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HomeMy WebLinkAboutTSCM CORPORATION 7City of Santa, a Clerk of the Council AGREEMENT TERMINATION �5 2911 JAN 26 PM 3* 52 Please complete this form when the attached agreement is no longer in effect Return form to the Clerk of the Council Office (M-30). G1 T i 1_ , A ANA Call 647-6520 if you have any questions. CLEF OU GIL = --------------------------------------------- NOTE: PLEASE INCLUDE ALL AMENDMENTS IF ANY. THANK YOU. The agreement with No. A_ was completed on and final payment has been made. Rcisetl 1UM7 Department: fitok Phone/Ext.: Signature: Date: INSURANCr 01N iL i, A-2010-043 WORK N"M PRo" ":E=r CLERK Cz rr.Utl;i AGREEMENT FOR PROVISION OF SERVICES qT 1117MAR 0 8 2010 THIS AGREEMENT, made and entered into this 17th day of January, 2010, by and between TSCM, a California corporation (hereinafter "Contractor"), and the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California (hereinafter "City"). RECITALS A. The City desires to retain a Contractor having special skill and knowledge in the field of street sweeping services. B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Contractor shall perform street sweeping services at the Santa Ana Regional Transportation Center at the following service levels: 3 times per week = clean all entrances, driveways, curbs, parking lots, parking structure levels, bus lanes and bus stalls. 2 times per week = clean the courtyard, walkway north and south of courtyard, utility drive area and the east platform. The City reserves the right to evaluate and modify the service levels set forth above during the term of this Agreement. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services Eight Hundred Twenty Five Dollars ($825.00) per month. The total sum to be expended under this Agreement shall not exceed $12,000.00 per year during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Term of this Agreement shall be a twelve (12) month period, with one (1) one-year renewal exercisable by the City under the same terms and conditions hereof. The term of this Agreement may be extended upon a writing executed by the Executive Director of the Public Works Agency and the City Attorney. 4. INDEPENDENT CONTRACTOR Contractor shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance naming the City, its officers, agents, volunteers, and employees as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Contractor shall supply the City with a fully executed additional insured endorsement in substantially the form attached hereto as Exhibit A upon execution of this Agreement and shall be approved in form by the City Legal Counsel. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Contractor, if Contractor has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Contractor is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. e. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Legal Counsel. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. f. If Contractor fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not effect Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance. 6. INDEMNIFICATION Contractor agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, Contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Contractor or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: and, Executive Director Public Works Agency - City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, California 92702 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Telefacsimile (714) 647-6515 4 To Contractor: TSCM 18281 Gothard Street, Ste. 109 Huntington Beach, CA 92648 A party may change its address by giving notice in writing to the other party. Thereafter, any notice, tender, demand, delivery, or other communication shall be addressed and transmitted to the new address. If sent by mail, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Contractor. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, that terms and conditions hereof, shall not bind or obligate Contractor nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Contractors retained by City. 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the City Manager, or his designee, may require Contractor to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 13. DISCRIMINATION Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement and all questions relating to its validity, interpretation, performance, and enforcement shall be government and construed in accordance with the laws of the State of California. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Contractor shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney Lisa E. Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: z r-- Raul Godinez II, Exe tive Director Public Works Agency CITY OF SANTA ANA David N. Ream City Manager - TSCM: Nam r jZA Title:. Tax ID# 0 ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company _ "�. 11 N !-eL� 111.�ttre m ee, CO This endorsement modifies such insurance as is afforded by the provisions of Policy # 41 i O 1 j j q tj O 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 and defense of suits arising from 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 contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective ` 1 `2 0 i U , this endorsement form as a part of Policy # Issued to TSCM UrPol2y-'�TiOM Named Insured o _ Countersigned by Authorized Representative 13 I a �°► �' CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDfYYYYi 7 1 naanueLR Spectrurn Risk Management THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 74 DiSCOvre PY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Irvine, CA 92618 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 0077485 wwra.s ectrurrrrask .am 945 75b 73Ii 849-l58-574T} INSURERS AFFORDING COVERAGE WSVREO TSCNA Corp 17791 Jamestown Lane s 15uRPR 6'r�m nsrar. Eyonorn4r lns,�G4�_.... Huntington Beach CA 92647 -. _ Mq%iRw c SI Paul Fare & Marina Ins Co i*1supm I, Everest National Insurance "Go fT{ •° INSURER E. TI4E POLICIES OF INSURANCE LISTED BELOW HAVC BCE N ISSUED TO THE MSURED NAMED ABOVE FOR THE POLICY PCRICO iNDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE. ISSUED OR MAY OLRTAIN, THE INSURANCE AFFORDED BY TI iE POLICIES OESCRIBCD HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONOITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED EY PAID CLAIMS- POLICY FEFECTi`tE ! F4LI�Y EaCpIRAT1i5N, s POLICY NUPOISER"it im"ga-mi 1IMITS A j,GENERALUA:eILITY MGsI0159499 111t2010 ! t;laoll PrcNnr.c,.iaRr;}.rE S __. 000D � __�_ ,j G�DMIVERCSAL! ENERAL LIAGIL TY : :. I L?AMii�rE TD RENTEIS pREftii5E5ltA Ix,'v�rencal 5 _ .a,caa ME€;sCalA>_ a A InstuzY PNERAL AGGREGAiF s _. _ 1wG+�.7 ,E413D ._2, 000I OM GEN', AfCREGATs":L WT,,-PLIESPE:R: � pR0!'SiJi iS G�MPSipAGG.....f - ..._.,. I,{i�a.aDC P01,CY F} O. I z L0C i Li AUTOMOBILE LIABILITY 02`GE27555220 .... tied?47=Q 111121ii.1 CGM18+`4E.75aN;LELiMir f i {ca A.:c+nanli S +. 1,030,000 3 ALL CIWNz0 l,ITc.s j BOML�xF' IN.:-IR ! NRF71 °, r q ' 6001 .Y KiLikx E Hurl ear NF oA,1 p_ F'Ra PI!RTY GARAGE 5 . GARAGE LIABILITY � - � - _AUTOON4F-fiAACCEPF-i4l 5 I AN Awro } CA ACC S AUT0ONLY� A—P S EXCESS (UMBRELLA LIABILITY 00450073.2 VV2010 1111`2>)11 EAt'H QCCURRENGE S. 4 000,000'.. V onx--i.a GLAIMS MADE S 4,000.1300 .�—.. S ,. OE taG TNLE i ...._._ 4,S_...- #{L I titi .S4 5 10 000 i WORKfR9 COMPENSATION CAT'OW0979101 'f11�`�'0i0 71112DII WC SaxTL+ CTH.; fa?HY it li5 E+9_. AND EMPLO YERV UA94LrTY Y"N ,..' {,W,� �y ttU Ii} �,, ,. + �.�-` � �. � �� � ,' dh �`� i raFG�+ih4E41eEr7 EXC"zLiJkls° E.L. EACH hCC1611IiT ....... _. S I_..� {Mtmilal4ley i� IaI11 F 4..!?ISSE GA EsNPL+3YEI, 5 1��fjl,0aa , ' e;s, r7ti5rn9rur�lur > `4 EG!.Ak. r'>�O' 4I4Nft Ez{IF y r __ ......_. ..___ �..._._. h L. GISEARE • P'CiC. CY LNITS 1 {} 0,000 OTHER .ate'` ') 'i..;.i..,.I.. ("At OU I'll DESCRWTION OF OPERATIONS t LOCA9ONS 1 VEHICLES fEX"USIONS A0DED8Y ENDORSIE.MENT! SPECIAL PROVISION"S Re- The. Depot at Santa Arka -1003 E, Santa Ana Blvd Santa Ana C:A, Done, its oTfEtcrs, agents and orhployees and Iho City. its Officers, agents and ernploycos are audit rinalinanreds with respect IG Ihoo, ganutal Liability per the alt ached blanket carrier form. Primary and nor nlnLuxlory wor-ifing applies. 4 t;K I INIGAI G HULL)tK 4.;ANUt:LLATI0IN Re- The Clepok at Santa, :Ana-1000 E. Santa Ann ENO Santa Ana CA SHOULDANYOF THEABOVE IlESCRISCO POUC4E3BECANCELLED REFORETHE EXPIRATION Santa Aria Regional Transportation Center DATE THEREOF, THE IMUiING INSURER WILL IG9DEXICOgO MAIL 30 R DAYS WRITTEN C Ci Santa Ana Public Works Agency NOTICE TO THE CERTIMATE HOLDER NAMED TO THE. LEFT, *j1}"„( K000*0 QI X 20 Civic Center Plaza, M-21 c�ISlx�ll� �ia�Ixe�Icoo sc�lee Santa Ana CA 92701 10 00p; r0 Non.Paym l of Prwnwm.. AUTHORIUD REPRESENTATIVE qWW JimL"Ja9efiouars ACLIRo Zs (Z009101) rs 1988-2009 ACORD CORPORATION. All rights raservecf. -tea# r 7' 1', 14 '_LIRN olx ...,--- +1-- x; aze. Z[y to .,4� At .v. 4� '1 ., 1 IMPORTANT if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate dads not confer rights to the cartiescate holder in lieu of such endorsement(s)- it 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 endorsoment(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the, certificate holier. nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 1.11 W" -11-)4i� °:.fPY": ;NLlr : ar , MGLO159499 THIS ENDMENE YF CILkNITGESIUS POLICY. PLEIvSE READ rl'CiUEFLTLLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS (FORM Q J'his endo m.-mcnt modifies insurancc: provided under the follokvirtgn CC)NI-MERCIA1, (1-TENERAL lAABfl.11'YC0%q-,KAGE PART SCI]MULF Nanie of Per -son or Organization: 11 Nrwn or orgmilzat i Otis wherc reqUired by uwiitcn contract, (Ifrto tntry appears rcquircd to complete this endorsement will bcshciwn in the l)eclaratioTL-} ws applicable to this endoTscnicnL) WHO IS tN UqSURED (Sccfiv n II) Is amended to inc I tide Hs an insttred the pcTson or organization shoa T, in the Suhodulc, but CrjV With respect to I'Wbihty arising out of "`your work' for that Ln,,;kttv(l by at Cor you, To the extent retlotred under Corillact, this Policy will apply w,, primary insurance to P&J0iotW insut,e�Lq -t,-hcJulvd abov;ct iind other in-aararzc which rivy be aviilatite to such additional iwuruds will be rion- cnntrtbutorT Section IV., Condition 4., of this poiicy i- xiiended accordirgly All Ater Terms and " londitions of this Policy lei tart uncllw%ed ('6L 216 ((4;'98) Page 1 of I 71212010 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/30/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. - - �' -`, ' IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be If SUBROGATION endorsed. 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). p gCDNTACT PRODUCER Spectrum Risk Management74 NAME -__ ISCOVeI�/ _: -_ Irvine, CA 92618 -HONE_(A(C No..,Ex tj 949-756 5730..._ FAX tA/c, No);- 949 756 5740_....__ .___E-MAIL_ ADDR_ESS;- _ - _ -_..._ www.spectrumrisk.com OC77485 INSURER(S) AFFORDING COVERAGE NAIC # INSURED TSCM Corp INSURER A: Mt. Hawle Insurance Co. 17791 Jamestown Lane INSURER B : American Economy Ins Co INsuRERc: St. Paul Fire &Marine Ins Co Huntington Beach CA 92647 INSURER D: Everest National Insurance Co. I INSURER E : INSURER F _--_--_- '—"'"—'"�'"'��"' RCVIJIVIY rYVMCSCK: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE TO ALL THE TERMS, BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP MM/DD/YYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY MGL0172984 1/1/2011 1/1/2012 EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY '', DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE OCCUR, MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY ''. $ 1,000,000 GENERAL AGGREGATE ',s 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG 1 $ 1,OOO,O00 POLICY ',.',, PRO- LOC B AUTOMOBILE LIABILITY 02CE20555220 1/1/2011 1/1/2012 COMBINED SINGLE LIMIT ANY AUTO', Ea accdent - $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident)' AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS :PROPERTY DAMAGE j (Per accident) : $ $ $ C UMBRELLA LIAB'', ✓ EXCESS LIAB OCCUR CLAIMS -MADE QK04501017 1/1/2011 1/1/2012 EACH OCCURRENCE s 4,000,00 AGGREGATE $ 4,000,00 DED V RETENTION $ 10,000 1$ '$ $ WCSTATU- iOTH-! TORY LIMITS : ER D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y CA10000979101 7/1/2010 7/1/2011 I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? � N / A in NH) atorydescribe E.L. DISEASE - EA EMPLOYEE'',, $ 1 ,000,000 if y S, If yas, describe under I DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) t Re: Parking lot sweeping services. The City its officers, agents, employees are named additional insureds with resepect to the general liability and o liability per the attached blanket carrier forms. CERTIFICATE HOLDER CANCELLATION The City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE. EXPIRATION Community Development Agency DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Carolyn Fullerton 20 Civic Center Plaza M-25 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 4M � T l Jim Waterhouse ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 1 of 9 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 0 2010 CA10000979101 TSCM Corp WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work describer) in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR Wf-IOL`I ALL OPERATIONS THE NATMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER. -1998 by the Workers Compensation Insurance Rating eurea u of California. Al rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual - 1999. i CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41: 54 PMA8tgr. C&4� 9 TSCM Corp 02CE20555220 COMMERCIAL AUTO CA 71 10 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. EXTENDED CANCELLATION CONDITION Paragraph 2.b. of the CANCELLATION Common Policy Condition is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. TEMPORARY SUBSTITUTE AUTO — PHYSICAL DAMAGE COVERAGE Under paragraph C. — CERTAIN TRAILERS, MO- BILE EQUIPMENT AND TEMPORARY SUBSTITUTE AUTOS of SECTION I — COVERED AUTOS, the following is added: If Physical Damage coverage is provided by this Cov- erage Form, then you have coverage for: Any "auto" you do not own while used with the per- mission of its owner as a temporary substitute for a covered "auto" you own that is out of service be- cause of its breakdown, repair, servicing, "loss" or destruction. BROAD FORM NAMED INSURED SECTION 11 — LIABILITY COVERAGE — A.I. WHO IS AN INSURED provision is amended by the addition of the following: d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisi- tion or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. BLANKET ADDITIONAL INSURED SECTION 11 — LIABILITY COVERAGE — A.1. WHO IS AN INSURED provision is amended by the addition of the following: e. Any person or organization for whom you are re- quired by an "insured contract" to provide insur- ance is an "insured", subject to the following additional provisions: (1) The "insured contract" must be in effect during the policy period shown in the Decla- rations, and must have been executed prior to the "bodily injury" or 'property damage". (2) This person or organization is an "insured" only to the extent you are liable due to your ongoing operations for that insured, whether the work is performed by you or for you, and only to the extent you are held liable for an "accident" occurring while a covered "auto" is being driven by you or one of your em- ployees. (3) There is no coverage provided to this person or organization for "bodily injury" to its em- ployees, nor for "property damage" to its property. (4) Coverage for this person or organization shall be limited to the extent of your negli- gence or fault according to the applicable principles of comparative negligence or fault. (5) The defense of any claim or "suit" must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or "suit". Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 Safeco and '1he Safeco bgo are registered Vademams of Sateco Ccwratix CA 71 10 03 07 Page I of 6 EP CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 3 of 9 (6) The coverage provided will not exceed the lesser of: (a) The coverage and/or limits of this policy: or (b) The coverage and/or limits required by the "insured contract". (7) A person's or organization s status as an "insured" under this subparagraph d ends when your operations for that "insured" are completed. EMPLOYEE AS INSURED Under Paragraph A. of Section 11 — LIABILITY COV- ERAGE item f . is added as follows: Your "employee" while using his owned auto", or an "auto'" owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that "auto". This coverage is excess to any other collectible insurance coverage. FELLOW EMPLOYEE COVERAGE Exclusion 5. FELLOW EMPLOYEE of SECTION It — LIABILITY COVERAGE — B. EXCLUSIONS is amended by the addition of the following: However, this exclusion does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire, and provided that any coverage under this provision only applies in excess over any other collectible insurance. BLANKET WAIVER OF SUBROGATION We waive the right of recovery we may have for pay- ments made for "bodily injury" or "property damage" on behalf of the persons or organizations added as "insureds" under Section It — LIABILITY COVERAGE — A.I.D. BROAD FORM NAMED INSURED and A.l.e. BLANKET ADDITIONAL INSURED. PHYSICAL DAMAGE — ADDITIONAL TRANS- PORTATION EXPENSE COVERAGE The first sentence of paragraph AA. of SECTION III — PHYSICAL DAMAGE COVERAGE is amended as follows: we will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. PERSONAL EFFECTS COVERAGE A. SECTION III — PHYSICAL DAMAGE COVER- AGE, AA. COVERAGE EXTENSIONS, is amended by adding the following: c. Personal Effects Coverage For any Owned "auto" that is involved in a covered `loss-, we will pay up to S500 for "personal effezts" that are lost or damaged as a result of the covered 'loss", without applying a deductible, EXTRA EXPENSE — BROADENED COVERAGE Paragraph A. — COVERAGE of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add: 5. We will pay for the expense of returning a stolen covered "auto" to you. AIRBAG COVERAGE Under paragraph B. — EXCLUSIONS of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. NEW VEHICLE REPLACEMENT COST Under Paragraph C — LIMIT OF INSURANCE of Section III — PHYSICAL DAMAGE COVERAGE sec- tion 2 is amended as follows: 2. An adjustment for depreciation and physical con- dition will be made in determining actual cash value in the event of a total loss. However, in the event of a total loss to your "new vehicle" to which this coverage applies, as shown in the declarations, we will pay at your option: a. The verifiable "new vehicle" purchase price you paid for your damaged vehicle, not in- cluding any insurance or warranties pur- chased; b. The purchase price, as negotiated by us, of a new vehicle of the same make, model and equipment, not including any furnishings, parts or equipment not installed by the manufacturer or manufacturer's dealership. If the same model is not available pay the purchase price of the most similar model available; Page 2 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 4 of 9 c. The market value of your damaged vehicle, not including any furnishings, parts or equip- ment not installed by the manufacturer or manufacturer's dealership. This coverage applies only to a covered "auto" of the private passenger, light truck or medium truck type (20,000 Jbs or less gross vehicle weight) and does not apply to initiation or set up costs associated with loans or leases, TWO OR MORE DEDUCTIBLES Under SECTION III — PHYSICAL DAMAGE COV- ERAGE, if two or more "company" policies or cover- age forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deduct- ible is the smaller (or smallest) deduct- ible it will be waived; or b. If the applicable Business Auto deduct- ible is not the smaller (or smallest) de- ductible it will be reduced by the amount of the smaller (or smallest) deductible: or c. If the loss involves two or more Busi- ness Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement "company" means: a. Safeco Insurance Company of America b. American States Insurance Company c. General Insurance Company of America d. American Economy Insurance Company e. First National Insurance Company of America f. American States Insurance Company of Texas g. American States Preferred Insurance Company h. Safeco Insurance Company of Illinois LOANILEASE GAP COVERAGE Under paragraph C — LIMIT OF INSURANCE of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: 4. The most we will pay for a total "loss" in any one "accident" is the greater of the following, subject to a $1,500 maximum limit: a. Actual cash value of the damaged or stolen property as of the time of the "loss", less an adjustment for depreciation and physical condition; or b. Balance due under the terms of the loan or lease that the damaged covered "auto" is subject to at the time of the loss-, less any one or all of the following adjustments: (1) Overdue payment and financial penalties associated with those payments as of the date of the loss". (2) Financial penalties imposed under a lease due to high mileage, exces- sive use or abnormal wear and tear. (3) Costs for extended warranties, Cre- dit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease. (4) Transfer or rollover balances from previous loans or leases, (5) Final payment due under a "Balloon Loan". (6) The dollar amount of any un-repaired damage that occurred prior to the "total loss" of a covered "auto". (7) Security deposits not refunded by a lessor. (8) All refunds payable or paid to you as a result of the early termination of a lease agreement or any war- ranty or extended service agree- ment on a covered "auto". (9) Any amount representing taxes. (10) Loan or lease termination fees GLASS REPAIR — WAIVER OF DEDUCTIBLE Under paragraph D. — DEDUCTIBLE of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. AMENDED DUTIES IN THE EVENT OF ACCI- DENT, CLAIM, SUrr OR LOSS The requirement in LOSS CONDITION 2.a. -- DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS — of SECTION IV — BUSINESS AUTO CONDITIONS that you must notify us of an CA 71 10 03 07 Page 3 of 6 EP CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 5 of 9 "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV — BUSINESS AUTO CONDITIONS — B.2. is amended by the addition of the following. If you unintentionally fail to disclose any hazards ex- isting at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. HIRED AUTO — LIMITED WORLD WIDE COVER- AGE Under Section IV — Business Conditions, Paragraph B.7.b.e(1) is replaced by the following: (1) The accident" or loss" results from the use of an "auto" hired for 30 days or less. RESULTANT MENTAL ANGUISH COVERAGE SECTION V — DEFINITIONS — C. is replaced by the following: "Bodily injury" means bodily injury, sickness or dis- ease sustained by a person including mental anguish or death resulting from any of these. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability cov- erage and if Comprehensive, Specified Causes of Loss or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow. The most we will pay for loss to any hired "auto" is $5o,000 or Actual Cash Value or Cost of Repair, whichever is smallest, minus a deductible. The de- ductible will be equal to the largest deductible appli- cable to any owned "auto" of the private passenger or light truck type for that coverage. Hired Auto Phy- sical Damage coverage is excess over any other col- tectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. HIRED AUTO PHYSICAL DAMAGE COVERAGE — LOSS OF USE SECTION III — PHYSICAL DAMAGE AA.b. Form does not apply. Subject to a maximum of $1,000 per accident, we will cover loss of use of a hired "auto' if it results from an accident, you are legally liable and the lessor in- curs an actual financial loss. RENTAL REIMBURSEMENT COVERAGE A. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" be- cause of a covered "loss" to a covered "auto". Payment applies in addition to the otherwise ap- plicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. B. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: 1. The number of days reasonably required to repair or replace the covered "auto", If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. 2. 30 days. C, Our payment is limited to the lesser of the fol- lowing amounts: 1. Necessary and actual expenses incurred. 2. $50 per day. D. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. E. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not al- ready provided for under the PHYSICAL DAM- AGE COVERAGE Coverage Extension. F. The Rental Reimbursement Coverage described above does not apply to a covered "auto" that is described or designated, as a covered "auto" on Page 4 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clark. 12/30/2010 2:41:54 PM Page 6 of 9 Rental Reimbursement Coverage Form CA 99 23. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE A. Coverage 1. We will pay with respect to a covered 'auto" for loss" to any electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the covered 'auto" at the time of the "loss", and such equipment is designed to be solely operated by use of the power from the "autols" electrical system, in or upon the covered 'auto". 2. We will pay with respect to a covered "auto" for loss" to any accessories used with the electronic equipment described in paragraph A. 1. above. However, this does not include tapes, records or discs. 3. If Audio, Visual and Data Electronic Equip- ment Coverage form CA 99 60 or CA 99 94 is attached to this policy, then the Audio, Vi- sual and Data Electronic Equipment Cover- age described above does not apply, S. Exclusions The exclusions that apply to PHYSICAL DAM- AGE COVERAGE, except for the exclusion relat- ing to Audio, Visual and Data Electronic Equipment, also apply to this coverage. In addi- tion, the following exclusions apply: We will not pay for either any electronic equip- ment or accessories used with such electronic equipment that is, 1. Necessary for the normal operation of the covered "auto" for the monitoring of the covered lautols" operating system; or 2. Both: a. an integral part of the same unit housing any sound reproducing equipment de- signed solely for the reproduction of sound if the sound reproducing equipment is permanently installed in the covered "auto"; and b. permanently installed in the opening of the dash or console normally used by the manufacturer for the installation of a radio. C. Limit of Insurance With respect to this coverage, the LIMIT OF IN- SURANCE provision of PHYSICAL DAMAGE COVERAGE is replaced by the following: 1. The most we will pay for "loss" to audio, vi- sual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of, a. The actual cash value of the damaged or stolen property as of the time of the "loss—, or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. c. S1,000. 2. An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of the "loss". 3. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. D. Deductible 1. If 'loss" to the audio, visual or data elec- tronic equipment or accessories used with this equipment is the result of a 'loss" to the covered auto,, under the Business Auto Coverage Form's Comprehensive or Colli- sion Coverage, then for each covered "auto" our obligation to pay for, repair, return or re- place damaged or stolen property will be re- duced by the applicable deductible shown in the Declarations. Any Comprehensive Cov- erage deductible shown in the Declarations does not apply to "loss" to audio, visual or data electronic equipment caused by fire or lightning. 2. If "loss" to the audio, visual or data elec- tronic equipment or accessories used with this equipment is the result of a 'loss" to the covered "auto" under the Business Auto Coverage Form's Specified Causes of Loss Coverage, then for each covered "auto" our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. 3. If "loss" occurs solely to the audio, visual or data electronic equipment or accessories used with this equipment, then for each cov- ered "auto" our obligation to pay for, repair, CA 71 10 03 07 Page 5 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 7 of 9 EP return or replace damaged or stolen property will be reduced by a S100 deductible. 4. In the event that there is more than one ap- plicable deductible, only the highest deduct- ible will apply. In no event will more than one deductible apply. SECTION V — DEFINITIONS is amended by adding the following* Q. "Personal effects" means your tangible property that is worn or carried by you, ex- cept for tools, jewelry, money, or securities. R. "New vehicle" means any 'auto" of which you are the original owner and the "auto" has not been previously titled and is less than 365 days past the purchase date. Page 6 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 8 Of 9 MGLO172984 'I -MS ENDORSENIENT CIUNGESJTHS POLICY, PLEASE REND ff CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS (FORM C) '['his endorsement modifies ins -trance provided under the followino: OWINIERCIAJ, GENER.A.I.. LIABILATYCOVERAGE PART SCIIIJI)CIA� Marne of Person or Organization: rcquired by NNTitten contract, J I person or organization,, fl-f no entry appears above, information required to complete this endorsement will beshown in the 0eclarations as applicable to this endorsement) NN-110 IS AN r4ST-7RED (Section H) is amended to include as an insured the person or organization shmvn in the Schedule- but only With respect to I jabi I ity arising out car "your work"' for thaL insured by or fear you. To the e%unt required utider contract this policy wi I I apply u,� pri rinry insurance to additional imiureds scheduled above; and other insurance which may be available to such -,xiditionol insureds,.vill be non- contributory, Section W., Condition 4., of this policy is amended according,,ly All other Terms and Conditions of this Policy remain unchanged. CGL 216 ((4,98) Page I of I 12/30/2010 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 9 of 9 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYYj �----' 12/30/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. — !' 1' IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed.' If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endor$ement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Spectrum Risk Management -CONTACT NAME 74 Discovery Irvine, CA 92618 PHONE__(A/G4 N4, Ea1) 949 756 5730__ FAx tac No);949 75..(-5740 - E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Mt. Hawley Insurance Co. www.spectrumrisk.com OC77485 INSURED TSCM Corp INSURERB: AmerlCan ECOnOmy Ins CO 17791 Jamestown Lane _ Huntington Beach CA 92647 INSURERC : St. Paul Fire & Marine Ins Co INSURER D : Everest National Insurance Co. INSURER E : INSURER F : 92 COVERAGES CERTIFICATrE NUMBER: s1s9337 RFvlslnN nlllnnRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I TYPE OF INSURANCE LTR ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP MMIDDIYYYY''. MM/DDlYYYY LIMITS A GENERAL LIABILITY III MGLO172984 1/1/2011 1/1/2012 EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE �', OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY ! $ 1,000,000 GENERAL AGGREGATE '',$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG '. $ 1,000,000 - LOC POLICY '.,, �/ PROJr B AUTOMOBILE LIABILITY 02CE20555220 1/1/2011 ; 1/1/2012 Ea aBcideDtSINGLE LIMIT ! $ 1,000,000 ANY AUTO ALL OWNED SCHEDULED AUTOS i� AUTOS BODILY INJURY (Per person), $ BODILY INJURY (Per accident)' $ i`J NON -OWNED HIRED AUTOS AUTOS _ PROPERTY DAMAGE Per acci dent) $ $ C UMBRELLA LIAB !, OCCUR QK04501017 1 /1 /2011 1/1/2012 EACH OCCURRENCE '', $ 4 1000,000 EXCESS LIAB', CLAIMS-MADEI'' AGGREGATE $ 4,000,000 DED RETENTION$ 10,000 '.$ $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑Y N / A CA10000979101 7/1/2010 7/1/2011 WCSTATU- ! ER TORY LIMITS E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE! $ 1 (Mandatory in NH) If yes, describe under j E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below ! - 'Ni DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) I , i Re: Parking lot sweeping services. The City its officers, agents, employees are named additional insureds with resepect to the general liability and o liability per the attached blanket carrier forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana THE. EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Community Development Agency Attn: Carolyn Fullerton ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza M-25 Santa Ana CA 92701 /j/� 9WW f (.Jim Waterhouse ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 1 of 9 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 CA10000979101 12/30/2010 TSCM Corp WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR WHOA ALL OPERATIONS THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER. -1998 by the Workers' Compensation Insurance Rating Surea u of California. All rigft reserved. From the WCIRB's Califomia Workers' Compensation Insurance Fomts Manual - 1999. CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PMANft & A 9 J TSCM Corp 11 02CE20555220 COMMERCIAL AUTO CA 71 10 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement, EXTENDED CANCELLATION CONDITION Paragraph 2.b. of the CANCELLATION Common Policy Condition is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. TEMPORARY SUBSTITUTE AUTO — PHYSICAL DAMAGE COVERAGE Under paragraph C. — CERTAIN TRAILERS, MO- BILE EQUIPMENT AND TEMPORARY SUBSTITUTE AUTOS of SECTION I — COVERED AUTOS, the following is added: If Physical Damage coverage is provided by this Cov- erage Form, then you have coverage for: Any "auto" you do not own while used with the per- mission of its owner as a temporary substitute for a covered *auto- you own that is out of service be- cause of its breakdown, repair, servicing, "loss" or destruction. BROAD FORM NAMED INSURED SECTION 11 — LIABILITY COVERAGE — A.I. WHO IS AN INSURED provision is amended by the addition of the following: d. Any business entity newly acquired or formed by you during the policy period provided you own 500/6 or more of the business entity and the business entity is not separately insured for Business Auto Coverage, Coverage is extended up to a maximum of 180 days following acquisi- tion or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. BLANKET ADDITIONAL INSURED SECTION 11 — LIABILITY COVERAGE — A.I. WHO IS AN INSURED provision is amended by the addition of the following: e. Any person or organization for whom you are re- quired by an "insured contract" to provide insur- ance is an "insured", subject to the following additional provisions: (1) The "insured contract" must be in effect during the policy period shown in the Decla- rations, and must have been executed prior to the "bodily injury" or 'property damage". (2) This person or organization is an "insured" only to the extent you are liable due to your ongoing operations for that insured, whether the work is performed by you or for you, and only to the extent you are held liable for an "accident" occurring while a covered "auto" is being driven by you or one of your em- ployees. (3) There is no coverage provided to this person or organization for "bodily injury" to its em- ployees, nor for "property damage" to its property. (4) Coverage for this person or organization shall be limited to the extent of your negli- gence or fault according to the applicable principles of comparative negligence or fault. (5) The defense of any claim or suit" must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or "suit". Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 SWem and The Sdeco logo are registered wManaris of Satem Capomfim CA 71 10 03 07 Page I of 6 EP CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 3 of 9 (6) The coverage provided will not exceed the PERSONAL EFFECTS COVERAGE lesser of: (a) The coverage and/or limits of this policy; or (b) The coverage and/or limits required by the "insured contract". (7) A person's or organizatiorTs status as an "insured" under this subparagraph d ends when your operations for that "insured" are completed. EMPLOYEE AS INSURED Under Paragraph A. of Section 11 — LIABILITY COV- ERAGE item f, is added as follows: Your "employee" while using his owned 'auto", or an "auto" owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that "auto". This coverage is excess to any other collectible insurance coverage. FELLOW EMPLOYEE COVERAGE Exclusion 5. FELLOW EMPLOYEE of SECTION 11 — LIABILITY COVERAGE — B. EXCLUSIONS is amended by the addition of the following: However, this exclusion does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire, and provided that any coverage under this provision only applies in excess over any other collectible insurance. BLANKET WAIVER OF SUBROGATION We waive the right of recovery we may have for pay- ments made for "bodily injury" or "property damage" on behalf of the persons or organizations added as ,insureds" under Section It — LIABILITY COVERAGE — A.1.13. BROAD FORM NAMED INSURED and A.I.e. BLANKET ADDITIONAL INSURED. PHYSICAL DAMAGE — ADDITIONAL TRANS- PORTATION EXPENSE COVERAGE The first sentence of paragraph A.4. of SECTION III — PHYSICAL DAMAGE COVERAGE is amended as follows, We will pay up to $50 per day to a maximum of S1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. A. SECTION III — PHYSICAL DAMAGE COVER- AGE, A.4. COVERAGE EXTENSIONS, is amended by adding the following, c. Personal Effects Coverage For any Owned "auto" that is involved in a covered "loss", we will pay up to $500 for "personal effects" that are lost or damaged as a result of the covered loss", without applying a deductible. Paragraph A. — COVERAGE of SECTION III -- PHYSICAL DAMAGE COVERAGE is amended to add: 5. We will pay for the expense of returning a stolen covered "auto" to you. AIRBAG COVERAGE Under paragraph B. — EXCLUSIONS of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. NEW VEHICLE REPLACEMENT COST Under Paragraph C — LIMIT OF INSURANCE of Section III — PHYSICAL DAMAGE COVERAGE sec- tion 2 is amended as follows: 2. An adjustment for depreciation and physical con- dition will be made in determining actual cash value in the event of a total loss. However, in the event of a total loss to your "new vehicle" to which this coverage applies, as shown in the declarations, we will pay at your option: a. The verifiable "new vehicle" purchase price you paid for your damaged vehicle, not in- cluding any insurance or warranties pur- chased; b. The purchase price, as negotiated by us, of a new vehicle of the same make, model and equipment, not including any furnishings, parts or equipment not installed by the manufacturer or manufacturer's dealership. If the same model is not available pay the purchase price of the most similar model available; Page 2 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 4 of 9 c. The market value of your damaged vehicle, not including any furnishings, parts or equip- ment not installed by the manufacturer or manufacturer's dealership. This coverage applies only to a covered "auto" of the private passenger, light truck or medium truck type (20,000 lbs or less gross vehicle weight) and does not apply to initiation or set up costs associated with loans or leases, TWO OR MORE DEDUCTIBLES Under SECTION III — PHYSICAL DAMAGE COV- ERAGE, if two or more "company" policies or cover- age forms apply to the same accident, the following applies to paragraph D. Deductible* a. If the applicable Business Auto deduct- ible is the smaller (or smallest) deduct- ible it will be waived; or b. If the applicable Business Auto deduct- ible is not the smaller (or smallest) de- ductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss involves two or more Busi- ness Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement "company" means: a. Safeco Insurance Company of America b. American States Insurance Company c. General Insurance Company of America d. American Economy Insurance Company e. First National Insurance Company of America f. American States Insurance Company of Texas g. American States Preferred Insurance Company h. Safeco, Insurance Company of Illinois LOANILEASE GAP COVERAGE Under paragraph C — LIMIT OF INSURANCE of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: 4. The most we will pay for a total "loss" in any one "accident" is the greater of the following, subject to a S1,500 maximum limit: a. Actual cash value of the damaged or stolen property as of the time of the "loss", less an adjustment for depreciation and physical condition: or b. Balance due under the terms of the loan or lease that the damaged covered "auto" is subject to at the time of the 'loss", less any one or all of the following adjustments: (1) Overdue payment and financial penalties associated with those payments as of the date of the "loss (2) Financial penalties imposed under a lease due to high mileage, exces- sive use or abnormal wear and tear. (3) Costs for extended warranties, Cre- dit Life Insuraoce, Health, Accident or Disability Insurance purchased with the loan or lease. (4) Transfer or rollover balances from previous loans or leases, (5) Final payment due under a "Balloon Loan ". (6) The dollar amount of any un-repaired damage that occurred prior to the "total loss" of a covered "auto". (7) Security deposits not refunded by a lessor. (8) All refunds payable or paid to you as a result of the early termination of a lease agreement or any war- ranty or extended service agree- ment on a covered "auto". (9) Any amount representing taxes. (10) Loan or lease termination fees GLASS REPAIR — WAIVER OF DEDUCTIBLE Under paragraph D. — DEDUCTIBLE of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. AMENDED DUTIES IN THE EVENT OF ACCI- DENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITION 2.a. — DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS — of SECTION IV — BUSINESS AUTO CONDITIONS that you must notify us of an CA 71 10 M 07 Page 3 of 6 EF CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 5 of 9 "accident" applies only when the `accident"' is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV — BUSINESS AUTO CONDITIONS — B.2. is amended by the addition of the following: If you unintentionally fail to disclose any hazards ex- isting at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. HIRED AUTO — LIMITED WORLD WIDE COVER- AGE Under Section IV — Business Conditions, Paragraph B.7.b.e(1) is replaced by the following* (1) The -accident" or "toss" results from the use of an "auto" hired for 30 days or less, RESULTANT MENTAL ANGUISH COVERAGE SECTION V — DEFINITIONS — C. is replaced by the following: "Bodily injury" means bodily injury, sickness or dis- ease sustained by a person including mental anguish or death resulting from any of these. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability cov- erage and if Comprehensive, Specified Causes of Loss or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow. The most we will pay for loss to any hired "auto" is W,000 or Actual Cash Value or Cost of Repair, whichever is smallest, minus a deductible. The de- ductible will be equal to the largest deductible appli- cable to any owned "auto, of the private passenger or light truck type for that coverage. Hired Auto Phy- sical Damage coverage is excess over any other col- lectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. HIRED AUTO PHYSICAL DAMAGE COVERAGE — LOSS OF USE SECTION Ht — PHYSICAL DAMAGE AA.b. Form does not apply. Subject to a maximum of S1,000 per accident, we will cover loss of use of a hired "auto" if it results from an accident, you are legally liable and the lessor in- curs an actual financial loss. RENTAL REIMBURSEMENT COVERAGE A. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" be- cause of a covered "loss" to a covered "auto". Payment applies in addition to the otherwise ap- plicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. B. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: 1. The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. 2. 30 days. C. Our payment is limited to the lesser of the fol- lowing amounts: 1. Necessary and actual expenses incurred. 2. S50 per day. D. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. E. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not al- ready provided for under the PHYSICAL DAM- AGE COVERAGE Coverage Extension. F. The Rental Reimbursement Coverage described above does not apply to a covered "auto" that is described or designated as a covered "auto"' on Page 4 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 6 of 9 Rental Reimbursement Coverage Form AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE A. Coverage 1. We will pay with respect to covered "auto" for "loss" to any electronic equipment that receives or transmits audio, visual or data signals and that isnot designed solely for the reproduction ofsound. This coverage applies only i/the equipment kapermanently installed in the covered °auto" at the time of the °losa"orthe equipment ioremovable from o housing unit which is permanently installed in the covered °auto" at the time of the "loos", and such equipment is designed to besolely operated byuse ofthe power from the "auto's^ electrical sysUem, in or upon the covered 'auto". 2. We will pay with respect to acovemd "auto" for "[oea"to any accessories used with the electronic equipment described in paragraph A.1-mbove. However, this does not include tapes. records nrdisne' 3. If Audio, Visual and Data Electronic Equip- ment Coverage form CA 00 60 or CA 99 94 is attached to this poicy, then the Audio' Vi- sual and Data Electronic Equipment Cover- age described above does not apply. B. Exclusions The exclusions that apply to PHYSICAL DAM- AGE COVERAGE, except for the exclusion relat- ing to Audo. Visual and Data Electronic Equipment, also apply 0nthis coverage. |naddi- tion, the following exclusions apply: We will not pay for either any electronic equip- ment or accessories used with such electronic equipment that is: 1. Necessary for the normal operation of the covered °auLo° for the monitoring of the covered ~auto'o~operating system; u/ a' an integral part ofthe same unit housing any sound equipment signed solely for the reproduction of sound if the sound reproducing equipment is permanently installed in the covered auto,,; and b. permanently installed in the opening of the dash orconsole normally used by the manufacturer for the installation ofa C. Limit mfInsurance With respect to this coverage, the LIMIT OF IN- SURANCE provision of PHYSICAL DAM/GE COVERAGE isreplaced bythe following: 1. The most we will pay for "loss" to audio, vi- sual or data electronic equipment and any accessories used with this equipment as result ofany one "ocoid*nt"isthe lesser cd- a' The actual cash value of the damaged o,stolen property asof the time of the b. The cost of repairing mreplacing the damaged or stolen property with other property of like kind and quality. 2. Anadjustment for depreciation and physical condition will be made in determining actual cash value at the time of the "loss ". 3. K a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. D. Deductible 1, If °loms" to the audio, visual or data elec- tronic equipment or accessories used with this equipment iathe result of a °hsa° to the covered °muto° under the Business Auto Coverage Fonn^a Comprehensive or Colli- sion Coverage, then for each covered "auto" our obligation bo pay for, repair, return or re- place damaged or stolen property will be re- duced by the applicable deductible shown in the Declarations. Any Comprehensive Cov- erage deductible shown in the Declarations does not apply to "loss" to audio, visual or data electronic equipment caused byfire or 2. If "loss"tothe audio, visual or data elec- tronic equipment or accessories used with this equipment is the result o/ a °loma" to the covered "auto" under the Business Auto Coverage Form'sSpecified Causes of Loss Coverage, then for each covered "auto', our obligation to pay for, repair, return or replace damaged orstolen property will be reduced byoS1O0 deductible. 3' |f~loss" occurs solely to the audio, visual o* data electronic equipment or accessories used with this equipment, then for each cov- ered "auto" our obligation to pay for, repair, CA n m m}Vr Page » of cER="°. 9159337 CLIENT CODE: e^—ie oi=i"clark" 12/30/2010 2.41.54 PM Page 7 of 9 EP return mreplace damaged or stolen property SECTION V—DEFINITIONS is amended by adding will bereduced byaS1V0 deductible. the : 4. In the event that there is more than one ap' Q. "Personal effects" means your tangible p|icab&ydeductib|e' only the highest deduct- property that is worn or cmnkad by you, ex' ib|ewiUapp|y.|nnoeventvviUm0nothanone cept for tools, jewelry, money, orsecurities. deductible apply. R. ~New vehicle" means any 'auto" of which you are the original owner and the "auto" has not been previously titled and is less than8GS days past the purchase date. Page aof 6 cERr,n.. 9159337 CLIENT CODE: oi."ie o^=ieclark" 12/30*010 2.41.54 PM Page 8 of 9 MGLO172984 MS ENDORSENIENTCKNNGES TMS POLICY. PLEILSE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS (FORM C) '['his endorsement rnodifies insurance provided under the follo%vinp* COMMERCIA1, 0ENER.A.I. SCHEIN "I'll' Narne of Person or Organization: .-Ul person or organizations where rcclifired by vNTitten contract. IP (if no entry appears above, information required to complete this endorsement will be :shown mi the Declarations as applicable to this endcTsement.) NN-110 IS AN ENSITRU) (Section ][I) is amended to include as an insured the person or organization sha%ii in the Schedule, but only With respect toy liability arising out of "your work" for that insured by or for you. To the e\tent required under contract this policy }gill apply as primiry insurance to additional insure&; scheduledabove.rod ether insurance which mav he avat ndd' 'onil insureds will be non- laf)k� to such tti contributory. Section IV., Condition 4., of this policy is amended accordingly. -All other Ten-ris and Conditions of this Policy remain unchanged. CGL 216 (04,98) Page I of I 12130/2010 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 9 of 9 CERTIFICATE OF LIABILITY INSURANCE (MM/DD/YYYY) P�l 2/30/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. — ~: IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Spectrum Risk Management CONTACT NAME 74 Discovery Irvine, CA 92618 PHONE-(A/G.._dQ.Exsl 949 75.6 5730__ FAX {ac Ho);_. 949-756 5740 ...__ E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE ! NAIC # INSURER A: Mt. Hawley Insurance Co. www.spectrumrisk.com OC77485 INSURED TSCM Corp Jamestown Lane INSURER B : American Economy Ins CO Huntington Huntington Beach CA 92647 INSURERC: St. Paul Fife & Marine Ins Co / I INSURERD: Everest National Insurance Co. INSURER E / INSURER F : COVERAGES CERTIFICATr *UMRFR- C11Fq'V17 REV! -,Ink] kll USIED• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP MM/DDIYYYY ! (MMIDDrryyyl LIMITS A GENERAL LIABILITY MGLO172984 1/1/2011 '..1/112012 EACH OCCURRENCE '',$ 2,000,000 COMMERCIAL GENERAL LIABILITY'' !PREMISESa occur ante)''. $ 50,000 CLAIMS-MADEOCCUR, MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY "', $ 1,000,000 GENERAL AGGREGATE'', $ 2,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: POLICY i PRO- JECT LOC PRODUCTS - COMP/OP AG $ 1,000,000 ',$ , B AUTOMOBILE LIABILITY 02CE20555220 1/1/2011 1/1/2012 COMBINED SINGLE LIMIT �Ea accident) $ 1,000,000 ANY AUTO _ ALL OWNED SCHEDULED AUTOS AUTOS � BODILY INJURY (Per person) $ i BODILY INJURY Per accident ( )$ NON -OWNED HIRED AUTOS AUTOS _ PROPERTY DAMAGE (Per accident)'', $ $ $ C UMBRELLA LIAB OCCUR QK04501017 1/1/2011 i 1/1/2012 EACH OCCURRENCE $ 4,000,000 EXCESS LIAB''. CLAIMS -MADE !, AGGREGATE ! $ 4,000,000 DED r/ RETENTION $10,000 $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑Y N / A CA10000979101 7/1/2010 7/1/2011 WC srnru- O7 H- TOR, LIMITS ER E.L. EACH ACCIDENT $ 1,000000 E.L. DISEASE - EA EMPLOYEE; $ 1,000000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT'', $ 1,000,000 DESCRIPTION OF OPERATIONS below i I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) I Re: Parking lot sweeping services. The City its officers, agents, employees are named additional insureds with resepect to the general liability and o liability per the attached blanket carrier forms. --- - CERTIFICATE HOLDER CANCELLATION The City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Community Development Agency ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Carolyn Fullerton AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza M-25 Santa Ana CA 92701 /L/j ,'�!1✓'`�—� J { �I Jim Waterhouse 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 1 of 9 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 CA 10000979101 12/30/2010 TSCM Corp WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR M-I0M ALL OPERATIONS THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER. .1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIR13's California Workers' Compensation Insurance Forms Manual - 1999. i CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PMA81§46.&� 9 TSCM Corp 3_ ce 02CE20555220 COMMERCIAL AUTO CA 71 10 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. EXTENDED CANCELLATION CONDITION Paragraph 2.b. of the CANCELLATION Common Policy Condition is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. TEMPORARY SUBSTITUTE AUTO — PHYSICAL DAMAGE COVERAGE Under paragraph C. — CERTAIN TRAILERS, MO- BILE EQUIPMENT AND TEMPORARY SUBSTITUTE AUTOS of SECTION I — COVERED AUTOS, the following is added: If Physical Damage coverage is provided by this Cov- erage Form, then you have coverage for: Any "auto" you do not own while used with the per- mission of its owner as a temporary substitute for a covered "auto, you own that is out of service be- cause of its breakdown, repair, servicing, "loss" or destruction. BROAD FORM NAMED INSURED SECTION 11 — LIABILITY COVERAGE — A.I. WHO IS AN INSURED provision is amended by the addition of the following, d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage, Coverage is extended up to a maximum of 180 days following acquisi- tion or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. BLANKET ADDITIONAL INSURED SECTION 11 — LIABILITY COVERAGE — A.1. WHO IS AN INSURED provision is amended by the addition of the following: e. Any person or organization for whom you are re- quired by an minsured contract' to provide insur- ance is an 'insured", subject to the following additional provisions: (1) The insured contract" must be in effect during the policy period shown in the Decla- rations, and must have been executed prior to the "bodily injury" or "property damage". (2) This person or organization is an "insured" only to the extent you are liable due to your ongoing operations for that insured, whether the work is performed by you or for you, and only to the extent you are held liable for an "accident" occurring while a covered "auto" is being driven by you or one of your em- ployees. (3) There is no coverage provided to this person or organization for "bodily injury" to its em- ployees, nor for "property damage,, to its property. (4) Coverage for this person or organization shall be limited to the extent of your negli- gence or fault according to the applicable principles of comparative negligence or fault. (5) The defense of any claim or suit" must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or "suit". Includes copyrighted material of Insurance Services Office, Inc., with its pen-nission. Copyright, Insurance Services Office, Inc., 1997 Saleco and the Sdeco kigo are registered trademams of Safeco Cawration CA 71 10 03 07 Page 1 of 6 EP CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 3 of 9 (6) The coverage provided will not exceed the PERSONAL EFFECTS COVERAGE IP,c;-.qPr nf- (a) The coverage and/or limits of this policy: or (b) The coverage and/or limits required by the "insured contract". (7) A person's or organizations status as an "insured" under this subparagraph d ends when your operations for that "insured" are completed. EMPLOYEE AS INSURED Under Paragraph A. of Section 11 — LIABILITY COV- ERAGE item f is added as follows: Your "employee" while using his owned -auto", or an "auto" owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that "auto". This coverage is excess to any other collectible insurance coverage. FELLOW EMPLOYEE COVERAGE Exclusion 5. FELLOW EMPLOYEE of SECTION If — LIABILITY COVERAGE — B. EXCLUSIONS is amended by the addition of the following: However, this exclusion does not apply if the 'bodily injury" results from the use of a covered "auto" you own or hire, and provided that any coverage under this provision only applies in excess over any other collectible insurance. BLANKET WAIVER OF SUBROGATION We waive the right of recovery we may have for pay- ments made for "bodily injury" or "property damage" on behalf of the persons or organizations added as "insureds" under Section It — LIABILITY COVERAGE — A.1.13. BROAD FORM NAMED INSURED and A.I.e. BLANKET ADDITIONAL INSURED. PHYSICAL DAMAGE — ADDITIONAL TRANS- PORTATION EXPENSE COVERAGE The first sentence of paragraph A.4. of SECTION III — PHYSICAL DAMAGE COVERAGE is amended as follows: We will pay up to S50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. A. SECTION III — PHYSICAL DAMAGE COVER- AGE, A.4. COVERAGE EXTENSIONS, is amended by adding the following, c. Personal Effects Coverage For any Owned "auto" that is involved in a covered "loss", we will pay up to $500 for "personal effects" that are lost or damaged as a result of the covered loss", without applying a deductible, EXTRA EXPENSE — BROADENED COVERAGE Paragraph A. — COVERAGE of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add: 5. We will pay for the expense of returning a stolen covered "auto" to you. AIRBAG COVERAGE Under paragraph B. — EXCLUSIONS of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. NEW VEHICLE REPLACEMENT COST Under Paragraph C — LIMIT OF INSURANCE of Section III — PHYSICAL DAMAGE COVERAGE sec- tion 2 is amended as follows: 2. An adjustment for depreciation and physical con- dition will be made in determining actual cash value in the event of a total loss. However, in the event of a total loss to your "new vehicle" to which this coverage applies, as shown in the declarations, we will pay at your option: a. The verifiable "new vehicle" purchase price you paid for your damaged vehicle, not in- cluding any insurance or warranties pur- chased; b. The purchase price, as negotiated by us, of a new vehicle of the same make, model and equipment, not including any furnishings, parts or equipment not installed by the manufacturer or manufacturer's dealership. If the same model is not available pay the purchase price of the most similar model available; Page 2 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 4 of 9 c. The market value of your damaged vehicle, not including any furnishings, parts or equip- ment not installed by the manufacturer or manufacturer's dealership. This coverage applies only to a covered "auto,, of the private passenger, light truck or medium truck type (20,000 lbs or less gross vehicle weight) and does not apply to initiation or set up costs associated with loans or leases, TWO OR MORE DEDUCTIBLES Under SECTION III — PHYSICAL DAMAGE COV- ERAGE, if two or more "company" policies or cover- age forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deduct- ible is the smaller (or smallest) deduct- ible it will be waived; or b. If the applicable Business Auto deduct- ible is not the smaller (or smallest) de- ductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss involves two or more Busi- ness Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement "company" means: a. Safeco insurance Company of America b. American States Insurance Company c. General Insurance Company of America d. American Economy Insurance Company e. First National Insurance Company of America f. American States Insurance Company of Texas g. American States Preferred Insurance Company h. Safeco Insurance Company of Illinois LOANILEASE GAP COVERAGE Under paragraph C — LIMIT OF INSURANCE of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: 4. The most we will pay for a total 'loss" in any one "accident" is the greater of the following, subject to a $1,500 maximum limit: a. Actual cash value of the damaged or stolen property as of the time of the "loss", less an adjustment for depreciation and physical condition; or b. Balance due under the terms of the loan or lease that the damaged covered 'auto" is subject to at the time of the 'loss, less any one or all of the following adjustments: (1) Overdue payment and financial penalties associated with those payments as of the date of the "loss". (2) Financial penalties imposed under a lease due to high mileage, exces- sive use or abnormal wear and tear. (3) Costs for extended warranties, Cre- dit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease. (4) Transfer or rollover balances from previous loans or leases, (5) Final payment due under a "Balloon Loan ". (6) The dollar amount of any un-repaired damage that occurred prior to the "total loss" of a covered "auto". (7) Security deposits not refunded by a lessor. (8) All refunds payable or paid to you as a result of the early termination of a lease agreement or any war- ranty or extended service agree- ment on a covered "auto". (9) Any amount representing taxes. (10) Loan or lease termination fees GLASS REPAIR — WAIVER OF DEDUCTIBLE Under paragraph D. — DEDUCTIBLE of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. AMENDED DUTIES IN THE EVENT OF ACCI- DENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITION 2.a. -- DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS — of SECTION IV — BUSINESS AUTO CONDITIONS that you must notify us of an CA 71 10 03 07 Page 3 of 6 EP CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 5 of 9 "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV — BUSINESS AUTO CONDITIONS — B.2. is amended by the addition of the following: If you unintentionally fail to disclose any hazards ex- isting at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. HIRED AUTO — LIMITED WORLD WIDE COVER- AGE Under Section IV — Business Conditions, Paragraph B.7.b.e(1) is replaced by the following, (1) The accident" or loss" results from the use of an "auto" hired for 30 days or less, RESULTANT MENTAL ANGUISH COVERAGE SECTION V — DEFINITIONS — C. is replaced by the following: -Bodily injury" means bodily injury, sickness or dis- ease sustained by a person including mental anguish or death resulting from any of these. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability cov- erage and if Comprehensive, Specified Causes of Loss or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow. The most we will pay for loss to any hired 'auto" is $50,000 or Actual Cash Value or Cost of Repair, whichever is smallest, minus a deductible, The de- ductible will be equal to the largest deductible appli- cable to any owned "auto" of the private passenger or light truck type for that coverage. Hired Auto Phy- sical Damage coverage is excess over any other col- lectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. HIRED AUTO PHYSICAL DAMAGE COVERAGE — LOSS OF USE SECTION III — PHYSICAL DAMAGE AA.b. Form does not apply. Subject to a maximum of $1,000 per accident, we will cover loss of use of a hired "auto" if it results from an accident, you are legally liable and the lessor in- curs an actual financial loss. RENTAL REIMBURSEMENT COVERAGE A. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" be- cause of a covered loss" to a covered "auto". Payment applies in addition to the otherwise ap- plicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage- B. We will pay only for those expenses incurred during the policy period beginning 24 hours after the 'loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: 1. The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. 2. 30 days. C. Our payment is limited to the lesser of the fol- lowing amounts: 1. Necessary and actual expenses incurred. 2. $50 per day. D. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. E. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not al- ready provided for under the PHYSICAL DAM- AGE COVERAGE Coverage Extension. F. The Rental Reimbursement Coverage described above does not apply to a covered "auto" that is described or designated as a covered "LaWo" on Page 4 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2AI:54 PM Page 6 of 9 Rental Reimbursement Coverage Form CA 99 23. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE A. Coverage 1. We will pay with respect to a covered auto" for "loss" to any electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the covered "auto" at the time of the ,loss", and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered 'auto". 2. We will pay with respect to a covered "auto" for loss" to any accessories used with the electronic equipment described in paragraph A. 1. above. However, this does not include tapes, records or discs_ 3. If Audio, Visual and Data Electronic Equip- ment Coverage form CA 99 60 or CA 99 94 is attached to this policy, then the Audio, Vi- sual and Data Electronic Equipment Cover- age described above does not apply. B. Exclusions The exclusions that apply to PHYSICAL DAM- AGE COVERAGE, except for the exclusion relat- ing to Audio, Visual and Data Electronic Equipment., also apply to this coverage. In addi- tion, the following exclusions apply: We will not pay for either any electronic equip- ment or accessories used with such electronic equipment that is: 1. Necessary for the normal operation of the covered "auto" for the monitoring of the covered lautols" operating system; or im *.I*T a. an integral part of the same unit housing any sound reproducing equipment de- signed solely for the reproduction of sound if the sound reproducing equipment is permanently installed in the covered *auto,,; and b. permanently installed in the opening of the dash or console normally used by the manufacturer for the installation of a radio. C. Limit of Insurance With respect to this coverage, the LIMIT OF IN- SURANCE provision of PHYSICAL DAMAGE COVERAGE is replaced by the following: 1. The most we will pay for "loss" to audio, vi- sual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of: a. The actual cash value of the damaged or stolen property as of the time of the "loss"; or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. c. S1,000. 2. An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of the "loss". 3. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. D. Deductible 1. If "loss" to the audio, visual or data elec- tronic equipment or accessories used with this equipment is the result of a loss" to the covered auto,, under the Business Auto Coverage Form's Comprehensive or Colli- sion Coverage, then for each covered "auto" our obligation to pay for, repair, return or re- place damaged or stolen property will be re- duced by the applicable deductible shown in the Declarations. Any Comprehensive Cov- erage deductible shown in the Declarations does not apply to "loss" to audio, visual or data electronic equipment caused by fire or lightning. 2. If "loss" to the audio, visual or data elec- tronic equipment or accessories used with this equipment is the result of a "loss" to the covered "auto" under the Business Auto Coverage Form's Specified Causes of Loss Coverage, then for each covered "auto" our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. 3. If loss" occurs solely to the audio, visual or data electronic equipment or accessories used with this equipment, then for each cov- ered 'auto" our obligation to pay for, repair, CA 71 10 03 07 Page 5 of 6 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 7 of 9 U return or replace damaged or stolen property SECTION V—DEFINITIONS is amended by adding will bereduced byuS1O0 deductible. the following: 4. In the event that there is more than one ap' 0. 'Personal effects" means your tangible p|ioab|ededuntib|a. only the highest deduct- property that is worn or carried by you, ex' ib|eudUapp|y. In no event will more than one cept for tools, jenme}ry, money, or securiti$s, deductible apply. R. ~New vehicle" means any ~oubx"mf which you are the original owner and the "auto" has not been previously titled and is k*os Lhan3G5 days past the purchase date. Page Vmo cERc"°.. 9159337 CLIENT CODE: Gi=ie Gi�ie Clarke 12/30/2010 2.41.54 PM Page 8 of 9 MGL01 72984 `11-11S ENDORSEMENT C11,VNGES MIS POLICY. PLEASEREAD rf CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS (FORM C) 'I'his endorsement modifies insurance provided under the following: CONIMERCIAL GhNFIR.Al. MARU.iry C0Vl­_,RAGE PART SCHED11"LF Name oll'I'mson or Organization: :ill pxson or organizations where required byvwittcri contract. (If no entry appears above, information required to complete this endorsement will be ihown in the Declarations as applicable to this endorsement ) -VI-7110 IS AN LNSURM (Section 11) is amended to include as an insured the person or orp,aru zatit. n .sha%vn in the Schedule- but only With respect to liability arising out of "your work" fire that insured by or for,vou, To the extent required wider contract this policy will apply as primary insurance to additional insureds 3chcduled above and other insurance which rimy be available to such ',,Xldit10n2l insureLLs will lie non- contributoq. Section IV., Condition 4., of this policy is amended according1v All other Terms and Conditions of this Policy remain unchanged. CGL 216 (04,981 Page I of I 12/30/2010 CERT NO.: 9159337 CLIENT CODE: Ginnie Ginnie Clarke 12/30/2010 2:41:54 PM Page 9 of 9