HomeMy WebLinkAboutHYGIENETICS ENVIRONMENTAL SERVICES, INC. 2 -2001
INC'U':A',IGE ON FILE' N-2001-0n
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CO SULTANT AGREEMENT CL[f,K OF 9ilf~C~ c. fi I
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THIS AGREEMENT, made and entered into this )t;r:). day of~, 2001 by <:).3
and between Hygienetics Enviromnental Services, Inc., a California Corpora1;j6n (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
environmental services during asbestos lead-paint removal.
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 $9,817.00 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 January
31,2003 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 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 ofthis 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 of the work under this Agreement, Consultant agrees to obtain and maintain any
employer's liability insurance with limits not less than $1,000,000 per accident.
d. 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.
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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 indemnity 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 negligent operations ofthe 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 negligent performance of services. This indemnity and hold
harmless agreement applies to all claims for damages, just compensation, restitution, judicial or
equitable relief suffered, by reason of the events referred to in this Section or by reason of the
terms of, or effects, arising from this Agreement. In the event that both parties contribute in any
manner or extent to the incidence of damages under the performance of this Agreement, then
each party shall bear responsibility for its proportionate share of the resulting damages. All
provisions included in this agreement are solely for the benefit ofthe parties hereto, and none of
the other provisions of this Agreement are shall inure to the benefit of any other person not a
party to the Agreement, and third parties shall have no rights hereunder.
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
3
include all nonpublic information. Confidential information includes not only written
information, but also information transferred orally, visually, electronically, or by other means.
Confidential information disclosed to either party by any subsidiary and/or agent of the other
party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure
shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is,
through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful
possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Consultant without
reference to information disclosed by the City.
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-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
4
Santa Ana, California 92702
telefacsirnile (714) 647-6515
To Consultant:
Hygienetics Environmental
1920 East Warner
Santa Ana, CA 92705
Attn: Marc Zimpelmann
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.
5
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 ofthis 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.
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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.
ATTEST:
CITY OF SANTA ANA
~e~~
Clerk of the Council
~,kffff
DAVID N. RE
+ City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By:
Michael Vig 0 a
Deputy City Attorney
RECOMMENDED FOR APPROVAL:
(?
CONSULTANT
M.~RC ZIMPElMANN, REA
REGlllNP,l QIRECT-OR
"
r oss
xecutive Director of the
Public Works Agency
Employer ill # 13-3992505
7
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Fr:cr;e: (949j 955-0201
Fax: (94g} 95540965
hy,;:ere:ics Er.'11ronm~:it2!r Serii::es, Inc.
F~bruary 28, 2001
" II
Mr. St~ve Worrall, P.E.
City of Santa Ana
Wat~r Resources Di\ision
Public Work Agency
220 S. Daisy Avenue
Santa Ana, California 92703
RE: Proposal for Asbestos and Lead-Based PaInt Consulting Senices for the \Yell #14 Pump Building,
Hydro-Generator Building, Resen'olr and Yard Piping at 2401 Brislql Avenue, Santa Ana, California.
Hygienetics Propos"l Number LA01l125R .
.I-I-'
D~ar Mr. Worrall:
-,'
Hygien~tics Environmental Services, Inc. is pleased to present the following proposal to provid~ environmental
consulting services for the interior and exterior of Well #14 Pump Building, Hydro-generator Building, Reservoir
and Yard Piping at 240 I Bristol Avenue, Santa Ana, California. This proposal specifically addressos th~ asbestos and
lead abatement, whicb will be nec~ssary before the material, is disturbed during the demolition pbase of the project A
daily rat~ to provide abatem~nt oversight as well as a rat~ to provide closeout documentation is indicated below,
Hygienetics' Technician will visually observe the r~moval of polychlorinated biphenyl fluid from el~ctrical equipment
and th~ removal of m~rcury switches. It should b~ not~d that no sampl~s will b~ collect~d. Hygienetics will also
r~view the hazardous waste manifests for the disposal polychlorinated biphenyl fluid from the designated electrical
equipment and the mercury contained in switches. Hygienetics assumes that this work will occur during the asbestos
and lead abatement phase of the project.
Our not to exceed fee for this work is 59,817.00
.
Scope of 'York for Asbestos and Lead Consulting Senices
1. Hygi~netics Environmental will attend one pre-construction meeting with the Abatement Contractor and the
City of Santa Ana to coordinate and re,'iew the requirem~nts as they relate the asb~stos and l~ad abat~ment.
Th~ Abatement Contractor will b~ r~quired to provid~ documentation to p~rform this work as well as provide
confirmation that th~ proper Agencies have be~n notified. In addition, Hygienetics will review the Abatement
Contractor Work Plan to ensure all regutatol)' requirem~nts will b~ followed;
2. During asbestos and lead abatement, Hygienetics will provide an Asbestos and Lead Abatem~nt Technician for no
more than 18 sbifts to perform compliance inspections, abatement air monitoring, and final clearance testing.
Asbestos air samples will be analyzed on-site using phase contrast microscopy. Lead air samples will be collected
in accordance with NIOSH Method 7082 and analyzed utilizing Flame Atomic Absorption.
3. Following completion of the abatement project, Hygienetics "ill provide City of Santa Ana with a Project
Summary Report and results of all sampling completed during the abatement. C?pies of contractor submittals and
records of daily inspections will also be included in our final report.
,,'
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Page 2
City of Santa Ana
Fee Proposal for Asbestos & Lead Consulting Ser..ices
'Yell #14 Pump & Hydro-Generator Buildings, Reservoir and Yard Piping
2401 Bristol Avenue, Santa Ana, California
J I Hygienetics Environmental Services, Inc.
. .
We thank you for giving us the opportunity to submit this proposal. Should you have any questions or require
further information, please do not hesitate to contact us at (949) 955-020 I.
Hygienetics Environmental Services, Inc.
. .
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Gregory R. Archung
Project Manager
California Certified Asbestos Consultant
Certification No. 92-0041
.'.
Attachment:
Fee Proposal
CC: Mike Gergis - Cil)' of Santa Ana
Marc Zimpelmann - Hygienetics Environmental
\\SA.'-'T AJl>A\DA T A\l'ILEl'.'E\\\PROPOSAL"'-'EW\LOl I 125R.doc
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environmental .
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Page 3
Ciro.' or Santa Ana
ree Proposal for Asbestos &. Lead Cons'ulting Seriices
'Yell #14 Pump &. Hydro-Generator Buildings, Reseryoir and Yard Piping
2401 Bristol Avenue, Santa Ana, California
~ I! H)'gienetics Emironmental Ser;ices, Inc.
Fee Proposal
.'
Task 1- Pre Construction Meeting, Re,iew of Submittals and Work Plan
Project Manager
Technical Aide
Miscellaneous Expenses
Subtct~!
'.
10 hours@565.00thour
2 hours @ 535.00thour
@Cost
..
5650.00
570.00
lli.QQ
$745.00
Task 2 - Construction Monitoring Senices - Per Shift Cost (actual number orshiits to be determined)
:. .
Project Manager
Asbestos &. Lead Abatement Monitor
Phase Contrast Microscopy Samples
Lead Air Samples
Mileage
Subtotal
1 hOllr@ S65.001hour
8 hOllrs@ S45.001hour
4 samples@56.00/each'
I samples@S15.00/each'
565.00
5360.00
524.00
515.00
lliJlQ
S474.00
A total of eighteen (18) shifts will be provided
58,532.00
Task 3 - Compliance Documentation Report
Project Manager
Asbestos & Lead Abatement Monitor
Technical Aide
Miscellaneous Expenses
Subtotal
2 hours @ S65.001hour
7 hours @ S45.001hour
2 hour@ 535.001hour
@Cost
5130.00
S315.00
570.00
lli..QQ
$540.00
Our estimated time and material not to exceed fee for this work
$9,817.00
The number of samples is an estimated; City of Santa Ana ",ill be invoiced only for the actual number of samples analyzed.
The number of samples is an estimated; City ofS311ta Ana wilt be invoiced only for the actual number of samples analyzed.
HygieneticsGl
Environmental
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 92701.
(Completion ofthe 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
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- - 949 955 0955 . P. 03/04
MAY-15-2001 10: 19 ... . HYGIENETlS5 SANTA ,ANA,,., Jllila.rA:"'I~E''''''. ~:' ,".": "" ':.", DATEfliiiD""'"
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UCER Sori.,. 501630 THIS CERTifICATE IS ISS ED AS A MATTER OF INfORMAnON
ON~V AND CONFERS NO RIGIlTS U'ON THE C~RnFICATE
HO~DER. THIS CEIlTIFICA TE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFOIlDED IV TIlE POLICIES .E~OW,
COMPANIES AFFORDING COVERAGE
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. c...~... CONTINENTAL CASUAL TV
..lon Ril. ServiG", Inc. of New York
2 World Trado Conler
N_Vollc, PlY 10041.10"
T.I.,hone: 212....1.1000
Fa: 212"79-1707
MURED ,.-,
HYGJENETICS ENVIRONMENTAL
SERVICES, INC.
110 PORTlAl/D STREET
llOSTON, MA 02114
CCM.... FEDERA, INSUAANCE COMPANY
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COM~'"' TRANSPORTATION INSURANCE CO.
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I~DleATeD, N01WIT>tSTANDI~G ANY REQUIREMENT. TERM OR COI<OfTIQN OF ANY CO~TRACT OR OTH!R DDCUMENT IMTI< ReSPECT TO WHICH THIS
CeR'I1'ICATE M4Y BE ISSUED OR MAY 'ERTAIN. THE I~SURANCI""ORDED B. THe POLICIES DESCRIBED HEREIN IS SUI.ECT To AU THE TERMS,
EXC,UBIONSANO CONomD~S D' SUCH .OLleIES, UMITS SHOWN M4Y ""VI BEEN RlDUCID BY PAID CLAIMS.
,-- - "-' -~ ";~IC~~- 'O\IC'f';'IM"o~1
TYPE. OF I"ISURAHCa POUCT NUMa(A DATr lllIillDDi'nl GAT. {MMJIKwY)
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SWOULD AMY M TH~ AIIOVIE DtICIUe. IIOUCIU "C....Cf:LLlD ""Olt& "ttf
CliY OF SANTA ANA E...."Of'I ~t( TfltEREOf. TNI IUUIHC COMPANY WILL .... ....I.
20 CIVIC CENT!" ItLAlA, SUITe M22 ~ DAYI WAlmH IrrIOT1CE TO T"I CEllntflCoAT, ..<K.OIIl......n TO TN! LEn,
P,O, lOX 1988 -W-~.~_~rw""'-b.. v'W" _.... , 1 'fit
SANTA ANA, C-' 92702 ~ _C ~_Qf_'" '>>OC ,~
'rATN'f; AONItii..UIMCH.ltIIC.OJ H'r
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APPR
ichael Vigliotta
Deputy City Attorney
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MAY-16-2001 10:20
HYGIENETICS SANTA ANA
949 955 0965 P.04/04
.
EXHIBIT B
ADDITIONAL INSURED ItNDOaSDe:NT
Foa COMNERCZAL GENEWtI. I.IABIL:J:TY POI.:J:CY
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 INSOREDS('ADDITIONAL
INSOREDS") WITH REGARD TO LIABILITY AND DEFENSE OF SUITS ARISING
FROM THE OPERATIONS AND USES PERFORMED BY OR ON BEHALF or THE
INSURED.
2. WITH RESPECT TO CLAIMS ARISING OUT or 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 BROOGHT 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 HAVEAS A CLA!MANTIr NOT SO INCLUDED.
4. WITH RESPECT TO THE ADDITIONAL INSUREDS, THIS INSURANCE SHALL
NOT BE CANCELED, OR MATERIALLY REDUCED IN COVERAGE OR LIMITS EXCEPT
AFTER THIRTY(30) DAYS WRITTEN NOTICE HAS BEEN GIVEN TO THE CITY or
SANTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA, CALIFORNIA 92701.
Policy Number GL 24786]530
S TO FORM
S.,lal': 601830
APPROVED
r
Michael Vigholta
Deputy City A ltorney
F>.ge2
TOTAL p.a3
TOTAL P.04