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Home My WebLink AboutINTERIOR DEMOLITION, INC. (3) j��IJJtir�I�„L + ILi `-2022-065-03A T ,NORK MAY PKULD UNTIL 1N0UR6}NCFFXPFRES !MAYOR ,TT7 T TRI, CITY MANAGER Valerie Amezcu9AT 1I APR 3 2925 '"4& � Alvaro Nunez MAYOR PRO TEM `; ;; CITY ATTORNEY Benjamin Vazquez Sonia R.Carva€ho COLINCILMEMBERS �, 1 CITY CLERK Phil Bacerra :•, Jennifer L.Hall Johnathan Ryan Hernandez Jessie Lopez David Penaloza Thai Viet Phan CITY OF SANT w ANA PUBLIC WORKS AGENCY it, Pow l r�} 20 Civic Center Plaza e P.O.Box 1988 U 6 1 Santa Ana,California 92702 Writ f Lpaq) wvw+r.santa-ana_org V 6 1Y March 17, 20125 Interior Demolition, Inc. Attn: George Molina, President 2621 Honolulu Ave. Montrose, CA 91020 Re: Extension of Agreement A-2022-065-03 for On-Call Demolition Services Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by Interior Demolition, Inc. (`'Contractor")and the City of Santa Ana, dated May 3, 2022, the time period of the Agreement is hereby extended for an additional onp(1)year period anti I April 14.2026. Any insurance certificates are required to be extended andlbr renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, g h� Nabil Saba, PE Executive Director, Public Works Agency CITY O A AN ATTEST '.A Alvaro Nunez Jennifer . Hall City Manager Cit , r APPROVED AS TO FORM CONTRACTOR Kyle Neilesen Geor e olina ` Assistant City Attorney Presi nt SANTA ANA CITY COUNCIL ValerR aniezcua Benjamin Vazquez Tha,Oel Phan Jesse LnP=z eta Le,,a Johnaihan Ryan Hernendez Qav+a Penalaza Maya b;ayor Pro Teem N%ard 2 Ward d 3 Ward 4 Ward 5 VJar 6 vameicua�gs«ita-aTi-a cv7 bva7.auex,+esanla-arse Q[a ?s+lra_�:c Santa-zna e!g le_ c erl.« LaUer+aasarla-ana c,a �re ?CF:usar+la-a;a erg drrnao afi`santa ana orb ACQ® DATE(MMIDDIYYYY) `" CERTIFICATE OF LIABILITY INSURANCE 2r'11/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. 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). PRODUCER CONTACT NAME: Debbie Williams HUB International Insurance Services Inc. No:916-993-7224O 4 cPQ BOX 255387 N E-MAIL Sacramento CA 95865 ADDRESS: debbie.williams@hubinternational.com INSURER S)AFFORDING COVERAGE NAIL# License#:0757776 INSURER A:Nautilus Insurance Company 17370 INSURED INTEDEM-01 INSURERS:Ke Risk Insurance Company 10885 Interior Demolition Inc INSURER Pine Street suRER c:State Compensation Insurance Fund of California 35076 Newhall CA 91321 INSURER D INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:454910765 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDTYPE OF INSURANCE INSD WVDSUBR Y POLICY NUMBER MMIDDrrYYY MM D LTR DfYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y ECP2035025-13 6/4/2024 6/4/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE 1XI OCCUR PREMISES Ea occurrence $100,000 X $5,000❑edlOccur MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GFNFRALAGGREGATE $2,000,000 POLICY� JE 6 LOC PRODUCTS-COMPIOP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y BAP2035024-13 6/4/2024 614l2025 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNF❑ PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A UMBRELLA LIAB X OCCUR FFX2035026-13 6/4/2024 6/4/2025 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DFD X I RETENTION$n $ G WORKERS COMPENSATION Y 1977624-24 9/2712024 9/27/2025 X I STATUTE ERH AND EMPLOYERS'LIABILITY Yf N ANYPROPRIE=TOPJPARTNERIEXE;GUTIVE N!A E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED? (Mandatory in Ni E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DFSCRiPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Professional Liability ECP2035025-13 6/4/2024 614/2025 Each ClaimlAggregate $1,000,000 Contractors Pollution Liability Each OccurrencelAgg. $1.000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Work performed by the named insured under written contract for the certificate holder. Additional Insured: City of Santa Ana,its officers,employees, agents and representatives are named as Additional Insureds with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non-Contributory. Waiver of Subrogation applies to Workers' Compensation. Excess Liability extends over the Auto Liability,General Liability, Contractors Pollution Liability and Professional Liability. Policies provide for 30 Days Notice of Cancellation,except 10 Days for Non-payment of Premium, Forms: 10217 0714,BENVCA06 0917,CA0444 1013, ECP1246 0121, ECP1248 0121,ECP1259 0121 APPROVED 8y Tu Tran Nguyen at 2:59 pm, Feb 11,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 13E CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS, Attn: Public Works Agency, CIPIDesign Engine 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92702 o4z"w— (D 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE