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HomeMy WebLinkAboutANGUIANO LAWN CARE INC. J 1P)SLIRANCL UI,I rILE WORK MAY PROCEED N-2Q25-15$ UNTIL INSURANCE EXPIPk$ CITY CLEF K DATE: JUL 0 3 2025 LICENSE AND RIGHT OF ENTRY n [1725 N Bristol St.,Santa Ana,California] This license and right of entry is dated June 5,2025 for identification purposes.The City of Santa Ana,a charter city and municipal corporation duly organized and existing under the Constitution and the laws of the State of California(collectively referred to as the"City"),as the legal owner("Owner")of the property located at Assessor Parcel Number 399-085-2.2,in the City of Santa Ana,County of Orange(the"Property"),does hereby grant Anguiano Lawn Care Inc.,a License and Right-of-Entry for the following purpose: Construction of a concrete block wall and installation of landscaping along Bristol Street per the attached specifications on City owned property located at 1725 N. Bristol Street, see attached EXHIBIT C. Anguiano Lawn Care Inc.,agrees to indemnify,defend,and hold harmless City from and against any and all actions, suits,claims,demands,judgments, losses,expenses,or liabilities,injuries and damages to persons and property, including death,arising out of or related to Angulano Lawn Care Inc.'s use of the Property or the entry by any Angulano Lawn Care Inc.party on the Property.Anguiano Lawn Care Inc.further agrees to repair any damage to the Property caused by the exercise of this License and Right of Entry at its sole cost and expense,and to restore the Property,with the exception of any improvements left thereon,as nearly as practicable to the state in which it existed prior to the use of the Property by Anguiano Lawn Care Inc. The rights herein granted are exclusive and Anguiano Lawn Care Inc.agrees not to assign,transfer,lease,pledge, or otherwise dispose of its License and Right-of-Entry without the prior express written approval of the City.This License and Right of Entry shall expire upon completion of said construction work,and in any event,no later than October 20,2025 unless terminated earlier or extended by written agreement between the Parties. CITY OF SAN ,4Z Alvaro Nunez Gregg Kessler City Manager Anguiano Lawn Care Inc. ATTEST: _ ' RECOMMNEDED FOR APPROVAL: „4 I &Jennifer l abil Saba i Executive Director Public Works Agency APPROVED AS TO FORM: Sonia R.Carvalho City Attorney By: Kyle Nellesen Assistant City Attorney I LEGAL DESCRIPTII AN ININN THE CITY OF SANTA ANA, COUNTY OF ORANGE, STATE GB CALIFORNIA THAT PORTION OF LOT 25 TRACT MAP NO. 1672 AS PER THE MAP FILED IN BOOK 48, PAGE 16 OF MISCELLANEOUS MAPS, OFFICIAL RECORDS OF SAID COUNTY, EXCEPTING THEREFROM THAT PORTION OF LOT 25 GRANTED IN FEE FOR PUBLIC STREET PURPOSES RECORDED AS INSTRUMENT NUMBER 0 , OFFICIAL RECORDS OF SAID COUNTY. CONTAINING AN APPROXIMATE AREA OF 4,621 SQUARE F'LI=T. SUBJECT TO EASEMENTS, RESERVAMONS, RESTRICTIONS, AND ANY OTHER RIGHTS OF RECORD, EXHIBIT "B" ATTACHED HERETO AND BY THIS RE lFERENCE MADE A PART HEREOF. THIS DESCRIPTION WAS PREPARED BY ME OR UNDER MY DIRECTION: "? . '� ANDS- ON CHRYSOSTOMO,L.S, 9216 DAT ;No. •:: PAGE I OF 1 SKETCH TO ACCOMPANY LEGAL DESCRIPTION EIGHTEENTH STREET Lo co co � 64.00' PARALLEL -- RIGHT OF WAY IS BASED ON CITY OF SANTA ANA PARCEL LIMITS ' t �r a t i �I R 1 a �I �. PROPERTY LINE L WALL LOCATION IMPROVEMENTS rr R/W WALLERTY MALL 0 ox o�F PROVIDE S.AIVIA c -CII 'ALGA' i■NITE A.LI N SAGEI.5 GAL. 2.5' O.C.. .0 2'kULCH 0E11EN All AROIINO PLANTS. BETME EN R/w AND BASE OF MALL, PROPERTY WALL TYPICAL SECTION 46'N 16" SCALE: xTS PRE CAST CONCRETE CAP I PILASTERS CORSTRUcTED AT START.END. I MA1°GNf gxANO I TYP.1 {..--� EVENT 50 FEET.AND ANY ANGLE POINT. III !I O.c fPN. AOIxT pN gpTH SIGES OF ALL PILA STfg5-.SEE SME ET SB17. P ILAS TEq SHALL BE VENEERED WGULTORED 510NE. STYLE: 'E SAx FRnxCiscp cGOBLESTONEITYR-/ COLOR TC NdTEH SPLIT FACE BLOCN P" FG CAP ALL OPEN 1/2'M I/V S0. 16 GAUGE TUBE STEEL TRELLIS. ENDS ITYP.I MELD HORI2. TUBING ON TOP OF VERT. Tu4IND. PROPERTY WALL W"STEEL TPBJJS STRUC ME ELEVATION' SCALE: Nis 20' 16' eULTUREO STONE VENEER ITYP.1 STYLE:SAN FgINC Nco COBBLESTONE. COLOR TO NATCH SPLIT FACE cW BECTION A—A N.T.s PARCEL R1 WALL AND LANDSCAPE DETAILS PAGE 2OF2 sec R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) `� 05/13/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT- If Me certificate holder Is an ADDITIONAL iN5 ED,the po Cy(€es)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 UUNIAUI NAME: Brandon Dempster JVRC Insurance Services PHONE 8187357600 Arc No Ext; {AIC,No€; 818-698-6401 5707 Corso Ave ADDRESS: serv€ces@jvrc€nsurance.com Ste 105 INSURERS)AFFORDING COVERAGE NAIC N Westlake Village CA 91362 INSURERA: Ategrlty Specialty Insurance Company 16427 INSURED INSURER B: Omaha National Insurance Company 16219 Angu€ano Lawn Care Inc INSURER C: PO Box 2849 INSURER D: INSURER E: Seal Beach CA 90740 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMlDDIWYY MMlDDIYYYY] LIMITS X COMMERCIALGENERALLIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE NOCCUR PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y Y 0I-C-AK-P20084995-1 08/25/2024 08/25/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY�X JECT LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accfdeM) $ HiREDAUTOS NON-OWNED AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY Y!N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000 000 B OFFICERIMEMBER EXCLUDED? NIA Y ONCC11838 04 09/29/2024 09/29/2025 (Mandatory InNH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE---POLICY UM IT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more spats Is requlred) City of Santa Ana,Its City Council,officers,officials,employees,agents,and volunteers are named as additional insureds with respect to Tu Tra n t,Digitally signed nb guy the general I€abil€ty policy.Waiver of subrogation applies with respect to the general liability and workers'compensation policies, '041e:.2025.05.21 Nguyen` 14A6:53-07'00' APPROVED By Tv Tran Nguyen at 2;46 pm,May 2i,202 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attention: CIP Engineering AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza,M-36 Santa Ana CA 92701 Jwela,W, ��..�ell O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -" OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II-Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds,the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract or agreement that such person or organization be 1. "Bodily injury", "property damage" or"personal added as an additional insured on your policy. and advertising Injury" arising out of the Such person or organization is an additional rendering of,or the failure to render, any insured only with respect to liability for"bodily professional architectural,engineering or injury", "property damage" or"personal and surveying services, including: advertising injury" caused, in whole or in part,by: a. The preparing,approving,or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, 2. The acts or omissions of those acting on your opinions, reports,surveys,field orders, change orders or drawings and behalf; specifications; or in the performance of your ongoing operations for b. Supervisory, inspection,architectural or the additional insured. engineering activities. However,the insurance afforded to such additional This exclusion applies even if the claims against insured: any insured allege negligence or other wrongdoing 1. Only applies to the extent permitted by law; in the supervision, hiring, employment, training or and monitoring of others -by that insured, if the 2. Will not be broader than that which you are "occurrence" which caused the "bodily injury" or required by the contract or agreement to "property damage", or the offense which caused provide for such additional insured. the "personal and advertising injury", involved the rendering of or the failure to render any A person's or organization's status as an additional professional architectural, engineering or insured under this endorsement ends when your surveying services. operations for that additional insured are completed. CG 20 33 04 130 Insurance Services Office, Inc., 2012 CG 20 33 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 2 Z. "Bodily injury" or"property damage"occurring C. With respect to the insurance afforded to these after additional insureds,the following is added to a. All work, including materials, parts or Section III- Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project(other than insured is the amount of Insurance: service, maintenance or repairs)to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed; or 2. Available under the applicable Limits of b. That portion of"your work"out of which the Insurance shown in the Declarations; injury or damage arises has been put to its intended use by any person or organization whichever is less. other than another contractor or This endorsement shall not increase the applicable subcontractor engaged in performing Limits of Insurance shown in the Declarations. operations for a principal as a part of the same project. CG 20 33 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 POLICY NUMBER:01-C-PK-P20084995-01 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization with whom the insured has agreed to waive rights of recovery, provided such agreement is made in writing and prior to the loss Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV-Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC ON 04 WS A (Ed.01-19) 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. Blanket Waiver:The additional premium for this endorsement shall be 2%of the California workers'compensation premium otherwise due on such remuneration. Specific Waiver:The additional premium for this endorsement shall be 5%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver of Subrogation As respects to all CAjobs performed by the named insured during the policy period where by written contract a waiver of subrogation is required prior to the commencement of work. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 09/29/2024 Policy No. ONCC11838-04 Endorsement No. Insured Insurance Company Omaha National Casualty Company Anguiano Lawn Care, Inc. Countersigned By &G/ A, � I� A`"ROB CERTIFICATE OF LIABILITY INSURANCE 05/1E3/2025 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER -ONtactINAME Victoria DUICICh SfafeFarm KEEGAN FERRARO,AGENT 75-1ADA vCNN Est: 562�131-3933 F N 562-594-6326 7923 Warner Ave. a-MAIL V3CTORIA@KEEGANFERRARO.COM Huntington Beach, CA 92647 Suite A INSURER(S)AFFORDING COVERAGE NAIC 9 INSURER A: State Farm Fire and Casualty Company 25143 INSURED INSURER B: Q Angulano,Juan DBAAnguiano Lawn Care INSURERC: 0 PO BOX 2849 INSURER D: Q Sea]Beach,CA 90740 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L.TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMlDD MMIOD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE El OCCUR DAMAGE TO RENTED PREMISES Eaoccurrence) $ MED EXP(Any one person) $ -PERSONAL$ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY Q JEC LOD PRODUCTS-COMP/OP AGG OTHER: $ COBIN AUTOMOBILE LIABILITY 648 2854-FO6-75 12/06/24 06106/25 Ea accmEentswGLELIMIT 1,000,000 ANY AUTO �,/ BODILY INJURY(Per person) 1,000,000 OWNED AUTOS ONLY X AUTOSULFD Y Y 648 9314-FO6-75 121`061`24 06�06�25 BODILY INJURY(Per accident) $ 1,000,000 HIRED NON-OWNED AUTOS ONLY AUTOS ONLY Par accident $ 1,000,000 Medical Payments 5,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ FEXCESS LIAR CLAIMS-MADE AGGREGATE $ IDED I I RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY $ ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N I A {Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ f yes,describe under DE F OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Comprehensive Deductible:$1,000 Collision Dedubtible:$1,000 "City of Santa Ana,its City Council, officers,officials,employees,agents,and volunteers" APPROVED By Tu Tran Nguyen at 2:46 pm,May 2f,2025 CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attention: CIP Engineering THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza,M-36 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE Completed by an authorized State Farm representative. If signaturca C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 4991450 1321149.14 04-13-.2022 6196AA WAIVER OF SUBROGATION UNDER THE LIABILITY COVERAGE This endorsement is a part of the policy. Except for the changes this endorsement makes, all other provisions of the policy remain the same and apply to this endorsement. It is agreed that we have no right of subrogation under Liability Coverage against the person or or- ganization whose name is shown immediately following the title of this endorsement on the Decla- rations Page to the extent that you have waived your legal right to recover from that person or organization pursuant to a written contract you had duly executed with that person or organization prior to the accident or loss. Person/Organization:"City of Santa Ana,its City Council, officers,officials,employees, agents,and volunteers" Page 1 of 1 6196AA ©,Copyright,State Farm Mutual Automobile Insurance Company,2013 6028-BU Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY,PLEASE READ IT CAREFULLY. 6028BU ADDITIONAL INSURED(Prior Notice of Termination) This endorsement modifies insurance provided under the following: AUTOMOBILE INSURANCE COVERAGE FORM SCHEDULE POLICY NUMBER: 648 9314-FO6-75A&648 2854-F06-75A NAMED INSURED: Anguiano,Juan QBA Angulano Lawn Care PO BOX 2849 Seal Beach,CA 90740 Name and Address of Additional Insured Person or Organization: City Of Santa Ana Attention:CIP Engineering 20 Civic Center Plaza,M-36 Santa Ana,Ca 92701 "City of Santa Ana, its City Council,officers,officials, employees,agents,and volunteers" This endorsement is a part of the policy. Except for the changes this endorsement makes, all other provisions of the policy remain the same and apply to this endorsement. 1.A person or organization shown on the Declarations Page as an Additional Insured is provided Liability Coverage, but only to the extent that person or organization qualifies as an insured as defined in Liability Coverage. 2. An Additional Insured has the same right of recovery under Liability Coverage as if they had not been shown on the Declarations Page as an Additional Insured. 3.If Liability Coverage is changed or terminated as to the interest of the Additional Insured,unless another number of days notice is shown on the Declarations Page, we will provide the Additional Insured; a. 10 days notice of such change or termination if the policy is nonrenewed or the cancellation is for nonpayment of premium; and b. 20 days notice of such change or termination if the cancellation is for any reason other than All other policy provisions apply. 6028-BU ©, Copyright,State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted material of Insurance Services Office, Inc.,with its permission i