HomeMy WebLinkAboutFIELDMAN, ROLAPP & ASSOCIATES 1AGREEMENT TERMINATION ��ii��
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City of Santa Ana
Revised 8-7-03 Clerk of the Council
INJURAIP,L7 iGUI 1 I f m_ -
WORK MAY N-0-1 PF;OCEEv
CLERK OF COUNCIL.
DATE: SEP 2 9 2005
16 j.kd^c�
A-2005-223
CONSULTANT AGREEMENT
THIS AGREEMENT, made and entered into this IV11- day of SWIf"'Xhtg, 2005 by
and between Fieldman, Rolapp & Associates (hereinafter "Consultant"),an 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
independent financial advisory services to provide financing feasibility, planning and
structuring, and possible debt issuance services, in connection with the proposed funding
of water, sewer and other public improvements through the possible formation of a
Community Facilities District.
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 from 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:
SCOPE OF SERVICES
Consultant shall perform those services as set forth in Exhibit A to this Agreement.
Additional services which may be provided by Consultant, upon the written request of
City, include :
• Assisting the City in obtaining enabling legislation or conducting referendum
elections.'
• Extraordinary services and extensive computer analysis in the structuring or
planning of any debt issue or financing program.
• The repeat of any element of a service described in Exhibit A, which is made
through no fault of Consultant.
• Financial management services, including capital improvement plans, economic
development planning, credit analysis or review and such other services that are
not ordinarily considered within the scope of services described in Exhibit A.
• Services rendered in connection with any undertaking of the City relating to a
continuing disclosure agreement entered into in order to comply with Securities
and Exchange Commission Rule 15c2-12 or other similar rules.
• Services rendered to the City in connection with calculations or determination of
any arbitrage rebate liability to the United States of America arising from
investment activities associated with debt issued to fund the project.
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 B.
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 June 30,
2007, 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 Finance and
Management 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. WORK PRODUCT
Consultant shall deliver to City all work product resulting from the services provided.
Said work product shall be submitted in a hard copy and produced in a form compatible with
City's computer system, as agreed between the Project Manager and Consultant.
Consultant agrees that City shall own any and all work product produced pursuant to this
Agreement, and further, City may utilize such work product in any manner deemed appropriate by
City.
6. 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 C 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. Professional liability (errors and omissions) insurance, with a combined single limit of
not less than $1,000,000 per claim.
e. 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.
(ii) Certificates of insurance shall be furnished to the City upon execution of
this Agreement and shall be approved in form by the City Attorney.
(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.
f. 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.
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 acts,
errors or omissions 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. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the
defense of the 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.
S. 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. 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 Consultant disclosed in a publicly available source; (c) is in rightful
possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Consultant without
reference to information disclosed by the City.
9. 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.
10. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this
Agreement shall be in writing and shall be deemed to be properly given if delivered in person or
mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other
telegraphic communication in the manner provided in this Section, to the following persons:
To City: 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:
Deputy City Manager for Development Services
City of Santa Ana
20 Civic Center Plaza (M-31)
P741
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-6954
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: Fieldman, Rolapp & Associates
19900 MacArthur Blvd., Suite 1100
Irvine, California 92612
telefacsimile (949) 474-8773
A party may change its address by giving notice in writing to the other party. Thereafter,
communication shall be addressed and transmitted to the new address. If sent by mail,
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, communication shall be effective or
deemed to have been given twenty-four (24) hours after the time set forth on the transmission
report issued by the transmitting facsimile machine, addressed as set forth above. For purposes
of calculating these time frames, weekends, federal, state, County or City holidays shall be
excluded.
11. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
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.
12. 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.
13. TERMINATION
This Agreement may be terminated by the either party 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.
14. 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.
15. JURISDICTION - VENUE
This Agreement has been executed and delivered in the State of California and the
validity, interpretation, performance, and enforcement of any of the clauses of this Agreement
shall be determined and governed by the laws of the State of California. Both parties further
agree that Orange County, California, shall be the venue for any action or proceeding that may
be brought or arise out of, in connection with or by reason of this Agreement.
16. PROFESSIONAL LICENSES
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.
17. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
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.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST:
PATRICIA E. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W.FLETCHER
City Attorney
By:
Laura Sheedy
Assistant City Attorney
CITY OF SANTA ANA
DAVID N. REAM
City Manager
CONSULTANT
FIELDMAN, ROLAPP & ASSOCIATES
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EXHIBIT A
TO
PROFESSIONAL SERVICES AGREEMENT FOR FINANCIAL ADVISOR
BY AND BETWEEN
THE CITY OF SANTA ANA
AND
HELDMAN, ROLAPP & ASSOCIATES
Scope of Services
A. General Services.
The Consultant shall perform an independent review of the proposed financing program The
Consultant's findings will be presented to the City for its review and comment. If the City elects
to proceed with a Community Facilities District, the Consultant shall assume primary
responsibility for assisting the City in coordinating the planning and execution of the formation of
the CFD. Insofar, as the Consultant is providing services, which are rendered only to the City,
the overall coordination of the proposed financing shall be such as to minimize the costs of the
transaction. Coincident with the financing review and maximizing the City's financing flexibility
and capital market access if the City decides to proceed with a financing program, Consultant will
provide the following:
Phase I:
1. Community Facilities District Study.
Initially Consultant will meet with City staff to outline the goals and objectives of the
City in order to commence a Community Facilities District study and feasibility analysis.
hi consultation with any other professionals also engaged in the process, Consultant will
meet with the landowner and its representatives to understand its public financing plan.
Consultant will evaluate the landowner's proposed financing program and provide
recommendations that would make the proposed Community Facilities District consistent
with industry practices and common industry benchmarks and also achieve the stated
goals and objectives of the City. Consultant will present a summary of its findings to the
City and will respond to comments and questions raised by the City Council. To the
extent that additional information is requested by the City, Consultant will conduct
additional research and present additional findings to the City.
Phase H:
1. Establish the Financine Objectives.
If the City decides to proceed in concept with a Community Facilities District, the
Consultant shall work with City staff identify the other required financing team members
and begin the process of coordinating their activities, consistent with the stated goals and
objectives of the City.
CITY OF SANTA ANATIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 1
As required by the California Government Code, the Consultant will take the lead in the
in the creation of local goals and policies to be considered and adopted prior to any action
by the City to commence proceedings to form a CFD.
Unless previously determined, Consultant shall recommend the method of sale of debt
and outline the steps required to achieve efficient market access.
2. Develop the Pre -Community Facilities District Formation Timetable.
The Consultant shall take the lead role in preparing a schedule and detailed description of
the interconnected responsibilities of each team member and update this schedule, with
refinements, as necessary, as the work progresses.
3. Monitor the Community Facilities District Formation and Transaction Process.
The Consultant shall have primary responsibility for the successful implementation of the
financing strategy and timetable that is adopted for each debt issue relating to the Project.
The Consultant shall prepare the timetables and work schedules necessary to create a
Community Facilities District and, if the CFD is formed, the activities required to sell and
deliver bonds. These timetables and work schedules will be designed to achieve the
desired results in a timely, efficient and cost-effective manner and Consultant will
coordinate and monitor the activities of all parties engaged in the financing transaction,
including conference calls and meetings of the financing team and the landowner.
Phase III:
The Services described in Phase III will commence upon appropriate action of the City
completing the final election creating the CFD. Except for certain tasks outlined in Phase II,
paragraph 3, Phase I and II services shall be deemed completed upon commencement of Phase III
services unless "change proceedings" are conducted or unless tasks outlined in Phase II are
required after the issuance of the fust series of bonds and in advance of a resolution of issuance
for an additional series of bonds. Specifically in Phase III, the Consultant will:
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 2
A
4. Review the Official Statement
Generally, SEC, MSRB, and GFOA guidelines encourage full disclosure so that
potential investors have sufficient data to analyze each proposed financing.
Upon direction of the City, the Consultant shall take the lead in review of the
official statement for each debt issue relating to the Project to insure that the
City's official statement is compiled in a manner consistent with industry
standards, typically including the following matters:
• Legal Authority for the Financing
• Security for the Financing
• Restrictions on Additional Financings
• Purpose and Funds for which the Financing is Being Issued
• Sources and Uses of Proceeds
• Revenue Sources:
• Outstanding Financings
• Planned Future Financings
• Legal Opinions Regarding Tax Exemption
• Such Other Matters as the Context May Require.
5. Procure and Coordinate Additional Service Providers
Should the City desire, the Consultant may act as City's representative in procuring the
services of financial printers for the official statement and related documents, and for the
printing of any securities. In addition, the Consultant may act as the City's representative
in procuring the services of trustees, paying agents, fiscal agents, feasibility consultants,
or escrow verification agents or other professionals, if the City directs.
6. Provide Financial Advice to the City Relating to Financing Documents.
Simultaneous with assisting in the preparation of official statements for each debt issue
relating to the Project, the Consultant shall assist the managing underwriters, bond
counsel and/or other legal advisors in the drafting of the respective financing resolutions,
notices and other legal documents. In this regard, the Consultant shall monitor document
preparation for a consistent and accurate presentation of the recommended business terms
and financing structure of each debt issue relating to the Project, it being specifically
understood however that the Consultant's services shall in no manner be construed as the
Consultant engaging in the practice of law.
7. Compute Sizing and Design Structure of Debt Issue.
The Consultant shall work with the City's staff to design a financing structure for each
debt issue relating to the Project that is consistent with the City's objectives, that
coordinates each transaction with outstanding issues and that reflects current conditions
in the capital markets.
CITY OF SANTA ANAXIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 3
S. Plan and Schedule Investor Briefings.
If appropriate, the Consultant shall develop a plan for presenting the financing program to
the investor community. The Consultant shall schedule underwriter and/or investor
visits, if appropriate; to assure the appropriate and most knowledgeable personnel are
available for the presentation and, if requested, will develop presentation materials and
assist the City officials in preparing for the presentations.
9. Conduct Credit Enhancement Evaluation.
If appropriate and at the City's direction, the Consultant will initiate discussions with the
landowner regarding letter of credit providers and vendors of other forms of credit
enhancements to provide credit support for the financing.
10. Conduct Market Analysis and Evaluate Timing of Market Entry.
The Consultant shall provide regular summaries of current municipal market conditions,
trends in the market and how these may favorably or unfavorably affect the City's
proposed financing.
In the case of a negotiated sale of debt, the Consultant shall perform a thorough
evaluation of market conditions preceding the negotiation of the terms of the sale of debt
and will assist the City with the negotiation of final issue structure, interest rates, interest
cost, reoffering terms and gross underwriting spread and provide a recommendation on
acceptance or rejection of the offer to purchase the debt. This assistance and evaluation
will focus on the following areas as determinants of interest cost:
• Size of financing
• Sources and uses of funds
• Terms and maturities of the debt issue
• Review of the rating in pricing of the debt issue
• Investment of debt issue proceeds
• Distribution mix among institutional and retail purchasers
• Interest rate, reoffering terms and underwriting discount with comparable
issues
• Redemption provisions
11. Recommend Award of Debt Issuance.
Based upon activities outlined in Task 10 above, the Consultant will recommend
accepting or rejecting offers to purchase the debt issue. If the City elects to award the
debt issue, the Consultant will instruct all parties and help facilitate the actions
required to formally consummate the award.
12. Provide Pre -Closing and Closing Activities.
The Consultant shall assist in arranging for the closing of each financing. The
Consultant shall assist counsel in assuming responsibility for such arrangements as
they are required, including arranging for or monitoring the progress of bond
printing, qualification of issues for book -entry status, signing and final delivery of the
securities and settlement of the costs of issuance.
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 4
EDIT B
TO
FINANCIAL ADVISORY SERVICES AGREEMENT
BY AND BETWEEN
CITY OF SANTA ANA
AND
FIELDMAN, ROLAPP & ASSOCIATES
Part I -Fees and Expenses
Phase I and Phase II Services
City agrees to pay at the Consultant's hourly rates per the table provided below; however, the
maximum fee to be paid under this agreement for Phase I and Phase II services shall not exceed
the amounts advanced under any landowner deposit and reimbursement agreement between the
City and any landowner. The City agrees to request funds and pursue funding in advance from
the landowner for Consultant's services. Fees earned by Consultant for Phase I and II services
will be billed monthly and will be payable within 30 days.
Personnel
Hourly Rate
Executive Officer..............................................................
$300.00
Principal..........................................................
$290.00
Principal/Senior Vice Presidents .......................................
$275.00
Vice Presidents.................................................................
$225.00
Assistant Vice Presidents ..................................................
$195.00
Senior Associate...............................................................
$150.00
Associates.........................................................................
$125.00
Analyst................................................................................
$85.00
Administrative Assistants ...................................................
$65.00
Clerical (Other)...................................................................
$35.00
Part 2 -Fees and Expenses
Phase III Services
For all services rendered under Phase III resulting in a negotiated sale of bonds, the City shall pay
consultant a fee based upon the following schedule for each negotiated sale of bonds.
Par Value of Bonds Fees
$1 to $5,000,000 $24,500
$5,000,001 to $7,500,000 $36,500
Over $7,500,000 to be negotiated
Payment of fees earned by Consultant pursuant to this Phase III shall be contingent on, and
payable at the closing of the debt issue(s) undertaken to finance the Project.
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit C, Page 1
Expenses
Expenses will be billed for separately and will cover, among other things, travel, lodging,
subsistence, overnight courier, computer, intemet posting and fax transmission charges.
Advances made on behalf of the City for costs of preparing, printing or distributing disclosure
materials or related matter whether by postal services or electronic means, may also be billed
through to the City upon prior authorization. Additionally, a surcharge of 6% of the net fee
amount is added to verifiable out-of-pocket costs for recovery of costs such as telephone, postage,
document reproduction and the like.
Limiting Terms and Conditions
The above fee is based on completion of work orders within twenty four months of the City's
initial authorization to proceed, and assumes that the City will provide all necessary information
in a timely manner and require other parties, including any landowner, to make available such
other information required in order for Consultant to perform and complete its assignments.
Abandonment
If, once commenced, the services of the Consultant are terminated prior to completion of its
Phase I study for any reason, or Consultant is directed to proceed with any subsequent phase of
the assignment and later requested to terminate its services, Consultant is to be reimbursed for
professional services and direct expenses incurred up to the time it receives notification of such
termination at the standard hourly rates described in Phases I and II of this Exhibit B.
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit C, Page 2
EXHIBIT C
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
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
Wood Gutmann & Bogart Insurance Brokers
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
15901 Red Hill Ave., Suite 100
Tustin CA 92780
714 505.7000
INSURER Hartford Insurance Company
www.wgbib.com
License No. 0679263
A
INSURER
B
Insured
INSURER
Fieldman, Rolapp & Associates
C
INSURER
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19900 MacArthur Blvd, #1100
Irvine CA 92612
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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.
POLICY
POLICY
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
M IDDDAT YV
EXPIRATION
M DATE Y
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $
COMMERCIAL GENERAL Lim
72.SBAAF9892
4/1/2005
4/1/2006
FIREOAMAGEAn tfln, $
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PERSONAL& ADV INJURY $
GENERAL AGGREGATE $
GENT AGO LIMIT APPLIES PER
PRODUCTS-COMP/OP AGG $
$
POLICY 7PROJECT MILOC
AUTOMOBILE LIABILITY
MY AUTO
72UECTQ4293
4/1/2005
4/1/2006
COMBINED SINGLE UMH $ 1,000,00(
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per P.) $
BODRV INJURY
HIRED AUTOS
NON -OWNED AUTOS
(Per ..Ment) $
PROPERTY DAMAGE
(Per a¢Ident) $
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA PCL $
ANY AUTO
AUTO ONLY: AGG$
EXCESS LIABILITY
EACH OCCURRENCE $
01
OCCUR 7 CLAIMS MADE
72.SBAAF9892
4/1/2005
4/1/2006
AGGREGATE $
$
DEWCT'mT
$
RETENTION $
WORKERS' COMPENSATION &
STATUTORY LIMIT I IDTHERT17",."k,¢, 4
EMPLOYERS' LIABILITY
EL EACH ACCIDENT $
72WBCNU7013
4/1/2005
4/1/2006
EL DISEASE - EA EMPLOYEE $
Is
EL DISEASE -POLICY OMIT
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional
insureds per attached SS 00 08 04 01.
, , h„
' v ary^ ; 5,� , �•. 6 tl lL n, Pfd 1 wY� � �
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Santa Ana
Attn: Clerk of the City Counsel
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
_aaQ—* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRE-
20 Civic Center Plaza (M-30)
Santa Ana CA 92702-1988
SENTATIVES. 10 Days forNon-Pa .ant of Pramlum
AUTHORIZED
REPRESENTATIVE
Dan Gorman
„�,'
,VTtk�„ ,
To: City of Santa Ana From: Blanca Roque 10-09-05 10:35am p. 3 of 6
IMPORTANT
If the cerdncate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement
on this certificate does not confer rights to the certlFlcate holder In lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certlncate
holder In lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon.
ACORD 25-S (7/97) created at www.e CertsONLINE.Com
To: City of Santa Ana From: Blanca Roque
Fieldman, Rolapp & Associates
BUSINESS 1-6WILITY COVERAGE FORM
(2) Notify us as soon as practicable.
Ycu must see to it that we receive a
written notice of the claim or "suit" as soon
as practicable.
Btt this condition will not be considered
broached unless the breach occurs after
Stich claim or "suit" is known to anyone
lis'ed In 2 .a. (1) through (5) above.
C. You and any other Involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or
legal papers received in connection
with the claim or "suit";
(2) Authorize us to obtain records and
other information;
(3) Cooperate with us in the investigation,
settlement of the claim or defense
against the "suit'; and
(4) Assist us, upon our request, in the
enforcement of any right against any
person or organization that may be
liable to the insured because of injury
or damage to which this insurance
may also apply.
d. N,7 insureds will, except at their own cost,
voluntarily make a payment, assume any
obligation, or incur any expense, other
than for first aid, without our consent.
3. Financial Responsibility Laws
a. "'hen this policy is certified as proof of
financial responsibility for the future under
*a provisions of any motor vehicle
financial responsibility law, the insurance
provided by the policy for "bodily injury"
nribifity and "property damage" liability will
compiy with the provisions of the law to the
e:dent of the coverage and limits of
insurance required by that law.
b. With respect to "mobile equipment" to
which this insurance applies, we will
p"wide any liability, uninsured motorists,
utderinsured motorists, no-fault or other
nNerage required by any motor vehicle
law. We will provide the required limits for
inose coverages.
4. Lego Action Against Us
No parson or organization has a right under
this c3verage form-
a. To join us as a party or otherwise bring us
Ir to a "suit" asking for damages from an
insured; or
b. To sue us on this coverage form unless all
of its terms have been fully compiled with.
Page 14 of 2)
7 ' /'
10-04-05 10:35am p. 4
72SBAAF9892
A person or organizatlon may sue us to
recover on an agreed settlement or on a fine[
judgment against an insured; but we will not be
liable for damages that are not payable under
the terms of this insurance or that are In
excess of the applicable limit of insurance. An
agreed settlement means a settlement and
release of liability signed by us, the insured
and the claimant or the claimants legal
representative.
5, Separation of insureds
Except with respect to the Limits of Insurance,
and any rights or dutisc specifically assigned in
this policy to the first Named Insured. this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each Insured against whom
a claim is made or "Suit" is brought,
6. Unintentional Failure to Dlsclose Hazards
It is agreed that based on our reliance on your
representations as to existing hazards, if
unintentionally you should fail to disclose all
such hazards at the inception date of your
policy, we shall not deny any coverage under
this Coverage Form because of such failure.
7. Other insurance - Primary Additional
Insured
If the written contract or agreement or permit
requires this insurance to be primary for any
person or organization with whom you agree to
include In WHO IS AN INSURED, this Other
Insurance Provision is applicable.
If other valid and collectible insurance is
available for a loss we cover under this
Business Liability Coverage Form, our
obligations are limited as follows:
a. Primary insurance
This insurance is primary. We win not
seek contributions from other insurance
available to the person or organization with
whom you agree to include in WHO IS AN
INSURED, except when b. applies.
b. Excess Insurance
This insurance is excess over:
(1) Any other insurance, whether primary,
excess, Contingent or on any other
basis:
(a) That is Fire, Extended Coverage,
13uildsr's Risk, Installation Risk or
similar coverage for "your work";
Form SS 00 08 04 01
of 5
To: City of Santa Ana From: Blanca Roque 10-04-05 10:35am p. 5 of 6
(b) That is Fire insurance for
premises rented to you or
temporarily occupied by you with
permission of the owner;
(c) That is Insurance purchased by
you to cover your liability as a
tenant for "property damage" to
premises rental to you or
temporarily occupied by you with
permission of the owner; or
(d) It the loss arises out of rhe
maintenance or use of aircraft,
"autos" or watercraft to the extent
not subject to Exclusion g. of
Section A. — Coverages -
(2) Any other primary insurance available
to you covering liability for damages
arising out of the premises or
operations for which you have been
added as an additional insured by
attachment of an endorsement.
"hen this insurance is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of;
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2; The total of all deductible and self-
insured amounts under all that other
insurance.
We win share the remaining loss, If any,
witty any other insurance that is not
doscribed in this excess of the Limits of
Irsurance shown in the Declarations of
it is Coverage Part.
c. K ettod of Sharing
If all the other insurance permits
contribution by equal shares, we wig follow
itis method also. Under this approach,
each insurer contributes equal amounts
aitit it has paid its applicable limit of
irsurance or none of the loss remains,
whichever comes first.
If, any of the other insurance does not
permit contribution by equal shares, we
v%W contribute by limits. Under this
method, each insurer's share is based on
it ratio of Its applicable limit of insurance
W the total applicable limits of insurance of
all insurers.
This provision provides such insurance as
4 afforded under this coverage form, but
only with respect to your operations, "your
Mnrk" or facilities owned or used by you.
Form SS 00080401
BUSINESS LIABILITY COVERAGE FORM
F. OPTIONAL COVERAGES
If listed or shown as applicable in the Declarations,
one or more of the following Optional Coverages
also apply. These coverages are subject to the
terms and conditions applicable to Business
Liability Coverage in this policy, except as provided
below:
1, Additional Insured - Designated Person or
Organization
WHO IS AN INSURED under Section C. is
amended to include as an insured the person
or organization shown in the Declarations, but
only with respect to ttablrity arising out of your
operations or premises owned by or rented to
you.
2. Additional Insured - Managers or Lessors
of Premises
a. WHO IS AN INSURED under Section C. Is
amended to include as an insured the
person(s) or organization(s) shown in the
Declarations; but only with respect to
liability arising out of the ownership,
maintenance or use of that part of the
premises leased to you and shown in the
Declarations and subject to the following
additional exclusions:
b. Additional Exclusions
This Insurance does not apply to:
(1) Any "occurrence" which takes place
after you cease to be a tenant In that
premises; or
(2) Structural alterations, new
construction or demolition operations
performed by or for that person or
organization.
3. Additional Insured - Grantor of Franchise
WHO IS AN INSURED under Section C. Is
amended to include as an insured the
person(s) or organization(s) shown In the
Declarations, but only with respect to their
liability as grantor of franchise to you.
4. Additional Insured " Lessor of Leased
Equipment
a. WHO IS AN INSURED under Section C. is
amended to include as on Insured the
person(s) or organization(s) shown in the
Declarations, but only with respect to their
liability arising out of the maintenance,
operation or use by you of equipment
leased to you by such person(s) or
organization(s).
b. Additional Exclusions:
This insurance does not apply.
Page 16 of 20
To: City of Santa Ana From: Atlanta Roque 10-04-05 10:35am p. 6 of 6
BUSINESS LIABILITY COVERAGE FORM
(1) To any "occurrence"which takes place
(a) "Bodily injury" or "property
after tha equipment lease expires; or
damage" for which the vendor is
(2) To "bodily injury' or "property damage"
obligated to pay damages by
arising gut of the sole negligence of
reason of the assumption of
the lessor,
liability in a contract or agreement.
5. Additional Insured - Owners or Other
This exclusion does not apply to
Interasts From Whom Land Has Been
liability for damages that the
Leased
vendor would have in the absence
WHO IS AN INSURED under Section C. is
of the contract or agreement;
amended to include as an Insured the person
(b) Any express warranty
or organization shown in the Declarations, but
unauthorized by you;
only wi0r respect to liability arising out of the
(c) Any physical or chemical change
ownership, maintenance or use of that part of
in the product made intentionally
the land leased to you and shown In the
by the vendor;
Declarations and subject to the following
(d) Repackaging, unless unpacked
additional exclusion_
solely for the purpose of
This insurance does nota Ito:
PPY
inspection, demonstration, testing,
a. Any "occurrence" that takes place after
or the substitution of parts under
you cease to lease that land; or
instructions from the
b. Structuraf alterations, new construction or
manufacturer, and then
dumolitlon operations performed by or for
repackaged in the onginef
the person or organization shown in the
container;
Dsclaretions.
(e) Any failure to make such
S. Additional Insured " State or Pollticaf
inspections, adjustments. tests or
Subd'vlsion- Permits
servicing as the vendor has
a. WHO IS AN INSURED under Section C. is
agreed to make or normally
amended to include as an insured the
undertakes make in the usual
course of buss iness, i connection
slate or political subdivision shown in the
with the distribution orsofa of the
Daclarations, but only with respect to
products'
operations performed by you or on your
behalf for which the state or poli0cal
(f) Demonstration, installation,
subdivision has issued a permit.
servicing or repair operations,
b. Additional Exclusions
except such operations performed
at the verdoPs premises in
This insurance does not apply to:
connection with tfie sale of the
(1,r "Bodily Injury". "property damage" or
product,
"personal and advertising injury'
(g) Products which, after distribution
arising out of operations performed for
or sale you, have been labeled
the state or political subdivision; or
or relabeled or used as a
(21 "Bodily injury" or "property damage"
container, part or ingredient of any
included in the "producicompleted
other thing or substance by or for
operations" hazard.
the vendor.
T. Additional Insured - Vendors
(2) This insurance does not apply to any
a. WHO IS AN INSURED under Section C, is
Insured person or organization, from
amended to include as an insured the
whom you have acquired such
persons) or organization(s) (referred to
products, or any ingredient, part or
below as vendor) shown in the
container, entering into, accompanying
Csdarations, but only with respect to
or containing such products.
"bodily injury" or "property damage" arising
(3) This Provision T. does not apply to any
out of "your products" which are distributed
vendor included as an insured by an
or sold in the regular course of the
endorsement issued by us and made
vendor's business.
a part of this Coverage Form.
b. Additional Exclusions
(1) The insurance afforded the vendor
does not apply to:
'
Page 16 of 2D
Form SS 00 08 04 01
To: City of Santa Ana From: Blanca Roque 10-04-05 10:25am p. 2 of 3
�iARIL r
IT- NSU
ru-.
Otte tl "I
10/4/2005
Protlucer Blanca Roque 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
Wood Gutmann & Bogart Insurance Brokers COVERAGE AFFORDED BY THE POLICIES BELOW.
15901 Red Hill Ave., Suite 100 INSURERS AFFORDING COVERAGE
Tustin CA 92780
714 505.7000 INSURER Indian Harbor Ins. Company
www.wgbib.com A
License No. 0679263
INSURER
Insured B
Fieldman, Rolapp & Associates INSURER
C
19900 MacArthur Blvd, #1100 INSURER
Irvine CA 92612 D
i vrlP. �. o, ,faro iwrv: r, .! nv,d .� ar I.,I.....
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR I HE 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.
POLICY
POLICY
NSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
MM/DD/DDYV
EXPIRATION
M DATEYV
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $
FIRE DAMAGE An 1 Pre $
COMMERCIAL GENERAL LIAB
MED EXP A one rson $
CLAIMS MADE OCCUR
PERSONAL a ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGG LIMIT APPLIES PER
PRODUCTS-COMP/OP AGG $
$
POLICY 7PROJECT 7LOC
AUTOMOBILE LIABILITY
AUTO
$
COMBINED SINGLE LIMITANY
BODILY INJURY
(Per person) $
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per ercldem) $
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY,
AUTO ONLY - EA ACCIDENT $
OLDERT AN EAAUTO AGG$
ANY AUTO
tC,.
EXCESS LIABILITY
EACH OCCURRENCE $
AGGREGATE $
OCCUR ❑ CLAIMS MADE
$
$
DEWCTIBLE
$
RETENTION $
WORKERS' COMPENSATION &
ISTATUTORY LIMIT THERI �r i1 !
EL EACH ACCIDENT $
EMPLOYERS' LIABILITY
ELDISEASE- EAEMPLOVEE $
EL DISEASE - PCUCY UMIT $
Errors & Omissions
ELU08776504
12/10/2004
12/10/2005
Limit: $1,000,000
Ded. $100,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
„�, t YT�AL ect a Yh Lr rr rr r , w r, rr Pryd'�.WI�1'
Y. f'. tl,�r:r \� i?Yv inv a r �11e llsN¢ <\ X11 . �.I 1.11ro\
rti_ t n.
\ ,LRS': .VYL lx�.S..A�
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Santa Ana
Attn: Clerk Of the Court
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE-
20 Civic Center Plaza (M-30)
Santa Ana CA 92702-1988
SENTATIVES. 10 Days for Non -Payment of Premium
AUTHORIZED
REPRESENTATIVE
Dan Gorman
^�
A'° r7'0101011 , a
\ \
rr�ryydy r r t +. A�Py
kMM4 �i I1r kM1�1!.
To: City of Santa Ana From: Blanca Roque 10-04-05 10:25am p. 3 of 3
IMPORTANT
If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder In lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the Issuing Insurer(s), authorized representative or producer, and the certificate holder. nor does It
affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon.
ACORD 25-S (7197) created at www.e CertsONLINE.Cem
To: City sof Santa Ana From: Blanca Roque 3-27-06 2:31pm p. 2 of 6
w
ACORO �., Ir
.2.
1Yf,i
)t`YI@
' 3 14s1C
Derem tlp'A"q,3/27/
:- . v��� ,tt:i^��.,y.€y n:'!�;: Ir,,...�v
)„,4
�':I,Wu):TI?t!^
la�waa ,,,' ,
,.
°C�. '
Proaucer Blanca Roque
,�1y,��1,&• ,; .?IId,e;p'.,F n5I{wg�ll�
0C
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
Wood Gutmann & Bogart Insurance Brokers
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
15901 Red Hill Ave., Suite 100
COVERAGE AFFORDED BY THE POLICIES BELOW.
Tustin CA 92780
714 505.7000
www.wgbib.com
INSURER Hartford Casualty Insurance Company
P nY
License No. 0679263
A
INSURER
B
Insured
Fieldman, Rolapp & Associates 2 0¢S—."2
INSURER
C
19900 MacArthur Blvd, #1100
Irvine CA 92612
INSURER
p
..... 7%
THE POLICIES OF INSURAN E LISTED ELOW H VE BEEN IS UED
TOT E INSURE 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.
POLICY
POLICY
INSR
LTR
TYPE OF INSURANCE
PoLICY NUMBER
EFFECTIVE
DATE
EXPIRATION
DATE
LIMITS
MM/DO/YY
MM/DD/YY
GENERAL LIABILITY
EACH OCCURRENCE $
COMMERgAL GENERAL UAB
72SBAAF9892
4/1/2006
4/1/2007
FRE DAMAGE (My 1Bre$
4l14 CLAIMS MADE FZ OCCUR
MED EXP one . $
PERSONAL& ADV INJURY E
GENERAL AGGREGAlbffftff
TE $
GENT AGG OMIT APPLIES PER
PRODUCTS-COMP/OP AGG
$$
POLICY PROJECT LOC
AUTOMOBILE
LIABILITY
AUTO
72UECTQ4293
4/12006
4/1/2007
COMBINED SINGLE UNIT $ 1,000,00
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per person)
]ANY
HIRED AUTOS$
BODILY INJURY
NON -OWNED AUTOS
(Per exitlera)
PROPERTY DAMAGE
(Per exltlm) $
GARAGE LIABILITY
AUTO ONLY -EA AGgDEM $
ANY AUTO
OTHER THAN EA ALC $
AUTO ONLY: AGG$
EXCESS LIABILITY
OCCUR El CLAIMS MADE
72SBAAF9892
4/12006
4/12007
EACH OCCURRENCE $
AGGREGATE $
Is
DEDUCTIBLE
RETENTION $
$
WORKERS' COMPENSATION &
EMPLOYERS' LIABILITY
STATUTORY LIMIT HER` A Yt`^'u "L}xc,'^"✓,E
72WBCNU7013
4/12006
4/12007
EL EACH $
AET
EL DISEASESE EEA EMPLOYEE $
EL DISEASE POLICY LIMIT $ 1 Min (in
DESCRIPTION OF OPERATIONS/LOCATIONSfVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additioal
insureds per attached SS 00 08 04 01.
Y��fy "
v,
� `S� 1�'
1� "� i�i1\ iE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Santa Ana EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn: Clerk of the City Counsel 3Q--_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE.
20 Civic Center Plaza (M-30) SENTATIVES. 10 Days for Non -Payment of Premium
Santa Ana CA 92702-1988 Au
REPRESENTATIVE
Den Gorman
To: City 'of Santa Ana From: Blanca Roque 3-21-06 2:31pm p. 3 of 6
IMPORTANT
If the certificate holder Is an ADDITIONAL INSURED, the poll cy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain poll Gas may
require an endorsement. A statement on this certificete does not confer rights to the certli cate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the Issuing Insurer(s), authorized representative or producer. and the certificate hostler, nor does It
affirmatively or negatively amend, extend or atter the coverage afforded by the policies listed thereon.
ACORD 25-S (7197) created at www.e Cer1sONLINE.COrn
i
To: City -of Santa Ana
From: Blanca Roque 3-21-06 2:31pm p. 9 of 6
Fieldman, Rolapp & Associates 72SBAAF9892 3/27/2006
BUSINESS LIABILITY COVERAGE FORM
(2) Notify us as soon as practicable.
Ycu must see to it that we receive a
wrtten notice of the claim or "suit" as soon
as practicable -
SO this condition will not be considered
broached unless the breach occurs after
Such claim or "suit" is known to anyone
lisped In 2 .a. (1) through (5) above.
c. You and any other Involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or
legal papers received in connection
with the claim or "suit";
(2) Authorize us to obtain records and
other information;
(3) Cooperate with us in the investigation,
settlement of the claim or defense
against the "suit"; and
(4) Assist us, upon our request, In the
enforcement of any right against any
person or organization that may be
liable to the insured because of injury
or damage to which this insurance
may also apply.
d. N,) insureds will, except at their own cost,
voluntarily make a payment, assume any
obligation, or incur any expanse, other
than for first aid, without our consent.
3. Financial Responsibility Laws
a. "'hen this policy is certified as proof of
financial responsibility for the future under
the pfovisions of any motor vehicle
financial responsibility law, the insurance
provided by the policy for "bodily injury"
liability and "property damage" liability will
comply with the provisions of the law to the
e:dent of the coverage and limits of
insurance required by that law.
It. With respect to "mobile equipment" to
which this insurance applies, we will
pi'ovide any liability, uninsured motorists,
u iderinsured motorists, no-fault or other
coverage required by any motor vehicle
lew. We will provide the required limits for
those coverages.
4. Legs: Action Against Us
No p°rson or organization has aright under
this c average form:
a. To join us as a party or otherwise bring us
irto a "suit" asking for damages from an
insured; or
b. To sue us on this coverage form unless all
of its terms have been fully complied with.
A person or organization may sue us to
recover on an agreed settlement or on a final
judgment against an insured: but we will not be
liable for damages that are not payable under
the terms of this insurance or that are in
excess of the applicable limit of insurance. An
agreed settlement means a settlement and
release of liability signed by us, the insured
and the claimant or the daiment's legal
representative.
5. Separation of Insureds
Except with respect to the Limits of Insurance,
and any rights or duties specifically assigned in
this policy to the first Named Insured, this
insurance applies:
a, As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom
a claim is made or"suit" is brought.
6. Unintentional Failure to Disclose Hazards
It is agreed that based on our reliance on your
representations as to existing hazards, if
unintentionally you should fail to disclose all
such hazards at the Inception date of your
policy, we shall not deny any coverage under
this coverage Form because of such failure.
7. Other Insurance - Primary Additional
Insured
If the written contract or agreement or permit
requires this insurance to be primary for any
person or organization with whom you agree to
include in WHO 15 AN INSURED, this Other
Insurance Provision is applicable,
If other valid and eollad6le insurance is
available for a loss we cover under this
Business Liability Coverage Form, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary, We will not
seek contributions from other insurance
available to the person or organization with
whom you agree to include in WHO IS AN
INSURED, except when b. applies.
b. Excess Insurance
This insurance is excess over:
(1) Any other insurance, whether primary,
excess, contingent or on any other
basis:
(a) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work";
Page 14 of 2 ] �
5
"// /� Form SS 00 08 04 01
To: Cit y,of Santa Ana From: Blanca Roque 3-27-06 2:31pm p. 5 of 6
(b) That is Fire insurance for
premises rented to you or
temporarily occupied by you with
permission of the owner;
(c) That is Insurance purchased by
you to cover your liability as a
tenant for "property damage" to
premises rented to you or
temporarily occupied by you with
permission of the owner; or
(d) If the loss arises out of the
maintenance or use of aircraft,
"autos" or watercraft to the extent
not subject to Exclusion Q. of
Section A. — Coverages.
(2) Any other primary insurance available
to you covering liability for damages
arising out of the premises or
operations for which you have been
added as an additional insured by
attachment of an endorsement.
W hen this insurance is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self-
insured amounts under all that other
insurance.
We will share the remaining loss, if any,
with any other insurance that is not
d ascribed to this excess of the Limlts of
Irsurance shown in the Declarations of
itis Coverage Part.
BUSINESS LIABILITY COVERAGE FORM
F. OPTIONAL COVERAGES
If listed or shown as applicable in the Declarations,
one or more of the following Optional Coverages
also apply. These coverages are subject to the
terms and conditions applicable to Business
Liability Coverage in this policy, except as provided
below:
1. Additional Insured - Designated Person or
Organization
WHO LS AN INSURED under Section C. is
amended to include as an insured the person
or organization shown in the Declarations, but
only with respect to liability arising out of your
operations or premises Owned by or rented to
you.
2. Additional Insured - Managers or Lessors
of Premises
a. WHO IS AN INSURED under Section C. is
amended to include as an insured the
persons) or organization(s) shown in the
Declarations; but only with respect to
liability arising out of the Ownership,
maintenanCe or use of that part of the
premises leased to you and shown in the
Declarations and subject to the following
additional exclusions:
b. Additional Exclusions
This insurance does not apply to:
(1) Any "occurrence" which takes place
after you cease to be a tenant in that
premises; or
(2) Structural alterations, new
construction or demolition operations
performed by or for that person or
organization.
c. Method of Sharing
3. Additional Insured - Grantor of Franchise
If all the other insurance permits
WHO IS AN INSURED under Section C. is
contribution by equal shares, we wig follow
amended to include as an insured the
ttis method also. Under this approach,
person(s) or organization(s) shown In the
e.ich insurer contributes equal amounts
Declarations, but only with respect to their
u -til it has paid its applicable limit of
liability as grantor of franchise to you.
irsurance or none of the toss remains,
4. Addittonat Insured - Lessor of Leased
whichever comes first.
Equipment
If any of the other insurance does not
a. WHO IS AN INSURED under Section C. is
permit contribution by equal shares, we
amended to include as an insured the
Kill contribute by limits. Under this
person(s) or organization(s) shown in the
method, each insurer's share is based on
Declarations, but only with respect to their
tiie ratio of its applicable limit of insurance
liebitity arising out of the maintenance,
to the total applicable limits of insurance of
operation or use by you of equipment
all insurers,
leased to you by such person(s) or
This provision provides such insurance as
organiZation(s).
is. afforded under this coverage form, but
b. Additional Exclusions:
only with respect to your operations. "your
work" or facilities owned or used by you.
This insurance does not appIT
Form SS SS 00 08 04 01 Page 15 of 20
To: City,of Santa Ana From: Blanca Roque 3-27-06 2:311 p. 6 of fi
BUSINESS LIABILITY COVERAGE FORM
(1) To any "occurrence" which takes place
(a) "Bodily injury" or "property
after the equipment lease expires; or
damage" for which the vender is
(2) To "bodily injury" or "property damage"
obligated to pay damages by
arising out of the sole negligence of
reason of the assumption of
the lessor.
[lability in a contract or agreement.
5. Additional Insured - owners or Other
This exclusion does not apply to
Interests From Whom Land Has Been
liability for damages that the
vendor would have in the absence
Leased
of the contract or agreement;
WHO IS AN INSURED under Section C. is
amended to Include as an insured the person
(b) Any express warranty
or organization shown in the Declarations, but
unauthorized by you;
only vrith respect to liability arising out of the
(c) Any physical or chemical change
ownership, maintenance or use of that part of
in the product made intentionally
the Is nd leased tc you and shown in the
by the vendor;
Decla ations and subject to the following
(d) Repackaging, unless unpacked
additional exclusion:
solely for the purpose of
This insurance does not apply to:
inspection, demonstration, testing,
a. Any "occurrence" that takes place after
or the substitution of parts under
you cease to lease that land; or
instructions from the
b. S ruotural alterations, new construction or
manufacturer, and then
dumolilion operations perronned by or for
repackaged in the original
the person or organization shown in the
container;
Declarations.
(e) Any failure to make such
S. Additional Insured - State or Political
inspections, adjustments. tests or
Subdivision - Permits
servicing as the vendor has
agreed to make or normally
a. WHO tS AN INSURED under Section C. is
undertakes to make in the usual
amended to Include a$ an insured the
course of business, in connection
state or political subdivision shown in the
with the distribution or sale Of the
Declarations, but only with respect to
products;
operations performed by you or on your
b-ahalf for which the state or political
(f) Demonstration, installation,
slrbiivlslon has issued a permit.
servicing or repair operations,
except such operations performed
b. Additional Exclusions
at the vendor's premises in
This insurance does not apply to:
connection with the sale of the
(1) "Bodily Injury", "property damage" or
product;
"personal and advertising injury"
(g) products which, after distribution
arising out of operations performed for
or sale by you, have been labeled
the state or political subdivision; or
or relabeled or used as a
(21 "Bodily injury" or "property damage"
container, part or ingredient of any
Included in the "product -completed
other thing or substance by at for
operalions" hazard.
the vendor.
T. Additional Insured - Vendors
(2) This insurance does not apply to any
a. viHO IS AN INSURED under Section C. is
insured person or organization, from
amended to include as an insured the
whom you have acquired such
person(s) or organization(s) (referred to
products, or any ingredient, part or
below as vendor) shown in the
container, entering into, accompanying
Declarations, but only with respect to
or containing such products.
"bodily injury" or "property damage" arising
(3) This Provlsicn 7. does not apply to any
Out of "your products" which are distributed
vendor included as an insured by an
cr sold in the regular course of the
endorsement issued by us and made
vendor's business.
a part of this Coverage Form.
b. Additional Exclusions
(1) The insurance afforded the vendor
does not apply to:
Page 16 of 2D
Form 99 00 08 04 01
To: City of Santa Ana From: Bobbie Detki 12-21-05 11:15am p. 2 of 3
1 . I
�4
P rodu Bobbie Detki
IHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
Wood Gutmann & Bogart Insurance Brokers
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE
15901 Red Hill Ave, Suite 100
AFFORDED By THE POLICIES BELOW,
INSUIRIERS AFFORDING UC)VFRAQF
Tustin CA 92780
714 505.7000
www.wgbib.com
INSURER Indian Harbor Ins. Company
License No. 0679263
A
INSURER
B
Insured
Fieldman, Rolapp, & Associates
INSURER
C
19900 MacArthur Blvd, #1100
Irvine CA 92612
INSURER
D
.... .... . . T .....
11
'gxqQ, '411 ..
T ""
POLICIES O INSURANCE LISTED BELOW HAVE BEEN ISSUE
ABOVETHE
TO THE INSURED NAMED 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 MAV 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 AVE BEEN REDUCED BY PAID CLAIMS.
POLICY
POLICY
NSR
EFFECTIVE
EXPIRATION
LTR
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
MM/DO%VY
MNVDD/YY
GENERAL LIABILITY
EACH OCCURRENCE S
COMMERCIAL GENERAL LIAB
CLAIMS
CLMS
FIRE DAMAGE (Ay lore )
MED EXP (AW .. Rer.n)
MADE
PERSONAL & ADV INJURY
GENERAL AGGREGATE
GEN, AGG UMIT APPLIES PER
PRODUCTS-COMP/OP AGG $
POLICY PROJECTLDC
$
AUTOMOBILE
LIABILITY
MY AUTO
COMBINED SINGLE UMIT
ALL OWNED AUTOSBODI
LY INJURY
SCHEDULED AUTOS
(Per Person) $
HIRED AUTOS
BODILY INJURY
NON -OWNED AUTOS
(Per amid
PROPERTY DAMAGE
GARAGE LIABILITY
AUTO DAILY - EA ACCIDENT
RMY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
LEXCESS LIABILITY
n
EACH OCCURRENCE $
AGGREGATE
OCCUR CI -AIMS MADE
DEDUCTIBLE
�RIETMTION
$
$
$
STATUTORY LIMIT T —H -�,,77�
E� $
WORKERS' COMPENSATION &
EMPLOYERS' LIABILITY
EL EACH ACCIDENT
EL DISEASE EA EMPLOYEE $
EL DISEASE - POLICY UMIT
tA
Errors & Omissions
ELU09090105
12/20/2005
12/20/2006
Limit $1 000 000
Ded. $1b0,060
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
F I
II Si -ti fes 11 `%VbI vrtJ�SO Nslul . . ...... .... 7;
IN .J'".: ma, ME
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Santa Ana EXPIRA ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR To MAIL
j
Attn. Clerk of the Court 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE-
20 Civic Center Plaza (M-30) SENTATIVES. 10 Days for Non -Payment of Premium
Santa Ana CA 92702-1988 AUTHORIZED
REPRESENTATIVE n CG
.Dan Gorman
P -
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the po llcy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this eertiflcate tloes not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not consfitute a contract between
the Issuing insurer(s), authodred representative or pmducer. and the certificate holder, nor does It
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S (7/97) created at www,e CertsONLINE.Cntn
P -
qV-14 —71)4 __ 22 :2,
6 J151,14 wew
2
.1. .1dcVW)
12/14/2006
Blanca Roque THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
Wood -Gutmann & Bogart/IIIB THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
910 S. El Camino Rea, Ste B. COVERAGE AFFORDED BY THE POLICIES BELOW.
San Clemente CA 92672 IN
(949) 542-7800 INSURER Indian Harbor Ins. Company
www.integrityint.com A
INSURER
Insuren B
INSURER
Fieldman, Rolapp & Associates C
INSURER
19900 MacArthur Blvd, #1100 Q
Irvine CA 92612 INSURER
71, 11: 1
"Q�
"M
POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE HNNUHLIJ NAMED ABOVE I UR THE VULIUY72141071 ZMZ
THE
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 SU
TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLI EJECT TO ALL THE
CIES. AGGREGATE LIMIT SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
NSR
�
POLICY IOLlll
TYPE OF INSURANCE FFECTIVE EXPIRATION
LTR POLICY DATE DATE
LIMITS I
TS
GENERAL LIABILITY MM/DD/YY MM/DD/YY
COMMERCIAL GENERAL LIM EACH OCCURRENCE $
FIRE DAMAGE A� one fire $CLAIMS MADE OCCUR MED EXP An onerson
PERSONAL & ADV INJURY
GEWL AGG LIMAPPLIES PER GENERAL AGGREGATE $
POUCY ROJECT�LDC
PRODUCTS-COMP/OP AEG $
AUTOMOBILE LIABILITY $
Y AUTO COMBINED SINGLE LIMIT
ALOWNED ALTUS $
SCHEDULED AUTOS BODILY INJURY
HIRED AUTOS (Per person) $
BODILY INJURYNON-OWNED AUTOS (Par e.Id.nt) $
PROPERTY DAMAGE
GARAGE LIABILITY (Per acrdsnt) $
MY AUTO AUTO ONLY-EAACCIDENT$
OTHER THAN EA ACC $
EXCESS LIABILITY AUTO ONLY: AEG$
OCCUR ] LAI., MAL,
-
EACH OCCURRENCE $
AGGREGATE $
DEDUCTIBLE
RULTHON $
WORKERS' COMPENSATION &
EMPLOYERS' LIABILITY STATUTORY LIMIT THER
EL EACH ACCIDENT $
EL DISEASE - EA EMPLOYEE $
Errors & 7missions FLLIU9bb94U(5 ELOISE F-POLICYUMIT $
_T�RIPTI �NF Ded. $1 0,0 0
OF E`ERAIKJN51LoCATIONS/V___ — — _9- I
EE"CLETrEXCLIJ§1rN ADDED T END UH5EMENTibftGIAL PROVISIONS
EVIDENCE OF ERRORS &OMISSIONS RENEWAL
. gmll Lo rVk, 1.1
SHOULD F OF THE ABOVEINDESCERIBED POLICIES BE CANCELLED BEFORE TME
City of Santa Ana EXPIRA�ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn: Cler of the Court 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE.
20 Civic Center Plaza (M-30) SENTATiVES. 10 Days for Non -Payment of pmo,jum
Santa Ana CA 92702-1988 AUTHORIZED
REPRESENTATIVE
Dan Gorman
T
81 0
0
"U,
xrg
2_1,��,,�,,,�,-,T�L�%77t,u,t,07.kS,,,"
. ..... �gg
P�
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does net confer rights to the certificate holder in lieu of such entlorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement, A statement on this certificate does not confer rights to the c'rfificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative of producer, and the certificate hdtler, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001108) created at www .e CertsONLINE.com
05-18-2007 10:04 From-Fieldman RolapP 949 474 8773 T-372 P-002/003 F-925
7 ,,,µ.. l -,,
. ' , I , , " I . 1 ': 1); � i. .. , 6 �� —DAD (MM1Cwy7)
. , . -,� I ` ml- , , F
r..... .. .... . ..
1,'N1412006
A IRI n.l.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ZE-1cer
Blanca Roque ONLY AND CONFERS NO MGHTS UPON THE CERTIFICATE HOLDER,
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
Wood -Gutmann & Bo.9arVIIIB
B.
COVERAGE AFFORDED BY THE POLICIR 111 5 BELOW -
910 S. EI Camino Rea, Ste
INSI IPFPS AFF -11
San Clemente
CA 92672
Indian Harbor Ins. Company
(949) 542-7800
INSURER
1
www.intogrityint.com
A
2C)().5-223
INSURER
A-
F�L_Pred
INSURER
Fieldman, Rolapp & Associates
r
INSURER
r'X
19900 MacArthur Blvd, #1100
INSURER
Irvine
CA 92612 E
FED
13rLUW HAVE BEEN -ISSUED TO THE INSUKEU NAMED AaGVE FOR THE POUCY PERIOD INDICAmo.
THE P =Ul OF
OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
NOTWITHSTANDING ANY REQUIREMENT,
PERTAIN,
TERM
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
CERTIFICATE MAY BE ISSUED OR MAY
POLICIES. AGGREGATE LIMITS SHOWN. MAYHAVEBEEN REDUCER By PAID CLAIMS.
TERMS, EXCLUSIONS AND CONDITIONS
OF SUCH
POLICY POLICY
EFFECTIVE EXPIRATION
INSR1 TYPE OF INSURANCE
DATE OA
POLICY NUMBER MMIDDNY MM/DIFIYY LIMITS
LTR
EACH OCCURRENCE
GENERAL LIABILITY
GE (Any ono }Ira)
FIRE DAMAGE U_
COMMIERCIA1. GENERAL LIAR
F-1OCCUR
MED EXP (Any =&!san 5
CLAIMS MADE
PERSONAL & ADV INJURY
GENERAL AGGREGATE S
KODUCT5,COMPiQP AGO
V NVAGG 41MIT AFKIFS PER
POLICYjnE2OJECTr7 LOC
A_UTQMOI31LF LIABILITY
COMMNED SINGLE LIMIT
Y AUTO
TOPILY INJURY
ALL OWNED AUTOS
(For Parson)
5CHEDU"13AMTOS
BODILY INJURY
HIRED AUT05
(Per noddent)
NOr+OwNED AUTOS
PROPERTY DAMAGE
A 1"
Z, AA
(Por accAwt) 5
AUTO ONLY - EA ACCIDENT 5
GARAGE LIABILITY
OTHER THAN EA ACC &
ANY AUTO
RUY0 ONLY: AGG $
F_xCESS LIABILITY
EACH OCCURRENCE
7OCCUR [:] CLAIMS MADEAGGREGATE
DEDUCTIBLE
/It r7.ey
STATOTORY LIMIT THE "h.
RETENTION -S
VVU1iUR5'COMPFNsATION &
EL EACH ACCIDENT
EMPLOYERS' LIABILITY
RL DISEASE - EA EMPLOYEE
EL DI5EA5E - POLICY LIMrI'
rrofs0missions
—EMD9559405
Dad, $1 MOM
DES61PTION uts OpMUMqWiL:qrATIIDNS7VEHIZ!LESIFXCLUtiluNti AUIJLIJ 0[Y_EN13QR5FMEN1/kPEGI9 PRQVLSIdNS
EVIDENCE OF ERRORS & OMISSIONS RENEWAL
`AWMAT U 1%
SHOULD ANY OF THE AaUVF QrZkUKIBED POLICIES BE CANCELLED BEFORE TME
Santa Ana
LXPaRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
TO THE
City of
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED
Atth; Clerk of the Court
07 OUT FAILURE TO MAIL SUCH NOTICE SHAM imposr. 140 OBLIGATION
OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE-
SENTATIVES. 10 Days for Nan-Paymont2f Promium
20 Civic Center Plaza (M-30)
Santa Ana
AUTH
CA 92702-1988 REPR959ORIZENTAD TIVF
Dan Gorman
j"I
05-18-2007 10:04 From-Fieldman Rolapp 949 474 8773 T-372 P.003/003 F-925
IMPORTANT
If the certificate holder is an ADDITIONAL INSUR513, the poiicy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(S).
If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder In lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing Insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
_f
0 "'()RA4
Z
ACORD 25 (2001108) created atwww,eCertsONUINF.com
05-18-2007 10;04 From-Fieldman Rolapp 949 474 9773 T-372 P.001/003 F-925
FIELDMAN I ROLAPP FAX
& ASSOCIATES
19900 MacArthur Blvd., Suite 1100
irvine, CA 92612-9-433
949.660.7300
Fax 949.474.8773
_— . — 41 mr-i nIFR THIS FAX TO:
1t yo6 ao not relive 1311 Int; inu—a.a-
�•.— —
eONFIDENTIALITY NOTICE
closure uncef applfccf ll taw- 11 the rao0rt U}i Orin n ss51,411ysprohlh ed C I YOU
TNS facsimile mo5s❑c�c is tnlenaod
only for the us�� f Ino intli�iduat ❑r entity to wMlch 1l Icomdf a>sed. and may conl❑in information
tool i5 privileged, ccanGdenl ❑I ana hUI On! is! {elcphon❑ of (949) 660 7309. ❑nd return 11�e ❑riEiiita
ret'Oenl, VOL, m{s,E3ommunlitic in orrorny rlPVeaso jaminnotify ustimmed;atelyoUY W ai Ins — — -- — --
na — •--- — — — —
messoOe 10 us of me (above adctrr.ss via the u.S. f ostol Service. rn❑nk yau-
Fax5n0OL
To: City of Septa Ana
From: Blanca Roque
Blanca Roque
Wood -Gutmann & Bogart/IIIB
910 S. EI Camino Real, Ste B.
San Clemente CA 92672
(949) 542-7800
www.integrityint.com
A-2005-223
Fieldman, Rolapp & Associates
19900 MacArthur Blvd, #1100
Irvine CA 92612
5-18-07 2:59pm p. 2 of 7
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.
INSURER Hartford Casualty Insurance Company
A
INSURER Oak River Insurance Company
B
INSURER
C
INSURER
D
INSURER
i cv t$tLUW HAVE BEEN ISSUED TO THE INSUREDiiiil NAUp
MED 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.
NSR POLICY POLICY
LTR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION
GENERAL LIABILITY DATE DATE
A COMMERCIAL GENERAL LIAB 72SBAAF9892 LIMITS
4/1 /2007 4/1/2008 EACH OCCURRENCE $
CLAIMS MADE OCCUR FIRE DAMAGE An one fire $
MED EXP (Any one ne-i e
Au I UMOBILE LIABILITY
A
u -UP AUU
$
ANY AUTO
72UECTQ4293$
ALL OWNED AUTOS
4/1/2007
4/1/2008
COMBINED SINGLE LIMIT
SCHEDULED AUTOS
BODILY INJURY
$ 1
HIRED AUTOS
(Per person)
NON -OWNED AUTOS
BODILY INJURY
$
(Per accident)
GARAGE LIABILITY
PROPERTY DAMAGE
(Per accident)
$
ANY AUTO
$
AUTO ONLY - EA ACCIDENT
$
A E CESS LIABILITY
OTHER THAN EA AC $
AUTO ONLY:
OCCUR 1:1CLAIMS MADE
72SBAAF9892
AGG $
4/1 /2007
4/1/2008
EACH OCCURRENCE
$
DEDUCTIBLE
AGGREGATE
$
RETENTION $
$
WORKERS' COMPENSATION &
B
$
EMPLOYERS' LIABILITY
22000505190714/1/2007
/2007
4/1/2008
STATUTORY LIMIT
THE
EA
PO
of Santa Ana is named as additional insured per attached SS 00 08 04 05 +
City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 'BE CANCELLED BEFORE THE
Attn: City Clerk E30RA; ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
______DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
20 Civic Center Plaza OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE-
Santa Ana SENTATIVES. ' 10 Days for Non -Payment of Premium
CA 92702 AUTHORIZED
REPRESENTATIVE
Dan Gorman ��'/'
To: City
nta
Blanca
5-18-07 2:59pm P. 3 of 7
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to
holder in lieu of such endorsement(s). the certificate
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
AF'PPaU'/ f. , TO FORM
'(Aly
tiro; ;ev
I ACORD 25 (2001108) created at www.eCertsONLINE.com
ty
: manta
(6) When You Are Added As An
Additional Insured To Other
Insurance
That is other insurance available to
YOU covering liability for damages
arising out of the premises or
operations, or products and completed
operations, for which you have been
added as an additional insured by that
insurance; or
(7) When You Add Others As An
Additional Insured To This
Insurance
That is other insurance available to an
additional insured.
However, the following provisions
apply to other insurance available to
any person or organization who is an
additional insured under this Coverage
Part:
(a) Primary Insurance When
Required By Contract
This insurance is primary if you
have agreed in a written contract,
written agreement or permit that
this insurance be primary. If other
insurance is also primary, we will
share with all that other insurance
by the method described in c.
below.
(b) Primary And Non -Contributory 8,
To Other Insurance When
Required By Contract
If you have agreed in a written
contract, written agreement or
permit that this insurance is
primary and non-contributory with
the additional insured's own
insurance, this insurance is
primary and we will not seek
contribution from that other
insurance.
Paragraphs (a) and (b) do not apply to
other insurance to which the additional
insured has been added as an
additional insured.
When this insurance is excess, we will
have no duty under this Coverage Part to
defend the insured against any "suit" if any
other insurer has a duty to defend the
insured against that "suit„. If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured's
rights against all those other insurerSA1`Y TR.G',.j ;_)
Form SS 00 08 04 05
:Sypm p,
BUSINESS LIABILITY COVERAGE FORM
When this insurance is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self-
insured amounts under all that other
insurance.
We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess Insurance provision and was not
bought specifically to apply in excess of the
Limits of Insurance shown in the
Declarations of this Coverage Part.
C. Method Of Sharing
If all the other insurance permits
contribution by equal shares, we will follow
this method also. Under this approach,
each insurer contributes equal amounts
until it has paid its applicable limit of
insurance or none of the loss remains,
whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will
contribute by limits. Under this method, each
insurer's share is based on the ratio of its
applicable limit of insurance to the total
applicable limits of insurance of all insurers.
Transfer Of Rights Of Recovery Against
Others To Us
a. Transfer Of Rights Of Recovery
If the insured has rights to recover all or
part of any payment, including
Supplementary Payments, we have made
under this Coverage Part, those rights are
transferred to us. The insured must do
nothing after loss to impair them. At our
request, the insured will bring "suit” or
transfer those rights to us and help us
enforce them. This condition does not
apply to Medical Expenses Coverage.
b. Waiver Of Rights Of Recovery (Waiver
Of Subrogation)
If the insured has waived any rights of
recovery against any person or
organization for all or part of any payment,
including Supplementary Payments, we
have made under this Coverage Part, we
also waive that right, provided the insured
waived their rights of recovery against
such person or organization in a contract,
AS Toag?OMiW or permit that was executed
prior to the injury or damage.
,y Page 17 of 24
City
BUSINESS LIABILITY COVERAGE FORM
F. OPTIONAL ADDITIONAL INSURED
COVERAGES
If listed or shown as applicable in the Declarations,
one or more of the following Optional Additional
Insured Coverages also apply. When any of these
Optional Additional Insured Coverages apply,
Paragraph 6. (Additional Insureds When Required
by Written Contract, Written Agreement or Permit)
of Section C., Who Is An Insured, does not apply
to the person or organization shown in the
Declarations. These coverages are subject to the
terms and conditions applicable to Business
Liability Coverage in this policy, except as
Provided below.-
11.
elow:1. Additional Insured - Designated Person Or
Organization
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations, but only with respect to liability
for "bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions or
the acts or omissions of those acting on your
behalf:
a. In the performance of your ongoing
operations; or
b. In connection with your premises owned
by or rented to you.
2. Additional Insured - Managers Or Lessors
Of Premises
a. WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Designated Person Or Organization; but only
with respect to liability arising out of the
ownership, maintenance or use of that part of
the premises leased to you and shown in the
Declarations.
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) Any "occurrence" which takes place
after you cease to be a tenant in that
premises; or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
-IV-ur 1:59pm p,
3. Additional Insured - Grantor Of Franchise
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Grantor Of Franchise, but only with respect to
their liability as grantor of franchise to you.
4. Additional Insured - Lessor Of Leased
Equipment
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Lessor of Leased Equipment,
but only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury" caused, in whole or
in part, by your maintenance, operation or
use of equipment leased to you by such
person(s) or organization(s).
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to any "occurrence" which
takes place after you cease to lease that
equipment.
S. Additional Insured - Owners Or Other
Interests From Whom Land Has Been
Leased
a• WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Owners Or Other Interests From
Whom Land Has Been Leased, but only
with respect to liability arising out of the
ownership, maintenance or use of that part
of the land leased to you and shown in the
Declarations,
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) Any "occurrence" that takes place
after you cease to lease that land; or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
6. Additional Insured - State Or Political
Subdivision — Permits
a. WHO IS AN INSURED under Section C. is
I'ORMamended to include as an additional
insured the state or political subdivision
shown in the Declarations as an Additional
Page 18 of 24
Form SS 00 08 04 05
Blanca Rarmp
P -
BUSINESS LIABILITY COVERAGE
Insured —State Or Political Subdivision
FORM
-
Permits, but only with respect to
operations performed by you or on your
(e) Any failure to make such
inspections, adjustments,
behalf for which the state or political
subdivision has issued a permit_
tests or
servicing as the vendor has agreed
to make or normally
b• With respect to the insurance afforded to
undertakes to
make in the usual course of
these additional insureds, the following
additional exclusions apply: I
business, in connection with the
distribution or sale of the
This insurance does not apply to:
products;
(f) Demonstration, installation,
(1) "Bodily injury", "property damage" or
"personal
servicing or repair operations,
except such operations
and advertising injury"
arising out of operations
performed
the vendor's premises in
performed for
the state or municipality;
c
connection with the sale of the
or
(2) "Bodily injury" or "property damage"
product;
(9) Products
included in the "product -completed
operations" hazard.
which, after distribution
or sale b Y you, have been labeled
7• Additional Insured —Vendors
or relabeled or used as a
container, part or ingredient
a• WHO IS AN INSURED under Section C. is
of any
other thing or substance by or for
amended to include as an additional
the vendor; or
insured the person(s) or organization(s)
(referred to below
(h) "Bodily injury" or property
damage" ,the
as vendor) shown in the
Declarations
arising out of sole
as an Additional Insured -
Vendor, but only with "bodily
negligence of the vendor for its
own
respect to
injury" or "property damage" arising out of
acts or omissions or those of
its employees or anyone
your products" which are distributed or
else
acting on its behalf. However, this
sold in the regular course of the vendor's
exclusion does not apply to:
business and only if this Coverage
Part
provides coverage for "bodily injury" or
"property
(�) The exceptions contained in
Subparagraphs (d) or (f);
damage" included within the
"products -completed operations hazard".
or
00 Such inspections,
b. The insurance afforded to the vendor is
adjustments, tests or servicing
as the vendor has
subject to the following additional exclusions:
agreed to
make or normally undertakes
(1) This insurance does not apply to:
to make in the usual course of
(a) "Bodily injury" or "property
damage" for which the vendor is
business, in connection with
the distribution or sale of the
obligated to pay damages by
reason of the assumption
products.
(2) This insurance does not apply to any
of
liability in a contract or agreement.
insured person or organization from
This exclusion does not apply to
whom you have acquired such
liability for damages that the
Products, or any ingredient, part or
vendor would have in the absence
container, entering into,
of the contract or agreement;
accompanying or containing such
(b) Any express warranty
products.
8. Additional Insured — Controlling Interest
unauthorized by you;
(c) Any physical or chemical change
WHO IS AN INSURED under Section C. is
in the product made intentionally
amended to include as an additional insured
by the vendor;
the person(s) or organization(s) shown in the
(d) Repackaging, unless unpacked
Declarations as an Additional Insured —
Controlling Interest, but only with respect to
solely for the purpose of inspection,
their liability arising out of:
demonstration, testing, or the
substitution
a. Their financial control of you; or
of parts under
instructions from the manufacturer
b. Premises they own, maintain or control
and then repackaged in the oricA.-T"���%5' --�
r`. oWh y ase or occupy these premises.
container;
Form SS 00 08 04 05
A5
Page 19 of 24
: Blanca Roque 5-18-07 2:59pm p,
BUSINESS LIABILITY COVERAGE FORM
This insurance does not apply to structural
alterations, new construction and demolition
operations performed by or for that person or
organization.
9. Additional Insured — Owners, Lessees Or
Contractors — Scheduled Person Or
Organization
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Owner, Lessees Or Contractors,
but only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury" caused, in whole or
in part, by your acts or omissions or the
acts or omissions of those acting on your
behalf:
{1) In the performance of your ongoing
operations for the additional
insured(s); or
(2) In connection with "your work"
performed for that additional insured
and included within the "products -
completed operations hazard", but
only if this Coverage Part provides
coverage for "bodily injury" or
"property damage" included within the
"products -completed operations
hazard".
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to "bodily injury", "property
damage" or "personal an advertising
injury" arising out of the rendering of, or
the failure to render, any professional
architectural, engineering or surveying
services, including:
{1) The preparing, approving, or failure to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, designs or
drawings and specifications; or
(2) Supervisory, inspection, architectural
or engineering activities.
10. Additional Insured — Co -Owner Of Insured
Premises
The limits of insurance that apply to additional
insureds are described in Section D. — Limits Of
Insurance.
How this insurance applies when other insurance
is available to an additional insured is described in
the Other Insurance Condition in Section E. —
Liability And Medical Expenses General
Conditions.
G. LIABILITY AND MEDICAL EXPENSES
DEFINITIONS
1• "Advertisement" means the widespread public
dissemination of information or images that
has the purpose of inducing the sale of goods,
products or services through:
a. (1) Radio;
(2) Television;
(3) Billboard;
(4) Magazine;
(5) Newspaper;
b. The Internet, but only that part of a web
site that is about goods, products or
services for the purposes of inducing the
sale of goods, products or services; or
c. Any other publication that is given
widespread public distribution.
However, "advertisement" does not include:
a. The design, printed material, information
or images contained in, on or upon the
packaging or labeling of any goods or
products; or
b. An interactive conversation between or
among persons through a computer network.
2. "Advertising idea" means any idea for an
"advertisement".
3. "Asbestos hazard" means an exposure or
threat of exposure to the actual or alleged
properties of asbestos and includes the mere
presence of asbestos in any form.
4• "Auto" means a land motor vehicle, trailer or
semi -trailer designed for travel on public
roads, including any attached machinery or
equipment. But "auto" does not include
"mobile equipment".
5. "Bodily injury" means physical:
WHO IS AN INSURED under Section C. is a. Injury;
amended to include as an additional insured
the person(s) or Organization(s) shown in the b Sickness; or
Declarations as an Additional Insured — Co- c. Disease
Owner Of Insured Premises, but only with sustained by a person and, if arising out of the
respect to their liability as co-owner of the above, mental anguish or death at any time.
premises shown in the Declarations.
6. "Covera a to r "means:
Page 20 of 24
Form SS 00 08 04 05
City of Santa Ana From; Blanca Roque
5-18-07 2,59pm p, 1 o
Wood -Gutmann & Bogart/11113
910 S. EI Camino Real, Ste B.
San Clemente CA 92672
Phone: (949) 542-7800
Fax: (949) 542-7804
www.integrityint.com
To:
City of Santa Ana
Attn: City Clerk
20 Civic Center Plaza
Santa Ana CA 92702
This document was created by eCertsONLINE.
Subject: Certification of Insurance
Fieldman, Rolapp & Associates
Date: 5/18/2007
Delivery Via: FAX 17146475414
No. of Pages: 7
The attached or linked document(s) contain certification of insurance coverage for the insured named
in the subject above. Your company is listed as the organization requesting receipt of these
documents.
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format, and you must have Adobe Acrobat Reader installed on your system. To download the Adobe
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