HomeMy WebLinkAboutBROWNING,SHARON & ASSCOCIATES 2 -2002
0,iJ~
Jf'.~S:, -r ,I F:i..E
~!.:f '.,.. .~...;?:_,
. ..~'_ -Lb_O,,-;F.ES
... .......... ..~-. -
. ;..-.' " '; .... ~ l.
;';;>-d-g-o;}
THIS AGREEMENT, made and entered into this ~ day of January, 2002 by and
between Sharon Browning & Associates, a California sole proprietorship (hereinafter
"Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and
existing under the Constitution and laws of the State of California (hereinafter "City").
"""
....,;
N-2002-008
CONSULTANT AGREEMENT
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in developing
and implementing a comprehensive approach for the Santa Ana Work Investment Board
of Director's strategic planning meeting to clarify its goals and action plans and to
maximize opportunities for leveraging funds.
B. Consultant represents that Consultant is able and willing to provide such services to the
City.
C. In undertaking the perfonnance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services perfonned by Consultant under this
Agreement will be perfonned in compliance with such standards as may reasonably be
expected from a professional consulting finn in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
tenns and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
Consultant shall perfonn those services as set forth in Exhibit A to this Agreement.
2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services,
the rates and charges identified in Exhibit A. The total sum to be expended under this
Agreement, shall not exceed $5000 during the tenn of this Agreement.
b. Payment by City shall be made within thirty (30) days following receipt of proper
invoice evidencing work perfonned, subject to City accounting procedures. Payment need not
be made for work which fails to meet the standards of perfonnance 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
,
2002, 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
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee ofthe 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.
S. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the City, its officers, employees, agents, volunteers and
representatives as additional insured(s) and shall include, but not be limited to protection against
. claims arising from bodily and personal injury, including death resulting therefrom and damage
to property, resulting from any act or occurrence arising out of Consultant's operations in the
performance of this Agreement, including, without limitation, acts involving vehicles. The
amounts of insurance shall be not less than the following: single limit coverage applying to
bodily and personal injury, including death resulting therefrom, and property damage, in the total
amount of $1,000,000 per occurrence. Consultant shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit B upon
execution of this Agreement and shall be approved in form by the City Attorney.
b. 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, 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 th"
,-.
.....,
d. If Consultant is or employs a licensed professional such as an architect or engineer:
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.
6. INDEMNIFICATION
Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents,
employees, consultants, special counsel, and representatives from liability: (I) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims
for personal injury, including health, and claims for property damage, which may arise from the
direct or indirect operations of the Consultant or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates to the services described in
section I of this Agreement; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects
arising from this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to
have been suffered, by reason ofthe events referred to in this Section or by reason of the terms
of, or effects, arising from 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 ofthe terms of, or
effects arising from this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding.
'-'
'wi
7. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
that it shall not use or disclose such information except in the performance ofthis 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 ofthe 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.
8. 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.
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, California 92702-1988
telefacsimile (714) 647-6956
With courtesy copies to:
Santa Ana Empowerment Zone
City of Santa Ana
20 Civic Center Plaza (M-21)
Santa Ana, California 92702
'-'
~
Santa Ana Workforce Investment Board
1000 East Santa Ana Boulevard, #200
Santa Ana, California 92701
telefacsimile (714) 565-2602
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 Consultant:
Sharon Browning & Associates
916 Greentree Road
Pacific Palisades, California 90272
telefacsimile (310) 459-5154
Attn: Sharon Browning
A party may change its address by giving notice in writing to the other party. Thereafter,
any notice, tender, demand, delivery, or other communication shall be addressed and transmitted
to the new address. If sent by mail, any notice, tender, demand, delivery, or other
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or
other communication shall be effective or deemed to have been given twenty-four (24) hours
after the time set forth on the transmission report issued by the transmitting facsimile machine,
addressed as set forth above. For purposes of calculating these time frames, weekends, federal,
state, County or City holidays shall be excluded.
10. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, and supersedes any and all other agreements, oral or written, between the parties. In
the event of a conflict between the terms of this Agreement and any attachments hereto, the
terms 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 acknowledQ'e. that no r"nr"o"ntot;nno ;nr1"~~~~nto
'-'
""""
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without
the City's prior written consent shall be considered null and void. Nothing in this Agreement
shall be construed to limit the City's ability to have any ofthe services which are the subject to
this Agreement performed by City personnel or by other consultants retained by City.
12. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of termination,
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.
13. DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital
status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited
by applicable law, in the recruitment, selection, training, utilization, promotion, termination or
other employment related activities. Consultant affirms that it is an equal opportunity employer
and shall comply with all applicable federal, state and local laws and regulations.
14. JURISDICTION - VENUE
This Agreement and all questions relating to its validity, interpretation, performance, and
enforcement shall be government and construed in accordance with the laws of the State of
California. This Agreement has been executed and delivered in the State of California and the
validity, interpretation, performance, and enforcement of any of the clauses of this Agreement
shall be determined and governed by the laws of the State of California. Both parties further
agree that Orange County, California, shall be the venue for any action or proceeding that may
be brought or arise out of, in connection with or by reason of this Agreement.
.......,
15. PROFESSIONAL LICENSES
""""
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United States, the State of California,
the City of Santa Ana and all other governmental agencies. Consultant shall notify the City
immediately and in writing of her 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 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.
PATRICIA E. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
Jo Reekstin
Executive Director ofthe Community
Development Agency
CITY OF SANTA
~
~~.~
Ih,
Sharon M. Browning
Sharon Browning & Associates
551-60-8471
ilSHAFlO'W'
BFlOWNING
&ASSOCIATES
...."I
ISSUES MANAGEMENT AND CONSENSUS PLANNING
January 5, 2002
Ms. Patricia Nunn
Economic Development Director
Community Development Agency
City of Santa Ana
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, California 92702
SUBJECT: PROPOSAL TO PROVIDE CONSULTATION AND MEETING
FACILITATION SERVICES TO THE SANTA ANA WORK
INVESTMENT BOARD OF DIRECTORS
Dear Ms. Nunn:
Per your request, Sharon Browning & Associates (SB&A) is pleased to submit the
following proposal to provide the Santa Ana Work Investment Board (SA WIB) with
meeting preparation and facilitation services relative to its February 24, 2002 Board of
Directors' strategic planning meeting.
Consulting Assignment
The SA WIB is interested in conducting a three-hour visioning and planning meeting to
review and update its strategic plan. The SA WIB, a 33-member policy board, is
interested in reaftirming its vision and mission, clarifying its goals and action plans and
maximizing opportunities for leveraging funds. SB&A will assist staff in developing
and implementing a comprehensive approach to the SA WIB Board of Directors'
strategic planning meeting.
Scope of Work
SB&A's professional services will include but not be limited to the following tasks and
activities:
1. Review relevant background materials including:
SA WIB 2000 Strategic Plan
SA WIB Operating Agreement
"-'
..,,;
Page 2/SAWIB Strategic Planning Meeting Proposal
2. Conduct background and planning meetings with the Chairman of the WIB and
the Economic Development Director
3. Participate in one or two staff planning meetings
4. Prepare a draft meeting agenda and process/desired outcomes' outline
5. Prepare a final meeting agenda
6. Assist with meeting facility arrangements
7. Facilitate one three-hour planning meeting
8. Record discussion on wall chart notes (during meeting)
9. Consult and assist with post-meeting action items (upon request)
Professional Fees
In order to complete the proposed scope of work, Sharon Browning will devote
approximately 18 hours at $130 per hour for a total professional fee of $2,340.
Projected consulting hours will be distributed as follows:
Activity
. Review of background documents
. Staff planning meetings
. Agenda and process outline preparation
. Facility arrangements
. Meeting facilitation and discussion recordation
. Post-meeting consultation
Hours
1
5
4
2
5
I
Total Projected Hours
18
Total Projected Fees:
$2,340
Browning: 18 hours x $I30/hour = $2,340
Tenn of Agreemeut
This agreement will remain in effect through completion of the scope of work or until
SA WIB notifies SB&A that its services are no longer required. SB&A will provide the
SA WIB with four weeks notice prior to unilaterally terminating its services. SA WIB
may terminate this agreement at any time.
'-
....,
Page 3/SAWIB Strategic Planning Meeting Proposal
SB&A welcomes the opportunity to work with the Santa Ana Work Investment Board
and looks forward to contributing to a successful planning meeting.
s~ t.;& .
Sharon M. Browning ~
5MB/hht
Accepted for the Santa Ana Work Investment Board by:
Name
Date
Title
'--'
,
-
EXHIBIT B
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
I. 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
ilSHARO)Q
BROWNING
&ASSOCIATES
....,I
ISSUES MANAGEMENT AND CONSENSUS PLANNING
January 7, 2002
Ms. Lydia Morgan
Fiscal Specialist
City of Santa Ana
1000 E. Santa AnH Rlvrl., Rm. 200
Santa Ana, CA 92701
RE: CITY OF SANTA ANA AS LOSS PAYEE OF GENERAL LIABILITY
AND AUTOMOBILE INSURANCE
Dear Ms. Morgan:
In regards to my impending consulting contract with Santa Ana Work Investment
Board (Patti Nunn) and per your request, this letter will serve to confirm that the
City of Santa Ana is named as a Loss Payee on both my general liability and
automobile insurance policies. I've asked both insurance companies to send Loss
Payee certificates directly to you. With regard to notification to the City of Santa
Ana of cancellation of either policy, I assume full responsibility for promptly
notifying the City in event of a cancellation.
Please call me should you require additional information or documentation.
S::;Lv ^.li .
Sharon M. Browning ~
..
,ACORD CERTIFICAU OF LIABILITY INSURA.....cE I f DATE
-~'" 02/11/02
PRODUC~R_ , THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lydd~ Martin Company 310-478.2625 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
11300 West Olympic Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 910 INSURERS AFFORDING COVERAGE
~~ngeles CA 90064 ...
INSURED SHARON BROWNING ASSOCIATES i INSURER A: HARTFORD CASUAL TV INSURANC~. COMPANY
--. ~
916 Greenlree Rd. INSURER B: ..-
INSURER c: --..--
Pacific Palisades CA 90272 INSURER 0:
INSURER E:
COVERAGES
THEPOLlCIESOFINSURANCELlSTEDBELOWHA VEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLlCYPERIODINDICA TED.NOTWITHST ANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MA YPERT AIN, THEINSURANCEAFFORDEDBYTHE POLICIES DESCRIBED HEREIN ISSUBJECTTOALL THETERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I,N~~ TYPE OF INSURANCE POLICY NUMBER : PRk+~Y EFFECTIVE POLICY EXPIRATloNT LIMITS
l GENERAL LIABILITY I EACH OCCURRENCE $1,000,000
A ~.E"CIAL GENERAL LIABILITY 72SBAKP7892 09/26/2001 09/26/2002 ! FIRE DAMAGE IAnv one flrel $300,000
CLAIMS MADE [!J OCCUR MED EXP IAnv one [Ierson\ $10,000
I PERSONAL & ADV INJURY ,1,000,000
--.J _, GENERAL AGGREGATE $~,OOO,OOO
~'L AGG:nE LIMIT AnS PER: PRODUCTS - COM PlOP AGG $
X POLICY I ~~R;. LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
- ANY AUTO (Eaaccidenl)
- ALL OWNED AUTOS BODILY INJURY
$
~ SCHEDULED AUTOS IPerperson)
I BODILY INJURY .. - --- .~
~-_. : HIRED AUTOS
$
'--- NON-OWNED AUTOS ' (Per accident)
- .-- --.--
~-, I PROPERTY DAMAGE $
(Per accident)
~~GE LIABILITY AUTO ONLY - EA ACCIDENT $ .-
ANY AUTO OTHER THAN EA ACC 1.
AUTO ONLY: AGG $
::J~SS LIABILITY EACH OCCURRENCE $ __u
OCCUR 0 CLAIMS MADE AGGREGATE ...- $
i $
,
=i ~EDucnBLE L
I~ RETENTION $ $
I rroRKERS COMPENSATION AND APPROVED AS TO ~ I_"YS..~T~T.~~ I 10TH.
EMPLOYERS' LIABILITY RM ..
E.L. EACH ACCID.ENT $
I ~ L.- .---
! L.g. OISEAS~:.~A~~~Q.'r.:~ ..!._- ----
E.L. DISEASE. POLICY LIMIT $
OTHER Deputy ( Ity Attorney
I
.
,
DESCRIPTION OF OPERATlONSILOCATlONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CERTIFICATE HOLDER CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND EMPLOYEES ARE NAMED ADDITIONAL INSURED PER ATTACHED FORM
EXCEPT 10 DAYS NON.PAYMENT OF PREMIUM
CERTIFICATE HOLDER I X i ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
I ~,..nllnUI'" nrUE:1 nDUE:t.IT AlnE: I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION l
Cj~y of Sen~~ An~
(714)847-6860
08/02/01 10'-~A P.002
.....J
"0
'-'
ADDITIONAL INSURED ENDORSEMENT
Insurance Company HARTFORD CASUAL TV INS CO
This endorsement modifies such Insurance as Is afforded by the provisions of
POlicy # 7?<;RAKP7IN? relating to the following:
1. The City of Santa Ana, 20 Civic center Plaza, Santa Ana California 92702;
its officers, employees, agents 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 92702
(Completion of the following, including countersignature is required to make this
endorsement effective.)
E.ffective 02/11/02
Policy # 72SBAKP 18~~
Issued to ::>HAKUN ~KUWNI11l:l U~I\: :>HARON BROWNING & ASSOCIATES
Name Insured
Countersigned by ~~
. this endorsement form as a part of
~1' ~TERINSURANCE EXCHA~E of the Automobile Club
.",. AUTOMOBILE INSURANCE RENEWAL DECLARATIONS
'..J
PLEASE READ: These declarations constitute our offer to renew this insurance for the policy period shown below. Renewal is contingent upon
your payment of alleas! the Minimum Due betore or on the Due Date shown in the enclosed Insurance Billing. Failure 10 pay at least the Minimum
Due before or on the Due Date shall mean that you rejected this renewal offer. All coverage afforded by this policy will then ~erminate at 12:01
a.m., Pacific 51andard Time, on the Effective Date shown in these declarations under "Policy Penod." These declarations, together with the
contract and the endorsements in effect, complete your policy. I
ITEM 1. YOUR NAME AND ADDRESS
BROWNING, GEORGE AND SHARON
916 GREENTREE RD
PACIFIC PALISADES CA 90272-3913
PROCESS DATE AUTO POLICY NUMBER
12-11-01 G 4841145
POLICY PERIOD (PACIFIC STANDARD TIME)
EFFECTIVE DATE 1-15-02 12:01 A.M.
EXPIRATION D;'TE 1-15-03 12:01 A.M.
ITEM 2. DESCRIPTION OF VEHICLES
VEH. I GARAGE ANTI-THEFT DEVICE AIR
NO. YEAR MAKE IDENTIFICATION NO. LEASED FINANCED ANNUAL MILES ELECTRONIC BAGS
ZIP CODE OTHER
! LOCATOR
I 00 BENZ WDBNG70J3YA109043 NO NO 90272 25,001 - 30,000 YES NO YES
2 90 BENZ WDBCA45E2LA533681 NO NO 90272 7,501 - 10,000 NO YES YES
3 89 PORS WPOAB0913KS120795 NO NO 90272 5,001 - 7,500 NO YES NO
VEHICLE SPECIAL EQUIPMENT * SOUND EOUIPMENT . PARKED
NUMBER CAMPER! 2.WAY TElE. IN
V AN eONV' OTHER PHONE RADIO OTHER GARAGE
RADIO
1 YES
2 I YEp
i ROVED AS" It PORM
3 , YE
r V UA..--
CRISTl'i"lt LEE SHAW
* WARNING: Under Part III of the pOlicy (Physical Damage), special coverage limitations apply unless coverage was Deputy City Attorney
specifically purchased for certain equipment. Coverage is indicated by an "X" in the appropriate equipment column,
ITEM 3. COVERAGES AND ANNUAL PREMIUMS (COVERAGES ARE NOT IN EFFECT UNLESS INDICATED AND A PREMIUM IS SHOWN)
POLICY I- LIABiliTY " . MEDICAL III. PHYSICAL DAMAGE IV. UNINSURED MOTORIST
PART
COVER. S -PROPERTY C " N-CAR L-UNINSURED F . BOQIL Y INJURY UNIt>(-
A. BODILY INJURY DAhAAOE l.tEO. PAY. eXCESS o - COMPREHENSIVE RENTAL E -COLLISION MOTORIST SUREO &. UNOERINSUREO
AGES MEO.PAY. EXPENSE COLLISION MOTOR VEHICLES
THOUSAND I THOUSAND THOUSAND THOUSAND THOUSAND ACTUAL CASH LESS ACTUAL CASH LESS UNINS. THOUSAND I THOUSAND
VEH DOLLARS DOLLARS DOLLARS DOLLARS OOLLARS VALUEQR SPECIFIEO OOLL.AAS VALUE OR SPECIFIED OED. UNINS DOLLARS I DOLLARS
i EACH EACH EACH EACH EACH Llt.lITOF PER OM LlhAlTOF COLL. EACH , EACH
'0 DEDUCTIBLE DEDUCTIBLE WAIVER
: PERSON OCCUR. OCCUR. PERSON PERSON LIABILITY LIABILITY PERSON , ACCIDENT
L ! ,
I 1 100 300 50 5 ACV 2000 20 ACV 2000 X 100 , 300
M , ,
I, 2 100 , 300 50 5 100 , 300
T I 3 100 , 300 50 5 ACV 2000 ACV 2000 X 100 , 300
S I , ,
, ,
, ,
, ,
, ,
P 1 342 182 51 116 27 790 70
R 2 250 131 39 53
~I
3 237 140 23 206 404 30
~.I I I
~
AUTO POLICY NUMBER G 4841145
POLICY EFFECTIVE DATE 1-15-02
ITEM 4, DRIVERS (UNLESS EXCLUDED)
DRIVER NAME GENDER DATE MARITAL DRIVER'S LICENSE I YEAR FIRST
NO. OF BIRTH STATUS NUMBER LICENSED
1 BROWNING, GEORGE LESLIE MALE 9-23-38 MARR lED ,.1 F 288390 54
2 BROWNING, SHARON FEMALE 7-31-43 MARR I ED J 710248 59
DRIVING RECORD STATUTORY DRIVER RATED GOOD DRIVER IMPROVEMENT CERTIFICATES
DRIVER
NO. NUMBER OF NO. OF TRAFFIC CONVICTIONS GOOD STATUS VEHICLE STUDENT MATURE
PRINCIPAL~ V-AT. DRIVINGCQURSE
FAULT ACCIDENTS MINOR SERIOUS MAJOR seVERE DRIVER NO. DRIVER
1 YES PRIMARY 3
2 YES PRIMARY 1 I
[rEM 5. ENDORSEMENTS AND CERTIFICATES IN EFFECT AT ISSUANCE
NUMBER TITLE
NUMBER
TITLE
2231 'GUARANTEED RENEWAL
2239 CLAIMS COST REDUCTION
2151 : ADDL INSURED NOTICE - DRIVER
2059 : ADDITIONAL INSURED NOTICE - VEHICLE
ANY lOSS UNDER PART III-PHYSICAL DAMAGE-IS PAYABLE AS INTEREST MAY APPEAR TO YOU AND
FOR QUESTIONS OR CHANGES
CALL 1-800-924-6141 TOll FREE
IT5oo.26
EOSOI