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HomeMy WebLinkAboutTOLERCO'S ELECTRIC 9 - 2002 -~INSURANC! ON tiLE WORK MAY PROCEED UNTIL INSURANCE EXPIRES . /OJ II 1..0\1').. CLERK OF COUNCIL DATE: N-2002-075 CONSULTANT AGREEMENT 03 THIS AGREEMENT, made and entered into this / ..;rVday of.:;/l~J../1 ,2002 by and between T olerico' s Electirc, a sole proprietorship (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"), RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of electrical and lighting repair, to provide repairs to the Depot at Santa Ana. 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 July 1,2002 and terminate on June 30, 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 Community Development Agency and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee 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 marmer 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 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. 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 I of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFIDENTIALITY If 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 3 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, 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 Community Development Agency City of Santa Ana 20 Civic Center Plaza (M-86) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6939 and, 4 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: T olerico' sElectric 12321 Moana Way Garden Grove, California 92640 (714) 636-6764 Attn: Kenneth Tolerico 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 5 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. 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 governed and construed in accordance with the laws ofthe 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. 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 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 SANT;;2 ~AM City Manager ~~~~cl PATRICIA E. HEALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W. FLETCHER :~Y~e~t Lau{a heedy Assistant City Attorney RECOMMENDED FOR APPROVAL: CONSULTANT / -..... ~'-) JO . REEKS TIN Exe utive Director of the Community Development Agency /$9. ~ . 5<1-87 Employer ID # or Individual SS # 7 TOLIRleo's ELECTRIC LICENSE #427918 ProllOUl City or Santa Ana Regional Transponation Center 1000 E. Santa Ana Blvd., Suile 108 Santa Ana. CA. 92701 Carolyn: Listed below are the Hourly Rates and Material Markup that we will be charging the City for the 2002-2003 Agreement. Material: Standard Markup, 25% over coSl. labor Rates: Midnight to 7 AM. Sundays and Holidays $ 49.00 per hour S 49.00 per hour S 73.50 per hour S 73.50 per hour S 100.00 per hour Monday through Friday, 7 AM to 6PM Saturday 7AM to 4PM Monday through Friday, 6PM to 12PM Saturday 5PM to 12PM ~,:?: KellJleth J. Tolerico Owner 12321 MOANA WAY, GARDEN GROVE, CA 92640. (714) 636-6742. Fax (714) 636-6764 A ~T~10~'~ C n~T~~1n1 ~9L9-9E9-~IL ~Z:LI Z00Z/II/90 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: ]. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 9270]; 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]. (Completion of the 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 8 . F.h-!"~2flil3 10:17.m From-CALIFORNIA SOUTHWESTERN INSURANCE AGENCY 949-588-8348 T-677 P.DD2/DD4 H32 ACORD". CERTIFICATE OF LIABILITY INSURANCE T DATE (M1IIOO/YYl 01/13/2003 ~DUCER (949)472-6560 FAX (949)588-8348 THIS CERTifiCATE IS ISSUED AS A MATTER OF INFORMATION ~lifornia Southwestern S/' '-0 ONLY AND CONfERS NO RIGHTS UPON THE CERTifiCATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Insurance Agency/Lic.' 0443354 ALTER THE COVERAGE AffORDED BY THE POLICIES BELOW. 21 Orchard \'\O~ INSURERS AfFORDING COVERAGE Lake Forest, CA 92630 ,""""0 ~~v INSURER A: Navigators Insurance Company INSURER B: Mercury Insurance Company Tolerico's Electric INSURER c: 12321 Meana Way INSURER 0: Ganden Grove, CA 92640 LNsuRER E: THE POLICIES OF INSURANCE liSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ASOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE liMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C~ ~ TV..OF'N.U....ce POUCYNUMBER FF "lll:i.f,)'~ lIMIT. ~N"""'UA8lUTY GAN00076 10/15/2002 10/15/2003 EACHOCCURRENC' $ 1,000.00 X COMMERCIAl. GENERAL UABILITY FIRE DAMAGE {Any one tint) $ 50,0011 l CLAIMS MADE ~ OCCUR MED EX? (Anyone person) $ 5 ,0011 A PERSONAL & AOV INJURY $ 1.000,000 GENERAL AGGREGATE S 2.000.0001 ~'~AOO~EnE.~~ APPrtIPER; PRODUCTS ~ COM PlOP AGG $ 1,000,00 X POLICY JEer LOC ~OBILE UABlllTY "'11054157 08/21/2002 08/21/2003 COMBINED SINGLE LIMIT (Eaaccldent) S 1,QOO.00C c- ANY AUTO X ALl.. OWNED AUTOS BODlL Y INJURY SCHEDULED AUTOS (Per person) $ B i" HIRED AUlOS BOCIL Y INJURY -X NON-OWNED AUTOS (Per accklenl) $ ..::.. pROPERTY DAMAGE $ (Per 8CCidenll ==rGE UABIUTY AUTO ONLY. EA ACCIDENT $ ANY AUTO DASrp FoRM OTHER THAN EAACC S APP AUiOONLY: AOO $ ~CESS UABtUTY <: ~ __ f'/l eACH OCCURRENCE $ P OCCUR 0 CU\JMS MADE C E LEE'l:;H W AGGREGATE S DeputY City Attorr ey $ ~ ~'DUCTIBLE S RETENTION S $ WORKERS COMPENSA"nON AND h'O\\~ljMITS I IU~lt EMPLOYERS' LlA8IUTY E..L. EACH ACCIDENT S E.L. DISEASE. EA EMPLOYE $ E.L. DISEASE. POLICY LIMIT S OTHeR I,..~C'P1lON OF OJ'ERAnoNStLOCA'ft':SN:;tiI;ESJEXCLUSlOMS ADDED IY ENDORSeuENTlSPE~L PROVI8JOMB as additional I-ert ficate holders, ts 0 1cers, .loyees, agents and representatives are named insured per attached endorsement ANF043 (12/97), but only with respects to general liability. 00: Maintenance/repair contract/ongoing operations 0 1000 E. Santa Ana Blvd. #108 10 day notice for non-payment of premium. CERTIFICATE HOL.DER I X I ADDITIONAL 'N8URED; 'NBU""R um"'" A CANCELLATION SHOULD ANY OF THE ABOVE oESCRiBED POUCIEB BI! CANCEL\.ED BEFORE THE EXPlRA1lON DATE THEMOF, mE ISSUING COMPANY 'NILL ~MAIL *30 DAYS WRITTEN NanCE TO THE CERTIFICATE HOLDER NAMED TD THe LEFT. Ci~y o~ S.n~. A"~ ~RE~~ /~ 1000 E. Santa Ana Blvd., n08 xxxx Santa Ana, CA 92701 At":ngn .,A-S, 17197\ 7./ / @ACORD CORPORATION 1988 ;OVERAGES . Me~-13c1~3 10:17.m from-CALifORNIA SOUTHWESTERN INSURANCE AGENCY 949-588-8348 T-577 P.003/004 f-531 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) 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 representetive or producer, and the certificate holder, nor does It affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. A RD 25-8 (7197) , F..b-.13~1rla3 10: 18.m From-CALI FORN IA SOUTHWESTERN I NSURANCE AGENCY 949-588-8348 T-677 P,004/004 F-631 THIS ENDORSEMENT CHANGES THE POllCY. PLEASE READ rr CAREFUlLY. BLANKET ADDmONALINSUBED ENDORSEMENT This endoJ"Sel'TlP.l't modifies insurance provided under the following: COMMERCIAL GENERAL llABn..ITY COVERAGE PART Sf 'HI<:IIULE Name of Pc.5OIl or Organiza1km: City of Santa Ana 1000 E. Santa Ana Blvd. #108. Santa Ana, CA 92701 Any penon or o'1V"'i7JIriI)D that the named insured is obligated by virtue of a written CODtI'llCt or agreement 10 provide insunmce such as is afforded by this policy and Is ap!lt<>.ed by tile ClBDpIIIIY in Wlithq; witbIn 30 days of the inception of the contract or agreement, or the inception oftbis POlicY. whichever is later, WHO IS AN INSURED (Section D) is "......vI"" to ;nclndl> as an insured the person(s) or orgl'ni.....rion(S) shown in the Schedule as an insured but only with respect tD the fullowing: 1. Liability arising out of your ongoing operations perfunned for that insured by or for you. or 2. Liability arising out of the ownership, ""';-""~, or use of premises while leased tD you. or 3. Liability arising out of the rnairJtenanee. operation or use by you of equipment while leased tD you by such person(s) or orgaDization(s), or 4. Operations performed by you or on your behalf for which the state or political subdivisioD bas issued a pencit Neither the coverages provided by this insurance Policy nor the provisions of this endorsement shall apply tD any claim arising out of the sole negligence of any additional insured or any of their agents/employees. Primary Wording: If required by written contract or agreement: Such insurance as is afforded' ,by this policy shsll be primary insurance. and any insurance or self-insurance maintained by the above additional insured(s) shall be excess of the insurance ANF 043 (12/97) FORM , feb-l1-.U03 04:07pm From-CALIFORNIA SOUTHWESTERN INSURANCE AGENCY 949-588-8348 T-641 P.001/001 F-574 ~~\-. FACSIMILE TRANSMISSION FROM W. BROWN & ASSOCIATES PROPERTY & CASUALTY INSURANCE SERVICES 19000 MACARTHUR BLVD. SUITE 700 IRVINE, CA 92612 VOICE NUMBER: (949) 851-2060 FACSIMILE NUMBER: (949) 794-0744 LICENSE #0755999 If you do not receive the Indicated number of pages, please contact sender. DATE: TO: February 12, 2003 FROM: Tiffany Christiansen Bolding AlTENTION: California Southwestern Ins. LF (949) 472-6549 Veronica or Laura REFERENCE: Tolericos Electric GAN00076 TOTAL PAGES: 1 We are currently an MGA for Navigators. The certificate for the City of Santa Ana issued 1/13/03 has been approved As always, should you have any questions or need additional information, please do not hesitate to call our office. Thank You & Best Regards. W. Brown & Associates Tiffany Christiansen Bolding ACOPO,. CERTIFICATE . - PRODUCER (949)472-6560 FAX (949) 58 -8348 California Southwestern Insurance Agency/Lic.# 0443354 21 Orchard Lake Forest, CA 92630 INSURED LIABILITY INSURAr-E DATE (MMIDDIYY) 01/13/2003 THIS CERTIFICATE IS ISSUE ;>'S A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ Tolerico's Electric 12321 Moana Way Ganden Grove, CA 92640 COVERAGES L....Q1 '/()O ~\ -" ~t' INSURER A: INSURER B: INSURER c. INSURER 0" INSURER E: INSURERS AFFORDING COVERAGE Navigators Insurance Company Mercury Insurance Company THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ INSR TYPE OF INSURANCE PQUCY NUMBER P8.kii~:~~~~E Pg~.f:/~~tbRC~N LIMITS LTR ~NERAL UABILJTY :;ANOO076 10/15/2002 10/15/2003 EACH OCCURRENCE $ 1,000,00C X CQMl-ilERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 50,00C I CLAIMS MADE 0 OCCUR MED EX? (Anyone per$on) $ 5,OOC ------.---. A '--- PERSONAL & ADV INJURY $ 1,000,00~ GENERAL AGGREGATE $ 2 ,OOO,OO~ - 1,000,00~ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ ~ POLICY n j~T n- LOC AUTOMOBilE LIABILITY C11054157 08/21/2002 08/21/2003 COMBINED SINGLE LIMIT - (Eaaccident) $ 1,000.00~ - ANY AUTO X ALL OWNED AUTOS BODILY INJURY (Perpefson) $ SCHEOULED AUTOS B X HIRED AUTOS BODILY INJURY X (Peraccidenl) $ -'-"- NON-OWNED AUTOS - PROPERTY DAMAGE $ (Peraccklenl) ==rGE LIABILITY FORM AUTO ONLY - EA ACCIDENT $ ANY AUTO APPROVED AS TO OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS LIABILITY JJr}J . n Mi EACH OCCURRENCE $ ~-OCCUR D CLAIMS MADE ,1"/ ( AGGREGATE $ Gra SheedY y $ =1 DEDUCTIBLE a City AttOrne $ Deputy RETENTION $ $ WORKERS COMPENSATION AND I-i'o\i,;'m;,~sl IUE.' EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ -- E.l. DISEASE ~ EA EMPLOYEE $ E.l. DISEASE - POLICY LIMIT $ OTHER rP:SCRIPTION OF OPERATlONSfLOCAT10NSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENTJSPECIAL PROVISIONS certificate holders, its officers, employees, agents and representatives are named as additional nsured per attached endorsement ANF043 (12/97), but only with respects to general 1 iability. ob: Maintenance/repair contract/ongoing operations @ 1000 E. Santa Ana Blvd. #108 10 day notice for non-payment of premium. 8S:0 11I,Il:lS0INnf9Z.*Oi:::!J CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ~~ MAIL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Santa Ana ~llI(JWilOOI J()(il(lIlOOi1t~XllIXIUlooxt(XX 1000 E. Santa Ana Bl vd. . #108 ~ IiX<<XXXXXXXX Santa Ana, CA 92701 AUTHOR D REP~SE~;Y ~ '7/ L: .:--/ ACORD 25-S (7/97) 1/ / @ACORDCORPORATION1988 (1ttly ,. --- "'" THIS ENDORSEMENT CHANGES THE POllCY. PLEASE READ IT CAREFULLY. BLANKET ADDmONALINSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMEROAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Santa Ana 1000 E. Santa Ana Blvd. #108, Santa Ana, CA 92701 Any person or organization that the named insured is obligated by virtue of a written contract or agreement to provide insurance such 35 is afforded by this policy and is approved by the Company in writing within 30 days of the inception of the contract or agreement, or the inception of this policy, whichever is later. WHO IS AN INSURED (Section ll) is amended to include 35 an insured the person(s) or organization(s) shown in the Schedule 35 an insured but only with respect to the following: I. Liability arising out of your ongoing operations performed for that insured by or for you, or 2. Liability arising out of the ownership, maintenance, or use of premises while leased to you, or 3. Liability arising out of the maintenance, operation or use by you of equipment while leased to you by such person(s) or organization(s), or 4. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit. Neither the coverages provided by this insurance policy nor the provisions of this endorsement shall apply to any claim arising out of the sole negligence of any additional insured or any of their agents/employees. Primary Wording: If required by written contract or agreement: Such insurance as is afforded by this policy shall be primary insurance, and any insurance or self-ins~rance maintained by the above additional insured(s) shall be excess of the lnsurance ANF 043 (12197) . GORM AS TO , APPROYED Q"'lk(\H'j 6S'0l~"SO,Nf\r ,.C. ......, .. . , '-' '..J IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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)