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HomeMy WebLinkAboutDEL HOYO, ROBERTO + N-2026-108 " ®..('014 c4 AY 1 a 2026 ARTS AND CULTURE RESTORART: MURAL RESTORATION AND CONSERVATION PROGRAM AGREEMENT BETWEEN THE CITY OF SANTA ANA AND ROBERTO DEL HOYO This Mural Restoration Program Agreement ("Agreement") is made and entered this 201h day of January, 2026, by and between the City of Santa Ana, a charter City and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"), and Roberto Del Hoyo ("Grantee")for the purpose of providing grant funding pursuant to the RestorArt: Mural Restoration and Conservation Program ("Restoration Program"). City and Grantee may herein individually be referred to as a "Party" and collectively be referred to as the "Parties"to the Agreement. RECITALS: A. On June 19, 2025, the Arts and Culture Commission reviewed all applicants and recommended that Grantee be awarded a mural restoration grant based on its Proposal for its restoration project ("Project"). A true and correct copy of Grantee's Proposal is attached hereto as Exhibit A and incorporated herein by reference. B. In undertaking the performance pursuant to this Agreement, Grantee represents that it is skilled and knowledgeable in the mural restoration and conservation arena and that the Project created or performed hereunder will be created or performed in compliance with such standards as may reasonably be expected from an artist. C. The Project mural restoration is located at: Address/Location: El Salvador Park 1825 W. Civic Center Dr. Santa Ana, CA 92703 Mural Title: All-Star Baseball Original Artist: Roberto Del Hoyo The Grantee agrees to restore the mural with respect for the original artwork and in accordance with best practices in mural conservation. 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. Term. This Agreement shall be effective upon signature by both Parties and shall expire one year from the date first written above, unless terminated earlier in accordance with this Agreement. 2. Funding. 2.1. Subject to Grantee's performance of all required actions under this Agreement, City shall provide funding, in two disbursements, as detailed below, of an amount not to exceed Twenty Thousand Dollars ($20,000) ("Grant Amount" or"Grant"). 1 2.2. Grantee will be paid in two (2) installments. First payment will be one-half of the funding amount provided above or ($10,000) and will be provided within thirty (30) days of the full execution of the Agreement by the Parties along with a complete invoice submitted by Grantee. The second and final payment will include the remaining amount of($10,000) and will be issued within thirty (30) days after the successful completion of the restoration, including proper anti- graffiti coating over the mural, and Grantee submits to the City all the proper invoice and final report for the Project. 2.3. Appropriate performance of the Grantee will be determined by City in its sole discretion. City reserves the right to cease funding after the first or second disbursement detailed above, and to be reimbursed the initial payment(s), if Grantee's performance is determined to be insufficient or unacceptable in the City's sole discretion. 2.3. City represents that there is no correlation or connection between its selection of individuals for grant awards and an individual's business relationship or potential business relationship with City. 3. Grant Activities. Grantee agrees: 3.1. To perform the activities described in Grantee's Grant Proposal and Timeline submitted to City for consideration dated March 3, 2025, a copy of which is attached as Exhibit A and incorporated into this Agreement as if set out in full. 3.2. To submit all reports (each, a "Report"), which shall include, at a minimum,the items set forth as required by the Proposal. No personally identifiable information shall be included in any of the Reports, except where specifically requested. The Reports shall be in a format that is reasonably acceptable to City. City may request additional information as City, in its sole discretion, determines is necessary to monitor performance of this Agreement. City shall have the right to use any Reports submitted by Grantee, or any portion thereof, for any reason. 3.3. To maintain all pertinent financial and accounting records pertaining to this Agreement in accordance with generally accepted accounting principles and other procedures reasonably specified by City. Upon termination or expiration of this Agreement or request by City, Grantee shall provide, at its expense, copies of all financial and accounting records produced by Grantee arising out of this Agreement. 3.4. To allow audits, compliance or special reviews and inspections, including on-site inspection, with or without prior notice, of Grantee's facilities by City or by third parties designated by City, or their authorized representatives. Grantee shall provide its full cooperation for any such audit, review or inspection, including providing timely access, for examination and copying of records (including computerized records) pertinent books, documents, papers, computer programs and records and reasonable access to its personnel. 3.5. To ensure that any areas utilized for the Project are maintained and restored to a well- maintained, safe, sanitary, and clean condition, and kept free of any hazardous waste at all times. All equipment associated with the installation of the artwork, trash and debris shall be removed and cleaned up on a daily basis. If applicable to the Project, Grantee shall place a drop cloth or similar barrier on the ground below the artwork while restoration is underway, which barrier shall be removed each day upon completion, of a restoration session. 2 3.6.The Project may not add advertising, religious art,sexual content, negative or violent imagery, convey political partisanship or add any hidden, subliminal, or camouflaged messages or statements of any kind or nature. Appropriateness of the content of the Project will be determined by City in its sole discretion. 3.7. The Project may not add any breach of intellectual property, trademarks, brands, or images of illegal activity, and the Grantee must be the copyright holder for the Project, if it is the original artist. It is the sole responsibility of the Grantee to obtain any and all applicable copyrights or trademarks associated with the artwork for the Project, if Grantee is original artist. 3.8. The restored Project mural must be covered in an anti-graffiti coating at the Grantee's expense. 3.9. Should the restored Project mural subsequently be defaced and/or not repaired, maintained, preserved and/or further conserved, the City has the option to repair, maintain, preserve, and/or conserve the Project mural, or alternatively, the City has the sole authority to remove, alter, or destroy the Project mural. 3.10. Grantee will have first right of refusal to re-restore said Project mural. If Grantee is unwilling to perform further restoration or unable to be contacted within a reasonable time, the City has the right to request the services needed from a different artist. 3.11. The City holds all rights to murals on city property, and as such the Project mural may be removed at the sole discretion of the City or as otherwise agreed upon with Grantee. 3.12. Grantee shall be responsible for complying with all Federal, State and local laws, ordinances, statutes and regulations, including, but not limited to zoning and other environmental requirements (if applicable), and for obtaining all required licenses, permits, or other authorizations applicable to the performance of Grantee's Project under this Agreement. 4. Termination. 4.1. City may immediately terminate this Agreement upon one or more of the following: 5.1.1. Grantee's violation of any federal, state or local law or regulation. 5.1.2. Grantee's breach of any of the terms or conditions of this Agreement, including the Proposal and Timeline, or any unapproved deviation from said documents that has not been cured within 30 days of written notice of such breach. 5.1.3. Grantee's failure to provide documents to the City, as requested by the City by a date certain, in order to maintain compliance with the Restoration Program, City Policies or Procedures, or this Agreement. 4.2. In the event the Agreement is terminated under Section 5.1, City reserves the right to require Grantee to refund any or all grant funds awarded to Grantee under this Agreement, and Grantee agrees to refund to City any or all grant funds awarded under this Agreement. 5. Limitation of Liability. 5.1. IN NO EVENT SHALL CITY BE LIABLE FOR ANY INDIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES OR EXPENSES FOR ANY NEGLIGENCE, BREACH OF CONTRACT OR ANY OTHER ACT ARISING OUT OF OR RELATING TO THIS AGREEMENT 3 OR THE ACTIVITIES COVERED HEREUNDER. 5.2. Section 6 and Section 7 do not limit Grantee's rights, including its ability to seek recovery, against anyone other than City, its directors, officers, employees, volunteers, agents, successors and assigns. 6. Indemnification. 6.1. Grantee shall defend, indemnify, protect and hold harmless the City, and its elected and appointed officers, employees, volunteers, members or agents from and against all claims for damages, liability, cost and expense (including without limitation attorney's fees) arising out of or alleged by third parties to be the result of the negligent acts, errors or omissions or the willful misconduct of the Grantee, and Grantee's employees, subcontractors or other persons, agencies or firms for whom Grantee is legally responsible in connection with the execution of the work covered by this Agreement. Grantee shall have no duty to indemnify or hold harmless the City if claims, damages, liability, costs, expenses(including without limitation, attorney's fees)arise from the sole negligence or sole willful misconduct of the City subsequent to declaration by the Grantee. Grantee's obligations shall survive the termination of this Agreement. 6.2. Grantee agrees to hereby fully release and forever discharge the City from any and all claims, demands, damages, losses, and liabilities (hereinafter collectively referred to as "claims"), which are or may be related to or in any way connected with the negligence or willful misconduct of its officers, officials, employees, or agents in connection with the restoration, creation, painting, performance or installation of the Project hereunder. 6.3. Grantee further agrees that City may in good faith and on reasonable terms settle any such claims and that City's right to indemnification shall extend to any such settlement, provided City has given notice of such claim and its intent to settle. City's right to indemnification is in addition to, and may be exercised independently of, any remedy held by City under this Agreement, at law or in equity. The indemnity provision set forth in this Agreement shall survive the termination or expiration of this Agreement indefinitely. 7. Insurance 7.1 Prior to undertaking performance of work under this Agreement, Grantee shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: MINIMUM SCOPE AND LIMIT OF INSURANCE Grantee shall maintain limits of insurance coverage in the following minimum amounts and shall be at least as broad as: • Commercial General Liability(CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal &advertising injury with limits no less than $1,000,000 per occurrence and $2,000,000 aggregate. • Automobile Liability (AL). Insurance Services Office Form CA 00 01 covering Code 1 (any auto), with combined single limits of $1,000,000. In the event Grantee does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance with existing limits, which can be lower than $1,000,000. • Workers' Compensation (WIC): as required by the State of California, with statutory limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per 4 accident, per employee, per policy for bodily injury or disease. This requirement can be waived if Grantee has no employees. If Grantee maintains broader coverage and/or higher limits than the minimums shown above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Grantee. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions: 1. CGL and AL policies: City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the Grantee including materials, parts, equipment, and personnel furnished in connection with such work or operations. 2. All required insurance policies: Insurance company(les) agrees to waive all rights of subrogation against City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the terms of any policy which arise from work performed by Grantee for City. 3. All required insurance policies: For any claims related to this contract, Grantee's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. 4. All required insurance policies: A severability of interest provision must apply for all the additional insureds, ensuring that Grantee's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with respect to the insurer's limits of liability. 5. Each insurance policy required herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non-renewed by the carrier, or materially changed except after thirty (30) days prior written notice has been given to City. Ten (10) days prior written shall be provided to City for policy cancellation or non-renewal due to non-payment. 6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: Executive Director, Community Development Agency, 20 Civic Center Plaza M-25, Santa Ana, CA 92701. The name and location of event should be included in the Description of Operations section of each certificate. Self-Insured Retentions Self-insured retentions must be declared to and approved by the City. City may require Grantee to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. Acceptability of Insurers Insurance is to be placed with insurers authorized to conduct business in the state of California with a current A.M. Best rating of no less than A:VII, unless otherwise acceptable to City. Verification of Coverage Grantee shall furnish City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage 5 required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to Entity before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Grantee's obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. Claims Made Policies If any of the required policies provide coverage on a claims-made basis: 1. The retroactive date must be shown and must be before the date of the contract or the beginning of work. 2. Insurance must be maintained and evidence of insurance must be provided for at least three (3) years after completion of work. 3. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a retroactive date prior to the contract effective date, Company must purchase "extended reporting" coverage for a minimum of three (3) years after completion of work. Subcontractors Grantee shall require and verify that all sub-contractors maintain insurance meeting all the requirements stated herein, and Grantee shall ensure that City is an additional insured on insurance required from sub-contractors. Special Risks or Circumstances City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. 8. General Provisions. 8.1. Grantee shall acquire prior written permission from City for any use of the City name or logo in association with the Project. 8.2. If any parts of this Agreement are held to be invalid or unenforceable, the remaining parts of the Agreement shall continue to be valid and enforceable. 8.3. Grantee shall comply with all governmental requirements that may now or in the future become applicable to the activities under this Agreement. 8.4. This Agreement, including Exhibit A, Proposal, and any amendments or schedules hereto, contain the full understanding and agreement of the Parties with respect to its subject matter, and no waiver, alteration or modification of any of the provisions to this Agreement shall be binding unless in writing and signed by an authorized officer of both Parties. 8.5. No waiver by either Party or any breach, default, or series of breaches or defaults, and no failure, refusal, or neglect of either Party to exercise any right, power, or option given to it under this Agreement or to insist upon strict compliance with the terms of this Agreement shall constitute a waiver of these provisions with respect to any subsequent breach or waiver by either Party or its right at any time thereafter to require exact and strict compliance with provisions of this Agreement. 6 8.6.Any notice or other communication required or permitted to be made or given by either Party pursuant to this Agreement will be in writing and will be deemed to have been duly given: (i)five (5) business days after the date of mailing if sent by registered or certified U.S. mail, postage prepaid, with return receipt requested; (ii) when transmitted if sent by facsimile, provided a confirmation of transmission is produced by the sending machine; or (iii) when delivered if delivered personally or sent by express courier service.All notices to City shall include a reference to the Project title. All notices will be sent to the other Party at its address as set forth below or at such other address as such Party will have specified in a notice given in accordance with this section: Grantee: Roberto Del Hoyo 4015 W. 22nd Pl. Santa Ana, CA 90018 City: City of Santa Ana City Clerk (M-30) 20 Civic Center Plaza P.O. Box 1988 Santa Ana, CA 92702 FAX (714) 647-6956 8.7. This Agreement is subject to all applicable local, State and Federal laws. 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. 8.8. Grantee agrees to comply with all applicable equal opportunity and affirmative action laws as appropriate, Grantee shall not discriminate because of race, color, religion, sex, gender identity, gender expression, marital status, sexual orientation, age, national origin, ancestry, medical condition, military or veteran status, genetic information, request for family care leave, request for leave for an employee's own serious health condition, request for pregnancy disability leave, disability, or otherwise as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Grantee affirms that it is an equal opportunity employer(if applicable)and shall comply with all applicable federal, state and local laws and regulations. 8.9. Any funds provided under this Agreement that are not expended, obligated or otherwise committed by the termination or expiration of this Agreement shall be immediately returned to City. 8.10. Grantee grants to City a non-exclusive, irrevocable, transferable, royalty free, worldwide license to use, reproduce, display, distribute, and prepare derivative works, in any form or media at the discretion of the City for the restoration Project conceived, performed or created as a result of this Agreement. 7 8.11.Grantee and any of the Grantee's agents, employees or representatives are,for all purposes under this Agreement, an independent contractor and shall not be deemed to be an employee of the City, and none of them shall be entitled to any benefits to which City employees are entitled including but not limited to, overtime, retirement benefits, work's compensation benefits, injury leave or other leave benefits. 8.12. Neither Party shall assign any rights or obligations under this Agreement. 8.13. Each Party 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. 8.14. Each Party warrants that they have executed this Agreement knowingly, freely and voluntarily and with full knowledge of its legal consequences. All Parties involved warrant and represent that, prior to executing this Agreement, each Party has had the opportunity to review and consider this matter with legal counsel, and that the terms of this Agreement, and its consequences, are fully understood by each Party. 8.15. This Agreement represents the entire agreement and understanding between the Parties, and supersedes any and all prior agreements and understandings between the Parties, whether oral or written. 8.16. Each undersigned represents and warrants that its signature herein below 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. {Signatures on following page} 8 IN WITNESS WHEREOF, the Parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA ,n1 �E-L�Nd1F HAL LVARO NUNEZ City Clerk ^" T City Manager APPROVED AS TO FORM: GRANTEE: SOMA R. CARVALHO City Attorney i By: Andrea Garcia-Miller Name: Roberto Del Hoyo Assistant City Attorney RECOMMENDED FOR APPROVAL: MICHAEL L. GARCIA Executive Director Community Development Agency S c 9 c s EXHIBIT A RESTORART: MURAL RESTORATION AND CONSERVATION PROGRAM PROPOSAL 10 ® DATE(MMIDDfYYYY)AC� CERTIFICATE OF LIABILITY INSURANCE 2;10;2026 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 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 endorsement(s). PRODUCER NAME: Tiffanie Rodriguez Stuttgart Insurance Solutions PHONE 88R R85-6145 FA AIC,No Ext: } (AIC,No): 31878 Del Obispo St. ADDRESS: Tiffanie custtlttgartinssrincesolutions.com Suite 1 18-513 INSURER(S)AFFORDING COVERAGE NAIL# San Juan Capistrano CA 92675 INSURER A: STATE NATO,INS CO INC 12831 INSURED INSURER B Ruberto Del Hoyo INSURER C: 4015 W 22ND Pl- INSURER D: INSURER E: LOS.ANGELES CA 90018-I029 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 CONTRACTOR 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 POLICY EFF POLICY LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMJDDIYYYY) (MMIDDIYYYY) LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0o0 CLAIMS-MADE F_x1 OCCUR PREMISES(Ea occurrence) $ 1 O(L000 MED EXP(Any one person) $ 5.000 A Y Y NXTHH7CWYK-00-GL 0723r2025 07/23/2026 PERSONAL B ADV INJURY $ 1,000po GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO LOC PRODUCTS-COMPJOP AGG S 27000,000 OTHER $ AUTOMOBILE LIABILITY (Ea accident) S ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED $ AUTOS ONLY AUTOS ONLY (Per accident) 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION - AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRiETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required) APPROVED By Tu Tran Nguyen at 3:27 pm,May 11,202t5 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana Attir.Executive(cont.in ACOR)101) ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa.Ana CA 92701 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Auto Insurance Declarations Page W Toggles A Farmers'Company Policy Number Named Insured(s) Premiums/Fees TCXGZW3JNV Gabriela Enriquez Full Term Policy Premium $3,231.00 Policy Period Roberto Del Hoyo From 01/30/2026 12:01 AM 0000000000 Fees* $2.64 To 07/30/2026 12:01AM gxenriquez@yahoo.com 4015 W 22ND PL Total** $3,233.64 Underwritten By 21st Century Casualty Company APPROVED3 Beaver Valley Road ry Tu Tran Nguyen at 3.27 pm,May 19,2021 Wilmington, DE 19803 See Information on Additional Fees below For questions, please call 1-855-864-1530 *'See your billing statement for installment amount(s) or go to www.gettoggle.com Household Driver and Resident Information Are there persons 15 years of age or older not listed below who reside in your household(even if temporarily away from home),or who are guests staying in your home in excess of 90 days, or who regularly operate your vehicle(s) listed below more than 30 days per year? If so, please contact us or update your policy in the self-service portal to add these drivers to your policy. Name Years Licensed Driver Status Name Years Licensed Driver Status Gabriela Enriquez 32 Covered Roberto Del Hoyo 32 Covered Driver History Operator Claim Citation Date Roberto Del Hoyo At Fault Accident -- 12/04/2024 Discounts Discount Type Applies to Vehicle(s) Discount Type Applies to Vehicle(s) Affinity Discount 3,2,1 Good Driver Discount 3,2 Superior Driver Discount 3 Multi-Car Discount 3,2,1 Information is effective 12/15/2025 04:13 PM TOG-AUT-CA03 5-24 TA gettoggle.com Page 1 AGENCY CUSTOMER ID: _ LOC#: `4��D,® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED Stuttgart Insurance Solutions Roberto Del Hoyo POLICY NUMBER NXTHH7CWYK-00-GL CARRIER NAIC CODE STATE NAIL INS CO INC 12831 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance —Certificate Holder Name: City of Santa Ana Attn: Executive Director,Community Development Agency ACORD 101 (2008/01) OO 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: NXTHH7CWYK-00-GL 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 PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement 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 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 Risk Management a division of Human Resources Managing Risk through Awareness and Action Zo AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE 1, D-QA0 �� VA () ("Representative"),attest that I am an authorized (Name and Title of Vendor Representative) representative of ("Company"),and (Consultant/Company Name) possess the authority to legally bind Company. In my capacity as Representative of Company,I represent and confirm the following,as relates to the agreement between Company and City of SantaAna,agreement number ("Agreement")to provide J`�y tr u.t-r4� , � �v��o. PC, A—Services"): (Services to be provided under agreement/contract) During the course and scope of Company's agreement with the City of Santa Ana,Company will not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if Company should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,Company shall forthwith comply with the provisions and provide proof of workers' compensation coverage immediately. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum professional liability insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. Signature (�- Date Print Nam Title kJOA 'D 1� e qu,4cd-, Cont Informatsan,i.e.,Telephone Number andlor Email Address WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANT DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND ATTORNEY'S FEES. Risk Management a division of Human Resources RWCVk IL Managing Risk through Awareness and Action VW AFFIDAVIT OF EXEMPTION FOR AUTOMOBILE LIABILITY INSURANCE ("Representative"),attest that I am an authorized (Name and Title of Vendor Representative) representative of ("Company"),and (Consultan(/Company Name) possess the authority to legally bind Company. In my capacity as Representative of Company, I represent and confirm the following,as relates to the agreement between Company and City of Santa Ana,agreement number ("Agreement")to provide -G al� �--(5,A%JQF O( 1 Q a-r-�<Vk`` raa- ("Services")- (Services to be provided under agrcementicontract) During the course and scope of Company's agreement with the City of Santa Ana, Company employees,consultants,representatives,and agents will not use and/or drive any Company owned/rented/leased/borrowed vehicles to perform Services to,for,or on behalf of City of Santa Ana. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum automobile liability insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. 6j2 '--2 1f 2-XS Signature ate Print Name Title 404 616 ( 0 Contact Informaiio ,i.e.,Telephone Number and/or Email ddress Afria%rit of Fvn.enri—r:.,..n,......,..s.a..,:—,:...:--•----- 1,. t a IMA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 05 POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE NXTHH7CWYK-00-GL 03/20/2026 State National Insurance Company, Inc. NAMED INSURED AUTHORIZED REPRESENTATIVE Roberta Del Hoyo 4015 W 22nd Pf Los Angeles,CA 90018 Ann Ryan COVERAGE PARTS AFFECTED Commercial General Liability Coverage Part CHANGES SEE ATTACHED SCHEDULE Return Total $0.00 Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 2 � Copyright, ISO Commercial Risk Services, Inc., 1983 SCHEDULE OF POLICY CHANGES It is understood and agreed that: The following forms are added: NXT-0084 BM GL 0218-Designated Additional Insured-Primary Insurance CG 20 37 04 13-Additional Insured-Owners, Lessees or Contractors-Completed Operations All other terms and conditions remain unchanged. IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 2 of 2 ❑ Copyright, ISO Commercial Risk Services, Inc., 1983 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ADDITIONAL INSURED - PRIMARY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person or Organization: City of Santa Ana, its City Council,officers,officials,employees,agents,and volunteers 20 Civic Center Plz Santa Ana, CA 92701 I. SECTION II -WHO IS AN INSURED is amended to include the person or organization shown in the SCHEDULE, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf.- 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. II. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III— LIMITS OF INSURANCE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. III. Coverage provided to the additional insured shown in the SCHEDULE is afforded on i) a primary basis, ii) a noncontributory basis, or iii) a primary and noncontributory basis in accordance with the applicable written contract between you and the additional insured. All other terms and conditions of the policy remain unchanged. NEXT-0084 BM GL 0218 Includes material copyrighted by Insurance Services Office, Inc. used with its Page 1 of 1 permission POLICY NUMBER: NXTHH7CWYK-00-GL COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City of Santa Ana, its City Council,officers,officials, Fine Artists,Including Painters,Sculptors,and Illustrators employees,agents,and volunteers services in CA 20 Civic Center Piz Santa Ana,CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we "Your work" a# the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 Auto Insurance Declarations Page M Toggle® A Farmers'Company Vehicle Information Veh.# Year/Make/Model/VIN Garaging Zip Lienholder Additional Interest 2004 JEEP LIBERTY/ 1 1J4GK58K44W176008 90016 2012 TOYOTA TACOMA PU DBL CAB SH/ � 2 90018 3TMJU4GN5CM137177 2022 VOLKSWAGEN ATLAS CROSS SPORT/ CALIFORNIA CREDIT UNION 3 1V2SE2CAXNC209809 90018 PO BOX 5131 LAKE FOREST, CA 92609 Veh. # Use Mileage 1 Pleasure 8,000 2 Commute 12,000 3 Commute 12,000 TOG-AUT-CA03 5-24 TA gettoggle.com Page 2 Auto Insurance Declarations Page W Toggles A Farmers`Company Coverage Information Coverage only applies to vehicles showing premium or'Included' Premiums by Vehicle Coverage Limits #1 #2 #3 Protect Your Assets Bodily Injury $30,000 each person Liability $60,000 each accident $281 $343 $205 Property Damage Liability $15,000 each accident $157 $224 $144 Protect Your Vehicle $500 $500 Comprehensive Actual Cash Value Less Deductible - Ded Ded $155 $492 $500 $500 Collision Actual Cash Value Less Deductible - Ded Ded $373 $847 Uninsured Motorist Property Damage with Actual Cash Value - $5 $5 Collision Uninsured Motorist Property Damage $3,500 each accident - - - Roadside Assistance $75 each disablement Included Included Included Rental Reimbursement - - - Limit is$1,000 unless another limit is Additional Equipment specified - Included Included Original Parts Replacement No Coverage - - - Protect You &Your Loved Ones Medical Payments No Coverage - - - Uninsured Motorist No Coverage - - - Bodily Injury Total Premium Per Vehicle $438 $1,100 $1,693 Policy and Endorsements This section lists the policy form number and any applicable endorsements that make up your insurance contract:TOG-AUT- CA00 1-22 TA;TOG-AUT-CA54 1-22 TA;TOG-AUT-CA60 1-22 TA;TOG-AUT-CA62 1-22 TA;TOG-AUT-CA50 1-22 TA Information on Additional Fees The"Fees"stated in the"Premium/Fees"section on the front apply on a per-policy, not an account basis.Your policy may include a fraud assessment fee of$0.88 per vehicle per six months and may be subject to a $5.00 late fee if your premium payment is not received on time.The following fee(s) may also apply: $50 cancellation fee, $4 installment plan fee, $10 returned payment fee. Fees may be deemed a part of the premium under applicable state law. TOG-AUT-CA03 5-24 TA gettoggle.com Page 3 Important Information About Your Policy The Compan Offers Existing Policyholders and New Applicants the Following Substantial Premium Redyuctions. GOOD DRIVER DISCOUNT (GDD) Uninsured/Underinsured Motorist and UMPD Available to drivers who have been $3,500 coverage premiums for the insured continuously licensed for the most recent vehicle principally operated by the certificate three-year period; have incurred no more than holder. Proof of course completion is required. one minor traffic conviction or one non-injury at-fault accident in the past three years; and AFFINITY GROUP DISCOUNT (GD) have had no major violation in the past ten Available to qualifying members of certain years. The Good Driver rate is at least a 20% occupation/affinity groups including: degreed discount from the Non-Good Driver rate. or licensed engineers; degreed scientists; licensed educators/educational administrators; SUPERIOR DRIVER DISCOUNT (SD4/SDS) licensed architects; certified public Available to drivers who have been accountants, degreed computer professionals; continuously licensed for the most recent four licensed dentists; licensed pharmacists; (SD4) or five (SD5) year period; have incurred licensed medical doctors/ no minor traffic convictions in the past three surgeons/veterinarians; employees of qualified years; have incurred no major violations in the companies; degreed finance/banking past ten years; and have not incurred a professionals; admin/management principally at-fault accident in the past four professionals; human resources managers; (SD4) or five (SD5) year period. degreed artists/writers; sales/marketing executives/managers; government/public MULTI-CAR DISCOUNT (MCD) employees (admin/technical); degreed health Available when 21st Century Insurance care/services professionals; licensed provides liability coverage for two or more inspectors; licensed insurance/language/real vehicles owned by the policyholder and/or estate professionals; licensed attorneys; law relatives residing in the same household. This enforcement officers; The reduction to your discount also applies if the policyholder is the premium will vary depending on program and co-registered owner of two or more vehicles coverage. Documentation may be required to garaged in the same household. Vehicles support program eligibility. insured for only Comprehensive and/or Collision do not qualify for this discount. The AUTOMOBILE ANTI THEFT DEVICE reduction to your premium will vary depending DISCOUNT (ATD) on the other individual rating factors used to A 15% discount is applied to the determine your premium. Comprehensive coverage premium when a vehicle is equipped with an approved theft MATURE DRIVER DISCOUNT (MDD) recovery device enabled with GPS tracking Available when the principal operator of an capabilities. For a list of approved systems, insured automobile is age 50 or older, has please contact us. successfully completed a Mature Driver Improvement Course approved by the MIXED POLICY RATING DISCOUNT (MXP) California DMV during the preceding three Available when there is one or more Good years and has had no chargeable at-fault Driver(s) and one or more Non-Good Driver(s) accidents or traffic convictions in the past three listed on the policy, and one or more of years. This discount results in a two percent these listed drivers has been continuously rated reduction in the Bodily Injury, Property as a Good Driver with the Company for the Damage, Medical Payments, previous 36 months. TOG-AUT-CA57 1-22 TA gettoggle.cam Page 4 GOOD STUDENT DISCOUNT-AUTOMOBILE or more) accident or been convicted of a POLICIES ONLY (GSD) moving violation or convicted of a traffic A Good Student Discount of 15% for females related offense involving alcohol or and 15% for males, applies to premiums for narcotics and Bodily Injury, Property Damage, Medical 4) has a Good Student Certification with an Payments, Uninsured Motorists, Underinsured official school stamp, signed and dated by a Motorists, Comprehensive, Collision and school administrator for the preceding UMPD $3,500 coverage applicable to the school semester or quarter verifying that insured vehicle provided the rated operator: the student qualifies as one of the 1) is at least 16 years of age, has less than following: named on the Honor Roll, or nine years of driving experience, single Dean's List or had a "B" (3.0) or better marital status and grade point average, or was in the top 20% 2) is a full time high school, college or of their class or university student (at least 12 units), or a 5) has graduated from a four-year college graduate student (with at least B units) and or university having maintained the 3) during the most recent three years has not qualifications listed in item #4 during the been involved in a principally at-fault (51% last two years of their schooling. TOG—AJT—CA57 1-22 TA gettoggle.com Page 5 AUTO BODY REPAIR CONSUMER BILL OF RIGHTS A CONSUMER IS ENTITLED TO: 1. SELECT THE AUTO BODY REPAIR SHOP TO REPAIR AUTO BODY DAMAGE COVERED BY THE INSURANCE COMPANY. AN INSURANCE COMPANY SHALL NOT REQUIRE THE REPAIRS TO BE DONE AT A SPECIFIC AUTO BODY REPAIR SHOP. 2. AN ITEMIZED WRITTEN ESTIMATE FOR AUTO BODY REPAIRS AND, UPON COMPLETION OF REPAIRS, A DETAILED INVOICE. THE ESTIMATE AND THE INVOICE MUST INCLUDE AN ITEMIZED LIST OF PARTS AND LABOR ALONG WITH THE TOTAL PRICE FOR THE WORK PERFORMED. THE ESTIMATE AND INVOICE MUST ALSO IDENTIFY ALL PARTS AS NEW, USED, AFTERMARKET, RECONDITIONED, OR REBUILT. 3. BE INFORMED ABOUT COVERAGE FOR TOWING AND STORAGE SERVICES. 4. BE INFORMED ABOUT THE EXTENT OF COVERAGE, IF ANY, FOR A REPLACEMENT RENTAL VEHICLE WHILE A DAMAGED VEHICLE IS BEING REPAIRED.. 5. BE INFORMED OF WHERE TO REPORT SUSPECTED FRAUD OR OTHER COMPLAINTS AND CONCERNS ABOUT AUTO BODY REPAIRS. 6. SEEK AND OBTAIN AN INDEPENDENT REPAIR ESTIMATE DIRECTLY FROM A REGISTERED AUTO BODY REPAIR SHOP FOR REPAIR OF A DAMAGED VEHICLE, EVEN WHEN PURSUING AN INSURANCE CLAIM FOR REPAIR OF THE VEHICLE. COMPLAINTS WITHIN THE JURISDICTION OF THE BUREAU OF AUTOMOTIVE REPAIR Complaints concerning the repair of a vehicle by an auto body repair shop should be directed to: Toll Free (866) 799-3811 Bureau of Automotive Repair 10949 North Mather Blvd. Rancho Cordova, CA 95670 The Bureau of Automotive Repair can also accept complaints over its website at: www.autorepair.ca.gov COMPLAINTS WITHIN THE JURISDICTION OF THE CALIFORNIA INSURANCE COMMISSIONER Any concerns regarding how an auto insurance claim is being handled should be submitted to the California Department of Insurance at: (800) 927-4357 or (213) 897-8921 California Department of Insurance Consumer Services Division 300 South Spring Street Los Angeles, CA 90013 The California Department of Insurance can also accept complaints over its website at: www.insurance.ca.gov ROR—CA(1215)TA gettoggle.com Page 6 EXPLANATION OF RATING PLAN Underwritten by 21st Century Casualty Company California law requires that we explain how traffic violation convictions and chargeable accidents can affect your insurance premium. SAFETY RECORD NOTICE Your Safety Record is one factor which determines your premium using the number of minor violations, major violations and principally at-fault accidents (>=51%) which occurred during the three years immediately preceding the effective date or renewal date of the policy. • Accident(s) on or after December 11, 2011: An accident is chargeable if the driver is determined to be at least 51% of the legal cause and for which either the accident resulted in bodily injury or death or the total loss or damage for Property Damage liability and/or Collision coverage exceeds $1000. • Accident(s) prior to December 11, 2011: An accident is chargeable if the driver is determined to beat least 51%of the proximate cause and for which a payment is made that exceeds $750 for a bodily injury liability coverage, or there is a death, or $1000 for property damage liability or collision coverage. In order to verify the driving record used to determine an individual's safety record points, the named insured must provide acceptable verification of the accident driving record for the prior three years for all operators rated on the policy. TOG-AUT-CA61 1-22 TA gettoggle.com Page 7 Policy Notices Attention California Policyholders California insureds may make a written request to their termination, expiration, nonrenewal or cancellation of insurer to designate one person, in addition to the your policy, in addition to you, please go to policyholder, to receive notice of lapse, termination, gettoggle.com and provide the following designee's expiration, nonrenewal, or cancellation of a policy for information: nonpayment of premium. If a notice of lapse, Designee name termination, expiration, nonrenewal, or cancellation of Email Address a policy for nonpayment of premium is sent to the Street Address, City, State and Zip named insured, the person designated by the named insured will also receive a copy of that notice. If we do not receive this information within thirty (30) If you want to name a third-party as the designee to days, we will assume you have declined to exercise the receive copies of notices of lapse, option to have a designee receive these notices. Renewal Mileage Notice The state of California requires that insurance If you were sent a request for updated odometer companies provide you with the annual mileage used information and you did not respond, the annual mileage for rating your current policy and the annual mileage for your vehicle(s) may be increased to the lesser of up to that will be used to rate your upcoming policy three mileage bands or the mileage default of 12,000. renewal. The use of this default may have impacted your renewal premium. Annual mileage is an estimate based on odometer information from third party sources or provided Please take note of the following Prior and Renewal directly from you. If there is a difference between the Annual mileage figures below. These are the miles used Prior Annual Mileage and the Renewal Annual Mileage in the rating of your policy. listed below, you may see a change in your renewal premium. PRIOR RENEWAL ANNUAL ANNUAL Year/Make/Model VIN MILEAGE MILEAGE 2004 JEEP LIBERTY 1J4GK58K44W176008 5000 8000 2012 TOYOTA TACOMA PU DSL CAB SH 3TMJU4GN5CM137177 12000 12000 2022 VOLKSWAGEN ATLAS CROSS SPORT 1V2SE2CAXNC209809 12000 12000 If the updated Renewal Annual Mileage shown above is an accurate reflection of the estimated annual mileage that you expect each vehicle to be driven over the next year, no further action is needed. If you need to correct the annual mileage information or if your mileage has changed, please contact us or visit gettoggle.com . TOG-AUT-CA58 1-22 TA gettoggle.com Page 8