HomeMy WebLinkAboutOLYMPIQUE FAÇADE ACCESS CONSULTING - 2006
INSURANCE ON fiLE
WORK MAY pROCEED
UNTIL INSURANCE EXPIRES
9.,211-07
CLERK OF COUNCIL
DATE: I,IO'~?
0: .,r<lf'C" (i) (!>I,G.\;,..;)
TIllS AGREEMENT, made and entered into this Ith day of December, 2006 by and
hetween Olympique Fa,ade Access Consulting, a California corporation (hereinafter
"Consnltant"), and the City of Santa Ana, a charter city and municipal corporation organized and
existing under the Constitution and laws orlhe State of California (hereinafter "City").
N-2006-122
CONSULTANT AGREEMENT
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
Cal/OSHA regulation compliance in relation to window cleaning.
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 lhat it is
knowledgeable in its field and that any services performed by Consultant WIder this
Agreement will be pcrformed in compliance with such standards as may reasonably be
expected horn a professional consulting fiml in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subjecllo the
terms and conditions hereinaftcr setforth, the parties agree as follows:
1. SCOPE OF SERVICES
Consultant shall provide services necessary to develop an Operating Procedures Outline
Sheet (OPOS) to ensure City compliance with Cal/OSHA regulations, as set forth in Exhibit A to
this Agreement.
2. DELIVERY OF WORK PRODUCT
Consultant shall deliver to City any work product which results from the services
provided. Said work product shall bc submitted in hard copy and produced in a form compatible
with City's computer system, as agreed bctwccn the Project Manager and Consultant.
In regard to all copyrightable material produced as a deliverable under this Agreement,
including but not limited to books, rep0l1s, plans, photographs, drawings, and computer programs,
Consultant agrees, for itself and for its officers, employees, agents, contractors, and volunteer
workers, that (a) other such material may not be copyrighted without prior review from thc City,
and (b) the authors of all such matcrial, whether copyrighted or not, award to the City, and to its
officers, agents and employees acting within the scope ofthcir official duties, as a condition of
payment to thc Consultant, a royalty-free, nonexclusive, irrevocablc license throughout the world
lor governmental purposes to disclose, publish, translate, reproduce, and use such materials.
3. COMPICNSATlON
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 thil1y (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.
4. TERM
This Agreement shall commence on the date tirst written above and terminate on June 30.
2007, unless terminated earlier in accordance with Section 13, below. The term of this
Agreement may be extended upon a writing executed by the Executive Director of Finance and
Management Services and the City Attorney.
5. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, he 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 \vhich are the subject matter ofthi5 Agreement; however, the services to be
provided by Consultant shall be provided in a manner consistent with all applicah]e 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.
6. INSlIRANCE
Prior to undertaking performance of work under this Agreement. Consultant shall
maintain and shall require its subcontractors, if any, to obtain and 11laintain insurance as described
below:
3. Commercial General Liability Insurance. Consultant shall maintain commercial
generalliabi]ity 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 Attomcy.
2
b. Business automobilc liability insurance, or equivalent form, with a combined singl!.:
limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for
owned, hired and non-owned automohiles.
c. Worker's Compensation Insurance. In accordance with the provisions or Section 1300
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
perf0I111anCe of the work under this Agreement, Consultant agrees to ohtain 8nd maintain any
employer's liability insurance with limits not less than $1,000,000 per accident.
d. Professional liability (errors and omissions) insurance, with a combined single limit of
not less than $1,000,000 per claim.
e. The following requirements apply to the insurance to be provided by Consultant
pursuant to this sedion:
(i) Consultam sball maintain all insurance required above in full force and
dTect lor 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 maimain the insurance required by this
section or Jails or retuses to furnish the City with required proof that insurance has been procured
and is in force and paid lor, the City shall have the right, at the City's election, to forthwith
terminate this Agreement. Such terminatinn shall not effect Consultant's right to be paid for its
time and materials expended prior to notification of termination. Consultant wai.vcs the right to
receive compensation and agrees to indemnify the City for any work performed prior to approval
of insurance by the City.
7. INDEMNIFICATION
Consultant agrees to and shall indemnify and hold harmless the City, its omcers, agents,
employees, consultants, special counsel, and representatives Irom liahility; (1) for personal injury,
damages, just compensation, restitution, judicial or equitable relief arising out of claims for
personal iujury, including health, and claims for property damage, which may arise from the
direct or indirect operations or 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
arisiug from this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or cquitable relief suffered, or alleged to have
been SlltTered, by reason of the events reterred to in this Section or by reason of the terms of, or
effects, arising from this Agreement. The Consullant Jurther agrees to indemnify, hold harmless,
and pay all costs for the defcnse of the City, including fees and costs for special counsel to be
3
selected by the City, regarding any action by a third party asserting that personnl injury, damages,
just compensation, restitution, judicial or equitable relief due to personal or property rights arises
hy rcason of the terms oC or effects arising from this Agreement. City may makt: all n:asonable
decisions "vith respect to its representation in any legal proceeding.
8, CONFIDENTIALITY
If COllSultant receives from the City information which due to the nature of such
information is reasonahly understood to be confidential and/or proprietary, Consultant agrees that
it shall not use or disclosc such information except in thc pcrformance of this Agreemcnt, and
fUliher agrees to exercise the same uegree of care it uses to protect its own information of like
importance, but in no event less than reasonabh: care. '''Confidential Information" shall include
all nonpublic information. Confidential infomlation includes uot only wrillen information, hut
also information transferred orally, visually, electronically, or by other means. Confidt:ntial
information disclosed to either party hy any subsidiary and/or agent of the other party is covered
by this Agreement. The Jureguing obligations of non-use and nondisclosure shall not apply to
any information that (a) has been disclosed in publicly available sources; (h) is, through no fault
ofthe Consultant disclosed in a publicly available source; (c) is in rightlcd possession of the
Consultant without an obligation of confidentiality; (d) is required to be disclosed by uperation uf
law; or (e) is independently developed by the Consultant without reference to infonnation
disclosed by the City.
9. CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interests and shall not have interests, direct
or indirect. which wuuld cunnict in any manner with performance of services specified under this
Agreement.
10. 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 telcfacsimile or other telegraphic
communication in the manner provided in this Section, to the follo\ving 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 Finance and Management Services
Building Maintenance Division
4
City of Santa Ana
20 Civic Center Plaza (M-II)
P.O. Rox 1988
Santa Ana, California 92702
te[efacsimile (714) 647-5421
and
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, Calilurnia 92702
telefacsimile (714) 647-6515
To Consultant:
Olympiquc Fa,adc Acccss Consulting
26212 Enterprise Court
Lake Forest, California 92630
lelefacsimile (949) 455-0798
A party may changc its addrcss by giving notice in writing to the other party. Thereafter,
any communication shall he addressed and transmitted to thc ncw addrcss. If sent by mail,
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 certilied. with postage prepaid, and
addressed as set forth above. If sent by telefaesimile, commw1ication shall be effective or deemed
to havc been givcn twcnty-four (24) hours after the time set forth on thc transmission report
issued by the transmitting facsimile machine, addressed as set forth above. For purposes of
calculating these time Ji-ames, weekends, federal, state, County or City holidays shall hc excluded.
11. 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, hetween the parties. In
the event of a contlict between the terms of this Agreement and any attachments hereto, the terms
of this Agreement shall prevail. This Agreement may not he modi tied except by written
instrument signed by the City and by an authorized represeutative of Consultant. The parties
agree that any terms or conditions of any purchase order or other instrument that arc inconsistent
with, or in addition to, the terms and conditions hereof, shall not bind or ohligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or othenvise, have been made by any party, or anyone acting all
behalf of any party which are not embodied herein.
12. ASSIGNMENT
Inasmu(;h 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 he considered null and void. Nothing in this Agreement shall
5
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,
13, TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
tem1inatiolL 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 pa)'ll1ent, the Executive Director may require Consultant to deliver
to tile 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
speciJied in the Recitals of this Agreement.
14. DlSClUMINATlON
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 kderal, state and local laws and regulations.
15. .JlJRISDlCTlON - VENUE
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 he determined and governed by the laws of the Stare of California. 130th 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.
16, PROFESSIONAL LlCENSF,S
Consultant shall, throughout the term orlhis Agreement, maintain all necessary licenses,
permits. approvals, waivers, and exemptions necessary for lhe provision of the services hereunder
and required by the laws and regulations of the United States, the State of California, lhe City of
Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and
in \vriting of its inability to obtain or maintain sllch permits, licenses, approvals, waivers, and
exemplions. Said inability shall be cause lor termination of this Agreement.
6
17. 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 Agreemenl, and shall
indemnil'y 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.
h. All Exhihits referenced herein and attached hereto shall he incorporated as i I' III Ill' 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: d
---
- '. ~~
(~i!.Jc_(<-<-'-/ ..... \
PATRICIA (HEALY- "---
Clerk oflhe Council
CITY OF SANTA ANA
~
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
J Vi
BY>}a'H4-::Y'~L <41'
La;(ra Sheedy (
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
OLYMPIQUE FA<;:ADE
ACCESS CONSULTING
T\\\)~~'M' ,'i\~:---,--,-,
FRANCISCO GUITERREZ
Executive Director ofthc
Finance and Management
Services Agency
~
TAX ID#
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OLYMPIQUE
Fa~ade Access Consulting
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November 17, 2006
Mario Ghizzi
City of Santa Ana
Building Maintenance Division
20 Civic Center Plaza, B-19
Santa Ana, CA 92701
RE:
OPOS Development Consulting Engagement
Project: Santa Ana City Hall
20 Civic Center Plaza
Santa Ana, CA 92701
Project No. ODC-039-06
Dear Mario:
Thank for you considering my firm to assist the City of Santa Ana with the above referenced Project As you know,
OL YMP/QUE is able to offer the City of Santa Ana high performance OPOS (Operating Procedures Outline Sheet)
Development Services and Project Management services for the Project's exterior building maintenance fa,ade
access code compliance, equipment and ongoing Scaffold Inspection and Testing requirements. The Operating
Procedures Outline Sheet (OPOS) will ensure owner compliance with the current Cal/OSHA regulation section
3282(p)(1)(c) that require building owners to provide their window cleaning contractors with an OPOS prior to
allowing them to use Bosuns Chair/CDA (Controlled Descent Apparatus) methods and/or counterweighted beams
as suspension points for their equipment An OPOS is also required when original equipment operating instructions
and manuals cannot be found on buildings with an existing window cleaning system (see section 3298 (a)(3-4)).
We are able to provide you with these professional services as a result of over 18 years of experience with exterior
building fal(ade access equipment Our professional affiliations and continued training wittJ the Scaffold Industry
Association (SIA) and International Window Cleaning Association (IWCAl also position OL YMPIQUE to deliver the
most up to date information on new technology and regulations for your project Additionally, our Cal/OSHA S.I.T.
Agency No. 36 status together with our intimate knowledge of the current Cal/OSHA Code governing both new
construction, existing building compliance, and renovation work allow us to efficiently develop and complete
projects free from future compliance liabilities. Costly facility operational hindrances that occur all too often as a
result of today's fast paced design and construction cycle can be eliminated through careful project management.
Access to Structural Engineering services and the latest material and equipment technologies through key vendors
carefully matched to specific projects is yet another benefit of hiring OL YMPIQUE.
Our PturesSibnillServices have been- carefully designed in stages; complete Willi milestone detiverabfes that ana' .
relative to key phases that are often required in roof-top system modernization as well as in the path to code
compliance. As a result, our clients are afforded the flexibility to be assisted with these key services over a timeline
that meets their budget These Professional Services are outlined in the following Project Initiation Proposal
complete for your review with the fees for each of the specific services.
San Diego Office
10439 RosefleStreel,SuiteC
San Diego, CA 92121
(858) 643-1644 Fax (B5B) 225-0596
Corporate Office
26232 ErllerpriseCourt
lakeFore5t, CAg,263(l..
(949)45&-0796 Fax (949)455-0798
WNW.facadeaccess.com
Los Angeles Office
Dispatch LOGiliion Only
Mailing Addless Coming Soon!
(323)604-079S Fax (323)297-2985
Contraclo.-s U"ense No. 870719
CaIIOSHAStTUc..ns... No. J6
,
r~,
Santa Ana City Hall - OPOS Development Consulting Engagement.doc
of 4
Company:
Project:
Page 2
City of Santa Ana
Santa Ana City Hall
20 Civic Center Plaza
Santa Ana, CA 92701
Project No. ODC-039-06
Attached hereto as Exhibit "A" is a complete Project Initiation Proposal setting forth the major milestone deliverables
by OL YMPIQUE in connection with the agreed Scope of Services. Certain detiverables and milestones will require
plan submittals, input and/or signoll by the City of Santa Ana and/or its Agents. the City of Santa Ana agrees that
it's Designated Project Lead or Agents will provide all plans, input and/or sign-oils on a timely basis.
If the above meets with your approval, please execute this Engagement Letter in the space provided below to
indicate the City of Santa Ana acceptance and agreement to same. Please return one fully executed original to our
offices.
Once again, thank you for selecting OL YMPIQUE to provide the services described herein. Current Cai/OSHA
regulations relating to your building are available by visiting www.dir.ca.oov/title8/sb701.html.
Sincerely,
David Ortiz
CEO
encl: Exhibit "A" Project Initiation Proposal
CUENT APPROVAL
Mario Ghizzi
City of Santa Ana
By:
Title:
Date:
OL YMPIQUE Fafi<'deAn:e,s.>' Com;u/liJ/g@eaI/OSHASITNo.36
CliElntlnitials
Santa Ana City Hail - OPOS Development Consulting Engagement.doc
of 4
Company:
Project:
Page 3
City of Santa Ana
Santa Ana City Hall
20 Civic Center Plaza
Santa Ana, CA 92701
Project No. OOC-039-06
EXHIBIT "A"
Project Inifiation Proposar
Project:
Santa Ana City Hall
20 Civic Center Plaza
Santa Ana, CA 92701
Scope of Services:
1. Initial Plan Review (Origina/ Architec/ura! Drawings Required) $0 included in item 2
An initial assessment of the project via a comprehensive physical site inspection and component
logging together with a review of the foilowing architectural drawings will be made. This assessment
wiil address project specific code compliance requirements and the identification of any fal'ade access
components required as a resuit. These may include tie-back anchors, pedestals, davits, roof guarding
and any permanent installations as required. Additionally, a review of the existing fal'ade access
components wiil be made which may include performing a duty cycle on any moving andlor mechanical
components.
a. Requirements:
i. Site access including roof and all other areas impacted by the fayade maintenance
requirements.
ii. Architecturai Drawings: Site Plan, Roof Pians, Floor Plans, Elevations
b. De1iverabtes:
I. Code Compliance Assessment Memo identifying any requiring instailations.
ii. Current Physical Condition Assessment and functionality of existing fagade access
components.
iii. Shop Drawings I Detail Sheets of required component installations_
2. 01'05 Development (CAD Drawings Required)*
$6,000.00
A comprehensive assessment of the project will be made. This assessment Will refine the project
specific code compliance and fagade access component requirements above in a comprehensive roof
level specific and elevation level specifIC Operating.Procedures OllUin",SileelIOPOS).ThisuOOJIIleIlh
will ensure owner compliance with the current Cal/OSHA regulations section 3282(p)(1)(c) that require
building owners to provide their window cleaning contractors with the OPOS prior to allowing them to
use Bosuns Chair/CDA (Controiled Descent Apparatus) methods andlor counterweighted beams as
suspension points for their equipment. The OPOS will be limited to the extent that any physical code
deficiencies identified in Step 1 will be corrected by those recommendations. These may include
retrofitting guard rails, tie-back anchors, pedestals, davits, and any permanent installations as required.
OL YMPIQUE Faf8dfJ Access Consulting@Cal/OSHASITNo.36
Client Initials
Santa Ana City Hall. OPOS Development Consulting Engagementdoc
of 4
Company:
Project:
Page 4
City of Santa Ana
Santa Ana City Haii
20 Civic Center Plaza
Santa Ana, CA 92701
Project No. ODC.039-06
The OPOS is intended to design an efficient and safe method for performing routine maintenance on
our buildings exterior fa,ade.
a, Requirements:
i. Architectural Drawings (CAD format): Site Plan, Roof Plans, Fioor Plans, Elevations,
SectiDns
II. Original Equipment Manufacturer/lnstaller ioad test certifications of all existing roof tie-back
anchors, davit pedestals and all other related suspension equipment. (These are usually
found in the original O&M package turned over by the Driginal GC)
b. Deliverables:
i. OPOS DDcument in triplicate. This will consist Df an 11X17 laminated dDcument which will
include the follDwing:
i. An iSDmetric plan view drawing of the buildings rDof with identification Df drops
zones, drop sequences, equipment configuratiDns and specific building
maintenance procedures,
ii. All provisions required to be included by Appendix A of Article 5 of the California
General Industry Safety Orders (Title 8, Appendix A of Article 5)
iii. Elevation Specific Ground Operations Access (boom lifts, extension poles etc.)
iv. CDA (Controlled Descent Apparatus) Access
v, Roof/Ground Rigged Suspended Scaffolding
vi, Site Work/Landscaping considerations
'CAD drafting seNices available if CAD mes are not available, Fees stan at $500.00
"Engineering Services, if required, are not included in this Proposal. Fees start at $800.00 if original engineered
calculations of tile projects components is not available..
3. Additional Services (as may be required>
a. Tie.Back Anchor Load Testing - (28 Anchors on Main Roan - if required
b. Engineering Calculations/Services - To verify anchor load capacity - if required,
c. CAD Design Services - To render original m,of plan and details--required.
$1,500.00
$800.00
$500.00
TOTAL
$8,800.00
OL YMPIQUE Fa~fldeAr.ces.'i Consulting@CaIIOSHASITNo.36
Clienllnilials
EXHIBIT B
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY PO!.lCY
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the lolluwing:
I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its
otliccrs, employees, agents, volunteers and representatives arc 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 afYorded by this policy is primary and is not
additional to or contrihuting with any other insurance carried by or for the henefit 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 companis limits of liability. The inclusion of any
person or organi7ation 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.
(Comph:tioIl of the following, including countersignature. is required to make this endorsement
cflective.)
Effective
Policy #
Issued to
, this endorsement form as a part of
Named Insured
Countersigned by
Authorized Representative
8
Jan 03 2007 2:~SPM
fP LASERJET 3200
1'.1
/jf:ORD. CERTIFICJ!,TE OF LIABILITY INSURAIIICE OPID~
OLYldP-3 01
PRODUCU. THIS CERTlFlCATL 18 ISSUED AS A MATTER OF INFORMAl
Argo Ilaurance (Anaheim) ONLY AND CONFE R8 NO RIGH:"s UPON THE CERTiFICATE
Lie*nse *0650964 1\'-2006-122 HOLDER. rHIS C~mFICATE DOES NOT AMENO, EXTEND I
5101 I!l. La Palmll Ave. ~ '201 Ai. TER THE COVE tAGlE AFFORD-ED BY THE POLICIES BEL
AnahAim CA 92807
Phone, 714-r'01-0668 P&x:7l4-701-0696 INSURERS AFFORD NO COVERAl;'E NA
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P~;MISES(~oo:u'l!Inc" S
_1JI..E~,~~_~E::'ll!~Lj--!_
f>E't~~_.\_~~!__~_
GENERAL AGGREGATE $
- - -----..--.------
PRJDUCTS-COMPIOf'AGO S
CCMllINEOSINOLEllMIT
IElllCddonll
,
:$
,
~-
--
-
--
,IoLLfM'IIEDAUTCS
:SCHCDUlI"D AUTOS
HIRD AUTOS
NON, OWNED .l\UTOI!I
Il(JOllY INJURY
(1"Ifperw~)
-----
BODlLYINJUAY
(P"BCdllenl)
'.
~~(jEUABlLlr'l'
-I ANY WTO
1-
r>R~O':RTYOAMA.GE
(p,rto:ddMI)
DHER THAN
A.UTOONlY:
.
FJlACC $
.
.
.
.
,..
"
i
--/1 I.,"
1'0 F )RM
AlJrOONLY. EAACCIDENT
ECE38ll'MBf'lELL.A. UAEllrTY
~ J OCC-JR [] CLAIMS MAOE
-l OEDIJCTIBL~
-l RETI:f'fflON S
WMKU$ COWeNSAT10N AND
II!MPL.OYeRS'U...m
Af\Jy PRQPRIITORl?AflTNERlEXE(;UTIVE
OffICEl<1I.EPAB:R EXCLUOED1
grJ;~~;~~~5 b.lgoo
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,
t----.
--1-'-
.
hORVll.l1 I'-'~~-
E:EACH~!?IOENT
E,l.DlSO':ASE-EAEMPLOY'E
0':.1 DISEASE - POLICY WAIT
.
.
.
] HJlB063l3
10/04/06
10'04/0'
Aggregate
Sa. Claim
$1,
$l~
000, 'll 0
OOO~':!.; 0
DESCRIPTION OF OPlAATlONS I LOCATJON81~ICLE i I i:XCLU5lI;)N' ADDeD BY II!~OOP.nI'oeNT / SPecIAL ""O\IlSIONS
~i8 io a prof.8.io~al Li&bLlity.
The Certif~cate bolder i. D~ed as additional insured.
City of Santa Ana
Mario Ghiz.i
20 Civic Canter pla::a
Sar.ta An& CA 92702
CANCELLATION
SHOULD NrfOFTHE Al.CJ\I'E DESCItIIlEt POLICIE81!lE CANCELLED BEFORt THe ~II'I llO
DATETHEREOF,TffEI61,UlNGINSURER"~LLINORA\IORrOMAll !!L lAYSMlIT!N
NOTlCe TO THE CI!:RT1I'I-::A.TE HOlDl!kN.UIlHlTOTtlE LEFT, .UT FJULURI'" 0 DOIMl II IL.L
It.POSE: NO OBLIGATlot OR LlA81llTYOl' AHYKlND Ul'OH TIE 1~;R, IT: AGENTS C
CERTIFICATE HOLDER
REPRESIiNTAT1V&S.
AUT?
r ...
ATW'~~.
;a, = ACORD CORPU~ATIO ~
9BB
ACORD 2. (2001 ~8)
Jan 03 2007 2;59PM
fP LRSERJET 3200
p.2
IMPORTANT
If tho certificate holdo, is an ADDITIONAL INSURED, the policy(ief') must be "ndorsed. A slalem.nt
on this certificate doe:; not confer rights to the certificate holder In I au of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and condlllo",' of the policy. certain policies may
require an andorsemt nt. A statement on this certlflcate does not cunfer rights to the certificate
holder In lieu of such, lndorsoment(s).
DISCLAIMER
The Certificate of InSL ranee on the reverse side of this form does r ot constitute a contract between
the issuIng Insurer{s). authorized representative or producer, and Ile certificate holder, nor does It
affirmatively or negatl rely amend, extend or alter the coverage affc,rded by thEl policies listed thereon.
ACORD 26 (2Q011\l8)
BROKER COPY
SG
STATE
COMPENSATION
INSUPtANCE!
FUND
P.o. BOX 420807, SAN FRANCISCO,CA 94142-0B07
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
N-2.001D-1'l.'Z.
GROUP: 000496
POLICY NUMBER: 0004715-2005
CERTIFICATE ID. 133
CERTIFICATE EXPIRES: 01-01-2008
01-01-2007/01-01-2008
ISSUE DATE: 12-22-2006
CITY OF SANTA ANA
MARID GHIZZI
20 CIVIC CENTER PLZ
SANTA ANA CA 92701-4058
SG
Thi;. IS to certify that we have issued a valid Workers' CompensGtion ins.urtlnce policy in iI form approved by tns
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon30 days advance wriller! Jlotice to the employ@.r
We will also give you 30days advllnce notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy OInd does nol i'lmend, extend or alter the coverage afforded
b'}i the policy listed, herein. Notwithstanding any requirement. term 01 condition of any contract or other document
With respect to which this certlflCi'lle of insurance may be issued or to which It may pertain, the Insurance
afforded by the pOlicy described herein is subject to all the terms, exclusions, and conditions, of such policy.
THORIZED REPRESENT A TI
~
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 P~R OCCURRENCE.
ENDORSEMENT #1600 - DAVID ORTIZ P,S,T - EXCLUDED.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2007 IS
------ATTACHED TO AND FORMS A PART OF THIS POLICY.
EMPLOYER
MESQUEMAI, INC DBA: OLYMPIQUE
CARE
26232 ENTERPRISE CT
LAKE FOREST CA S2630
EXPERT BUILDING
/\=
._;- '-~_~ /,',; TO FORM
~~tt
; h.',~,':, ~,'t"~;icJ,CY
PRINTED
[B13,NBj
12-22-2006
(REV.2-051
}2/27/2000
1B: 2<-
805212, 891
THOLLAND INS 'Nes
P~GE
01 Ie:::
OP ICAP 1--:;;;::: ::;--
MEsQU-l 1~12/.::7/0L_
THIS CERTIFICATE IS ISSUED AS A. MATTER OF INFORMATIIIN
ONLY AND CONFER~ NO RIGH'tS UPON THE CEFlTlFICATi
HOLDER. THIS CERTI FICA TE DOE2; NOT AMEND, EXTEND 011
ALTER 1HE eOVI::IU.]E AFFORDED BY THE: POLICIES r.ELON.
ACORD.
CERTIFICATE OF LIABILITY INSURANCE
~uo."
U"it:ed Agenc.ies, tno;:, (A}
eA Lic~n$~ *0252636
638 LinderQ Canyo~ Rd.,Sbe
Oak Park CA ~1~17
pnone: 805-212-4a90
30.
Fax:
805-212 -4891
INSURERS AFFORDlNC GOVERAGE
I NAIC~_~
,""u...,
Ms3qu_-l.i, Ir.ae, dba: 01ympi'J.lQ
Exp!:U"t :~:ildinl] r.RrP,
01~iq.l.e l!'aO<\de Acce85
COl1sultJ.'t'9
f;xper't. 3uildinq Ca...
261~2 E1terpriBEl CQU~t
ULke FO~8't CIl. 92l;:1JO
! 'NSl.i~~'"
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t===
COVERAGES
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MY "'PUI~,~~m. lU'l00.'Xl"'rITtO' C> .......cQorrFlACT OFi.OTH:"DOc~~a" '''''T"''~F'K' TC WH"'HT>l:.C~ICFC',TEW.Y e\-.'~~U~ O~
'..... ".,.,," 'ME IN:;U''''''~. .....",.IJ"" ~nft F'::UCI~ D~% GO> ~E~EIN'~, ,J/U"'" TC "'-'- T.... Tffiu~. EJ<ClJ8lJ~ ~'<Il ~J"V"rlQ",! O. 5ClCo1
~U A('GFJ::c.'"",- .1""J1;~",,"" ,~""Y"~"~~~RF'J"""~Y"""C Cl"J."'3
rrfEQ.'""U~"'C~
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I DeaO )13912
,
09/27/06
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ru....l....'""'rr~
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09/27.07 I ~'lEwae,[~o""J."",1
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, L~~__
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~ 2. ,000 . OO'~
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~~~~,OOO,OOQ =
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-.-----
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El<r.~.."''"............'.1AIIIutY t---
t ~~" ~ OV'.'"~, I ",0' '004197-01
i '- ::::~
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09/21/06
, ...~OO( ,000 _
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r-
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DM<;"'''''~H (;f OF'EfI,O'rn<~ I cc~-,""s IV."'OI." r ""ccU"ClN~.&L\llI;.D 9.V ~"" R-.--r /...(CIA' """""'''''''
ThlP. city of Sant... AJ),A, :iota eff.i.cers, <DlIi'~oy"$, agentl!l Ilnd xapil"G.~~...ti~.$
'i.~'" named ad addi.t;i.Q~..l :i1'll!lurea W1.tn cespec~ t.o the general liab;l,la.'ty ~
u..e aetooc:had for:4 CG 20 33 0-' OIJ.
~lO daYH noLic8 ~f Q~~c~lla~ion shall be 9iv~n {or non-payment of pr~~.
l'{.....
-
I'ORM-~
,1.\
CERtIFICATE HOLD!R
C.AN~ELLATION
C!.TYSA3
.,..",",--"","o~m~....o" o~.",,",,' "",-",a ",,_.,c,t>@"""ot;TI'~<'Oll>).lION
""'".....~5IlF.l_EUl8UI!IJI'"""IIe""U...."""'Io'tlR..._,~
30'" ""I'$~"",",,"
~lICIOm_c.EFI11fIC.T&"OCll5R;"_lOT""LVT,'U''''''cUOll!fllOO80~HlLL ~'JOOCi:
C3.ty ",1: 5a.nt. ~Clo
2:\"1 r:iv__c CenW:I" Pla.~.
Santa hna CA 92702
_fCI011"a,.,TIO~()j\lAAllIJ"'t~"'V""'CU"""'Hn.$IIflVI!.l'_N~llA
1'1JD. Holland
7<:~~i'RL~~; '..
....._"'.......~~
AU~~'l~."":''''''AlI..
ACORD 25 (2001108)
12/27/200" 10:2~
8052121891
THOLLAND INS 3VCS
PAGE 02/e,
COMNIERClAL GENl'RAL UMlIU'I'Y
CG 20 33 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE FlEAD IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, L.ESSEES OR
CONTRACTORS - AUTOMATIC 5T JI.TUS WHEN
REQUIRED IN CC)NSTRUCTION AGREEMENT WITH YOU
This endersemelll modifies inoul< nee provided under the fol\QWinlf
COMMERCIAL GENERAL LIP BIUTY COVERAGE PART
A. section II - Who Is An Ins .,.d i5 amended 10
inolude as an additlOl1al insur!d en)' person. or ()r-
ganization for whom you 8'" I erforming operations
wnan you and suen pelSOn "organlmtion have
a9reOO in WItting in a conlra Jt or agreemelll thaI
suon person or organization 118 added as an addl-
tional insured on your poticy Such pBl'8On or or~
ganization is an additional i lsur~ only with. re-
spect to liability for "bod Iy injury". 'ploperIV
damage' or "perional OIl'I advertising injury"
caused, In whoie Of in part, tr ';
1. your acts or omissions: 01
2. Tn. acts or omiasions 01 those 801ing on your
behaff;
in the pelformance of your ( ngOlng operatio,," lor
the additional insured.
A petson's or organization'S ;latus aO an additional
insured under this endorse. nenl ends when your
operations for thaI addIIiOl",1 insured ere 00lT>-
pIoted.
':'. l
I;") t '()It M
-/%
~ ( J:c. _____.
"
B. WIth respect to llIe insurance afforded 10 th..e
additional insuAds. \he M\OWing a<I<Ii1Ional .xelu-
sions apply:
ThIs insurance (1oeG not apply 10:
1. 'Bodily inju~r. '\lroperIV damage" or "peraonal
and atlvertis;ng injury" .lising 0\1\ of the render-
Ing of. or lh., fallura \Q render. any p<<>tes9ionai
orchi\ecl\lral, engin....ling or ouNeying ..r.
\llces. includ log:
a. The prepertng. apprOlliog. or faiting 10 pre
P"'" or approve, mape. .hop drawings
opinions repoo1B. SUNays. lieId orde",
ch8nge orders or draw;ngs and specifies-.
liOns; or
b. SUl"'lVit<>ry. inepeolion. architeclural O'
enginee ing .oIivities.
2. "Bodily injtJ 'Y" or 'plOperIV damage' oec:urril'll
after.
a. All WOIk. including malTfrials. parts ,r
equipm,nl furnished in connectlon wIl,
auon w,>r1<, on \he project (other than so'"
vice. !falntsnance or ",peiO;) \0 be 1'8-
formed by or on behl!l\f of the I!Iddrtion~1 il:-
oured(sl at lhe location of \lie cove" a
operlrtinns has been completed: or
b. ~ P"rtIon of ''yout wort" out of which tt 8
injury or damage alises has been pullo Is
inlended uae l1y any pe!$On or organizaticn
gthwf tt~n another contractor or 8ubcontr8 >-
tor en, aged In performing oporatlons for ·
prinal'll as 8 pert 01 the aame project.
CG 20 33 07 Q4
0150 Properties. Inc.. 2004
Page 1 cf 1
]
7-",
..""
-/f
( . r~, I
,. .1 :2)
CHECKLIST FOR PROCESSING AGREEMENTS AND AMENDMENTS
,
, '
TO: CLERK OF THE COUNCIL OFFICE
r
FROM: DEPT: t1 ti-A-I'tct
CONTACT PERSON: M. G,l-ll Z2..f
MAIL STOP:
Mlt
SOo'/?
EXT.:
THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY:
AGREEMENT NUMBER (il amendment): A I N
AMENDMENT NUMBER (il applicable):
COUNCIL APPROVAL DATE:
AMOUNT: 0 OVER $10,000 ~ UNDER $10,000
NAME OF CONSULTANT: ()L'f t''If'I~vf mC;Ao:l't: AC&0?s CoNSJt-Ttt.{'l
TERM OF AGREEMENT: EFFECTIVE DATE: ~ 1<' lc't>b TERMINATION DATE: bE,e-' z tDo:J-
o 1ST
o 2ND
o 3RD
o
INSURANCE REQUIRED: 0 NO
~ YES II yes, f ATTACHED 0 IN PROGRESS
o AUTO )if CGL (Commercial General Liability)
p:r. PROFESSIONAL LIABILITY ~ WORKERS COMPENSATION
(INS. APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC)
SIGNATURES REQUIRED:
o VENDOR
o CITY ATTORNEY
o
o
AGENCY (UNDER $10,000)
OTHER
COMMENTS:
OFFICE USE ONLY:
PROCESS
o
DO NOT PROCESS
o MISSING SIGNATURES
D NEEDS COUNCIL APPROVAL
D OTHER
ADDITIONAL REMARKS: /1/, rl ()06 - /'?.<:.