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HomeMy WebLinkAboutSTEVENS, ROBERT W. A-2026-085-04 Q01i05[z02e 6 U YY 2 5 7026, FACILITY USE AGREEMENT WITH ROBERT W. STEVENS FOR USE OF RIVER VIEW GOLF COURSE THIS FACILITY USE AGREEMENT is made and entered into on June 10, 2026, by and between Robert W. Stevens ("User"), and 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"). City and User may be collectively referred to as the"Parties"or individually as a"Party". E RECITALS A. The User has a need for a venue to conduct golf instruction and/or lessons. B. The City acknowledges the community need for programs such as those offered by User that expand competitive, and non-competitive athletic opportunities within the City of Santa Ana, C. The Parties have entered into this Agreement for the purpose of setting forth the terms and conditions for the User to use designated areas at the River View Golf Course for the administration of golf instruction and/or lessons. The parties agree as follows: 1. GRANT OF PERMISSION AND FACILITIES TO BE USED City hereby grants User the limited,non-exclusive right to utilize designated areas of River View Golf Course("Facilities") to provide golf instruction and/or lessons pursuant to the Scope of Use set forth in Exhibit A, attached hereto and incorporated herein by reference. 2. COMPENSATION For the use of the Facilities described in Section 1 of this Agreement, User shall pay City fees as described in Exhibit A. 3. TERM The term of this Agreement shall begin on July 1, 2026 and terminate on June 30, 2027, unless terminated pursuant to the terms of this Agreement. 4, COMPLIANCE WITH RULES AND REGULATIONS User shall use and occupy the Facilities in a safe and careful manner and shall comply with all applicable local, state, and federal laws in its use of and activities in the Facilities,including as to the conduct of its employees, agents, clients, customers, guests, and others using the Facilities by reason of this Agreement.User shall also comply with all rules and regulations of City in effect during its use of the Facilities. Failure to abide by such laws,rules, or regulations,or any condition Page 1 of 5 of this Agreement,may result in the immediate termination of this Agreement in the sole discretion of the City. 5. BACKGROUND CHECKS User shall ensure that all employees, subcontractors, and any volunteers are fingerprinted and background checked prior to conducting,any work pursuant to this Agreement.User shall not assign any employee, agent, subcontractor, volunteer or the User personally to provide services pursuant to this Agreement, if that employee, agent, subcontractor, volunteer, or the User personally are required to register as a sex offender under California Penal Code Section 290 ct sect,haven.conviction for any crime of moral turpitude,have a conviction for a sexual based crime, have a conviction for a violent felony as defined in California Penal Code Section 667.5(e),or has ' a conviction for a serious felony as defined in California Penal Code Section 1192.7(c). Disqualifying convictions include but are not limited to, violations of California Penal Code Sections 37, 128,136.1 with Section 186.22,187,190-190.4 and 192(a),205,206,207-209.5.,211, 212, 212.5, 213, 214, 215, 218-219, 220, 236.1(b) or 236.1(c), 243.4, 261, 261.5, 273.5, 2621 264.1,266, 266c,266h, 266i, 266j,267,269, 272, 273a,273ab,273d,285, 286,288, 288a,288.2, 288.3,288.4,288.5,288.7,289,290,311.1,311.2,311:3, 311.4,311.10,3.11.11,314,347(a),368, 417(b), 451(a),518 with 186.22, 647.6, 653f(c), 664 and 187, 667.5(c), -18745, 18750, or 18755, 12022,53, 11418(b)(1) or(b)(2); Business and Professions Code Section 729.' 6. INDEMNIFICATION User agrees to and shall indemnify, protect, defend, and hold harmless City, its officers, agents, employees, consultants, special counsel, and representatives from and against any and all claims, damages,judgments, attorney's fees, costs and expenses arising out of, involving, or in connection with the use of the Facilities or the acts or omissions of User, its officers, agents, employees, volunteers, guests, or invitees, whether or not such acts or omissions constitute permitted uses of the Facilities. 7. INSURANCE Insurance requirements are attached hereto and incorporated herein as Exhibit B. W. CONFLICT OF INTEREST CLAUSE. User 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 udder this Agreement. 9. FORCE MA.IUERE In the event that the Facilities are rendered unavailable due to destruction,partial or total, acts of nature, work stoppages or other labor disturbances, civil commotion, war, or any other Page 2 of 5 action by governmental agencies, or for any reason beyond the control of City,City shall have the right to terminate this Agreement without penalty. 10. LICENSES AND PERMITS User represents and warrants that it, and any agents, independent contractors, subcontractors,vendors,or others acting on its behalf under or with respect to this Agreement,will at all times.during the term of this Agreement have and maintain in force any and all licenses, permits,or approvals required by law for the conduct of User's activities under this Agreement. I 11. DAMAGE TO FACILITIES User shall be liable for any damage to the Facilities caused by any act of negligence of User, its partners, agents, servants, contractors, representatives, guests, employees, invitees, or customers. City may, at its option,repair such damage, and User agrees to reimburse City for the total cost of repair. 12. PROPERTY BELONGING TO USER City shall not be responsible for lost, stolen, or damages property belonging to User, its partners, agents, servants, contractors, representatives, guests,employees,invitees,or customers. 13. NOTICE Any notice,tender,demand, delivery,or other communication pursuant to this Agreement shall be in writing and directed to the addresses below or such addresses as either party may later specify in writing.Notice is deemed effective on the date it is given if hand-delivered or received by facsimile that day. Notice given by U.S. mail shall be deemed to have been given three (3) business days after it is deposited in the U.S.mail,postage prepaid and addressed as follows: To City: City Clerk City of Santa Ana 20 Civic Center Plaza(M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 With copies to: Executive Director of Parks, Recreation.and Community Services City of Santa Ana 20 Civic Center Plaza(M-23) t P.O.Box 1988 , Santa Ana, California 92702 ; Page 3 of 5 i To User: Robert W. Stevens 45 Augusta Irvine, CA 92620 LsteLveiispgti@iiisn.com 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and Exclusive statement between the City and User regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties regarding the use of the Facilities. In the event of a conflict between the terms of this Agreement and any attachments hereto, the torms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of User. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof,shall not bind or obligate User or the City.Each Marty to this Agreement acknowledges that no representations, inducements,promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 15. ASSIGNMENT User may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of'the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void, User shall not allow any other person or entity to use the Facilities without the prior written consent of City. 16. TERNIINATIUN This Agreement may be terminated by the City upon thirty(30) days written notice. 17. NONDISCRIMINATION User shall not discriminate because of race,color,creed,religion,sex,marital status,sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status,age,national origin,ancestry,or disability,as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this Agreement. User affirm that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 18. JURISDICTION -VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, perf'ortnance, 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 Page 4 of 5 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, 19. AUTHORITY The person(s) executing this Agreement on behalf of the Parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said Parties and that by so executing this Agreement, the Parties hereto are formally bound to the provisions of this Agreement. IN WITNESS WHEREOF, the Parties hereto have executed this Agreement the date and year first above written. AT; EST CITY F SANTA A r Jr e fe L. aL Alvaro Nunez I, ,. Ci ,erk City Manager APPROVED AS TO FORM: SONIA R. CARVALHO USER: E F City Attorney Robert VV.Stevens(May 28,2C26 15 32 19 PDT) Jonathan T. Martine By: Robert Stevens Assistant City Attorney Title:Golf Instructor RE MMENDED ' VAL: H k Seo Executiv ector o ar s, Recreation and Community Services Agency Page 5 of 5 I EXHIBIT A SCOPE OF SERVICES l Scope of Services 1. DESCRIPTION OF USE Robert W. Stevens C User", "Robert W. Stevens") is an individual focused on developing and providing advanced golf performance training. Robert W. Stevens may conduct the following„activities at designated areas within permitted City of Santa Ana Facilities: a. Small Group Golf Lessons, Camps and Programs A structured golf program offering participants the opportunity to develop and refine golf skills through structured practices.Participants will receive coaching focused on technique,physical conditioning, and sportsmanship,while fostering personal growth,discipline,and goal-setting. b. Private Golf Lessons 'Phis program will provide private,perfornance-focused instruction for up,intended to support golfers in achieving higher levels of technical proficiency and competitive readiness through customized coaching. 2. FACILITIES User is permitted to operate the programming outlined in this Agreement at the following City of Santa Ana Facilities ("Facilities"): a. River`view Golf Course 1800 W. Santa Clara Ave. Santa Ana, CA 92706 User shall use the Facilities solely for the purposes outlined in this Agreement and for.no other purpose without the City's prior written consent.User shall not access or use the Facilities unless a City-authorized representative or designee is present.Assigned days,times, and designated areas are subject to modification during the period of this Agreement if required for City programs, maintenance, special events, or other operational needs, as determined by the City or assigned designee in its sole discretion. User shall comply with all applicable federal, state, and local Iaws, regulations, codes, and ordinances.User shall further comply with all directives issued by City of Santa Ana personnel or assigned designee, and applicable golf rules as may be promulgated from time to time by the City or assigned designee. User hereby acknowledges receipt of and agrees to comply with all current golf rules. The City reserves the right to relocate, reschedule,or suspend User's use if the scheduled Facility becomes inoperable, unsafe, or otherwise unavailable due to maintenance, emergency conditions, or operational necessity, as determined by the City or assigned designee. 3. TERMS OF USE For a period of one (1) year, commencing July 1, 2026 and terminating June 30, 2027 ("Term"), Putting for Eagle may conduct golf programming during dates, times, and locations assigned weekly by City'.s assigned designee managing day-to-day golf course operations. Beginning July 1,2026,User shall be provided with City-designated driving range stations at River View Golf Course during operating hours as assigned by City's assigned designee. Requests for space allocations shall be made to City's assigned designee prior to use.User shall be responsible for managing participant attendance and submit attendance reports to City's assigned designee monthly. The City and its' assigned designee reserve the right to require adjustments to the schedule, staffing, or facility use based on the anticipated attendance. User shall provide C#y's assigned designee with written notice 30 days in advance of all group lessons and golf camps. All participants,shall execute the City of Santa Ana class waiver prior to facility entry.Participants under the age of eighteen (18) must have the waiver executed by a parent or legal guardian. Executed waivers shall be collected by User, submitted to City's assigned designee, and remain valid and on file for the duration of the Term. User shall be responsible for managing participant and spectator conduct. Spectators, including parents and guardians,shall remain in designated viewing areas and shall not be permitted unless authorized by City's assigned designee. i User shall not sell, distribute, or otherwise provide for compensation any food, beverages, concessions, merchandise, or promotional items at the Facilities without prior written approval from the City's assigned designee. i This prohibition shall include,but not be limited to; sales conducted by User's employees, agents, representatives,volunteers,participants,parents, or affiliated organizations. User shall not permit any third party to conduct sales,fundraising, or commercial activity at the Facilities in connection with User's programming without prior written approval from the City's assigned designee. 4. PERSONNEL 'User shall provide qualified, certified golf coaches for all golf activities conducted at City of Santa Ana facilities. User shall be solely responsible for the supervision, conduct, and control of its employees, agents,representatives,volunteers,and participants at all times. User shall not permit any third party, independent contractor;parent,or participant to provide golf instruction or conduct golf programming at the Facilities without prior written approval from the .City. User shall not sublicense,assign,or otherwise permit third parties to utilize the Facilities for aquatic programming under this Agreement without prior written approval by the City. ! User shall ensure that all employees,agents,and representatives who work with or are in proximity f to minors have;successfiilly completed background screening and any other required certifications in compliance with applicable federal,state,and local requirements. User represents and warrants that such personnel are legally eligible and suitable to work with:minors. User shall ensure that no User personnel engage in one-on-one supervision of a minor in locker rooms, restroonns, or other private areas at the Facilities, User shall maintain appropriate supervision of participants at all times in all areas of the Facility,including locker rooms,spectator areas, and pool deck spaces. User shall be responsible for any injuries, losses, or damages arising out of or related to golf programming activities except to the extent caused by sole negligence or willful misconduct of the City. City's assigned designee shall conduct facility opening and closing procedures, and maintain required maintenance levels and ensure compliance with applicable health and safety regulations. � The City reserves the right to immediately suspend golf activities due to weather conditions, air quality concerns,mechanical failure, contamination events, or any other condition deemed unsafe for continued use, as determined by the City in its sole discretion. 5. EQUIPMENT i User shall be solely responsible for providing and maintaining all golf lesson related equipment, including. Storage of User equipment at the Facilities may be requested in writing and shall be f subject to prior written approval by the City's assigned designee. Approval, if granted, may be revoked at the City's discretion. Any equipment stored at City Facilities must be well-maintained and kept orderly. i User may display program-related signage at the Facilities only with the City's assigned designee prior written approval. All proposed banners shall be either jointly produced in coordination with the City in accordance with the City's style guide standards or submitted by User for review and approval prior to installation. User shall be solely responsible for all costs associated with the design,production, and installation of approved banners or signage. Approved banners shall be limited to designated display areas as determined by the City's assigned designee and shall comply with all size, content, placement, and- installation requirements established by the City's assigned designee.All banners and signage shall be installed and removed in a manner that does not damage City property.User shall be responsible for any damage resulting from the installation,display,or removal of such materials. The City's assigned designee reserves the right to require the removal of any banner or signage at any time,in its sole discretion. User shall promptly notify the City's assigned designee, of any building or facility issues, including damage,vandalism, or theft. 6. PAYMENT The User shalt pay a base fee of Five Hundred Dollars ($500.00) per month for the use of the Facility,for a total annual base fee of Six Thousand Dollars($6,000) during the Term,. The City shall issue invoices for all assessed fees on a monthly basis(or other agreed billing cycle). Late payments may be subject to penalties or interest as permitted by law. 7. NO EXCLUSIVE RIGHTS Nothing in this Agreement shall be construed to grant User any exclusive rights to use the Facilities or any portion thereof. The City's assigned designee reserves the right to schedule, operate, and permit the use of the Facilities by other individuals, organizations, or programs at any time, including during the Term of this Agremnent. User acknowledges that its use of the Facilities is non-exclusive and subordinate to City programs, maintenance activities, special events, or other operational needs, as determined by the City in its sole discretion. Nothing in this Agreement shall be interpreted to create any priority scheduling rights, continued use rights, or expectation of renewal beyond the Term stated herein. i f I I C 1 I EXHIBIT B INSURANCE REQUIREMENTS E `EEY E1 1 4 I I 1 Insurance Requirements User shall procure and maintain for the duration of the agreement,the following insurance coverages: MINIMUM SCOPE AND LIMIT OF INSURANCE User 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. • Sexual Abuse or Molestation Liability (SAME): If the CGL policy referenced above is not endorsed to include affirmative coverage for sexual abuse or molestation, User shall obtain and maintain a policy covering Sexual Abuse and Molestation with a limit of no less than$1,000,000 per occurrence or claim. • Automobile Liability(AL): Insurance Services Office Form CA 00 01 covering Code I (any auto),with combined single limits of$1,000,000.In the event User does not maintain commercial automobile liability insurance,City will accept evidence of personal automobile insurance, provided that such policy is endorsed for business use and provides coverage with a minimum Limit of$1,000,000.Required policy limits can be met with primary and umbrella/excess insurance policies. • Workers' Compensation (WC): 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 accident, per employee, per policy for bodily injury or disease.This requirement can be waived if User has no employees. User attests that its workers' compensation coverage extends to all persons who will be working with the City under the agreed scope of services. If User 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 User. Any available insurance proceeds iri 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, SAML and AT,policies: City of Santa Ana,its City Council,its officers,officials, E employees, agents, and volunteers are to be covered as additional insureds with respect to t liability arising out of work or operations performed by or on behalf of the User including materials,parts, equipment,and personnel furnished in connection with such work or operations. 2. CGL, AL, and WC policies: Insurance company(ies)agrees to waive all rights of subrogation against City,its City Council,its officers, officials,employees,agents,and volunteers for losses paid under the terns of any policy which arisa from work performed by User for City. t I k 3. All required insurance policies:For any claims related to this contract,User'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 User'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 iasurauce 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 notice-shall be provided to City for policy cancellation or noa-renewal due to non,-payment. 6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: Parks,Recreations,and Community Services Agency;20 Civic Center Plaza M- 23, Santa Ana, CA 92701.The name and the 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 User 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:Vll,unless otherwise acceptable to City. Verification of Coverage User shall furnish City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy.Iisting all policy endorsements to Entity before work begins.However, failure to obtain the required documents prior to the work beginning shall not waive User'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,User must purchase"extended reporting" coverage for a minimum of three(3)years after completion of work. Subcontractors User shall require and verify that all sub-contractors maintain insurance meeting all the requirements stated herein; and User 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 an the nature of the risk, prior experience, insurer, coverage, or other special circumstances, i I 1 i 1 TE J AC R" CERTIFICATE OF LIABILITY INSURANCE DA 4f(141202ti YI 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 endorsemertt(s). PRODUCER CONTACT NAME: Arthur J. Gallagher Risk Management Services, LLC PHONE E 804-239-0544 NC No:864-239-2435 15 S Main St Ste 200 ADDRESS: GGB.PGA AJG.COM Greenville SC 29601 INSURERS AFFORDING COVERAGE NAIC# INSURER A:HDI Global Specialty SE INSURED PGAOFAM-01 INSURER THE MEMBERS AND ASSOCIATES : OF THE PROFESSIONAL GOLFERS ASSOC. OF AMERICA INSURER C MEMBER: Robert W. Stevens(#27039755) INSURERD: 1916 PGA Parkway INSURERE: Frisco TX 75033 INSURER F COVERAGES CERTIFICATE NUMBER:1232323504 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. INTRR' ADDTYPE OF INSURANCE INSD WVD POLICY NUMBER I MMI-01c, YY MMIODIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y HDGL003701855 4l112026 41112027 EACH OCCURRENCE S1,000,400 CLAIMS-MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence S 1,000,400 MED EXP(Any one person) so PERSONAL&ADV INJURY 31,000,4DO GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 3,000,4DO POLICY JEC PROT ❑ LOC. PRODUCTS-COMPIOPAGG 53.000,000 X OTHER: MemberlAssociate I S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ee accident _ ANY AUTO BODILY INJURY(Per person) 3 OWNED SCHEDULED AUTOS ONLY AU TO S BODILY INJURY(Per accident) 5 HIRED NON-OWNE❑ PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per accident 5 A X UMBRELLA LIAB X OCCUR HDEX003741424 41112026 41112027 EACH OCCURRENCE S 5,000,040 EXCESS LIAR CLAIMS-MADE AGGREGATE S 5,000,04D ❑ED RETENTION 5 S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 5 If yen,descnhe under DESCRIPTION OF OPERATIONS below E-L.DISEASE-POLICY LIMIT S A Sexual Abuse&Molestation HDGL003701855 41112026 4/1/2027 Per Person $ ,040,040 Aggregate $2,040,040 DESCRIPTION OF OPERATIONS!LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required( COVERAGE APPLIES TO PGA MEMBERS,ASSOCIATES,STUDENTS AND JUNIOR LEAGUE PARTICIPANTS WHILE PLAYING,PRACTICING, OFFICIATING,TEACHING OR COACHING THE GAMES OF GOLF AND INCIDENTAL CLUB REPAIR. *A WRITTEN CONTRACT EXECUTED PRIOR TO A LOSS IS REQUIRED FOR A CERTIFICATE HOLDER TO BE ADDED AS AN ADDITIONAL INSURED* Umbrella liability limit for Sexual Abuse&Molestation capped at$3,000,000, City of Santa Ana,its City Council,officers,offcials,employees,agents,and volunteers are included as Additional Insured on the General Liability policy,as per endorsement#CG 20 26 04 13. A Waiver of Subrogation is included in favor of Additional Insured under the General Liability coverage as evidenced herein as required by written contract. CERTIFICATE HOLDER APPROVED CANCELLATION By Tu Tran Nguyen at 3:19 pm,Apr 23,2026 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS, Attn Parks, Recreation, and Community Servic 20 Civic Center Plaza M-23 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 CC7 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD State Farm Mutual Automobile Insurance Company PO 8 oomuingtonBiL 61702-2358 • State Far AT2 A-2108 A STEVENS, YASMIN & ROBERT W 45AUGUSTA AUTO RENEWAL IRVINE CA 92620-3283 PREMIUM PAID: $451.19 DO NOT PAY. Your premium is billed through the State Farm Payment Plan LAP�PROVED State Farm Payment Plan Number: 1003079402 ran Nguyen at 3:19 pm,Apr 23,2026 y Your State Farm Agent MIKE MAST Policy Number, C171868-005-05H Office:831-384-0155 Policy Period: March 5, 2026 to September 5, 2026 Address:326 RESERVATION RD STE C Vehicle: MARINA, CA 93933-3257 2008 TOYOTA HIGHLANDER if y9u have a ne w orditferent car,have added any drivers,orhave moved, Principal Driver: please contact your agent. ROBERTW STEVENS Thankyou forchoosing State Farm. Notice of insurance Information collection practices- You have the right to submit a written request to access, personal,family, or household insurance transactions: correct,amend,or delete your personal information and the We may collect customer information from persons other right to receive a response within 30 days of submitting your than the individual or individuals applying for coverage. request. If we deny your request,you have the right to file a Such customer information as well as other personal or statement with us containing the information you feel is privileged information subsequently collected may, in certain accurate and fair along with the reasons you disagree with circumstances, be disclosed to third parties without your our denial. Instructions on how to file such request and our authorization as permitted by law. full privacy notice can be found (continued on next page) Policy Number:C17 1868-005.05H Page number 1 of 5 Prepared January 12,2026 1004583 143562 202 01-15-2018 CONVENIENCE SAVES TIME, MONEY ... AND TREES, You have the option to pay your bills online by opting for ePayment on statefarmxoms. Get to a better State`'. Tree StateFarm www.statefarm.com/customer-carelprivacy-security/privacy process the payment as a check transaction.When we use or contact your State Farm Agent. information from your check to make an electronic fund Location used to determine rate charged-45 AUGUSTA, transfer, funds may be withdrawn from your account as soon IRVINE CA 92620. as the same day we receive your payment, and you will not When you provide a check as payment, you authorize us receive your check back from your financial institution. either to use information from your check to make a one-time electronic fund transfer from your account or to VEHICLE INFORMATION Review your policy information carefully. If anything is incorrect, or if there are any changes to your vehicle information,please let us know right away. Vehicle Identification Vehicle Description Number[VIN) Who principally drives this vehicle? How is this vehicle normally used? 2008 TOYOTA HIGHLANDER JTEDS43AX82031288 ROBERT STEVENS,a married individual, To Work,School or Pleasure, who will have 39 years of driving experience as of March 05,2026. Other Household Vehicle(s) Your premium may be influenced by other State Farm policies that currently insure the following vehicle(s) in your household; 2011 HONDA ACCORD The premium on the expiring policy term was based on 900 model. In addition,we review the comprehensive, collision, miles per year, bodily injury and property damage claim experience The premium on the renewal policy term was based on 900 annually to determine which makes and models have miles per year. earned decreases or increases from State Farm's standard Premium Adjustment rates. If any changes result from our reviews, adjustments Each year,we review our medical payments and personal are reflected in the rates shown on this renewal notice. injury protection coverages claim experience to determine the vehicle safety discount that is applied to each make and DRIVER INFORMATION Assigned Driver(s) The following driver(s)are assigned to the vehicle(s)on this policy. Driving Experience as of Marital Name March 05,2026 Status ROBERT W STEVENS 39 years Married Policy Number:C171868-005-05H Page number 2 of 5 Prepared January 12,2026 •: StateFarm Other Household Driver(s) In addition to the Principal Driver(s)and Assigned Driver(s),your premium may be influenced by the drivers shown below and other individuals permitted to drive your vehicle. This list does not extend or expand coverage beyond that contained in this automobile policy. The drivers listed below are the drivers reported to us that most frequently drive other vehicles in your household. YA5MIN GUTIERREZ It is your responsibility to inform us of all regular For business related vehicles, also include the drivers of your vehicles and changes to those drivers business owner(s)and employee(s)that drive the throughout the life of your policy. Failure to disclose vehicle(s)in any capacity drivers may result in denial of coverage. Regular Principal Driver&Assigned Drivers drivers, regardless of their relationship to the primary For each automobile,the Principal Driver is the individual named insured or their residence address, include: who most frequently drives it. • All drivers who drive the vehicle(s)on the policy Each driver is designated as an Assigned Driver on the once or more in a typical month household automobile that they most frequently drive.Your • All drivers who regularly drive the vehicle(s)at premium may be influenced by the information shown for least three months of the year these drivers. COVERAGE AND LIMITS See your policy far an explanation of these coverages. A Liability Bodily Injury 100,0001300,000 Property Damage 50,000 $222,46 C Medical Payments 10,000 $18.97 D Comprehensive $44.58 G 250 Deductible Collision $106.63 H Emergency Road Service $4.51 U Uninsured Motor Vehicle Bodily Injury 100,000/300,000 $51.84 U1 Uninsured Motor Vehicle Property Damage $2.20 Total Premium $451.19 If any coverage you carry is changed to give broader you the broader protection without issuing a new policy, protection with no additional premium charge, we will give starting on the date we adopt the broader protection. DISCOUNTS These adjustments have already been applied to your premium. Multiple Line (continued on next page) Policy Number:C17 1868-005-05H Page number 3 of 5 Prepared January 12,2026 .•: SfafeaFarm- DISCOUNTS continued Multicar ✓ Vehicle Safety ✓ Driving Safety Record ✓ California Good Driver ✓ Loyalty ✓ Total Discounts $1,485.60 Other Available Discounts) You may be eligible for additional discounts See the enclosed insert for more information. Mature Driver SURCHARGES AND DISCOUNTS Driving Safety Record Rating Plan more than $1000. For accidents occurring prior to Your driving safety record, along with other rating factors, December 11, 2011,an accident shall be chargeable determines what you pay for Liability, Medical Payments, provided it resulted in death or in payment(s) by an insurer Comprehensive, Collision,and Uninsured Motor Vehicle due to damage to any property in the amount of more than Coverages. Policyholders with no accidents and convictions $750. pay less than those with accidents and convictions. For applicants without prior insurance at the time of the The Driving Safety Record Rate Level that is assigned to accident,an accident shall be chargeable provided it your policy moves up, down, or stays the same every policy resulted in damage to any property in the amount of more renewal,depending upon your driving record. For every 12 than $1000 (more than$750 if the accident occurred prior to months since the renewal following the occurrence of a December 11, 2011). chargeable accident or the conviction of a minor violation, Chargeable accidents for renewal business are those which the initial assigned Driver Record Level for that chargeable resulted in bodily injury or death or State Farm claim accident or conviction shall be lowered by 1 level. For each payments totaling more than$1000 (more than $750 for 12 month period since the conviction of a major violation, accidents occurring prior to December 11,2011)under the initial assigned Driver Record Level for that conviction property damage liability coverage and collision coverage shall be lowered by 2 levels. The Rate Level is increased if combined. there are subsequent chargeable accidents or convictions. For more information about the rating plan, please contact Definition of Chargeable Accidents your State Farm agent. Chargeable accidents for new business are those which Superior Driver Rate Level resulted in bodily injury or death or in payment(s) by an insurer due to damage to any property in the amount of ADDITIONAL INFORMATION IMPORTANT NOTICE If any information on this renewal notice is incomplete or For your protection California law requires the inaccurate,or if you want to confirm the information we have following to appear with this policy: Any person who in our records, please contact your agent. For additional knowingly presents false or fraudulent information to information regarding discounts or coverages, see your obtain or amend insurance coverage or to make a claim State Farm agent or visit statefarmi for the payment of a loss is guilty of a crime and may be Endorsement 6130Q effective MAR 05 2026. subject to fines and confinement in state prison. Important Notice Regarding Your Premium State Farm works hard to offer you the best combination of price,service,and protection. The amount you pay for automobile insurance is determined by many factors including: (continued on next page) Policy Number:C17 1868-005-05H Page number 4 of 5 Prepared January 12,2026 :• StateFarm- • The coverage you have • Where you live • The kind of car you drive • How the car is used • Who drives the car Any premium adjustment is reflected on this Auto Renewal. If you have any questions, please contact your agent. Buying a new car? Remember to contact your agent! When you buy an additional car or one that replaces a car already on your policy,you need to report the change to your agent promptly. Even though the dealership you purchased the car from may offer to notify your agent or insurance company,you, as the named insured,are responsible for reporting all changes to your auto policy. By contacting your agent,you can help; • avoid any complications or lack of coverage in the event of an accident or loss, • avoid insurance verification problems with a lienholder,the police,or the department of motor vehicles, and • ensure that you receive any new discounts you may be entitled to. Your current State Farm policy automatically provides certain coverages for a new or replacement car for up to a specified, limited number of days after you take possession of the car. Please refer to your policy for the number of days that applies in your state. If you have any questions about coverage for a newly acquired car, please contact your State Farm agent. Disclaimer: This message is provided for informational purposes only and does not grant any insurance coverage. The terms and conditions of coverage are set forth in your State Farm Gar Policy booklet, the most recently issued Declarations Page, and any applicable endorsements. Policy Number:C17 1868-005-05H Page number 5 of 5 Prepared January 12,2026 POUCYNUMBI ; HDGL003701855 C CIAL-GENERA-L.IABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL. INSURED-DESIGNATED PERSON OFF ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s)- ANY PERSON OR ORGANIZATION WHOM YOU HAVE AGREED TO INCLUDE AS AN ADDITIONAL_INSURED UNDER A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE,DATE OF LOSS 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 insurance afforded to such additional insured include as an additional insured the person(s) or will not be broader than that which you are organization(s) shown in the Schedule, but only required by the contract or agreement to with respect to liability for "bodily injury", "property provide for such additional insured. damage" or "personal and advertising injury" EL With respect to the insurance afforded to these caused, in whole or in part, by your acts or additional insureds, the following is added to omissions or the acts or omissions of those acting Section III—Limits Of Insurance: on your behalf: 1. In the performance of your ongoing operations; ]f coverage provided to the additional insured is required by a contract or agreement, the most we or will pay on behalf of the additional insured is the 2. In connection with your premises owned by or amount of insurance: rented to you. 1. Required by the contract or agreement;or However: 2. Available under the applicable Limits of 1, The insurance afforded to such additional Insurance shown in the Declarations; insured only applies to the extent perrnitted by whichever is less. law; and 2. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement, the Limits of Insurance shown in the Declarations. CG 20 26 0413 ©Insurance Services Office,Inc.,2012 Page 1 of 1 POLICY NUMBER: HDGL003701855 COMMERCIAL GENERAL LIABILITY CG24041219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s)Or Organization(s): Any person(s) or organization(s) if required under your written contract or agreement with such person(s)or organization(s), provided such contract or agreement was executed prior to the date of the"occurrence" or offense. 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 against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 0412 19 C Insurance Services Office, Inc., 2018 Page 1 of 1 CITY OF SANTA ANA Risk Management a division of Human Resources , Managing Risk through Awareness and Action AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE 1. Robert W. Stevens ("Representative"), attest that I am an authorized (Name and Title of Vendor Representative) representative of Robert W. Stevens ("Company"),and (ConsultantrC'ompany 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 Golf Instruction ("Services"): (Services to be provided under a-gecmentfcontract) 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. 4/23/2026 5imature Robert Stevens Print Name —— Golf Instructor Title 714-788-7251. rstevenspga@msn.com Contact Infiormation,i.e..Telephone Number an&ur 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 COS-r OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND ATTORNEY'S FEES. Affidavit of Exemption for Workers'Compensation Insurance 11.12.2024