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HomeMy WebLinkAboutUNITED INSPECTION & TESTING, INC. 4AWORK MAY PPU, .Lr p uNjit_ !NSURanl~ : ~:xPIRE :~ A-2008-012-01 ' CLER OF COU( ~_,I . ~aTF AUG ~ 5 200$ FIRST AMENDMENT TO UNITED INSPECTION AND TESTING CONSULTANT AGREEMENT THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into this ~ day of August 2008, by and between United Inspection & Testing, Inc., a Delaware corporation ("Consultant") and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). RECITALS: A. The parties entered into Consultant Agreement A 2008-012 dated January 7, 2008, (hereinafter "said Agreement") by which Consultant has provided material testing and construction inspection services. B. In accordance with the terms and conditions of said Agreement, the parties wish to amend the attached Fee Schedule to comply with California prevailing wage requirements. WHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this Amendment to Consultant Agreement, the parties agree as follows: Section 2, COMPENSATION, shall be amended by replacing the current Appendix C, with a new "Fee Schedule" dated .luly 1, 2008, attached hereto as Appendix C, and incorporated by reference. 2. All other terms and conditions as set forth in the original Agreement shall remain in full force and effect. // // // // // // IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Consultant Agreement on the date and year first written above. ATTEST: n` PATRICIA E. HEALY Clerk of the Cotmcil CITY OF SANTA ANA /WY A ~ `,~ DAVID N. RE City Manager APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney By: Lisa E. Storck Assistant City Attorney RECOMMENDED FOR AP AL: JAMES G. ROSS Executive Director ~'~lic Works Agency CONSULTANT UNITED INSPECTION & TESTING, INC. ~_ By: JE J. ICHARDS Pre d ~,IUNI T ED M ETS Company APPENDIX C FEE SCHEDULE TESTING AND INSPECTION SERVICES FOR THE CITY OF SANTA ANA CAPITAL IMPROVEMENT PROJECTS Revision 1 1-Jul-08 ITEM ESTIMATED QUANTITY UNIT HOURLY RATE/ UNIT COST ESTIMATED COST Soillnspection 1,000 Hours $68.66 $ 68,660.00 Concrete Inspection 1,500 Hours $71.22 $ 106,830.00 Masonry Inspection 800 Hours $71.22 $ 56,976.00 Reinforcing Steel Inspection 1,200 Hours $71.22 $ 85,464.00 Asphalt Concrete Inspection 500 Hours $68.66 $ 34,330.00 6" Concrete Cylinder (ASTM C-39) 400 Units $17 $ 6,800.00 2X4 Mortar Sample (ASTM C-39) 200 Units $17 $ 3,400.00 3X3X6 Grout Sam le ASTM C-1019 200 Units $17 $ 3,400.00 Mason Prisms ASTM E-447 150 Units $17 $ 2,550.00 Ultrasonic Testin of Steel Connectors 50 Each` $25 $ 1,250.00 Post Tension Reinforcing Inspection 200 Hours $71.22 $ 14,244.00 Post Tension Concrete Inspection 200 Hours $71.22 $ 14,244.00 Structural Steel Inspection 100 Hours $71.22 $ 7,122.00 Connecting Bolt Torque Testing 100 Each* $25.00 $ 2,500.00 Precast Concrete 350 Hours $55.00 $ 19,250.00 Deputy Inspection 100 Hours $71.22 $ 7,122.00 Mechanicallnspection 100 Hours $70.00 $ 7,000.00 Plumbing Inspection 100 Hours $70.00 $ 7,000.00 Electricallnspection 100 Hours $70.00 $ 7,000.00 TOTAL $ 455,142.00 * Typical industry practices utilize hourly rates for Technicians for the Ultrasonic Testing of Steel Connectors and Torque Testing of Connecting Bolts. These disciplines are included in the State of California DIR Prevailing Wage determination, which provides for an hourly wage rate for these technicians. ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID E DATE (MMlDDNYVY) CONSO-2 01/04/08 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, PRODUCER. Butwin Insurance Group suite 414 60 Cutter Mill Road Great Neck NY 11021-3104 ~hone:516-466-4200 Fax:516-466-4213 INSURED INSURERS AFFORDING COVERAGE INSURER A AIG NAIC# United Inspection Inc 22620 Goldencrest Suite 114 Moreno valley CA 92553 & Testing Drive INSURER B INSURER C INSURER D INSURER E Houston Casualty Co. J!l'ationa1 Union Fire Ins _ Co_ COVERAGES THE POLICIES OF INSURANCE L1S1ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA1ED N01WITHSTANDING ANY REQUIREMENT, 1ERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, T~E 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 LTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE (MMlDDNY) DATE (MMlDDIYY] LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 - A X X COMMERCIAL GENERAL LIABILITY 4022676 07/01/07 07/01/08 PREMISES (Ea occurence) $500,000 - ::=J CLAI MS MADE ~ OCCUR MED EXP (Anyone person) $ 10,000 - PERSONAL & ADV INJURY $1,000,000 - GENERAL AGGREGATE $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMPIOP AGG $ 2,000,000 I n PRO- nLOC POLICY JECT AUTOMOBILE LIABILITY 07~m- COMBINED S'NGLE LIMIT - $1,000,000 B X ANY AUTO 3853974 07/01/08 (Ea accident) - ALL OWNED AUTOS :t> ta.~ ~O aODIL Y INJURY - ~ V $ SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS O?-,C'f. aODIL Y INJURY - $ NON.OWNED AUTOS IPer aCCIdent) - "L. \Sf'. ~'C ,~ ~I.\O~ne~ - ~\~ Il" PROPERTY DAMAGE $ ': _%~n\ o""\~ IPer aCCIdent) GARAGE LIABILITY ~":)'- C *1"/ AUTO ONLY. EA ACCIDENT $ ==i ANY AUTO OTHER THAN EA ACC $ I AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY i EACH OCCURRENCE $4,000,000 A !J OCCUR D CLAIMS MADE BE4803422 07/01/07 07/01/08 AGGREGA1E $ 4,000,000 $ ~ DEDUCTIBLE $ X RE1ENTION $10,000 $ WORKERS COMPENSATION ANO X ITORYLIMITS I IOJ:t A EMPLOYERS' LIABILITY WC7578176 07/01/07 07/01/08 ANY PROPRIETOR/PARTNERiEXECUTI VE EL EACH ACCIDENT $ 1000000 OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 1000000 If yes, describe under $ 1000000 SPECIAL PROVISIONS below EL DISEASE, POLICY LIMIT OTHER I C ~rofessional Liab i H70616143 10/01/07 10/01/08 Ea Claim 1,000,000 Retro Date 9/1/85 I Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The City of Santa Ana, its officers, employees, agents, volunteers and representatives are additiona insureds CERTIFICATE HOLDER CANCELLATION SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Santa Ana 20 Civic Center ~laza Santa Ana CA 92701 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 INSURER, ITS AGENTS OR REPRESENTATIVES. AUTH D REPRESENTATIVE ACORD 25 (2001/08) @)ACORDCORPORATION 1988 I 'I BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. j (The followro -allachilg clallSe" need be comp/eled only when lhis endorsement is issued subsequent to preparatiJn of lhe policy). This endorsement, effective 12:01 AM 01/01/2007 forms a part of Policy No. we 757-81-76 Issued to CONSOLI DATED ENG INEERING LABORATORI ES By AMERICAN HOME ASSURANCE COMPANY We have a right to recover our payments from anyone lable for an injury covered by this policy. We wi. not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perfonn fer such person or organization. The additional premium for this endorsement shall be for this policy. 2. % of the total estimated workers compensation premium JO#- ~~~O 1\lta" <<'Oi~O t:. ~ 1"01' -tO~C ". . '€-' S \ '!..\o'(\\e, \..\S~ C\\'J ~ ~"'0 ot :v) -1 we 04 0361 (Ed. 11190) Countersigned by ~~ INSURED'S COpy Authorized Representative l------________,.--"...--_~_______.H_.______________..._. , . . POLICYNUtaR; 40Z2676 ao.....ClAL CIBtft!It& LIMruTV cellM1Dn mlS ENDORSEMENT CHAM_ nlE POlJCY. PlEME READ rr CAREFlI.l Y. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERs TO US lhIs IIf1dorternent ~.ln8l.l'ml:8 plOYlded LInder Ih, illIIIIag: COMMERCIALGa6W. UA8IUlY COVERAGE P.aRr SCHBUE Name of Person cro..-twn..: (If IX) ~ liIppen 'baN. Info....... .....d Iv CIampi.. ....,darH... MI be II'KMn In hi Dllllnacn -'PPDDIiIl. to.... ........q TIle TRANSFER OF RICIfTS a= RECOVERY AGAINST t'8I T.18 CancItion (8edlm IV _ ctlMMER- ow. eeNERAl LWlI.IfY COta1'lDNS) i. amlndld bJ- .......lIbW1g: 'NII._ Illy rIfI'd fI rccz~' M __ hive agiairl8t -..... VI' ~ showllln the SdIdje above t11C8U1e of paymlrtl ... meki tr _ or damage - . -~ft your alV)Eg opendIans or ')till- ~' den. um:ler a COf1b"act wlh", ~ or arganiZ8tlon ala 1__11 tile .~etetl q-al:.. hazard". Ttis waiver appllt18 on,. b tile Pl!IrIlB Or organizali.. ~ III" Sctl81U9 iIIIMNe. o tOyJ-A 1a,! 't ..,-rtflfJ r<C~ ~~ t. s~O~\\O{{\e'1 ~ti d :r) C824041093 Copyli~ lnaurance ServioeI 0Ii0e, ~ 1S92 PIG.1oft D POUCY NUMBER: G L 402-26-76 COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU i This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury. caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insuredlr, the fOllowing additional exclusions apply: 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: a. The preparing, approving, or failing to prepare or approve. maps, shop draw-' ings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury~ or "property damage" occur- ring after: 8. All work, including materials, parts or equipment fumished in connection with such work, on the project lather than service, maintenance or repairs) to be per formed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put. to its intended use by any person or organization other than another con- tractor or subcontractor engaged in per- forming operations for a principal as a part of the same project. ,." 'to tO~ ~,~o~!> ;'tO~C~ . \S~ t. ~ f>.,tto"('{\e'l \,.: '(\\ C\\'J f>.,ss\s't'O 01 or:r) CG 20 330704 <<:>150 Properties, Inc.,2004 INSURED'S COPY o Page 1 of 1 POL~YNUMBER: 4022676 CO..,ERCIAL GENERAL LIABILITY CG 20 37 C11 04 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsemert ll'lOdifies irJ5lJrance provided under the following: COM MERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE tions Blanket Additional Insureds All covered operations, if required by written contract Information recp..lired to complete this SchedUe, if not shown aoove, Will be shONn in the Dedaralions. Section II - Who Is An Insured is amended to include as an additional insll"ed the person(s) or crganlzatlor(s) 1l00Nn In the Bclhedule, but only with reipaot to liabiltly for "ooditjt injury" or "property dam- llge" cllused, In whole or In part, by "your work" at the wtlen dSilgiited and dilicrlbed In the &chid- IJle cf this endol'l8menl performed tor tnllt .ddi~onll in5Ured all:l iry,;llJded in trti: "proc1Jcts-campeled operations hazard', CG 20370704 ClISO Propertiei, Inc" 2004 PilUi10f1 C THIS EtIJOASEMENT CltANGES THE POLri. PLEASE 1E'm IT CAREFULLY. ENDORSEMENT .. Th1s endorsement, effectlvell:(]1 A.M. 07/01/07 forms I part of Policy No. 3853974 imllM to CONSCl..IlATED ENGINEERING IIIJ AIG LABS WAIVER OF TRANSFER Of RIGHTS OF RECOVERY AGAINST OTHERS TO US This endaf!HJlDt madtf'ft hDrvlnr pf'TJVtdm undt1r rhff )'bllaUWi BUSIHESS AllIO COVERAGE FORM S.c;tign IV - .U~I AI&D CGnlfitjQm:, A, - Lo. CQnditiQnl, !i. - Tranner gf RiIlU gf Rlmvery "lInt OIhIn 11) UI. t.unended to mid: However, we wtl wa1ve any r1gI1t of reca./f!:fy we I'ave against any perlOO or organtzatlon wtt~ whom you have enb!red into a cnrIract or agreement because of JIiIYIlIent5 we make under-this. Coverage Form arisillg oot of an lIacddent" or "loss" if: (1) The aaa:ident" or 11m" is due to operatims; ~rtaken in accordance with the contract eKisling beb.veen you and such perDl or oryanizatioo i and (2) The c:a1UKt lJ" IIIr....." Will entered Into pr1m 19 IllY M.dclent" or "laD". No waiver of the right of rea.wry will directly or indirectly appl, to ywr employees or employees r:I tI'le perKln or arpnlDtton, and we re.ve CMlr rlghll or aen to be relmbuned from any r.m..... fundllltnined by any injurM .m"". sa. &s- AUTHORIZED RfPRfSftfTATIVE 62897 (6195) ,.,.. POLICY NUMBER: 3853974 CC--llCIAL AUIO <<:A.ea. THIS !NOORIIEMIMr CHANGES THE PCI.ICY. 'LEAIIE READ IT CARIAlUY. DESIGNATED INSURED This endorsement rtaI_ in&lJ1lI'lR psvld8d ~nr;Wr Ihl ill.. BUSINESS AUTO OOVE~ FCRM GARAGE COVERAGS rolit~ MOTOR CARRlERCOVERMiEFORM TRUCKERS CO'IERAGE fo()RU W ill respect to aMBI'ag8 JIOVIdelllly hi endOl1iement, u,. pavilions of the Coterage Form apply..... Il1CdliIId '" l'Iis endorsement. Thlllndoru"""t 1aIns.t pncrMGrCllll&nUtlgn(l) whll.~ .~.Ln'" ....r tM WI'Ia II An I....... 'mvllba fA ... COVll'Igl j:MII. ""1liIa.c1,,~"" Mt slter cO\I6rap pnMded IrllIe Cawn:tge Form. . lbil 8nlilWi&l'Tlent 5111..,. the J:mq- eIfiIdivI!I on the Incllll_ lIIe Of lie ~1fY UI'IIHD Inbhr eWe il: lndi..-d IIIIDW . B1dorsament sffeci\e 07/01/07 1m nsure CONSOLIDATED ENGINEERN3 LABS. EBERHART JUNITED CONSULTANTS UNITED INSPECTION & TESTING INC "'Ign lit' 2"- ~ (/dIoIized Representa1ive) SCHEDJlE ....... of Person{s} erQopniz:atim1(sJ: BLANKET ADDITIONAL INSUREDS, ON A PRIMARY AND NON CONTRIBUTORY BASIS tlltllintry app"I...lnfGl'~I....iPM tI:l eomplet!l t~.rt:lor~""'w111 be shown 10 !he I~dmltlons., III'Pllcable to the endolSl!I1IEI'JI.) ..." p....~" or D'1I..... Il'IClYI'IIn.. 8cho<l\llllli an '111..... b LII1b_ Coveragl. but onJtllII.. ..banI thII: "'00 or or~anizsbl ~es .1 - ,,-..red" under the M1111s An InlllACl PrW'~ QontalnoQ'llt laialll "lie tAw. Form. ~o to)?J.'l\. ~'O ~a ~i~O , o?<,c'f... t S\ :\\ot(\e~ \.\S~ .c\'t~ ~ . ~~ J-r) l1 CA 21148 02 99 CqI...t;, Im!llJrance SOrvilESOIlite, Inc.,1S6 ....e 1 of 1 A _ 020 - o~oz AC t) CERTIFICATE OF LIABILITY INSURANCE ~ o GATE IlANIODVVVYY) . „ coa s 2 Ds/25/os PltoDUCl~ THJ,S CERTIFICATE 15 ISSUED As A AAATTER Of INFORMATION Satwin Iasuraace Gxoup ONLY AND CONFERS NO R!(RiTS UPON THE CERTIFICATE Suite 414 HOLDER. THlS GERTINCATE ODES NOT AMEND, EXTEND OR 60 Cutter mill Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Great kTeck NY 11021-3104 PhonB :516 -466 -4200 I!'a3C :516 -466-4213 INSURERS AFFORDING COVERAGE HJUG it RJSURED INSUiER Pi YaLleru3 ~1m Ylq Ted. ca. United IallpCCtlOII 6 TeStiag INSLIRERB: AIf~ 22620 Goldenrxee^t Drive INSaaERC- Houston Casualty Co. suite 119 Moreao Valle CA 92553 INSUIT~D y easuRER E: COVERAGE8 THE POLICIES OF INSURANCE LISTED BELOW HRVE BAN 15SLED TO THE INSURED NAMED PROVE FOR THE POLIC`f PETtIDD INDICATED. NOIWIIFSTAN06VG AVY REIgJIREMENT, TERM OR CONDttTCN OFANY CONTRACT OF OTFER DOCUNENf Yt11TFi RESP'cC7 Tn WHICH THIS C;?aTFICATE MAY >3E ISSUED OR M4Y PERTAIN, THE INSURANCE AFFtNDED BY THE POLIpES DESCRI9®HEAEIN IS 5U8.£CT TO ALL ThE T ERM75, EXCLUSOAIS AIWA CONDITpNS OF SUCH POLICIES. AGGREGATE ! NUTS SHO~NN MAY HAVE clEEN Ri-'11CfD SY PAS CLAk~. LTR TYPE OF INSURANCE PoL1CY NUMBER pA-~ I~ALyyvl pA~ {MLgpOryYi uwrs GENENAL LIABILTIY ~ ! EACH OCCURNENCE 5 1, O DD , 0 D D A X X eoMMERCIALG1E.z4LLIAEIUTY `4D22676 07/01/08 07/Ol/09 1PREMISES(E®oecusrwri 5_500,000 CLAIMS MADE ~ OOCLR f MED E?~ (Any ars D~~+1 $ 1 O . D D 0 PER90NN.dADV INJI.FY S 1,ODO,OOD ~ ~ GEn~RAL AGGREGAI:' s 2 , 000 , D00 GEML AGATE LMR APPLIES P9i: ( PRCOUCCS - COMPIOP AAriGG $ 2 , OOD , OOO aOLlcv ~ ~ LOC ~ AUT OY06N2 LIACLITY coMa[NEDSINGLELNrflr s 1 000 000 A X X ANYAUia 3853974 07/01/08 D7/01/09 (E>t lCO~EfI[I . , ALL OWNED AUTOS BODILY fNJURY $ scrEDU~ auras + (~ I~ Dim Hp7EDPiJ1105 / ~ '~V Qd ~ i? {P~lacdd xl Y $ NOHFCOAMED AUTOS . er ~tJ~ ~ PROPERTY DMS4GE . ~ ~ fPerecddeMM $ GARAGE LWBILm ~• ALIfO ONLY - cA ACCIDEM $ ANY NfTO `, ~j S~ ~j\~.+ ~ r. 2 OR-~R ThW~i E.4 ACC S ta'r l( ALTO O[~Y: ~ 5 ExcesaruMBRET.LALUB~m EACHOCCURRENCa= x4,000,000 B X occuR ~aAiMSNPeE 8$3128610 I 07/01 07/D1/D9 AGGFEt GA1c 54,000,000 $ DEDUCnaLE ~ x RErENrroN :1ooaD a YIIORISERS COMPENSATION AND M Y ' T0.9Y LiMfi 9 ER ~ B E PLO ERS LUIBLm ANY PRDPRFETORIPARTNERIEXECUTIVE iPC757$176 D7/ Di/D$ D7/D~/D9 E.L. E4CtI Al'CIDEM _ $ ~DDDDOD O~G3ia~AEHBER EXCLUDED? ) E.L.DISEASE-E:4EMPLOYE~ $10DOODD SPEC W. PROY~ 1510 5~9AGV1 ~ ~ E.L. DISEASE-POLICY LIMB $ 1000OOD C PDP~ eaaiohai Liab I H 70715549 10/01/07 10/01/08 ( £a Ciaim 1,000,000 Retro Date 9/1/85 ~ Aggregate 2,000,000 OEBCRIPTlON OF OPERATIONS /LOCATIONS 1 YBfCLE91 E)ICLU8ION9 AOO® BY ENOOR9EMENT 19PECIAL PRDVIMWI9 TA8 CITY OF SANTA ANA, ITS OFFICffiLS, EMPLOYEES, ACiENT3, VOLLtN'rE1~RS AND REPR8S8l7TATIV'J69 AR>z NAi!~D A3 ADDITTO~NA.T, INSUREDS WTTB RESP$CTS TO THE OPEAITIONS P>eRFO~D SY OR ON RTITtAT.7P OF TH$ NA1s~D. INIISRED, TIiIS INSURANGB IS ~T!!~Rn AND NON CORiTRIBLPlORY WITH ]!NY OTHER nQ9LJRANCB CARRIED BY OR !'OR TH1C BENEFIT OF THS ADDITI014;ATa INSL11;iEDS, 10 DAY NON P713~NT CAN~'tT•T•a'PION APPLIES CERTIFICATE HOLDER CANCELLATT6N ~AL~.LrAAN SHOULD ANY OF T}E ABOVE ~$C RBED POLJCIES 8E CANCELLED BEFORE TFE E7RIAATON DATE THEREOF, 7FE 198UN0 la9URER W9.L ENDEAVOR'aD MAIL 3 D DYIY& Vi7iiTIEN CITY OP' SANTA ALFA NOTICE TO Ti£ CEitTF1CATE HOLDER NApED TO THE LEFT, Bur FA[ URE To DO SD SWLLL PLTHLI C 9YOT,tRS AOLNCY WppgE NO OBLIGATION OR uABItTTV eF ANY IalaD UPON THE NSURER, ITS Amara DR 8038 STR'r~ET ANM3Y-M-22 20 CI'PIC CQaTER FLASA REPRES@IfAT1YE3. SANTA At~- CA 92701 REPRESENTATrvE ACORD 25 {2©01/08) ®ACORD CORPORATISM 1988 EXHIBIT D Insurance Company ADDITIONAL INSURED ENDC}RSBNfENP FOR C~IVIlVIF,RCIAL GENERAL LIABILTI'Y POLICY National Union Fire Ins Co This endorsement modifies such insurance as is afforded by the provisions of Policy # 4022576 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 insureds ("additional insureds") with regard to liability aad defense of suits arising fmm 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 insurance as is afforded by this policy is primary and is not additional to or contn'buting with any other insurance caaxied by or for the benefit of the additional insureds. 3. This insurance applies separately fa each insured against whore claim is made or suit is brought except with respect to the compan~s limits of liability. The inclusion o#' any person or organization as au insured steal! not affect any right which such person ar organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shad not be cancelled, or materially reduced in coverage or limits except after thn-ty (30) days written notice has boen given to the Gity of Santa Ana;~20 Civic Center Plaza, Santa Ana, California 9271. (Completion of the following, including countersignature, is required. to make dais endorsement effective.) Effective 7/i/08 ,this endorsement Evan as a part of Policy # 402 676 Issued to _Unified Tesi~ina Cori?oratipp ba Unified In~t~~~pd Testino Ahmed Insured ~~ _+~o~tntorsignad by ~ ~O Authorized. Representative D g,5 A,~pgpVE LISP E G~ty A t~ ne`J Assistant ~~k~-) , From:Ellen Begun . FaxID:516-466-4213 Date:12/17/2008 11:26 AM Page: 1 of 1 ACORD. CERTIFICATE OF LIABILITY INSURANCE OP 10 EB I DATE (MMlDDIVYVY) CONSO-2 12/17/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Butwin Insurance Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Sui te 414 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 60 cutter Mill Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Great Neck NY 11021-3104 Fhone:516-466-4200 Fax:516-466-4213 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A lIaUonlll l1nion riu In_. Co. United Testing Co~oration dba United Inspect10n 'NSLRC;;'3 AIG and Testing INSURERC Houston Casualty Co. -- 22620 Goldencreest Drive Suite 114 -. .- MOreno Valley CA 92553 II\SU~EF 0 i I~.ISJRER E I COVERAGES T>-JF pr, 11.1[:; CJF Ir'15JRMCE LISTEl' ::lELUVV I-.AV:::: 'iEEt>. ISSUE) TO TrE IMill;;>ED hlAMED ABOVE F:..:R THE POLICY PCRI,)D INm :ATi'-O t\07VI/ITHSTAN[llr'~G ANY Ri::OLlREMcNT, TERM OR '~t,;r"DIT O"l::::F NJT CONTRACT OR OThE>< DOCl'MI:N WITt-: RE::;::>tCT TC W...JICH THIS CERTII-ICATE MA.Y BE ISSUED')R MAV PE::.>IA N T-iE I'EURANCE AFF'1RCEl' ey ft,E PCll(Ii:S 0::3(.:;>18ED HEREIN IS SUBJE.CT TO ALL TrE: TERMS ::)(C~'JSIONS AND CONDITIONS i)F Sllel- F'A "~IES. AG'~REt~A11:: L Mi "Sl-<OW'~ \1AY HAVE B::EN F<EDLCED By PA.ID ':..AIMS LTR NSR P DATE (MMIOOM') LIMITS " DATE (MMfDDIYY) POLICY NUMBER TYPE OF INSURANCE GENERAL LIABILITY [MMERL~ Al -,"NEf,:AL LI(\BILI~) nAM"'M^CE ~ "~IJR h[I\LN,'R: fir F")LI:::' _:x A 07/01/09 EACH l)CCURFE~KE S 1,000,000 FREMISE", :Ea "(~~,r~llce) $ 500,000 MF:iE;(P(^nyuner'~r,un,1 $10,000 PE%)I'JAL i'. ADV 1t\,IUI'{Y $ 1 , 000 , 000 GE~IERAL AGGREr,AJE ~ 2 , 000 , 000 ~Rr)::;IWTS. COMP/OP A.:::<; 1$ 2,000,000_ 4022676 07/01/08 $1,000,000 A AUTOMOBILE LIABILITY X A~IY A.lfLj ALL O'NI~'::D AUT8S 3853974 ':8M3INFDSIt\'-,LELIMT lEa accij~..r.) S.-:HEOULEC) AUTOS HIh.'_L,A!WiS '~r)~j 'J\:vN!:.L' AI iT' GARAGE LIABILITY AUT(':J~jLY 'OAACC::IDENT ,-,THER ThA~j 9'. ACe A,UTCONLY AGG , EACH 00 :URRI::NCE $ 4 ,0,00 ,000 -.---.- 07/01/08 07/01/09 ';:3GREGATE I.~ 4,000,000 I '" --- 07/01/08 07/01/09 E L EACHACCIO::N":" , 1000000 EL DlS~SE-E:AEMP~:JYEE I 1000000 E.L DISEASI:: - FOLIC', LIMIT , 1000000 !...t-J'iAIWi B EXCESSIUMBRELLA LIABILITY )!J' ~U'f _J j',IMS ~/ADE b::'ESUCT8LE X REmmOt, $10000 i WORKERS COMPENSATlDN AND EMPLOYERS' LIABILITY M\Ph,:,PRI~":;>r'll..RT1.ERfE)(EC:jTI\lE ')FFICE'f/\tEM8.-r E\rLUDE[l} I Y~5 ~~'."r D" undn >'PE..IAL PRC;VI:;I<lt,.:S l'~low OTHER WC7578176 BI!:3128610 B C PrOfessional Liab Retro Date 9/1/85 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Santa Ana Corporate Yard, 202 South center Street, Santa 92702, job statinq 3/28/08 H 707-15549 10/01/08 10/01/09 Ea Claim Aqqreqate 1,000,000 2,000,000 Ana, CA CERTIFICATE HOLDER CANCELLATION CrTYSAA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Santa Ana IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR F.O. Box 19BB, M-22 REPRESENTATIVES. Santa Ana CA 92702 AU~ REPRESENTATIVE ACORD 25(2001108) @ACOROCORPORATION1988