HomeMy WebLinkAboutPB FARRADYNE 1A - 2005
INSURANCE ON FILE
WORK iliA'! PROCEED
UNTIL INSURANCE EXPIRES
"1-/8,07
CLERK OF COUNCil
O~TE: g./S-Q7
0: pwA/1'mNp, AMENDMENT TO CONSULTANT AGREEMENT
(Vlllh N.)
A-2003-173.0 I
--
THIS AMENDMENT TO CONSULTANT AGREEMENT is entered into on
March 7, 2005, by and between PB Farradyne, a division of Parsons Brinkerhoff Quade
& Douglas, a Delaware corporation ("Consultant") and the City of Santa Ana, a charter
city and municipal corporation of the State of California ("City").
Recitals:
A. The parties entered into Agreement A-2003-173, dated September 22, 2003,
(hereinafter "said Agreement") by which Consultant has provided services in relation
to the Adaptive Downtown Traffic Signal Project.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
extend the term of said Agreement to allow time to complete the project.
Wherefore, in consideration of the covenants contained in said Agreement, and subject
to all the terms and conditions of said Agreement, except those amended in this
Amendment to Consultant Agreement, the parties agree as follows:
1. Section 3, TERM, shall be deleted in its entirety and replaced with the following:
"'-"
"This Agreement shall commence on September 22, 2003 and terminate upon
completion of the services set forth in Section 1, Scope of Services, unless terminated
earlier in accordance with Section 12, below. The term of this Agreement may be
extended upon a writing executed by the Executive Director of Public Works Agency
and the City Attorney."
IN WITNESS WHEREOF, the parties hereto have executed this Amendment to
Consultant Agreement on the date and year first written above.
CITY OF SANTA ANA
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
." ~'J /.
By ,-'LiLCU;~,,-'X (J' ,/0 I
Laura Sheedy J
Assistant City Attorney
\"....-
- CERTIFICATE OF INSURANCE Cefrillc.ale,'IIu~r
MARSH 00)
.
PRODUCER
~S eERr'FlCATE 'S ISSUED AS A MATTER or 'NFORMATIO' ONLY AND CONFERS NO RJGHrs
MARSH CANADA LIMiTeD UPON THE CERtiFICATE HOLDER. THIS CeRTIFICATE DOES NOT AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDeo BY THE ~OL'CIES BELOW.
SUITE 2500,240. 4TH A YE:-iUE SW I COMPANIES AFFORDING COVERAGE
CALGAR Y, AB TZP 4H4
INSURED COMPANy ACE INA INSlIRANCF. COMPANY
A - ~ 003 -/73-0/ A
TELYENT FARRADYNE INC. COMPANY LIBERTY MUTU^L INSURANCE COMPANY
B
3206 TOWER OAKS BL YD. COMPANY
ROCKYILLE, M:.J 20852 A~ )..C()3~ (1~ C
COMPAH'(
D
COVERAGES
co. TYPE OF INSURANCE POUCY NUMBER POUCv EFFECTIVE POUCv EXPIRATION LIMITS
LTR ::JAT~ (MMtODIY'Q DAT'liMMlD~
A GE"'ERALAGGREGATE S 1.XtO,OOO
GENERAL. UABILITV
~ COMMERCIAL GENERAl.. LlABrUTY PRODUCTS - COMP/Op AGG , 1,OOIl,oeG
· 0 ClAIMS MADE t8'J OCCUlt CGL52375) 1 I PSRsONAI. So AfJV lNJURY , 1,000,000
P~OD~CTS' COMPLET!D OPEAATIONS OGLG2 I 6J2D4 I 06130/06 041l8/07
EACH OCCURRENCE S 1,000,000
SlJDDEN & ACCIDENTAl.. r>OLlUTION
aoDlLYINJUAYJo,/lf{)PItOPfltn'g"Iol~E FJRE OAMA.GE (ll.r1y 01111 lira) .
~ BLAtOl(n CONTRACTUAL lfABIllTY IvlEO EXPIAI1r or.eperSOllj . 10,000
A AUTOMOBLE llA8:JLITY COMBINED SINGLE LIMIT . 1,000,000
ANY AliTa
ALL.OWNEOAUTOS BODILYIN.,'URY .
(PeT"PllfSOI1)
SCHEDULED AUTOS CALH08138436 {)6130/06 041l &107
HIRED AUTOS BODILYIi'ill.RY .
(Per Accidentl
NON-OWNED AUTOS .
I PROPERTY DAMAGE I I
GARAGE UABIUTY AUTO ONlY_ EAACClDEf'fi .
B ANV AUTO orNER THA~ AUTO ON;. Y
EACH ACCIDENT S
AGGREGATE .
excESS UAB,tLITY I EACI-lOCCURRENCE .
B UMBRELLA FORM AGGRE"GATe S
OTHEi'l THA~~ UMBREllA, FO.r.M r-- I
s
B ~,;,,"~KEAS' COMPENSAlION AND X .l-. W(;.sr...ruTORV.. ! ~ OTHER J
EIJIPLOYERS'LIABILITY LIMITS
WCI-Dn_ a €ACH ACCIDENT . 1,000,000 !
THE PROPIllETOR! PA.IlTNE~1 DINel 170470-0l6 06130106 04118107
EL DISEASE - POLICY LIMIT , i ,000.000
EXEeur.....e OFFJCfIU ARE: OExCt.
EL OISEASE EACH EMPLOYE!: . 1,000.000
on...
DESCRIPTION Of; OPERATIONS' 1.0CAnoNS I VEHICLES' SPECJAlITEMS
RE: PROOF OF INSURANCE COVERAGE
It I, ""'oby undo",ood and aO'''' 1M" ,.... City of Sanla Ano, PWA - Tn,",portatlO" & T'affle Ero9l...o,',O OopartmOnl, is added., art Add':lo,all""'ed, ''''h ""pod to 'he
above-,oto' gene"'"ablllly eo'.."agO&, bu, D"y a, '''''I, Into",,, may appe" with 'o'Dee, to ,he Opo,.lIo" 01 Ihe Named '''",ed described abovo.
CERTIFICATE HOLDER CANCELLATrON
8hOlJll) ANY OF TI1.F; POLlGlES Oe;SCFi18ED ..EREI'- aE CANCELLE.:J EIl:fOilE T}{f l!;llPIRATION DAn:
TKE~Oo". THE "3IJReR(5)AfFOAtlI/olG COVERo\Olo "MLl ENDEo\.VOR TOloWl..1g OAVS\"fl.fTEN
City of Santa Ana NDrlGEr0ll1[CERTlF1CArEJ-lOl..J).;;l'l~:C.IIUTF.l\JlUFlE TOw./L SLlCHI-IOT'.a; SfW.L
~:~~?&Ell.~~~~"~N;~~~:~ [:; E::~"r~~~de~~~DMlr'(J\lH;IG.
PW A - Transportation & Traffic Engineering "'RSHCANADAlIM'Tr~
20. CiVIC Ct:nte; Plaza
Santa Ana, CA n701 1
Arlo: Vinh Nguyen, P.E., Sr. Civil Engineer MM1{Jf02) \6""""" VAUDASOF 12/1SJO&
~
..J..:::"::.'.
~ ~",--,,,,,,_,,,,,'J'Ql.(T!'\I."""Y"IO"''''..''''.oG:l 11I;>.
~C1 ;/3
~~RSH
CERTIFICATE OF INSURANCE
Cerlif~C<lI!!' Number
003,
MARSH CANMJA I./MITED
SUITE 2500, 240. 4TH A YENUE SW
CALCAR Y, AB TZP 4H4
INSURED COMPANY ACE INA INSURANn COM~ANY
A
TELYENT FARRADYNE INC. COMPANY
B
3206 TOWER OAKS BL YD. I COMPANY
ROCKVILLE, MD 20852 i C ----."-
COMPANY
.. D
COVERAGES
CO. TYPE Of INSURANCE I POLICY NUMBER POLI~ '..EFFECTIVE POlICY EXPIRATION LIMITS
trR DATE tMMlDDlYYI CATE (MMlODIVV)
GENERAL AGGREGATe s
GENERAL !.lABILITY
t:J , COMMERCIAl, GENERAL UA8ILfTY PROoUCTS - COMPIOP AGe> S
R 0 CLAIMS MADE 0 OCCUR PERSONAL & Atlv li'OJUF;!Y S
~ EACH OCCURREIIICE S
ARE DAMAGE (Any one Ilre~ .
MEO EXP (Any CflIl pel'$On) I
AUTOMOBILE UASllrrY CO~E:DSJNGl.ELIIvl~T s
ANY AUTO I
AlL OWNED AUTOS 80011. Y rNJURY I
SCHEDULED AUTOS (PerPcrson)
1= HIRED AUTOs BOD1L Y INJlRf
I (P&r.Aceldon4t I
NON.()~ED AllrDS
PROPfRrr DAMAGE I
GARAGE UABJUTY AUTO ONL V _ SA ACCIDENT I
AAV AUTO OTHER THAN AUTO ONLy.
EACH "'CODE,,",'T I
AGGREGATE I
exCESS UAB4UTY EACH OCClJRRENce I
8' UMBRElLA FOaM I AGGREGATE I
CTiHER lHAN UMBRELLA FORM
S
WORKERS' COMPENSATION AND X 1 we STA7lJTORY ! lOTHt:R
EMPl.OYERS' LIABILITY 1Il(m; I
El E1ICH ACCIOENT S
THE PROPRlf.rQltJiPAATNrJ;lS f D INCL I I EL DISEASE - POLICY LJ\IIIT I
tXI!!CUTM; OFFICERS ARe: DE""'-
a. DISEASE EACH EMPLOYEE .
A OTHER EACH ClAIM. EACH WROt..:GFlJL ACT
I 1,OO(l.OO~
PROFESSIONAl.. LIABiliTY I ERRORS &. EOPOO3525 I 06130106 04I11ll07
OMISSIONS LIABILITY
ANNU"lAGGREGATE . 1,000.000
O!SCRlPTJON OF OPERATIONS Il.OCATIONS I VEHICLES {SPECIAL ITEMS
RE: PROOF OF INSURANCE COVERAGE
CERTIFICATE HOLDER CANCELLATION
SHOI..uI >loNY or TH[ J>O~IClE$OE$C~BEO tlBl~IN liE Cf.NCEJ..,EO BaroR[. TI-E E.I<P!J<.IirlON CA.T!;
T1i~REO~, HiE. ~~ "'fFOIIDII';G OOVl::/VlOE WIU !.'faEA'IIOl<: TO. ~ Co\YS WRITTEN
City of Santa Ana l\jQ1'lCE '0 TI"lE CC~TTFICATE HOLCER I'IA.MEO tEREIN, aUT FA.I,Uil~ TO INdL SUCH I'IOTlCt SMAlL
~NOOllLICMTlON Of'llJ.t.BlLtfYOF M'r KIN" lJPQ"i THE ifIIW~R<S>AFfOADIIIlGCOYEFl.A.GE.
THEIR I\GEI1IrsOFl REPRES~~rATI\IES. OR r,'E I5:iVEROF fHl~ CfRTIFrc.o.TE
r PW ^ - TransportatJOn & Traffic Engmeenng MARSH CANADA liMITED V~ --
20 CIVIC Center Plaza - J
I Santa Ana, CA 92701
AUn Vmh Nguyen, P E, Sr CIVil Hngmc5r MfJI113l02l ( ____"o'U.tD AS OF: 12115.106 I
rHIS CERTIFICATE IS ISSlJEO AS A, MATTER OF INFORMATION OI'~L.Y All,tD CONFERS NO RIGHTS
UPOI>J THE CI:RiIFlCATE HOLDER. THIS CI:RTJFlCATE DOES NOT AMEND, EXTENO OR ALTER
TI-IE COVERAGE AFFOROI!:O BY THE; POl.ICIES 6ElOW.
COMPANIES AFFORDING COVERAGE
'~""""._""'''''~'>CIll.lD'I_~,_",_ -<<l3&d.x
~ch
-.-,._._~ ~."'4 ....';;"'" .C'C;
.
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
tnsurance Company
ACE lNA INSURANCE COMPANY_
This endorsement modifies such insurance as is affOrded by the provisions
of Polley # _CGL523753/0GLG21632041_ relating to the following:
1. The City of Santa Ana. 20 CJvic Center Plaza, Santa Ana, California
92701: its officers. employees. agents, volunteel"$ and representatives are named
as additional insureds ("additional insureds") with regard 10 liability and defense of
suits arising from the operations and uses pertonned by or on behalf of the named
insured.
2. With respect to claims arising out of the operations and uses
performed by or on behalf of the named insured, such insurance as is
afforded by this policy is primary and is not additional to or contributIng with
any other Insurance carried by or for the benefit of the additional insureds.
3. This Insurance applies separately to each insured against
whom claim is made or suit is brought except with respect to the company's
limits of liability. The inclusion of any person or organization as an insured
shall not affect any right whiCh such person or organization would have as a
claimant If not so included.
4. With respect to the additional insureds. this insurance shall
not be cancelled, or materially reduced in coverage or limits except after
thirty (30) days written notice has been given to the City of Santa Ana, 20
Civic Center Plaza, Santa Ana. California 92701.
(Completion of the following, including countersignature, is required to
make this endorsement effective.)
Effective _JUNE 30, 2006---.0 this endorsement fonn as a part of
Polioy # _ CGLS23753/0GJ..Q216J2041
Issued to _TELVENT FARRADYNE iNG,
Named Insured
Countersigned by
/~5l)
, .
(,
.' . 1:1.... '
1\@fe..g Yi-UZ- ~ -It - 2,,:03 -173
..---.CERTIFICA: E OF INSURANCE ~'ficaleNurro'" ;
[' ~~~~::::AD^-LlM'::-----I~:EE*'s,*,~7:E,~F~:~~'::'~~= I
SUITE 2500. 240 - 4TH A VENUE SW COMPANIES AFFORDiNG COVERAGE
CALGARY. AH T2P 4H4
INSUREO
COMPANY
A
COMPANY
B
COMPANY
C
COMPANY
o
fEDERAL INSURANCE COMPANY
TEL VENT F ARRADYNE INC
3206 TOWER OAKS BLVD
ROCKVILLE. MD 20852
.-..-.....--
CHUBB INSURANCE COMPANY OF CANADA
COVERAGES
35870772
'\ POLICY EI'ff:CTlVE POLICY EXPIRATION
DATE tM~!?iDL_ _._...~A..!!U..~~
l
I
I
I
GENERAL AGGREGATE
---....--...--
co. I
LTR ,
A ~ENERAl LIABILITY
COMMERCIAL GENERAL LIABILITY
o CLI\lMS MAOl:: t81 OCCUR.
!t8J PRODUCTS & COMPLETED OPEA'.iIQNS
tg) SUOOEN & ACCIDENTAl POLLUTION
l8J 800ILY IKJV"" ....0 f>ROI't'.R'lY O...../lGE
~ BlANKET COHTRACTUAl t lA8lllTY
11', A . AU;~MOBILE c.;;;;~;:;:..,
i ANY AUTO
, All OWNED AUTOS
l SCHEDULED AUTOS
i HIRED AUTOS
! 0 NON-OWNED AU"TOS
I P
f.-----t--- .
'I I GARAGE LIABILITY
I 0 ANY AUTO
, 0
! p
TYPE OF INSURANCE
POLICY NUMBER
PRODUCTS - COMPIQP AGG
()4/ 18/07
06101/08
PERSONAl. & AOV INJuRY
f------.....--....---.. - ,
t:AC.; \,)Ct;URflENCE
PROPERTY GAMAGE
1 $ 10,000
I
I $ , .000,000
1$
IS _________
I
j S
I
j
FIRE DAMAGE. {A\')'j ()f'\~ fife;
M!;;.O l-:.,XP (Anyone person)
73546717
04!j8/()7
04/ I g/Og
COMB\!-leO SI!-lGLE LIMIT
-'
BODILY INJURY
(Per Person)
~---
BOOIL Y INJURY
(PelA<:<juel1\;
......_-
AUTO ON\. Y - FA ".CCID~NT
S
I
..-" -..j
j
OTHER THAN AUTO ONl Y
f------
...-f.
I
I
4--.
i
!
\
i
fACH ACCI[)!;NT I S
-;~GREGATE I S
I S
EAC.; OCCUR!'ENCE i
AGGREGATE I s
--+ T 1.'ieST. ATUT~:-I='1 OTHER --I-~'
I UM\Tl:).. .
EL EACh ACCiDENT i $
"...-i
EXCESS LIABILITY
o UMBRElLA FORM
o OTHER THAN 11MBRELLA fORM
-.J
I--
I
I
..-.+.................
; WORKE:l:!t' COMPENSATiON ANLl
, EMPLOYERS' LIABILITY
i THE PRQPRJETOR j PARTNERS I
! EXECWTIVE OFFICERS Idl~,
o INCL
o EXCL
EL DISEASE - POl'CY LIMIT
$
Hr-OTHER I
I PROFESSIONAL LIABILITY I ERRORS & I
OMISSIONS LIABILITY 1
. : __......_______--1.__ I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES i SPECIAL ITEMS
\
-_._..._---_..j.~~_...-
i
!
EL Dt$EASE...:.ACW F>:.,.1-PLOY€E:
I S
Yi7R96W
04!18107
E.A.Ch Q..,p.,iM, EACH WRvNG~ UL ACT
()6iOl108 -----------------.-
~LANNUAL AGGREGATE
$ 1.000,000
$ 1.000,000
RE PROOF OF INSURANCE COVERAGE
It '5 "<'YOby understood and agreed that the City of Santa Ana, P\NA - Transportation & Traffic Engineering Department, is added as an Additional Insured, with respect 10 the
above-noted general liability coverages, but only as their interest may appear with resp(,'Cllo the operations of the Named Insured described above
CERTIFICATE HOLDER
CANCELLATIO,r-
$i:OUlO ANY Of TH~ t:'\}\.,Cll:'S nf,3c?:1~D rlER2':N BE CA,"-'CElLf.G ae:rt"::<RF. THE p.;P:RI!.";i)~ (:...H[
THE~.E~-,"rlf ".JtWHU<(S) N'FORQ,!'J(; CCVE~E W:LL. ENOtAVOP. ,0 W>Jl.J9 CAYS h"{lnL~j
NuTIC~:: TO THE CC:RTf+:I(:..ATE !-,OLlER !>./AMiU) !"1f.Rr:N BU'i u.\H..uRE TO "'!AlL we,,", "V'..) ; let ;)tlAll
\MK)~ NZ) OBUOf,T!C-N OR uABi" ,T" v~ Ar~Y ~JN(l UPCr<i THE jNSUR€RI~YI ~rfOMOlN'3 C0',,-::AJ\.G~
TH~::;::: .t..GENTS OR ~~E~'>fNT,.l, tfOlU"i, OH HIE ~$;:SU€R (.F rH'S~;'ERnfl:::';A If.
MARSH CANAoALl'HlTj /1 _~_..
!V L.-~
~M~ (31~~_ __ - H;!-~ VAllO AS OF HiS:Apr-Q7
L
! Ctty of Santa Ana
PWA ~ Transportation & Traffic Engint"t:rmg
20 Civic Cenler i'l:lLa
Sant,] Ana. CA 92701
"'j
"'rill. \' mh Nguyen, rE. Sf. eml ~~~I~~:~
-_..j
. ,r""',_f '~"'"(." "(, "<1:A.<!;f1'",-,: r ~'iiiW'<!>-1'.....'J-.", ~a,c,,~ $,*,,'<';" ::i.":) 'jv.
,'>x/
--::::::-Xy L:./
-1
'(;----/
/ j(.
I ~
,"-,
I
Liability Insurance
Endorsement
Policy Period
APRIL J8, 2007 TO JUNE 1,2008
Effective Date
APRIL 18. 2007
Policy Number
3587-07-71.:iAB
Insured
Tl::.LVENT fARRADYNE INC AND
TEL VENT USA. INC.
Name of Company
FEDER...\L [NSURA.NCECOMPANY
Date Issued
SEI'TE:V1BER&,2007
CiENERALLIABlUTY
rhis l'ndorsement applies to the following forms:
WHO IS AN
INSURED
OesignatedPerson
Or Organization
LiabiJity Insurance
Form 80-02-237~Ed 4-94)
SCHEDULE
Designated Person or Organization:
CITY OF SANTA ANA
Under Who Is An Insured, the following provision is added:
Any person or organization designated in the Schedule above and
with whom yotl havc agreed in a written contract or agreement to
add as an INSURED, but they are INSLJREDSonly with respect to
liability arising out of your operations or premises owned by or
rented to you.
However, our obligation to such persons or organizations as
insureds is limited to:
the terms and conditions of th is i Ilsurance; or
the minimum requir\:d tcmlS and conditions of such written
contract or agreement;
whichever is less, and ends when:
the written contract or agreement expin:s; or
this policy expires;
ADDITIONAL INSURED/OESIGNA TED PERSON OR ORG.
Refelel'1ce. Copy
Endorsement
/;... ----
/Y/'" -./.
~." <. ; .,----;'" Lk:
contmued
Page 1
UtlbiJity insurance
Form 80-02-23qEd. 4-94)
whichever is earlier
CONDITIONS
Only with rcspectto coverage afforded under this endorsementto
the person or organization designated in the Schedule above,
under Conditions, the following provision is added:
GOVERNMENT IMMUNITY
We shall not without obtaining the express advance writtcn
permission from General Counsel of the CITY OF STA ANA, raise
any defense involving in any way the jurisdiction of the
tribunal over the person of the CITY OF ST A ANA, the immunity
of the CITY OF ST A ANA, it'sCommissioners,officers, <lgents,
or employees, the governmental nature of the CITY OF ST A ANA,
or the provisions of any statutcs respecting suits against
the CITY OF STA ANA.
CONDITIONS
Under Conditions of the Common Policy Conditions form, the
provision titled Cancellation is amended to include:
CANCELLATION
This insurance may not be materially modified or cancdled
withollt thirty (30) days writtcnnotification (except 10 d"ys
notice for nonpayment ofpremium)to: THE CITY OF STA ANA,
CALIFORNIA, addressed to the specific ail1)(U1. where the CITY
OF ST A ANA plate was issuetl, altn: police motor vehicle
inspector.
All other terms and conditions remain unchanged.
Authorized Representative
/2;J~
'm.. r
/.r/{.7--,
'~./'
/-
ADDITIONAL INSURED/DESIGNA TED PERSON OR ORG.
t<eferen-:e COpy'
Endorsement
.m /
)II -.
. ,
last page
Page 2
. .
Liability Insurance
Endorsement
Policy Period
AI)RILI8.2007 TO JUNl: L 2008
Effective Date
APRI L I ii, 2007
Policy Number
3587-07'711AH
Insured
Tl:LVENT FARRADYNE INC AND
TEL VENT USA. INC.
Name of Company
FEDERAL INSURANCECnMPA NY
Date Issued
AUGUST 10. 2007
GENERALLlABILlTY
This Endorsementapplies to the following Jlmns:
Conditions
Other Insurance"
Primary Additional
Insured
Liability Insurance
Form 80-02-26~Ed 4-01)
Under Conditions, the following condition is added:
If you agree, in a written contract, agreement or permit, to provide primary insurance for any
person or organization included in Who Is An Insured, this Other Insurance' Primary Additional
Insured condition applies.
If other valid and collectible insurance is available to the insured for loss we would otherwise
cover under this insurance, our Obligations arc limited as follows.
Primary Insurance
This insurance is primary. We will not seek contriblltionsfrom any other insurance available to the
persoll or organization with whom you agree to include in Who Is An Insured. except when the
Excess Insurance provision applies.
Excess Insurance
Tbis insurance is excess over any other insurance, wbether primary, excess, contingent or on any
uther basis:
A. that is Fire, Extended Coverage, Builder'sRisk, Installation Risk or similar insurance for
your work;
>/,-
y~,<
Other Insurance - Primary AddIRh1i'lli:t~e Copy
Endorsement
COrltillued
Page -I
Conditions
Other Insurance-
Primary Additional
Insured
(continued)
Liability Insurance
Form 80-02-26S:JEd. 4-01)
B.
that is insurance that applies to property damage to premises rented h) you or temporarily
ot~cupied by you with pcrmissionofthe owncr:
if the loss arises out of aircraft, autos or watcrcrafi (10 tbe extent nol subject to the Aircraft,
Aulos Or W alertTaft exclusion):
c.
D. that is iIlsurnIlce:
I. proVIded to YOll by any person or organization working under contract or ,lgrecrnent
for you; or
, ll.llder which you are induded as an insured: or
E. thai is insurance under any Property section oftllis )lolicy.
When thIS II1surance is excess, we will have no duty [0 defend the insured against any suit ifany
otber insurer has a duty lo Jcfcnd such insured against such suit. I I' no other insur"r ckknds. we
will undertake to do so, but wewill be t~ntitled to the insured'srights against all those other
insurers.
When this insurance is excess over other insurane", we will pay only our share of the amount of
loss, if any, that exceeds the sum of the total:
amount that all (,lther insurance would pay for loss in the absence ofthis insurance; and
of all deductible and self. insllrecnmollnts under all other insurance.
We Will share the remaining loss, i I' any, with any other insumnee that is mlt described in this
Excess Insuranceprovlsiol1 and was not negotiated specifically to apply in excess of the 1.imitsOr
Insurance shown in the Declarations of this insurance.
Method of Sharing
If all or the other insurance pemlits contribution by equal shares, we will follow this method alst).
Under this method eaeh insurcreontributcs equal amounts until it has paid its applicable limits of
insurance or none of the loss remains, whichevt:r comes first.
rf any of the ot]1er insllrance docs not permit contribution by equal shares, we will contribute by
limits. Under this method, each insurer'sshare is bascd 011 the ratio of its appl icable limits of
insurance to the total applicable limits ofinstlrance of all insurers.
All other tcrms and conditions remaillunchanged.
Authorized Representative
w~
, ,/' :.~ '-
/" . ,
. I,
I ,,/ (I'
I
Olherlnsurance' PrimaryA(Jditiona~ence Copy
Endorsement
fast page
Page 2
A - ~OO 3
/72>
MARSH
CERTlACATE t>A'-JueER
01Q
-.oocEll
MARSH CANADA LIMITED
70 UNIVERSITY AVENUE, SUITE 800
TORONtO, ON M5J2M4
THIS CE,ATF)CATE IS JSSU[;D AS A MATTER CF !f\FORM,\TION Ol'I..Y AND COf>FER$ NO RJ3HTS \..POf>.l1l-E CfRTlflCATC HOI...!::€:R
()T}.E:A 'tHAN THOSE PRO'Y,CED flY tHIS POUCv TH1$ ca:nlACr\.tE (X)ES. NOT Mlt(HO. EXlENO ~ AlTffi T)-E ~
MFt;;R.Q;t) 8Y 'tHE P<XJCtES ~ reElH..
COMPANES AffOftDWG COVERAGE
_D
TEL VENt FARRADYNE INC.
3206 TOWER OAKS BLVD.
ROCKVILLE, MD 20652
c..OWN'f't
A
TWIN CITY FIRE INSURANCE COMPANY
cow""'"
B
COIooI'''''''
C
~""y
o
CO~.'.
Tl1f$lS TO C(RT1fY ntAT 'tHE Paleo ($- ~ l.iS'TfO ~ HAVE. ~ lSSUEO TO nE H3lIED ~ HEREJii FeR. nE PERIOO fS INSlflANCE 1tOCAT'ED, NOTYt'lTHSTAHrnNG AHY ~AENi, TERM OR CONOmON 1$~""
C:CJH'l'RACT" ()lit one DOCUMENT WITH FiEtifltCl TO'Mi.ICH Tt-E c::SmFlCATE MAY BE I58t..EO ~ MAY ~AIH. TtE IN5'.FINfCE ~ BY T~ POl.ICES U$TfO HEREIN IS SlaIECT TO All.. nE "!"ERWS. ('.ClfOT1ONS NO €,XCU.J81CNS Cf-
SlX:H PQlJG."ES uwrm SJofOWi'IN MAY I'4AVE &N REOUCfD BY PAID ClAIMS
c;o
UIl
TYP\!!'_
l'CUCY NUM8lll
PQUCY Il'RCTM DATE
'MMIOOI'fV)
POL<:Y EJ<l'IIA11ON DAn
\..MIOOI'fV)
UNftS
GENER.JrL UA8UlY
G9ERAl~'Te
COM"-ERClAL GOI'RAl LlABL'TY
PR(XlUC TS < CQoMPlOP ~
C\.A(\L'i M~
O""'LIl.
~ " AQV 1'NJUR'r
~ S" CON't'AACTQR.S PROT
EN::HOCC~
FIRE OAMAQ; IA#ly OAII ftre)
WEO€n> 1M, OM pon~l
j;
.$
AUlOMOQU.LUSr8iUi"t
(AlMarNE.O'~l.tU!T
ANY AuTO
ALL ~D AUTQ:8
0Cl0tl y IN..JORV
{'P.~.
$
$oEt.a.J'...E"O AUTOS
PRi~r'r DAMAGe.
I $
'UWONl~_"ACCIt""T~ _$ ~i
one THM AUTO CoNt '(
- -- --~~
:"'HACC\~"'N' $ _ 1
A~OAn: $; i
fA(,J~"""'~-;:;;;- ----~__ $ _ .1
AGa:~n'-OATe: S ;
-CHH.cR -i
",N'~U"' -, ,:ooOOoi
.----1
1.000.000 !
1,000,000
$ ----J
I1IRfP AUTos.
900C.v<~y
tP~~::Mnl)
N0N.-0'A~[) Al.;TOS
GAAAGf. UABUTl'
B "" ,um
I
ElCO$$ UHilUi'f
U~llft i;,~M
C '(1..-:RY"4>,N \..='-lBAfL..o\ f,,-~M
A
~.- COMM::NSAnoH AHO fMPl:OYfRS'
UASalT't
83 WB TC1327
01/31/07
01/31108
,-t(-. f1K~jsnJ.(} PAR rr....R$.!
EXfCV11'{[ OfFICERS AAE
11 :~ .mm
EL OfSfAf..€ f'(lt.JCY t .MIT
EL Q(;:;(.A.SE:. ~H EMPlOYfE
OHa
OE$Cfl$'fJON Of' OP[R.6.rJON9lLOCAl1oH3NE.H~cw. rTEMS
RE: PROOF OF COVERAGE.
CSlTlfICA1;E t\Ot.tlE~
:',;~it; ':;c~t~,:'A'li9N
$HO\.W ANY Of ll-E. llOUClf.a cor..R1ElED rERElN BE. CANCELLEO ~_ DE ~rfON DAn:. TJ.6ECF. il"E
I~S) ~ COVERAGE. WIlL EN)EA~ TO MAIL }Q. OAYS ~ OOTlce TO tHE: ~TlACAiE
HO..OCR NAtED ~. 9VT FAJl\..AE 10 lMlL SJ.X;H NOTICE SKAU IW'OSf NO OBLlGAflON ~ UAB!un Of:. ANY
KINO lPON nE !NS~3) !\FFOOOINa COVlRAGE, Tt-EIA AGf:ms ()ft ~SENrA.Tl'1E,s.. 00 HE W~ a: THf.S
CXRflftCA1'E
CITY OF SANTA ANA
PWA - TRANSPORTATION & TRAFFiC ENGINEERING
20 CIVIC CENTER PLAZA
SANTA ANA, CA 92701
WAR>>! CNU.DA UMJT'EO
I/;!. /i ,,-'-m_
,~~ 4L/t.C;(~
MM1 (3102)
DATE: 5121'1007
:/4\
\ ";
" ' <'
/! ..
l
/ ' .
I
/
. .
"
Crystal Kingsmith
MARSH
Marsh Canada Limited
Livingston Place
222. 3rd Avenue S.W" Suite 1100
Calgary, Alberta T2P 084
4032907900 Fax 403261 9882
Memo
To:
Date,
From:
Subject:
Vinh Nguyen
September 10, 2007
Crystal Kingsmith
City of Santa Ana
As per your request, please find enclosed the endorsement adding the City of Santa Ana as an
insured to the liability policy including a letter from Chubb outlining the policy change that was
made.
Please note that there is a typo error in the last paragraph of the letter. It says "City of Los
Angeles" instead of "City of Santa Ana", However, the endorsement specifically shows the City
of Santa Ana.
Trust at! is found to be in order.
Sincerely,
C f01'cY]V'-~
Crystal Kingsmith
MAte ~./,-w>h y. 1\-\ l "-'I'r,d1^'. C<:::moanIE')
~ .
..
:ll"h ('anad:l Limited
:! :1,,<1 \H~nU{; S\\
< ;\B
Rc: Additional Insured: The Cil~ of Santa Ana
Named Insured
'fclventFarradyne
Policy Type
Mod Pkg.
Policy Number
35870772
Effective Date
4i18/2007
Underwriting Company
Federal Insurance Company
To Whom It May Concern:
Our broker has recently furnished us with copies of special endorsements that you have
requested we add to the General Liability Policy that we have issued to the named insured. For
various reasons we do not accept endorsements to our policies that are initiated or drafted by
individuals or entities outside of our company.
Alternatively, we will.lgree to the following:
Insurance Requirements
· You, your employees, officers, volunteer,.., representatives and agent... will be added as an
additional insured under the above referenced named insured's General Liability policy, as
providedfor in the attached Additional Insured Endorsement 80-()2-2373.
· Additional Insured protection afforded to you will he issued on a primary ami non
contributory basis, m' outlined in endorsement 80-02-2653. A copy of the endorsement is
attached for J'our reference.
· We will prm,ide you with notice of cancellation in accordance with the term... outlined in the
Common Policy Conditions, Cancellation provision of the insured's contract. This affords
60 da.vs notice of cancel/ation, 20 days for non payment of premium.
· Upon request, we will provide YOll with a certijied copy of the General Liability polk:v to
which you are afforded additional insured protection.
· Our General Liability policy contains tl "!I'everahi/i~~' of interest.." (Separ(l/ion of Insureds)
provi...ioll, as outlined on page 23 of tire General Liability polh)',
Sincerely,
.Jodi Petrillo
We trust that the above points address the requirements of the General Liability for the specified
contract. Please remember that whether or not a claim is covered under any insurance policy can only
be determined at the time of loss by applying all the policy provisions to the facts and circumstances of
the claim.
WI;; trust that the above points address the requirements of the General Liability special Endorsement
for the City of Los Angeles. Please remember that whether or not a claim is covered under any
insurance policy can only be determined at the time of loss by applying all the policy provisions to the
facts and circumstances of the claim.
A-'2"O~-113
"
~
-o(
MARSH CERTIFICATE OF INSURANCE CERTlFICATEMMllER
08I09-011-WC
"""'""" niI& CERTFICATE IS ISSUED ItS II MATTER OF lNfORMA11ON Dtl..Y AHD CONFERS NO RIGHTS UPOH THE CERTIFICATE
MARSH CANADA L m. HOLDER OTHER Tw.N THOSE PROVIDED BY ntlS POUC'I'. nus CERTIFICATE DOES NOT N.IEND. EXTEI<I> OR ALTER llE
COVERAGE AFFORDED BY TI-E POUClES DESCRIBED I-EREIN.
70 UNIVERSITY AVE., 8TH FLOOR
TORONTO, ONTARIO Co..ANIES NFORDING COVERAGE
MSJ 2M4
........ -"" LIBERTY MUTUAL INSURANCE COMPANY
TELVENT FARRADYNE INC. .
3206 TOWER OAKS BLVD. ~
ROCKVILLE, MD 20852 .
co..""
c
-""
D
COVERAGeS
THIS IS TO CERTIFY THAT THE POlICIES OF INSURANCE USTED HEREIN HAVE BEEN ISSUED TO 1I-E INSlIRED NAAIED HEREIN FOR TJ-E PEFlDD Of I~ NltCATEl. NOlWlTHSTANDINGNN REQUIREMENT. 1ERM OR CONOITlOH OF NfY
CONlRACT OR OTHER OOCUMEH'TWIllf RESPECT TO WHICH 1HE CERT1FlCATE MAY BE ISSUED OR MAY PERTNN. THE IHSI..lRANCE I\FFORDED BY THE I'OUCIES llSlBl HEREIN IS Sl.IlJE;CT TO All THE 1ERMS, COMIITlONS AND EXa.lISIONS
OF SUCH POLICIES. lIMITS SHOWN MIlo'!' HAVE BEfN REDUCED BY PAlO CLAIMS.
co """"""""" """"....... POUC'l'EFI'EC'TlVEDAlE. POUCYlEllPIRAllONOATE ~D
CD -" -"
~G8lEfW. UA8lUTY GENERAL AGGREWt. TE .
ca.1MERClAlGENERllLLIA8lLITY PROOUCTS. COMP/OP AGG .
f- h""",,"""
0 OC"", PERSOMAl &AlJV !HJUff .
OWNER'S & CONTRAClOR'$ PROT EACH OCCURRENCE .
- FIRE DAMAGE (.In)' """ InJ .
-
MEDEXPlAnY__l .
AUTOIIOIII\.E UA8lUTY COM8IIED8INGLEU~ .
- AH>'AUTO
- AlLOWNEOAlITOS 800ILYINJURY .
- ,...-
SCHEDUlE!) AUTOS
I- IlOOllV1NJURV
H1REDAUros .
I- ,... ......
I- """",,,,,,ones
- PROPERN D/lIMGE .
......""""'" AUTOOHlY-EAACCIDENT .
'- "".on> OTHERTHANAUTOONLY:
- '^CH""",,"' .
- """"""E
.
=r=:o~ EACH~RENCE .
......""" .
OTHER THAN 1MBRaLA FORM .
A WClRKERS'cc:.PENSAlIONANDEMPLOVERS' X I ~':';'~AT\J.TORY I I OlHER
"""'""
WC2.B71-17Q470-028 02116108 02/16/09 a EACHNXDENT . 1,000,000
nJEPROPRlETORIPAATNERS/ Pl'~ a OlSEA$E-POUCYUMT . 1,000.000
exec:UTNEOFl'ICERSARE:
~" a 0lSEAIlE EACH EloIPI,OYEE . 1,000,000
0"'"
DI!SCRll'l1ONOIFOP9ATlOM$ILOCA1KlNSNalCLI!SIV'ECtAl.ITEMS
RE: PROOF OF WORKERS COMPENSATION COVERAGE.
CERTIFICATE HOLDER CAIICllUA_
SIiOUl.D AN'( OF 1HE POUClES DESCRIBED HEREIN BE CN<<:EUED BEFORE THE EXPIRAllON IlATE lHEREOF. TIE
CITY OF SANTA ANA 1NSUREA(8} AFFORlllNG CO\IEA.AGE WILL ENDEAVOUR TO w.I. all [),f.YS WAlTiEN N:lTICE TO THE CERllFICATE
PWA - TRANSPORTATION & TRAFFIC ENGINEERING tIOI.DER tw.lEO tERJ;:1N, BUT fAILURE TO llWL SUOi NOTICE SHALL M"OSE NO OBlIGATION OR U/l.8l1TY Of N<<
Kl~ uPON THE INSURER,S) AFFORDING COVERAGE. THEIR AGEN1'S OR REPRESENTATIVES. OR lHE ISS~ Of TltIS
20 CIVIC CENTER PLAZA CERTFlCAN-
SANTA ANA, CA 92701 1MRSHCAHAD.A~1'I!'D
.J:= /
~-0iLtj
MM1(3I021 DATE: 5I2nJJ07
~
CERTIFICATE NUMBER
PRODUCER
08/09-011-WC
MARSH CANADA LTD.
70 UNIVERSITY AVE., 8TH FLOOR
TORONTO, ONTARIO
M5J 2M4
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER OTHER THAN THOSE PROVIDED BY THIS POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN
COMPANIES AFFORDING COVERAGE
INSURED
TELVENT FARRADYNE INC.
3206 TOWER OAKS BLVD.
ROCKVILLE, MD 20852
A - cR003 - /73
A - ,2003 - /7J- 0 /
COMPANY
A
LIBERTY MUTUAL INSURANCE COMPANY
COMPANY
B
COMPANY
C
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE PERIOD OF INSURANCE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY
CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS
OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE INSURANCE
POLICY NUMBER
POLICY EFFECTIVE DATE
(MM/DDIYY)
POLICY EXPIRATION DATE
(MM/DDIYY)
LIMITS
GENERAL LIABILITY
GENERAL AGGREGATE
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE
o OCCUR
PRODUCTS - COMPtOP AGG
PERSONAL /I. ADV INJURY
OWNER"S /I. CONTRACTOR'S PROT
EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
(Per person)
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
BOOIL Y INJURY
(Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY
EACH OCCURRENCE
UMBRELLA FORM
AGGREGATE
OTHER THAN UMBRELLA FORM
WC2-B71-170470-028
021 16/08
OTHER
A
WORKERS' COMPENSATION AND EMPLOYERS'
LIABILITY
02/16/09
EL EACH ACCIDENT
1,000,000
1,000,000
1,000,000
THE PROPRIETOR! PARTNERSf
EXECUTIVE OFFICERS ARE:
X INCL
EL DISEASE - POLICY LIMIT
EXCL
EL DISEASE EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONSJLOCATlONSNEHIClESISPECIAL ITEMS
RE: PROOF OF WORKERS COMPENSATION COVERAGE.
CITY OF SANTA ANA
PWA - TRANSPORTATION & TRAFFIC ENGINEERING
20 CIVIC CENTER PLAZA
SANTA ANA, CA 92701
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE
INSURER(S) AFFORDING COVERAGE Will ENDEAVOUR TO MAil ;lQ DAYS WRITTEN NOTICE TO THE CERTIFICATE
HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY
KIND UPON THE INSURER(S) AFFORDING COVERAGE, THEIR AGENTS OR REPRESENTATIVES, OR THE ISSUER OF THIS
CERTIFICATE.
MARSH CANADA UMITED
(p'. /' ~-,
/;-~.< xte:?&z.A
,/ ~/ "'
MM1 (3/02)
DATE: 5/2/2007
'~
/:=~"