HomeMy WebLinkAboutBTI APPRAISAL 1A-2015 o: ca,~ ~ z)
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_ ~d ` _ ~ _ AMENDMENT TO AGREEMENT
THIS AMENDMENT, made and entered into this 1st day of June, 2010, by and between BTI Appraisal,
~`~~ic. ("Consultant") and the City of Santa Ana, a charter city and municipal corporation duly organized
,~a,,o and existing under the Constitution and laws of the State of California ("City"), collectively referred to
herein as "the Parties".
a
RECITALS
A. The Parties entered into that certain agreement entitled "Consultant Agreement" dated
~ , 2010, hereinafter referred to as "said Agreement", for the provision of appraisal services;
B. The Parties hereto now desire to amend the scope of work and compensation term of said
Agreement.
WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter
contained and made, and subject to all of the terms and conditions of said Agreement as hereby amended,
the parties hereto do hereby agree as follows:
1. The Recitals shall be amended to reflect these additional terms:
A. Title III of Division B of the Housing and Economic Recovery Act of 2008 (Pub. L
110-289, 122 Stat. 2654 enacted July 30, 2009) makes available to certain qualified
municipalities for certain qualified grant funds termed Neighborhood Stabilization Program
under a program termed the Neighborhood Stabilization Program.
B. The City desires to retain a consultant having special skill and knowledge in the field of
real property acquisition and appraisal services for the Neighborhood Stabilization Program
(NSP).
2. Section 1, the "Scope of Work" term of said Agreement is hereby amended as follows:
A. Consultant shall perform real property consulting and appraisal services for the NSP
Homeownership Program at the following prices:
"As-Is" Appraisal $400.00
"Repaired Value" Appraisal $300.00 .
Updated "Repaired Value Appraisal $200.00
TOTAL : $900.00 maximum per property
B. Appraisals for any other program (Downpayment Assistance Program or Rental
Housing) shall be charged the Rates per the Consultant Fee Schedule attached hereto and
incorporated herein as Exhibit A.
C. Consultant must complete and attach a U.S. Department of Housing and Urban
Development Certificate of Appraiser for each appraisal. See attached copy of form
attached hereto and incorporated herein as Exhibit B.
C. Consultant must follow the U.S. Department of Housing and Urban Development
Guide for Preparing an Appraisal Scope of Work, attached hereto and incorporated herein
as Exhibit C.
i '
D. Each appraisal must be completed by Consultant within five (5) working days from
the day requested by the City.
E. Consultant shall not subcontract any assignment from the City.
F. Failure to work within this Scope of Work may result in termination of this
Agreement.
3. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged
and in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Amendment to said Agreement the
date and year first above written.
ATTEST: CITY OF SANTA ANA
F,-'
Maria D. Huizar David N. Ream
Clerk of the Council City Manager
APPROVED AS TO FORM: RECOMMENDED FOR APPROVAL:
Joseph W. Fletcher
City Attorney
t s ' 1,, ~ ~
Lisa E. Storck Cynthia J. Ne son, Deputy City Manager
Assistant City Attorney for Development Services
CONSULTANT
BTI Ap 'sal, Inc.
By: M O'Rourke, Vice Chairman
' ~ ~
EXHIBIT A
Fee Schedule
Type of Appraisal Fee
Single Family Residential
Iirterior and Exterior $450+
Muhifamly Residential
2-4 Units $750+
5-10 Units $1,000+
11-20 Units $1,50+
21-30 Units $2,000+
31- Urr~its $2,500+
Multq~le buildings Quote
Vacant Land
Form $1,000+
Narrative $1,500+
C omrnercial/Industrial
Form N/A
Narrative $2,500+
i
1 '
EXIBIT B
HUD CERTIFICATE OF APPRAISER
I hereby certify:
That on date(s), I personally made a field inspection of the property
herein appraised and have afforded the owner or a designated representative the opportunity to
accompany me on this inspection. I have also personally made a field inspection of the comparable sales
relied upon in making said appraisal. The property being appraised and the comparable sales relied
upon in making this appraisal were as represented in the appraisal.
That to the best of my knowledge and belief the statements contained in the appraisal herein
set forth are true, and the information upon which the opinions expressed therein are based is correct;
subject to the limiting conditions therein set forth.
That I understand that such appraisal may be used in connection with the acquisition of
property for a project utilizing U.S. Department of Housing and Urban Development funds.
That such appraisal has been made in conformity with appropriate laws, regulations, and
policies and procedures applicable to appraisal of property for such purposes; and that to the best of my
knowledge no portion of the value assigned to such property consists of items which are
noncompensable under the established law of said State.
That any decrease or increase in the fair market value of real property prior to the date of
valuation caused by the project for which such property is acquired, or by the likelihood that the
property would be acquired for such project, other than that due to physical deterioration within the
reasonable control of the owner, was disregarded in determining the compensation for the property.
That neither my employment nor my compensation for making this appraisal and report are in
any way contingent upon the values reported herein.
That I have no direct or indirect present or contemplated future personal interest in such
property or in any benefit from the acquisition of such property appraised.
That I have not revealed the findings and results of such appraisal to anyone other than the
proper officials of the acquiring agency or officials of the U.S. Department of Housing and Urban
Development and I will not do so until so authorized by said officials, or until I am required to do so by
due process of law, or until I am released from this obligation by having publicly testified as to such
findings.
That I have not given consideration to, or included in my appraisal, any allowance for relocation
assistance benefits.
That my opinion of the fair market value of the property to be acquired as of the
day of 20 is $ based upon my
independent appraisal and the exercise of my professional judgment.
Name Signature
Date
(Note: Other statements, required by the regulations of an appraisal organization of which the appraiser
is a member or by circumstances connected with the appraisal assignment or the preparation of the
appraisal, maybe inserted where appropriate.)
f~ ,
EXHIBIT C
U.S. Department of Housing and Urban Development (HUD)
Guide for Rreparing An Appraisal Scope of Work
HUD Handbook 1378, Appendix 19
The Uniform Relocation Assistance and Real Property Acquisition Policies Act (URA) and its
implementing regulations (49 CFR Part 24) set forth minimum requirements for real property acquisition
appraisals for Federal and federally-assisted programs. Appraisals subject to the URA must be prepared
according to these requirements. The acquiring agency may also have additional supplemental appraisal
requirements which may be attached.
The acquiring agency has a legitimate role in contributing to the appraisal process, especially in
developing the scope of work and defining the appraisal problem. The scope of work and development
of an appraisal under these requirements depends on the complexity of the appraisal problem
The scope of work is a written set of expectations that form an agreement or understanding between
the appraiser and the agency as to the specific requirements of the appraisal, resulting in a report to be
delivered to the agency by the appraiser. It includes identification of the intended use and intended
user; definition of fair market value; statement of assumptions and limiting conditions; and
certifications. It should specify performance requirements, or it should reference them from another
source, such as the agency's appraisal procedural manual. The scope of work must address the unique,
unusual and variable appraisal performance requirements of the appraisal. Either the appraiser or the
agency may recommend modifications to the initial scope of work, but both parties must approve
changes.
SCOPE OF WORK: The appraiser must, at a minimum:
1. Provide an appraisal meeting the definition of an appraisal found at 49 CFR 24.2(a)(3).
2. Afford the property owner or the owner's designated representative the opportunity to accompany
the appraiser on the inspection of the property.
3. Perform an inspection of the subject property. The inspection should be appropriate for the appraisal
problem, and the scope of work should address:
• The extent of the inspection and description of the neighborhood and proposed project area,
• The extent of the subject property inspection, including interior and exterior areas,
• The level of detail of the description of the physical characteristics of the property being
appraised (and, in the case of a partial acquisition, the remaining property),
4. In the appraisal report, include an adequate description of the physical characteristics of the property
being appraised (i.e., sketch of the property and provide the location and dimensions of any
improvements) and a description of comparable sales. The appraisal report should also include
adequate photographs of the subject property and comparable sales, and provide location maps of the
property and comparable sales
5. In the appraisal report, include items required by the acquiring agency, including but not limited to
the following:
I
• Property right(s) to be acquired, e.g., fee simple, easement, etc.,
• Value being appraised (usually fair market value), and its definition
• Appraised as if free and clear of contamination (or as specified),
• Date of the appraisal report and the date of valuation,
• A realty/personality report as required by 49 CFR 24.103(a)(2)(i),
• Known and observed encumbrances, if any,
• Title information,
• Location,
• Zoning,
• Present use, and
• At least a 5-year sales history of the property.
6. In the appraisal report, identify the highest and best use. If highest and best use is in question or
different from the existing use, provide an appropriate analysis identifying the market-based highest
and best use.
7. Present and analyze relevant market information. (Specific requirements for market information
should be included in the agency's appraisal procedural manual and should include research, analysis,
and verification of comparable sales. Inspection of the comparable sales should also be specified.)
8. In developing and reporting the appraisal, disregard any decrease or increase in the fair market value
of the real property caused by the project for which the property is to be acquired, or by the likelihood
that the property would be acquired for the project. (If necessary, the appraiser may cite the
Jurisdictional Exception or Supplemental Standards Rules under USPAP to ensure compliance with USPAP
while following this and other Uniform Act requirements.)
9. Report his or her analysis, opinions, and conclusions in the appraisal report.
ADDITIONAL REQUIREMENTS FOR A SCOPE OF WORK:
INTENDED USE: This appraisal is to estimate the fair market value of the property, as of the specified
date of valuation, for the proposed acquisition of the property rights specified (i.e., fee simple, etc.) for a
Federally assisted project.
INTENDED USER: The intended user of this appraisal report is primarily the acquiring agency, but its
funding partners may review the appraisal as part of their program oversight activities.
App. 19-2 [03/07 ] 1378 CHG-8 Appendix 19
DEFINITION OF FAIR MARKET VALUE: This is determined by State law. Fair market value, however, is
generally defined as the price that a seller is willing to accept and a buyer is willing to pay on the open
market in an arm's length transaction, and usually includes the following:
1. Buyer and seller are typically motivated;
2. Both parties are well informed or well advised, each acting in what he or she considers his or her own
best interest;
3. A reasonable time is allowed for exposure in the open market;
4. Payment is made in terms of cash in U. S. dollars or in terms of financial arrangements comparable
thereto; and
5. The price represents the normal consideration for the property sold unaffected by special or creative
financing or sales concessions granted by anyone associated with the sale.
CERTIFICATION: The appraisal shall include a certification of the appraiser (see attached sample).
ASSUMPTIONS AND LIMITING CONDITIONS: The appraiser shall state all relevant assumptions and
limiting conditions. In addition, the acquiring agency may provide other assumptions and conditions that
may be required for the particular appraisal assignment, such as:
• The data search requirements and parameters that may be required for the project.
• Identification of the technology requirements, including approaches to value, to be used to
analyze the data.
• Need for machinery and equipment appraisals, soil studies, potential zoning changes, etc.
• Instructions to the appraiser to appraise the property "As Is" or subject to repairs or corrective
action.
• As applicable include any information on property contamination to be provided and
considered by the appraiser in making the appraisal.
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PRODUCER 818-986-8200 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HOFFMAN BROWN COMPANY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5000 Van Nuys Blvd., ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
6th Floor COMPANIES AFFORDING COVERAGE
l Sherman Oaks, CA 91403 COMPANY
A Hartford Casualty Ins. Co.
~ INSURED COMPANY
BTI Appraisal g Oak River Insurance Company
605 W. Olympic Blvd., ;'Y820 COMPANY
Los Angeles CA 90015 C
COMPANY
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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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE IMM/PPlYY) DATE IMM/DD1YY)
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A GENERAL LIABILITY 72SBADW3709 10/01 /09 10/01 /10 GENERAL AGGREGATE S 2 000 000
x COMMERCIAL GENERAL LIABILITY PRODUCTS • COMP/OP AG_G 8 2 OOO.i 000
CLAIMS MADE ~ pCCUR PERSONAL & ADV INJURY @ 1 000 000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE 8 1 000 000
FIRE DAMAGE (Any one fire) 8 300 000
MED EXP IAny one person) S 10 000
,4 AUTOMOBILE LIABILITY 72SBADW3709 10/01/09 10/01/10
ANY AUTO COMBINED SINGLE LIMIT @ 1, 000, 000
ALL OWNEp AUTOS A
Og BODILY INJURY @
SCHEDULED AUTOS ~ O ~ ~ (Per pereonl
X HIRED AUTOS
p BODILY INJURY S
X NON-OWNED AUTOS ! IPer accident)
~c ~K
~ ~ ~ ~ E~ S OR C,ney PROPERTY DAMAGE $
GARAGE LIABILITY S`Sta(\t ~ AUTO ONLY - EA ACCIDENT B
ANY AUTO PS ~ ~j OTHER THAN AUTO ONLY +E
EACH ACCIDENT @
AGGREGATE @
EXCEBS LIABILITY EACH OCCURRENCE 8
UMBRELLA FORM AGGREGATE S
OTHER THAN UMBRELLA FORM @
B WORKERS COMPENSATION AND 2200008374 5/09/10 5/09/11 WC STA ITS DEH ~ •
I! EMPLOYERS' LIABILITY EL EACH ACCIDENT @ 1 000, 000
THE PROPAIETOR! INOL EL DISEASE -POLICY LIMIT @ 1, 000, OOD
PARTNERS/EXECUTIVE
• OFFICERS ARE; EXCL EL DISEASE - EA EMPLOYEE 8 1, 000, 000
OTHER
I
DESCRIPTION OF OPERATIONS/LOCATIDNSNEHICLESISPECIALITEMS This certificate replaces & supersedes any
Certificate Holder is named as an Additional Insured under the General certificate previously issued.
Liability policy as respects to the operations of the Named Insured;
Waiver of Subrogation included; Coverage is primary/non-contributory;
per Form SS00080406, attached. ' 10 days notice for non-payment.
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Santa Ana EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
20 Civic Center Plaza "3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Santa Ana, CA 92702 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
• OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUT IZ REPRESENTATI
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Er~ISINESS UApIIITY coVERAGE FORM
2. Applicable To Medical Expenses Coverage e, A trust, you are an Insured. Your trustees
We will not pay expenses far "bodlly InJury"; are also Insureds, but only wltil respeoi to
their duties as trustees,
a, Any Insured 2, Each of the following Is also an Insured;
To any Insured, exvepi "volunteerwarkers",
b, Hired Person a. Employees And Volunteer Warkers
To a person hired to da work for or an behalf Your "volunteer Warkers° only while
of any Insured or a tenant of any Insured, performing duties related to the conduol of
a, InJury on Normally Occupied Premises Your business, ar your "employaes~', other
than either your executive officers (If you
To a person InJurod on lhak part of are an organization other Than a
premises you own or rant that the person partnership, Joint venture or Ilmited liability
normally occupies, company) or your managers (If you are a
d. Warkers' compensation And simElar limited Ilablllty company), but only for acts
laws wllhin the scope of lholr employment by
you or while performing duties related to
To a person, wl7athel' , or net an the conduct of yowl' business,
"employee" of any Insured, If benefits for
the "bodlly InJury" are payable er mull bo However, none of these "employees" ar
provided under a workers' compensation "volunteer workers" are Insureds tor;
or disability bonaflls law ar a similar law. (1) "sodlly ln)ury° or "personal and
e. Athletics Activities ~ advorllsing InJury":
To a person insured while practicing, (a) To you, tc your partners ar
instructing ar part{clpating fn any physical n'tembers (If you are a partnership
exercises Qr games, sports ar athlelio or Joint vHnturo), to your members
contests. (If you are a Iirnltod liability
company), or to a co•"employee"
f. Products~Completed Operations f'lazard while In the course of his ar her
Included wllh .the "products-completed omploymerit or performing cluiles
operations hazard", related to the conduct of your
g. Justness liability Exclusions business, of to your .ocher
Excluded undersusiness llabiilly Coverage, "volunteer workers" ,while
perforrning dutlos related to the
C. WHO CS AN INSURED conduct of your business;
1. If you are designated In the poclaratlons as _ _ _ (bj Ta the spouse, .chihl,, ,,.parent, .
a. An individual, you and your spouse era brother or sister of that oo-
' insureds, but only with respect to the "employee" ar that "volunteer
conduct of a business of whloh you are the worker" as a cortsequenee of
sole owrier. ~ Paragraph (T)(a) above;
b. A partnership or Jalnt venture, you are an ~ (e) Far which there Is any obligation
. insured, Your members, your partners, and to share damages with or repay
their sl~ousos are also Insureds, but only with someohe else who must pay
respect to iho oonduct of your business, damages because of the InJury
c, A Ilmited liability company, you are an described In Paragraphs (1)(a) or
Insured, Your members are also Insureds, (b) above; or
put only with respect to the conduct of your (d) Arising out of his ar her providing
business, Yaur managers are insureds, but or failing to provide professional
only with respeet to their dukles as your health care services,
managers, If you are not in the business of
d. An organization oilier Than a partnership, providing professional health care
Joint venture or Ilmited Ilahllity company, you services, Paragraph (d) does not apply
are an insured, Yaur "executive officers" and fo any nurse, emergency medical
directors are insur•eds,~but only with respect technician or paramedle employed by
to their dutlos as your officers or directors, you to provide such services,
Your stockholders are also Insureds, but only (2) "Property damage" to properly;
wish respect to their. Ilabiliiy as stockholders, (a) owned, occupied ar used by,
Page 10 of 2Q• Form SS 00 08 Oa 06
E3USiNE5S LIABiL.iT1' COVEPiAGE FORS
(b) Rented io, fn the care, custody or b. Coverage under ibis provision does not
control of, or aver which physical apply io:
control is being exercised for any (1) "Bodily Injury" or "property .damage"
purpose by you, any of your that occurred; or
"employees", "volunteer workers",
i any partner or member (!f you are (2) Personal and advertising injury
a partnership or joins venture), or arising out of an offense committed
any member (if you are a limited before you acquired or formed the
liability company). organization.
b, Real Estate Manager 4. Operator Of Mobile Equipment
Any person (other than your "employee" or Wiih respect io "mobile equipment" registered In
m "volunteer worker"), or any organization your name under any motor vehicle registration
while acting as your real estate manager. law, any person is an Insured while driving such
' c. Temporary Custodians Of Your equipment along a public highway with your
~ Property permiss?on. Any ocher person or organization
responsible for the conduct of such person is
Any person or organization having proper also an Insured, but only with respect to liability
o temporary ousiody of your property, if you arising out of the operation of the equipment, and
~ die, but only: only if no other insurance of any kind !s available
tD (1} With respect to ?iabllity arising out of the io that person or organization for this- Ilability.
~ ~ maintenance or use of that property; and However, no person or organization is an Insured
~ {2} Until your legal representative has with respect to: •
a
bean appointed, a. "Bodily injury" to a co-"employee" of the
N d. Legal Representative tf You Die person driving the equipment; 'or
~ Your legal representative if ycu die, but b. "Property damage" io property owned by,
only with respect to duties as such. That rented to, in the charge of or oocupled by
representative will have all your rights and you or the empiayer of any .person who Is
duties underihis insurance, an insured under this provision.
e, Unnamed Subsidiary Operator of Nonowned Watercraft
Any subsidiary and subsidiary thereof, of With respect io watercraft you do not own that
~ yours which is a legally incorporated entity is less than 51 feel long and is not being used
_ of which you own a financial lnfaresi of io carry persons for a charge, any person !s an
~t7io~e than 5~'%of ~fhe wofing stochan site- ~ ' , " • insured-while operaiing~-such-~watercrafi--with -
effective date ofihis Coverage Part, your permission. Any other parson or
organizaiicn responsible for the conduoi of
~ The insurance afforded herein for any such person Js also an insured, but only with
subsidiary not shown in the Declarations respect to Ilability arising out of the operation
~ as a named insured does ribs apply io
~ of the watercraft, and only if no other '
injury or damage with respect to which an
~ insurance of any kind is available to that
insured under this insurance Is also an person or organization for this liability,
Insured under another policy or would be
~ an Insured under such policy but for its However, no person ar organization !s an
termination or upon the exhaustion of its insured wish respect io:
~ limits of insurance, a, "Bodily Injury" io a co-"employee" of the
_ 3, Newly Acquired Or Formed. organizatfan person operating the watercraft; or
Any organization you newly acquire or form, b. "Properly damage" io property owned by,
other than a partnership, Jolni venture or rented to, In the charge of or occupied by
limited Ilability company, and over which you you ar the employer of any person who Js
e~ maintain financial Interest of more than 5D% ai an Insured underthls provision.
the voting stock, will qualify as a 1Jamed 6, Additional insureds When Required By
Insured if there is na other similar insurance Written Contract, Written Agreement Or
T available to chat organization: However; permit
a. Coverage under this provision Is afforded . 'The person(s) or organization(s) identified ,in
only until the 18Dih day after you acquire •Paragraphs a, through f. below are additional
or form the organization or the end of the Insureds when you have agreed, in,a written
policy period, whichever is earlier; and
Form SS UO D8 DQ 05 Page ?1 of 24
i
~EISINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a (e) Any failure to malts sucll
permit Issued by a state or political inspections, adjustments, teals ar
subdivision, Thal such parson or organlzatlon servicing as the vendor has
bo added as an additional Insured on your agreed to make ar normally
policy, provided the Injury or damage occurs undertakes to make In tl~e usual
I subsequent to the sxeoutlon of the contract or aourse of business, In connection
agreement, arihe issuance of the permit, with the dlstrlbutlolt or sale of the
i A person or organlzatlon is an addltlanal products; •
Insured under this provision only for that (f) Demonstration, Installation,
period of time roqulred by the contract, servlaing or repair operations,
agreement or pormil, except such operations performed
at the vendor's promises In
However, no such person ar organlzatlon Is an connection -with the sale of the
additional Insured under this provision if such product;
parson or organlzallon~ Is Included as an
additional Insursd by art endorsement Issued (g) Products which, after dislributlan
by us and, made a part of this Coverage Part, ar sale by you, hays been labeled
Including all persons ar organizatlohs added •or relabeled, or used as a
as addltlanal Insureds under the specific aantalner, part or Ingredient of any
addltlanal insured coverage grants In Suction other thing or substance py or for
• F', .-optional Additional Insured Coverages, ~ the vendor; or
a. Vendors (h) "Bodily Injury" or "property
damage" arising out of the solo
Any person(s) or organization(s) (referred to rlegllgonce of the vendor for Its
below as vsndor), but only with respect to awn acts or omissions or those of
"bodily Injury" or "property damage" al'Ising Its employees or anyone else
out of "your produets° which are dlsirlbtated acting on Its behalf, i-lowevsr, this
or sold In the regular course of the vendor's exclusion doss not apply to;
business and only If this coverage Part The sxaeplians captained in
provides covorago for bodily injury ar
"property damage" included within the suhparagraphs (d) or (f}; or
"producls~campleted operaiions hazard", (ii} such inspections, ad•jlisiments,
(1 } The insurance afforded to the vsndor tests or seivicing as the vendor
Is subJoct io fhe fallowing additlorral has agreed to male or normally
exclusions; undertakes to make In the usual
_ course of buslnerss, In
. This insurance dace •nol apply-to;. _ . -
• ~ ~ ~ coniiectiori with the distribution
(aj "Bodily Injury" or "prolasrty or sale of tits produais•
damage" for which the vendor is (2) This Insurance does nai apply to any
obligated io pay damages by Insured person or organizailon fro~i
. reason of the assumption of whom you have acquired such products,
. Ilabllity In a contract or agreement, or any ingrediept, part or cantalner,
This exclusion does not apply to ontsring Info, accompanying' or
Ilabllity for damages that the Goptaining such products,
vendor would have In the absence
of the contract or agreement; b. Lessors of Equipment
(b) Any express warranty (1) Any person or organizailon from
unauthorized by you; whom you lease equipment; but only
w)th respect to their liability for "bodily
(a) Any physical ar chemical change injury", "property damage" or
• In ihs product made lntsnilonally "personal and advertising Injury"
by the vendor; CaU56d, in whale or In parr, by your
(d) Repackaging, except when maintenance, operation or use of
• unpacked solely for the purpose of equipment leased to you by such
inspection, demonstration, testing, person or organization,
or 'the substitution of parts under •
instructions cram the manufacturer,
and then repackaged in the
orlgh~al container;
Page 12 of 2~1 Form SS 00 08 04~ 06
BUSINESS LIABILITI' COVE~iAGE FOhI1r
(2) 1Nif11 respect to the insurance afforded e, Permits issued t3y State Or Pafitica[
to these additlonal Insureds, This Subdivisions
Insurance does not. apply to any {1) Any state or political subdivision, but
"occurrence" which takes place after only with respeot to operatlons
you cease is lease chat equipment, performed by you or on your behalf far
c, Lessors Of Land Ot• Premises which the state or political subdivision
' (1} Any person or organization from has issued a permit.
whom you lease land or premises, but (2) With respect to the Insurance afforded
only with respect io liability arising out to these additlonal insureds, this
of the ownership, maintenance or use Insurance does nai apply to:
of thal pars of the land or premises (a) "Bodily fnjur)+", "property damage"
~ leased to you.
or personal and advertising
(2) With respect to the insurance afforded injury" arising out of operatlons
,,-i io these additlonal Insureds, this ~ performed for the stale or
Insurance does not apply io; municipality; or
o (a} Any "occurrence" which lakes (b) "Bodily injury" or "property damage"
o place afer you cease to lease that included within the "products-
~ land or be a tenant in that completed operations hazard".
~ premises; or t. Any Other Party
(b) Structural allerailons, new (1) Any other person or.organizatlon who
construction or demolition is not an insured under Paragraphs a.
°o operatlons performed by or on through e, above, .but ,only with
,n behalf of such person ar respect to liability ~or~ "bodily injury",
organization. "property damage'' or "personal and
~ d. Architects, Pnginears OrSurveyrors advertising injury" Doused, in whole or
(1} Any architect, engineer, or surveyor, but in part, by your acts or omissions or
only with respect to liability for "bodily the acts or omissions of those eating
on your behalf:
injury , property damage or personal
= and advertising injury" caused, in whole (a} In the pertormance of your
or in parl, by your acts or omissions or ongoing operations,
. the acts or omissions of,those acting on (b} In connection with your prtmises
_ yQUr...boh~lf
: . _ _ -owned-by ar~rent~ed to you; or .
(a) In connection with your premises; ~ (c) In connection with "your work" and
or Included within the "products•
(b) In the performance of your completed operations hazard", but
~ ongoing operatlons performed by only If
you or on your behalf,
~ (i) The written contract or written
(2) With respect io the Insurance afforded agreement requires you to
>
= to these additlonal insureds, the provide such coverage to
following additional exclusion applies; such additional insured; and
1= This insurance does not apply to (il) This Coverage Part provides
~ "bodily Injury", "property damage" or coverage for "bodUy injury+" or
"personal and advenlsing Injury" "property damage" Included
arising out of the rendering of or the within the "produc~s-
failure io render ~ any professional completed operations hazard",
~ services by or for you, Including: {2) With respect io the insurance afforded
(a) The preparing, approving, or to these additional insureds, this
failure io prepare or approve, insurance does not apply to:
= maps, shop drawings, opinions, "Bodily injury", "property damage" or
- reports, surveys, field orders, ~ "personal and advertising injury"
change orders, designs or arising out of the rendering of, or the
• drawings and specifications; or failure to render an
y professional
(b) Supervisory, inspection, archiiecturai, engineering or surveying
archlieciural or engineering services,.including:
activities.
Form Sfi pn AS 0~4'a6 harm 4 ~ ~i as
i
I
~USIN~SS IIABILITY COVERAGE FORM
This Paragraph f, applies separately is (3) We have issued this poiloy In reliance
you and any additional Insured, upon your representations,
3. Financial 12esponsibllity l..aws b. Unintentional Failure To plsclo$e
' a. When this policy is certified as proof of Hazards
tinanalal responslbllliy for the future under If unintenilonally you should fail to disclose
the provisions of any motor vehicle all hazards relating io the canducl of your
financial responsibility law, the hisurance business at the Inoeptlon date of this
~ provided by fhe policy for "bodily injury" Coverage Part, we shall not deny any
liability and "property damage" liability will coverage under fhis Coverage Part
comply with the provisions of the law to bocause of such failure.
the extent of the ooverage and limits of 7, Other Insurance
insurance required by chat law. If other valid and ccllectlblo Insurance Is
b, With respeoi to "mobile equipment" io avallabls for a loss we oover under this
' which this Insurance applies, we will Coverage part, our obligations are limited as
provide any liability, uninsured motorists, follows:
underinsured motorists, no-fault or other a. Prima Insurance
~ ooverage required by any motor 'vehicle
law. We will provide the required limits for This Insuranoe Is primary except when b.
those coverages, below applies. If ocher Insuranoe is also
4, legal Action Against Us primary, we will share with all that other
No person or organization has a right under insurance by the method described in c.
this Coverage Form; below.
a. To Joln us as a party or otherwise bring us b. Excess Insurance
info a "suit" asking for damages from an This insurance Is excess over any of the
Insured; or other Insurance, whether primary, excess,
b. To sue us on this Coverage Form unless contingent or on any other basis;
all of lis terms have been fully ocmplled (1) Your Work
with, That Is Fire, Extended Coverage,
' A person or orpaniiation may sue us to recover Builder's Risk, Installation Rlsk or
on an agreed settlement or on a final Judgment similar coverage for "your work";
against an insured; but we will not be liable far ~ (2) premises Rented To You
damages that are not payable undertheterms of That is fire, lightning or explosion
this insurance or that are in excess of the insurance for premises rented to you
i_ _ . _appllcable Ilmlt . Qf. Iq;?tar_ans~,_ An a9re~sl.... _ _
! settlement means a settlement and release' of ~ 'or"ierrtporarily ~o~cupled ~by you wlth~~`~"-`
Ilabilfly signed by us, the Insured and the permission of the owner;
claimant orihe claimant's legal representative. (3) Tenant Liability
5, Separation Of Insureds That is Insurance purchased by you io
~ cover your liability as a tenant for
Except with respeoi to the Limits of Insurance, "property damage" to premises ranted
and any rights or duffles specifically assigned io you or temporarily oocupled by you
In this policy to the first Named Insured, this with ermission of the owner
j insurance applies; p
a. As If eaoh Named Insured were the only (4) Aircraft, Auto Or Watercraft
Named Insured; and If the loss arises out of the maintenance
b, Separately to eaoh insured against whom or use of airoraft, "autos" or waierorafl to
a claim is made or "suit" is brought. the extent not subject to Exoluslan g., of
6, Representations Section A. -Coverages,
a. When You Accept This Policy (S) Property pamage To Horrowed
Equipment Or Use Of Elevators
By accepting fhis policy, you agree: If the loss arises out of "property
(1) The statements in the Declarations damage" to borrowed equipment or
I are accurate and complete; the use of elevators to the exleni not
(2) Those statements are based upon subject to Exclusion k, of Seeilon A.
' representations you made io us; and Coverages.
Page 16 of 2~ Form SS 00 08 Oq Ob
i
7
BUSINESS i_IABILITY COVERAGB FORM
(6j When You Are Added As An When this insurance is excess over other
Additional Insured To Other Insurance, we will pay only our share of
Insurance the amount of the loss, if any, That
Thai is ocher Insurance available tc exceeds the sum of:
you covering liability for darpages ~ (1) The total amount Thai all such other
arising out of the premises cr insurance would pay for the loss In the
operations, or products and completed absence of this insurance; and
operations, for which you have bean (2) The total of all deductible and self
added as an additional insured by that insured amounts under all that ocher
insurance; or insurance.
(7) When You Add Others As An We will share the remaining loss, if any, with
~ Additional Insured To This any ocher insurance that fs not described in
~ ~ Insurance
°p ~ ~ this Excess Insurance provision and was not
~ Thai is other insurance available tc an bought specifically to apply in excess of the
additional insured. Limits of Insurance shown In the
' o However, cite following provisions Declarefions of this Coverage Part.
o apply to other insurance available to c. Method Of Sharing
~ ~ ~ any person or organization who Is an If all the other insurance permits
additional Insured under this Coverage ~ . contribution by equal shares, we will follow
Parl. this method also, Under this approach,
~ (a) Primary Insurance When each Insurer contributes equal amounts
o Required By Contract until ii has paid its applicable limit of
~ This insurance is primary if you insurance or none of the Toss remains,
* have agreed in a written contract, whichever comes first.
written agreement or permit that If any of the other Insurance does not pemnit
= this Insurance be primary. If other coniribuiion by equal shares, we will
insurance is also primary, we will contribute by limits. Underihis method, each
share with all that other insurance insurer's share is based on the ratio of its
by the method described in c, applicable limit of insurance to the total
below, applicable limits pf insurance. of all insurers,
~ (b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against
To Other Insurance When Others To Us
~ Required. By Contract.- -
_ •-.-a~~-Transfer Of Rights~OfRecovery..._....
If .you have agreed in a written If the insured has rights to recover all or
contract, written agreement, or part of any payment, including
~ permit that this insurance is Supplementary Payments, we have made
~ primary and non-contributory wish under this Coverage Part, those rights are
the additional insured's own transferred io us. The insured must do
insurance, this insurance is
nothing after Ivss to impair them. At our
~ primary and we will not seek request, the insured will bring "suit" or
coniribuiion from that other. transfer those rights io us and help us.
1= insurance. enforce them. This condition does not
~ Paragraphs (a) and (b) do not apply to apply to Medical Expenses Coverage,
~ other insurance tc which the additional
~ Insured has been added as an ~ b. Waiver Of Rights Of.Recovery (Waiver
I~ Of Subrogation)
additional insured.
~ When this Insurance is excess, we will If the Insured has waived any rights of
recovery against any person or
have no duty under this Coverage Part to organizatlan for all or part of any payment,
defend the insured against any "cult" if any including Supplementary Payments, we
other insurer has a duty io defend the leave made under this Coverage Pari, we
Insured against that "suit". If no ocher also waive that right, provided the insured
insurer defends, we will undertake io do waived their rights of recovery agains#
so, but we will be entitled to the insured's such person or organization in a contract,
rights against all those other Insurers. agreement or permit Thai was executed
prior to the injury or damage.
Porm SS 00 08 Oa 05 ~ Page 17 of 24
i
BUSINESS LIABILITY COVERAGE FORM
OPTIONAL. ADDITIONAL, iI~lSUREp 3. Additional Insured . Grantor of Franchise
COVERAGES WHO Is AN INSURED under Section c, Is
' If Rsled orsl~town as applicable In the Declarations, amended to include as an additional Insured
' one or more of the following Optional Additlonal the person(s) or organization(s) shown In the
I Insured Coverages also apply. When any of these Declaratlons as an Additional Insured
Grantor Of Franchise, but only with respoct to
o s e Cave a es a l
optional Addill nal In ur d r g Pp Y, their IlabUlty as grantor of franchise to you,
Paragraph 6, (Additlonal Insureds Whop Requh•ed
by 1Nritten Contract, Wrttlen Agreement or Permit) Additional Insured ~ Lessor of Leased
of Soctlon C., Wl~o Is An Insured, Boos noi. apply Equipment
to the person ar organization shown in the a. WHo IS AN INSURED uhder Seation C, Is
peclaratlons,~ Those coverages are subJoot to the amended to Include as an addltlonal
terms and conditions applicable to Business Insured the person(s) or arganizallon(s)
hlability coverage In this policy, except as shown In the peclarallons as an Additlonal
provided below; Insured -Lessor of Leased Equipment,
1, Additional Insured ~ Designated Person Or but only with respect to liability far "bodily
organization Injury", "properly damage" or "personal
WNo 15 AN INSURED trndor Seotlon c. Is and advertising Injury" caused, In whole ar •
amended to Include as an additional insured In part, by your maintenance, operation or
tl7e person(s) or organization(s) shown in the use of equipment leased to you by such
peclarallons, but only with respect io liabllliy person(s) or organization(s),
for "bodily Injury", "properly damage" or b, With respect ~to the Insurance afforded to
"personal and advertising Injury" caused, In these additional insureds, this Insurance
whole or in part, by your acts or omissions or does not apply to any "occurrence" which
the acts or omissions of those acting on your takes place after you cease to lease that
behalf; equipment,
a, In the performance of your ongoing Additional Insured ~ owners or gther
operations; or Interests From Whom Land Has Been
b, In connection with -your premises owned Leased
by or reeled to you. a. WHO IS AN INSURER under' Socilort C. Is
2, Additional Insured -Managers Or lessors amended to include as an addltlonal
Of Premises insured the person(s) or organlzatlon(s)
shown in the Declarations as an Additional
a. WHO IS AN INSURED under Secllon C. Is Insured -Owners Or ocher Interests From
.amended.lo..include-as-an~addltloilal-ihsurod,.. - Whom Land Has Been -Leased; but only
the person(s) or arganlzation(s) shown In the with respect to liability arising out of the
peelaratlans as an Additlonal Insured ownership, maintenance or use of that part
Designated Person or Organization; but only of the land leased to you and shown In the
with respoct to liability arlsi,ng out of the peclarallons,
ownership, maintenance or use of that earl of b, Wiih respect to the Insurance afforded io
the promises leased to you and shown in the these addltlonal Insureds, the following
peclarallons, addillonai exclusions apply:
b. With respoct io iho insr.irance afforded to
those additional insureds, the following This insurance doss noi apply io:
addltlonal exclusions apply; (1) Any "occurrence" that lakes place
This Insurance does not apply io; after you cease to lease Thal land; or
(1) Any "occurrence" which lakes place (2) Structural altoratlons, new
after you cease io be a Tenant In that construction or demolition operations
performed by or on behalf of such
premises; or person or organization,
(2) Structural alieratlans, new g, Additional Insured - State Or Political
• construction or demolition operations
performed by or on behalf of such Subdivision -Permits
person or organization. a. WHO IS AN INSURED under Section C. is
amended to Include as an additional
Insurod the state or political subdivision
shown in the Declaratlons as an Additlonal
Page 48 of 2A• Form SS 00 08 Oq~ 05
i
BUSINBSS l_IABfI_ITl' COVERAGE FORM
Insured State Or Political Subdivision - (e) Any failure to make suclt
• Permits, but only with respect to Inspections, adJusimenis, tests or
operailons performed by you or on your servicing as the vendor has agreed
behalf for which the slate or political io make or normally undertakes to
subdivision has issued a permit, make In the usual course of
b. With respect to the insurance afforded to business, in connection with the
these additional insureds, the fallowing disiribuilon orsale of the products;
additional exclusions apply; (f) Demonstration, installation,
This insurance does not apply to; seNicing or repair operailons,
except such operations performed
(1) "bodily Injury", "property damage" ar at the vendor's premises in
"personal and advertising Injury" connection with the sale of the
N arising out of operations performed for product;
~ the state or municipality; or .
~ (2) "Bodily Injury" or "property damage" {g) Products which, oiler distribution
included in the "product-completed ar sale by you, have been labeled
or relabeled or used as a
0 operations" hazard, container, part or Ingredient of any
o Additional Insured-Vendors other thing or substance by or for
~ a. WHO IS AN INSURED under Section C, is the vender; or
amended to include es an additional (h) "Bodily injury" or "property
N insured the person(s) or organization(s) . damage" arising, out of the sole
ro (referred to below as vendor) shown in the ' . negligence of the vendor for lis
~ a Declarations as en Additional Insured - own•acts or omissions or those of
N Vendor, but only wish respect io "bodily its employees. or. anyone else
ao injury" or "property damage" arising out cf acting on its behalf, However, tilts
"your products" which are distributed or exclusion does not apply to;
sold.in the regular course of the vendor's
(i) The exceptipns Gontalned in
business and only if this Coverage Part Sub era ra its d or f or
provides coverage far "bodily Injury" or p g p
"property damage" included wfihJn the (if) Such inspections,
"products-completed operailons hazard", ad)ustments, tests or servicing
as the vendor has agreed fo
b. The insurance afforded to the vendor is make or normally undertakes
subject i4 the following additional exclusions: _ io_.make,in the. usual course of
('P) This insurance does not apply to; • ~ ~ business, in connection with
(a) "bodily injury" or "property the distribution or sale of the
damage" for which the vendor is products,
obligated to pay • damages by (2)• This Insurance does not apply to any•
reason of the assumption of .Insured person or organization from
Ilabllfty In a contract or agreement, wham ycu have acquired suoh
This exclusion does not apply io products, or any Ingredleht, part or
~ liability for damages that the container, entering inic,
vendor would leave in the absence acoompanyfng or oontalning such
of the contract or agreement; products,
(b) Any express warranty a, Additional insured -Controlling Interest
unauthorized by you; WHO 15 AtJ INSURED under Section C,• Is
f~ (c) Any physical or chemical change amended to include as an additional Insured
in the product made inientionaily the parson(s) or organization(s) shown in the
by the vendot; Declarations as an Additional Insured -
y: (d) Repackaging, unless unpacked Controlling Interest, but only wish respect la
~ solely for the purpose of Inspection, their llabilify arising out of:
demonsirailon, testing, or the a, Thelrfinanclal control of you; or
substitution of parts under b. Premises they own, maintain or control
instructions from the manufacturer, while you lease or occupy these premises.
and then repackaged fn the original
container;
Form 5S DO Da Da 06 ~ ~ Pape 19 of 24
DUSINESS LIABILITY C01?CRAGE FORM
i This Insurance does not apply io structural The limits of Insurance that apply io adcJiilonal
alterations, new construction and demolition Insureds are described In Sectlon p, - L1ml1s Of
operallons perfol•med by o!• for that person or insurance,
_ organlzation• How this Insurance applies when other Insurance
9, Additional Insured ~ Owners, Lessees Or Is available to an addltlonal insured Is described in
contractors scheduled person Or the other Insurance Condition in Suction B•
Organization Liability And Medical Expenses General
a. WNO IS AN INSURED under Sectlon C, Is Condltlons•
amended to Include as an addltlonal G, LIABILITY AND MEDICAL. EXPENSES
Insured the person(s) or organization(s) DEFINITIONS
shown In lfto poclaratlons as an Additional
Insured -owner, Lessees or Contractors, 1, "Advertisement" means the widespread public
! put only with respect to liability for "bodily dlssominaiion of {nformatlon or h~nages that
fnJury", "property damage" or "personal has the purpose of inducing the sale of goods,
and advortlsing ih)ury" caused, In whole or products or servlaes through;
In part, py your acts or omissions or the . a. (1 } Radio;
acts or omisslorts of those acting an your (2) Television;
behalf; (3) Billboard;
(1) In the performance of your ongoing (4) Magazine;
ofaeratlons for tl~e additional
Jnsured(s); or (5) Newspaper;
(2} !n connection with "your work" ~ b• The Internet, put only that part of a web
performed for that additional Insured site that is about goods, products or
and included within the "produots~ sorvlces for the purposes o.f Inducing the
completed operallons hazard", but sale of goods, products pr services; ar
only If this Coverage Parl provides a. Any other pulilleatlon that Is given
coverage for "bodily injury" or widespread public distribution,
"property damage" included within the However, "advertisement"dnes nal Include;
"products-completed operations
a. 7ho design, printed material, information
hazard • or Images contained In, on or upon the
b. With respect io the insurance afforded to packagh}g ar labeling of any goods or
these addltlonal insureds, this Insurance products; or
does not apply to "bodily InJury", "property b. An interactive conversation between or
damage" or, ".personal . •an adverlisin~..
_ _ ...among persons,{hrough -a:•compuiernetwork, .
Injury er•Ising out of the render(ng of, or
the failure to yonder, any professional 2• "Advertising Idea" means any Idea for an
architectural, engineering or surveying "advertisement°,
services, Including; 3, "Asbestos hazard" means an exposure or
(1) The preparing, approving, or failure io threat of exposure io the actual or alleged
prepare or approve, maps, snap properties of asbestos and Includes the mare
drawings, opinions, reports, surveys, presence of asbestos in any form,
held orders, change orders, designs ar q~, "Auto" means a land motor vehlclo, troller or
drawings and speclficaiions; or soml-trailer designed for travel on publla
(2) Supervisory, inspecflon, architectural roads', including any attached machinery or
or engineering activities, oquipment• Bui "auto" does not Include
' 10, Additional insured - ca-owner Of insured "mobile equipment",
Premises 5. "Bodily InJury" means physioaL'
WHO 18 AN IiJSURED under Seotfon C. is a, Injury;
amended to include as an additional Insured b. sickness; or
the person(s) ar Organization(s) shown in the c. Disease
~ Declarations as an Addlfionai Insured Co-
Owner Of Insured premises, but only wish sustained by a person and, if arising out of the
respect to il~eir liability as ao~owner of the above, mental anguish or death at any time.
premises shown In the pealaratlons. 6, "Coverage territory" means;
Page 20 of 24 Form SS 00 08 04 06
u5/ 14/ ~O1C ?P.' 0:..]. PAX 535A
~1~001/001
i
_ I
I CERTIFICATE OF INSURANCE ISSUE DATE 05/14i201i ~
I
I THIS CERTIFICATE TS ISSUED AS A MATTER O.E' INFORMATION ONLY AND CONFERS ~I01
I RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NO^1 AMEND, EXi~,~Dl
I OR ALTER THE COVERAGE AFFGRDED BY THE POLICIES BELOW.
I PRODUCER ( COMPANIES AFFORDING COVERAGE I
I Herbert H. Lindy Ins. Agerrcy, Inc. I i
175 Second Avenue, #410 I General Star National i i
I Needham, MA 02494-2876 I I I
I -I
I INSURED I
I Ben F Tunnell III I
I (
I I
! 605 W Olympic Blvd Ste 820 I ~
I Los Angeles CA 90015
I I
I _COVERAGES I
I THIS IS TO CERTIFY THAT 'T'HE POLICIES OF :INSURANCE LISTED BELOW HAVE .EL'NI
I ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATFD,1 I
I NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION CF ANY CONTRACT OR OTC-iERI
I DOCUMENT WITH RESPECT TO WHICH `T'HIS CERTIFICATE MAY BE ISSUED OR i~iAYl
i PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB~s''.`TI
I TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHC[^iNl
I MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I I I
I POLICY NO. NJA 949566E
I POLICY 'T'ERM: 01/17/2010 - 01/17/2011
I LIMITS OF LIABILITY: $ 1,000,000.00 each claim; I
i
I $ 2,000,000.00 annual aggregate; I
I DEDUCTIBLE: $ 500.00 / $ 1,000.00 each claim/annual a I I
{ PRIOR ACTS DATE: 01/17/2002 ggregate; I i
I Coverage is on a claims-made basis. I
DESCRIPTION OF OPERATIONS I
I _ I
I Real Estate Appraisers Professional Liability. I
I I
I CERTIFICATE HOLDER J CANCELLATION I
I I SHOULD ANY OF THE ABOVE DESCRIBED POLICiESI
(City of Santa Ana ( BE CANCELLED BEFORE THE EXPIRATION L%A~'EI
120 Civic Center Plaza I THEREOF, THE ISSUING COMPANY WILL ENDEAVOR) ~
IM-37 J TO MAIL 60 DAYS WRITTEN NOTICE TO THE(
(Santa ana, CA 92701 J CERTIFICATE HOLDER NAMED TO THE LEFT, BUT)
I J FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE(
I I NO OBLIGATION OR LIABILITY OF ANY K~NDI
I i UPON THE COMPANY, ITS AGENTS ')R)
I I REPRESENTATIVES.
I I i
I I AUTHORIZED REPRESENTATIVE J
I
I
I I _ Q I i
I ' z~~ ~~~,<,~.J I
I I f
I
_ I
I
i
I