Loading...
HomeMy WebLinkAboutTrauth, Dennis dba GOLDEN STATE ELECTRIC 1City of Santa~a Clerk of the Council AGREEMENT TERMINATION Please complete this form when the attached agreement is ~~` loiig~r in effect. Return form to the Clerk of the Council Office_(M-30~. Call 647-5237 if you have any questions. ~_, ~ , „~ The agreement with N-2006-007-02 No. and final payment has been made. NUMBER _ N-2006-007 N-2006-007-01 N-2006-007-02 Revised 07-23-07 City of Santa gYCi009 Anc AUG 3 U 2001 [downtown ~e~~o~o~rnent ~lV(SwCn was completed on (;-~- -~~j -~~=/ Department: ~' j ~~ ,~~ 1~J~ ! Al,; Phone/Ext.: _ ~~~~~ i ; ~~ Signature: ~ ;' ,~ ~ ~ .-., Date: ~~ ~ ~ ~ C(- ~~~ Mitre-Ramirez, Norma From: Alvidrez, Jesse Sent: Thursday, May 20, 2010 7:00 AM To: Mitre-Ramirez, Norma Subject: RE: Term. of TRAUTH, DENNIS dba GOLDEN STATE ELECTRIC Yes the information is correct. Jesse From: Mitre-Ramirez, Norma Sent: Wednesday, May 19, 2010 4:02 PM To: Alvidrez, Jesse Subject: Term. of TRAUTH, DENNIS dba GOLDEN STATE ELECTRIC Good Afternoon Jesse, Per our conversation, I'm sending this email to confirm that you have indicated that all three of the agreements mentioned below have been completed and can be closed. AGREMNT [+AE NUMBS FIX AG#AT- EXP INS_EXP SUdB,fECT TRAUTH, DENNIS dba N-2006-007 1 12/31/2006 05/09/2007 ELECTRICAL SERVICE SUMP GOLDEN STATE PUMP AND LIGHTING ELECTRIC FIXTURES TRAUTH, DENNIS dba N-2006-007-01 1A 06/30/2007 05/09/2007 FIRST AMENDMENT TO GOLDEN STATE INCREASE COMPENSATION ELECTRIC ND EXTEND TERM TRAUTH, DENNIS dba N-2006-007-02 1 B 06/30/2009 05/09/2007 SECOND AMENDMENT TO GOLDEN STATE INCREASE COMPENSATION ELECTRIC ND EXTEND TERM Norma Mitre Senior Deputy Clerk of the Council Clerk of the Council Office 20 Civic Center Plaza, M-30 P.O. Box 1988 Santa Ana, CA 92702 T: (714) 647-6520 F: (714) 647-6956 www.santa-ana.or~ t rl ~~C11tri 1 . N-2006-007 cy,Cj-DL.r J~ \:, -l;l<? CONTRACTOR AGREEMENT D',Nfl (IAl(i~ THIS AGREEMENT, made and entered into this I" day of January, 2006 by and between Dennis Trauth dba Golden State Electric (hereinafter "Contractor"), and thc 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"). RECIT ALS A. The City desires to retain a Contractor having special skill and knowledge in the field of electrical work. B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement wiD 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: 1. SCOPE OF SERVICES Contractor shall perform those services as set forth in Exhibit A to this Agreement. The parties anticipate that Contractor will provide additional services upon request of the Community Development Agency. Contractor shall submit a written proposal. Upon agreement of the terms of additional work, the Executive Director, or her designee, will issue a written authorization to commence the work. 2. COMPENSATION a, City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit A, and any additional work authorizations executed by the Executive Director. The total sum to be expended under this Agreement shall not exceed $10,000.00 during the term of this Agreement. b. Paymcnt by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. . 3. TERM This Agreement shall commence on the date first written above and terminate on December 31, 2006, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of the Community Development Agency and the City Attorney. 4. INDEPENDENT CONTRACTOR Contractor 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 Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Contractor 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 Contractor'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. Contractor shall supply City with a fully executed additional insured endorsement in substantially the form attached hereto as Exhibit B upon execution of this Agreement and shall be approved in form by the City Attorney. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non-owned automobiles. c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Contractor, if Contractor 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, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. 2 d. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor 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. e. If Contractor 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 Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Contractor agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, Contractors, special counsel, and representatives from liability for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Contractor or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section I of this Agreement The Contractor 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. 7. CONFIDENTIALITY If Contractor receives trom the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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 intormation 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 3 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 Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or 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: Executive Director of Community Development City of Santa Ana 20 Civic Center Plaza (M-25) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6736 and City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6515 To Contractor: Golden State Electric 21342 Conradi Avenue Torrance, California 90502 telefacsimile (310) 782-7918 4 A party may change its address by giving notice in writing to the other party. Thereafter, any 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. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor, 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 Contractor. 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 Contractor nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor 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 Contractors retained by City. 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor 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 Contractor 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 Contractor 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. 5 13. DISCRIMINATION Contractor 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. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Contractor shall, throughout the term ofthis 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. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each ofthe 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. II II II II II 6 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ~ PATRICIA E. HEALY Clerk of the Council " CITY OF SANTA ANA ;~~At/2- DAY I N. REAM City Manager ATTEST: APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney i '} . ./. ',,- I ,_ ','.' ~ ( By. ,'"" "...-" . "/'/ Laura Sheedy / Assistant City Attorney GOLDEN STATE ELECTRIC RECOMMENDED FOR APPROVAL: ~DJ\J\.AO- ~ ~ DENNIS TRAUTH Owner/Operator Tax ID# 33 - oY3g ;;1.11 7 EXHIBIT A SCOPE OF SERVICE Consultant shall provide electrical service as follows: . 3rd & Broadway - Replace existing sump pump as set forth in Attachment J, hereto. . Spurgeon Building - Flag pole light, as set forth in Attachment 2, hereto. . 3rd & Bush Parking Lot - install 2 - 50 Amp, 220 Volt outlets, as set forth in Attachment 3, hereto and Retrofit Existing Pole Lights as set forth in Attachment 4, hereto. 8 : GOLDENSTATEELECTIUC Contractor's License#574002 21342 Conradi Avenue Torrance, CA 90502 Phone: 310-782-8350 Fax: 310-782-7918 Proposal#380 1 0 Ann: Jessie Alvarez City of Santa Ana August 25, 2005 Job Location: 3m and Broadway Replace existing Swnp Pwnp The existing swnppumpwill be replaced with a new Zoeller#N53 with 35 ft. cord length and 1- 1/2 discharge complete for $480_00. Ace E P TAN C E: -1Q~_..~ Dennis Trauth - Owner/Operator ~ -~-O~ Date ~~ )'fithorized Representative 0 O/-/O-DC:, Date Attachnent ] FROM : GOLDEN STRTE ELECTRIC PHONE NO. 310 782 7918 Rug. 252004 12: 19PM Pi . . ... , GOLDEN STATE ELECTRIC Contractor's Liccnse#574002 21342 Conradi Avenue Torrance, CA 90502 Phone: 310-7&a.8350 Fax: 310-782-7918 Proposal#3 80 11 Attn: Jessie Alvarez City of Santa Ana August 25, 2005 Job Location: Spurgeon Building Flag Pole Light A new 400 Watt Metal Halide Flood Light is proposed with new conduit on fooffor $400.00. A C C E P TAN C E: fJ~ J/uUJ:J:-tt Dennis Trauth - Owner/Operator 5/- )-S- - 0 S- Date fd::::a~ ()/-/o-oro Date Attad:urent 2 -- 12/20/2005 Tlm 11:19 FAX 714+565 4020 CITY OF SANTA ANA I4J 002/003 GOLDEN STATE ELECTRIC ContraQOr's Lice.Jte1l'CS7400Z ZlJ42 Camlldi AVM.De Ton'llDOO, CA 90502 Phone: 310-782-3350 F8lC 310-782-791& Prop<l$Bl.#38040 Attn: Jesse Alvarez City of Santa ADa 305 E Fawtb Street, Suite 201 Santa Ana, CA 92701 DecemhcoT 15, 200S Job: 301 &. BlIsh Parking Lot Subject: 2 . SO Alap, 2.20 Volt outlets CloJdcD State Elcavie JlIl:'Po sts to supply lIIId iDstaIJ roatcriabl for lbe iDsta1IatiorJ of 2 - SO Amp, 220 Voltoutlels, ODe oneadl oftbe exisri"K poll! li8b1s- These outl~ will both come fiom one 50 AJnp, 220 Volt bteaIcer using lhe existins cirouit in @f01IIJCI to pull new wire to tho Iigbt polos. :zo ft of SO Amp ;ore! will be provided for each outlet with OIID spid..- box lit eadi cord end. ToW of2 spider boxes with OFl protected 12.0 Volt, U grcuod outlets. (SIBDdard 3 prong plus) Golden Sf.8lc ElIeecrIc prapose$ to petfOt\... the above wort foc $3,742.00. ACCEPTANCE: &~ _ ,.J I)J-A DeiIDis Traulh - o-~ - 1:;'-/5-0'1; Date ~ ~ Representative () C>/-Io- 00 Date JI:tt.a c:hrrent 3 12/20/2005 rUE 11:19 FAX 714+565 4020 CITY OF SANTA ANA I4i 003/ 003 GOLDEN STATE ELECTRIC Conll'aClDr's LiCl:llse#C514002 21342 Coaradi AvanU8 Tomnce. CA 90502 PIwne: 310-'7A2-11S0Fn: )I()..782-7918 Proposal#38041 AtIn: Jesse AIvvez City ofSmta Ana 305 2Fonrth StrcOl, Suilo WI Santa Ana, CA 92701 Del;rmbor 15, 200S Job: 3'" & Bush 1'addDg Lot RcbofitliDg Eldsting Pole Llgl1ts Sllbjegf; Golden St.ate rn-ic proposes to supply lIIId Install DIcctricalllWerials to rep/a4le the 4 . 250 Watt High PresSIlte Sodium. ballasls md IIImps with 400 Watt MeIlIl Halide for greater 1ip1mg. Golden Stare Electric P'0l0 s~s tD ...r"....1I1. above wort< ll$ described for $1,550.00. ACCEPTANCE: ~ ;j)~J~ Dennis Trauth - o-lOperator -1 :;.. -I S-t)~ J)abl ~~~ . Repn:sentative C>f-IO-Ore:, Date A ttachrrEnt 4 F'RODI;c:e:R PROWORKS iNSURANCE SERVICES,INC LICENSE #{)063i5B 25550 HAWTHORNE BLVD. #305 TORRANCE, CA 90505 310-465-0200 I ACORD . ~ CERTIFICATE OF LIABILITY INSURANCE \tI!SUREO GOLDEN STATE ELECTRIC DENNIS TRAUTH 21342 CONRADI AVENUE TORRANCE, CA 90502 I COVERAG~S THE POUCIE::S OF INSURANCE. LIsTEn BELOW HAVE SEEN ISSUED TO THS INSURED NAMeo ABOVE FOR THE POLICY pg,RIOD INDICATED. NO"WITH~-- \ND1NG ANY REQUI~~MENT. Tl:.f;1M OR CONDITION or ANY CONTRACT OR OiliER DOCUMENT YI/ITH RES~I:CT TO WHICH THIS GERTtPICATr. MAY Be: IS:IIED OR. MAY PERTAIN. THE INSURANCE AFFOROED aY THE POUCIF;:;S DESCRI8~D HEREIN IS sueJEcr TO Al.1.. THE TERMS, EXCLUSIONS AND CONDITIONS (;I: SUCH POI.IC1ES. AGGRE:GATEWA1TS SHOWN MAY HA,VE BEEN RE:OUCED BY PAID Cl.AIMS. ~{RIAOiJ' POLIcy NUM9ER. poucvi;:Ft CTIve POl,tcYEXPIRATlON rNSU~.~R 0: INSUReR E. _._~_L-_" . \ U"""T!l 1( 00,000 : 00,000 . __H 5,000 1 ,r 00,000 ?:i 00,000 . J,t 00,009 A . GENE.RAl UAElILm G-Xl COMIUIE~CI^LG,"NeFl:ALLlABILlTY _~ ClAIMS MAOI;;: [K) OCCIJI'! - --- ---- - - --- GEN'lAGC1~EGATE LIMIT A.F'F't.1E8 PER: -Xl POI.,IOY - PRO. ' .~ lOC I AUTOMOBILE LlA.Bll..,ITY 1 ANY Jl,UTO Ar.l OWNED AUTOS . ,5CHEDUlEDAUtOS ,..URED AVl"OS. Nm.,hOINNEO MJTOS WSR-000037 05/09/2005 0510912006 EACH OCGUt"\RENCE t- "Of(M^l..i~ I~Kt.N\tU . _.--- I>R,~.~ISES @~.GU~rl5f)___ _.!.__. ME.!:l~~~~~~~_!._ PE.Fi:.SPN,oI,l & M)V ItJJl.!!!!'~_..!...._ ~ .1135'NERAlAGG~EGATI:. ,$ ~~P~~.I.COMr>.1!?~~~J_ I COM6INIDSIN<;.1.l: LIMIT ,; (~ila<<'I(I"nll .. -------.. ----...- OOO\lYl!'lJUR"f E (Ptrrpdr'>;dfl) .-~- --- !'DDll V INJURY S (r'<ilr8CCldlJnt) --~- ~-- P~OPE.RTY tlJ..MAGE (F~aecffJl!It'Il) , I aeeSS1IJMBRE!UA UAElIUlY ~- _] OCCU~ I._.J CLAIMS MACE .' I -~-- 1-.0 ~~\1 ~.W~,!,EAA~__ .S OTHER THAN EA Ace ~!....-......-_. WTOONl)': AGG .Ii .~CH?E.~B"'e~~_. ..~~_,__ , ^~_OR~_ .~_. O~~G'E UA91lI'TY AN)'^\JTD DEDUCTISll<: RETENTtON WORKERS COMF'EN9PoTlON AND EMPlOYE~' i..IPt,B1UTY ^NY PRQf'RIETaRt~^RTNl;~/El('ECUTlVE. OffICERIME:M.!I:eR EXClUDfD? ~PEt~'r~R~~~1~NS b~1ow ( OTHE:~ -~-_.. .!~--. . ~iltMHs.1 L~{~_..~. , l<:.l._~~~~IDENT . So E,J.. grsEASt:: ).!~ EMpl..OYEE t E.l. DISEASE) POLICy LIMn " OEscrUPTlON OF OPIOFtATJONs f lOCATtONS ,VEHIClES rEXCl,UtJ,oN'S ADDE.O e'l' l;f\tpaRSEME:NT f 9PECIAl PROVISIONS THE CITY OF SANTA ANA, iTS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED AS REQUIREO PER WRITTEN CONTRACT. JOB: ELECTRICAL RE:PAIR CERTIFICATE HOLDER THE CITY OF SANTA ANA ATTN: JESSE ALVIDREZ 20 CIVIC CENTER PLAZA #M16 SANTA ANA, CA 92701 CANCELLATION SHOULD "'NY THE AGOV~ IJi:iSCRIBEO POUCIES Be CANCE;t.t.ED BE~OFl.~ THIl: E.lf RATION DA~ TH EO~. I-IE 19~UING lN$UR~R. Wrl.L~~~)j;All, 30 DAY,s I fRlTTEN NOTICE OTHE: ~T1n e L.DERNAM!ODTOttfl;;l.Enx;o~mtrr~ ;'E;PIi~~Xmil~~ ACORD Z5 (20011081 . ACORD CORPORA TICii Has t.~ ' (p.) POLICY NUMBER: WSR-000037 WELDO(" THIS ENDORSEMENT CHANGES THE POLICY. PL!:ASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY COVERAGE PART This endorsement modifies insurance provided under the following: SCHEDULE THE CITY OF SANTA ANA Attn.: Jesse Alvidrez 305 E, 4"', Street #201 Santa Ana, CA 92701 Re: Electrical Repair (If no entry appears above, information required to complete this endorsement will be shown in the Declaration1 as applicable to this endorsement) A. Section 11- Who is An Insuredis amended to include "s an insured the person or organis"tion shown in the Schedule, but only as respect to liability arising out of "your work" for that insured by or fOr you, a.With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2, Exclusions This insurance does not apply to "bodily injury", "property damage' or "personal and advertising injury" which does not specifically arise out of "your work" for that insured by or for YOU. WEL0005 C.lf you are required by the terms of an "insured contract" to provide primary insurance to any insured included by virtue of this endorsement, then this insurance shall be primary, but only with respect 10 liability arising our of "your work' for that insured by you or for you, Any other insurance available to that insured will apply as excess and wili not contribute towards the primary insurance afforded by the provisions of this endorsement. .' ~', ; Page 1 01 1 "'--K_~. t:Z .. J / /~~-,-J~:2- (3") CERTHOLOER COPY SG STATE COMPENSATION IN SURANCE FUND P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE OATE: 01-01-2006 GROUP: POLICY NUMBER: 1500351-2008 CERTIFICATE 10: 55 CERTIFICATE EXPIRES: 01-01-2007 01-01-2006/01-01-2007 CITY OF SANTA ANA 305 E 4TH ST, STE 201 SANTA ANA CA 92701 SG This is to certify that we have issued a valid Workers' Compensation insurance policy in a form ,approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain. the insurance afforded by the policy described herein is subject to all the terms, exclusions. and conditions, of such policy. ~ ~~t! ~ AUTHORIZED REPRESENT A TIVE PRESIDENT UNLESS INOICATED OTHERWISE BY ENOORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING: THOSE NAMED IN THE POLICY OECLARATIONS AS AN INOIVIOUAL EMPLOYER OR A HUSBANO ANO WIFE EMPLOYER; EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUOEO UNOER CALIFORNIA WORKERS' COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUOING OEFENSE COSTS: $1,000,000 PER OCCURRENCE. , ,'~ , Received By City of Santa Ana DEe 2 9 2005 Downtown Development Division X*'-~V~7 EMPLOYER TRAUTH,DENNIS WILFRED 21342 CONRAOI AVE TORRANCE CA 90502 SG (REV.2-05) e, ~-' M0408 PRINTEO 12-17-2005 . Progress'l ve _ C.NJalty lnsuran ce Co. PO Box 94739 Oeveland, OH 44101 800-444.4487 PROGREJ.J/VE" COMMERCIAL AurO INSURANCE Policy number: 04476549-5 De<:ember 2, 2005 Page 1 of 1 Certificate of Insurance CartificatetloUer CllY OF SANTA ANA 305 E 4TH ST STE 201 SANTA ANA, CA 92701 Insured ..... DENNis TRAUTH GOLDEN STATE ELECTRI 21342 CONRADI AVE TORRANCE, CA 90502 Agen' PROGRESSIVE PO BOX 94739 CLEVELAND, OH 44101 This document certifies that insurance policies identmed below have been issued by the designated insurer to the insured named above lor the peliod(s} indicated. This Celtmcate is issued lor information purposes only. It confers no rights upon the certificate holder and does not change, alter, modify, Of extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subjed to all the terms, exclusions, lim~ations, endorsements, and conditions of these policies. Policy Effedive Date: Feb 24,2005 Policy ExpiratiOl'l Date: Feb 24, 2006 Units $1,000,000 Combined Single Limit Insurance coverage(s) Bodily Injury/Property Damage Description of LocationNehicles/Specialltems ScheduledaU1Dsonly. . 1999 CHEVROLET FLATBED TRUCK lGBGC34R1XF099018 Certifica1l! number 336051T'/549 Please be advised that the certificate holder will not be notified in the event of a mid-term cancellation. 2)-fA) ~ ,I " ~.J f'._' C' ". :,.':(.)Rtv1 ,'J Form 5241 (10/02) 7(J. '7""<) > v :<,~:_. -.---.--. . ',l.',".., --~-- -,.':"y ',": ' , ~.