HomeMy WebLinkAboutCAA PLANNING 1ACity of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Clerk of the Council Office (M -30).
Call 647 -6520 if you have any questions.
The agreement with
No. # A -2008- /(/, 60 W
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CLERK OF COUNCIL
DATE: 'juL 16 ZOOS FIRST AMENDMENT TO
t'• �+ /'*�'�; CONSULTANT AGREEMENT
THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into
on June 2, 2008, by and between CAA Planning, a California 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- 2007 -155, dated June 18, 2007, (hereinafter
"said Agreement ") by which Consultant has provided environmental consulting
services.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
extend the term of said Agreement and amend the Scope of Services and Fee
Schedule to reflect additional staff and increased fees during the extended term.
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
First Amendment to Consultant Agreement, the parties agree as follows:
1. Section 1, SCOPE OF SERVICES, shall be deleted in its entirety and replaced with
the following:
"Consultant shall provide traffic/ transportation technical study services pursuant to
the California Environmental Quality Act and the National Environmental Policy Act,
as set forth in City's Request for Qualifications for Environmental Consultants,
incorporated to this Agreement by reference, and Consultant's Proposal, attached to
this First Amendment to Agreement as Exhibit A -1 and incorporated by reference.
Said services shall be provided at request of the Executive Director of the Planning
and Building Agency, as evidenced by a writing signed by the Executive Director and
the City Attorney."
2. Section 3.a., COMPENSATION, shall be amended by replacing the fee schedule set
forth in Exhibit A with the new fee schedule set forth in Exhibit A -1, attached hereto.
3. Section 3, TERM, shall be amended to extend the termination date to June 30, 2009
4. Except as hereinabove amended, all terms and conditions of said Agreement shall
remain in full force and effect.
A- 2008 -106
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to
Consultant Agreement on the date and year first written above.
ATTEST:
PATRICIA E. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By: X/, 10 -0 �/
La Sheerly
Assistant City A orney
CITY OF SANTA ANA
1
DAVID N. REAM
City Manager
CAA PLANNING
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I . Firm Background/ History
Business Organization
Throughout public agencies and within the business community, CAA Planning (CAA) is recognized as an
environmental and planning consulting firm offering the highest level of technical expertise and
professional capability. CAA is known for its exceptional depth of senior talent, its self - starter philosophy,
and its commitment — as a partner to the client — to handle every project as if it were our own.
With many years of experience in the public and private sectors, CAA is deeply involved in the intricacies
of California Environmental Quality Act (CEQA) and National Environmental Policy Act (NEPA)
analysis, as well as the planning and entitlement process. CAA's expertise can save clients time and money
where it counts the most, and CAA is known for its outstanding adherence to strict schedules. In working
with public agencies, CAA serves as an extension of staff, enhancing the City of Santa Ana team. CAA
does not assume more work than we can do well, and CAA does not put inexperienced people in charge of
a project.
CAA possesses senior management level personnel knowledgeable in virtually every expertise touching
the planning process. This makes CAA's CEQA/NEPA compliance documents above reproach, since a
large part of the environmental planning process is the anticipation of issues before they are stated to the
City. This saves time, money, and effort, and results in an environmental analysis process of great
integrity. The principals of CAA have processed environmental documents ranging in size from large to
small, controversial to routine, finite to evolving.
CAA, a California corporation, is an urban planning and environmental impact documentation consulting
company providing services to the private and public land development community. The principal offices
of CAA are located in the City of Aliso Viejo in southern Orange County. Our contact information is
provided below.
CAA Planning 949 -581 -2888
85 Argonaut, Suite 220 949 -581 -3599 fax
Aliso Viejo, CA 92656 mail @caaplanning.com
CAA is proposed to be the primary firm for providing services requested in the RFQ. As individual --
projects are identified, technical subconsultants in specific areas may be necessary, such as for the
preparation of traffic, noise, or air quality assessments. Any proposed subconsultants would be submitted
for review and approval prior to commencement of work on a particular project. A partial listing of
potential sub - consultants is provided in the organizational chart on page seven.
Company History
Established in 1981, CAA was organized with the philosophy that the process of achieving the goals of our
clients is best accomplished by a management team that produces informative, legally defensible
implementation documents for carrying out a project. Our extensive experience in and for the public sector
enables us to establish an instant and effective relationship with staff, decision makers, and the public. Our
strong public hearing and public speaking skills are often called upon by public agencies to assist in the
public debate of a project.
The corporation is led and owned by C. David Culbertson, Chairman, and Shawna L. Schaffner, Chief
Executive Officer. The company is organized into three functional areas of expertise: CEQA/NEPA,
Current Planning (including major project management); and the California Coastal Act. In addition to
three principals, the company employs six professional and administrative support staff. The CEQA
9 City of Santa Ana Environmental Consulting Services
Statement of Qualifications
Section includes three professional full -time staff. Additional professional planning staff members
regularly provide services to CAA on a contract basis for CEQA/NEPA- related matters.
2. Work /Services Approach
CAA's role in the preparation of a project's CEQA compliance documentation is to provide an objective
evaluation of a project's potential environmental effects. CAA's role in communicating results of a
project's study to the public at large is primarily through preparation of thorough and easy -to -use
documents. The ability to distill material that is frequently very technical into an accessible format is
' essential. CAA often provides executive summaries and user - friendly synopses to upload onto agency
websites to facilitate additional outreach beyond that legally mandated by CEQA/NEPA and other federal
and state laws.
In addition, an important role CAA undertakes for each project is to educate the local public regarding the
span and limitations of environmental review, and to identify opportunities for public input. An individual
project's results are typically categorized as significant, less than significant with mitigation, less than
significant, or no impact. Mitigation measures are identified where needed and available to reduce
potentially significant impacts.
We see ourselves as an extension of City staff to help ensure project success. Our extensive experience in
the public sector enables us to establish an instant and effective relationship with staff, decision makers,
and the public. We provide a "soup to nuts" support for project environmental compliance, not just
drafting of the CEQA/NEPA document. Early in the process, we can help develop project strategies to
minimize time and monies spent and also provide mitigation monitoring during project construction to
ensure full CEQA/NEPA compliance to protect the City.
CAA will provide environmental consulting services to the City to perform the necessary environmental
planning and management tasks to prepare and adopt CEQA/NEPA compliance documentation for various
projects as identified. These services will assist in complying with applicable environmental regulations
and policies. The scope of CEQA/NEPA compliance services that CAA offers includes not only the
environmental clearances for the proposed individual development projects, but on -call availability for
questions and consultations as needed.
CAA's expertise in CEQA/NEPA is unsurpassed. Within the scope of the contract services, CAA will
assist in the preparation, processing, and approval of documentation related to CEQA/NEPA for
implementation of individually proposed projects of varying scale and complexity. This includes providing
advice to approaches on handling complex environmental analyses. CAA will assist with applicable state
and federal agencies and other affected parties concerning documentation and project approvals.
3. Project Initiation and Process
Communication will play a major role in the execution and conduct of the environmental consulting
contract with the City. Poor communication can result in project delays, missed deadlines, and potential
losses in funding for grants, etc. In keeping with its reputation of meeting project schedules and assuring
the client's accessibility to accountable staff, CAA proposes a well defined and proven methodology of
effecting and maintaining a smooth project implementation and providing excellent responses to the
environmental consulting needs of the City.
0?9112�ii 2 City of Santa Ana Environmental Consulting Services
Statement of Qualfcations
L
A representative CAA methodology consists of ten components that follow. Please keep in mind this
approach is very flexible and can be amended or further tailored to meet any client's needs.
To ensure that accountability is clearly defined in the contract, first lines of
communication between the client and the CAA team will be with the CAA Principal -In-
Charge and the designated CAA Project Manager.
2. The project kick- off/startup meeting will be attended by the CAA Principal -In- Charge and
the CAA Project Manager.
3. All subsequent project management meetings will be attended by the CAA Project
Manager or, in his/her absence, by the Principal -In- Charge.
4. Within five working days, as a follow -up to all meetings, the attending CAA principal will
provide a concurrence memo to the Client Project Manager outlining action points,
decisions, and assignments.
The CAA Project Manager will indicate CAA's initial thoughts on the project within five
working days to the Client Project Manager. Concurrently, the CAA Project Manager will
request additional information, as needed. For minor projects, the Project Manager will
initiate the environmental process. For purposes of this proposal, a "minor project" is
defined as a project resulting in the preparation of a Categorical Exemption, a Statutory
Exemption, a Categorical Exclusion, or a simple Negative Declaration (one with only
minor mitigation, if any).
6. For major projects (e.g., Environmental Impact Reports), the CAA Project Manager will
submit a brief Scope of Work to the client for review and approval. The document will
identify CAA's understanding of the project and the scope of work, including
methodology and sampling protocol, if appropriate, names of individuals and
subconsultants assigned to carry out tasks, an estimated cost based upon the appropriate
fee schedule(s), and project schedule /duration.
7. For complex projects, the CAA Project Manager will schedule regular meetings with the
designated Client Project Manager.
8. The CAA Project Manager will provide, at a minimum, monthly status reports to the
Client Project Manager.
9. E -mail, fax, courier service, and overnight delivery will be used on a regular basis to
expedite communication. Memos, draft documents, and minor reports will be transmitted
by these media, as appropriate.
10. In all cases, draft CEQA documents and notices will be provided for review, comment, and
approval prior to finalization and public release.
The combination of the CAA approach to City projects and the experience and expertise of staff will
enable the prompt development and processing of environmental compliance documentation for all levels
of projects proposed. CAA can be prepared to commence project initiation and processing immediately
after selection by the City.
4. Quality Assurance Plan
When an individual project is identified, CAA will prepare a detailed scope of work and cost proposal for
City review and approval. Through initial consultation, CAA will develop a precise project description to
be used during the execution of the project. Early consultation with affected stakeholders, such as resource
3 City of Santa Ana Environmental Consulting Services
Statement of Qualifications
agencies, municipalities, local organizations, and/or neighbors is recommended to solicit input on potential
project issues. These approaches make for a much more predictable environmental review process and
reduce changes in contract scope and budget.
Project budgets are broken out into tasks with an associated line item amount depending upon the unique
issues and processing needs for that project. Contract budgets are monitored weekly to ensure the project is
within budget, as well as the cost allocated for each task. If unanticipated issues are identified, deviations
from the original scope of work and/or project description will be brought immediately to the City's
attention with a description of the additional work required and associated costs, if any.
Prior to submittal to the City, work products are thoroughly reviewed internally by senior project
management. Screencheck copies of documents will be provided for review and approval prior to
finalization and being made available to the public.
Project management costs are built into billing rates for all senior level staff. Initial training of staff is
never billed to CAA clients. Questions on bills for a project are handled directly by the Principal in
Charge, and clients are encouraged to contact CAA on any billing questions or dispute of charges.
5. Staff Qualifications/ Personnel Experience
Because of its corporate philosophy, CAA can expand or contract its organization by association with
appropriate professionals in the field. CAA can provide the full range of environmental and technical
services for any project undertaken by a public agency, whether in -house or by aggressive management of
subconsultants. Most importantly, CAA has represented many municipalities and school districts on
CEQA - related matters and projects.
Because of our size, CAA is selective concerning the number of projects for which the firm is responsible
at any given time. This philosophy ensures that each project is managed personally by a firm principal who
works directly with the client on every facet of the project.
The experience of the project manager and key personnel are described below. The CAA team brings years
of experience across a wide range of projects. The CAA CEQA team is led by Shawna L. Schaffner, Chief
Executive Officer, and includes Thomas B. Mathews, President; Paul E. Shaver, Manager of Planning and
Engineering Services; Kathleen M. Crum, Associate Planner and Margaret F. Partridge, Associate Planner.
Complete staff resumes for the CEQA team are included in Appendix A.
Shawna L. Schaffner
As Chief Executive Officer, Ms. Schaffner oversees the daily operations at CAA and is head of
CAA's CEQA planning program. Ms. Schaffner focuses on the preparation of environmental
compliance documents and processes for CEQA/NEPA engagements, managing project coordination
and completion among subconsultants, clients, and staff experts. Ms. Schaffner has maintained an
energy among CAA's staff for rigorous analysis in environmental documents. CAA's environmental
analyses, therefore, not only consist of accurate, comprehensive inventories and rigorous analysis,
but also focus on problem solving. Ms. Schaffner has worked closely with local cities, counties and
school districts in the preparation of CEQA required reports for residential, commercial, and public
facility projects. In addition to her work under CEQA, Ms. Schaffner has extensive experience in
current planning. She has worked on the preparation and processing of numerous Planned
Community District Regulations, zone changes and Coastal Development Permits. Ms. Schaffner
would be the project manager for any proposed work for the City of Santa Ana.
4 City of Santa Ana Environmental Consulting Services
Statement of Qualifications
Thomas B. Mathews
As President of CAA, Mr. Mathews provides direct project management services for several of the
Company's larger clients on a wide range of project types in several jurisdictions. In addition to
project management, his expertise includes effective coordination among clients, subconsultants, and
staff resources. His past experience managing and implementing entitlements for numerous planned
communities in Orange County is a valuable asset to the environmental team. With over 30 years as
a professional planner, Mr. Mathews is recognized in both the public and private sectors as an
accomplished manager. He understands the critical time- sensitive nature and fiduciary obligations of
programming and managing large -scale and complex projects.
Paul E. Shaver
The CEQA team is further enhanced by the contributions of Paul Shaver. As Manager of Planning
and Engineering Services at CAA, Mr. Shaver is responsible for the day -to -day management of
entitlement and permitting for all development projects. This expertise brings a key skill set that
allows for a successful interface with CEQA, specifically pertaining to the development of relevant
and effective mitigation measures. Additionally, Mr. Shaver brings extensive experience managing
the coordination of engineering and utilities for large construction projects. In particular, Mr.
Shaver's recent assignment with Soka University, where he was responsible for the coordination of
all grading and site improvement plans, provides value -added expertise to CAA and the City.
Kathleen M. Crum, Associate Planner
As Associate Planner, Ms. Crum assists in the research for CEQA related projects and in the
preparation of EIRs and Environmental Assessments. As a prior legal assistant at CAA, she has been
responsible for research and analysis of environmental cases, as well as assisting in the preparation
of documentation for clients and governmental agencies. Ms. Crum has extensive experience with
the California Coastal Act, and works on numerous projects requiring interface with the California
Coastal Commission. Previously, Ms. Crum worked in the construction and planning departments at
Mission Viejo Company, assisting in the preparation of various documents involved in processing
projects through county approval.
Margaret F. Partridge, Associate Planner
As an Associate Planner, Ms. Partridge brings her wealth of public and private sector CEQA
planning experience to her work at CAA. Responsible for land -use research and environmental
entitlement processing, her recent assignments have ranged from school site analysis to the authoring
of complex entitlement documents for a high -end office and retail center. Previously, Ms. Partridge
received her master's degree in Urban and Regional Planning and has worked for a private
environmental consulting firm, as well as local cities.
CAA has never had a CEQA determination overturned by a court of appeals in over 27 years of providing
urban planning and environmental impact documentation services to the public and private development
communities. Although many projects have been controversial, no Negative Declaration, Environmental
Determination, or Environmental Impact Report written by CAA has been overturned in a court or found
inadequate by decision makers.
f�
5 City of Santa Ana Environmental Consulting Services
Statement of Qualifications
6. Staff Augmentation /Technical Subconsultants
Based on numerous years of experience in the environmental planning field, CAA has found that an
interdisciplinary team approach best serves the client's interest and ensures the integrity of a project's
analysis. CAA has also determined that the top technical specialists are most often found in their own
consulting businesses. Therefore, for projects requiring technical expertise in such areas as traffic, noise,
air quality, geotechnical, and biological resources analysis, CAA relies upon other consultants recognized
and respected in their fields. This association, in the form of subconsultant agreements, ensures that
technical consultant expertise is customized to individual client and project needs.
The Project Team Organization Chart provided on page seven indicates the percentage of involvement for
each staff member who may actually perform work for City projects. The chart also includes a partial
listing of potential subconsultant team members. The identified subconsultants do not represent a complete
list of available subconsultants. Additionally, the percentage of staff time available to dedicate to a City
project will vary based on the specific projects. In the past, CAA has been willing to dedicate up to 100
percent of a staff member's time to a project.
CAA recognizes that each client need is different, and as a result, the use of technical consultants can be
customized on a project -by- project basis. This business structure offers great cost efficiencies, as clients
pay for only those technical services needed and used. Qualifications and resumes for potential technical
consultant work efforts will be provided prior to the City's approval of the consultants suggested by CAA.
7. Scope of Services
The scope of services provided by CAA will involve the preparation and processing of CEQA/NEPA
documentation, which may include the following types of documents and services:
• Preparation of Initial Study/Environmental Assessment
• Preparation and processing of Negative Declarations and Mitigated Negative
Declarations/Findings of No Significance (FONSI)
• Preparation and processing of Environmental Impact Reports (EIR) (i.e., project, program,
master, subsequent, or supplemental)/Environmental Impact Statements (EIS)
• Addenda to previously approved Mitigated Negative Declarations/FONSIs
• Addenda to previously certified EIRs/EISs
• Notices of Preparation
• Notice of Intent/Notice of Availability
• Notice of Completion
• Notice of Determination
• Notice of Exemption
• On -Call Services
• Project Staff Reports
• Response to Comments
• Mitigation Monitoring and Reporting Programs and Plans
• Resolutions
• Findings of Fact
• Statements of Overriding Consideration
• Presentations of CEQA/NEPA process at Scoping Meetings
6 City of Santa Ana Environmental Consulting Services
Statement of Qualifications
10
1
1
analyze the project and provide more detail regarding how to approach the project in a cost - effective and
timely manner.
12. Fees
General Conditions and
Schedule of Fees for Professional Services
Standard Billing Rates
Effective January 1, 2008*
Classification
Hourly Rate
Principal
$275
Principal Planner 1
$150
Principal Planner II
$145
Senior Project Manager
$135
Project Manager
$125
Engineering Coordinator
$125
Senior Planner
$110
Associate Planner 1
$100
Associate Planner II
$85
Graphics Manager
$75
Assistant Planner
$65
*Rates are subject to revision effective
January 1 of each year
General Conditions
1. Reimbursable expenses (travel accommodations including rental vehicles and regularly scheduled
commercial airline flights, food and lodging, blueprinting and reproduction, delivery/courier, supplies,
extensive mailing postage, etc.) are billed at cost and are in addition to the estimated fee for the
proj ect.
2. Automobile mileage outside Orange County will be billed at $0.505 per mile.
3. Hourly rates apply to work time as well as travel time and waiting time that occurs at public hearings.
Rates increase 50% for depositions or court testimony.
4. Statements will be submitted monthly for work in progress or upon completion of work. Statements are
payable upon receipt. Any statement unpaid after thirty (30) days shall be subject to the maximum
monthly interest charge provided by law on amounts thirty (30) days past due. If Client fails to pay
Consultant within sixty (60) days after invoice is rendered, client agrees Consultant shall have the right
to consider such default in payment a material breach of the entire agreement, and, upon written
notice, the duties, obligations, and responsibilities of Consultant under this agreement are terminated.
5. Client hereby agrees that the balance in a billing statement is correct and binding unless the Client
notifies the Consultant in writing within ten (10) days of the date of billing and informs Consultant of
alleged incorrect item; provided, however, that the foregoing shall apply only to the description of
work performed as set forth in the billing statement, and if after such ten (10) day period Client
discovers a mathematical error in the billing statement, Client shall not be bound by the erroneous
balance, which Consultant hereby agrees to correct.
6. Consultant makes no warranty as to its findings, except that the work is performed using generally
accepted methods.
7. Consultant makes no warranty that the project will be approved by any governmental agency, nor
endorsed by any citizens group.
f
14 City of Santa Ana Environmental Consulting Services
Statement of Qualifications
8. Client agrees to limit the Consultant's liability to the Client and to all Contractors and Subcontractors
on the project due to Consultant's material, willful, and grossly negligent acts, errors, or omissions, to
the sum of $50,000 or to the Consultant's fee, whichever is less.
9. In the event either party commences legal action to enforce this Agreement of the General Conditions,
the prevailing party shall be entitled to recover its reasonable attorney's fees and costs incurred in the
action, in addition to all other relief to which the prevailing party is entitled.
10. In the event of a mid -phase contract suspension, billings will be prorated to reflect tasks in progress,
except where a task was completed early, in which case it will be billed as if the task were complete.
11. Client agrees and concurs that Consultant is obligated to only Client to perform and/or receive
direction or instructions on the project, and that Consultant is not obligated to perform and/or take
direction or instructions from Client's other Consultants or Subconsultants without prior written
notification and concurrence by Consultant.
13. Insurance Requirements
Subsequent to the selection of CAA as the project consultant and prior to commencement of work, CAA
will provide proof of the required insurance coverage for General Liability, Automobile Liability and
Worker's Compensation. Following are responses to the insurance- related attachments in the City's RFQ.
Attachment A
CAA does not maintain company -owned vehicles. Insurance coverage is required and individually
provided by CAA employees on personal vehicles.
' Attachment B
CAA insurance is provided by The Hartford. The Hartford will provide an Additional Insured
Endorsement to the City, but, by corporate policy, does not use non - Hartford forms. Due to submittal
' page limitations for the RFQ, the Endorsement form is not included herein as it exceeds 10 pages.
The Endorsement will be provided prior to initiation of any projects undertaken by CAA on behalf
of the City.
14. Additional Services
' Land Use Regulations
More than 27 years ago, Chairman C. David Culbertson developed a new zoning philosophy and format
which has since been applied to nearly every major landholding in South Orange County.
' Prior to the new philosophy, nearly all zoning regulations allowed only a narrow range of uses on a piece
of property. All others were prohibited. Recognizing the negative side of these rigid regulations, co-
'' founder, C. David Culbertson developed a more builder /developer friendly zoning format and philosophy
that was adopted by the County of Orange.
One of the major benefits of this new zoning philosophy is the ability to respond to market forces without
' the need for unnecessary, time consuming and costly zone changes and amendments. This approach can be
applied to zoning, specific plans, and local coastal programs. Major landowners throughout southern
California have adopted CAA's philosophy because it saves money and time for large -scale comprehensive
' land development.
95 City of Santa Ana Environmental Consulting Services
Statement of Qualifications
ACORD CERTIFICATE OF LIABILITY INSURANCE DAT04/101200 YY>
TM.
PRODUCER Phone: (949) 597 -1001 Fax: (949)597 -2199
ALLIED BROKERS
26487 RANCHO PARKWAYS
LAKE FOREST CA 92630 A-2008-106
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD
INSURERS AFFORDING COVERAGE
NAIC #
Agency Lic#: OF65208
GENERAL
INSURED
INSURER A: Hartford Casualty Insurance Company
29424
INSURER B: Oak River Insurance Company
34630
85 ARGONAUT, ADAMS &ASSOCIATES, INC.
85 ARGONAUT, SUITE 220
INSURER C: Houston Casualty Company
42374
INSURER D:
ALISO VIEJO CA 92656
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FV7 OCCUR
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
INSR NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD
POLICY EXPIRAIiON
DATE MMD
/D
--
LIMITS
AUTHORIZED ENTATIVOE
GENERAL
LIABILITY
72SBANI1293
08/01/07
08/01/08
EACH OCCURRENCE
$ 2,000,000
X
PREMISES DAMAGE TO (Ea RENTED Ix)
$ 300,000
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FV7 OCCUR
MED. EXP (Any one person)
$ 10,000
PERSONAL 6 ADV INJURY
$ 2,000,000
A
GENERAL AGGREGATE
$ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JE 0 LOC
PRODUCTS- COMP /OP AGG.
$ 4,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
72SBAN11293
08/01/07
08/01/08
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per person)
$
A
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE
LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS / UMBRELLA LIABILITY
OCCUR El CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
$
RETENTION $
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2210013354 -071
08/31/07
08/31/08
TORY uMITS OTHER
E.L. EACH ACCIDENT
$ 1,000,000
B
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yea, describe under
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
E.L. DISEASE- POLICY LIMIT
$ 1,000,000
SPECIAL PROVISIONS below
C
OTHER: Professional Liability
Claims Made Form
H70616295
01/01/08
10/08/08
$3,000,000 per occurrence
$3,000,000 General Aggregate
$10,000 Deductible Each Claim
DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIA P OVISIONS
*Except 10 days for non payment of premium. CITY OF SANTA ANA, ITS OFFICERS, AGENTS, VOLUNTEERS AND EMPLOYEES SHALL BE
NAMED AS AN ADDITIONAL INSURED PER ATTACHMENT B.
CITY OF SANTA ANA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30'
PLANNING AND BUILDING AGENCY
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
20 CIVIC CENTER PLACE
INSURER, ITS AGENTS OR REPRESENTATIVES.
SANTA ANA, CA 92702
AUTHORIZED ENTATIVOE
Attention:
Ar`non Oe renn.l In o�
I___ - ---r ..�I UZFV4 v 9 ACORD CORPORATION 1988
ATTACHMENT B
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company HARTFORD CASUALTY INS co
This endorsom_ent modifies such insurance as is afforripd by the provisions of--Policy _
72SRANTI _93 relating to the following,
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its
officers, employees, agents, volunteers and representatives are named as additional insured's
( "additional insured's") with regard to liability and defense of suits arising rrom the operations
and uses performed 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 in 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 insured's.
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 -- A,,.,t 1, inn,7 , this. endorsement form as a part of
Policy # —:726BANV 2_0_3
Issued to GU AIEPIT-9 My- P TM"
Named nsurp
Countersigned by
thorized Representative
C1916%
ACORD,a CERTIFICATE OF LIABILITY INSURANCE
DATE02708YYYY)
09 /EIN DD
PRODUCER LIC #OD10299 1- 949 -297 -4900
venture Pacific Insurance Services, Inc.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
INSR
R
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
26487 Rancho Parkway South
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC#
Lake Forest, CA 92630
29424
INSURED
Culbertson Adams & Associates, Inc.
INSURERA. HARTFORD CAS INS CO
INSURERS: OAR RIVER INS CO
34630
85 Argonaut, Suite 220
INSURERC HOUSTON CAB CO
42374
INSURER D.
Aliso Viejo, CA 92656
_ --
INSURER E:
$300,000
MEDEXP(AnyonePerson)
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
R
DD'L
-
Y NUMBER POLIC
POLICYEFFECTIVE
DATE MMIDDI
POUCYEXPIRATION
DATE MMIDDrYY)
LIMOS
A
GENERALLIABILITY
72SBAN11293 08/01/08
08/01/09
EACH OCCURRENCE
$2,000,000
X COMMERCIAL GENERAL LIABILITY
)M=ETO] RENTED —_
PREMISES(Eacccurence )
$300,000
MEDEXP(AnyonePerson)
CLAIMSMADE X7 OCCUR
__$10,000
PERSONAL& ADV INJURY
52,000,000
'
GENERAL AGGREGATE
$4,000,000
GENT AGGREGATE LIMIT APPLIES PER.
PRODUCTS COMPIOPAGG
$4,000,000
X POLICY F 'ERCT LOC
A
AUTOMOBILE LIABILITY 72SHANI1293
08/01/08 08/01/09
COMBINED SINGLE LIMIT
$2,000,000
ANY AUTO
(Eaacndent)
BODILY INJURY
ALL OWNED AUTOS
$
SCHEDULED AUTOS
(Per Person)
X HIRED AUTOS
BODILY INJURY
I $
X NON -OWNED AUTOS
—
I
Per..,Jert)
PROPE RTY DAMAGE 5
(PerawidI
GARAGE LIABILITY',
_
,
AUTO ONLY - EA ACCIDENT $
ANY AUTO
I
..: EA ACS
$
OUTOONLYN AGG
EXCESSIUMBRELLA LIABILITY
/ ✓
EACHOCCURRENCE
$
OCCUR CLAIMS MADE'
-
AGGREGATE
S
DEDUCTIBLE
S
RETENTION S
$
e WORKERS COMPENSATION AND
2210013354 -081 08/31/08
08/31/09 X WCSTATU- OTH
_._.TORY LIMITS __. ER-
EMPLOYERS'LIABILITV
ANY PROPRIETORIPARTNERIEXECUTIVE
E.L. EACH ACCIDENT C$1,000,000
'OFFICER /MEMBER EXCLUDED?
E.L. DISEASE EA EMPLOYEE $1,000,000
If yes, tlesonee under
As PROVISIONS below
E. L. DISEASE - POLICY LIMIT $1,000,000
OTHER
C Professional Liability
H70616295
10/08/07
10/08/08 Claims Made Form 3,000,000
Aggregate 3,000,000
Deductible
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
*Except 10 days for non payment of premium.
CITY OF SANTA ANA, ITS OFFICERS, AGENTS, VOLUNTEERS AND EMPLOYEES SHALL BE NAMED
AS ADDITIONAL INSURED PER HARTFORD FORM ATTACHED.
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2001108) eokuda
9681887
Certificate Delivery by CerlificatesNow - www.ConfinTNelcom - 877.669.8600
ACORD CORPORATION 1988
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF SANTA ANA
DATE THEREOF, THE ISSUING INSURER WILL AIII MAIL 30 DAYS WRITTEN
PLANNING AND BUILDING AGENCY
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
%xaci{re wSx>nu�I�oarAr�clox tmuaw wwi{x o7Nlxix�iut9wrtiKilxi{I{X
20 CIVIC CENTER PLACE
X EIfpNO( CyXXXX% XX XXXX%%X% XX %XXXXX % %XX%XXXXXX%XX%XXXXXXXX
AUTHORIZED REPRESENTATIVE
SAMTA ANA, CA 92702
USA
ACORD 25 (2001108) eokuda
9681887
Certificate Delivery by CerlificatesNow - www.ConfinTNelcom - 877.669.8600
ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
BUSINESS LIABILITY COVERAGE FORM
2. Applicable To Medical Expenses Coverage
We will not pay expenses for "bodily injury"
a. Any Insured
To any insured, except "volunteer workers '.
b. Hired Person
To a person hired to do work for or on behalf
of any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of
premises you own or rent that the person
normally occupies.
d. Workers' Compensation And Similar
Laws
To a person, whether or not an
"employee" of any insured, if benefits for
the "bodily injury" are payable or must be
provided under a workers' compensation
or disability benefits law or a similar law.
e. Athletics Activities
To a person injured while practicing,
instructing or participating in any physical
exercises or games, sports or athletic
contests.
f. Products - Completed Operations Hazard
Included with the "products- completed
operations hazard ".
g. Business Liability Exclusions
Excluded under Business Liability Coverage.
C. WHO IS AN INSURED
1. If you are designated it the Declarations as
a. An inclivldual, you and your spouse are
insureds, but only with respect to the
conduct of a business of which you are the
sole owner
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A 'united liability company, you are an
insured. Your members are also irsureds,
but only with respect to the conduct of your
business. Your managers are insureds, but
only with respect to their duties as your
managers.
d. An organization other than a partnership,
,pint venture or limited liability company, you
are an insured. Your "executive officers" and
directors are insureds, but only with respect
to their duties as your officers or directors.
Your stockholder are also insureds, but only
with respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees
are also Insureds, but only with respect to
their duties as trustees.
2, Each of the following is also an insured:
a. Employees And Volunteer Workers
Your "volunteer workers" only while
performing duties related to the conduct of
your business, or your "employees ", other
than either your "executive officers" (if you
are an organization other than a
partnership, joint venture or limited liability
company) or your managers (if you are a
limited liability company), but only for acts
within the scope of their employment by
you or while performing duties related to
the conduct of your business.
However, none of these "employees" or
"volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and
advertising injury":
(a) To you, to your partners or
members (if you are a partnership
orjoint venture), to your members
(if you are a limited liability
company), or to a co- "employee"
while in the course of his or her
employment or performing duties
related to the conduct of your
business, or to your other
"volunteer workers" while
performing dunes related to the
conduct of your business;
(b) To the spouse, child, parent,
brother or sister of that co-
"employee" or that "volunteer
worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation
to share damages with or repay
someone else who must pay
damages because of the injury
described in Paragraphs (1)(a) or
(b) above, or
(d) Arising out of his or her providing
or failing to provide professional
health care services.
If you are not in the business of
Providing professional health care
services. Paragraph (d) does not -apply
to any nurse, emergency medical
technician or paramedic employed by
you to provide such services.
(2) "Property damage" to property:
(a) Owned, occupied or used by,
Page 10 of 24 Form SS 00 08 04 05
(b) Rented to, in the care, custody or
control of, or over which physical
control is being exercised for any
purpose by you, any of your
"employees "volunteer workers ",
any partner or member (if you are
a partnership or joint venture), or
any member (if you are a limited
liability company).
b. Real Estate Manager
Any person (other than your "employee" or
"volunteer worker "), or any organization
while acting as your real estate manager.
c. Temporary Custodians Of Your
Property
Any person or organization having proper
temporary custody of your property if you
die, but only:
(1) With respect to liability arising out of the
maintenance or use of that property, and
(2) Until your legal representative has
been appointed.
d. Legal Representative If You Die
Your legal representative if you die, but
only with respect to duties as such. That
representative will have all your rights and
duties under this insurance.
e. Unnamed Subsidiary
Any subsidiary and subsidiary thereof, of
yours which is a legally incorporated entity
of which you own a financial interest of
more than 50% of the voting stock on the
effective date of this Coverage Part.
The insurance afforded herein for any
subsidiary not shown in the Declarations
as a named insured does not apply to
injury or damage with respect to which an
insured under this insurance is also an
insured ander another policy or would be
an insured under such policy but for Its
termination or upon the exhaustion of its
limits of insurance.
3. Newly Acquired Or Formed Organization
Any organization you newly acquire or form,
other than a partnership, joint venture or
limited liabilty company, and over which you
maintain financial interest of more than 50% of
the voting stock, will qualify as a Named
Insured if there is no other similar insurance
available to that organization. However:
a. Coverage under this provision is afforded
only until the 160th day after you acquire
or form the organization or the end of the
policy period, whichever is earlier; and
BUSINESS LIABILITY COVERAGE FORM
b. Coverage under this provision does not
apply to:
(1) "Bodily injury' or "property damage"
that occurred; or
(2) 'Personal and advertising injury"
arising out of an offense committed
before you acquired or formed the
organization.
4. Operator Of Mobile Equipment
With respect to "mobile equipment" registered in
your name under any motor vehicle registration
law, any person is an insured while driving such
equipment along a public highway with your
permission. Any other person or organization
responsible for the conduct of such person is
also an insured, but only with respect to liability
arising out of the operation of the equipment, and
only if no other insurance of any kind is available
to that person or organization for this liability
However, no person or organization is an insured
with respect to:
a. 'Bodily injury" to a co-"employee" of the
person driving the equipment; or
b. 'Property damage" to property owned by,
rented to, in the charge of or occupied by
you or the employer of any person who is
an insured under this provision.
Operator of Nonowned Watercraft
With respect to watercraft you do not own that
is less than 51 feet long and is not being used
to carry persons for a charge, any person is an
insured while operating such watercraft with
your permission. Any other person or
organization responsible for the conduct of
such person is also an insured, but only with
respect to liability arising out of the operation
of the watercraft, and only if no other
insurance of any kind is available to that
person ci organization for this liability.
However, no person or organization is an
Insured with respect to:
a. "Bodily injury" to a co-"employee" of the
person operating the watercraft, or
b. "Property damage" to property owned by,
rented to, in the charge of or occupied by
you or the employer of any person who is
an insured under this provision.
6. Additional Insureds When Required By
Written Contract, Written Agreement Or
Permit
The person(s) or organizations) identified in
Paragraphs a. through f. below are additional
insureds when you have agreed, in a written
Form SS 00 08 04 05 Page 11 of 24
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a
(e) Any failure to make such
permit issued by a state or political
inspections, adjustments, tests or
subdivision, that such person or organization
servicing as the vendor has
be added as an additional insured on your
agreed to make or normally
policy, provided the injury or damage occurs
undertakes to make in the usual
subsequent to the execution of the contract or
course of business, in connection
agreement, or the Issuance of the permit.
with the distribution or sale of the
A person or organization is an additional
products;
insured under this provision only for that
(f) Demonstration, installation,
period of time required by the contract,
servicing or repair operations,
agreement or permit,
except such operations performed
However, no such person or organization is an
at the vendor's premises in
additional insured under this provision if such
connection with the sale of the
person or organization is included as an
product;
additional insured by an endorsement issued
(g) Products which, after distribution
by us and made a part of this Coverage Part,
or sale by you, have been labeled
including all persons or organizations added
or relabeled or used as a
as additional insureds under the specific
container, part or ingredient of any
additional insured coverage grants in Section
other thing or substance by or for
F. — Optional Additional Insured Coverages.
the vendor; or
a. Vendors
(h) "Bodily injury" or "property
Any person(s) or organization(s) (referred to
damage" arising out of the sole
below as vendor), but only with respect to
negligence of the vendor for its
"bodily injury"
y 7 ry" or "property damage" arising
own acts or omissions or those of
out of "your products" which are distributed
its employees or anyone else
or sold in the regular course of the vendor's
acting on its behalf. However, this
business and only if this Coverage Part
exclusion does not apply to:
provides coverage for "bodily injury" or
(i) The exceptions contained in
"property damage' included within the
Subparagraphs (d) or (f); or
" products - completed operations hazard ",
(ii) Such inspections, adjustments,
(1) The insurance afforded to the vendor
tests or servicing as the vendor
is subject to the following additional
has agreed to make or normally
exclusions:
undertakes to make in the usual
This insurence does not apply to
course of business, in
(a) "Bodily injury" or properly
P y
connection with the distribution
damage" for which the vendor is
or sale of the products.
obligated to pay damages by
(2) This insurance does rot apply to any
reason of the assumption of
insured person or organization fiom
'iabillty in a contract or agreement.
whom you have acquired such products,
This exclusion does not apply lu
or any ingredient, part or container,
liability for damages that the
entering into, accompany;ng or
vendor would have in the absence
containing such products.
of the contract or agreement;
b. Lessors Of Equipment
(b) Any express warranty
(1) Any person or organization from
unauthorized by you;
whom you lease equipment but only
c An
O y physical chemical change
with respect to their liability for "bodily
t
in the product made intentionally
injury", "property damage" or
by the vendor;
"personal and advertising injury"
(d) Repackaging, except when
caused, in whole or in part, by your
unpacked solely for the purpose of
maintenance, operation or use of
inspection, demonstration, testing,
equipment leased to you by such
or the substitution of parts under
person or organization.
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24
Form SS 00 08 04 05
C.
(2) With respect to the insurance afforded
to these additional insureds, this
insurance does not apply to any
"occurrence" which takes place after
you cease to lease that equipment.
Lessors Of Land Or Premises
(1) Any person or organization from
whom you lease land or premises, but
only with respect to liability arising out
of the ownership, maintenance or use
of that part of the land or premises
leased to you.
(2) With respect to the insurance afforded
to these additional insureds, this
Insurance does not apply to:
(a) Any "occurrence" which takes
place after you cease to lease that
land or be a tenant in that
premises; or
(b) Structural alterations, new
construction or demolition
operations performed by or on
behalf of such person or
organization.
Architects, Engineers Or Surveyors
(1) Any architect. engineer, or surveyor, but
only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury' caused, in whole
or in part, by your acts or omissions or
the acts or omissions of those acting on
your behalf:
(a) In connection with your prem ses;
or
(b) In the performance of your
ongoing operations performed by
you or on your behalf.
(2) With rrsject to the insurance afforded
to these additional insureds, the
following additional exclusion applies:
This insurance does not apply to
"bodily injury ", "property damage" or
"personal and advertising injury"
arising out of the rendering of or the
failure to render any professional
services by or for you, including:
(a) The preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
architectural or engineering
activities.
BUSINESS LIABILITY COVERAGE FORM
e. Permits Issued By State Or Political
Subdivisions
(1) Any state or political subdivision, but
only with respect to operations
performed by you or on your behalf for
which the state or political subdivision
has issued a permit.
(2) With respect to the insurance afforded
to these additional insureds, this
insurance does not apply to:
(a) "Bodily injury", "property damage"
or "personal and advertising
injury" arising out of operations
Performed for the state or
municipality; or
(b) "Bodily injury" or "property damage"
included within the "products -
completed operations hazard ".
It. Any Other Party
(1) Any other person or organization who
is not an insured under Paragraphs a.
through e. above, but only with
respect to liability for "bodily injury ",
"property damage" or "personal and
advertising injury" caused, in whole or
in part, by your acts or omissions or
the acts or omissions of those acting
on your behalf:
(a) In the performance of your
ongoing operations;
(b) In connection with your premises
owned by or rented to you; or
(c) In connection with "your work" and
included within the "products -
completed operations hazard ", but
only if
(i) The written contract or written
agreement requires you to
piovice such coverage to
such additional insured; and
(ii) This Coverage Part provides
coverage for "bodily injury" or
"property damage" included
within the "products -
compieted operations hazard ".
(2) With respect to the insurance afforded
to these additional insureds, this
insurance does not apply to:
"Bodily injury", "property damage" or
"personal and advertising injury"
arising out of the rendering of, or the
failure to render, any professional
architectural, engineering or surveying
services, including:
Form SS 00 08 04 05 Page 13 of 24
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports., surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
architectural or engineering
activities.
The limits of insurance that apply to additional
Insureds are described in Section D. — Limits
Of Insurance.
How this insurance applies when other
insurance is available to an additional insured
is described in the Other Insurance Condition
in Section E. — Liability And Medical Expenses
General Conditions.
No person or organization is an insured with
respect to the conduct of any current or past
parmership, joint venture or limited liability
company that is not shown as a Named Insured in
the Declarations.
D. LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE
1. The Most We Will Pay
The Limits of Insurance shown In the
Declarations and the rules below fix the most
we will pay regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits ".
2. Aggregate Limits
The most we will pay for:
a. Damages because of "bodily injury" and
"property damage" Included in the
"products- complaled operations hazard" Is
[lie Rod,irts- Cnmploted Operations
Aggregate Limit shown in the
Declarations.
h. Damages because of all other "bodily
injury", "property damage' or "personal
and advertising injury", including medical
expenses, is the General Aggregate Limit
shown in the Declarations.
This General Aggregate Limit applies
separately to each of your "locations"
ownea by or rented to you.
"Locatlon" means premises Involving the
same or connecting lots, or premises
whose connection is interrupted only by a
street, roadway or right -of -way of a
railroad.
This General Aggregate limit does not
apply to "property damage" to premises
wMle rented to you or temporarily
occupied by you with permission of the
owner, arising out of fire, lightning or
explosion.
3. Each Occurrence Limit
Subject to 2.a. or 2.b above, whichever
applies, the most we will pay for the sum of all
damages because of all "bodily injury ",
"property damage" and medical expenses
arising out of any one "occurrence" is the
Liability and Medical Expenses Limit shown in
the Declarations.
The most we will pay For all medical expenses
because of "bodily injury" sustained by any
one person is the Medical Expenses Limit
shown in the Declarations.
4. Personal And Advertising Injury Limit
Subject to 2.b, above, the most we will pay for
the sum of all damages because of all
"personal and advertising injury" sustained by
any one person or organization is the Personal
and Advertising Injury Limit shown in the
Declarations.
5. Damage To Premises Rented To You Limit
The Damage To Premises Rented To You
Limit is the most we will pay under Business
Liability Coverage for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
Gghtning or explosion, while rented to you or
temporarily occupied by you with permission of
the owner,
In the case of damage by fire, lightning or
explosion, the Damage to Premises Rented To
You Limit applies to all damage proximately
caused by the same event, whether such
damage results from fire, lightning or explosion
or any combination of these.
6. How Limits Apply To Additional Insureds
The most we will pay on behalf of a person or
organization who is an additional insured
under this Coverage Part is the lesser or:
a. The limits of insurance specified in a
written contract, written agreement or
permit issued by a state or political
subdivision; or
b. The Limits of Insurance shown in the
Declarations.
Such amount shall be a part of and not in
addition to the Limits of Insurance shown in
the Declarations and described in this Section.
Page 14 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
If more than one limit of insurance Linder this
(1) Immediately send us copies of any
policy and any endorsements attached thereto
demands, notices, summonses or
applies to any claim or "suit ", the most we will pay
legal papers received in connection
under this policy and the endorsements is the
with the claim or "suit"
single highest limit of liability of all coverages
(2) Authorize us to obtain records and
applicable to such claim or "suit ". However, this
other information;
paragraph does not apply to the Medical Expenses
limit set forth in Paragraph 3. above.
(3) Cooperate with us in the investigaf.on,
The Limits of Insurance of this Coverage Part apply
settlement of the claim or defense
"suit ";
against the and
separately to each consecutive annual period and to
(4) Assist
any remaining period of less than 12 months, starting
us, upon our request, in the
with the beginning of the policy period shown in the
enforcement of any right against any
Declarations, unless the policy period is extended
person or organization that may be
after issuance for an additional period of less than 12
liable to the insured because of Injury
months. In that case, the additional period will be
or damage to which this insurance
deemed part of the last preceding period for purposes
may also apply.
of determining the Limits of Insurance.
d. Obligations At The Insured's Own Cost
E. LIABILITY AND MEDICAL EXPENSES
No insured will, except at that insured's awn
GENERAL CONDITIONS
cost, voluntarily make a payment, assume
any obligation, or incur any expense, other
1. Bankruptcy
than for first aid, without our consent.
Bankruptcy or insolvency of the insured or of
e. Additional Insured's Other Insurance
the insured's estate will not relieve us of our
If we cover a claim or "suit" under this
obligations under this Coverage Part.
Coverage Part that may also he covered
2. Duties In The Event Of Occurrence,
by other insurance available to an
Offense, Claim Or Suit
additional insured, such additional insured
a. Notice Of Occurrence Or Offense
must submit such claim or "suit" to the
You or any additional insured must see to
other insurer for defense and indemnity.
it that we are notified as soon as
However, this provision does not apply
P to
practicable of an "occurrence' or an
the extent that you have agreed in a
offense which may result in a claim. To
written contract, written agreement or
the extent possible, notice should include:
permit that this insurance is primary and
(1) Hcw, when and where the "occurrence"
non - contributory with the additional
or offense took place;
insured's own insurance.
f. Knowledge Of An Occurrence, Offense,
(2) The names and addresses of any
Claim Or Suit
injured persons and witnesses; and
(3) The nature and location of any injury
Paragraphs a. and b. app'.y to you or to
or damage arising out of the
any additional Insured only when such
"occurrence ",
"occurrence" or offense.
offense, claim or "suit" is
known to:
b. Notice Of Claim
(1) You or any additional insured that is
If a claim is made or "suit" is brought
an individual;
against any insured, you or any additional
(2) Any partner, if you or an additional
insured must:
insured is a partnership;
(1) Immediately record the specifics of the
(3) Any manager, if you or an additional
elaim or "suit" and the date received;
insured is a limited liability company;
and
(2) Notify us as soon as practicable.
(4) Any "executive officer" or insurance
manager, if you or an additional
You or any additional insured must see to
insured is a corporation;
it that we receive a written notice of the
"suit"
(5) Any trustee, if you or an add-- .tional
claim or as soon as practicable.
insured is a trust; or
c. Assistance And Cooperation Of The
(6) Any elected or appointed official, if you
Insured
or an additional insured is a political
You and any other involved insured must:
subdivision or public entity.
Form SS 00 08 04 05 Page 15 of 24
BUSINESS LIABILITY COVERAGE FORM
3.
4.
U
6.
This Paragraph I. applies separately to
you and any additional insured.
Financial Responsibility Laws
a. When this policy is certified as proof of
Financial responsibility for the future under
the provisions of any motor vehicle
financial responsibility law, the insurance
provided by the policy for "bodily injury"
liability and "property damage" liability will
comply with the provisions of the law to
the extent of the coverage and limits of
insurance required by that law
I With respect to "mobile equipment" to
which this insurance applies, we will
provide any liability, uninsured motorists,
urderinsured motorists, no -fault or other
coverage required by any motor vehicle
law, We will provide the required limits for
those coverages.
Legal Action Against Us
No person or organization has a right under
this Coverage Form:
a. To join us as a party or otherwise bring us
into a "suit" asking for damages from an
ensured; or
b. To sue us on this Coverage Form unless
all of its terms have been fully complied
with.
A person or organization may sue us to recover
on an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this insurance or that are in excess of the
applicable limit of insurance. An agreed
settlement means a settlement and release of
liability signed by us, the insured and the
claimant or the claimant's legal representative.
Separation Of Insureds
Except with respect to the Limits of Insurance.
and any rights or duties specifically assigned
in this policy to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom
a claim is made or "suit" is brought.
Representations
a. When You Accept This Policy
By accepting this policy, you agree:
(1) The statements in the Declarations
are accurate and complete;
(2) Those statements are based upon
representations you made to us; and
(3) We have issued this policy in reliance
upon your representations.
b. Unintentional Failure To Disclose
Hazards
If unintentionally you should fail to disclose
all hazards relating to the conduct of your
business at the inception date of this
Coverage Part, we shall not deny any
coverage under this Coverage Part
because of such failure.
7. Otherinsurance
If other valid and collectible insurance is
available for a loss %e cover under this
Coverage Part, our obligations are limited as
follows:
a. Primary Insurance
This insurance is primary except when b.
below applies. If other insurance is also
primary, we will share with all that other
insurance by the method described in c.
below.
I Excesslnsurance
This insurance is excess over any of the
other insurance, whether primary, excess,
contingent or on any other basis:
(1) Your Work
That is Fire, Extended Coverage,
Builders Risk, Installation Risk or
similar coverage for "your work"
(2) Premises Rented To You
That is fire, lightning or explosion
insurance for premises rented to you
or temporarily occupied by you with
permission of the owner;
(3) Tenant Liability
That is insurance purchased by you to
cover your liability as a tenant for
"property damage" to premises rented
to you or temporarily occupied by you
with permission of the owner;
(4) Aircraft, Auto Or Watercraft
It the loss arises out of the maintenance
or use of aircraft, "autos" or watercraft to
the extent not subject to Exclusion g. of
Section A. — Coverages.
(5) Property Damage To Borrowed
Equipment Or Use Of Elevators
If the loss arises out of "property
damage" to borrowed equipment or
the use of elevators to the extent not
subject to Exclusion k. of Section A. —
Coverages.
Page 16 of 24 Form SS 00 08 04 05
(6) When You Are Added As An
Additional Insured To Other
Insurance
That is other insurance available to
you covering liability for damages
arising out of the premises or
operations, or products and completed
operations, for which you have been
added as an additional insured by that
insurance; or
(7) When You Add Others As An
Additional Insured To This
Insurance
That is other insurance available to an
additional insured.
However, the following provisions
apply to other insurance available to
any person or organization who is an
additional insured under this Coverage
Part:
(a) Primary Insurance When
Required By Contract
This insurance is primary is you
have agreed in a written contract,
written agreement or permit that
this insurance be primary. If other
insurance is also primary, we will
share with all that other Insurance
by the method described in c.
below.
(b) Primary And Non - Contributory
To Other Insurance When
Required By Contract
If you have agreed in a written
curthact, written agreement or
permit that this insurance is
primary and non - contributory svith
the additional insured's own
Insuance, this insurance is
primary and we will not seek
contribution from that other
insurance.
Paragraphs (a) and (b) do not apply to
other insurance to which the additional
insured has been added as an
additional insured.
When this insurance Is excess, we will
have no duty under this Coverage Part to
defend the insured against any "suit" if any
other insurer has a duty to defend me
insured against that "suit ". If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured's
rights against all those other insurers.
BUSINESS LIABILITY COVERAGE FORM
When this insurance is excess over other
insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self -
insured amounts under all that other
insurance.
We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess Insurance provision and was not
bought specifically to apply in excess of the
Limits of Insurance shown in the
Declarations of this Coverage Part.
c. Method Of Sharing
If all the other insurance permits
contribution by equal shares, we will follow
this method also. Under this approach,
each insurer contributes equal amounts
until it has paid its applicable limit of
insurance or none of the loss remains,
whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will
contribute by limits. Under this method, each
insurer's share is based on the ratio of its
applicable limit of insurance to the total
applicahle limits of insurance of all insurers.
8. Transfer Of Rights Of Recovery Against
Others To Us
a. Transfer Of Rights Of Recovery
If the insured has rights to recover all or
part of any payment, including
Supplementary Paymerts, we have made
under this Coverage Part, those rights are
transferred to us. The insured must do
nothing after loss to impair them. At our
request, the ! insured will bring "suit" or
transfer those rights to us and help us
enforce them. This condition does not
apply to Medical Expenses Coverage.
b. Waiver Of Rights Of Recovery (Waiver
Of Subrogation)
If the insured has waived any rights of
recovery against any person or
organization for all or part of any payment,
including Supplementary Payments, vie
have made under this Coverage Part, we
also waive that right, provided the insured
waived their rights of recovery against
such person or organization in a contract,
agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
BUSINESS LIABILITY COVERAGE FORM
F. OPTIONAL ADDITIONAL INSURED
COVERAGES
If listed or shown as applicable in the Declarations,
one or more of the following Optional Additional
Insured Coverages also apply. When any of these
Optional Additional Insured Coverages apply,
Paragraph 6. (Additional Insureds When Required
by Written Contract, Written Agreement or Permit)
of Section C., Who Is An Insured, does not apply
to the person or organization shown in the
Declarations. These coverages are subject to the
terms and conditions applicable to Business
Liability Coverage in this policy, except as
provided below;
1. Additional Insured - Designated Pension Or
Organization
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the persons) or organizations) shown in the
Declarations, but only with respect to liability
for "bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions or
the acts or omissions of those acting on your
behalf
a. In the performance of your ongoing
operations; or
b. In connection with your prernises owned
by or rented to you.
2. Additional Insured - Managers Or Lessors
Of Premises
a. WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or or ganization(s) shown in the
Declarations as an Additional Insured -
Designated Person Or Organization; but only
with respect to liability arising out of the
ownership. maintenance or use of that pact of
the premises leased to you and shown in the
Declarations.
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply
This insurance does not apply to:
(1) Any "occurrence" which takes place
after you cease to be a tenant in that
premises; or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
3, Additional Insured - Grantor Of Franchise
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or organization(s) shown in the
Declarations as an Additional Insured -
Grantor Of Franchise, but only with respect to
their liability as grantor of franchise to you.
4. Additional Insured - Lessor Of Leased
Equipment
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the person(s) or organizations)
shown in the Declarations as an Additional
Insured — Lessor of Leased Equipment,
but only with respect to liability for "bodily
njury", "property damage" or "personal
and advertising injury' caused, in whole or
in part, by your maintenance, operation or
use of equipment leased to you by such
persons) or organization(s).
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to any "occurrence" which
takes place after you cease to lease that
equipment.
5. Additional Insured - Owners Or Other
Interests From Whom Land Has Been
Leased
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the persons) or organization(s)
shown in the Declarations as an Additional
Insured — Owners Or Other Interests From
Whom Land Has Been Leased, but only
with respect to liability arising out of the
ownership, maintenance or use of that part
of the land leased to you and shown in the
Declarations.
b. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply
This insurance does not apply lo:
(1) Any " occurence" that takes place
after you cease to lease that land, or
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
person or organization.
6. Additional Insured - State Or Political
Subdivision — Permits
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the state or political subdivision
shown in the Declarations as an Additional
Page 18 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
Insured - Stale Or Political Subdivision -
(e) Any faiiure to make such
Permits, but only with respect to
inspections, adjustments, tests or
operations performed by you or on your
servicing as the vendor has agreed
behalf for which the state or political
to make or normally undertakes to
subdivision has issued a permit.
make in the usual course of
b. With respect to the insurance afforded to
business, in connection with the
these additional insureds, the following
distribution or sale of the products;
additional exclusions apply:
(f) Demonstration, installation,
This insurance does not apply to:
servicing or repair operations,
(1) "Bodily injury", "property damage" or
except such operations performed
'personal and advertising injury"
at the vendor's premises in
arising out of operations performed for
connection with the sale of the
the state or municipality; or
product;
2 "Bodily injury" or
O j y' "property damage"
(9) Products which, after distribution
e
included " the "product - completed
or sale by you, have been labeled
operations" hazard.
or relabeled or used as a
container, part or ingredient of any
7. Additional Insured - Vendors
other thing or substance by or for
a. WHO IS AN INSURED under Section C. is
the vendor; or
amended to include as an additional
(h) "Bodily injury" or "property
insured the persons) or organization(s)
damage' arising out of the sole
(referred to below as vendor) shown in the
negligence of the vendor for its
Declarations as an Additional Insured -
own acts or omissions or those of
Vendor, but only with respect to "bodily
its employees or anyone else
injury" or "property damage" arising out of
acting on its behalf. However, this
"your products" which are distributed or
exclusion does not apply to:
sold in the regular course of the vendor's
business and only if this Coverage Part
d
(i) The exceptions contained in
provides coverage for "bodily injury' or
Subparagraphs (d) or (f); or
"property damage" included within the
(ii) Such inspections,
"products- completed operations hazard ",
adjustments, tests or servicing
b. The insurance afforded to the vendor is
as the vendor has agreed to
subject to the following additional exclusions:
make or normally undertakes
to make in the usual course of
(1) This insurance does not apply to:
business, in connection with
(a) "Bodily irjjry" or "property
the distribution or, sale of the
damage" for which the vendor is
products.
obligated to pay damages by
(2) This insurance does not apply to any
reason of the assumption of
insured person or organization from
liability in a contract or agreament.
whom you have acquired such
This exclusion does riot apply to
products, or any ingredient, part or
liability for damages that the
container, entering into,
vendor wouA have in the absence
accompanying or containing such
of the contract or agreement;
products.
(b) Any express warranty
8. Additional Insured - Controlling Interest
unauthorized by you;
WHO IS AN INSURED under Section C. is
(c) Any physical or chemical change
amended to include as an additional insured
in the product made intentionally
the person(s) or organizations) shown in the
by the vendor;
Declarations as an Additional Insured -
fd) Repackaging, unless unpacked
Controlling Interest, but only with respect to
solely for the pri of Inspection,
their liability arising out of:
demonstration, testing, or the
a. Their financial control of you; or
substitution of parts under
b. Premises they own, maintain or control
Instructions from the manufacturer,
while you lease or occupy these premises,
and then repackaged in the original
container,
Form SS 00 08 04 05 Page 19 of 24
BUSINESS LIABILITY COVERAGE FORM
Th.s insurance does not apply to structural
alterations, new construction and demolition
operations performed by or for that person or
organization.
9. Additional Insured — Owners, Lessees Or
Contractors — Scheduled Person Or
Organization
a. WHO IS AN INSURED under Section C. is
amended to include as an additional
insured the persons) or organization(s)
shown in the Declarations as an Additional
Insured — Owner, Lessees Or Contractors,
but only with respect to liability for "bodily
injury", "property damage" or "personal
and advertising injury" caused, in whole or
in part, by your acts or omissions or the
acts or omissions of those acting on your
behalf:
(1) In the performance of your ongoing
operations for the additional
insured(s), or
(2) In connection with "your work"
purormed for that additional insured
and included within the "products -
completed operations hazard ", but
only if this Coverage Part provides
coverage for "bodily injury" or
"property damage" included within the
"products- completed operations
hazard ".
b. With respect to the insurance afforded to
these additional insureds, this insurance
does not apply to "bodily injury", "property
damage" or "personal an advertising
injury" arising out of the rendering of, or
the failure to render, any p,ofessional
arch itoctu rat, engineering or surveying
services, including:
(1) The preparing, approving, or failure to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, designs or
drawings and specifications; or
(2) Supervisory, inspection, architectural
or engineering activities.
10. Additional Insured — Co -Owner Of Insured
Premises
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
the person(s) or Organizaticnfs) shown in the
Declarations as an Additional Insured — Co-
Owner Of Insured Premises, but only with
respect to their liability as co -owner of the
prem -uses shown in the Declarations.
The limits of insurance that apply to additional
insureds are described in Section D. — Limits Of
Insurance.
How this insurance applies when other insurance
is available to an additional .nsured is described in
the Other Insurance Condition in Section E. —
Liability And Medical Expenses General
Conditions.
G. LIABILITY AND MEDICAL EXPENSES
DEFINITIONS
1. "Advertisement" means the widespread public
dissemination of information or images that
has the purpose of inducing the sale of goods,
products or services `through:
a. (1) Radio;
(2) Television;
(3) Billboard;
(4) Magazine;
(5) Newspaper;
b. The Internet, but only that part of a web
site that is about goods, products or
services for the purposes of inducing the
sale of goods, products or services; or
G. Any other publication that is given
widespread public distribution.
However, "advertisement" does not include:
a. The design, printed material, information
or images contained in, on or upon the
packaging or labeling of any goods or
products; or
b. An interactive conversation between or
among persons through a computer network.
2. "Advertising idea" means Lny idea for an
"advertisement ".
3. "Asbestos hazard" means an exposure or
threat of exposure to the actual or alleged
prepc:rtres of asbestos and includes the mare
presence of asbestos in any form.
4. "Auto" means a land motor vehicle, trailer or
semi - trailer designed for travel on public
roads, including any attached machinery or
equipment. But "auto" does not include
"mobile equipment ".
S. "Bodily injury" means physical:
a. Injury;
b. Sickness; or
c. Disease
sustained by a person and, it arising out of the
above, mental anguish or death at any time.
6. "Coverage territory" means:
Page 20 of 24 Form SS 00 08 04 05
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10 (Ed 01 -07)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA
BLANKET BASIS
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right
against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work
under a written contract that requires you to obtain this agreement from us.)
The additional premium for this endorsement shall be 2.00 % of the California workers' compensation premium otherwise
due on such remuneration.
The minimum premium for this endorsement is $ 350.00
Schedule
Person or Organization Job Description
ALL ORGANIZATIONS FOR WHOM THE WAIVER OF SUBROGATION IS ALL CALIFORNIA OPERATIONS
ISSUED
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated,
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 08.131;2008 Policy No. 2200013354 -082 Endorsement No. 1
Insured CULBERTSON ADAMS & ASSOCIATES, INC. Premium $
insurance Company Countersigned by 6' .44� Xlii? 08
Oak River Insurance Company
WC 99 04 10
(Ed 01 -07)