HomeMy WebLinkAboutFIELDMAN, ROLAPP & ASSOCIATES�zoo7
AGREEMENT TERMINATION,
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Please complete this form when the attached agreement is no longer in effect.
Return form to the Deputy Clerk of the Council (M-30). Call 647-5237 if you fiav:ariy Clue t%a�rrs _ `
The agreement
No. // 02 QQ Q S9 was completed on
and final payment has been made.
Department:
Date:
/V
City of Santa Ana
Revised 08-28-06 Clerk of the Council
a lad
INSURANCEON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
CLERK —OF
GATE: 6-//- o7
b. 1: ms (Y) (F. Cwlletrez)
PROFESSIONAL SERVICES AGREEMENT
FOR FINANCIAL ADVISOR
N-2007-059
This agreement has been entered into this /G day of �, a2� by and between the
City of Santa Ana, California (the "City") and Fieldman, Rolapp & Associates, (herein, the
"Consultant").
WHEREAS, the City desires independent financial advisory services to be performed in
connection with assist in reviewing financing mechanisms to provide funding for road
improvements (herein, the "Project"); and
WHEREAS, the City desires to retain the professional and technical services of the Consultant
for the purpose of financial planning, (herein, the "Services").
WHEREAS, the Consultant is well qualified to provide professional financial advice to public
entities such as the City;
NOW, THEREFORE, in consideration of the above recitals and the mutual covenants and
conditions hereinafter set forth, it is agreed as follows:
Section 1 Financial Advisory Services.
As directed by the City, Consultant will provide services in connection with the
assist in reviewing financing mechanisms to provide funding for road
improvements as such Services are fully described in Exhibit A attached to this
Agreement. Consultant is engaged in an expert financial advisory capacity to the
City only. It is expressly understood that the Services rendered hereunder are
rendered solely to the City of Santa Ana. Consultant does not undertake any
responsibility to review disclosure documents on behalf of owners or beneficial
owners of bonds or debt which may arise from the Consultant's work hereunder.
Section 2 Additional Services.
Services performed for the City by Consultant that are not otherwise specifically
identified in Exhibit A to this Agreement, shall be additional services.
Additional services include, but are not limited to, the following:
2.01 Assisting the City in obtaining enabling legislation or conducting referendum
elections.
2.02 Extraordinary services and extensive computer analysis in the structuring or
planning of any debt issue or financing program.
2.03 The repeat of any element of a service described in Exhibit A to this Agreement
which is made necessary through no fault of Consultant.
2.04 Financial management services, including development of financial policies,
capital improvement plans, economic development planning, credit analysis or
review and such other services that are not ordinarily considered within the scope
of services described in Exhibit A to this Agreement.
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Page 1
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2.05 Services rendered in connection with any undertaking of the City relating to a
continuing disclosure agreement entered into in order to comply with Securities
and Exchange Commission Rule 15c2-12 or other similar rules.
2.06 Services rendered to the City in connection with calculations or determination of
any arbitrage rebate liability to the United States of America arising from
investment activities associated with debt issued to fund the Project.
Section 3 Compensation.
3.01 For Consultant's performance of Services as described in Section 1 of this
Agreement the Consultant's compensation will be as provided in Part 1 of Exhibit
B attached to this Agreement, plus Consultant's expenses incurred in rendering
such Services. Consultant's expenses may include, but are not limited to travel,
telephone/conference calls, postage, courier, database access services, and
printing.
3.02 For Consultant's performance of additional services as described in Section 2 of
this Agreement, the Consultant's compensation will be as provided in Part 2 of
Exhibit B attached to this agreement, plus Consultant's expenses incurred in
rendering such services. Consultant's expenses may include, but are not limited
to travel, telephone/conference calls, postage, courier, database access services
and printing.
3.03 Payment for Consultant's Services rendered pursuant to Section 1 of this
Agreement shall be as provided for in Exhibit B to this Agreement, unless
specified to the contrary elsewhere in this Agreement. The Consultant may
submit monthly invoices for payment for services provided pursuant to Section 2
of this Agreement unless an alternate date or dates have been specifically agreed
to in writing. Unless otherwise specified, payment of Consultant's compensation
and expenses is due thirty (30) days after submission of Consultant's invoice for
services.
3.04 In the event the Services of the Consultant are abandoned prior to completion of
Consultant's work, Consultant shall be compensated for Services performed to
the point of abandonment as if such Services were an additional service pursuant
to Section 2 of this Agreement, subject to a maximum fee of of time and
expense's billed to date. An act of abandonment shall be deemed to have
occurred when no action has been taken by the City relative to the services of the
Consultant for a period of three (3) months from the date of the initial
performance of a service, or there has been a written notification to the
Consultant of an abandonment of the Project by the City.
3.05 Consultant fees set forth in this Agreement and Exhibits are guaranteed by
Consultant for a period of twelve (12) months from the date of this Agreement.
Section 4 Personnel.
Consultant has, or will secure, all personnel required to perform the services
under this Agreement. Consultant shall make available other qualified personnel
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Page 2
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of the firm as may be required to complete Consultant's services. The City has
the right to approve or disapprove any proposed changes in Consultant's staff
providing service to the City. The City and Consultant agree that such personnel
are employees only of Consultant and shall not be considered to be employees of
the City in any way whatsoever.
Section 5 Term of Agreement.
This Agreement shall continue in full force and effect for a period of 24 months
from the date hereof unless terminated by either party by not less than thirty (30)
days written notice to the other party except that the Agreement shall continue in
full force and effect until completion of Consultant's services or until an
abandonment shall have occurred as described in Section 3.04 hereof. This
Agreement may be extended from time to time as agreed by the City and the
Consultant.
Section 6 Modification.
This Agreement contains the entire agreement of the parties. It may be amended
in whole or in part from time to time by mutual consent of the parties. This shall
not prohibit the City and Consultant from entering into separate agreements for
other services.
Section 7 Assignment.
The rights and obligations of the City under this Agreement shall inure to the
benefit of and shall be binding upon the successors and assigns of the City. This
agreement may not be assigned by the Consultant without the consent of the City
except for compensation due Consultant.
Section 8 Disclosure.
Consultant does not assume the responsibilities of the City, nor the
responsibilities of the other professionals and vendors representing the City, in
the provision of services and the preparation of the financing documents,
including initial and secondary market disclosure, for financings undertaken by
the City. Information obtained by Consultant and included in any disclosure
documents is, by reason of experience, believed to be accurate; however, such
information is not guaranteed by Consultant.
Section 9 Confidentiality.
The Consultant agrees that all financial, statistical, personal, technical and other
data and information designated by the City as confidential shall be protected by
the Consultant from unauthorized use or disclosure.
Section 10 Indemnification.
The City and Consultant shall each indemnify and hold harmless the other from
and against any and all losses, claims, damages, expenses, including legal fees
for defense, or liabilities, collectively, damages, to which either may be subjected
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Page 3
PRA097930 v30.&,/Projecttt 07142
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by reason of the other's acts, errors or omissions, except however, neither will
indemnify the other from or against damages by reason of changed events and
conditions beyond the control of either.
Section 11 Insurance.
11.01 Consultant shall maintain workers' compensation and employer's liability
insurance during the term of this Agreement.
11.02 Consultant, at its own expense, shall obtain and maintain insurance at all times
during the prosecution of this contract. Such insurance must be written with a
Best Guide "A" -rated or higher insurance carrier admitted to write insurance in
the state where the work is located.
11.03 Certificates of insurance naming the City as an additional insured shall be
submitted to the City evidencing the required coverages, limits and locations of
operations to which the insurance applies, and the policies of insurance shall
contain a 30 -day notice of cancellation or non -renewal.
11.04 Insurance coverages shall not be less than the following:
A. Workers' Compensation
1. State worker's compensation statutory benefits
2. Employer's Liability -policy limits of not less than $1,000,000.
B. Comprehensive General Liability coverage with policy limits of not less than
$1,000,000 combined single limit for bodily injury and property damage and
including coverage for the following:
1. Premises operations
2. Contractual liability
3. Products
4. Completed operation
C. Errors and omissions with policy limits of $standard amount.
Section 12 Permits/Licenses.
The Consultant shall obtain any permits or licenses, as may be required for it to
complete the services required under this Agreement.
Section 13 Binding Effect.
13.01 A waiver or indulgence by the City of a breach of any provision of this
Agreement by the Consultant shall not operate or be construed as a waiver of any
subsequent breach by the Consultant.
13.02 All agreements and covenants contained herein are severable and in the event any
of them shall be held to be invalid by any competent court, this Agreement shall
CITY OF SANTA ANAIFIELDMAN, ROLAPP & ASSOCIATES Page 4
FRA097910 v3_0.d, c/Project# m142
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be interpreted as if such invalid agreements or covenants were not contained
herein, and the remaining provisions of this Agreement shall not be affected by
such determination and shall remain in full force and effect. This Agreement
shall not fail because any part or any clause hereof shall be held indefinite or
invalid.
13.03 Each parry hereto represents and warrants that this Agreement has been duly
authorized and executed by it and constitutes its valid and binding agreement,
and that any governmental approvals necessary for the performance of this
Agreement have been obtained.
13.04 The validity, interpretation and construction of this Agreement and of each part
hereof shall be governed by the laws of the State of California. Venue for any
lawsuit concerning this agreement is Orange County, California.
IN WITNESS Whereof, the parties have duly executed this Agreement as of the day and year
first above set forth.
CITY OF SVT,, ANA
By; cZz / •U�E�
Date:
Fieldman, Rolapp & Associates
19900 MacArthur Boulevard, Suite 1100
Irvine, CA 92612
By: Za
D . MX "rjov-7
Clerk of the Council
AI'PRO'/1.J i;:ti TO FORM
ilior:ey
Title: T(,N4-` r
RECOMMENDED FOR APPROVAL:
'tS�\Ct\j�o C �� 1� .d�
FraR;LSCO�Utlerrez
Executive Director
Finance & Management Services Agency
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES
FR1097930 v3_OAoc/Project# 07142
Ree, Daze: 5-9-07/JVP/Ic
Page 5
EXHIBIT A
TO
PROFESSIONAL SERVICES AGREEMENT FOR FINANCIAL ADVISOR
BY AND BETWEEN
THE CITY OF SANTA ANA
AND
FIELDMAN, ROLAPP & ASSOCIATES
Scope of Services
The Consultant shall perform all the duties and services specifically set forth herein and shall
provide such other services as it deems necessary or advisable, or are reasonable and necessary to
accomplish the intent of this Agreement in a manner consistent with the standards and practice of
professional financial advisors prevailing at the time such services are rendered to the City.
The City may, with the concurrence of Consultant, expand this Agreement to include any
additional services not specifically identified within the terms of this Agreement. Any additional
services may be described in an addendum to this Exhibit A and are subject to fees described in
Exhibit B to this Agreement.
Specifically, we expect to
✓ Assist the City in determining the appropriate revenue sources to pay for long-tenn
infrastructure improvements.
✓ Identify the timing of those revenue sources in order to evaluate if debt financing is
appropriate, or required.
✓ If debt is required, determine and recommend the "best' form of debt to finance these
improvements that are required before the funding sources are sufficient to pay them in
cash.
✓ Measure the costs of a borrowing program, as required.
✓ Assist the City and their consultant in the determination of annual borrowing amount, the
number of projects that can be supported by City staff and the duration of time required
to complete the selected projects.
✓ Measure and analyze the annual costs of the funding and financing program to the
relevant stakeholders.
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 1
05-14-2007 15:33 From-Fieldman Rolapp 948 474 8773 T-362 P 002/002 F-902
EXHIBIT B
TO
FINANCIAL ADVISORY SERVICES AGREEMENT
BY AND BETWEEN
CITY OF SANTA ANA AND FIELDMAN, ROLAPP & ASSOCIATES
Fees and Expenses
Patti: Fee for Services
Financial Advisory Services performed pursuant to Section l and Section 2 of this Agreement,
and as more fully described in the Scope of Services set forth in Exhibit A, will be billed at the
then current hourly rates. The total compensation for Financial Advisory Services shall not
exceed $25,000. The table below reflects the rates in effect as of the date of execution of this
Agreement.
Personnel
Hourly Rate
Executive Officers ............................................................
$300.00
Principals..........................................................................
$290.00
Senior Vice President.......................................................
$275.00
Vice Presidents.................................................................
$225.00
Assistant Vice President ...................................................
$195.00
Senior Associate...............................................................
$150.00
Associate...........................................................................
$125.00
Analyst. ...................................................
........................... $85.00
Administrative Assistants ...................................................
$65.00
Clerical................................................................................
$35.00
Expenses
Expenses will be billed for separately and will cover, among other things, travel, lodging,
subsistence, overnight courier, computer, and fax transmission charges. Advances made on
behalf of the City for costs of preparing, printing, or distributing disclosure materials or related
matter whether by postal services or electronic means, may also be billed through to the City
upon prior authorization. Additionally, a surcharge of 6% of the net fee amount is added to
verifiable out-of-pocket costs for recovery of costs such as telephone, postage, document
reproduction and the like.
Limiting Terms and Conditions
The above fee is based on completion of work orders within six months of the City's
authorization to proceed, and assumes that the City will provide all necessary information in a
timely manner.
The fee shown above in Part 1 presumes attendance at up to 10 meetingsin the City's offices or
such other location within a 25 -mile radius of the City place of business as the City may
designate. Preparation for, and attendance at City Counsel meetings on any basis other than "by
appointment" may be charged at our normal hourly rates as shown in Part 2, above.
Abandonment
If, once commenced, the services of the Consultant are terminated prior to completion of our final
report for any reason, we are to be reimbursed for professional services and direct expenses
incurred up to the time we receive notification of such termination at the standard hourly rates
shown in Part 2, subject to a minimum charge of time and expense's billed to date.
CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit B, Page 1
i05-18-2507 10:04 From—Fieldman Rolapp 049 474 8773 T-372 P 002/003 F-925
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THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
Wood -Gutmann & Bogar:111113
910 S. El Camino Real, Ste B.
THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE
COVERAGE AFFORDED SY THE POLICIES BELOW.
INSL UVERAGE
INSURER Indian Harbor Ins. Company
San Clemente CA 92672
(949) 542-7800
www.integHtyint.com
A
INSURER
'2 2-359
A-!
INSURER
ASUred
Fieldman, Rolapp & Associates
C
INSURER
19900 MacArthur Blvd, 01100
Irvine CA 92612
D
INSURER
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POLICIES i FUJI I HE FULIE77FI713510M I Ell.
THE OF INSURANCE LISTENTECON'RAV939EWTS—SUIED TO THE INSURED NAME
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 CLAIMS.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY
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DATE
POLICY
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QAj7YY
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AUTOMOBILE LIABILITY
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ALL OWNED AUTOS
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IPROPERTY
IPM occidono $
GARAGE LIABILITY
85L""'EA ACCIDENT 5
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FL DISEASE- EA EMPLOYEE $
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1121M Dad, $160,060
NSII_O� I 0Nh/VLN1UUWLAL[JJbKJNb AWMW 11T gmMOPMEM,SPECIAL PROVISIONS
EVIDENCE OF ERRORS & OMISSIONS RF_NEWAI_
SHOULD ANCANCELY OF THE ABOVE PUCRIBED POLICIES BE CANCELLED BEFORE THE
City of Santa Ana
Attn: Clark Of the Court
EXPaRA71ON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
—DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHAM IMPOSE NO OBLIGATION
OR LIABILITY OF ANY VINO UPON THE COMPANY, ITS AGENTS OR REPRU-
20 Civic Center Plaza (M-30)
Santa Ana CA 92702-1988
SIEWATIVES. 10 Drys for Nan-Paymwvt of Premium
AUTHORIZED
REPRESENTATIVE
Dan Gorman
RD 25-S;
ej;1CCIRD CDR
05-18-2)807 10:04 From-Fieldman Rolapp 949 474 8773 T-372 P 003/003 F-925
IIM10l:11IF:1LltI
If the certificate holder is an ADDITIONAL INSURED, the polity0as) must be endorsed. A statement
on this carti8ette does not Confer rights to the certificate holder in lieu of such endorsamant(s).
It SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
requlre an endorsement. A statement on this certificate does not Confer rights to the certificate
holder In lieu of such endor iement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute s contract between
the issuing InsurisKs), authorized representative or producer, and the cardficato holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001108) created atw .eCertsDNLINE.com
To: City of Santa Ana From: Blanca Roque 5-18-01 2:59pm p, 2 of 1
ACORN
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THIS CERTIFICATE IS AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
Wood -Gutmann & Boq art/IIIB
910 S. EI Camino Real, Ste B.
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
San Clemente CA 92672
INSURER Hartford Casualty Insurance Company
(949) 542-7800
www.integrityint.com
INSURER Oak River Insurance Company
4_200'5-223
(� �p
Insured
INSURER
Feldman, Rolapp & Associates
INSURER
19900 MacArthur Blvd, #1100
Irvine CA 92612
INSURER
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THE POLICIES F INSURA CE ISTE BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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 CLAIMS.
POLICY
POLICY
NSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
DATE
EXPIRATION
DATE
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIAB
CLAIMS MADE MOCGUR
72SBAAF9892
4/1/2007
4/1/2008
EACH OCCURRENCE $
DRE DAMAGE one fire $
MED EXP one arson $
PERSONAL & AOV INJURY $
GENERAL AGGREGATE $
GEN'L AGG "Mfr APPLIES PER
PROOUCTS-COMPIOP AGG $ 2,000,000
$
POLICY RMECT LOC
AUTOMOBILE LIABILITY
A
ANY AUTO
72UECTQ4293
4/1/2007
4/1/2008
COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per person) S
BODILY INJURY
HIRED AUTOS
NON -OWNED AU T)S
(Per aecltlent) $
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(Per eccltlera) $
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AUTO MY -EA ACCIDENT $
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OCCUR F1 CLAIMS MADE
72SBAAF9892
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4/1/2008
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AGGREGATE $
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$
$
REFENTION $
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EMPLOYERS'' LIgg�NSYTION&
2200050519071
4/1/207
4/1/208
STATUTORY LIMIT TH \\e'I, 1--
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EL DISEASE - EA EMPLOYEE $1000 00
EL DISEASE - POLICY "MIT $
DIERIPTI N OF OPERAI N L ATI VEHILE EX LU I N ADDEDBYEND EM Ni PE IALPR VI y T =
City of Santa Ana is named as additional insured per attached SS 00 08 04 05
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Santa Ana
Attn: City Clerk
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30_� DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE-
20 Civic Center Plaza
SENTATWES. 10 Days for Non -Payment ofPremlum
AUTHORIZED
REPRESENTATIVE lid.
Dan Gorman
Santa Ana CA 92702
AtitC�S'��}FJ 7777777_777;vv
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To: City of Santa Ana From: Blanca Roque 5-18-07 2:59pm p. 3 of 7
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).
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.
A1`PR0'v,) F.:i "YO FORM
ACORD 25 (2001108) created at www.e CertsONLINE.com
To: City of Santa Ana From: Blanca Roque 5-18-07 2:59pm p. 4 of 7
(6) When You Are Added As An
Additional Insured To Other
Insurance
That is other insurance available to
you covering liability for damages
arising out of the premises or
operations, or products and completed
operations, for which you have been
added as an additional insured by that
insurance; or
(7) When You Add Others As An
Additional Insured To This
Insurance
That is other insurance available to an
additional insured.
However, the following provisions
apply to other insurance available to
any person or organization who is an
additional insured under this Coverage
Part:
(a) Primary Insurance When
Required By Contract
This insurance is primary if you
have agreed in a written contract,
written agreement or permit that
this insurance be primary. If other
insurance is also primary, we will
share with all that other insurance
by the method described in c.
below.
(b} Primary And Non -Contributory
To Other Insurance When
Required By Contract
If you have agreed in a written
contract, written agreement or
permit that this insurance is
primary and noncontributory with
the additional Insured's own
insurance, this insurance is
primary and we will not seek
contribution from that other
insurance.
Paragraphs (a) and (b) do not apply to
other insurance to which the additional
insured has been added as an
additional insured.
When this insurance is excess, we will
have no duty under this Coverage Part to
defend the insured against any "suit" if any
other insurer has a duty to defend the
insured against that "suit". If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured's
rights against all those other insurersIT2C';iL
BUSINESS LIABILITY COVERAGE FORM
When this insurance is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self-
insured amounts under all that other
insurance.
We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess Insurance provision and was not
bought specifically to apply in excess of the
Limits of Insurance shown in the
Declarations of this Coverage Part.
c. Method Of Sharing
If all the other insurance permits
contribution by equal shares, we will follow
this method also. Under this approach,
each insurer contributes equal amounts
until it has paid its applicable limit of
insurance or none of the loss remains,
whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will
contribute by limits. Under this method, each
insurer's share is based on the ratio of its
applicable limit of insurance to the total
applicable limits of insurance of all insurers.
8. Transfer Of Rights Of Recovery Against
Others To Us
a. Transfer Of Rights Of Recovery
If the insured has rights to recover all or
part of any payment, including
Supplementary Payments, we have made
under this Coverage Part, those rights are
transferred to us. The insured must do
nothing after loss to impair them. At our
request, the insured will bring "suit" or
transfer those rights to us and help us
enforce them. This condition does not
apply to Medical Expenses Coverage.
b. Waiver Of Rights Of Recovery (Waiver
Of Subrogation)
If the insured has waived any rights of
recovery against any person or
organization for all or part of any payment,
including Supplementary Payments, we
have made under this Coverage Part, we
also waive that right, provided the insured
waived their rights of recovery against
such person or organization in a contract,
AS t OaFOjtiW or permit that was executed
prior to the injury or damage.
3111
Form SS 00 08 04 05 - Page 17 of 24
To: City of Santa Ana From: Blanca Roque 5-18-07 2:59pm p, 5 of 7
BUSINESS LIABILITY COVERAGE FORM
F. OPTIONAL ADDITIONAL INSURED
COVERAGES
If listed or shown as applicable in the Declarations,
one or more of the following Optional Additional
Insured Coverages also apply. When any of these
Optional Additional Insured Coverages apply,
Paragraph 6. (Additional Insureds When Required
by Written Contract, Written Agreement or Permit)
of Section C., Who Is An Insured, does not apply
to the person or organization shown in the
Declarations. These coverages are subject to the
terms and conditions applicable to Business
Liability Coverage in this policy, except as
provided below:
1. Additional Insured - Designated Person Or
Organization
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations, but only with respect to liability
for "bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions or
the acts or omissions of those acting on your
behalf:
a. In the performance of your ongoing
operations; or
b. In connection with your premises owned
by or rented to you.
2. Additional Insured - Managers Or Lessors
Of Premises
a. WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Designated Person Or Organization; but only
with respect to liability arising out of the
ownership, maintenance or use of that part of
the premises leased to you and shown in the
Declarations.
In. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) Any 'occurrence" which takes place
after you cease to be a tenant in that
premises; or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
AFPROVL.: /..7
Page 18 of 24
3. Additional Insured - Grantor OF Franchise
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Grantor Of Franchise, but only with respect to
their liability as grantor of franchise to you.
4. Additional Insured - Lessor Of Leased
Equipment
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Lessor of Leased Equipment,
but only with respect to liability for "bodily
injury", "property damage' or "personal
and advertising injury" caused, in whole or
in part, by your maintenance, operation or
use of equipment leased to you by such
person(s) or organization(s).
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to any "occurrence" which
takes place after you cease to lease that
equipment.
5. Additional Insured - Owners Or Other
Interests From Whom Land Has Been
Leased
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organization(s)
shown in the Declarations as an Additional
Insured — Owners Or Other Interests From
Whom Land Has Been Leased, but only
with respect to liability arising out of the
ownership, maintenance or use of that part
of the land leased to you and shown in the
Declarations.
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
(1) Any "occurrence" that takes place
after you cease to lease that land; or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
6. Additional Insured - State Or Political
Subdivision — Permits
a. WHO SAN INSURED under Section C. is
TO t� hOf2lYIamended to include as an additional
insured the state or political subdivision
T s
Form SS 00 08 04 05
To: City of Santa Ana From: Blanca Roque 5-18-07 2:59pm p. 6 of 7
BUSINESS LIABILITY COVERAGE FORM
Insured — State Or Political Subdivision -
(e) Any failure to make such
Permits, but only with respect to
inspections, adjustments, tests or
operations performed by you or on your
servicing as the vendor has agreed
behalf for which the state or political
to make or normally undertakes to
subdivision has issued a permit.
make in the usual course of
b. With respect to the insurance afforded to
business, in connection with the
these additional insureds, the following
distribution or sale of the products;
additional exclusions apply:
(f) Demonstration, installation,
This insurance does not apply to:
servicing or repair operations,
(1) "Bodily injury", "property damage" or
except such operations performed
" and advertising injury"
at the vendor's premises inpersonal
arising out of operations performed for
connection with the sale of the
the state or municipality; or
product;
(2) "Bodily injury" or "property damage"
(g) Products which, after distribution
included in the "product -completed
or sale by you, have been labeled
operations" hazard.
or relabeled or used as a
container, part or ingredient of any
7. Additional Insured—Vendors
other thing or substance by or for
a. WHO IS AN INSURED under Section C. is
the vendor; or
amended to include as an additional
(h) "Bodily injury" or "property
insured the person(s) or organization(s)
damage" arising out of the sole
(referred to below as vendor) shown in the
negligence of the vendor for its
Declarations as an Additional Insured -
own acts or omissions or those of
Vendor, but only with respect to "bodily
its employees or anyone else
injury" or "property damage" arising out of
acting on its behalf However, this
"your products" which are distributed or
exclusion does not apply to:
sold in the regular course of the vendor's
(I) The exceptions contained in
business and only if this Coverage Part
"bodily
Subparagraphs {d) or {f); or
provides coverage for injury" or
"property damage" included within the
(i i) Such inspections,
"products -completed operations hazard".
adjustments, tests or servicing
b. The insurance afforded to the vendor is
as the vendor has agreed to
subject to the following additional exclusions:
make or normally undertakesto
make in the usual course of
(1) This insurance does not apply to:
business, in connection with
(a) "Bodily injury" or "property
the distribution or sale of the
damage" for which the vendor Is
products.
obligated to pay damages by
(2) This insurance does not apply to any
reason of the assumption of
insured person or organization from
liability in a contract or agreement.
whom you have acquired such
This exclusion does not apply to
products, or any ingredient, part or
liability for damages that the
container, entering into,
vendor would have in the absence
accompanying or containing such
of the contract or agreement;
products.
(b) Any express warranty
unauthorized by you;
(c) Any physical or chemical change
in the product made intentionally
by the vendor;
(d) Repackaging, unless unpacked
solely for the purpose of inspection,
demonstration, testing, or the
substitution of parts under
instructions from the manufacturer
and then repackaged in the org�k��x'
container;
S�Cp
8. Additional Insured — Controlling Interest
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the persons) or organization(s) shown in the
Declarations as an Additional Insured —
Controlling Interest, but only with respect to
their liability arising out of:
a. Their financial control of you; or
b. Premises they own, maintain or control
.)- syh"lfase or occupy these premises.
Form SS 00 08 04 05
\s.,...,
Page 19 of 24
To; City of Santa Ana From: Blanca Roque 5-18-07 2:59pm p. 7 of 7
BUSINESS LIABILITY COVERAGE FORM
This insurance does not apply to structural
The limits of insurance that apply to additional
alterations, new construction and demolition
insureds are described in Section D. — Limits Of
operations performed by or for that person or
Insurance.
organization.
How this insurance applies when other insurance
9. Additional Insured — Owners, Lessees Or
is available to an additional insured is described in
Contractors — Scheduled Person Or
the Other Insurance Condition in Section E. —
Organization
Liability And Medical Expenses General
a. WHO IS AN INSURED under Section C. is
Conditions.
amended to include as an additional
G. LIABILITY AND MEDICAL EXPENSES
insured the person(s) or organizations)
DEFINITIONS
shown in the Declarations as an Additional
Insured — Owner, Lessees Or Contractors,
1. "Advertisement" means the widespread public
but only with respect to liability for "bodily
dissemination of information or images that
injury", "property damage" or "personal
has the purpose of inducing the sale of goods,
and advertising injury" caused, in whole or
products or services through:
in part, by your acts or omissions or the
a. (1) Radio;
acts or omissions of those acting on your
(2) Television;
behalf:
(3) Billboard;
(1) In the performance of your ongoing
(4) Magazine;
operations for the additional
insured(s); or
(5) Newspaper;
(2) In connection with "your work"
b. The Internet, but only that part of a web
performed for that additional insured
site that is about goods, products or
and included within the "products-
services for the purposes of inducing the
completed operations hazard", but
sale of goods, products or services; or
only if this Coverage Part provides
c. Any other publication that is given
coverage for "bodily injury" or
widespread public distribution.
"property damage" included within the
However, "advertisement" does not include:
"products -completed operations
hazard".
a. The design, printed material, information
b. With respect to the insurance afforded to
or images contained in, on or upon the
these additional insureds, this insurance
packaging or labeling of any goods or
products; or
does not apply to "bodily injury", "property
damage" or "personal an advertising
p, An interactive conversation between or
injury" arising out of the rendering of, or
among persons through a computer network.
the failure to render, any professional
2• "Advertising idea" means any idea for an
architectural, engineering or surveying
"advertisement".
services, including:
3. "Asbestos hazard" means an exposure or
(1) The preparing, approving, or failure to
threat of exposure to the actual or alleged
prepare or approve, maps, shop
properties of asbestos and includes the mere
drawings, opinions, reports, surveys,
presence of asbestos in any form.
field orders, change orders, designs or
4. "Auto" means a land motor vehicle, trailer or
drawings and specifications; or
semi -trailer designed for travel on public
(2) Supervisory, inspection, architectural
roads, including any attached machinery or
or engineering activities.
equipment. But "auto" does not include
10. Additional Insured — Co -Owner Of Insured
"mobile equipment".
Premises
5. "Bodily injury" means physical:
WHO IS AN INSURED under Section C. is
a. Injury;
amended to include as an additional insured
b. Sickness; or
the person(s) or Orgenization(s) shown in the
Declarations as an Additional Insured — Co -
c. Disease
Owner Of Insured Premises, but only with
sustained by a person and, if arising out of the
respect to their liability as co-owner of the
above, mental anguish or death at any time.
premises shown in the Declarations.
6, "Coverage to ri " means:
Page 20 of 24
Form SS 00 08 04 05
To: City of Santa Ana from: Blanca Roque 5-18-07 2:59pm p. 1 of 7
;From:
Wood -Gutmann & Bogart/IIIB
910 S. EI Camino Real, Ste B. if ,1!
San Clemente CA 92672
Phone: (949) 542-7800 i
Fax: (949) 542-7804 9
www.integritAnt.com 5
ecerm
online
r Y IOc� or msrrae a Evld4w of teeny yn�/{/�'
v V
_VA
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From, Blanca Roque
...n- ... ....t .�.ti ....s
To: Subject:
City of Santa Ana
'Attn: City Clerk Date:
20 Civic Center Plaza Delivery Via:
Santa Ana CA 92702 No. of Pages:
This document was created by eCertsONLI NE.
Certification of Insurance
Fieldman, Rolapp & Associates
5/18/2007
FAX 17146475414
7
The attached or linked document(s) contain certification of insurance coverage for the insured named
in the subject above. Your company is listed as the organization requesting receipt of these
documents.
If this document is sent via e-mail, you must click on the link below The linked document is in a pdf
format, and you must have Adobe Acrobat Reader installed on your system. To download the Adobe
Reader for free, visit www.Adobe.com.
If you have any questions regarding the content of this message, you should contact the
Producer/Agency listed on the attached/linked documents.
�77W: ("1411) -,Z
ON /-IJD/PJ6-
ro.e i ti�✓� /��✓ice 2
Pie = vs . slr�� Aov�n a� /. -(Neem. a )Cwo 7V nw,?
THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENT RTO WHICH R 5 ADDRESSED AN Y CONTNN INfOR nON THAT IS PRNFEGED, CONFIDENTIAL AND EXEMPT FROM ONCLOSURE UNDER
APPLICABLE LAW. IF THE READER OF THE MESSAGE 5 NOT THE ININTENOED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSI&E FOR DELMERNG THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY
NOTIFIED THAT ANY DISSEMINATION. DISTRIEU➢ON OR COPYING OF THIS COMMUNICATION 15 STRICTLY PROHIBITED. F YOU MVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMMEDIATELY BY
TELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADORESSVIAREGULAR POSTAL SERVICE.
www.eCertsOnline.com I•�T�Z X�g�O
®2002 Insurance Visions, inc
Oil P4M ,4'eove!5-4,i xsizf
Blanca Roque
Wood -Gutmann & Bogart/IIIB
910 S EI Camino Real, Ste B. CA 92672
San Clemente
(949) 542-7800 w- Loo l -0s.7
www.integrityint.com A 13
Redman, Rolapp & Associates
19900 MacArthur Blvd, #1100 CA 92612
Irvine
Elanca Roque
12 18 07 lliNam P.
b1AY 12118
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO UPON THE CERTIFICATE HOLDER.
THIS CERTIFICATE DOES RIGHTS
AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURER Indian Harbor Ins. Company
14
INSURER
INSURER
INSURER
INSURER
THE POLICIES Of INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TH
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH
TERMS CE7(CLUSIONS AND CONDITIONS OFTSUCH POL CSESR AGGREGA EDLEMITS SHOWN IMAY HA ERBEEN REDUCED BY PAID CLAIMS. THE
POLICY POLICY
EFFECTIVE EXPIRATION LIMITS
TYPE OF INSURANCE I POLICY NUMBER
MADE
SINGLE UMIT
AUTO
(per person
OWNED AUTOS
EXILED AUTOS
I
BODILY INJUI
(per eocidert)
I I
:D AUTOS
PROPERTY D
d -OWNED AUTOS
(per eccideml
AUTO
CLAIMS MADE
L4r'A Tr'rc rlsn+.w,o SHOU LDANYUt Inc
EXPIRAJION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
City of Santa Ana 3O_ DAYS WRITTEN NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE
Attn: Clerk of the Court LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE DCD Ysf o� Non Payment of Preml m
SENTATIVES.
20 Civic Center Plaza (M-30) CA 82702-1988 AUTHOREPRESENED n
Santa Ana � afn
1,A/A../n6 /"/.im i1,�eC✓✓VS— / 6 ,ice' �.
L N ' en Gorman ,r
..,� ,. „rc.a L.n, �r � ���•:6A�enti.riYYabttlarEC�iiIfR'�x88B,
P•
: Banca
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(les) must he endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WVED, 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
AI
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
authorized representative the issuing insurers}, or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or after the coverage afforded by The policies listed thereon.
created at www.e CertsONLINE.com
ACORD 25-5 (7/97)
From:
Wood -Gutmann & Bogart/111B
910 S. EI Camino Real, Ste B.
San Clemente
Phone (949) 542-7800
Fax: (949) 542-7804
CA
www.inlegritOt com
City of Santa Ana
Attn: Clerk of the Court
20 Civic Center Plaza (M-30)
Santa Ana
92672
"v
4
CA 92702-19884
��#n
C� of ptgutfuta6 b Evfd9nse d Prbt+eAY
From: Blanca Roque
Subject:
Date:
Delivery Via:
No. of Pages:
Certification of Insurance
Fieldman, Rolapp & Associates
12/1812007
FAX 17146475414
This document was created by eCertsONLINE.
The attached or linked document(s) contain certification of Insurance coverage for the insured named
in the subject above. Your company is listed as the organization requesting receipt of these
documents.
ail, you must click on the link below The linked document is in a pdf
If this document is sent via e-mbe Acrobat Reader installed on your system. To download the Adobe
format, and you must have Ado
Reader for free, visit www.Adobe.com.
if you oduhave any
questions I sd on
rt he attached/linked dinthe
conte contentof
this message, you should contact the
NDER
THIS MESSAGE IS INTENDED FOR THE USE OF THE INS
OR ENTITY TO WNILH R IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRNL THE
MESSACONFIGE
TO
H AND NDEMPT FROM DISCLOSURE E
APPLICABLE UAW. IF THE ED READER OF THEM F WE IIS NOT THE NINTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR V ED THIS C THE MESSAGE TO THE INTENDED RECIPIENT YOU ARE HEREBY
NOTIFIED THAT ANY HE REA ER OF DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. F YOU IT
RECEIVED THIS COMMUNICATION IN ERROR, PIEPSE NOTIFY OS FHEOIPTELY BY
TETIFIED HATDR OTRNMINATIN.DI THE MESUTION US AT THE ABOVE ADDRESS VMREGUTAR PWTAL SERVICE
www.ecertsonline.com
0 2002 Insurance Visions, Inc.
X'o: City of Santa Ana From: Blanca Roque 12-11-08 2:9tipm p. 2 of 3
-ff-^/,,�oo 7
/-^ OR!�
ACN
,�yq^ � I✓"s�' II
FSTI ff W`,'_
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7
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Producer
THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
Wood -Gutmann & Bogart/IIIB
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
940 Calle Negocio, Ste. 240
COVERAGE AFFORDED BY THE POLICIES BELOW.
San Clemente, CA 92673
INSURER Indian Harbor Ins. Company
(949) 542-7800
www intogrityint.com
INSURER
Insured
INSURER
Fieldman, Rolapp & Associates, Inc.
Fieldman, Rolapp Financial Services, LLC
INSURER
19900 MacArthur Blvd, #1100
Irvine CA 92612
INSURER
E
_-
"
-
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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 CLAIMS.
POLICY
POLICY
NSR
EFFECTIVE
EXPIRATION
LTR
TYPE OF INSURANCE
POLICY NUMBER
DATE
DATEDD/Y
LIMITS
GENERALLIABILITY
EACH OCCURRENCE $
COMMERCIAL GENERAL LIAB
DRE DAMAGE one fire $
CLAIMS MADE MOCCOR
MED EXP (Any ore rwn $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN 'L AGG LIMIT APPLES PER
PRODUCTS-COMP/OP AGG $
POLICY MPROJECTn LOC
$
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMN
$
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per Perron) $
HIRED AUTOS
BODILY INJURY
NON -OWNED AUTOS
(Per ecCidela) S
PROPERTY DAMAGE
(Per e.Idmo $
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY
EACH OCCURRENCE $
OCCUR ❑ CLAIMS MADE
AGGREGATE $
$
DEIXICTIB LE
RETENTION $
WORKERS' COMPENSATION &
e e n.
STATUTORY UMIT H s-
EMPLOYERS' LIABILITY
EL EACH ACCIDENT $
EL DISEASE - EA EMPLOYEE $
L DISEASE -POUCY EMIT $
EIml
rrors missions
Ded. $100,000
DE RIPTI N OF PF.RATI N !L ATI N VEHI LE EX LUN BY END R EQ/IEN,T. PF 1 L PRVI 1 4
'AVD /DDEED
�. Iy; SIT 1 'I A>,,
I-
1N1WP1'1:1-MWer1i.'a M1 Tde-P:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Santa Ana
EXPIRA� ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn: GIeNFefthc2ovrt
30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Center
20 Civic Center Plaza (AA3�r M �/ 7
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
Santa Ana 92702-1988
OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE-
SENTATI VES. ' 10 Days for Nonpayment of Premium
AUTHORIZED
REPRESENTATIVE
Dan Gorman
I ,
CERT Nn.: 4176441 Blanca Fovue 19/11/Pe03 2:43:06 PM Paye 1
3'o: Cit? of Santa Ana From: Blanca Roque 12-11-08 2:46pm p. 3 of 3
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 endwsement(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 ceflstitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon.
ACORD 25-S (7/97) created at www.e CertsONLINE.cum
CRRT NC. 4176441 Plaeca Rowe 12/11/2808 2:43 06 PM Page 2
To:. City of Santa Ana From: Blanca Roque 12-11-08 2:46pm p. 1 of 3
From:
Wood -Gutmann & Bogart/IIIB
940 Calle Negocio, Ste. 240
San Clemente, CA 92673
(949)542-7000
www.intogrityint.com
To:
City of Santa Ana
Attn: Clerk of the Court
20 Civic Center Plaza (M-30)
SANTA ANA CA 92702-1988
This document was created by eCertsONLINE
FAX DOCUMENT
Certificate of Insurance Delivery by emrteonline TM
From: Blanca Roque
Subject: Certification of Insurance: Fieldman, Rolapp &
Associates
Date: 12/11/2008
Delivery Via: FAX 17146475414
No. of Pages: 3
The attached or linked document(s) contain certification of insurance coverage for the insured named
in the subject above. Your company is listed as the organization requesting receipt of these
documents.
If this document is sent via e-mail, you must click on the link below. The linked document is in a pdf
format, and you must have Adobe Acrobat Reader installed on your system. To download the Adobe
Reader for free, visit www.Adobe.com.
If you have any questions regarding the content of this message, you should contact the
Producer/Agency listed on the attached/linked documents.
THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO VIHICH IT IS ADDRESSED AND NAY CONTAIN INFORM%TION THAT IE PRIVILEGED, CONFIDENTIAL PND EkENPT FROMDISCLOSORE UNDER APPLICABLE
LA'A. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT. OR THE EMPLOYEE OR AGENT RESP"ELE FOR DELIVERING THE NESSAGE TO THE INTENDED RECIPIENT. YW ARE HEREBY NOTIFl ED THAT AN+
DISP.EMNATIOV, DISTRIBUTION OR COPYING OF -HIS COIMJNICATION IS STRI CRY PROHIBITED. IF YOU HAVE RECEIVED THS CO NICADON IN ERROR, PLEASE NOTIFY OS I MEDIATELYOYTELEPHONE AND RETURN
THE ORIGINAL MESSAGE TO US AT THE ABODE ADDRESS VN REGUU+P POSTAL SERVICE.
0 2002 Certificate of Insurance Delivered by ecerlsonline TIR Insurance Visions, Inc. All rights reserved.
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/77
Wood -Gutmann & Bogart/IIIB
940 Calle Negocio, Ste. 240
San Clemente, CA 92673
(949) 542-7800
www.integrityint.com
Fieldman, Rolapp & Associates, Inc.
Fieldman, Rolapp Financial Services, LLC
Applied Best Practices, LLC
19900 MacArthur Blvd, #1100
Irvine CA 92612
TCERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 1/26/2010
HIS
ONLY AND CONFERS NO RIGHTS UPN THE CERTIFICATE HOLDER,
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURER Indian Harbor Ins. Company
INSURER
B
INSURER
INSURER
D
INSURER
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NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF AN0 11 RE
Y CONTRACT ORO HER DOCUMENT WITH RESPECT TO WHI HATHS
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 neAV UA111
TYPE OF INSURANCE POLICY NUMBER
EFFECTIVE D(Ri TION
LIABILITY
DATE
MM/DDlYY M �p /YY
�RAA,L
RCIAL GENERAL LIABMS
BODILY INJURY
MADE OCCUR
FIRE C
kNY AUTO
ALL OWNED AUTOS
COMBINED SINGLE LIMIT
;CHEDULED AUTOS
BODILY INJURY
TIRED AUTOS
(Per person)
iON-OWNED AUTOS
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
ZAGE LIABILITY
(Per accident)
NY AUTO
AUTO ONLY - EA ACCIDENT
:ESS LIABILITY
OTHERTHAN EA A
AUTO ONLY:
CUR CLAIMS MADE
A
EACH OCCURRENCE
—_--
AGGREGATE
VVLN0 HiS' CoMPENSAnON &
EMPLOYERS' LIABILITY STATUTORY LII
EL EACH ACCIDEN
� DISEASE - EA N
Errors & Omissions ELU115086-09 12/20/2009 12/20/2010 1LLiDI $2 0 01,0
Ded. $100,000
APPROVED AS TO POR]VI
Laura Sti Sheedy
Assistant City Attorney
LIMITS
30RATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEA11111:1-OKE THE
VOR TO MAIL
City of Santa Ana [.S11TNno17—
__jDan
EFT, BUTAYS WRITTEN FAI URE TO MAILE TO THE SUCH OTICCE HALL IMPOSE IFICATE O OBLIGATIONS
20 Clerk t the Court R LIABILITY OF ANY 19ND UPON THE COMPANY, ITS AGENTS OR REPRE-
20 Civic Center Plaza (M-30) ENTATIVES. ` 10 Days for Non -Payment of Premium.
Santa Ana CA 92702-1988
Gorman
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IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the poiicy(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 after the coverage afforded by the policies listed thereon.
ACORD 25-S (7/97)
created at www. eCertsONUNEco_m__
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