HomeMy WebLinkAboutPACIFIC COAST BOTTLING 1 -2001
. .
'-" 'NSU~~: 01:l..,~~~
I.\~... r;';i}: ;'~"':?'C'i~g200 1-174
CONSULTANT AGREEMENT \f i' W;.g -(11.-'
~~ ~,Yr()/ c.fl~
THIS AGREEMENT, made and entered into this 22 day of May, 2001 by and between 'PI-J
Pacific Coast Bottling, (hereinafter "Consultant"), and the City of Santa Ana, a charter city and
municipal corporation organized and existing under the Constitution and laws of the State of
California (hereinafter "City").
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
supplying bottled water.
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 $10,000.00 during the term of this Agreement.
b. Payment by City shall be made within thirty (30) days following receipt of proper
invoice evidencing work performed, subject to City accounting procedures. Payment need not
be made for work which fails to meet the standards of performance set forth in the Recitals
which may reasonably be expected by City.
3. TERM
This Agreement shall commence on the date first written above and terminate on 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 Public
Works Agency and the City Attorney.
1
'"
'.J
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, ajoint venture relationship, or
to allow the City to exercise discretion or control over the professional manner in which
Consultant performs the services which are the subject matter of this Agreement; however, the
services to be provided by Consultant shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Consultant shall pay all salaries and
wages, employer's social security taxes, unemployment insurance and similar taxes relating to
employees and shall be responsible for all applicable withholding taxes.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the City, its officers, employees, agents, volunteers and
representatives as additional insured(s) and shall include, but not be limited to protection against
claims arising from bodily and personal injury, including death resulting therefrom and damage
to property, resulting from any act or occurrence arising out of Consultant's operations in the
performance of this Agreement, including, without limitation, acts involving vehicles. The
amounts of insurance shall be not less than the following: single limit coverage applying to
bodily and personal injury, including death resulting therefrom, and property damage, in the total
amount of $1,000,000 per occurrence. Consultant shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit B upon
execution of this Agreement and shall be approved in form by the City Attorney.
b. 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 the
performance ofthe 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. 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.
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 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 1 of this Agreement; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason ofthe 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.
7. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
that it shall not use or disclose such information except in the performance of this Agreement,
and further agrees to exercise the same degree of care it uses to protect its own information of
like importance, but in no event less than reasonable care. "Confidential Information" shall
include all nonpublic information. Confidential information includes not only written
information, but also information transferred orally, visually, electronically, or by other means.
Confidential information disclosed to either party by any subsidiary and/or agent of the other
party is covered by this Agreement. 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,
3
'-
'-'
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 oflaw; 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
te1efacsimi1e (714) 647-6956
With courtesy copies to:
Executive Director of the Public Works Agency
City of Santa Ana
20 Civic Center Plaza (M-21)
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
te1efacsimi1e (714) 647-6515
4
'-'
"wi
To Consultant:
Pacific Coast Bottling
2614 S. Oak Street
Santa Ana, CA 92707
(714) 957-8657
Attn: Dennis Salmans
A party may change its address by giving notice in writing to the other party. Thereafter,
any notice, tender, demand, delivery, or other communication shall be addressed and transmitted
to the new address. If sent by mail, any notice, tender, demand, delivery, or other
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or
other communication shall be effective or deemed to have been given twenty-four (24) hours
after the time set forth on the transmission report issued by the transmitting facsimile machine,
addressed as set forth above. For purposes of calculating these time frames, weekends, federal,
state, County or City holidays shall be excluded.
10. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, and supersedes any and all other agreements, oral or written, between the parties. In
the event of a conflict between the terms of this Agreement and any attachments hereto, the
terms ofthis Agreement shall prevail. This Agreement may not be modified except by written
instrument signed by the City and by an authorized representative of Consultant. The parties
agree that any terms or conditions of any purchase order or other instrument that are inconsistent
with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
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 ofthe 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.
5
'-'
....,;
12. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shaH be entitled to receive and the City shall pay Consultant
compensation for aH services performed by Consultant prior to receipt of such notice of termination,
subject to the foHowing conditions:
a. As a condition of such payment, the Executive Director may require Consultant to deliver
to the City aH work product completed as of such date, and in such case such work product shaH 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 ofrace, 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 shaH 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
irnmediatelyand in writing of her inability to obtain or maintain such permits, licenses,
approvals, waivers, and exemptions. Said inability shall be cause for termination ofthis
Agreement.
6
'-"
'-'
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 shaH
indemnify City fuHy, 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 shaH 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:
CITY OF SANTA ANA
~;;:;~
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Atto~ey
RECOMMENDED FOR APPROVAL:
R
CONSULTANT
r Ross
xecutive Director of the
Public Works Agency
~
. p
((N ) y~
TITLE) -"-4-.eL /77/U~
Employer ill # 330930728
7
"""
'wi
EXHIBIT A
Provide bottled water in halfliter bottles using water directly from the City source at 2614 S.
Oak Street.
Service to be performed:
All water shall be packed in cardboard cases, provided by the Contractor, consisting of 24 bottles
each. All water shall be picked up by the City at 2614 S. Oak Street. The City shall provide the
Contractor with a disc with camera-ready artwork. The Contractor shall then send the disc to a
printer who shall allow us have a "print-check" prior to printing the labels. The cost of the
labels shall be included in the price of each case of water. The cost of the four plates for printing
shall be paid by the City. Each order shall be placed one week prior to expected delivery and
shall consist of a minimum of two pallets.
Where:
2614 S. Oak Street
When:
For a sixth month period, ending June 30, 2001
For how much:
4 printing plates $65.00/each
Case of 24 half liter bottles $ 5.90/case
CA Redemption fee per case $ 0.60/case
State Processing fee per case $ O.l2/case
Pallets $ 5.00/each
The total sum payable shall not exceed ten thousand dollars.
Special Provisions:
The Contractor shall maintain a current "Water Bottling Plant License" issued by the
Department of Health Services, Food and Drug Branch. A copy of which shall be provided to
the City. The Contractor must also maintain a current City Business License.
8
. "
'-'
.....,
EXHIBIT B
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its
officers, employees, agents, volunteers and representatives are named as additional insureds
(" additional insureds") with regard to liability and defense of suits arising from the operations
and uses performed by or on behalf of the named insured.
2. With respect to claims arising out of the operations and uses performed by or on
behalf of the named insured, such insurance as is afforded by this policy is primary and is not
additional to or contributing with any other insurance carried by or for the benefit of the
additional insureds.
3. This insurance applies separately to each insured against whom claim is made or
suit is brought except with respect to the company's limits of liability. The inclusion of any
person or organization as an insured shall not affect any right which such person or organization
would have as a claimant if not so included.
4. With respect to the additional insureds, this insurance shall not be cancelled, or
materially reduced in coverage or limits except after thirty (30) days written notice has been
given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701.
(Completion ofthe following, including countersignature, is required to make this endorsement
effective.)
, this endorsement form as a part of
Effective
Policy #
Issued to
Named Insured
Countersigned by
Authorized Representative
9
I ACORDm CERTIFICAV OF LIABILITY INSUvNCE I DATE (MMlDDfYY)
07/13/2001
'",CDUCER (909)793-2373 FAX (909)798-6983 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Davis & Graeber Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
470 E. Highland Ave. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box '40
Redlands, CA 92373 INSURERS AFFORDING COVERAGE
INSURED Gold Coast Water Company, LLC INSURER A: Travelers Indemnity Co. of CT
13231 Slover Ave INSURER B: Travelers Indemnity Co. of IL
Fontana, CA 92337 . INSURER c: State Compensation Insurance Fund
INSURER 0:
, INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN IGATED. DING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTlFIC ,~, R
MAY PERTAIN, THE INSURANCE AFFORDED BY THE PQLlCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAlMS.
INSR TYPE OF INSURANCE. POLlCV NUMBER P8.k+i~~~58~E Pgi!ft~~~~N LIMITS
LTR
~NERAL LIABILITY 660693X6870TCTOO 11/28/2000 11/28/2001 EACH OCCURRENCE $ l,OOO,OO(
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,000
l CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5,000
A PERSONAL & ADV INJURY $ 1,000,000
- GENERAL AGGREGATE $ 2,000,000
~'L AGG~EnELlMlT APnS PER: PRODUCTS. CQMP/OP AGG $ 2,000,000
POLICY ~~8T lOe
~TOMOB1LE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Eaaccident)
l-
I-- ALL OWNED AUTOS BOOIL Y INJURY
{Per person) $
I-- SCHEDULED AUTOS
I- HIRED AUTOS BODILY INJURY
(PeraCCidenl) $
I-- NON-OWNED AUTOS
- PROPERTY DAMAGE $
(Per accident)
~RAGE LIABILITY AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS LIABILITY ~UPOO07W564TILOO 11/28/2000 11/28/2001 EACH OCCURRENCE $ 5,000,00(
~~OCCUR 0 CLAIMS MADE AGGREGATE $ 5,OOO,OO(
B $
::;rl DEDUCTIBLE $
X RETENTION. S 10,OO( $
WORKERS COMPENSATION AND 160329600 11/18/2001 11/01/2001 X I T':\'i\JLf..1Ns I IOJ~'
EMPLOYERS' LIABILITY $ 1,000,000
C E.L. EACH ACCIDENT
E.L. DISEASE. EA EMPLOYE $ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESJEXClUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
e: Operations of the Named Insured - Location: 2614 Oak St., Santa Ana, CA 92707.
ertificate holder is an additional insured/vendor per terms/conditions of the policy.
en days notice of cancellation for non-payment of premium.
CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL.LED BEFORE THE
"-.J City of Santa Ana, its officers, employees, EXPIRATION DATE THEREOF, THE ISSUING COMPANY WilL ENDEAVOR TO MAIL
agents, volunteers & representatives JL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn: Nancy Bailey/Public Works Agency BUT FAILURE TO MAlL SUCH NOTICE SHALL IMPOSE NO OBL]GATION OR LIABILITY
220-A S. Daisy Avenue OF ANY KINO UPON THE COMPANY, ]TS AGENTS OR REPRESENTATIVES.
Santa Ana, CA 92703 AUTHORIZED REPRESENTATIVE ~
Frederick Yauaer CIC/FML
ACORD 25-S (7/97) FAX: (714)647-6515
@ACORD CORPORATION 198B
'-"
-...I
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(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 alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (7/97)
nf'C 07 01 12:03p
O"c 05 01 03:09p
pacif'ic coast
.....'lbl i c Works
'-'
bottling 714 957 8699
71464...jJ45
EXHIBIT B
ADDITIONAL INSURED E'-'DORSEMENT
FO~ COMMERCIAL GEl\'ERAL :~lABILlTY POLICY
Insuranc: Company --"1be--tiQyJ.-90 rd
This endorsement mod1Les such insurance as is afforded by the provisions of Policy
# - ::t~WF(.;'(cfiL relating 10 the following: _
J. The City M Santa Ana, 20 Civic Center Plaza. Santa Ana, California 92701; it,
affic,,,s, employef.s, agellts, volunl~rs and representatives are named as additional insureds
("additional insureds") with regard to liability and defens,: of suits arising from the operations
and u;es performed by'" on behalf oflhe named insured.
2. With resp""t to claims arising out of the oI,erations an[l uses performed by or on
bchalfoflhe named insured, such insurance as is afforded by this polley is primary and is nol
additional to or cOlltributing with any other insurance carried by or for the benefit ofthc
additi(Hlal insureds
3. This insurance applies separately to each insured agail1St whom claim is made or
suit is brought except wi!!: respeetto the company's limits of liability., The inclusion of any
person or org.nizaLon as an insurcd shallllo! affect any right which such person Or organizalion
would have as a claimant ifnot so included.
4. With respeclto the additional insureds, this insurance shall not be cancelled. or
materi,lly reduced in cove.-age or limits eKCep! after thirty <30) days ~tten notice has been
given to the City of Santa Ana, 20 Civie Center Plaza, Santa Ana, C.llfoHlia 9270t.
(Completion of thc following, inClUding countersignature, i; required to make this endorsement
effeolivo.) ,
Effeclive i~~l . this eNforsement form 35 a part of
Policy # . l(~~.~ . ~
Issued to . iLC n ?-n:\+\ I V1~ (Cf-rR0:bo 11 .
Named III ed
(
Countersigned b~c~.
Authori:~ed Representative
o
/\l"PROVED AS TO FOR~
'~d; 2/4'~
~t-ll:l.y City Attorney
p.2
p.IO
Dee
07 01
DEe-OHIOI
ACORD.
12:03p
11I,4IA~
pacific
coast
bottling
714
S57
86SS
p.3
W S~IIH !ND!SSOCI!TfS
li~H Ilrl\.A II:; vr
FRO~IH!O'
.ala,ISDl6i 1-566 P 00//001 F-l/O
LI"U.I..I II ...__....'tJ--pA""....r-~ I __...'.
THIS L}EATlFtCA Te IS IS~~~D AS A MATTER OF INFORMATION
ONL V AND CONff.AS NO RIGHTS UPON THE CE:RTIF1CATE
",OLt EM. THIS CE'RTlFlCATE oOES NOT AMEt4D. EX1 END OR
ALTE~ 11i! COVEAMlE AFFORDED BY THE POLICIES BELOW.
~,
INSURERS AFFORDING COVERAGE
PAOOVCP:A
TIlADDWS W. ;)MITH iI. AS!lOC.
20151 S.W. IHRClI ST. SlIITF. 250
BEWPORT 8KAClI CA '2860 l' 21.
Phone:94'-622-2095 F.K,94~-&76-0168
p4eij:ic Coast: Boetlin.g Corp
MiChl.sl cwmdnfJ
18Dl parkcourt place .ZOO
SanCII Ana CA '~'Ol
~~: TRAVELERS
INS.\JRE"~'
1I"$u",EAC;
lN5UREflO
1~5vRfR ~
l'tlOPBBTr .. CASUAL'rY
INSliltED
--
COVEMAGES
f11~N 13&i"lIiOo TO THE INStil'llE.C NIlWlEO ...ItOVE fOR HE "OLICY PE"IOD INDIC....T~D, ...oTINITH$T"'!llDtNC.
;C ~TIlACT OR OTHER OOCUMeNi lYITI'i ~SPfiiCT T(l Wt-t\CH '1t4tS CERt'JJI!ICAn: MAY SE ISSuED OR
I>{I1ICIl::S DE5C~I6EO HERf"tN IS SUllJECT TO ALL Tti: TllAMS. iilCCLU51Oro;S "'Pro CONOlTlO"'-S or- SUCH
tu.. RClDUett) IV PAolO ClAIMS.
THE l'ouClliSOF fIllS~'RANCf I,.lSreo BEI,.OW "AY~
/IN" RECUtFlEM'~T. l'!'AM ~ COflIOITIOf>I OF ANY (
MAV PER'l"AIN_ n...e 1N!:URAp.,c1;: &l=r.tJR!)ED BY lHE
POllC11:5_ AGG~8J"T;: tlMTIJ SI-IQWN MA" HI'IV~ e
LTA 'j T\'P~ 01' NSl,IFtANCE
a(NUliAl LIAtlllT'l'
A. I .x . COMhlERcr4l.GE~1tI. L!/lBlt.t'fY B10-Z':l85N017"''l'IL-D1
In C\.,,\IMSlIIoOE [!J OCr.:Uf\
h
fIOLIC't HUUUR
Fl.~"~1:T1V
j)An:I~1I'YY DUE ....,CDl'f1' LlMlfS ,._
I lU.CHOCCUflAENCI! \1,000.000
I' 101-ZS/01110/25/02: 1 FIA~DA.M"","l!I"",)w"..llt.1 S 50,000
I.4EOEl(P{Myll~f!!I''5l1'1t $5,000
P~SOHAL&"'OVlI\lJURY S 1, 000,000
I GI:~.....Uj;GAEn/l,"E 12.000,000
PRODUl;TS..COMPIOP"'GG ,112,000,. 000
1--
------
GEI\I'I,. .f\OGRI:GAfl, LIMIT Al7Pi.IFS pm I
POle' il ~~i n..oc.
A fi:::~~:';un i-
~,liLLOW"I:DJ.UTOS . 810
~ SCrEDulfD.\LJTClS
X HIfl.f:D AUTO~
n NOt-l.(lWNED ""UfOS
-I
! [JIlCE$S l....l!Ill.l'n -
OCC'JA =:J ClAlMS!JI'-D!
j
10/25/01 I
I
I
:
I
1'C:OMlllll\ltOO~I~LEdlAlr
tEl Ig~:g"'ll
>---
10/25/02.) BOOILYINJUJIIIY
[PIt 1I..~lItIl
I
1 s 1,000,000
-2,a5W017 ''1'I.L-Ol
!umll1'INJ'--IftY
(Per"t"tcknf)
,
"ROPDH"Y O,llAAGf
(~'~c14lAll1l
I'
~ACf UAIlllr'
I (......YAU10
-
AUl00N:Y.~ACC~Nl It
j.OTioIERTMAi': EAACC: 5
I'IUTOONLY AGG I
~~~_~ee
AGCREGATE
,
,
,
.
T....
I
~
I
~
'I ! ~oAV LIMIT.! I I"'~;"
E.I,.. 'ACt1 ACCIOEN'l"
~Ol,tCTl&.f
RE1'ENTIDN
WORIIE'" COMCIt NaATIOt.I ANI)
\ ElAPjoY!M' U.1i IUTY
E 1,.,~'$RM~.€.I'"M"lO~~ S
f.l.._ OIS!;AS[. POl.lC'l' LJMfT I
.L J
pe"st:RWJ ION OF OfIER,ITION~LOC/tl!CN:tI'fHtClt':'1 J[CLU'SIONS ADDED lrV to.IDOASfME~Tj!l.t1EC!AL f"ROVlSIONS
Certificate Holder i8 in~l\1,t'.d && addit.ional in.sured 61S respect". the
inJiure(l'1I p;a-oauct8. ())ottle,l WBt;Q('). 10 ".1"9 notice of ~ance11ation
non Pil}'lll:8nt of premiWl\;,
if for
CERTlrlCATE HOLDER
I
Iy 1"~DNt:lrtSUAtO:INSURiAlrnIER;
CMY OF
CANCULATION
$HOIIL'J I'MY Of 'r"" A80ve oc-SClU8fD 1'01lCE!I BE CANCELLED lif.f'ORli TIE EXPI"..n
ItA,!!: '11I!flEOf'. 1", I~SYI~ INS\JAl'A Wll.L ~.lJl ~ MY!!; WAin
NOTICE TO,.WIiCf<A11I'ICATE HOLDER NAMtO'rO 1t1~U!t:T.
C1~y of san~a AnA
At.t:.a: Them Coughrun.
Water Man_O'er
220-A &o\lth Daisy Jlvenue
l5ant.a Ana CA !IIn03
I
ACORD '5.S (1/911
~
"ACORO CORPORATION \S88
n..c 07 01 12: 03p
12/07/2001 13:54 FAX
pacific
8772871 ',15
coast bottlint
TilE IIARTFIlRD PAC
714
T
957
8699
p.4
141001
'-'
'wi
IhEZ
fA CORDCERTl}o'I!~ATE OF LIABILITY INSURANCE December 7, 2001
~n.!.,..~r TlIlSCERTlnCATt: IoS J!:!!iVED AS A MArTt;.R (If
2.l071l5 INFORMATION ONLY AfliD CONFERS NO RIGHTS urON
P;ychcx InltrTonJnl nlE cunlnCATF. HOI.DO_ TIDS CF,RTfFlCATE
1.1 e ~bnr()n! Don NI)T AMl.::\'D, EXTEi\:l.l OJ/..u. TER THE COVERAGE
3C!fJnnin8tOll Av~nur AF}"OJWfSD BY TNt t'OunES BELO\\',
F''''''''gto:t,CT
l.ICHH91)
I..~;;J-----'--
P/.ClFfC COAST nOlfl.'?o:G COU'OM TION
f)HA;
It01 P.II,RK..CUURT Pllif20Q
SI >ITA "NA,e,,-
~HOl F~",:'H4\l~786<W
iiiE POLICIES or IN!UiA;.;cif JSTI"i)iiIT-ow HAVE UiiE:"-ISSllED m'iHil',JsUIl.ED NAMED ADOYB fOR THI;; POUCY pERIOD
INO/eA IfD. !\01 WlTHST I\Nllf.JG ^~'Y REQUI:tJ;MENI, TERM OR CONDmOil Of AJIIY CONTRAC. OR OTHtR DOCUMeNT V.1TH
RlSPECT TO WI-UCHTiHS C[!\~-lflCA1EMAY Ell: l~'SlIEDOR MAyrERTA.N, -nu; 1NSURANCE Aff.ORDm RV 1"HE POLJ('ll:;S
or SCRWt.v HEREtN ,S SlIDTI'C 1 TO A.l.L TffE Tflt'\1:5, EXCLUSIONS AND CO:-,UlflONSOf SUCH POl.lCUS_ AGGREGATE' UMITS
Sf OWl>.' MAY HAVE !lEEN R}D JCEDBY PAID CLAIMS
GClltr:;oIU:;obilily - Inl..rrr;
C(l'lllmfcjalGclI(r.lIU~1li]ity
CLinlsMlld:;
Ol."~UJ'
PO',c)'N"",bc.
"(licyEllCcli~tDJle
I'cli~yEJlpi!t Dillt-
G~ 1~",1 ^-~f;rt::Olc l.im'I Appli". Pu
Policy:
J'rcict!:
LOC
A"Ii)tI.ebiltLbbIHIy
Au'^uln",
AlIOWl\Cd^\.llo~:
S;:lcdu1edAl>cn.
Hil;dAII!\l,;
r..'a"OwncdAulD.
Po; cy Numbcr
Puleyffk.:I"IC'D,J[l.":
Pol tV ExpiDliollOa'~,
Cl'lCI'Lialllliif
An.AII.".o
f'ofcyNurnbcr:
Plllc-yEllCdiwl!nlIC'
_~c'1f.I';',~h'm~_
I);Il'nLiabilil)'
OttWTtl1CC;
C1i1:nuM~de:
DenltliblC':
I(e~,)llion.
P(li,:yNloIlllbcc.
1'<;>1"ybir..,ri.."n"IC_
roli~J.tJlpi/':)lionOllie~ __
WG-.kU'.C9ffij'i/luriaol
& F.....Io}fr."jLiabibl)'
InJ..rru_lf"(lrdU.ICOYfr~
InSlIm ^ l-lARTFORD UNDERWRITERS, f.'\'S co
ImwerB
tnsllftrC:
InSlIfCrD'
In$wtrE.;
LimilI
E.acbOcet~lICe
f;re~$C'{;myomfire)
M"" ~i* (any 006 ptmft)
Ptnlm<ll& Advli.bility;
Gtn(;J;uA;~g~.Ie:
Products- :<impIOpAllg:
,
,
,
,
,
,
Jns~'",;
L1mils
Cumb Smile Limh(ea aeeident):
ijOlti~'lnJlry(Ptfpetlilln):
DOdilyll\j'ry(PuAtl;idc:nl)
Pmpuiyn nlUlJt(Pt-t Att:idc.ltJ
,
,
,
,
IllIu,en
limllli
""!<;IOnl,, [A. Ac.,ilknl:
~r1"li~nA\lIDOrUy>
EAAecide'll;
A i.lr.
Undll
[jlKho..~..."'noo;
Argltl!.'lC
s
,
[n...rr,.:
,
,
Lilnib
WCStarlrtD-ylimtl!:
Olhcr:
Polly NUIl1t>cr' 7t-WE GYl90S fL Eull PccilllfJll;
Poli:y F.n-~'t1i..c D~Ie. 17 .ocr -01 E.L. Di.irn~ _ EA Emp~e.
"oh''iE.~i""lionQ~_____11_"OCT.Ql e.L Oi~S:. .PDlic:y Limit:_
Dn-'riptloo of lIptnl'iffn.IJofOlIi(l;IS).'dlidoElln"du.ioM ~lIdetl by cndllnrmfllusp.-daJ )r-t'"KID~;
WArEllBOTTLlI'Ii(;
Ins......:A.
x
SI,OOO.ooOoo
$1,000.000.00
51,000,(:00.00 _
(cr'iRcatclloldrr
ATlN,THOIV/ l'OV(,HR,,\N
CITtOFSA.NT^^NA
UO-A S DAISY AVENUZ:
S..."TA ANA, CA!,l270l
F;1X ~ '(
Ilert"n~r N~nWtt:l)]21-iiocnJl
C....~U..lio,
SIIDlIldlny-,fOltJ\lovt deitnllrdpohclc~belC"T.te\edbefOTtlthc
CIIpirlltioilllolr1hct'eof,lhei~~uioE:inmrctwin~I".....jllndil,\'l:
II'rinf"ROti(cto lItecertio,calC ttoidun.1med III the len, b.1i -I h. J
-' Lt. ,- .. ,- f ,I" J r '1
"
...UTI-IORII ED RF-I'RESENT A nVC:.
J-j---
APPROVED AS TO FORM
.tt:~~
,)cputy City Attorney
oC'~ U I UJ. J.c... t,.J,jt'"
Dec 05 01 03:0Sp
,.. 0.... ~ I ~....
vue::>..
"'~"''''''''''''& I...... '""'"". ............-
Public !Jorks
7141""3345
....."
'-"
:
S ?S ~~ .~\
n~t \1 . 'Ii
U ,_,_ cuuii\.! .
EXHIBITB c\.E\\r. Q'f srMl~ ~14~
In'nQ
ADDITIONAL INSURED ESDORSEMENT
FQ~ COMMERCIAL GE!\'ERAL :LlABILlTY POLICY
Insurane:Company ~f~rd
This ;ndorsement mod~~es such insurance as is afforded by lhe provisions of Policy
#I -1o~VF.{-,.yl~'L relating to the following: I
I, The City flf Santa Ana, 20 Civic Center Plaza, Santa An., California 92701; its
offic,n, employees, agents, volunteers and representatives are name1 as additional insureds
("additional insureds") with regard to liability and defens.: of suits 8Ilsing from the operations
and u~es performcd by O! on behalf oCthc named insured,
i
'2, . With resl":ctlo claims arising out of the oI,erations an\! uses performed by or on
behalf of the named insured, such insurance as is afforded by this pOlley is primary and is nol
additi'llla! to or contributing with any other insurance carried by or far the benelit ofthc
additi"nal insureds, .
3. This insurance applies separately \0 each insured agai~st whom claim is made or
suit is broug.~t oxcept wi&. respect to the company's limits of/iability~ The inclusion of any
person or organizotion "'. nn insured shaUnot affect any nuht which s~ch person or organization
would have as a claimant ifnol so included, :
4. With respect to the additional insureds, this insurance Shall not be cancelled, or
materi,lly reduced in eove;'age or limits except after thirty (30) days ~tlen notice has been
given to the City of Santa i\n., 20 Civic CenterPJaza, Santa Ana, Cal!fomia 92701,
(Completion oCthe followi:1g, including countersignature, i; required \0 make this endorsement
cffeoliv:.)
Effectiv~1fir1 , this e",lorsemen~ form 0; a part of
Policy # , '{Tq~, : ~
Issued 10 iL.C:;:;-n ~\l ~ rtJl1eO'Af-1nf1
Named In ed
Countersigned b~c~,
Authori;~ed Representative
1\
....-
p.IO
-,
~c:.... ...., IU.L .1."........1""' r-",""""'l"'~ .......C~...
.....................fI,
. . .
....-
~C.IJoZIO' 11i:1IA~ FROIi-THI"<U" r SMITH ~ND~SSOCIATES
I
ACORD. li~H Ilrv,'"' I t; + 4141&1111 T.565 P.OOI/OOI F.m
vr L''"'U.....,. I' ...--- \;. .J.--r^I.,;'&',r-,)
- --..... --
PfKlOUC[A TH'" '~ERTIF1CATE IS Il!!UEO AS A MAnEII OF INFORMAnoN
ONLY AND CONFERS NO RIGHTS UPON THE CERTIACATE
THADDEUS W. iJM%TK " ,p.S!lOC. HOLtER. THIS C~RTIACATE DOn NOT AMEND, EXTEND OR
20151 s.W. IHI\C11 ST. SUITE 250 ALTE~ TH~ COVERAGE AFFOROEO BY THE POlICIES BELOW.
NEWPOJlT .SAOt CA _2860 J '721 INSURERS AFfORDING COVERAGE
Phone:",-622-20'5 F,,,..9U..&11i-Dl68
LN$UAlEO -
INSUPl!A-= 'l'RAVELERS PROPEl<TY U CASUALTY
P&Cil!ic C:i Bottling COX>> ~'''I~
Michl.al ~ ns t1Suft!Rr;:
18D1 p.r court place 'ZOO lNSURi" 0:
Santa AlIa CA 92'701
,- I.'olSVR'A !!
COVERAGES
lH1i POUCliS 01' 1N~'AN\lCf ,,1ST!;) &ELOW !'lAVi ~!CllOl:l!\lD TO THE INsu"EO!ll~~O AgQ\l!,DA tHt: ~1.1C'" 1'~100 -.oICAT;O. '-IO'l'INiTH.$TA...cINCo
M:Y RiCUIAEIol(t(T. r!RM 0<1 CCM)ITION OF ANY CO\lTAACT OR OllilA COCUl.leNT ....m'ii ~.s"iCT rei wl-l'lCt-iTtfI$ C;"TJfI!ICA~ MAt K tS5uEtl CIA
......... 'VlI1<.l. 110E 1N!:Ullb\.\ICIi: ~i'fQI\DED.y lHE la(IUOfS DiSCl'lllltO HERe'1N 1$ SUILI!CTTO AU. T"E TlilWS. i](CLuSlOsS ANOCONOlTtOkS Oil' .stJCH
POllC1f~. ...cG~EaATi\.1Mln SIofOWN ......, H"ve-IlE[:Poi RaQUCEl) I\' PAlO C\,AIYS,
m T'fll'~Of' LIl,\nI:ANCl!. - ~1C""'1AfUJt
,,!!NOll lJA'Iln"
A ..! ~\!Mfl'QALCe~I.LtA8lllT1' Q~O-2985W011-~IL-D1
_ U c~lUSu~1 [j] CCOJf\
~~
DnE Mt.'IDDIY'l' "'I
llACIt OCCURRENCi
10/25/02 ! ,!AL!J)A,...ol,Ql!tJY!,.....III..
I.4EOIiIt"''''''I'MlpMgt\)
P!"I!Oro/IoL..,.OVINJU""
,'~AGGAEOA'ni.
",..n
'1,000.000
150,000
S 5.000
11,000,000
12...000,DOO
"l\OOUCTS.CdMPIO"~ 12,000,000
10/25/01
f-
~L AQGA~!,LUdiT APPlES p~'
I IpOl.CY! Ij~~T nLOC
'~TOJ>t08ILI!U.U<<JTY
A _ A!'tY"U'tO
~ AL()N!lifD/.uTOS
~ SCrEQuLED ,\UTOS
~ H.fI.r!O AUTOl
~ NOl<o.()WPlriD AUTOS
COMll~O s,:ISCU: \.lUll'
1!lllIcl'_1
:J:L.ooo,OOO
J.O/2.5/0.2. aOOJl"YlNJ\Jllv
(Pll....'''^'
10/2!t/O~
B1C-2'85W017-~1L-Dl
.
BOOll\'lI'UUftT
rp..."c,....)
.
~,.~~~~,....&G! ,
h:CElIAIllrr.
HA.....,"U'O
AUTO ONl'l'. t.a. &CeDENT ~
EAICC .
"'" .
0'",," THAN
",IITO~LV'.
f....."'H Oc[;uAA'l'fCe
ACOAEGATE'
.
.
.
.
.
DCUSLlAltl,lT';
::~:rCCC\JA =:J CLNM$. wAO€
-, D(tVCTt&.r!
--1 AEl'Ep,tTION t
WOAllf'" COMP1H8"TlQN ANO
IMPLOY(M"Ll.lelllTY
TOA" LI",.rsl I....;..
ll., IiACI1 ACCIOfH'l'
I
~ I .
lil$CRlPJIlJH O,"OI'E""TIONS/'I.QC.TICNSo"eHtCL~:Jl'1 JC:L~O"" ADDlED IV ~OOAUMD4TJS'Er:1AL fROVtSfONS
Certificato Holder is inclut'.d AB additional in.Q.red as ra!&pects the
in.u:red'. pl'04ucta. (:b-ottle<1 wat.er) . 10 Oays not!.!;. af e&Zlcellation
non pa1JNmt of prel'fti 'IlII'..
I! L.tllS.....,t.'.. Eu~LO'tliE ,
1!.L.OI$l>AS(.POLICYI,IMlT J
onE~
.
if for
CERTIFICA IE HOlDEJI
ty I AI~1HSURED:IN$UAEFlt.mc";.........
enY OF
CANCI;LlATION
,"DU!;) ","'1'011 TttC "lave "ISCAlII!D 1I0UCIf:S.' C'ANCE.LUO .UORa THI! _Iftl.
bAn. T"'I:"'''OI'. T...rssUINCINS.UAEA WILL ~l1-1L ..3JL.. 0""5 WAITT
N01!Cl TO "101& C~.IIN')CATI! hOLDER KA."'IC' Ta THe. LEFT.
C1~y of santa Ana
Attc: Them Cougbrm~
Water Manager
220-A South DaLey A'\"8DUe
santa Ana CA .~703
ACORO 25.S (7/97)
~.
III ACORD CORPORATION '988
u~c u, U.l .1 c.; u..::>t-
,..al.O~T.I.(; L;Ud=>~
,",UI.otwJ.J.HE.
JJ."T ~~, oo~~
r-'~
,
12/07/2001 13:S4 PH 8772A71;aS
TilE UARTFORO PAC
T
....."
~001
"
'-'
lr~
~ CORD CERTU'lCATE OF LlABILrry INSUll.Al':CE December 7, 2001
P,ndl.'I't. TmSCERnnCA,TtmmVEDAS A MA1TU0,.
2JOiOS I~U'OR.'\ol4TIOH om Y AND CONF'EIU NO RICHn UPON
P.ycllClilnltn'anml TIIX CVtTIFICATF. HQUU!:R. TRlS C}:RTInCATE
llrUml'lln:! VOIS sor ,UIEr.'VD, U'UNlJ OR ALTER THE COVERACE:
]CSJlalmlllSfoll.......rfllJC A''''''OIWt:O av THt POLICIES BELO"',
FlmlieotlO:'I,CT
OOJz.19IJ
1o.;lIull Jnl.rn..\lTonlinlCo"'~
P/.CJFIC COAST Borru~m COU'ORATlON Jns\lJU A: J-rAATfOl\.D UNDERWR.ITE!L~ n\S co
DlIA; l_lfrR,
1131 'A1UC.COtJIlTl'L 1ff200 ......'"
&.m<<D:
$,.'NTA A.NA.,CA InsamI:
~~rol F,":'1"9~716W _ -
THt POliCIES or L'C!u:tANCl! :.!Suo Bli"tOW HA V.E DAEN' JSSUiD TO niE.ll~S\1l\ED NAMED ABOVE fOK TJ1]:; t'QUCY PElUOD
INOfCATED. NOlWITHSTANlU:lQ Ia'NY REQVIItfME,~r. TER.'" OK CONJ'JJnOH Of ",,:vy CONTRACT OF. OTHU. DOCUM~NT ~1TH
Rl SPEClIO WHlCH'nus CE!\:'If1CATE MAY In:: JSSUEl) OR MAY FERTALN. 'r&: lNSlJRANCE AFJ:OlWED RY TMF. POLleleS
m-SCl\U:J~D HEREl..... JSsunn;Cf TO AlL TKETfR.\fS,IlXCLUS:oNSANnco:,:omON$OfSl!CH POucn::i. AGOllEOATfUMITS
SJ.'OWNM.WHAYIl IlC:EN JUi2Jc.."EOBYPAlDCl..NMS- -
CtMr.al Uabail)' 1\I1;.nr: Limitl
Cnvnnd21 OCllCl'ilt l.i:I':Mlky Each Occt-mm:c: S
CI-._h\l5Mgdr; lircl>Mtaft(mYClAlnre); S
(k:1Ir Mt4 Explt/IIC CallY 0lIl1 penlla): ,
PO:lCyNulllbcr: PCISUJIaI I. Ad~ LiabililY: ,
Ptt'icy!<<cclivtDale: CiencnlA.1JrrI1~ ,
h!lcyElpir.tnll': 'muts. CclmplUp ^", ,
CClBnl^!tre:DIc:I.i,uiIAN'ricsPtl':
Policy,
PttjCtl:
LOC:.
AIII\1m6bilcU:tbDlI)' fAllinI': UrNlS
Iw,AIII~, ClImbS'maIeUmiI(c.am,Mknt): S
All O_dA\Jh)I: HQ4iI)'lnj\l)'(Pe'pttJon}: .
S:ledu~dAlIun: Dodi1Yln.i\l)'(PuAecidcnl}: .
Hi,."'",ulO5; I'zoptnyDJI\llp(FCf ^~idcul): S
NOli Owf1td "\olin;
PQ/.cy}l:W'lIlr~r;
PtrtcyElkcli'VCDan-:
~!,"EllltjDtia..DafC.
C'!".CILblllliI7 IIII,wrer ~ trmhs
AnrA~o: A~ o.J, . SA. A",oIft1':
rol:t)'Numhn: ~rn~oAwoOaly:
J'Gliey Eltc~tin n~I':; EA ACQkll,; S
POt.C7E'.I.;'~hvoOO~fC; - ...~ .
EJunLtabUiIJ In,u.rtr: Lillliu
Occ.1lIl'cncc: ~<<laCkllllfCnn; .
CII'll~Ml4t-; AGft,~IC: .
1)c:("lIcliblc:
tcU'1l1ior.~ ,
Po!i:y'Nwl\bcr;
P~;:,Eitr,C1i"'I:D:r.rc:
r\1r::Ycallil'3l:onDa~ -
Wo.'1:.r'ICOlUj)UL;afin (n1l..O:" Ll",;b
&lnafloJ"r'sUabilil)' WCSQ1llto~Limitt: X
""'or.
roll:yNIlll'.t:cr: 76WEGYI90S E.L.Eu:h.'t~ $1,000,000.00
"o1i:yF.m,'C1i\'C~It: l7.0CHlI !.L. Dilus-:. EAt. bnployct: 11,000.000.00
l'oliIV&",,,;n.'io.D:r.r. 17.OCT~2 E.LOilus<:.J'o].icyLim!t SI.ooo4:00.oo
Dfl,~'[plioll of "Pfnf'ioD""lon{;Oltlll'fItkktJuclu,lol\I added by tnrllN'l~"CIIlftrcl.1 ~~i"DItI;
WArfnBOnLI~O
CCI'lIl1catcnow,,~ C.an<<llar.II
AnN;lNOMl'Ol.lCiHR.\N SI10u!daAy"ll"Ulc.abollt(l~poIic1nll.tafJ:elI1iNrOR1he
CITI OP SM"T^ AN^ ppiratQQ dalt lhcreof, Ibt nlum, iasurcr win .......In ...11 In .bY"
22()'^:Ii DAISY A V~1JE ,mDfrllDOtitIIoUacecrfifiCllcholdeturncdlUlheJcft.. n .b.J
. .... . ....11" ...... .If #11.: J....o, , .
SA~TAAN^.CAIlI2'O] ~J r .
F;_\~ l( -
Rtfrn_c. N..",blr: O]2'1.1I01.'tlil A 1ll'HQ1U2 ED Rfl'RESE.'lI' A TIVIi,
~<--
..
TIIE X
.bettl in~
7146473345
714 957.....f99
p.2
Nov 30 01 10:41a
!'lev 29 01 04:24p
Public Works
~"C'-'C co~st
p.2
ACORD.
CERTIFIC
ATE OF LIABILITY INSURANCI;Acrl~1"t) I "~';;;';,~'1
TNilfCuo">lIlATE 19 IS9U!D AS A MATT!R OFINFOftMA'!lOll
ONl. v AND C_ NO IUGNlS UI'ON THE CERTIFICATE
HULlJf.'A. THIS ceRTIFICATE. DOES NOT AMl!Nfl, EXUMO OR
~:A 't'HE. COVEJlAGE AFFOFIDEO BY HtE POlICIES BElOW,.._
INSUIlERS ~FORDlNG coveRAGE
"""".....
TH.JI.I)I)'GUS w. SMITH .. usoe_
201~1 5.". S:IRC'R S'l', S'tJrTE .~50
NZWPOR~ BEACH CA ,Zi,g ~12l
.bono",'-6~2-20gs F.x",,-,'6-016.
~""'D
'J'IIA1I1:~l:llS PROPIlM'Y .. CASU"",""
P.ei fiC' Coast J:tott.l::.
_h"hll..l Cw.n.iZl.!1
, ,ut 'Parkr.ourt. p1;Ulf
Banta Ana. C" 9:2701
nliJ Co'rP
, '200
1'I91Jf1t. A
INIliIo'fEFS.
lPiil.l"EFC
r;:-~ 0-
~,
-
COVliRA~iS
THE; PQlIClE.S Q11~ Jtl~. '-ISTiC IlalJ'l\lI""''lli' ,aN GIlil60 to T~ 1""$UP'leo~y!O aloycro" lHf: "a.-'CY PIi!Hl0lJ 1~'OIC"f'!;'\}. ~1J'EWll>-Ili IA"OING
MY AlOlJ\II.fNeNT, 11!~""Ol'COI'CIrrl(lClll)I""""Y':;(Nn'lAtro...l)1'iot!.'" OOC\JlrIIilil,.WI1''' .1I;SII;CI T;)W...'a4 'lG6,~lJ!lC.nl! IM.V e~ I!.W&lO'"
t,lAVpt;.J\t"'f'II.1hf.l~31J1'l~ .tJ:FQAQin~T"'.Lrl.lUOIl:.SotSC"lefDHE,,(I"1S IULilCTl:OAL~ Tltl TitlU'.UCLUIlI~II&""C COl\'CJl'Il"lNSOPSlJe14
POlICIES AGClUCA11L LIMlTS !loICw/lI MU "'''VI! lIE :N "R1UCIiO QV P~UCLA'tll$
Ltlil fYPfDfltdUftJINC(. ... -4== lIULlUNurd6I
QArI!;RAlu....rv I
A fxl~oMW~I,,".""E"EA"'~IJ.9tLlT"'181'l.):9.I!i""017"Tlt.-Ol
~".~'~ ~-~~
'tJ[/IIl. fIIQCI'le.QATl!: lMl'l' HlflLI!S PE!'l:
'-l POLICY i ~li't9r LOC
fj..UTOM\lIllL~ UlUlM.llr
\. ...",...",'1"0
.l:\\.\.OW.'IEO,lUrOli
~5CtoteO\.l."O'lUrt'5
D~'IAmAIJTc.:;
L~ NON.QWNWAUmS
I ro~"H
D IMIWC If
10J2!-,JOl
0..
L,Mlre
i
-I
iACMOCCURFIf:~ I.~,OOO~OOO
10/25/0.2: !j!lIl"I!UAM&OE{fIIl'J_~nll {.50,O~O
lw=nl"llPl/w;O.'O.~;1I'I1 ! 5, DOO
!1l'!II\'OfII.~a"'OV!'C,jl.lflv 'l,OOOrOOO
~
IOt:"NE""'-.A(JQfIl"GArr a. .2 ~ 000.000
-.aD\Jl:l$'~lOjlM;G 'S:i!,.OOO ODD
I co..... '''''~<llEU.'' ['
~~~~~a~~ ..
'I!ICOlc'fli'iJUIl" ,
tP.plll\ll"1 1
~~~~~~'r , ~
t-
i
~-
: "-ilPHtTY ()A""AG.€
(Pt.,c:t"'I"1l
i
:"
ace,,"
...lJTOOI\IL.... Ul....CC,oa.'T s
OTMeRTIoINt Ell"eC l:i:
I Au'TODI'lLY' ~o ~ I
''''C"wO'C\ll'I\ENCF ; t
~~JE-
.
:)I;nl)(:':"MIiLl;
!JfI!."II!"l"IO"< I
I wo""'os OOMf'r I'l!IJIITION ,I\ND
1,:~:""'L'"L''' ---L- Laura Sheedy
L Deputy City Alte ney
05$~C~ OrQllfllhflUN!IILOCATlor.:iI\'EMO.I!ii-ltC\.\Ii1Qt.lS#IOUta BY fMUOilliUllflt~~I'OM
C.I'~ific,ate Ilg14.~' 11: ine:11Jtle4 .... additional lB.Cu.red a. re!l:plll(!t:t the
in:!ll.u:;ed's p:rodu-ct.. ttlott:l.,l w4.te~). 10 ~Y' nOIC.1ee 01. aana.l1at.i.on
non paymsnt of prumi WIt.
i_l~"W
~"(;C:'Of"\:r $
I EL C/I5eA5( E.A ElAflI.O'l'li' 1
"
, fL.gr!';!:AS' POi.lCYl!MlT.L~
if tor
~r: AU'
l1':ha&ku.
CBftTlFfC"'T~ 110l,,-;)EIII
I y ! ""Ul"ONA:.;"SU".D.~...-a'" ~li.nu.,
CT'l'Y 0Ji"
CDlClu..aT1ON
8tI0Ul.IlIM otr TMi' AII0'wt Dliilic:ftlltCg f1"LIi;18 at c.u.rluUl.aeJtORfl'lf UPlftATIOfl
QAn:l.'I!!Iti1...ltolll$.$UlN$INWIl(AWlI.I. ......" ..a.. O"'rIW~
NOTiC!! rnnUiGPIr1lllCA1.E!I'tOLMII NIl.MUJ TO l"t' LE'fT.
City gt Santa Ana
At.tn: TmP COllgbr...r:
W.to,," llaulllft'lZ'
220".l SO'\Ith z:l8.;\BY Aven\le
$8)1,,",& Ana ~ 9'-7U
>COIlO 2S-S (71)7J
r,r,ACORD COAPOflATIQN 1_
~"n''''''''''''''''''' .".,..." ."-""Lll_'III'l~J
I/,jJ."'" 11\1\1~.,._~m..
bottlin~
7148473345
714 957~99
1146413345
p.3
Nov 30 01 10:41a
Nov 28 01 II: 35a
Ilov IS 01 t13: 13p
Public Works
pa",-, c COllst
P'...I:>lic WOl"'ks
p.3
p.3
EXHIBIT B
ADDlTIONAL INSURED ENDORSEMENT
mil COMMERCIAL GENERAL :~IABILITY POLICY
ll"urdllto Company -Iv t'\ ve I e. (s.
~~~{
cc{'SuC!
[lit
Thi! erodorsemer,t modifies such insurance as is alforoed by the provisions of Policy
# LID' .;?QS.S::l4LJ2.relating 10 Ihe Collowing:
l::j --r:r L. - 0 (
1. The Cily or Santa Ana, 20 Civic Center Plaza, Santa Ana. CaliCornia 92701; its
om"ers, ernploycei, ag:nls. volunteers and reprcsenlati.,es are named as additional insureds
("additional insureds") with n:gllld to liability and dcfc<se of St.its arising from the operations
and uses perfom,ed by or on behalf oflhe named insured.
2. With respect to claims arising out ofthe operations and uses perfonned by or OIl
beh"lf oflh. named insured, such insurance as is afforded by this policy is primary and is not
addithJnal to or (-ontributing with any other i.15'Ur8uce Gamed by or for the benefit of the
additional insureds.
3_ Thi. iU5'uance applies separately to eacb insured against wllom claim is made or
suit is brought excepl with respecl to tile company's limits ofliability. The inclusion of any
person or organ;"ation lS an insured shall nol allilet any right whiell ~ucb person or organization
would have as ~ claimllill ifnot.so included.
4. With r<~pecllo the additional insun:ds, t:Us insurance shall nol be cancelled. or
mat,maUy reduced ii, ""verage or limilO except all.r thirty (30) days written notice ha. be""
given to the City ofS""ta Ano, 10 Civie Center Plaza. Santa Ana, California 92701.
(Conplelion Oflhe folllwing, in<l~ding counle:signalu:'e, is required to make Ibis erulorsement
efCe:live.)
Emctivc-1Q /., ,- 0
policy# ~O W'
Issued to'. C I C.
__ ,th:s endorsement form .,; a part of
"0 I
V1
Named
-to.. ~~
Counter~igned b~".
Au.
9
APPROVED AS TO FORM
_!?:~A. ",(J,,,
'Lal1r~" Sheedy (
rkpu\y City Attorney