. . A III1OII'S or 0I'Q8II1lItIDn', ,talUs as 111 tnsur8d under Inls endCIrumenl ends when your operations for that Insured lit compllllØ. NIl CIIVtII8 will be I'OIIfIIed n. In the atlsence DI this endurIIIII8IIt. 110 IIIÞIIIY WOUld be imposed by law on you. co.aoe shaH be umlled Ie the ellblnl 01 )'Our negligence or 18111 1Ca111I1n Ia the aøPicabll pmclp!eS 01 co" fauIL WIll Itllld Ia the Insurance IIIarØeCI \lie addltlllnel I1ll1111C1, pI~ <4. 01 COMMERCIAL GENERAL LIABILITY CONDITIONS (Sect1ac1 IV) Is dlleted and replaCed by the IonNl .. CItIIr ......n. L ThIS inlUl'l!lœ Js )limaI\' and nonconlr1bulory, and II1II' oblogilians lit nQI affKI8Ø by lIlY otner IIISInI1Ce CIITied by auch addhlnal In,urad wIIe\IIer prImary, Kess, conIifIgd, or on Illy DIller bull. II. 11111 Idd~iDNl prcM$gn IPPIIII gnly 10 Ihe person or organiutJon shown in !he Sctledllie. Named Insured: Policy No: Policy Period: SOUTHLAND COMMUNICATIONS D1-CD-~77669~a . 09/30/03 to 09/30/04, CG7I8D1Iøa ~ 5/S- _.or. ** TOTFIL PAŒ.B2 ** ~P ,ERTHQCbER COpy ~~!IŠ' \, P.O.BO~j80~, SANFRANCISCO,CA94,)42-P8P~ INSU'A<\N,':CÉ """"";y,,!;,,',, ,','r '. F U ~ Ç) CERTIFìcA TE 'ÒF ,:WO~KERS'"COMPENSA TIÒN\í~URANCE t' ~ ,.' C t;rÝ OF SANTA ANA ATTN"ILIDNA DE, ROSA CONTRACT SPEC! 20 cTv I CCENTE~Î'LAZA;M"'!+3, SANTA ANA CA '2702 ¡, ,.: , ¡ GROUP: POLICY NUMBER: 12S6302-2D03 CERTIFICATE 10: .' 43 CERTIFICÂTE,éxPIRES: 04-01-2004 04-01-2D03/04-01-2004 , ,^1-lrl A-:,qd~~, ". i; ì:' ISSUE DATE: 04-01-2003 .' " .: ~...' ,/ i . .,/ "'" J¡ 'T' This is to certify that we have issued a valid Workers'Compensatlon insurance pOlicy in a form approved by the C.lifornia Insurance Commissioner 10 tho emplo,e; named balow for ~~a policy period indicatod. This policy is not $ubjocI 10 cancellation bylho Fund except upon 30 clays' adv_nce _illon notice 10 tho, employer, ,." '., ' ' We w;;1 01$0 give you :30 .daYS"a¡j~_n;ce notice should ,this policy be cancelled pri,or to:u~,normalé~Plralion. Th;S cartlirc-ta oì"ì~$l"¡"a i$ no; a.~ ins~f.nca policy and does nole~;n(.eXI¡~,¡i or_iter the¿ovéra¡¡'è_fforded by the p'oliòiosAiståd he""ih. NOf,^,il~st_n'din~ _ny requirement.tarm. or c9ndi,tior o{,any'.:onlract:'QrotlÌar âocumarrt with res¡;ect,lo Which this' certificate of insurance may"ba"issued or may,pèr\aín./lhelnsútanco,'affordod by the ""..T' , policies d~crib~èI herein i$ subjact to al< the terms,".xc¡~sl~ns and condition. ,of such pÔlicies./' ,; r:"" /7'.""~,""",'",,' "",:,'.;:; //~ "J1~.ð.i~", AUTHORIZi¡Ó'REPRESENTATIVE PRESIDENT':;.."';', .. , .. ,Ii," ~ i', \"', EMP~OYÉ~'S;,LIABILh~ LiMiT INCLUDING[)EFENSE:èO~.T~,: ,~;L"'ô'c)\to,',',9?;OO":,,,,, p'~~¡ioC",,~R, RENe,' .E. ,'. '. '\. ; / "', ", ;: ' " " .,', ' " \ 'fNDDRSEMENT"N206SENTITLED CERnFI~~TEHDLDERS' ~?T~;CE;,'EFFEcnVE'04~O1"2~0~, IS¡AIT~~~~"i:O~D ' " ~~Sþ.PAATDFTHISP?~fCY'\ f' ",'\ \.,/ ., ',:.¡r,r ,'\; " L ",'- . .t ' j ,'/ i ;".., ,.." , \ t l ' ßQUTHLAND ,CÞ,R ÇO,UNTERS : 14Q7,NBp.TA,)lIA'Sj¡" STE 107 , ORÄNGE:CA9286~ r : ~ U l r"OVEDÂS TO BORN, ':~~:~t/Ý \;,;:,t"i City Attorney .. , r:', ¡ t, ' EMPLOYER ,::..,J,. ' '. "..' -' "".. COMMUNICATIONSI!-, Dþ.TA INC ,. "",".]"'1.,,1"". ".,-"".W"."=-"....,,,"""':"""'" ".1""'- ,",..,.. , "", jd '1' " PRINTED:"03:i7-2qè)3 PD40B , .._"~.;.",.._,,.- ,; AC()RD. ' CERTIFICATE OF LIABILITY INSURANCl;,u¥~?S I DATE IMMlDDIYY) 09/29/04 PRDDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Freeman 0; Pearce Ins. - COCIA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lic. #0559854 HOLOER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1216 N. Tustin Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orange CA 92867 INSURERS AFFORDING COVERAGE Phone: 714-558-1334 Fax: 714-628-1330 INSURED ~og~i~~c~ommunications INSURER A' Golden Eagle Insurance Corp. DBA:SOUTHLAND CAR COUNTERS INSURER B, Markel American Insurance Co DBA:PHOENIX DATA SERVICES INSURER C, DBA:FIELD DATA SVCS-INLAND EMP 1407 N. Batavia St, Su~te 107 INSURER D' Orange CA 92867 INSURERE, COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AEOVE FOR THE POllCV PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDI'TION OF ANV CONTRACT OR OTHER DOCUMEN'TWITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE lIMI'TS SHOWN MAV HAVE BEEN REOUCED BY PAID CLAIMS, I LTR I I DATE MMlDDIYY TYPE OF INSURANCE GENERAL LIABILITY I DA'TE MMlDDIYY POLICY NUMBER EACH OCCURRENCE 09/30/05 "REDAMAGE(A,,"oa',a) A X COMMERCIAL GENERAL LlABIUTY CBP9888381 CLAIMS MADE 0 OCCUR 09/30/04 MED EXP (Ao, on. pe"on) PERSONAL & ADV INJURV GENERALAGGREGATE PRODUCTS. COMP/OP AGG LOC A COMBINED SINGLE LIMIT 09/30/05 lEa "d'",) ANY AUTO ALL OWNED AUTOS CBP9888381 09/30/04 SCHEDULED AUTOS X HIRED AUTOS X NON-OWNED AUTOS 8ODlLVINJURV (P"p."on) BODILVINJURV IP".""",) PROPERTY DAMAGE ¡P""""") DEDUCTIBLE AUTO ONLY. EAACCIDENT $ EA ACC $ AGG $ $ $ $ $ $ OTHER THAN AUTOONLV, EACH DCCURRENCE AGGREGATE REmmc" WORKERS COMPENSATION AND EMPlOVERS' LIABILITY OTHER $ E,I.DlSEASE-EAEMPLOVE $ E.L, DISEASE - POLlCV LIMIT $ B PROF LIAB INS MG-820157 "CLAIMS MADE" PRIOR ACTS: 03-01-00 DESCRIPTION OF OPERATIONSILOCATIONSlVEH'CLES/EXClUSJaNS ADDED BY ENDORSEMEN'TISPECIAL PROVISIONS "CANCELLATION - EXCEPT 10 DAYS NOTICE FOR NON PAYMENT OF PREMIUM. THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS 0; VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS CONTRACT ARE CONCERNED. RE: TRAFFIC COUNTING CONTRACT -PROJECT 5512 03/01/04 03/01/05 EA CLAIM AGGREGATE CERTIFICATE HOLDER Y ADDITIONAL INSURED; INSURER LETTER; A CANCELLATION LIMITS $ 1 000 000 $100 000 $ 10 000 $ 1 000 000 $2 000 000 $2,000 000 $1,000,000 $1,000,000 $1 000 000 THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS ATTN: ZED KEKULA 20 CIVIC CENTER M-21 SANTA ANA CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, 'THE ISSUING INSURER WILL""""""'" MAIL ..3..0..!.. DAYS WRITTEN NOTICE TO THE CERTIFICA'TE HOLDER NAMED TO THE LEFT. B~ SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. 115 AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA'TIVE Leonard E Freema SANTO 13 ACORD 25-5 (7/97) 12/09/2004 17:03 FAX 3237829822 REALEST ATE. LOADED. FDS ~ 002/002 DEC 01 201M 03:52 FR FREEMAN - PERRCE 714 62B 1330 TO 132JJ?51666 P. 01/01 flTU . . Iœl. L'1 f1rY: .,:l3. 375-lfø¿,(, T" foIlowIns ~ - 8180 addtMI to 1bI8 ç..-.. ... A. AÞDlTIONALIN$\IREDS - BY CONTRACT. AGItEElENT OR PeRMIT 1. ~ Z. unciII' SECT1ON ,,- WHO IS AN INSURED is 8IIIIIIICIed 10 Include lIS an Insured ~ person or orgeniUItOn "'*' lOll 8Id IIUCh person or II/I8IIIzIIIio hIVe I'8IIC in writing in a canlfllGt. agreement or III'II1t "* lucII peIIIIII or GlgllllIøIian be III!d8d If an IIddilianal Insured an your pollc:y 10 IIOV1de InsllTllnC8 8UåI al Is effonJed unøer this Covlll1lge Part. Such III'Son or organlZ8llan Is not entllledlo any notIct, 111111 we ere AICIulrwd 10 nnd 10 the N8111811 nurecI and Is an IIdØlllonal insured only WIllI respect 10 liability Ring aut 01: .. VCIID' angaIn GP8'IIItans perfarmea for that IIIIIØn or OIanizaIion; or II. PremI8eI or f8cItIIie8l1Wn8d or ulllld by you. WillI I'88pecI \0 IOYtSian 1... 8bove, a III'8CIII's or OI8I\IZaIiCn's StaluS as 811 Insured under tills endarMment ends When your openlllOJ\S far that peraan or arganiZaIIan are 1XIII11eIIId. WillI I8pect 10 pnMsIan, 1.b. above, 8 peraan', or OIanlZlllian', ItIIIu8 as an tnsunKI unciii' 1hII ~ ends when ltleir cantrllCt or ~ willi you far Such premIIeI ar fadIIIeI endII. Z. 'This endCII8emeII pnMIJan A. dOeS not 8pIy: .. Ulll-.1h8 wrbn conII8CI or 8I88'IIeIII .. been 8Kecutec/, or perm. h88 been Issuec/, prtor 10 the "bodily Injury", °Jlllp8rty d8mIIge" or "þ8r8oiIeI8Id IIIVIIIIIsIng~; II. To "bodily injwy" or "II'OpeIty dlllll88" occunIng aIIer: (1) N. wM, JndudII'Ig II18I8ri8Is, I8/tB or IICIIÎPI1I8I1I full1i8l1llllln COtInectlan with ,uch wor1c, In IlIa In:Ij8ct (oilier ItI8n servtce, ~ or 11Ip8trs) to be perfonnec by or an ÞtIIJ8f of Ihe ectdl\lonellnlUred(l) at 1118 .... of the (:OVefIId operations has been c:ampI8t8cI; .or (2) ThaI CII1Ion øI "your WOtk" out øI which the ItIuIy or dl8l1lle arI8e8 I1a8 been put to iIIInI8I1ded use by any peqon or 0fg8IIiz1llJan aIh8r than anaIher conIIacIar or sulK;onbactor eng8gea In peIformIng open¡IIans for II IIncïpales a perl aI tile same Proj8CI; , , , " Co To tile rendefirv of or føilure ID render any p,g,essiofIaI seMceS inCluding, bill not IimII8d 10, II'Iy prafessIanaI archIIectur8l. ~ or IIUIY8YIng servioet SUCh as: . 11) The ~ ap)lOll/n, or f81g to JI1III8 or IIØPrCIIIe. III8&. 8hop 1hWIngs, opinions, 18018, SUMIYI, field OIGet'S, ch8nge 0IdII'I or drawing8 and lpeçJicatons; II11II , I ' Ia) SupørvIlClly,In8ØeCIiaÍ1, BrchIIøáInI or engIrIHrIIlg ac:Iivities; II. To "bodly if1uf1!", "property eIamIge" or "p8I8or\8I and IIIIvalll8lng Injury" IIIIsIng OUt of any ICt. error or amIs8IDn ItIIIt I88Ub fnIm ItI8 8ddIIonaI""""1 SOle negIIgenae or WI'OI1gdOing: .. To ~ I8tSOII or ~anizatlan in<:IUded 18 811 insured undet ØIOVIsion B, of this al1ClOfSement, f. TO IIny 1*801\ or organlDlllon Induded 18 an In8ured by 8 '1IIW8\8 addtllonal ill8Ut8d 8IICIIIrSem8nI Is8uIIII by us end mad. . lIlt of tIllS paIic:y. , NAIlED IHSIIB: SOUTIII.M) CØlUar:AnOHS . DATA INC. POLICY IUIIER: C3' 91188381 POLlCY PERIOD: 09/30/04 TO 09/30/05 ~ ,2/:z CI8CG - Cl71D) -- _O\ØIIId ........, - - 0IIc0a !no. will ill - ** TOTAL. PAGE.S1 ** , 12/16/2004 12: 07 FAX 3237829822 REAlEST A TE. LOADED. FDS Ii!! 002/002 12/15/:æ04 16,23 STATE COMPENSATION -+ 913233751666 NO. 133 00Ø2 CERTHOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142.0807 O»M~~N""TfON INSURAN". I=UN C CERTIFiCATE OF WORKERS' COMPENSATION INSURANCE rs8tll!: ».a.'fllh 12-15-2004 GROUP' POLIC'lNUMB£R: 12"301-~00. CERTIFICATE 10: 120 CER'I1FICATE EXPIRES: 0.-01-1005 .. -01-200./0.. Dl.IOOJ Thl. lalo ~ .,..... '-elo..... . V8IId ~ ComIJensoIIon '- policy In I fOrm 8PI>I'Öved by the CaIîrornia InlulII- CÐmnn.ioll8r to Iha 8mpioy8r - botow ... till policy P8J1oc Indicet8if. This OlIO\' II not oubect 10 -Wan bI tile Fund 811C8p1 upon 3D dl)'8 -- wrfIIon notiCllO!hI omp/oyer. We Wflllloo giVe you 30 ~"""OI /lOb ""- this poIoy be -led prforlo.. 110II1I8I øpir8Øan. ThI$ CtIIIIcII8 of ÍIIIUIW1Got " not... '"""""'" policy """ don IlOl_, eodend or ...... the ~ IIfDIWd bI the poley IIs88d h8nIIn. ~d!nø 81'1' ~ III"" or condIUon or II1II' - or - docunìènt with =.::. t~=-.ø"'V:= =:= ~~ :,~: thaM..".. -ed by the poIJcy ~ -- A.k...w.. t:. eL... - -I:.ImIa'. Io:UZUn IoDIn' IIICLD:1nIœ IJØIIIn CO8'l8: $1.000,000 'lit 0CCIIRIIIII'c:I. II1I:I0118- uno - RDcIBR C InSg,_. - 1IXCLUmm. , ~ '1100 . DOIJGLU R - ftIIiIS. - UCLlJlJl. IIIIDOIt8aa't UJOO - ftIIV II soana SIIC. - 1lECL0IIQ. -II....., '20'5 III'f%TLIID C1IIInFXCAD IIOLDIIRS' IIO'Z'J:CII IU'nC!'fIft 04-01-2003 rs UftCIIZD 1'0 AIIIII - A PU'r 01' ftZ. l'œ.:tcY. .-emIR APPROVED AS TO FORM - /~~ - -WIt ettt Jttlbtö., SOIr1'IIUIID CØIIIIOIIZCA'1'%cm:s .. laTA Die 1»>., 8OU'1'BLII!ID en -as 8370 ~ IItoVl> - 20' uvzar.Y II:tIoloS all '02U -- -"'-""""'-'--"'--8I'ATI!_-- ~--