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HomeMy WebLinkAboutESTRADA, JAIME INSURANCE NOT ON FILE WORK MAY NOT PROCEED A-2026-085-05 CITY CLERK DATE: 5 2026 f A(IQ) FACILITY USE AGREEMENT WITH JAMIE ESTRADA FOR USE OF RIVER VIEW GOLF COURSE C• Lang- C 01.E THIS FACILITY USE AGREEMMNT is made and entered into on June 16a', 2026, by and between Jamie Estrada ("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". RECITALS A. The User has a need for a venue to conduct golf instruction and/or lessons. I 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. i 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 I 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 i 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 9 I Page 1 of 5 i I 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 et seq,have a conviction for any crime of moral turpitude,have a conviction for a sexual based crime, f have a conviction for a violent felony as defined in California Penal Code Section 667.5(c), 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, 262, 264.1,266,266c, 266h,266i,266j, 267,269,272,273a,273ab, 273d,285, 286, 288,288a, 288.2, j 288.3,288.4,288.5,288.7,289,290,311.1,311,2,311.3,311.4, 311.10,311.11, 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 Exbibit B, 8. 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 under this Agreement. 9. FORCE MAJUERE 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. 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) P.O, Box 1988 Santa Ana, California 92702 To User: Jamie Estrada 909 W Riviera Dr Santa Ana, CA 92706 Page 3 of 5 j strada5C_otmai l.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 terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of 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 party to this Agreement acknowledges that no representations, inducements, promises or agreements,orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 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. TERMINATION 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 infonnation, 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 affirms 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, 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. Page 4 of 5 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 SANT ANA e f r L H it Alvaro Nunez Cit C er City Manager APPR.O D AS TO FORM: SONIA R. CARVALHO USER: City Attorney Jonathan T. Martin y:J A� -1 k- C��A, . i Assistant City Attorney Title:.�, �era RECOMMENDED FOR APPROVAL: �p'i 1-/ 7Hawk Scott V Executive Director of Parks, Recreation and Community Services Agency Page 5 of 5 EXIMIT A SCOPE OF SERVICES i { i I i i Scope of Selvices 1. DESCRIPTION OF USE Jamie Estrada ("User", "Jamie Estrada") is an individual focused on developing and providing advanced golf performance training. Jamie Estrada 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 This program will provide private,performance-focused instruction for up,intended to support golfers in achieving higher levels of technical proficiency and competitive readiness through customized coaching. '2. FACILITIES } i 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 Iocal laws, 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. I I 3. TERMS OF USE For a period of one (1) year, commencing July 1, 2026 and terminating June 30, 2027 ("Tenn"), Janie Estrada 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 City'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 waiverprior 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. 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. 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 to minors have successfully completed background screening and any other required certifications ; in compliance with applicable federal, state, and local requirements. User represents and warrants 4 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, restrooms, 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 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 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. 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, i User shall promptly notify the City's assigned designee, of any building or facility issues, including damage, vandalism, or theft. , 6. PAYMENT The User shall 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 either agreed billing cycle). Late payments may be subject to penalties or interest as permitted by law. 7. NO EXCLUSIVE RIGHT'S 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 Terre of this Agreement. 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 I i EXHIBIT B INSURANCE REQUIREMENTS I I a i Insurance Requirements User shall procure and maintain for the duration of the agreement,the following insurance coverages: MINIMUM SCOPE AND LIMIT OF INSURANCE i 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 CO 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(SAML): 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 1 (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 in excess of the specified minimurd 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 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 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 terms of any policy which arise from work performed by User for City. 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. d. All requked 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 l against whom a claim is made or snit 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 notice 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, 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 Catifomia with a current A.M: Best rating of no less than ANII,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 listing 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 minimuin of three (3)years after completion of work. i i Subcontractors User shall require and verify that all sub-contractors maintain insurance meeting all the requirements stated herein, and User skull 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 tine risk,prior experience, insurer, coverage, or other special circumstances. r i J i ACC CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD1YYYY) 05/07/2026 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 CONTACT NAME: Next First Insurance Agency,Inc. PHON o (855)22Z-5919 a(c No PO Box 60787 Palo Alto,CA 94306 EMAIL ADDRESS: suPPort@nextinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: State Natfonal Insurance Company,Inc. 12831 INSURED INSURER B: Jamie Estrada INSURER C Jamie Estrada 909 W Riviera Dr Santa Ana,CA 92706 INSURER D INSURER E: INSURER F: _ COVERAGES CERTIFICATE NUMBER:388127066 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. I TYPEOFINSURANCE ADDLSUBR POLICYNUMBER MWDDY LTR IYYYY MMIDDIYYYY LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 �OCCUR DAMAGES( RENTED CLAIMS-MADE PREMISES Ea occurrence $1 00,000.00 VIED EXP{Any one person) $5,000.00 A X X NXT2EYGBIC-05-GL 07/27/2025 07/27/2026 PERSONAL&ADV INJURY S1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S3,000,000.00 POLICY❑JECT PRO ❑LOC PRODUCTS-COMIPIOP AGG $3,000,000.00 X PRO- OTHER: $ AUTOMOBILE LIABILITY COMBINED8INGLELIMIT S Ea accident ANY AUTO BODILY INJURY{Per person) $ OWNED SCHEDULED BODILY INJURY{Per accident) S AUTOS ONLY AUTOS HIRED NON-OVVNFD PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETORIPARTNER/EXECUTIVE F E.L.EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Each Occurrence: $1,000,000.00 A Professional Liability NXT2EYGBIC-OS-GL 07/27/2025 07/27/2026 Aggregate: $3,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES{ACORD tD1,Additional Remarks Schedule,may be attached if more space is required) The Certificate Holder is City Of Santa Ana Parks&Recreation.Waiver of Subrogation applies an General Liability in favor of the Certificate Holder and as required by written contract usual to the Insured's Operations,This Certificate Holder is an Additional Insured on the General Liability policy per the Additional Insured Automatic Status Endorsement.All Additional Insured privileges apply only if required by written agreement between the Certificate Holder and the insured,and are subject to policy terms and conditions. APPROVED CERTIFICATE HOLDER CANCELLATION By.Tu Tran Nguyen.at.4:07 pm,.May:oZ,2f728. City Of Santa Ana Parks&Recreation LIVE CERTIFICATE 20 Civic Center Plz#M-23 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana,CA 92701 ® THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE )F.,— Click or scan to view O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 5tateFarm State Farm Mutua'Automob°e nsurance Company 20994 4 A MUTL VOL PO Box 2358 DECLARATIONS PAGE Bloomington!L 61702 2358 PAGE 10F2 NAMED-NSURED AT2 75-2DE3-4 A A POLICY NUMBER 0193103-F22-75J EST °:0996 Ow POL`CY PER OD DEC 22 2025 to JUN 22 2026 909 RIV IERA DR; JAMIE 12 01 A M Standard Tme 09 IV 5ANTA ANA CA 92706-1527 AGENT ALEX MORA=NSURANCE AGENCY'-NC 1111 E KATELLA AVE STE 230 ORANGE,_CA 92867-5060 APPROVED By Tu Tran Nguyen at 4:07 pm,May 07.2026 PHONE:(714)635-8000 DO NOT PAY PREM=UMS SHOWN ON THIS PAGE: =F AN AMOUNT=S DUE-_THEN A SEPARATE STATEMENT:S ENCLOSED: YOUR GAR YEAR MAKE MODEL BODY STYLE VEH`--CLE-D_NUMBER CLASS 2017 HONDA ACCORD 4DR 1 HGCR2F55HA013528 6030CV11 SYMBOLS COVERAGE&L M'TS PREM'UMS A L ab ty Coverage Body=njury L m is ...... .__ Each Person, Each Aocdent � ,. -._;—----T._ T $50,000 $100.000 :Property Damage L m A _ .._ _. Each Acc dent $50-000 C Med ca=Payments Coverage $36.97 L'mi Each Person - $5,000 Comprehens ve Coverage-$500 Deductb:e �G Co--son Coverage-$500 Deduct'b'e $388,86 —._._... _..._. Emergency Road Service Coverage -- --- _ $4-74 R1' Car Renta.and Trave Expenses Coverage _ $30 99 L m't-Car Rents Expense ' Each Day Each Loss $50 $1.500 U Un nsured Motor Veh c e Coverage s~� $47.47 Bod y'njury Umts W _4 Each Person Each Ace'dent � ;,$3o 000 $60 000 U1 Un nsured Motor Veh o e Property Damage Coverage $5,49 Tata= rem-um for DEC 22 2025 to JUN 22 2026- 995 83 This is nor a Lill- MPORTANT MESSAGES WPORTANT NOT.GE For your protect on Ca=Porn a aw requ res the fo=ow ng to appear w=th th-s po=cy= Any person who know-ng-y presents fa=se or fraudu=ent-nformat-on to obta`n or amend`nsurance coveragge or to make a c°a=m for the payment of a-ass-s gu f°.ty of a cr me and may be subject to nes and oonf-nement`n state pr-son, Rep aced po;cy number 0193103-75= Not°ee of nsurance nformat on co==ect-on pract-ces-persona-_fam y_or househo`d`nsurance transact'ons° We may correct customer'nformaton from persons other than the-ndv dua:or'nd v'dua s app y'ng for coverage Such customer nfonnaton as we'as other persona or pry eged nformaton subsequent'y coiiected may.'n certan c rcumstances. be d'seosed to th`rd part`es w1hout your authorzat'on as perm`tted by`.aw You have the rght to subm t a wr ten request to access-correct-amend-or delete your persona--nformat`on and the r ght to race`ve a response wth'n 30 days of submit`ng your request f we diegg your request_you have the rght to f e a statement wth us conta'n'ng the'nformat'on you fee 's accurate and fa'r song wtfi the reasons you d'sagree wth our den a nstrucYons on how to f'a such request and our fu• pr vacy not ce can be found www statefarm com/customer care/prvacy securty/prvaey or contact your State Farm Agent. CONT NUED 00915/10566 See Reverse S de -ss ca.2 os M2 ,:_,its. Stateftm ca State Farm Mutual Auto►noW-e=nsuranoe Company 20994-4-A MUTL VOL u PO Box2358 DECLARATIONS PAGE Bloomington 161702-2358 PAGE 2OF2 NAMED NSURED 75-21)E3-4 A A POLICY NUMBER 019 3103-F22-76J ESTo:o9es Dose POLICY PERIOD DEC 22 2D25 to JUN 22 2026 909 RIVZERA DRR A: AMI 12�01 A-M.Standard T me 09 SANTA ANA CA 92706-1527 ems, 3fCFki7N YOUR POLICY POE<CIFBOQFCLRT&EiIDQRSMENTSs( ee pa cy_68ygptEiu �11d25aCndrifoP co�reFage data s) FORM 9805B.16ANqDUANTSRENEIWA MNOTICpE 0 THIS ATIAPPLY. INCLUDINGLTWOSEOTSSUED-TO YOU 57RZ�ATOR- CAIR��NDATORY NDORSElENT BOX 44C609: KENNESAW GA 30160-0609: 6126MO EnnCESS COVERAGE FOR PERSONAL VEHICLE SHARING: 61291 AMENDATORY ENDORSEMENT. Agent; ALEX MORA'NSURANCE AGENCY NC Te'ephone=(714)635-8000 00916/10566 Prepared DEC,242025 2DE3-68A °55�3866 GA2 05-2902 to:�025=:[ €n:�254=, '�SXO •n-oDL:a:� This policy is issued by Stale Farm Mutual Automobile Insurance Company. MUTUAL CONDITIONS t. Membership.While this policy is in force,the first insured shown on the Declarations Page is entitled to vote at all meetings of members and to receive dividends the Board of Directors In Its discretion may declare in accordance with reasonable classifications and groupings of policyholders established by such Board. 2. No Contingent Liability. This policy is non-assessable. 3. Annual Meeting. The annual meeting of the members of the company shall be held at its home office at Bloomington, Illinois,on the second Monday of June at the hour of 10:00 A.M., unless the Board of Directors shall elect 10 change the time and place of such meeting, in which case, but not otherwise, due notice shall be mailed each member at the address disclosed in this policy at least 10 days prior thereto. In Witness Whereof, the State Farm Mutual Automobile Insurance Company has caused this policy to be sfgned by its President and Secretary at Bloomington, Illinois, Secretary President Important... California taw requires us to provide you with information for filing complaints with the Slate Insurance Department regarding the coverage and service provided under this policy. Complaints should be filed only after you and Slat* Farm or your agent or other company representative have failed to reach asatisfactory agreement on a problem. Please forward such complaints to: California Department of Insurance Consumer Services Division 300 South Spring Street Los Angeles,CA 90013 Or file a complaint through the Department of Insurance's Internet Web site(www.insurance.ca.gov) Or call toll tree 1-800-927-HELP(4357) NOTICE We are required to furnish you with the following information: t. An automobile liability insurance company may cancel a policy before the end of the current policy period for reasons described in the provision titles!Cancellation which is located in the General Terms section of your policy (refer to the Contents in the beginning of your policy for the page number). 2. An automobile liability insurance company may increase the premium or refuse to renew the policy for any of the following reasons: a. Accident involvement by an insures!,and whether an insured is at fault in the accident, b. A change in,or an addition of,an insured vehicle. c. A change in,or addition of,an insured under the policy. d. A change in the location of garaging of an insured vehicle. e, A change in the use of the insured vehicle, f. Convictions for violating any provision of the Vehicle Code or the Peral Code relating to the operation of a motor vehicle. g.The payment made by an insurer due to a claim filed by an insured or a third party. An automobile liability insurance company may increase the premium or refuse to renew the policy for reasons that are not listed above but which are lawful and not unfairly discriminatory. cavd2 I tiro COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II -WHO IS AN INSURED is amended to include the following*asinsureds: 1. Lessor of Leased Equipment Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to their liability for "bodily injury', "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. No such person or organization is an insured under this section: a. Upon expiration or termination of their contract or agreement with you for such leased equipment ends; b. For any"bodily injury'or"property damage"caused by an"occurrence"which takes place after expiration or termination of their contract or agreement with you; or G. For any "personal and advertising injury' caused by an "offense" which takes place after expiration or termination of their contract or agreement with you. 2. Managers or Lessors of Premises Any person or organization from whom you lease premises when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to liability arising out of your ownership, maintenance or use of that part of the premises leased to you. No such person or organization is an insured under this section for any: a. For"bodily injury'or"property damage"caused by an'occurrence"which takes place after you cease to be a tenant in that premises. b. Structural alterations, new construction or demolition operations performed by or on behalf of such person ororganization. 3. Grantor of Franchise Any person or organization (referred to below as grantor of a franchise)with whom you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, but only with respect to"bodily injury' or"property damage" arising out of" liability as grantor of a franchise to you S. 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, NXT-0116 BM GL 0218 Includes material copyrighted by Insurance Services Office, Inc. used with its Page 1 of 2 permission I COMMERCIAL GENERAL LIABILITY C. With respect to the provisions of this endorsement, the following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance: Regardless of whether other insurance is available to an additional insured on a primary basis, this insurance will be primary and noncontributory if a written contract between you and the additional insured specifically requires that this insurance be primary. All other terms and conditions of the policy remain unchanged, I NXT-0115 BM GL 0218 Includes material copyrighted by Insurance Services Office, Inc. used with its Page 2 of 2 permission I POLICY NUMBER; NXT2EYGBIC-05-GL COMMERCIAL GENERAL LIABILITY CG 24 0412 19 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 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 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 04 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1 a 91 info QTY0FSmr:74NA _ YOPSAMANA ff A MViagement a div{S I a 6 of Ifymon I{8sflurCM slhfl of Vunawkesco rcc5 Managing Rifle through Awarenast avid Anion - ;h Awar.A7 and Aeaion AM DAVIT OF EXr.h4PTIOM FOR WORKERS'CphIprNSATION lXSf]RANf,R PEN.SATION INSURANCE ! 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