HomeMy WebLinkAboutSOFTMASTER 1C - 2004
A-2004-257
t: ~tXJ
{ 1..14JhtI
THIRD AMENDMENT TO AGREEMENT FOR PROVISION OF SERVICES
THIS THIRD AMENDMENT, made and entered into this 18th day of November, 2004,
between the City of Santa Ana, a charter city and municipal corporation duly organized and existing
under the Constitution and laws of the State of California ("City"), and Softmaster, Inc.
("Consultant").
Rf;CIIALS
A. The City and the Consultant entered that certain agreement dated December 18, 2001,
hereinafter referred to as "said Agreement", pursuant to the Request for Proposals ("RFP") for
Consultant to provide temporary technical contract service persons and consulting services. An
amendment to that agreement was entered into on December 19, 2002.
B. The parties hereto now desire to amend the Term and Compensation sections of said
agreement in order to provide continuous uninterrupted services to the City under the Agreement.
WHEREFORE, in consideration of the mutual and respective covenants and promises
hereinafter contained and made, and subject to all of the terms and conditions of said Agreement as
hereby amended, the parties hereto do hereby agree as follows:
1. Section 1, the "Term and Conditions" of said Agreement as amended is hereby amended to be a
period beginning on December 18,2004, and ending on December 31,2005.
2. Section 2, the "Compensation" term of said Agreement is hereby amended to provide the City will
pay to Consultant total compensation under this Agreement which shall not exceed $2,850,000.
Said total compensation shall be divided between any and all of the Consultants selected by the
City, as determined at the City's discretion.
3. Except as hereinabove modified, the terms and conditions of said Agreement and all Exhibits
thereto, remain unchanged and in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Amendment to said
Agreement the date and year first above written.
ATTEST
~~!4
Clerk of the Council
CITY OF SANTA ANA
a~a,
DAVID N. REAM
City Manager
(SIGNATURES CONTINUED)
INSURANCE UN FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
I;;. - ól.'f-p'-f
CLERK OF COUNCIL
DATE: 1;;.-1- o'f
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
.
By: m'L V~
Michael Vigliotta
Deputy City Attorney
TO CONTENT:
a R.. orna
Executive 'ictor
Finance & anagement Services Agency
SOFTMASTER, INC
~
[ signatur'€]
Name: &k/t'dG éhBd
Title: (~)
EmployerID# é/ç-~j.Ý>7Yf
or Individual SS #
Dec~30-03 [14: 10P
, .
r""'-rl"""IUWMI...... ..-. ............-
P.02
.~~ CERTIFICAT._. OF LIABILITY INSURAN ': ~:ñ~=
THI8 CEltTIFICA'II!! 18 ISSUED AS A IllATn" Of' INI'ORIIATlON
ONLY' AND 00_'" NO RIOHTa UPON TH~ CERTlI'ICATE
HOLDER. THIS celml'lCATI! DOE' NOT AMÞD, EXTEND OR
AlTIR TIlE OOVERABE AF~~EtI BY ~~ POLICI!!. DaoW.
IN8U"ERa AF~ORl) NG COVERAGE J NAlC ,
'tNSUl'l~. .ar~orwi- '-" -. ,1= - '
¡,,~-;;;,'Ðni~-:-t~ s:."'i1i~....ur~. ","-=--'
INI~ _. - .--. .-- .,-.
~~".
INSlmEW 110:
COVE !8
Tio1l! POLl~ O~ INS\..RANCt: uS!'E::O ~~,OW tiAVE eE~ ~SUEO TO Tl1t IN5UftfC NAMEO A8OV~ fOR THE POUCY PERlon I"IDICATED NOTWITHST^NDlHG
,.".'.¡ AEQUIRE&.IIlNT, Ti:1W OR CONDITiON 01:' ANY CONT~AC1' OA OTHiR OOCUMENT wn H RESPECT TO WHlCM TI'I15 c:ERT FIC^T~ ftlAy BE IssuED OR
MA'( peRTAIN, THI! IHSURANCf A)" OR-DEe BY THe POLICIES DESCRI&En H£RtIN IS SUBJECf TO AlL THIi£ T!RMS, E)lCLUSI~S A,ND GONCITIOH& 01" SUCH
P( I,.ICJES. AG(Jllle.QAT¡; LlMITI5I SHOWN M,t.Y HAve aEEH filitJVŒD BY p^'n CiV\IMS.
-- ..' ,.-. . PCK.,ICY'MJMKa . -r
"""DuœJI
"i naøa:-anc-
~8Ii TMko1.09Y Dr.!.."., BuJ.... B
l~Y.!."', CII taus
(9'9) T5,1-955'
INS\.IIIIm
-. '
SO~~.1A1K', .tn.::-
~E'Q'1I ~b8n
2-01540 Oak Cr..t. nri.~
O~aaond e.r, ~ '1765
A-i{ß03.~~4
4--~o.;L - ;J..J 3
A-~/) 1- õ2.S(e
~.
',,":..-;...,-;
AI
I
,
S!IA Klfll097
A'
A
ø, BN. ~OSl'
, 8BA Klfll097
..---.--.
'. 'PJ?i"''';: .
. .~ , I' 1"~'
1!~.-aUALIA8LITY
P (Ç<'''' i c..."",.."""
'~
~
LIIIn;
.1,,, 0,000
1.a/2./2003
EACH CC(;U~HkNC[
~O'-
~¡IIIKi!"'_'). .
MECEXP(~.~~¡) $ ,000
PeR~~.t~w-4.A!A" s
~~9~p.(IAT! :12,OOO!~ÖOO
~~~!!:..95!~'("¡~AGQ .i
12/2./200.
12/24/2003
12/2./2003
COIotI.....uAiHGlr.LlMrr
(~'1ØDM1
1I0OI'''',,,,,,,, "'E"
\t"1trr-rM~)
. , .
I!IOr.II¡VJN.KIHY S
~1f1CC"'nlJ
.. . ., -..
,""OI-Hl'V bANAQIi: I .
I~"-~
,1,000,000
12/24/200'
12/2&/200'
',1'
AUTO ONl'r CÁ~ClDe'NT ,
.,''> ,
\ ' 1 ""¡ . ~-¡'.
OTH~ THN4
AU'TOONl"l'.
!!'...cc s
-.
I
.--:-,-.".' ' " -L~'
, LUll ..; ~";' p,~~" w.
- ~,'I'. ¡." ,. ....., .~~:...;~.~
,,').. .~.Q -": . ..1 f" ~.
- , .¡ . i ,~ .." ,I
.-... ...,..,_...
Dli.oucna-c
RI!:TlNTION So
WORfŒMeDlPt!~IJ\ìJON ~
~ '~YI" LUlllJTf
..... 'I' ..ItOPAltTORlPÞJ; TNEAJE.1(Ef.'.~ II,¡ e
omCOW,&4'EA EX«(.VOECI'"
H ....1MIoet undlt
\ OIlOW' -
8 OT1Œft p~o ... :Lonal
L;l.abUity IJl.1Þj.",t t.o
11:5,000 doId1>e:ttibJ...
2~a':n~~~tä~Ync'em'l1~'Wru::n-TI_--
V.l.U¡ n8p8ac. '-0 \\be op8z:oaUQ... of
1ft..NcI ttJ.da Þ<8¡*Gt. t,o tM ~.~ Li.Ahil.i-ty. hz- at~c:Ib" fOEa .. 04 .. O:i 93
0017.5
CI!ItTl~ICÞ,T1! HOLt..ft
'ft\8 I:'u;r 9' ",pI~. AD..
.m nJJ.\In't8ti'.
20 CivJ.a c.n.t82' Pl...
88At.& .J.aa, Ca !!>21G:i.
.:Lt. 6tf.u.Z'8. 8Q8D'C8
I I
ACORD 25 (20°"0.)
~H9.C'¡lIlItll",*".
~II!Ø".!!:.
.
.
I
I
~
.
!:!:J~__c"eMl'LOvæ 5
r:.L. 0t2ASe -I"'OLleY lIMIT I
hr Cl.allll
.AQ!Þ"8\l8"
IIoIt..o Dolt.
1, 0, 0
$1,000,000
12/24/1"8
~_d
CANCELLATION
IHOU..D IMI OP-ntl MCMI ÞUOfWIïp ~- ~L.lÞ8IP<IN! M Dil8RA11ON
'DAn 'TtIIIIœ0P'. .". ..... ~ WILL YIOCAvOR, 'to IIIoIrI. ~.O- MY' WIIIII'flVI
MOnt. 10 'I'ItI;¡ cunlACA~ MOLDU NAIIfm TO TME Lln. IUJ,.AILI.RI! TO DO IIJ ttMU
IMPOII!: NO 08UGA'TIIOIII OR LMIU1Y Of" 'Hf IÇlIIØ 1.8~ THI! IIIIIUUft. ". 1IðI:JfT8 0lIl
~Sl!!ilTAIMI.
C>ACO~ COF!l'ORATION 11811
~ec~~O-03 04:10P
P.03
-'. .
THIS ENDORSEMENT CHÞ-NGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED. DESIGNATED PERSON OR
ORGANIZATION
Thhl endorsement modifies Insurance provicltd under !tie foIlowfng:
BUSINESS UABlLITY COVERAGI! FORM
C, 'MIo i. en Insured In the BUSINESS LIABILITY
COVERAGE FORM Is Iilmend8d to '"elude II an
Insured I:h8 petSOl, or organization shown in the
DtCU1lr¡¡tlons but only with respect to liability arising
oul of thfl opel'8tion of the named l/\SIIrø.
For losses co~el'8d undar the BUSINESS UARILlTY
COVERAGE of this policy this Insurance Is primlilrily
to other valid and collective in8ur.oce which Is
available to the parson or orglniz8tian shown in the
Declaratlon888 8n Additlanallnsured.
Add"ionallnsur8tl.
City of Santa Ani, ... ofl'lcere. a"lIIat-
volunt.G1'8, 8Mploy- and age.
20 Civic: Center
SIma AnI, CllII2701
. }'"
.' .t".,'~ . ".
~t/¥f:~E'
'''' .',' ..,L';.'!' ",-
Form SS 04 "8 OS 93 Printlle in U.S.A. (NS)
COpyright, Hartford Fire Insutlnce Com Piny, 1993
ACORD",
CERTIFIC.E OF LIAS) ITY INSU
If - .;2X9r';
CITY OF INDUSTRY
626 854.9541
CA 91744
DArE (hiM/CD
2/21/200
THIS CERTlF,CA TE IS ISSUeD AS A MATIER OF INFORMATION
OHL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS ceRT'F/CAfE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
\NCE
PRODUC," The Master Insurance Agency, Inc.
18053 VALLEY BLVD
INSURED
SOFTMASTER INC,
20840 OAK CREST OR.
DIAMOND BAR, CA 91765
INSURER A Everest National Insurance Com an
INSURER 8'
INSURER c:
INSURER D:
INSURER E
COVERAGI1S
THE POLICIES OF INSURANCE LISTED BElOW /;AVE BEEN ISSlIEO TO THE INSU ED NAMEOABOVE FOR THE POLICY PERIOO INDICATED, NOMTHSTANDIN
ANY REQUIR"MENT, TERM OR CONDrTlON OF ANY CONTRACT OR OTHER DOCU ENT WITH RESPECT TO WHICH THIS CERTIFICATE MAy SE ISSUED OR
MAY PERTAIN, THE INSURANCEAFFORDE[) BY THE POliCIES [)ESCRIBED HEREI IS SUBJECT TO All THE TERMS. EXCLUSIONS AND CONDmONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEE.N REDUCED BY PAID CLAI s.
~M 7YPE OF IN$URANCE l POUCYNUMBER I.ri1Jb~, DATf!'r(~,:rbom-)
GENERAL UAWUìY I
COMMERCIAL GENERAL. LIABILlTV
¡ CLAIMS MADE 0 OCCUR
GEN'L- AGGREGATE LIMIT APPLIES PER;
PDLlC\' 0 frg 0 LOC
AUTOMOGILE lIABIUTY
ANY AUTO
.ALL OWNED AUTOS
sCHËDULEC AlJTOS
HIRED AUTOS
NON-OWNEDAUTOS
LillITS
EACH OCCURRENCE $
FIREO~~~'WOf1.f~.1 S
MED EXP (Anyone perlOnJ S
PERSONA ... & ADV INJURV $
GêlllfRAl AGGRE.GATe. s
PRODUCTS. GOMPI()P AGI3 $
'\ ;'F'tOV Li ),\:
¡(¡FOR)
COMaINEb SINGLE LIMIT $
(E"IIIICe d8n1.)
'BODILYI~JURV $
(PlirpØrson)
BOOIL Y INJURY $
(Per eccidllr'll)
PROPERTY DAMAGE .
(Per 8ccident)
GARAGE LIAB U'h"
ANY AUTO
,-!d. "" !L:t&¡.~_.. ",..._,-
i£&;"I~
OTHER THAN
AUTO QNl Y:
AUTO ONlV. EAACCIDENT :$
EA ACC $
A<>G .
E.XG~S UA6ILIT'Y
OCCUR 0 CLAIMS MADE.
;, 'ì' ;', C!l'.
.>.!li:,; C'
EACH OCCURREHCE
AGGRE~T!:
A
3900037744021
10/27/2003
10/27/2004
.
.
.
.
.
01/..
ER
1.
E.l. DISEASE" EA EMPLOYEE $
E.L. DISEASE. POLICY lIfUlT $
1,O~
1,00
1,OC
DEOUCTlBLE
RETEhnON $
WORKERS COMPENSAtiON AND
EMPLOVEFt5' UABlLlTY
on.IEIt
DESCRIPTION OF OPERATlONSll0CA11ONSlVEHICLESlEXCLUSJONS ADØEO &tV EriDORSEIIE /'SPECIAL lROVlSION$
SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSI NS, INSURED FOR THE I..OCAT.ON AT:
2512 CHAMBERS RD..
TUSTIN, CA 92780
'30 DAYS NOTICE SHOULD THE POLICY CANCEL FOR NO -PAYMENT
CERTIFICATE HO\.CER
AOOITJONAl.I~SURE[); IIriSURER L.!mR:
CITY OF SANTA ANA
ITS OFFICERS, AGENTS AND EMPLOYEES
20 CIVIC CENTER PLAZA
P.O. BOX 19S8.M12
SANTA ANA
CA 92702
CANCELLATION
SHOULD Nrf 01" THE 4SOVE OE$CRIBED I'OUCIU BE: CANCElLEO BEFORE THI' EX
DATE THEREOF, THE JS$UINQ INSURER WILL ENDEAVOR TO MAIL ~ DAVS W
NOTICE TO THE CU,TlFlCA1'e HOLDER NMlE:c ÌC 'rHI: UiFT, auf FAILuRE TO DO 8(
IMP05E NO OBLIGATION OR L.WIIL.JTY OF ANV KlI\8D UPON THE INSUIŒR. ITS AGENT
RI!PR9~TA. T1\IES.
AuTI10FtltP.:O ":EPRESENTAl1VE
~~~
............-.......,., .....-...,
. ---- --.--.-. "-_.
.
09/14/2005 14:35
714-647-5406
CSA INFO SVCS
PAGE 10
PPlODUClEII
ACORD", CERTIFICATE OF LIABILITY INSURANCE
IDA"
10-25-2004
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERnFlCATE DOES NOT_~~IND. EXTEND OR
ALTER THE COVERAGE AFFORDED IY THE POUCIES 8ELoW.
STUCKEY & COMPANY/PHS
539645 P: (866)467-8730 F: (977)538-8526
P. O. BOX 29611
:U\RLOTTE NC 28229
/T"."'. A-,;;{{JOI-:J50
SOFTMASTER INC A-",/J'J~-;l.J3
20640 OAK CREST DR !+-dco.3-;;I../A
DIAMOND BAR CA 91765 A -(}{J(y/.-;?51
COVERAGES
INSURERS AFFORDING COVERAGE
INsuFlERA,Hartford Casual tv Ins Co
JNSUFK;JtIl:
INf:UR&R Cl
INSUflER 0:
IN1!iUA~ ~
THE POLICIES OF IN~~RANCE UBTED BELOW HAVE BEeN ISS~ED TO THE INSURED NAMED AeOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR OONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI~ CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED 8V THE POLICIES DfSCIllBED HEREIN IS SUBJECT TO ALL THE TERMS, EXClUSIONS AND CONDITION' OF 'UCH
POUCIES, AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS,
r,\R TYJl! DJ ""UAAJlC!1 IIOLlCl. NUU'" roJ,tr;;y If~ r:k!2r.!':.'r~N I "IIIITI .
OINIRAL LlAIItU'IY r EMti OCCUftneNl;e: 1,2,000 000
1l - 84 SBA KW9097 12/24/04 12/24/05 FIMDAMA.EI....~... 1.300,000
COMMEflIClAl QENEM.L UA8/UTY
I ClAJM5 MADf! l1tJ OCCUR MiD ~ ,Any DrJI' P."lrl'il'llI .10 000
X Business Liab PERSONAL' MY INJURY ,2,000,000
f- GEfIIERAL AGOREGATE .4,000,000
n'L ^GCmrATE~;; APPL1i ~R; PlIDDucn: . COMP.IOP AGG .4.000.000
"'L1O. I ~ IX LOG
~TONO"'E UAIIL.,... 12/24/04 12/24/05 COMIIlNm SJNGLl L.IMIT .2,000,000
A A.NV....Ul'O 84 SBA KW9097. tbi~tl
, f-
c- ALL OWNED AUTOS BODfL.Y INJURY
.
SCHEDULED AUTOG !P.rPttMN -
rx f111~A,UTOS ! BODIL. INJl.fI.
if .
NON-OWNED AUTOS fiP8r.lll:!llidlnQ
=
- PROP,II'TV DAMAGl .
I,.., eecldlntl
)'--"" ~"". L1ULnY AUTO ONLY- EA ACCIDENT .
.-1 ANY AUTO OTHI!"TI-lAN &;:^^~(: .
A\JTG DNLY; '0. .
~I~ lAC,", OCCURRENCE. ,
.
f-J OCCUR U ClAIMS IMDE ,.. I ~GfI~GATG .
\ .
R D"UOTI~" chp !. //>. .
RIlHNTION . ~I .
WOR." (!C)M'EPaATION AMD J - ~V~ i" i IOl:-
IMN.,OYIII' l-IAIIUTY
H. EACH ACODENT .
f..L DISEASE, E,A. EMPLOY1:f. 0
-- . ',,_.' ",., E.L. DISEASE. PQI..U.Y_UMIT .
OTH"
DfSGIIIrIlON 011 OlllUtAno.....l/LOCATIONlNEHICLHIIXCLWlIONa ADDED II'f ENDOUEMfNf!l.te"'J. P~YltION'
Those usual to the Insured's Operations. Coverage is primary ..
non-contributory per the Business Liability Coverage Form 330008, attached co
chis policy. The Cicy of Santa Ana, its officers, employees, agents and
volunteers ar.e listad as Aaditional Insured.s.
CERTIFICATE HOLD~" I X I AIlDITIDOALI"'."""'UAIII",",,!, A
IThe City of Santa Ana, Its Officers,
, "'Ilployees. Agents and Volunteers
.~ Civic Center Plaza
Santa Ana, CA, 92701
ACORD 2(;.(; 17/9 71
CANCELLA TlON
SHOULO ANY OF THE ABOVE [)EBCRIBED poue;l~ &I! eANCEU.EO DEFORE THE'
EXPIRATIOIol OAH THEIlroF. THE "'UINO IN$VAER WILL ENDEAVOR TO MAIL
.0 DAVS \oVl!ITTEN NOTICE 110 DAVS FOR NON-PAVMENT) To TH~ CeRTlFIGATE
HOLDER NAMED TO THE LEFT. aUT FAILURE TO DO 50 SHALL IMPOSE NO
OBLIGATION OR UABIUTV O~ ANY KIND UPON THE INSURER. IT. AGENT5 OR
REPRESENT A llVEll.
~QREPRE&I!~~I . \.
I ~~Ia..,-'t~t....
o ACORD CORPORATION IN.
r--..
...~...
. ...<. - .
.,' . -..
. .." .'
. . ,. .,
, , ".
, ,,-. ..
<ThE' ....
ffii.Ii1'FORD .
THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED. DESIGNATED PERSON OR
ORGANIZATION
This endol'llement modifies insurance provided under the followin~: 84 SBA KW9097
BUSINESS UABIL.ITY COVERAGE FORM
C. Who is an insured in the BUSINESS LlABI L11Y or losses oovered under the BUSINESS
C. Who Is an inSlng in !he eU$INE$S LIABILITY
COVEAA<OE FOAM 19 ameooeg to Irr:lude as an
insured the person gr grganlzallon shQOlm I~ Ihe
Declarations but only wl~ respeclto liability arising
Out of the operations of the nlllled In.urecl.
For losses covered under the BUSINESS
LIABILITY COVERAGE of this polley ltIis insurance Is
primarily 10 other vaiid and collective insurance which i.
available tg the pel'!lon or OrQlInlzaflon
shown in Ihe Declarations as an Additional Insured.
/"-
CITY OF SANTAANA,
ITS OFFICERS, eMPLOYEES,
AGeNTS AND VOLUNTEERS
20 CIVIC CENTER PLAZA
SANTA ANA CA 92701
,BE C/~
.~
Form 55 04 4805 93 Printed in U.S.A. (NS)
Copyright, Har1ford Fir.. Ineur"nce Company, ;9>/3
L~ 3911d
SOAS O-"NI 1150
9~PS-LP9-P1L
SE:PI S~~~!PI!6~
ACORU", CERTIFICATE OF LIABILITY INSURANCE I DATE IMMfDD/rYj
1111912004
"OOUO". Th" Mast..r Insurance Agency, Inc. THIS CERTIFICATE IS ISSUED ",. A MATTER QF INFORMATION
16053 VALLI:Y 6LVO ONLV AND CONFERS NO RIGHTS UPON TH!: C~RTIPICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED OV THE PQLlCIES BELOW.
.---- CITY OF INDUSTRY CA ~1744 INSURERS ..."FORCING COVERAGE
Uj261 854.9541
I~SUReo INSUfU!!ftA: NATIONAL LIABILITY AND FIRE INSURANCE CO.
SOFTMASTER INC, IN:5URER 5: .. ..
20640 OAK CREST DR. IN6URIOR c;
DIAMOND BAR. CA 91765 I INSURER 0, ..
j .-1 IINSURj:R e;
COVERAGES
THE ~OLICIES OF INSURANCE LISTED BELOW f-l'>VE BEEN ISSUED TO THE INSURED NAM.D ABOV. FOR THE POliCY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF MY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR.
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLiClES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POllCtES. AGGREGATE LIMITS SHOWN MAY HAVE sl!eN ~e:DUCED BY PAlD CLAIMS.
.~f:1 TVPI!OPINSURANCE POUCYNUMSEIil P8t+i";P6~IE "Bkf~f~~"
L.l1Yn"5
...?!.NIIUL UAQILITV
COMMERCIAL GGNE:RAL LIABILITY
I CLAlVIS MADE 0 OCCUR
_ ~CH OCCURRENCE $
FIRE: DAMAGE (Anyone Ore) $
MfO EXf' (Any l:ln\!l POr~n/ $
pE:ReONAL 6. A()V friJUtW :)
GENERAL^GGR~GATe $
I'''Clt:!UCT&. C~MPIO~ AG.Q; !;
'1',.
~L A!JC3RE~ LIMIT A.P~S PER:
, POLICY I I ~~T i I LOC
~TOM~nlll.e L.IAI!IILITY
_ M'yAlJiO
_ ACL OWNEO AUTOS
_ ~HEOuLec Aljl'Oe
_ HIRl;;D AUTOS
_ NON-OWNED AUTOS
.
COMBINED SINGLE LIMIT
(Eiil',,.,.;l;i<;!nl)
.
<)
..... ~
. .
eODll Y INJURY
(f'orlllilrson)
. I.
I
/" '-..
.I
'-, x
BOCIL Y INJURY
{Peraeei~l"It)
,
~~! LIABILITY
1 ANY AUTO
'-1
- -., --tI v
,'; ,
'-. -~
\,r
PROPERtY'OAtMGe;
(~1!lf8CciO&nl)
$
}-----,
n I
. ,dl_
'--"'"
--:-/
,'" !'(
....UTOONLY-~A'XICI::NT :Ii
I
I
.
.
.
cAACf:
AGG
OTHER ll-IAN
AUTO Of'lL Y:
EXCESI5 LlAfIllITY
o OCCUR 0 GLAIM$ MADE
lJ OIiiD\,ICTlaL.E
1--1 REt!NT~N S
-- -WOR~ERS C'rj'M"'~~ATlONA.ND
, EMPLOVGIUi' UABIUTY
~CH OCCURRENCE
AGGRI2GATE
10/2712004
.
.
--. '--'-X"ri-~~"
1 0/2112005 EL EAOH ,00105"Y .
E.L.. 016C....::II:. .I!A EM~~Q"I'!;. $
I'<.L. OISE:ASl:: - fllOUCV L1MrT ill
.
A
0100000037--041
1,000,000
1,000,000
1,000;000
OTH~
I
I
OESCA.IPnON OF QPERATIOf.W/lOCATIONSlVtiOCLE!IIEXCLUSIOJIIS ADDEO 6Y ENDORSEMI!NT/SI"EGlAL. PROVlllcmS
SUBJECT TO POLICY TERMS, cONDITIONS AND EXCLUSIONS, INSURED FOR THE LOCATION AT:
2512 CHAM6ERS RD.,
TUSTIN. CA 92780
'30 DAYS NOTICE SHOULD THE POLICY CANCEL FOR NON-PAYMENT
CERTIFICATE IiOLIJ~R I I AODl1LONAL INSLR!:O: INSURER L~EIil::
CANCELLA'tION
:SHOULD ItN((IFYHllEAIOVi DESCRlBE~ l"OL-1CII;$ BE CANCELL.EP g~ORI! THE EXII'IRA110N ..
gATE THC~f, THill 'ISUIN$ INSURER WIL.-L ENDUVOR TO MAIL ...l2... DAYS WIUTT~N ,
NO'fICE TQ THE CERTIFICATlI-IOLOER NAMED TO YH&: LIiiI"T, I!UT FAILURE TO DO SO SttALl
IMPOSE NO OliU,.JQATION OR UASIL.ITY OF A~ KIND UP"ON THI!! INSURER, IT5 AGENTS.. O~
REPRE!JENTATlVe:S_
AUTHOfUZfiP FtSPRESENTATIVE
~r
k
~\;(J
-' (:',: .~I .
CITY OF SANTA ANA
.~ OFFICERS, AGENTS AND EMPLOYEES
CIVIC CENTER PLAZA
P.O. BOX 1988-M12
SANTA ~A CA 92702
ACORD 25.3 (1/97)
LM: L.PW v1_Q.8an 11122104-8:36 OV U&il~arl"le
lP: lPW v1.Q.e on 11122104.9.39 by UlillrflljlM
. .
I!lACORI1 CO~PORATION'1:9n',
f1FI/1:0:l"':
80 391;'d
58A5 O~I 1:'58
90PS-LP9-PTL
SE:PT S00~/PT/60
AkQBD", CERTIFICATE OF LIABILITY INSURANCE I DATE {MrNDDlYYI' .
11412005 "~'"'.
PAOClUCIA The Master Insurance Agency, Inc. THt5 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ..',
18053 VALLEY BLVD ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND oft' "
ALTER THE COVERAGE AFFORDED BY THE POLICIES BJ;LOW. ,," "
CITY OF INDUSTRY CA 91744 INSURERS AFFORDING COVERAGE
,\ (626) 854"9541
.._URlO INSURJ;;R. A: TUDOR INSURANCE COMPANY . ~"L._'"
SOFT MASTER INC. INSURER 8: ";j.,"":'
tN5UM/il:C: " . ,,,,ow,,,,:
20640 OAK CREST DR INSURER 0: "':""'''l,.r,
DIAMONQ BAR CA 91765 lNSURER E: ',-",:;"..
,
COVERAGES
"...::-.
',~.,"...
THE POLICIES OF INSURANCE LISfEC SIlLOW HAVE SEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATEO. NOTWrn-lSTANQJNG-- .
ANY REIlUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSU5D,:.Qa",_
MAY PERTAI~, THE INSURANCE AFFOR~EO BY TH5 POLICI5S DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POliCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C~MS. , ~"'::!-;,i;:"I'
111_14 ~ I'OUCYE.-IRATIQW ,.'
'-~'fl\ nPQOFINSURMCE PClUC"NU~ER DATE ~ ciATii(MMlnnl"l'V\ LIMITS ...,,,,_:_~.,.....
~NERAl UABlUl'l" EACH OCCURAIlN~~" ...,.':.~j.,~
GOMMIi:RCIAl G,l;;N!;;R:AL LlASfUTY f::IRI; DAMAQ!F. {Any orI8 fire) S "-'I"
!.~~"."~o~J:Joccu. ....'.....,.-.--..--._... .. '__. _________ .. :;=A~yA::::~~.._.:.- _' c;':'::
GEN~RALAGGRl!;GATE . S '-~H;'
PRODUCTS. COMPIOP A.GO S , ,".',' ,
.
,'..,.'
CANCELLATION " ',"'.'
IHOULDANYO, TM! AlOVIi! DESCRIBED POLlCI~ 88 CANCELLED BEFQAI!!!1'ltIIX,.IMrlo"'!
DATE T'HEIU!O'. niB ISSUINIJ IN!JUR!1iL WJLL II!NDEAVOR TO MAIL ~ DAVS WR!TI-E!'r"
~OTICE TO THECeRTJFICATE J10LDiR NAMEO TO 'THe l!fT, BUT FAJI.URE TO lXJ SOS~~~'
IMI"08E NO OBllG4TIOIt Olil: LIABILITY OF AN'( KIND UPON THI! INSU~ER.., ITS AGEN~ ~~._
KURE3Ii!NTATfVll.
AUTHORIZED Rl.PRi!SI5NTAllYE.
~N'l.AGiGRi~Ii,j.fMITAP~Pm
! POi.LC'r' II ~:g: I lux;
Al,lTQMQ~LIl! 1..IAIlIIl,.I'I'\l'
3ANVAUTO
All OWNE;:O AUTOS
~ ' SCHJ;;[]Ul!;iO AUTOS
HIRGO AUTOS
h F NON.OW.EDAUTOS
r,RMlI L.IAIIUTY
H NiY ^UTO
COMBINeD SINGLE UMIT $
(EEl8CCldllnl)
BOOll V INJURY $
(Pl:rl:lor~)
I BODilY INJURY $
(f'llrttOQlGllnt)
PR.OF'ERTY DAMAGE .
tP..r~d~1
-.'- -.,
.. .-. '---_._~ ~.~,--
AUTO ONlY_1;A ACCIDENT $
eA ACe $
AGG .
$
.
.
$
$
~IIOJ;:"
~.L. EACH ACCICENT $
E::I".DISEASE. EA 1:l4j:;lD'9I:I:-Y--.
E.l. DISEASe - POLICY LIMIT S.
OTHER Tl-iPIN
AUTOONLY~
EXCESS lIAB1UTV
p'occu~ D CLAIM' MACE
ROEDlJOtlBlE
ReTENTION $
WORKeRS COMrt:NaATJON ANO
eMf'I.OYERS' LlABIUTY
EACH OCCURRENCE
AO~EGATE
OTHER
ERRORS & OMISSIONS
A DEDUCTIB~E; $ti,OOO
EDPO003485
12/2412004
12/2412005 PER. AGGREGATE
"~"'PT1CN OF OPI!RAnoNIlI.O~ngNINf;HIGL65IEXCLU81ONl5 ADDeo BY ENDOft6CMENTI9'ECIAl. PROvtIlON$
SUBJECT TO POLICY TERMS. CONDITIONS AND EXCLUSIONS, INSURED FOR THE LOCATION:
2512 CHAMBERS RD., TUSTIN CA 92780
*;i0 DAYS NOTICE SHOUL.D THE POLICY CANCEL. FOR NON-PAYMENT OF PREMIUM
CERTIFICATE HOLDER I I "".mo....'......o, I..U.... LOTTEI<
CITY OF SANTA ANA ITS OFFICE:RS, AGENTS AND
EMPLOYE:ES
CIVIC CENTER PLAZA
P.O. BO)( 1988-M12
SANTA~A CA92702
ACORD 2ti-$ (11V71
lM: lPW v1.8.f1 on 114/05 - g;52 by U88rNM'If!
~~..... .~
.;:.
,. ';R',;,.-.->.
""'":'''''
.,;\j,;,\{tIl~",-
.'h":,~l\'l.-,:r","::".
,," 1"".,,,',:,..
, J'..',..'"
'" .."
"~I
tt,Il,:, "
',"
"--
..""
..
1,000,000"
,
\:,;',;.J~:, _
",:,:~.'......
'~;;"..-- .
.
LP~ LPW \/1.lf,e, '"'" V4105 - I:S3 by UterNralT1lJ
$ACORll CORPORAnON 1988
PC'''Jti
~E :i:'1 ~tltlUi:'1I6{t.....
Gtl 38\1d
50A5 OjNI \150
9tli:'~-Li:'9-p1L