HomeMy WebLinkAboutRICK HAMM CONSTRUCTIONAGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effecQ?? ? ? ? ? ? ?®
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Return form to the Deputy Clerk of the Council (M-30). Call 647-5237 if you l?`#ng ue`stions;? CfyL A
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The agreement with
No. N- aRCQV- 080 was completed on 6-Y' 14 p `7
and final payment has been made.
Department:
Signature: /?p?,? ?,?t -?S
Date: OHLcq 6Z2I0
City of Santa Ana
Clerk of the Council
Revised 06-01-07
INSURANCE ON FILE
WORK MAY PROCEED
UI'lTIL INSU~NCE EXPIRES
fl.-/S~Of t VIle..: 8'1-0'1
ClERK OF COONC
"TE: '1- 'J.O- 07
O' COA (2)
. Go.'o,/ Lomeli
N-2007 -080
CONSULTANT AGREEMENT
THIS AGREEMENT made and entered into this 26th day of June 2007 by and between
Rick Hamm Construction, a California corporation (hereinafter "Consultant"), and the
Community Redevelopment Agency of the City of Santa Ana, a public body, corporate and
politic (hereinafter "Agency").
RECITALS
A. The Agency desires to retain a consultant having special skill and knowledge in the field
of minor building renovation.
B. Consultant represents that Consultant is able and willing to provide such services to the
Agency.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably be
expected from a professional consulting firm in the field.
NOW THEREFORE, in consideration ofthe mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
This is an agreement for on-call services, as needed basis for minor building renovations,
including but not limited to, sign and awning removal, landscape removal and patching.
Consultant shall be informed by the Agency of each pending project. Consultant shall reply, in
writing, within five working days with a formal bid. The bid shall include compensation
requirements and time frame as to when the project shall be completed. The Agency has the
discretion to accept, reject or negotiate with Consultant and shall do so in writing executed by
the Executive Director.
2. COMPENSA nON
a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the
rates and charges set forth in each bid submitted. The total sum to be expended pursuant to this
Agreement shall not exceed $10,000 during the term of this Agreement.
b. Payment by Agency shall be made within thirty (30) days following receipt of proper
invoice evidencing work performed, subject to Agency 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 Agency.
3. TERM
This Agreement shall commence on the date first written above and terminate on June 30,
2008 unless terminated earlier in accordance with Section 12, below. The term of this
Agreement may be extended upon a writing executed by the Executive Director ofthe
Agency and the Agency General Counsel.
4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term ofthis Agreement, be construed to be an
independent contractor and not an employee of the Agency. This Agreement is not intended nor
shall it be construed to create an employer-employee relationship, ajoint venture relationship, or
to allow the Agency to exercise discretion or control over the professional manner in which
Consultant performs the services which are the subject matter of this Agreement; however, the
services to be provided by Consultant shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Consultant shall pay all salaries and
wages, employer's social security taxes, unemployment insurance and similar taxes relating to
employees and shall be responsible for all applicable withholding taxes.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the Agency, the City of Santa Ana, 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
Agency with a fully executed additional insured endorsement in substantially the form attached
hereto as Exhibit A upon execution of this Agreement and shall be approved in form by the
Agency Counsel.
b. Business automobile liability insurance, or equivalent form, with a combined single
limit of not less than $ 1,000,000 per occurrence. Such insurance shall include coverage for
owned, hired and non-owned automobiles.
c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300
of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against
liability for worker's compensation or to undertake self-insurance. Prior to commencing the
performance of the work under this Agreement, Consultant agrees to obtain and maintain any
employer's liability insurance with limits not less than $ I ,000,000 per accident.
d. The following requirements apply to the insurance to be provided by Consultant
pursuant to this section:
(i) Consultant shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement.
(ii) Certificates of insurance shall be furnished to the Agency upon execution
ofthis Agreement and shall be approved in form by the Agency Counsel.
(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 Agency.
e. If Consultant fails or refuses to produce or maintain the insurance required by this
section or fails or refuses to furnish the Agency with required proof that insurance has been
procured and is in force and paid for, the Agency shall have the right, at the Agency's election,
to forthwith terminate this Agreement. Such termination shall not effect Consultant's right to be
paid for its time and materials expended prior to notification of termination. Consultant waives
the right to receive compensation and agrees to indemnity the Agency for any work performed
prior to approval of insurance by the Agency.
6. INDEMNIFICATION
Consultant agrees to and shall indemnity and hold harmless the Agency, its officers,
agents, employees, consultants, special counsel, and representatives from liability for personal
injury, damages,just compensation, restitution, judicial or equitable relief arising out of claims
for personal injury, including health, and claims for property damage, which may arise from the
direct or indirect operations of the Consultant or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates to the services described in
section I of this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to
have been suffered, by reason of the events referred to in this Section or by reason of the terms
of, or effects, arising from this Agreement. The Consultant further agrees to indemnity, hold
harmless, and pay all costs for the defense of the Agency, including fees and costs for special
counsel to be selected by the Agency, regarding any action by a third party challenging the
validity of this Agreement, or asserting that personal injury, damages, just compensation,
restitution, judicial or equitable relief due to personal or property rights arises by reason of the
terms of, or effects arising from this Agreement. Agency may make all reasonable decisions
with respect to its representation in any legal proceeding.
7. CONFIDENTIALITY
If Consultant receives from the Agency information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
that it shall not use or disclose such information except in the performance of this Agreement,
and further agrees to exercise the same degree of care it uses to protect its own information of
like importance, but in no event less than reasonable care. "Confidential Information" shall
include all nonpublic information. Confidential information includes not only written
information, but also information transferred orally, visually, electronically, or by other means.
Confidential information disclosed to either party by any subsidiary and/or agent of the other
party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure
shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is,
through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful
possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation oflaw; or (e) is independently developed by the Consultant without
reference to information disclosed by the Agency.
8. CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interests and shall not have interests, direct
or indirect, which would conflict in any manner with performance of services specified under
this Agreement.
9. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this
Agreement shall be in writing and shall be deemed to be properly given if delivered in person or
mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other
telegraphic communication in the manner provided in this Section, to the following persons:
To Agency:
Community Redevelopment Agency
City of Santa Ana
20 Civic Center Plaza (M-25)
P.O. Box 1988
Santa Ana, CA 92702-1988
telefacsimile (714) 647-6549
With courtesy copy to:
Agency General Counsel
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-6515
To Consultant:
Rick Hamm Construction, Inc.
201 W. Carleton Avenue
Orange, California 92867
Telefacsimile (714) 532-]078
A party may change its address by giving notice in writing to the other party. Thereafter,
any communication shall be addressed and transmitted to the new address. 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 certified, with postage prepaid, and addressed
as set forth above. If sent by telefacsimile, communication shall be effective or deemed to have
been given twenty-four (24) hours after the time set forth on the transmission report issued by the
transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time
frames, weekends, federal, state, County or City holidays shall be excluded.
10. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the Agency
and Consultant, and supersedes any and all other agreements, oral or written, between the parties.
In the event of a conflict between the terms ofthis Agreement and any attachments hereto, the
terms of this Agreement shall prevail. This Agreement may not be modified except by written
instrument signed by the Agency and by an authorized representative of Consultant. The parties
agree that any terms or conditions of any purchase order or other instrument that are inconsistent
with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor
the Agency. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the Agency and any such assignment, transfer, delegation or subcontract
without the Agency's prior written consent shall be considered null and void. Nothing in this
Agreement shall be construed to limit the Agency's ability to have any of the services which are
the subject to this Agreement performed by Agency personnel or by other consultants retained by
Agency.
12. TERMINATION
This Agreement may be terminated by the Agency upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the Agency shall pay
Consultant compensation for all services performed by Consultant prior to receipt of such notice of
termination, subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to deliver
to the Agency all work product completed as of such date, and in such case such work product shall
be the property ofthe Agency unless prohibited by law, and Consultant consents to the Agency's
use thereof for such purposes as the Agency deems appropriate.
b. Payment need not be made for work which fails to meet the standard ofperfonnance
specified in the Recitals ofthis Agreement.
13. DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital
status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited
by applicable law, in the recruitment, selection, training, utilization, promotion, termination or
other employment related activities. Consultant affirms that it is an equal opportunity employer
and shall comply with all applicable federal, state and local laws and regulations.
14. JURISDICTION - VENUE
This Agreement has been executed and delivered in the State of California and the
validity, interpretation, performance, and enforcement of any of the clauses ofthis Agreement
shall be determined and governed by the laws of the State of California. Both parties further
agree that Orange County, California, shall be the venue for any action or proceeding that may
be brought or arise out of, in connection with or by reason of this Agreement.
15. GOVERNMENT LAWS AND REGULATIONS
The Consultant shall carry out the work undertaken pursuant to this Agreement in
conformance with all applicable laws, ordinances, statutes, codes, rules, regulations, orders, and
decrees of the United States, the State of California, the County of Orange, the City, or any other
political subdivision with jurisdiction over property within the City, and of any other political
subdivision, agency, or instrumentality exercising jurisdiction over the City, the Consultant or
the Property, including all applicable federal, state, and local occupation, safety and health laws,
rules, regulations and standards, applicable state and federal labor standards, applicable
prevailing wage requirements, the City zoning and development standards, City permits and
approvals, building, plumbing, mechanical and electrical codes, as they apply to work
undertaken pursuant to this Agreement, and all other provisions of the City and its Municipal
Code (as they apply to work undertaken pursuant to this Agreement), and the Unruh Civil Rights
Act, Civil Code ~ 51 et seq.
16. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow has the power,
authority and right to bind their respective parties to each of the terms ofthis Agreement, and shall
indemnity Agency fully, including reasonable costs and attorney's fees, for any injuries or damages
to Agency in the event that such authority or power is not, in fact, held by the signatory or is
withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as iffully set
forth in the body ofthis Agreement.
II
II
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above written.
ATTEST: /
c/~
PATRICIA E. HEALY
Secretary
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
Agency General Counsel
BY:~CAC~
Laura heedy
Assistant Counsel .
CITY OF SANTA ANA
~N1'~
~ DAVID N. RE {
City Manager
COMMUNITY REDEVELOPMENT
AGENCY OF THE
CITY OF SANTA ANA
vrtevn . .~ f Muu0
pltSTEPHEN ~ ARDING
Executive Director
RICK HAMM CONSTRUCTION, INC.
kL~
RICK HAMM
President
TAX ID: 33-011-303,
EXHIBIT A
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
I. The Community Redevelopment Agency of the City of Santa Ana, 20 Civic
Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and
representatives are named as additional insureds ("additional insureds") with regard to liability
and defense of suits arising from the operations and uses performed by or on behalf ofthe named
insured.
2. With respect to claims arising out of the operations and uses performed by or on
behalf of the named insured, such insurance as is afforded by this policy is primary and is not
additional to or contributing with any other insurance carried by or for the benefit ofthe
additional insureds.
3. This insurance applies separately to each insured against whom claim is made or
suit is brought except with respect to the company's limits of liability. The inclusion of any
person or organization as an insured shall not affect any right which such person or organization
would have as a claimant if not so included.
4. With respect to the additional insureds, this insurance shall not be cancelled, or
materially reduced in coverage or limits except after thirty (30) days written notice has been
given to the Community Redevelopment Agency of the City of Santa Ana, 20 Civic Center
Plaza, Santa Ana, California 92701.
(Completion of the following, including countersignature, is required to make this endorsement
effective.)
Effective
Policy #
Issued to
, this endorsement form as a part of
Named Insured
Countersigned by
Authorized Representative
..
~~ WW~_ p. L UL 1
Date (mmfddfyy)
Producer
ChllriseMll'j
5/29/200 I
THIS CERTIFICATE IS ISSUED AS A MAl Tn~ OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THt. GI'RTlflCATE HOLDER.
THIS CERTIFICATE DOES NOT AMEND. tXTEND OR AlTER THE
COVERAGE AFFORDED BY THE POLICIES B~lO'N.
GarretVMosierfGriffithfSistrunk Ins. Services
12 Truman
Irvine CA 92620
(949)559-6700 .
www.garrett-mosler.com
0B84519
N'~007-()80
INSUJ:ER Gemini Insurance Company
(CRC-Sterling West)
INSl"'. General Insurance Co (Salem)
Insur
INSU~Efl
Rick Hamm Construction Inc.
INSU~ ER
201 West Carleton Avenue
Orange
CA 92867
rNSU~ER
THE OF INSURANC LISTED B lOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOV H 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 HEROIN IS SUBJECT TO ALL THE
TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDJCoD BY PAID CLAIMS.
POLICY POLICY
EffECTIVE EXPIRATION
D,\TE DATE:
) MMI 0 Y
NS.
LTR
TYPE Of INSURANCE
POLICY NUMBER
GENERAL LlABIUTY
A C~MERaAL GHERAl LIAR VCGP013929
ClAIMS MADE 00CCUR
2/15(.'007
2/15/2008
B
lOC
24CC0329633
2/15/:~007
2/15/2008
GARAGE LIABiliTY
ANY AUTO
EXCESS LIABILITY
OCCUR 0 ClAIMS MADE
Ai :~11..0 './B0
DED.)CTlBLE
RETENTION S
WORKERS' COMPENSATION &
EMPlOYERS' liABILITY
.. ~'
<{fiLL -- .
c [",l
AS.:i15Wi1t Ci Y t\i;,T ';1.
DES RPTION OF OPERA110NS/LO ATI NSNEHICLE EXCLUSION ADDEO IlY ENDOFSEMEN IS CtAL PR VI IONS
LIMITS
EACH OCCURRENCE ,
nRE DAMAGE (An . one fire S
MfOEXP' O~ ""'" s 5000
PERSONAL,," ADV INJlIRY , 1 0000
GENERAL AGGREGATE: , 00
PROOUCTS-COMP/'JP AGG , 000 0
,
COMBINED SINGLE u....rr , 1 000 000
BODilY INJURY
(Pe-rpersonJ ,
BODILY INJURV
(Peraocldent) ,
PROPERTY DAMAC [
(Pffllcddenl) ,
AUTO O~ V . fA ACClOfNT ,
OTHER THAN EAAC ,
AUTO CM.Y' AG ,
fAD-! oCCURREN( E ,
AGGREGATE: ,
,
,
,
STATUTORY UMll H
El EACH ACCIDENT ,
El DISEASE. EA EMPlOYEE ,
El DISEASE. PilleV LIMIT ,
Cert holder is included as additional insured under general liability per attached endorsement lorm Vi001820304 but only
il required under written contract, subject to all policy terms and cc ndrtions. '
City of Santa Ana
Community Development Agency
its officers, agents, employees & volunteers
Attn: Gaby Lomelli
PO Box 1988 M.25
Santa Ana CA 92702
SHOULD ANY OF THE AIlOYE DESCRIBED POLICIES BE CANCEUED BEFORE THE
EI(PIRATK)N DAlE THEREOF. THE ISSUING COMPANY Will ENDEAVOR 10 MAil
_ ~__~_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
lI:FT. BUT FAILURE TO MAtL SUCH NOllel S~iAl( tMPOSE NO OBUGATlON
OR lIABIlIlV OF ANY KIND UPON THE COMP."NY, ns AGENTS OR REPRE-
SENTATIVES. "10 Days for Non..paymerlt of Premium
AJTHORllID
RPRESENTATlVE
----0.,~----"..
. \- r'/_
...... "< CLf-.J..- --
'---- ~
,"
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED. the poJic.y(tes} must be endorsed. A statement
on this certificate does nat confer rights to the certificate holder in lieu of such endQfsement(s).
If SUBROGA liON IS WAIVED, subject to the terms and conditions of the policy. certain policies may
require an endorsement. A statement on this certificate llces not confer rights to the certifICate
holder rn lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this lorm does not constitute a contract betw2:en
the issuing insurer(s). authorized representative or producer. and the certificate holder, nor doe~; it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thewoll.
~ ''') {)'I i;D AS TO FOiU\tl
~ .';""- '. . ....~
_LlfJ~a--
-"--L~Ll;rd Sl.tt Si.,~;:;Jj
ACORD 25 (2001108)
_, - . ~ '" '" ttOl';' i~V
A. ~,' l~, lEr~~d j~ ~w.e C;;tSoNlINE.COO1
,.
Policy Numh." VCGP013929
InmredName: Rick Hamm Construction Inc.
Number:
VE 0181 03 04
Effectivt Dnte: 5129/2007
THIS EI\'DORSEMENT CHANGES THE POLICY. PLEASE READ IT CARE [?VLL Y.
BLANKET ADDITIONAL II\SURED ENDORSEMENT
This endorsement modifies insurance provided under the following;
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERA 110"lS LIABILITY COVERAGE PART
A. Section II - Who is An Insured is amended to include as an insured any person or
organization for whom you are perforrning operations when you and such person or
organization have agreed in writing in a contract or agreement that such person or
organization be added as an additional insured on your policy Such person ('r organization is
an additional insured but only with respect to liability caused by your ongoing operations
performed for that insured. A person's or org,mization's status as an insured under this
endorsement ends when your operations for that insured are completed, This insurance does
not apply to liability caused by the sole negligence of any additional insured.
R With respect to the insurance afforded to these additional insureds, the following additional
exclusions applies:
This insurance does not apply to:
L The preparing, approving, of failing to prepare or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders or drawings and specifications; and
L Supervisory, inspection, architectural or engineering activities.
AI
A,S
~J/3
L ; :": r~;:' (;1. ~.;--;;~.~~~ /-
Page 1 ofl
A\.jl~.L;"L L'il'j; /-\ltc'r'-,~'
ACORO- ~1~J!F.ii~j.t;'V
~~~:ff4t:~. ,
Producer
Andraw Yount
'F&.-"r'~"";~i~~\1.}~;~i~iil~ij~:~itR,~~i:~f" Date (mm(~d/1Y)
~. 1<~"~'- .~~~~!.~ll,U-';;~~~~ 5/29/2007
THIS CERTWICATE IS ISSUED AS A M,A_TTER OF INfORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
nus CERTIFICATE DOES Nor AMEND, EXTEND OR ALTER THE
COVERAGE AffORDED BY THE POUCIES BELOW.
Kimbrell Insurance Agency
950 E Katella Ave.. ~
Orange
714-538-8723
www.Kimbrell-insurance.com
0619648
CA 92867
INSIJRER Truck Insurance Exchange
\
lNS'JRER
I
INSJRER
C
INSJRER
Insur-&d
Rick Hamm Construction Inc.
201 Carleton
Orange
CA 92867
INSR TYPE OF INSURANCE POLICY NUMBER LIMITS
LT"
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENlRAL LIAS fIRE DAMAGE "_tire) $
CLAIMS MADE OOCCUR MID EXP (M 0f1I!' $
PERSOIMt. " ADV INJURY .
GENERAL AGGREGATE $
PIIODUCTS.COMPfOP AGG .
LOC $
COMBINED SINGLi UMIT
$
BODILY INJURY
(Pet person) .
800ll Y INJURY
(PwleeidWtt) .
pROKRTY DAMAGE:
(P&r1Ccldlnt) $
GARAGE lIABILJTV AUTO ONLY, EA ACCIOENT .
ANY AUTO OTHER THAN EAACC ~
UTO ONLY: AGe .
EXCESS UABllITY fACH OCCURREhlCE .
OCCUR o CLAIMS MADE AGGREGATE .
$
OEOOCTlBU .
REl"ENT~NS .
A WORKERS' COMPENSATION & 820094453 8/1/2006 8/112007 STATUTORY LIMIT THt .>~f~~;,:'
EMPlOYERS' LIABILITY El EACH ACCIO€NT . 1
El DISEASE. EA [MP\.OYEE" . 1
El DISEASE: - PCUCV LIMIT .
DE RIPTlON. OF OP
CA IONS EHI LES X l
A[)[) B ENDORSEM
r'PR()\lbL 1\.',:, i-'(; i:~-~d) l'
IA IOV7k
~...23
Laur~~~:~';-'. ;~---'''",~Jj ._~-
AS';:lstant L\ry Attorr"ey
~El'{;ij(iil'iY,'"
P.O. Box 1988 M-25
Santa Ana
CA
92702
. -~ ~
_~ . . _ ,_. -: _", ' ~'t. -r
~. ~ ~~ .~~ ~~,
SHOULD ANY OF THE ABOVE DESCRIBED pOUCtES BE CANCEllED BEFORE THE
EXPIRATION 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 SHALL IMPOSE NO OBLIGATION
OR llA8lUTY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRE-
SENTATIVES. "'10 D.y. for Non-P.yrrwmt 0' PremIum
UTt<<>RtZED
IlEPRESfNT ATIVE
City of Santa Ana
Community Redevelopment Agency
~~~