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HomeMy WebLinkAboutGOLD GRAPHICS 1-2006 , ^ INSUR~NCE ON fill , Rr. 'J l'1"tzGCEH, wO '''I'~UR'\',''('E EXPIRE:> UN-ilL i \(..) I ~, - -t ~ (--<:(P CLERK OF COUI!(,\l OA.TE: ~ _((P-otp N-2006-036 AGREEMENT BETWEEN THE CITY OF SANTA ANA AND GOLD GRAPHICS MANUFACTURING COMPANY o~ u>;l-L,:),) CG-~ THIS AGREEMENT is made and entered into this 15th day of May 2006, by and between the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the constitution and laws of the State of California ("City") and Gold Graphics Manufacturing Company, hereinafter referred to as ("Contractor"), RECITALS: A The City desires to retain the services of a contractor to manufacture, install and remove banners at The Depot at Santa Ana, B. Contractor represents that it is experienced and qualified to manufacture, install and remove banners and is able and willing to provide such services to the City, C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field, THEREFORE, in consideration of their mutual and respective promises, the parties hereto do hereby agree as follows: L Scope of Services Contractor shall provide installation of manufactured banners at assorted locations on The Depot property, including maintenance and removal as necessary according to the proposal dated April 6, 2006, attached hereto as Exhibit A, and incorporated herein by reference, 2, Standard of Performance In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in the field specified in the Recitals and Exhibit A of this Agreement, and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a contracting firm in that field, 3. Term/Time for Completion This Agreement shall commence on the date first written above and terminate on iTur)l2. i3l1 2007, unless terminated earlier in accordance with Section 5, 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. The services to be performed pursuant to this Agreement shall be completed within ninety (90) working days from the day of notification to proceed from the Executive Director of Community Development Agency, which shall not be umeasonably withheld. 4. Compensation The City agrees to pay to Contractor, and Contractor agrees to accept, as full compensation for Contractor's services pursuant to this Agreement, payment not to exceed Ten Thousand Dollars ($10,000.00). Payment by City shall be made within 30 days of receipt of a proper invoice evidencing work performed. Notwithstanding the foregoing, payment need not be made for work which fails to meet the standards of performance which may reasonably be expected by City of Contractor. 5. Termination of Agreement This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor 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 Contractor 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 Contractor 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. 6. Independent Contractor Contractor 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 Contractor performs the services which are the subject matter of this Agreement; however, the 2 services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor 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. 7. Insurance Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Contractor 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 Contractor'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. Contractor 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, Contractor, if Contractor 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, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Contractor 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. 3 e. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor 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 Contractor 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 Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 8. Notice Notice and written communication sent by one party to the other shall be personally delivered or sent by U. S. Mail, postage prepaid, to the following addresses: If sent by Contractor to the City: Executive Director/CDA City of Santa Ana P.O. Box 1988 (M-25) Santa Ana, CA 92702 If sent by the City to Contractor: Andy Gold Gold Graphics 12450 Montague Street Pacoima, CA 91331 818/899-1183 9. Subcontractors None of the services included in this Agreement shall be subcontracted without the prior written approval of the Executive Director of the Community Development Agency. Contractor shall be fully responsible to the City for performance of any subcontractors. 4 10. Indemnification Contractor shall defend, indemnify and save harmless the City of Santa Ana, and its officers, agents and employees, from claims of any kind or nature (including Worker's Compensation claims) for damages to physical property and/or physical injury or death to persons resulting from or arising out of acts, errors or omissions of Contractor, its agents, employees or subcontractors, in the performance of work pursuant to this Agreement. 11. Certification of Non-Discrimination Contractor certifies that it will not discriminate against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex or age, in compliance with Government Code 12900, et seq. Contractor agrees to take affirmative action to insure that applicants are employed, and that employees are treated during employment, without regard to their race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex or age. 12. Validitv The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of the Agreement. 13. Laws Governing this Agreement This Agreement shall be governed by and construed in accordance with laws of the State of California. 14. Exclusivity and Amendment of Agreement This Agreement supersedes any and all other Agreements either oral or in wntmg between the parties hereto with respect to such employment in any manner whatsoever. 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, and that no other agreement or amendment hereto shall be effective unless executed in writing and signed by both the City and Contractor. 15. Professional Licenses Contractor 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 5 Gold Graphics Quote <I9 Manufacturing Company 12450 Montague Street. Pacoima, CA 91331 818-899-1183. Fax 818-899-2430 Print Date: 4/6/2006 Time: 10:26:45AM Page 1 of 1 Customer: Depot at Santa Ana 1000 East Santa Ana Blvd. I Suite 108 I Santa Ana, CA 92701 I Estimate # Contact: I Rep: I Estimator: 011412 Carolyn Fullerton Andy Gold Phone: FAX: 1 Santa Ana Train Station Bms Notes: Item No Description Quantity Unit Price Extension Price 001 Double Faced Light Pole Bms 30 $109.50 $3,285.00 30" x 78" banners, 4 color on outdoor vinyl. sewn back to back (common images) 30 banners=14 for platfonn/16 for Driveway Prototypes included 10% maximum overs of banner quantity ordered are included. Freight and storage included(banner storage after removal up to 90 days) Sales tax not included. 002 Double Faced Courtyard Banners 6 $93.00 $558.00 24"x4B" double sided triangle banners. Finished with sleeves at top. Sales tax not included. 003 Installation and Removal 1 $4,174.00 $4,174.00 Installation of banners, separate prototype installation, and maintenance included (maintenance due to normal wear and tear included; maintenance due to unforseen circumstances will be extra) Removal not included. 30 banners=14 for platfonn/16 for driveway Hardware for 29 single unit installations and 11 double unit installations. Abol/e price is quoted to our relllew of final art and specifications. Terms: net 30 days OIl approved credit . no discounts. All state taxel!> or special taxes charged elWa. Quotatic applies for 15 days. OIIerruns 0( underruns will not exceed 10 percent of the quantity ordered. Gold Graphics wlU bill for the actual quantity delivered within this tolerance. If th cuslomel'" requires a guaranteed quantity. the percentage must be stated al the time of quotation. Note: For local truck delivery add $85.00. For local same day messenger delivery add $45.00 ACORD,. CERTIFICATE OF LIABILITY INSU PROOIK:llft LUCCHESE INSURANCE AGENCY. INC. 9795 CABRINI DRIVE. SUITE 206 BURBANK. CA 91504 THIS CERTIF ONLY AND C HOLDER. TH Al Tl!R THE C 0... n: (MMIOOM') 05/04/200 TE IS ISSUED AS A MATTER OF INFORMATION FERS NO RIGHTS UPON THE CERTifiCATE CERTIFICATE DOES NOT AMEND, EXTEND OR VERAGE AFFORDED BY THE POI.ICIES BELOW, ,"~o" GBDGraphics, Inc dba: Gold Graphics Manufacturing Company, Inc. 12450 MO'lague St. Pacoima. CA 91331 SURERS AFFOROrNG COVERAGE COVERAGES I THE POLICIES OF INSURANCE 'ISTSDOOl."'" HAVE BEEN lSSUEOTO THE INSUREO NA".OABOVE ~OR THE POLICY PERIOD INOICATEO. NOTWITHSTANDING ANY REOUIRE"ENT. TER" OR CONDITION OF ^" CONTRACT OR OTHER DOcU"ENT WITH RI~PEor TO WHICH THIS CERTIFICATE MAY BE 'SSUED OR MAY PERTAIN. THE INSURANCF AFFOROEO DTTHE "DUc/ES OESCRIDEO HFRFlN 'S SUllJECTTO fll THE TERMS. ""CLUSIONS ANO CONDITIONS OF SUCH ,,!,<'CI~OREG'Tf'IM,n;SHOWNMAYH"EBSENREOUCEOBYPAlDelAlMS .ii MltA"",,,, , _ 'll< T'lPfOl'llISlIIWICC .OUC...""..... ATE. DA ....,.. A......."..""'" 57UUN UL 6500 07/0112005 107 1/2006 "ACHOCC","""c, I. 1.000,000 X co_"""""".."",-,...,u", ! ""DA"'G":;",_.~) 300.000 'l Cl-'''''''''''0 OCCUR "",OEXP,...,."""",,,,,, '10.000 ' ~RSO_'AOV"""",,, 1.0000Qil. --I """""'AOG.'GATE . 2 GENUGO""TE lM' APPUES."" ~"",,"CTS. C...."P AGO . .000000 I P!;ty flLOC A ~lIrOMOBllf: llABlUTY ~j "'N'r'AUTO C I ^lJ..O~OAUTOS j I 9CHEOULEQ ^Ums )( tlllil'EOAUTOS X I'IIOfll..oWNlmAUTos I. ...._ 11i.rlfDrl! C_:!1lI IUSlJranoe ComDany ~tate ~mDAn <ltjon,IMYrancs FuO;rl ! 1'~l1~EJ~O._ I PNSU~RE tNSURfA: A' lNStJReR.~: INGU~~ c: 0710112005 107/(11120OG I , I I co.....~os""''''"..rr+' s 1000000 1(.UOl;O;j',,~~ ._ " I 800J1. Y INJURY I $ iP"'"'.o" 1=- I . COOllY lNJUR\' I~P~:tcOdtlllll _ _~ $ i ~~~IfN'"GIi , S -'-- "'N'I'AI.,ITO EXCE:1r8 lIABIlITY ! f-J OCCUR 0 CWNs "'.. I II CfDVCTI(tt,f RETiNnON :Ii ~COflMlNSAnoH~NO BtPLOV!f\t$' LtAOIUlY . A.~!O ONt Y - EA A.CCtOENT, . j ,$ OrHEIl: THAN ~CC.l AUTOONlv -'00 S onl.l:rt I , , I I J I , ! ! i /'/ ) I -c , ~"CH OCCURRI!NCe FGG~GA" I ~ I wt..:::;M,TU-, TO"YllMITS f'l~CHACCIOENT /: . .,,--. " , J i~" /~4 \--".::> 'j/ o ' , F:"a, I, E.l DISEASE. r;Il.EMPtOYE :5 e.!.. DISf:ASE. POlicY llt.1IT $ j , Df5mIPTlON OF 0#'ERA,1lONSIt.ocA....~ftCLf.!llEXcWSlON$ Aoot.O BY EtoIDMSSWNTISII"IlCw. PROVISl0H8 It Is undersloce and agreed that certificate holder is named as AddltiOnallnsu'ed 'With respect to liability arising out of the Operations Of the named Insured. Endorsement attached. I I i , I . 10 day notice of cancellation for non,payment Of premium ClI!ftnFtCATE HOlDfl:R AODmotw.. No/;VIQ;O: INSlJRl:R U;m't CANC~LlA.rION I The Depot at Santa Ana 1000 East Santa Ana Blvd. Suite 108 Santa Ana, CA 92701 Fax (714) 565-2693 SHQUlDANY Of THE A~ D(se~IBED POUcu::sa, C"~Cl'lLfOlt.r:~oRE ~1"l!,'("'R.\TfON OA1E17HeRl:0f. TltI; 'rUING INSUftUWlLl MAlL .30 _ OAY5 'Mtl~N ""nee TO "" C"""lOATE HOlD.. ""'0 m THE lEn, _ ". _ = =:~ '.... ~~ ~!lL~.'/, Ir ,.. - _ -....$h AlIrHOJu~c "a>Rr3fNtA1M ~L . I , "'" olhhr Ii ACORD COIlPOllA TlON 1911 .:. C" (\ T "" ~ _. _ dSv'vO SO vO F;,,1oJ ACORD 2S.S (7117) GOOl 100'<3: nzu 2'd 1:l"1 LL Ma~ 04 06 04:50p Tllac::l . I I I I I I ADDITIONAL INSURED ENDORSEMENT I I Insurance Company: Hartford CaSualty In~urancCompa"V I This endorsement modifies such insurance as .s affprded by the provisions of Policy No, 57UUN UL 6500 relating to the fOllol^'il'1g: I The City of Santa Ana, 20 Civic Center Plaza. Sa~ta Ana, Califomia 92701, its officers, employees, agents and representatlve~ are named as additional insureds ("additional insureds") with regard to Iiabilit~ and defense of suits arising from the operations and uses performed by or On b~alf of the named insured, I With respect to claims ariSing out of lf1e operations t1nd uses performed by or on behalf of the named insured, SUCh insurance as fls afforded by this POlicy Is primary and is not addifional to or contributing witfj any other insurance carried by or for the benefit of the additional insureds, I I , ThIS insurance applies separately to each insured a~ainSI whom claim is made or suit is brought exwpl with respect to the comp~ny's limits of liability. The inclusion of any person or organization as an insuted shall not affect any right which such person or organization Would have as a faimant if not so .ncluded. With respect to the addllional insureds, thIS insural'ljCe shall not be cancelled, or materially reduced in coverage or limits eXcept after thirty (30) days written notice as been given to the C/ly of Santa Ana, 20 CjVit Center Plaza, Santa Ana, California 92701 I I (Completion of the fol/owlng, inClUding counter~gnature. is required to make this endorsement effectiv@.) I I . this endorsement forms a part of I 1. 2. 3. 4 Effective 05/04/2006 Policy No. 57UUN UL 6500 Must Match Policy Number Above I I Issued to: GaD GraDhics. Inc. db.: Gold Graahics Man$facturina Comaanv. Inc. Named Insured I I , -., dh-~r~u I I COUNTERSIGNED BY; rL / N _,4 .e-:1-P -Y;;,"',,?; ," \ J;:rr) I ./ / , I' . ::00/ lDO'c nzu p.3 sep 22 06 OS:41a Tlla~l Slt'!p 07 06 04~5Sp Tll!lt:l~, N _;'0%- D3f> .~ ~,~,:ORD.. CERTIFICATE OF LIABILITY INSURANCE__L_,;;;~';;~~': ....... CERTlfICATt: ts ISSueD AS ^ MA.TTER Of' INF'I'RMATIO" ONLY ANO CONPEItS NO mGHTS UroN THf! CERTIf'ICAlt I'-~"'-~-~'~ _..~._~,- "-,, 9795 C. ABRINJ DHiVE, SUITE 206 .ALTER THE COVERAGE APPOIlDED BY THF "<~ll4;~.ES 8FIQw_ BVR6ANI<, CA 1)1504 1N8UR:StS AFFORDING: CUVttotAI.E I~ -~dGraphiCS MlJnul'act:lJnnO Compaoy ~~~;tfurrr.C{lsualtvlnsl~om~~~= I ~;:~o;;r;,:~, ~:: , -==---= =-=- I ~__ ~~ CQVERAGES IrHE POl1C1~ OF 1N5lJl:ANCEUSTEO BELOW !-fAVli. KEN ISSlIII[;'l'QTHIiINtiURf:<O I'CAMEOMJOVE t'()R1HE POlICY pe:tUOO lrfDlC":iic--;,-;; 'wn ~~, '''-';;-')IN( , ...NY REQIJ$Ret.lENT, TeRM OR CONOI"rtON Of ANY CONTMCT OR OfHDI: DOCUMEtH 'MTH RESP6CT TO WHICH lHIS CIE~'nFICATE MA ell: C,S\Jt:;\ ,)f' MAV PERTAIN, TliE ItlSURl\NCE AFfiOR(JIOO IIV"floIe PQUCIES DESCRIBeO HEReM IS SU6JECT TO All THe TERNS, fXCI.USION\; ANr" -:0...0 TiOtl'" ",. <. '-":' POl.-leIES, ^GGAlO:GA.'l'C\.ItolrTtl;SHQVm MAY HAVElJt::l:fIIft~OUCEO BY PAjDCl.N&lS. T'l'l'&0l'1tttllfWICE - I ~"\llldet' N A ~,X":-=C:E~<lAL~i...k'r.' 57UUN Ul6500 07/0"2006 07/0112007 ::o::;i~~'i~; : CLAtlloSW'oOl ~ OC<:un I I ;. ~N"~-;~GR\iG,l..Tt ll: .-wll~ ~'t I 1 POCle~ MO. l.OC A ~OIIOUILEUA!I.1lm' 57UUNUl6500 .--------ro7i<Y"12OO6 Q7/0112007 COMIJ,,*,O$l!JG\FI '.., \ y.,,, lE-aeeil!''''f >~x > ;:~;::~:s X Hll'ItC/\lJ"fOoS X "ON<Wf~l\l.nOS ,1_ __~ iJ~'~ : 000.LlcK ,iJL')Jl.ll ME;O~\A,lrt<'~I""~ll'!l 1 "ERSONA"':li:~.~r~~~.~ \ GE'll!llAl"<.lG~''''''' '.: ~(\ ,<,lQll(J:';: -..j...~'H MOO\ICTS..CO~~~ I '":J(,,lll:(' I ,{I ~ I." eOl)lll'II<JU~ {""'~I [IlOOL,(lNAJRY :....I~) ~lJQtUI' \JIINY^iJTO ImtS:5LIAIIIlIl'r r-.J OCCUR L'I ClAlMSw.oE , ~ -I I ! L I f'''''''EKO' Ull.""'G~ (P9rAnoI.on) IPIJ7QONL'f ~!,(:Cl~(~~~-- ( IlTHERTHAN ~ \ ':.: '; [;"",Y ,c, UCl'lOCWAA.~ .lo~~~ __._1 f- 'j'O!lJVC'fUJii Ilt'~H't\OM $ WOOMCA$ <:OMPEHSIUlOIW AfCl io.lPLO'l'tAS'LlAD/UTl 7. csi'r~'rirr1'" T \JhllT;lJ FP t.L~AS.CI~.__ E.\ ~~~"'_~.~!'lO.Y~i; E.L.lll$O;:ASI: I"OLlC'.'''I,T_. ~ ,mER I 0ESCRIP'tlONot0l'6lA1'IONSoUlCAlJOIoM\If'our:~uaGtIIMlQl;O" f~'fIt~~H& The City of Santa Ana, Its Oftic;er5, Ageots, and Er, ployee.s are named 85 Additional Insured with respect" to alll( h 0 )f:'r;I"')~ ' p~ormed by the named insured. Revised CFRnF1(:ATE HOLDER r I I ___~..10-d6y noltce '~sent for nOl'lkp-ayment of premium 1XIADOO1olW.~'N!UllAIJ;T~ CA.tlCELLAJIt)N $iIO\A.OAN'I' OF'I'II'liIMOVf IlESCllIfIQU'()UCll';SIlIi C"'Iol(~IIH' ""~l" ~ IN tpcw: [I:]'; CiryofSRllta Ana Th~ Depot al Santa Ana 1000 b. ::;atlta /t..M. Bl",d, Santa Ana, CA 92701 " ""T1lMG501',ftll!l5lltw>l(ll...........wu. NOtIlZNTHI~TFlCA1'2HOl'>t:!l.lCMlf:tImntElEF1 _,,_,0 11"':' ml"lL~ .... ^~- , Fax. (/14) 565.2693 AcmtO 2!.-$ (""'T1 . ~.--~ . .@ ACORO ~ojfJ")Rjr, rKiN-j-i\U. "' Sep 22 06 OS:41a Sep 0'1 OS 05:00p Tlla~l Tl1.Bgl~_ ADDITIONAL INSURED ENDORSEMENT InslIr.mc. Company; Hartford Ca8l1iltv In$lIrancComoanv This endorsement modlf",. such insurance as is afforded by the proviSion, " POliCY No. -1>7UUN UL 6500 relating to the following" The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, Californi;;, B-2/01, .~ officers. employees. agents, volunteers and repre:;;;entatives are r,alrlcd l' additions{ insureds (Waddibonal InsuredS") wrth r&gard to liability a"ld dG:fp.n~~ 0' suits arising from the operatione and uses p~rformed by or an behalf d t\l; named Insured. 2. With reSpoClt to claims arising ovt of tne operations and uses performed by '~I {HI behalf of the named Insured. such jnsurance as iR ~fforded by thit pul,c:, pnmary and is not additional to or contributing with any otlier inSllrance kWl~"l by or for the benefit at the additional insured 3, Th~ Il1syrance applies separately to each insured against whom claim is m~ci!'- l '" suit is brought l!!Ixoept with re~pAct to the company's limit~ of liabIlity "h, incluSiOn of any person or organlz.a.tlon as an insured shan not affect an\, 'lqr'\ which SlJC~ persOtl or organization would have as a daimant If not so Inc\ud~ 4 With respecl to the additional insured, this in5uronce shall not be canl,,;elle(L (. materially f'@dllced in covera9~ Of limits e:-:.c;;ept after thirty (30) days written 'lot'Ct as been given to the Cd)! of Santa Ana, 20 Civic Center PI.!l:z:l. St'tntA An? Clllifomia 92701 (CompleUon of the followin\l. including cOllntersignatllre, is required to make this endorsement effective.) Effective 09/07/2006 , this endorsement lorms a part of Policy No. 57UUN UL 6500 Must Match Polic)' Number AbovI Issued to: ceo GrBDhics.lnc. cfba: Gold Gr.aPhicB ManufactunnQ Company, ine, N.med Insured COUNTERSIGNED BY, p'l7/L.~~--C-- --- J/~ 2-/'- . r -:zV.------...----