HomeMy WebLinkAboutCAL STATE FULLERTON FOUND. 1C coos
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Please complete this form when the attached agreement is no longer in effect.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). Call 647-5238 if you have any
questions.
----------------------------
The agreement with
was completed on C ~ U ~ ,and final payment has been made.
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Department: ~~~ ~~~ ~~~~
Signature: ~ ~~~~ ~~
Date: ~ '
Revised 8-7-03
City of Santa Ana
Clerk of the Council
,
INSURANCE ON FIll
NOlii, Mi,Y PROCEED
JNIIL INSURA,NCE EXPIRES
1 - -05
CLERK OF COUNCIL
DATE: ~--iS-05'
N-200S-019
-'
CONSULTANT AGREEMENT
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THIS AGREEMENT made and entered into this ..J.. ~~day of January 200S by and
between California State University Fullerton Foundation, a nonprofit auxiliary and fiscal agent
of California State University, Fullerton and the Center for Oral and Public History (hereinafter
"Consultant"), 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").
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
conducting oral history interviews to teach classes for the City's leisure class program.
B. Consultant represents that Consultant is able and willing to provide such services to the
City.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably be
expected ITom a professional consulting firm in the field.
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.
SCOPE OF SERVICES
Consultant shall perform those services as set forth in Exhibit A to this Agreement.
2.
COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services,
the rates and charges identified in Exhibit A. The total sum to be expended under this
Agreement shall not exceed $1,000.00 during the term of this Agreement.
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.
3.
TERM
This Agreement shall commence on the date first written above and terminate on
December 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 Executive Director of Parks,
Recreation and Community Services 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 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
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. Commercial General Liability Insurance. Consultant 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 Consultant'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. Consultant shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit B upon
execution of this Agreement and shall be approved in form by the City Attorney.
b. Reserved
c. 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.
d. The following requirements apply to the insurance to be provided by Consultant
pursuant to this section:
(i)
Consultant shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement.
Certificates of insurance shall be furnished to the City upon execution of
this Agreement and shall be approved in form by the City Attorney.
(ii)
2
(iii)
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.
e. If Consultant 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 Consultant's right to be paid for its
time and materials expended prior to notification of termination. Consultant 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
Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents,
employees, consultants, special counsel, and representatives from liability 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
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.
7.
CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
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. "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.
8.
CONFLICT OF INTEREST CLAUSE
Consultant covenants that it present! y 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
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:
3
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 copy to:
Executive Director of Parks, Recreation and Community Services
City of Santa Ana
20 Civic Center Plaza (M-23)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 571-4235
To Consultant:
Tanya Thompson, Acting Director
Office of Sponsored Programs
2600 E. Nutwood Avenue, Suite 275
Fullerton, California 92831
telefacsimile (714) 278-1256
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.
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 ofthis 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.
4
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.
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.
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 its 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
All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth
in the body of this Agreement.
5
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST:
CITY OF SANTA ANA
~< -_: - r£-r
PATRICIA E. HEALY'
Clerk of the Council
/i/
/ '
U%4Î ;;2.
DAVID N. REAM
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
~;
By: leu 1(J
Lau'ra Sheedy
Assistant City Attorney
". 1
)LUI! V
/
CONSULTANT
RECOMMENDED FOR APPROVAL:
CSU FULLERTON FOUNDATION
/ 1;1;, h/. í)',
{.L~ . c/<. 41 ¡( U ¿:¿bA-.
WILLIAM M. DICKERSON
Executive Director
GERARDO MOUE
Executive Director f Parks,
Recreation and Co munity Services
Tax ID# 95-2081258
6
EXHIBIT A
SCOPE OF SERVICES
Consultant shall instruct youth and adults, 16 years and older, in How to Conduct a Family or
Neighborhood Oral History, as follows:
FEES
.
,
'\-'
two X
Consultant shall teach the three-hour class during .fStlf' separate sessions.
The classes will be held at the Santa Ana Main Library at a date and time to be agreed
between Consultant and City. Consultant may adjust the schedule, based on the
availability of rooms in the City's facility and holidays scheduled by Consultant.
Each class shall have a minimum of 10 and a maximum of 20, registered and paid
participants.
If the minimum registration has not been reached by the first class, the class may be
cancelled by mutual agreement of Consultant and City, with no compensation owed
Consultant for any cancelled class session.
.
.
.
.
Each participant in the class shall pay a $15.00 class registration fee per three-hour class.
No refunds will be made to participants after the first class unless the class is cancelled
by the Parks, Recreation and Community Services Agency.
City shall collect registration fees from each participant. Consultant shall refer interested
students to City for registration.
Consultant shall receive seventy percent (70%) of total fees collected for the classes
within fifteen (15) working days after completion of each class session. City shall retain
thirty percent (30%) of the fees collected.
Consultant agrees that City shall be entitled to audit Consultant's records and classes to
ensure compliance with this Agreement and that all participants are registered.
Consultant may not waive class participation/registration fees.
City shall prepare class rosters and provide a copy to Consultant. Only registered
participants, listed on roster, may participate in class.
.
.
.
.
.
.
7
EXHIBIT B
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:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; 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 92701.
(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
8
,
.
31.Jan-2Q05
Driver Alliant Insurance Services
600 Montgomery Street
9th Floor
San Francisco, CA 94111
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
PRODUCER
(415) 403.1400
INSURED
CSU Fullerton, Foundation
2600 Nutwood Ave., Suite 275
Fullerton, CA 92631-3599
Attn: Bill Herbert
INSURERS AFFORDING COVERAGE
Please refer to Coverages section below.
481
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CoverageType
Insurer
Policy
EffectiveDate ExplratlonDate L.lmllType
Amount
SIR Fund LJab1l1
AGPIP S.I.R Fund
AGPIP-0405--01
Excess SIR E&O Uab Evidence of Insuran Onl
GENESIS
YXB3OO954A'
01-Jul-2004 01-Jul-2005 Generalliabili - Each Occurrence
Autoliabill Incl. tn GL limit
HireG'NonOwned Auto Incl. In GL limit
ProdJCom 1.0 rations InclinGLLimit
Contractual Liabili IncllnGLUmit
01-JuI-2004 01-Jul-20Q5 Generalliabili -Each Occurrence
re ate - Combined Cov. A & B
Auto Liabili Incl. In GL limit
HireG'NonOwned Auto Incl. In GL limit
ProdJCom .0 rations InclinGLlimit
Contractual Liabili InclinGLUmit
01-Jul-2{J05 SIR Errors & Omissions
Excess SIR Errors & Omissions
01-Jul-2004 01-Jul-2005 GeneralLiabili - Each Occurrence
""'.00)
Excess SIR Liabif
GENESIS
YXB3OO954A'
$750,COO
$3,00::>,00::>
$250,000
$750,000
ExcessL.labili
For Evidence of Insurance Onl
Schools Excess Uability Fund
T0704-19J1247
$14,000,000
APPROVED AS TO FORM
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLEs/EXCLUSIONS ADDED BY ENDORSEMENTS/SPECIAL PROVISIONS
City of Santa Ana, its officers, employees, agents, volunteers and representatives are named additional insureds as respects Consult Agreement
between the City of Santa Ana and CSU Fullerton Foundation for leisure class program. Project Title: Family or Neighborhood Oral History Workshops.
Project Period: Janua 2005 - December 2005.
IMPORTANT
If tI1e certificate hoider is an AODITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate hoider in I~u of such endorsement(s).
If SUBROGATION IS WAIVED, subject to Ihe loons and conditions of the policy, certain poiicies may require an endorsement. A statement on Ihis certificate does not confer rights to the certificate
holder In lieu of such endorsemen s.
The Cartificate of Insurance on this form does f\Ot constitute a contract betwean the issuing insurer(s}, autl10rizad representative Of producer, and the certificate holder, nOf does it aflirma~vely or
negativelyarneod,extendorattarlheooverageafforded by the poIicias listed thereon.
DISCLAIMER
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Attn: Clerk of The City Council
6476-1741
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLOER NAMED TO THE LEFT, BUT FAILURE TO
DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE COMPANY, ITS
AGENTS OR REPRESENTATIVES.
AUTHORIZEDREPRESENTATlVE~.....v ~ ~
,
TIllS ENDORSEMENT CHANGES TIŒ POLICY. PLEASE READ IT CAREFULLY.
POLICY CHANGES
Eodo,,.,,,,,,nt
Number 14
POUCY NUMBER ENDORSEMENT EFFECTIVE COMPANY
YXB300954A J~l 2004 G~esæIDmmmceComo~
NAMED INSURED COVERAGE PARTS AFFECl'ED
Califumia Stale Umversity Risk Mana¡ement Authority - Tbe Schoo! Policy
Auxiliary G1:oup Purchase I:osurance Program Retained Limit Form
Cove¡age Part A
CHANGES
BLANKET AOOmONAL INSIJJ!F.D
PlIlagraph D. in SECTION IT - WHO IS AN INSURED in CO\Ierage Part A Is deleted and replaced hy thc following:
D.
Asly person, entity, or organizaDon you arc required by an lwIured contract to include as an insured we will
include as an Insured under this policy but OJÙY with respect to bodily iJljury. penona! Injury, advertising
injury or pr-operty damaae arWna out of your operatlODS or premises owned by or rented to you. This insurance
shall be limited to the extent of cavenge and Limits of Liability required by the insured eontract and shaU not
increase thè limits stated in SECl'ION m' - LIMIT(S) OF INSVRANCJ!: or alter any of the terms' of coverage
stated in 1bÏ8 policy. The Insured contract must be effective and eKecuted prior to a covered occorrenœ. The
insurance provided hr:rcin to any peœon, entity. or III!)' orpn~tion qWllliÿlng as an Iosured, does not apply 10
any liøbility occurring after those operations or use of premises have ceased.
Except with respect to the relevant Limit(s) of Imaranee, any applicable exclusion(s), and any I̡hts or duties
specil!caI1y assigned to 1be Fint Named InlUred, this policy applies separately to each Insured against whom
çIa!m or suit æ brought
The terms of Endorsement Numbers 15 and 17 do not apply to this endOlSement.
Signed at Stamford, Connecticut on June 25, 2004
APPROVED AS TO FOR!v¡
~ 2/2-
/Laura SlÜt Sheedy
Assistant City A¡¡orl~V
SPIU.F 999-1
/~~
Copyrlab~ Geoeais In,uraDc:e Company, 2004
Authorized. Representative
Feb 02 05 02:46p
p.2
AC.DRQ. . CI!:RTIFICA TE OF LIABILITY INSURANCE I DATE (NWDDIYYYY)
02/02/2005
'''''''''CB< (7J.4)!/23-1860 FAX (714)!/3!/-1654 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA11ON
Brown It Browtt of Cal iforaia, Inca DNL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO &ox 6!/89 ALTER THE COVERAGE AFFORDED BY THE POUClES BELOYI.
Orange, CA !/2863
INSURERS AFFORDING COVERAGE NAIe "
INSURED CSU Ful1er~ FOUndat"10ft INSURER A. State Fund
2600 Nutwood Avenue INSURER B
Suite Z75 INSURER c:
Fullerton, CA !/Z831 INSURER D:
INSURER E
COVERAG~"
THE POUCES OF INSURANCE laSTED BElOW' K\VE BEEN ISSlED TO TtE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOI::ATED. NOTWlTHSTANDfNG
IW'f RECUREMENT, TERM OR CONDITION OF Am CONTRACT OR OTIER DOCI.JŒNT WITH RESPECT TO WHICH THIS CER11FICATE MAY BE ISSUED OR
MAY PERTAIN, i1-E INSURANCE AFFORDED BV THE POl.JCIEs DESCRIBED HEREIN IS SUBJECT TO ALL THE. TERMS, EXCLl.JSIONS ANO CONOITJONS OF SUCH
~S.þßGREGATE llMIT5 SHOWN MAY HA.'Æ BEEN REDUCED BY PADCLAN$.
1NU1 T'fPEOF INSUIUtHCE paJCy NUM8ER POlICY ~ POLICY RAT UOIITS
GENERAl. UA8LITY EACH 0CC<JR1>E!ICE ,
I- DAMAOE TO RENTED
COMMERCIA.l GENERAL UABlUT'f ,
~ =:J CCA*$ MADE 0 OCCUR toteD EKP (Anr one pecson) ,
PERSONAl.- & ADJ INJURY ,
GENERAL AGGftEGA"Œ ,
GEN'L NJGREG#\ TE LIMIT APPlIES PER. ÞRODtJCTS. CQMPoP "GG ,
~POUCYn~ nlOC
AU'1'OM08ItÆlMØ/LfTY COMBINED S1NGl£ UMff
- ,
A~"UTO (E.açIC~
-
~ All OWNED AIJfDS BODILY INJURY
,
SCHEDUlED AUTOS (perpetSOð)
- APPROVED AS TO FORN
HIRED AUTOS BOOIL Y INJURY
- ,
NON.oINNED...UTOS . ¿:1r¡ (Peraccl6eonl)
-
'" ),Á /J t7A PROPERTY DAMAGe .
::z- (?eraccidenl;)
=f""""'-"Y .a ~'~;~ ecdy AUTO ONLY - EA ACCIENT ,
ANY A.UTO Assistant Cit ' J ttorney one< n<AN EA-='
AUTO ONLY AGG .
EXCESSIUMMEUA LIAIIIUTY EACH OCCURRENCE ,
5:x,CUR 0 CtMI$ MACE AGGREGATE ,
=i== '
,
. ,
WCRKER5COMP'ENSAT1CH AND 566000008-()4 07/01/2004 07/01/Z005 X WCSTATIJ- I"""
EMPlOYERS' UABIUTY 1,000,000
A N'(V PRQPRtETORIPARTNERlEXEClmVE EL EACH ACCIDENT .
OfACERlMEMBER EXCLIJOED? EL. OISEA$E-EAEMPlOYEl $ 1 000.000
~,dftcrjbeunø.r 1,000 .0001
EClAt. PROVISIONS below E.1... DISEASE. POlICY lIMIT $
OTHER
DeSCRJP110N OF 0PERA.1f:S Il.OOAJIONS' YEHIClES I EXCWStONS ADDED BV eNOORSEMENI' I SPeCW. PROVIS«)NS
PI: Dr. Art ur Hansen
Project Title: Fanrily or Neighborhood Oral History Workshops
Project Period: J..uary 2005 - DecenDer Z005
ERTlFICATE
R
CANCELLA110N
Ci ty of S8IIta ABa
ATIN: Clerk of the City Counsel
20 Civic Center Plaza. (M-30)
P.O. &ox 1!/88
Santa AN. CA 92702-1988
StiOUl.ÐANY OF THE AeO'œ œSCI\I8eD POUCH!S BECAHCe1.l8) BEFORE TME
EXPlRAT10N DATE THEREOF. THE I5SUING INSURER WILL ENDEAVOR. TO M~L
~ OAV$ WftlnEN NOTICE TO THE CERTtACAlC HOlDER NAMED TO THE LEFT,
BUT FM..URE TO MAIL $UC~ MOT1C:E SHALL IMf'OSENO OBlIGATION OR. LIABILITY
OF Atft taNO UPON THE INSURER. ITS
AU D R8PRRS :A.
ACORDU (2OO1Q8) FAX:
(714)647-6!/56
@ACORD CORPORATtON 1188
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.:
CERTIFICATE OF INSURANCE ,
EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS.
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER: PUBLIC ENTITY (ADDmONAL INSURED)
Driver Allia¡J.t Insurance Services C-Lty 0 [, San:ta. AM
P. O. Box 28323 20 C~v~e Cent~ Plaza, M-28
Santa Ana, CA 92799-8323 Santa. AM, CA 92701
(949) 660-8163
License No: OC 36861
NAMED INSURED (EVENT HOLDER): EVENT INFORMATION:
S~epha~e GeoÆge AI - õl.D()5- 01 '1 TYPE: r n.6 :tJtuc..ü.o YlILt - EYlgwh/SpaYÚ.6h,
DATE(S): 2/07/05~6/30/05 HL6~Mlf, PÆe.6eJr.V
CenteJr. f,M OÆILt & Pub~e HL6~OÆlf/CSUF LOCATION: S.A. Ubl!.CUttf Pho~a.6
This i~ to certify that the policies of insurance listed below have been issued to the insured named above for the policy period
indicated Notwithstanding any requirements, terms or conditions of any contIact or other document with respect to which this
certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms,
exclusions and conditions of such policies. Limits shown may have been reduced by paid claims.
INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER: 05SEPI 000001
MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2005 EXPIRATION: JANUARY 1,2006
COMMERCIAL GENERAL UABIUTY OCCURRENCE FORM DEDUCTIBlE: NONE
General Agsregate Limit $ 2.000.000
Products It Completed OpcnIdons 1,000,000
Personal It Advertising Injury 1.000,000
Each OccUITCDCC Limit 1.000.000
Fire Damase (Any One Fire) SO.OOO
Medical Payments (Any One Penon) S.ooo
The limits of insurance apply separately to each event insured by this policy as jf a separate policy of insurance has been issued for that event.
"Who is insured" is amended to include. as an insured. the person or organization shown in this schedule, but only with respect to ¡iability arising out of the
ownership, maintenance or use of tile premises used by the named insured (event holder), This insurance does not apply to: Any"occurrence" which takes place
after the event holder ceases to'be a tenant in that premises.
OTHER ADDITIONAL INSUREDS
APPROVED AS TO FORJv, '
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LdUW iy -,
Assistant Ci y Alwrn.;,
CANCELLATION' Should the above described policy to cancelled before the expiration date thereof. the issuing company wilJ mail 30 days written notice to the
certificate ho1der and additionaJ insureds listed.
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AUTHORlZED REPRESENTATIVE:
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DATE ISSUED:
2/07/05