HomeMy WebLinkAboutECHAN, BARBARACity of Santa Ana
..~._r Clerk of the Council
AGREEMENT TERMINATION
Call 647-6520 if ou have an ~ ~~
y y questions. ~- '-
- `~1
---=-
n ~ -------------
?~~ A
Please complete this form when the attached agreement is no longer in effect. r r~.
r (~ ~t~ ^• ~!6
Return form to the Clerk of the Council Office M 30
The agreement with
No. ~~(~ 08 - ~ was completed on / ~.7% / C~
and final payment has been made.
Department:
Phone/Ext.: ~aec~~C~\I~~ ~~U~
r mE ~.. ~~:~r-.~
Revised 12-07-07
signature: EEB 01200 J
Date: ~ D ~ fD/~,
INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
s- - / - OS ..fJft~UiKjA!11 ,
CLERK OF COUNCIL ~ .
DATE: PROFESSIONAL SERVICES AGREEMENT
THIS AGREEMENT made and entered into this ~ day of November, 2007 by and between
Barbara A. Echan (hereinafter "Contractor"), and the City of Santa Ana, a charter city and municipal
corporation organized and existing under the Constitution and laws of the State of California (hereinafter
"City").
N-2008-005
RECITALS
A. The City desires to retain a Contractor having special skill and knowledge in the field of
arbitration and mediation to provide professional administrative hearing services.
B. Contractor represents that Contractor is able and willing to provide such services to the City.
C. In undertaking the performance of this Agreement, Contractor represents that she is
knowledgeable in the field and that any services performed by Contractor under this Agreement
will be performed in compliance with such standards as may reasonably be expected from a
professional consulting firm in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms
and conditions hereinafter set forth, the parties agree as follows:
I. SCOPE OF SERVICES
Contractor will provide professional Administrative Hearing services for the City of Santa Ana
Community Preservation Department and Public Works Department, as set forth Exhibit A. Said
hearings may include Vehicle Abatement, Administrative Citation Appeals, and Alternative Public
Nuisance Abatement. Administrative Hearing officer services may be utilized by other agencies within
the City of Santa Ana.
2. COMPENSATION
a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates
and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed
$10,000.00 during the term of this Agreement.
b. Payment by City shall be made within thirty (30) days following receipt of proper invoice
evidencing work performed, subject to City accounting procedures. Payment need not be made for work
which fails to meet the standards of performance set forth in the Recitals which may reasonably be
expected by City.
3. TERM
This Agreement shall commence on November 1,2007 and terminate on December 31,2008,
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 of the Planning and Building Agency, the
Executive Director of the Public Works Agency and the City Attorney and Contractor.
4. INDEPENDENT CONTRACTOR
Contractor shall, during the entire term of this Agreement, be construed to be an independent
contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to
create an employer~mployee relationship, a joint venture relationship, or to allow the City to exercise
discretion or control over the professional manner in which Contractor performs the services which are
the subject matter ofthis Agreement; however, the services to be provided by Contractor shall be
provided in a manner consistent with all applicable standards and regulations governing such services.
Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and
similar taxes relating to employees and shall be responsible for all applicable withholding taxes.
S. INSURANCE
Prior to undertaking performance of work under this Agreement, Contractor shall maintain and
shall require its subcontractors, if any, to obtain and maintain:
a. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the
Labor Code, Contractor, if Contractor has any employees, Contractor is required to be insured against
liability for worker's compensation or to undertake self~insurance. Prior to commencing the performance
of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability
insurance with limits not less than $1,000,000 per accident.
b. Professional liability (errors and omissions) insurance, with a combined single limit of not
less than $1,000,000 per claim.
c. The following requirements apply to the insurance to be provided by Contractor pursuant to
this section:
(i) Contractor shall maintain all insurance required above in full force and effect for
the entire period covered by this Agreement.
(ii) Certificates of insurance shall be furnished to the City upon execution of this
Agreement and shall be approved in form by the City Attorney.
(Hi) Certificates and policies shall state that the policies shall not be canceled or
reduced in coverage or changed in any other material aspect without thirty (30)
days prior written notice to the City.
6. INDEMNIFICATION
Contractor agrees to and shall indemnify and hold harmless the City, 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 operations of the Contractor
or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates
to the provision of services described in Section I of this Agreement.
7. CONFIDENTIALITY
If Contractor receives from the City information which due to the nature of such information is
reasonably understood to be confidential and/or proprietary, Contractor 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
2
information includes not only written infonnation, 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 infonnation that (a) has been disclosed in publicly available sources;
(b) is, through no fault of the Contractor disclosed in a publicly available source; (c) is in rightful
possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by
operation of law; or (e) is independently developed by the Contractor without reference to infonnation
disclosed by the City.
8. CONFLICT OF INTEREST CLAUSE
Contractor covenants that it presently has no interests and shall not have interests, direct or
indirect, which would conflict in any manner with perfonnance 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 City:
Clerk ofthe City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
telefacsimile (714) 647-6956
With courtesy copies to:
Executive Director of Planning and Building)
City of Santa Ana
20 Civic Center Plaza (M-20)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 973-1461
and
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-6515
To Contractor:
Barbara A. Echan
3056 Madeira Avenue
Costa Mesa, California 92626
3
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, dilly 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 City and
Contractor, and supersedes any and all other agreements, oral or written, between the parties. In the event
of a conflict between the terms of this 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 City and by Contractor. 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 Contractor nor the City. 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 Contractor,
Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written
consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior
written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit
the City's ability to have any of the services which are the subject to this Agreement performed by City
personnel or by other contractors retained by City.
12. TERMINATION
This Agreement may be terminated by either party upon thirty (30) days written notice of
termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor
compensation for all services performed by Contractor prior to receipt of such notice of termination, subject
to the following conditions:
a As a condition of such payment, the Executive Director may require Contractor to deliver to the
City written Findings and Determination for any case in which Contractor has served as a hearing officer, and
in such case such Findings and Determination shall be the property of the City unless prohibited by law, and
Contractor consents to the City's use thereof for such purposes as the City deems appropriate.
b. Payment need not be made for work which fails to meet the standard of performance specified in
the Recitals of this Agreement.
13. DISCRIMINATION
Contractor 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.
4
Contractor affinns 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, perfonnance, and enforcement of any of the clauses of this Agreement shall be detennined
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. PROFESSIONAL LICENSES
Contractor shall, throughout the term of this Agreement, maintain all necessary licenses, pennits,
approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by
the laws and regulations ofthe United States, the State of California, the City of Santa Ana and all other
governmental agencies. Contractor shall notifY the City immediately and in writing of its inability to
obtain or maintain such pennits, licenses, approvals, waivers, and exemptions. Said inability shall be
cause for tennination of this Agreement.
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 of this Agreement, and shall indemnifY City
fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such
authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the
body of this Agreement.
II
II
II
II
II
II
II
5
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above
written.
ATTEST:
CITY OF SANTA ANA
~
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By: fr/({ \ \r, .~ \( L If;'(..
Laut8. Sheedy ..:::?
Assistant City Attorney
BARBARA A. ECHAN
RECOMMENDED FOR APPROVAL:
c-f!nA hl'.J A A (). f1-.Aa1"--
BARBARA A. ECHAN
TaxID# S47'BA -~312
~vmo
ecutive Director of the
Planning & Building W
6
EXHIBIT A
SCOPE OF SERVICES
I. Backanound
In order to provide effective and expeditious hearings to individuals cited for violation of the Santa
Ana Municipal Code, the City would like to develop 8 list of Hearing Officers to conduct
administrative hearings regarding alleged violations of the City's Municipal Code. In an effort to
streamline the hearing process, the City proposes to establish a list of qualified hearing officers
that can be assigned as needed on a rotating basis,
Contractor shall conduct Administrative Hearings for the City of Santa Ana. Primarily the
Contractor will hear administrative citation appeals, alternative nuisance abatement proceedings
and vehicle abatement proceedings associated with action of the City's Planning & Building
Agency and Public Works Agency. Contractor may be asked to provide administrative hearings
for other City Agency's.
The Hearing Officer will be charged with making a just determination as to whether a municipal
code was violated, whether the property owner is still in violation, and will also make
determinations as to whether the process for the abatement of a nuisance, including inoperative
vehides, will move forward. Hearings will be held in accordance with the City of Santa Ana
Municipal Code sections 1-21.8,16-119,17-105,17-108, and 17-135.
1/, Generallnfonnation
It is the intent of the City to establish a list of qualified Hearing Officers. The actual number of
hearing officers to be utilized will depend on the total number of qualified candidates established
by the proposal process, and the number of hearings to be provided.
A When appropriate, the City will provide forms and information in its possession relevant to the
conduct of a fair hearing, including but not limited to Notices of Violation, Administrative
Citations, and Vehide Abatement Notices.
B, The Hearing Officer shall be responsible for the review of documents provided by the City
prior to the hearing.
C. All documents and other products used or developed during preparation for a hearing will
become the property of the City.
· Contractor shall preside over the City's administrative hearings. Cotnractor will be required
to independently evaluate the facts of each case and make a determination as to the merits
of that case based upon the information presented at the hearing and the Santa Ana
Municipal Code. The Hearing Officer must be experienced and knowledgeable in
administrative hearing procedures. The Hearing Officer shall be responsive and maintain
excellent working relationships with property owners, residents, business representatives,
and City staff. Contractor's service will include preparation of findings of facts, hearing
dispositions, billing statements, and other documents as necessary.
Job Requirements for Administrative Hearing Officers
A. A hearing officer must be independent and impartial. In this regard, a hearing officer may not:
1. be an employee of the City of Santa Ana or any publiC agency that is involved in testifying
at a hearing; be a member of any board of commission of the City of Santa Ana;
2, have a personal or professional interest that would conflict with his or her objectivity in
the hearing;
7
B. All hearings will be conducted at Santa Ana City Hall, at dates and times to be determined by the
City.
C. A hearing officer must possess the necessary support and equipment to perform his/her duties as
a hearing officer. At a minimum, the hearing officer must have and maintain in good working order
(1) a telephone (monitored during business hours by a secretary, answering service or answering
machine or system); (2) a facsimile machine; (3) a personal computer, with internet service,
running Windows and Microsoft Office compatible software; and (4) an electronic mail address.
D. A hearing officer must possess standards of neutrality and confidentiality.
e, A hearing officer must organize and maintain individual case files along with detailed records of
activity on each case, such as research, drafting of orders, decisions, and correspondence,
F. A hearing officer must comply with all legal and contractual timelines, inCluding but not limited to:
1. rendering a final written decision, including findings of fact disposing of all issues raised
by the parties in a hearing not later than the 10th day following the date on which the
request for hearing was filed;
2. mailing the final written decision to the City on the date the decision is rendered;
3, returning individual case files'to the City within 30 days of rendering a final decision. The
files which must be organized and maintained by the hearing officer are the property of
the City of Santa Ana and must be maintained in accordance with the Agency's record
retention schedule. It is therefore imperative that the files are returned to the Agency
within 30 days of the date of the issuance of the final decision,
4. Upon notification that the agency has received a request for a document pursuant to the
public information act, the relevant document must be provided to the City immediately.
G, The hearing officer shall prepare and submit to either the Planning & Building Agency and/or the
Public Works Agency by the fifth of each month a standard invoice detailing the activities and
expenses by case. An invoice template will be provided, Payment for services and
reimbursement of expenses by the City to a hearing officer are further conditioned upon:
1, The reasonableness of the amount of time spent by the hearing officer on the case(s) for
which the hearing officer is seeking payment/reimbursement;
2, The hearing officer's timely submission of reasonable and acceptable documentation
supporting all expenses being claimed by the hearing officer; and
3. The hearing officer's prompt return to the City of all file materials relating to closed cases.
4. Contractor's services will be billed to the nearest quarter hour.
I. Providing hearing officer services to other clients is not barred so long as the hearing officer does
not decline the request for hearing services more than two consecutive times; specifically, the
hearing officer must:
1. maintain the ability to respond to requests for hearings and prehearing motions within 24
hours;
2. meet all applicable time lines; and
3. demonstrate that such outside practice does not conflict with contractual work with the
City of Santa Ana,
J, Comply with the decision format requirements set by the City pursuant to the rules governing a
hearing officer's decision as per SAMC 1-21,8,16-119,17-105,17-108, and 17-135. The
decisions of the hearing officer must indude formal findings of fact, and meet in all respects the
minimum requirements applicable to the decisions of executive agencies conducting contested
cases.
K. There is no guarantee as to the number of cases that will be assigned to a hearing officer. The
City anticipates that it will establish a list of qualified hearing officers and assign hearings all on a
given date based on a rotation of the names on the list.
8
. .
COMPENSATION
City agrees to pay and Contractor agrees to accept as total compensation for all services and costs, a
rate of $100.00 per hour, to the nearest quarter hour, for all hearing officer services provided to City. Said
services include review of the materials provided by City, holding of the hearing and providing findings
and determination. 'Mth the exception of City validating parking receipts for the time that hearing officer
is performing services for City, City will not pay costs associated with providing the hearings including
travel time to and from the hearing site.
9
01/01/1999 04:59
7145415512
COASTAL MEDIATIOt~
PAGE 02
~
.PRCFBSSDW. LIABILITY JNSUR.AICB
..... to tilt
NAl'llWAL AS:!llCIATQ ~ SAlAR.JHD ~ PURCHA$DiI) ~
END ~ 912160
PREVIOUS# INITIAL
AU1H.# CP05CT7770
Nm:a.d Anursd:
ILAR&\RA BCHAN I:IIA WASTAL M8DL\.l1tNsmtVlCBS
Cautal M.cIiatian Senru.
3OS6 Madeira A~
C~bt. Mea CA 92626
I!\IJIEH:B Of INStlRANl:::S .ntlftd wI:h c.rtaiII
~ATLLOYI,l'S,~
PARTIC1PATI~ 1IBRBCJtI: HIOI5
MJSCEl.LANBOUS B&O ProC..mw. Liability lmun.Dce
LIMITS OF LIABn.ITY:
.Eacll claim:
~~.
Diaudible
Retroactive Date:
Sl,lD),<IXlOO
$l.lD),(Q)JJ()
Sl.anoo IIIeh claim
NONE
PREMIUM Ollclu<liag ..o:IIllIn;mts):
$683.00
Purchaai.Dg Choap tax: foe CA @ 35i
Dl"9
TOTAL UDYD'S PREMIUM ODl:lndiDt T~:
S7(1149
Speaa.l Cooditiou:
See Attacbed Schedule c4 Penna and. EndcnmantlI
Not.ict of CJaim Ie Swvio. d. Su.it:
Lord, ~ ~ Brook
130 South LaS&1l6 Street
Chicago n... 60603
WOI'ding - MJ.....tt.'htOUJ PrdNlimal Lia.bility ATR
PERIOD OF INSURANCB:
From....y 1. '1tI1T 12:01 a.m. to War :J. D1112:Ol LID.
In ~ r1l tilt additieM1 pmniulll paUj IlIIIl. in ~ ~ UIe I.......... .. tbe ~ att'lldled hIreCo, t1lo abow ~
membIc ;. 11II ANuM l.lMtr 1be ~ r1l1~ '"-' to tbt ~ AaoddJlIIl rL smri.c1 Pmf..um1l ~. Omljl. fa or
~q IlIinoI. by Undenni.. at lJoyd's:, Lmdm (mt inawpcnted) tor the ~ tL ~ and IlmitJ tIlliabOfty IPICIfItd atwM. All
Qtb..- --. awtitiml&, IDllIllduricn of.r. ~.. ~
This 0IrtifM& nut u.. ~ 0IrtIficat. II a tne ClCIp)' rL ... adpal daGIImIet ~
All otMr tmu,. ~ limita ud ...,h....... remain 1'_"'Dpd.
Attu:bIId to aDd tormiag pert at Cer1:if'ute No.: Nt 9lJX) - 06 UNlERWRlTERS AT LLOYD"S, LONDON
0I.t.d: April 24, 'NJ7
~ Bq~1J't Marbta,!no.
db. ~ Marbta ~ ./'tpDq,
IDe. {
By ~7:P~
f'1lM."i41 (po(}) ~
~
l'ILB CDII"J"
AMENDATORY ENDORSEMENT NO.: 91260
ASSURED:
BARBARA ECHAN DBA COASTAL MEDIATION
SERVICES
EFFECTIVE: January 1,2008 to May 1,2008
30 DAY NOTICE OF CANCELLATION ENDORSEMENT
In consideration of the additional premium paid as shown above, it is hereby
understood and agreed that if Underwriters cancel this insurance for any reason
other than non-payment of premium, Underwriters shall provide a 3O-day written
notice of cancellation to the following:
City of Santa Ana
20 Civic Center Plaza
Santa Ana CA 92702-1988
All other terms, conditions, limits and exclusions remain unchanged.
Attached to and forming part of Certificate No.: NI 9000 - 06
Dated: January 14,2008
UNDERWRITERS AT LLOYD'S, LONDON
AUTHORIZATION NO.: CP0607770
Complete Efiity Markets, Inc.
dba Complete uity Markets Insurance Agency, Inc,
(CASL#OD4407
BY~7Y~
AIF 2119 (fX5/07)
Lib(el99)**(38)23 revised 7/04 8/04
Endorsement #6
~lVI.
E.L.M. INSURANc:E BROKERS! INC
1990 EAST GRAND AVE, SUITE 210 I EL SEGUNDO, CA 90245
-i.l b1 . l! r(
N -,;J.OD f? - OD5
TEL (310) 322-1301
FAX (310) 322-1302
CA L1C # 0028706
..
5/8/08
BINDER # 36701,01
Page 1 of2
INSURED: Barbara Echan
3056 Madena Ave
Costa Mesa, CA 92626
AGENT: E.L.M. Insurance Brokers Inc
1990 E Grand Ave suite 210
EI Segundo, CA 90245
Binder is effective from 12:01 AM 05/01/08 to 12:01 AM 07/27/08 unless cancelled or replaced by the Policy.
Policy is effective from 12:01 AM 05/01/08 to 12:01 AM 05/01/09.
This is to certify that, in accordance with your instructions, we have bound coverage as follows:
COMPANY: Certain Underwriters at Lloyds, London
POLICY NO:
0509-00122403A
AM BEST: A, XV
COVERAGE: Miscellaneous Professional Liability
COVERED Alternative Dispute Resolution services for others for a fee.
SERVICES:
RETRO DATE: 5/1/07
LIMITS: $1,000,000 per claim limit
$1,000,000 aggregate limit
DEDUCTIBLE: $5,000 per claim
CONDITIONS: Defense expenses are INSIDE policy limits.
Deductibles apply to loss and claim expense.
SUBJECT TO: Carrier's receipt of premium
.. ~-~) ~t....l
j .'~. -., :"" .
~o -bG1-----
-" .,
- .
....- . -., ,- ""
,. ' "" , '.'~
FORMS:
BRP MPL policy form
Nuclear Incident Exclusion
Service of Suit Clause (U.S.A.)
Several Liability Notice
War and Civil War Exclusion
War and Terrorism Exclusion Endorsement
Radioactive Contamination Exclusion Clause Liability Direct
Notice of Cancellation - ADR
Asbestos Exclusion
Extended Reporting Period Endorsement 100% - 125% Bilateral
PAYMENT
TERMS:
If you have not been previously provided with a copy of the policy form and endorsements, specimens
are enclosed or will be provided at your request. Please read them carefully.
Option 1 - Payment in full: PLUS any quoted and fees are due upon receipt of our invoice. Save
postage and overnight charges! PAY BY FAX with ELM - see attached form.
Option 2 - Financing: 25% down PLUS any quoted and fees are due upon receipt of our invoice. You
can use your own finance company (copy of the finance agreement is required at binding), or we can
provide you with an excellent financing quote with same-day draft authority through IBEX Financial
Services. Please advise if you are interested.
The following must be received if you use your own finance company:
1. A signed copy of your finance agreement listing ELM Insurance Brokers, Inc. as the Wholesaler -
..
.._:.Jt1VI.
E.L.M. INSURANCEBRO~ERS, IN<::
1990 EAST GRAND AVE, SUITE 210 I EL SEGUNDO, CA 90245
TEL (310) 322-1301
FAX (310) 322-1302
CA L1C # OD26706
5/8/08
BINDER # 36701.01
Page 2 of 2
Payment terms cont..
NO LATER than 5 days
after receiving our invoice.
2. Financed premium - NO LATER than 20 days after policy inception. Your finance company must
be instructed to release
funds within this time to avoid possible cancellation due to non-payment.
NON.ADMITTE The Company offering this indication is non-admitted in the state of California. The Insured MUST
D NOTICE: receive written instructions from your agency to sign the attached SLA D-1 BEFORE coverage becomes
effective. If not, your agency will be responsible for any applicable minimum earned premium should the
Insured exercise their right to pro-rata cancellation
DISCLAIMER: In order to complete the underwriting process, we must receive the additional information requested
under the "Subject to" section above. The Carrier listed is not required to bind coverage prior to their
receipt, review, and underwriting approval of the requested additional information. This indication is
strictly conditioned upon no material change in risk occurring between the date of this letter and the
inception date of the proposed policy (including any claim or notice or circumstances that may
reasonably be expected to give rise to a claim under any policy of which the policy being proposed by
this letter is a renewal or replacement). In the event of such change of risk, the Insurer may in its sole
discretion, whether or not this offer has already been accepted by the Policyholder, modify andlor
withdraw this offer.
Please note that this indication contains only a general description of coverages provided. For a
detailed description of the terms of this indication, you must refer to the policy itself and any
endorsements indicated.
PREMIUM:
$ 497.00
14.91 State Tax
. 0.62 CA Stamp Fee
$ 512.53 Total Premium is Minimum and Deposit for policy period.
No flat cancellations. 25% minimum retained premium in the event of cancellation.
This Binder is subject to all terms and conditions of the policy to be issued. The Binder shall be terminated and voided by delivery of a
policy to either the Insured, his agent or representative. The coverage will remain in effect for the term indicated unless cancelled by
the Insured, or the Company, via written notice.
41~'
Frederick J. Fisher