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Home My WebLink AboutHYGIENETICS ENVIRONMENTAL SERVICES, INC. 1 -2002 ~ INSUHANCE or~ FILE WORK MAY PROCEED UNTIL INSURANCE EXpiRES ~-l-63 CLERK Of COUNCIL CONSUL T ANT AGREEMENT DATE: 10-21-02- THIS AGREEMENT, made and entered into this ~day of 13 ('l-o/J~ 2002 by and between Hygienetics Environmental Services, Inc., a Delaware Corporation (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-2002-141 . o'Y' (\;; F~Ll I f- I {\; RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of environmental services to provide lead-based paint abatement monitoring for the Santiago Creek Bridge at Bristol Street. 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: 1. SCOPE OF SERVICES Consultant shall perform those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement, shall not exceed $9,644.00 during the term of this Agreement. b. Payment by City shaJl 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 3],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 Public Works 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 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 shaH be provided in a manner consistent with aH applicable standards and regulations governing such services. Consultant shaH pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shaH be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shaH 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 shaH 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 shaH 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 $],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 the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $] ,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. Said policy or policies shall give to the City prompt and timely notice of claim made or suit instituted arising out of Consultant's operations hereunder. 2 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 shalI 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 shalI not effect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section I of this Agreement. This indemnity and hold harmless agreement applies to alI claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alIeged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. 7. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shalI 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" shalI include alI nonpublic information. Confidential information includes not only written information, but also information transferred oralIy, visual1y, 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 3 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, CA 92702-1988 telefacsimile (714) 647-6956 With courtesy copies to: Executive Director of the Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-2l) P.O. Box 1988 Santa Ana, California 92702 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: 4 Hygienetics Environmental 1920 East Warner Santa Ana, CA 92705 Attn: Allan Coffee 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 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 Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 12. TERMINA nON This Agreement may be terminated by the City upon thirty (30) days written notice of terminatioll. 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: 5 a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City, in a form compatible with City's computer system, 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 governed 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. 6 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA AN) Z):;;~ City Manager ( PATRICIA E. HEALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney By: Lau Sheedy Assistant City Attorney RECOMMENDED FOR A~L: ~'Av~J1 (/4 ,tAMES G. ROSS // Executive Director of the / Public Works Agency CONSULTANT ALL~~ Regional Director Employer ID # 13-3992505 K:\ WPDOCS\D009\POO 1 \00005402.DOC 7 ~cr-ll-~~~2 12:33 HYG I ENETJ CS SANTA ANA 949 955 0965 P.02/05 - . Hygienetics@1 Environmental HY8Ienp.'tlc, EnvIronmental Services, Inc. 1920 East WClmer AlIenue Suite A 5am8 Aoa. CA 92705 Phone: (94~) 95:;,0201 FaJ:~ (9119) 955.0965 September 11, 2002 EXHIBIT "A" Mr. M,ke Gl1'gis CIty of Santa Ana Construction Engineering Section 20 Civic Center Plaza, M-22 Santa Ana, California 92702 RE: Revised Proposal for Lead-Paint Abatement Monitoring, Bristol Bridge Project, Santa Ana, California, HygieDelics Proposal Number LA021788 Dear Mr, Girgis: HYgienetics Environmental Services, Inc, (HygienetiCs) IS pleased 10 present the following proposal to provide Lead-based paint abatement monitoring and prepare a final report at the above-referenced location, Hygitnetics fee is based on the project requiring 16 shifts to complete. If additional shifts are required, they will be billed at S559.00/S-hour shift. Our Time aDd Materials fee for this work is _ 59,644,00 Scope of Work 1) Hygienerics will collect and have analyzed six (6) soil samples prior to and after the lead abatement on the beams under the bridge; 2) Hygicnehcs will provide a California Lead Project Monitor to verity work prachce of the abatement contractor; 3) Following complel1on of the project, Hygienetics will provide the City of Santa Ana with a Project Summary Repon and results of all sampling completed during the project. Copies of conlTactor subnurtals and records of daily inspections will also be included in our fmal report Thank you for giving Hygienetics the OPportunity to provide this proposal. Should you have any questions regording this project, do not hesitate to contact us. or en . Project Manager California Certified Asbestos Consultant Encl: Fee Proposal L\t"KOroSAL\NEWlLAOlI78S. DOC SEP-II-2002 12:33 HYGIENETICS SANTA ANA 949 955 0955 P.03/05 . . Fee Propo.al - City of Santa Ana Bristol Brid,e ProJed Task 1 - Lead Soil Samples lead Soil Samples 12 samples@ $ 25.00 Isample $ 300.00 5300.00 Task 2 -AbateIDent Monitorinl! per 8 hour Shift Inspectors 8 hours @ $ 50.00 Ihr $ 400.00 Project Manager I hours @ $ 70.00 Ibr $ 7000 Lead Wipe Samples 4 samples @ $ 20.00 IsampJe $ 8000 Mileage 30 miles@ $ 0.30 Imile $ 9.00 TOTAL $ 559.00 Estimated nUIDber of Shifts 16 sblfts @ $559.00 I.hift $ 8,944.00 Task 3 - Closeout ReDort PrOject Manager Clerical CopieSlMail 4 hours @ $ 70.00 Ihr $ 280.00 2 hours @ $ 35.00 !hr $ 70.00 Aleost $ 50.00 $ 400.00 59,644.00 Total Estimated Cost FEE PROPOSAL 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 9270 I; 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 9270 l. (Completion of the following, including countersignature, is required to make this endorsement effective. ) Effective Policy # Issued to , this endorsement form as a part of Named Insured Countersigned by Authorized Representative 8 ACORD,' DATE (MM/DD/YY) 08/28/02 l'RODUCER Aon Risk Services, Inc. of New York 685 3rd Avenue New York NY 10017 USA THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TillS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, PHONE. (866) 266-7475 FAX. (866) 467-7847 INSURERS AFFORDING COVERAGE INSURED HYGIENETICS ENVIRONMENTAL SERVICES, INC. 180 PORTLAND STREET BOSTON MA 02114 USA INSURER A: INSURER B: Continental Casualty Company American International SpeCialty Lines INSURER Co INSURER. D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIlE INSURED NAMED ABOVE FOR Tl-IE POLICY PERIOD INDICATED, NOTWITIlSTANDlNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WJTH RESPECT TO WHICH THIS CERTlFICA TE MAYBE ISSUED OR MA Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGA1E LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICy NUMBER POLICY E.'FECTIVE POLICY EXPIRA nON DATE(MM\DD\YY) DATE(MM\DD\YY) LIMITS .A GENERAL LIABILITY GL25188850 GF.~!ERAr, t.I.Z\.BILI'J'Y 01101/02 01/01/03 EACH OCCURRENCE $1,000,000 $50,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR HkE DAMAGElArlYone lire) MED EXP (Anv one pt:rsOll) 5 000 $1,000,000 $2,000,000 $1,000,000 PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER, D PRO- 0 X POLICY JECT LOC GENERAL AGGREGATE PRODUCTS - COMP/OP AGG A AUTOMOBILE LJABlLIl'Y X ANY AUTO X ALL OWNED AUTOS X SCHEDULED AUTOS X HfRED AUTOS X NON OWNED AUTOS BUA251888578 Automobile - Commercial 01101/02 01101/03 COMBINEO SINGLE LIMIT (Eaac~ident) $1,000,000 BODILY INJURY (Per person) BODILY INJURY (PeraccKIent) PROPERTY DAMAGE (Per ac~ident) GARAGE LIABILITY AS TO F RM AUTO ONLY - EA ACCIDENT ANY AUTO > - OTHER mAN AUTO ONLY , EA ACC EXCESS LIABILITY OCCUR 0 CLAIMS MADE lee y Deputy City A orney AGG EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION A WORKERS COMPENSA'rION AND EMPLOYERS'LlABILllT WC251888516 we {AOS} WC251888547 WC (OR & WI) 01101102 01/01/02 01101/03 E.L. EACH ACCIDENT $1,000,000 $1,000,000 $1,000,000 $1,000,000 $3,000,000 A E.L DISEASE-POLICY LIMIT . OlDER 267 87 37 Contractors Ops & Prof. Servo E.L. DISEASE_EA EMPLOYEE 01/01/02 01/01/03 Limit (1) Limit (2) ElIvirn SVC~ E&O DESCRIPTION OF OPERATlONSILOCATlONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Umbrella extends to General Liability, Automobile and Workers' Compensation poliCies noted. E & 0 Claims Made Limit refers to Each Claim Limit, Aggregate Limit. The City of Santa Ana, its' officers, employees, agents, volunteers and representatives are included as Additional Insureds, except under Workers Compensation, with I' CITY OF SANTA ANA PUBLIC WORKS AGENCY! CONSTRUCTION ENGINEERING ATTN: MR. MICHEL GIRGIS P.O. BOX 1988!M-22 SANTA ANA, CA 92702 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, mE ISSUING COMPANY WILL ,"'-q)E" 9R TO MAJL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEfT, BUT r' {lURE T9 gg SO $11 \bl IHpg~r trg OEU'2 'T-!9rJ OR 1.1' EIbITY OF 'r," KH'D "P'0rJTIIEC9t[P'W'.JT'; '9UI"[$ 8R \"EPRESEHT''FI''BS. AumORIZED REPRESENTATIVE Certificate No : 570003773792 Holder Identifier: . Attachment to ACORD Certificate for HYGIENETICS ENVIRONMENTAL SERVICES, INC. The terms. conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all tems, conditions, coverages or exclusions contained in the policy. INSUREO HYGIENETICS ENVIRONMENTAL SERVICES, INC. 180 PORTLAND STREET BOSTON MA 02114 USA lNSURER lNSURER lNSURER INSURER ADDITIONAL POLICIES INSURER If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. POLlCY POLlCY INSR TI'PE OF INSWUNCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS LT. POLICY DESCRJPTION DATE DATE DESCRIPTION OF OPERA TlONSILOCA TlONSNEfHCLESfEXCLUSrONS ADDED I3Y ENDORSEMENT/SPECIAL PROVISIONS respect to, Project - Environmental Consulting Services; Location 7683, Santiago Creek Bridge over at Bristol Street; for Construction Monitoring Services; Start Date _ 8/10/02. APPROVED AS TO FORM ~~~r Deputy City Attorney Certificate No : 570003773792 _. ~~~~ .~.~~ ~~ HUN u~UWP 203 863 6305 TO 91866q677847 P.02/04 '. .. EXl:IIBIT B ADDIIIONAL INSURRD ENDORSEMENT FOR COMMERCIAL GENEP-AI.. UA13ILl~ POLley Insurance COlllpany Continental Casualty Company This endorsement modifies sllch iDS\Il"anCe as is afforded by the provisions of Polky # . GL25188850 relating to the followiD~: I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are nallled as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and Ilses perfonned by or on behalf of the named insllred, 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 persOll or orgllllization ~ M insured shall not affect any rigllt which such person or organization would have as a claimant if not so included. 4, With respect to the additional illsureds, this inSWlIlICe shall not be cane_llell, or materially reduced in coverage Or limits eXellpt after thiny (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, inclucling cOlllltersignature, is req1.\ired to make this endorsement effective.) Eff~ctive Policy # Issued to August 10, 2002 GL25188850 Hy ienetics Environmental Services, Inc. Named Insured Countersigned by M7 / L ~ ~~~:d{~esentative- APPROYED AS 1'0 FORM ~i<cIA/ ~~~~;dY / Deputy City Attorney