HomeMy WebLinkAboutMORALES, JAZLY (2) N-2026-164
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COUNCIL AIDE PROFESSIONAL SERVICES AGREEMENT
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S.0uYGici►LDS) THIS AGREEMENT is made and entered into on this 15t day of July,2026 by and between
Jazly Giselle Morales ("Consultant"), 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").
RECITALS
A. The City desires to obtain the services of a Consultant to provide administrative,
constituent, and legislative support for a member of the Santa Ana City Council.
B. Consultant represents that Consultant is qualified to perform these services.
C. In undertaking the performance of this Agreement,Consultant represents that Consultant
is knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably be
expected from a professional in the field.
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. SCOPE OF SERVICES
a. Consultant shall perform during the term of this Agreement,the tasks and obligations
including all labor, materials, tools, equipment, and incidental customary work
required to fully and adequately provide administrative, constituent, and legislative
support services for Councilmember Thai Viet Phan("Councilmember")as provided
in this Agreement and in the Scope of Services as described in subsection b below.
b. At the direction of Councilmember, Consultant shall perform a variety of
administrative, constituent, and legislative functions and tasks, including but not
limited to, conducting complex administrative studies, researching and responding
to constituents' inquiries, drafting written communications involving strategy,
policies, and/ or procedures, coordinating assigned project activities, preparing
creative projects, and serving as a liaison, where necessary.
c. As may be required for services performed while at City Hall,the City may provide
access to the Councilmember's office space—consistent with City procedures should
• Consultant require limited access to perform services required by the
Councilmember. Consultant shall maintain a business location separate from City
and Consultant understands that such access to office space is not required by the
City but provided to the Consultant on an as-needed basis and should only be used
when City Hall is open to the public or while the Councilmember is present.
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2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services
for City, the hourly pay rate of $40.00, for services rendered pursuant to this
agreement, and that monthly billing pursuant to this Agreement, shall not exceed a
total sum of five thousand dollars ($5,000) per month. Consultant agrees and
understands that no changes to this pay rate shall be made during the term of this Agreement.
The total sum to be expended under this Agreement shall not exceed $ 40,000 during the
term of this Agreement.
b. Consultant agrees and understands that the not-to-exceed amount, provided above,
includes reimbursement for all out-of-pocket expenses, including but not limited to,
mileage, copying costs, and mail services authorized at the sole direction of the
Councilmember in connection with the performance of duties under this Agreement.
The City shall not make any separate payments for any of the above expenses.
c. Consultant shall submit monthly invoices to City for work performed during the
billing period. Payment by City shall be made within thirty (30) days following
receipt of proper invoice evidencing work performed, subject to City accounting
procedures. Monthly invoices shall be in substantially the form attached hereto as
Exhibit"A."
3. TERM
This Agreement shall continence on July I,2026,and terminate on June 30,2027,unless
terminated earlier in accordance with Section 19, below.
4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor
shall it be construed to create an employer-employee relationship, a joint venture relationship,
or to allow the City to exercise discretion or control over the professional manner in which
Consultant performs the services which are the subject matter of this Agreement;however,the
services to be provided by Consultant shall be provided in a manner consistent with all applicable
standards and regulations governing such services. Consultant shall pay all salaries and wages,
benefits, employer's social security taxes, unemployment insurance, and similar taxes relating
to employees and shall be responsible for all applicable withholding taxes.
5. POLITICAL CAMPAIGN ACTIVITIES
a. Consultant is prohibited from the following political campaign activities
while this Agreement is in place:
i) Acting as campaign treasurer/manager or a campaign consultant for any
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candidate for Santa Ana City Council or Mayor;
2) Campaigning for any candidate for Santa Ana City Council or Mayor and
at the same time,working pursuant to this agreement and/or charging the
City for the lime spent campaigning pursuant to this agreement;
3) Using City equipment, supplies or resources to campaign for any
candidate for Santa Ana City Council or Mayor;
4) Accepting any campaign contributions on behalf of any candidate for
Santa Ma City Council of Mayor;
5) Campaigning while wearing any attire or logo that identifies you as a
Consultant for the City of Santa Ana;
6) Campaigning while using any City room,building, or location that
has not been specifically designated for political speech;
7) Receiving any payment or reimbursement from a campaign candidate
for Santa Ana City Council or Mayor or their campaign account;
and/or
8) Opening a campaign committee or pulling nomination papers to run as a
candidate for Santa Ana City Council or Mayor.
b. Consultant will sign the declaration attached hereto as Exhibit B
acknowledging said prohibitions.
6. PROHIBITION AGAINST APPOINTMENT TO CITY BOARD OR
COMMISSION
Consultant is prohibited from accepting appointment or continuing with any prior
appointment to any City Board or City Commission set forth in Chapter 2 of the Santa Ana
Municipal Code while this Agreement is effective.
7. BACKGROUND CHECK
Consultant agrees to submit to a background check including, but not limited to, a live
scan and records check to City's satisfaction. Failure to do so is grounds for termination of this
Agreement.
8. OWNERSHIP OF MATERIALS
This Agreement creates a non-exclusive and perpetual license for City to copy, use,
modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property
embodied in plans, specifications, studies, drawings, estimates, and other documents or works
of authorship fixed in any tangible medium of expression,including but not limited to,physical
drawings or data magnetically or otherwise recorded on computer diskettes,which are prepared
or caused to be prepared by Consultant under this Agreement ("Documents & Data").
Consultant shall require all subcontractors to agree in writing that City is granted a non-
exclusive and perpetual license for any Documents&Data the subcontractor prepares under this
Agreement. Consultant represents and warrants that Consultant has the legal right to license any
and all Documents&Data. Consultant makes no such representation and warranty in regard to
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Documents &Data which were provided to Consultant by the City. City shall not be limited in
any way in its use of the Documents and Data at any time,provided that any such use not within
the purposes intended by this Agreement shall be at City's sole risk.
9. INSURANCE
Insurance requirements are attached hereto as Exhibit C.
10. INDEMNIFICATION
Consultant agrees to defend, and shall indemnify and hold harmless the City, its
officers, agents, employees, contractors, special counsel, and representatives from liability: (1)
for personal injury, damages,just compensation, restitution,judicial or equitable relief arising
out of claims for personal injury, including death, and claims for property damage, which may
arise from the negligent operations of the Consultant,its subcontractors, agents, employees,or
other persons acting on its behalf which relates to the services described in section 1 of this
Agreement; and (2) from any claim that personal injury, damages, just compensation,
restitution,judicial or equitable relief is due by reason of the terms of or effects arising from this
Agreement.This indemnity and hold harmless agreement applies to all claims for damages,just
compensation,restitution,judicial or equitable relief suffered, or alleged to have been suffered,
by reason of the events referred to in this Section or by reason of the terms of,or effects, arising
from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all
costs for the defense of the City, including fees and costs for special counsel to be selected by
the City, regarding any action by a third party challenging the validity of this Agreement, or
asserting that personal injury,damages,just compensation,restitution,judicial or equitable relief
due to personal or property rights arises by reason of the terms of, or effects arising from this
Agreement. City may make all reasonable decisions with respect to its representation in any
legal proceeding.
11. INTELLECTUAL PROPERTY INDEMNIFICATION
Consultant shall defend and indemnify the City,its officers,agents,representatives, and
employees against any and all liability, including costs, for infringement of any United States'
letters patent, trademark, or copyright infringement, including costs, contained in the work
product or documents provided by Consultant to the City pursuant to this Agreement.
12. RECORDS
Consultant shall keep records and invoices in connection with the work to be performed
under this Agreement. Consultant shall maintain complete and accurate records with respect to
the costs incurred under this Agreement and any services, expenditures, and disbursements
charged to the City for a minimum period of three(3)years,or for any longer period required by
law, from the date of final payment to Consultant under this Agreement. All such records and
invoices shall be clearly identifiable. Consultant shall allow a representative of the City to
examine,audit,and make transcripts or copies of such records and any other documents created
pursuant to this Agreement during regular business hours. Consultant shall allow inspection of
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all work, data,documents, proceedings, and activities related to this Agreement for a period of
three(3) years from the date of fmal payment to Consultant under this Agreement.
13. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
that it shall not use or disclose such information except in the performance of this Agreement,
and further agrees to exercise the same degree of care it uses to protect its own information of
like importance, but in no event less than reasonable care. "Confidential Information" shall
include all nonpublic information. Confidential information includes not only written
information,but also information transferred orally, visually, electronically,or by other means.
Confidential information disclosed to either party by any subsidiary and/or agent of the other
party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure
shall not apply to any information that(a) has been disclosed in publicly available sources; (b)
is,through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful
possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Consultant without
reference to information disclosed by the City.
14. CONFLICT OF INTEREST CLAUSE
a. Consultant represents that neither it nor any of its officers,partners or employees has
a financial interest, as defined in Section 87103 of the Government Code, in the
subject matter of this Agreement other than the right to receive payment from City
for services rendered.
b. Consultant agrees that it shall not make,participate in making, or in any way attempt
to use its position as consultant to influence any decision of City in which Consultant
knows, or has reason to know, that any of its officers,partners or employees has a
financial interest as defined in Section 87103 of the Government Code.
c. Consultant warrants that neither Consultant nor any of its officers, partners or
employees,has any financial interest in any real property,building or structure within
2,500 feet of the location of any project or assignment to which this Agreement may
apply in the City of Santa Ma. Consultant agrees to disclose to City any financial
interest in such property as may be acquired by its officers, partners or employees
during the term of this Agreement.
d. In accordance with the City's Conflict of Interest Code, if determined by the City
Manager to be a designated position, Consultant shall file a Statement of Economic
Interests (Form 700) with the Fair Political Practices Commission.
15. NON-EXCLUSIVE
Consultant understands and agrees that this is a non-exclusive Agreement and City may
enter into other agreements with other consultants and may use any of the contractors with whom
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City has contracts and, therefore, the City cannot estimate nor guarantee the volume or amount
of work to be received by Consultant under this Agreement.
16. NON-DISCRIMINATION
Consultant 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 any services provided under this Agreement.
Consultant affirms that it is an equal opportunity employer and shall comply with all applicable
federal, state and local laws and regulations.
17. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, and supersedes any and all other agreements,oral or written,between the parties. 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 Consultant. The parties
agree that anyterms 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 Consultant 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 is not embodied herein.
18. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant 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. Nothing in this Agreement
shall be construed to limit the City's ability to have any of the services which are the subject to
this Agreement performed by City personnel or by other Consultants retained by City.
19. TERMINATION
This Agreement may be terminated by the City upon thirty(30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay
Consultant compensation for all services performed by Consultant prior to receipt of such notice
of termination,subject to the following conditions:
a. As a condition of such payment,Consultant maybe required to deliver to the City
all work product(s) completed as of such date, and in such case such work
product shall be the property of the City unless prohibited by law,and Consultant
consents to the City's use thereof for such purposes as the City deems
appropriate.
b. Payment need not be made for work which fails to meet the standard of
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performance specified in the Recitals of this Agreement.
Consultant's term shall automatically terminate immediately if, at any time, the
Councilmember is no longer an elected member or Mayor of the Santa Arm City Council.
20. WAIVER
No waiver of breach, failure of any condition, or any right or remedy contained in or
granted by the provisions of this Agreement shall be effective unless it is in writing and signed
by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or
right,or remedy shall be deemed a waiver of any other breach,failure,right or remedy,whether
or not similar,nor shall any waiver constitute a continuing waiver unless the writing so specifies.
21. 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.
22. PROFESSIONAL LICENSES
Consultant shall,throughout the term of this Agreement,maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United States,the State of California,
the City of Santa Ana and all other governmental agencies. Consultant shall notify the City
immediately and in writing of its inability to obtain or maintain such permits, licenses,
approvals, waivers, and exemptions. Said inability shall be cause for termination of this
Agreement.
23. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this
Agreement shall be in writing and shall be deemed to be properly given if delivered in person
or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic
communication in the manner provided in this Section,to the following persons:
To City:
City Clerk
20 Civic Center Plaza(M-30)
P.O.Box 1988
Santa Ma, CA 92702-1988
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With courtesy copies to:
City Manager
City of Santa Ana
20 Civic Center Plaza(M-31)
P.O.Box 1988
Santa Ana,CA 92702
To Consultant:
Iazly Giselle Morales
329 S. Harbor Blvd#61
Santa Ana, CA 92704
A party may change its address by giving notice in writing to the other party. Thereafter,
any communication shall be addressed and transmitted to the new address. If sent by mail,
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by fax,communication shall be effective or deemed to have
been given twenty-four(24)hours after the time set forth on the transmission report issued by
the transmitting facsimile machine, addressed as set forth above. For purposes of calculating
these time frames, weekends,federal, state, County or City holidays shall be excluded.
24. MISCELLANEOUS PROVISIONS
a. 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.
b. All Exhibits referenced herein, if any, and attached hereto shall be incorporated
as if fully set forth in the body of this Agreement.
[signatures appear on following page]
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SIGNATURE PAGE TO COUNCIL AIDE PROFESSIONAL SERVICES AGREEMENT
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST CITY O SANT A
4111IaiH 11 -' Alvaro Nunez
-u • City Manager
APPROVED AS TO FORM CONSULTANT
SONIA R. CARVALHO
City Attorney
17azG 3. /L1 eJ
Jazly G.AA"orales(Jul 1.202613:44:59 PDT)
By:
Jonathan T. Marti z Jazly Giselle Morales
Assistant City A ey
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EXHIBIT A
Month and Year Invoice
Your Name
Street Address Invoice#:
City, ST Zip Code Agreement #:
Phone Date:
Bill To:
City of Santa Ana
20 Civic Hourly Rate:
Center Plaza Total Billable Hours:
Santa Ana, CA Amount Due:
92701
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
EXHIBIT B
Acknowledgment Regarding Political Activities Prohibitions
Jazly Morales
,am an independent contractor working as a Council Aide pursuant to this
Agreement.
1. I acknowledge and agree that during the term of this Agreement, I will not participate or conduct
the following political activities:
a) Acting as campaign treasurer/manager or a campaign consultant for any candidate
for Santa Ana City Council or Mayor;
b) Campaigning for any candidate for Santa Ana City Council or Mayor and at the
same time,working pursuant to this agreement and/or charging the City for the time
spent campaigning pursuant to this agreement;
c) Using City equipment, supplies or resources to campaign for any candidate for
Santa Ana City Council or Mayor;
d) Accepting any campaign contributions on behalf of any candidate for Santa Ma
City Council of Mayor;
e) Campaigning while wearing any attire or logo that identifies you as a Consultant
for the City of Santa Ma;
f) Campaigning while using any City room, building, or location that has not been
specifically designated for political speech;
g) Receiving any payment or reimbursement from a campaign candidate for Santa Ma
City Council or Mayor or their campaign account; and/or
h) Opening a campaign committee or pulling nomination papers to run as a candidate
for Santa Ma City Council or Mayor.
2. I acknowledge and understand that failure to abide by any of the above prohibitions are grounds
for immediate termination of this Agreement.
Signed this day of n
JazlyT Morales a54/_ : Mn.a4, -
(NameofConsultant) ( n orConsultant)
06/22/2026
Date
Stephanie Garcia S 9//�x2c a.
(Name of Witness) (Signature itfiess)
EXHIBIT C
Insurance Requirements
Consultant shall procure and maintain for the duration of the agreement, the following insurance
coverages:
MINIMUM SCOPE AND LIMIT OF INSURANCE
Consultant shall maintain limits of insurance coverage in the following minimum amounts and shall
be at least as broad as:
• 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 Consultant 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.
If Consultant 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
Consultant. 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. City of Santa Ma,its City Council,its officers,officials,employees,agents,and volunteers
are to be covered as additional insureds on Consultant's AL policy with respect to liability
arising out of work or operations performed by or on behalf of the Consultant including
materials, parts, equipment, and personnel furnished in connection with such work or
operations.
2. 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 the Consultant's AL policy which arise from work performed by Consultant for
City.
3. All required insurance policies: For any claims related to this contract, ConsuItant'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 Consultant'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 notice shall be provided to City for policy cancellation or non-
renewal due to non-payment.
6. The Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa
Ana, Attention: City Manager's Office M-31, 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 Consultant
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
Consultant 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 Consultant'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, Consultant must purchase "extended
reporting"coverage for a minimum of three(3)years after completion of work.
Subcontractors
Consultant shall require and verify that all sub-contractors maintain insurance meeting
all the requirements stated herein,and Consultant 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.
NATIONAL GENE RAL
an Allstate company Policy Number: Date of Notice
Po Box 3199•Winston Salem NC 27102-3199 04/29/2026 07:07 PM
Named Insured:
ABEL CELESTINO MORALES-LUNA
ABEL CELESTINO MORALES-LUNA Policy Period:
Policy Underwritten By:
Integon National Insurance
Company
24 Hour Claim Reporting: 1-800-468-3466
For Policy Information:877-468-3466
www.mynatgenpolicy.com
Your Agent:
Southland Auto Insurance
638 S Harbor
Santa Ana CA 92335
(714)775-2300
CA PERSONAL AUTO DECLARATIONS PAGE
Renewal Effective 616/2026 12:01 AM
INTEGON NATIONAL INSURANCE COMPANY
Drivers and Household Residents
#1 Abel Celestino Morales-Luna Operator: Principal#3
Driver Status License# Lic.State Date of Birth Gender Marital Status Driver Pts Yrs.Licensed
Rated Driver XXX9139 CA XX/XX/1975 Male Married 0 26 US;0 INT'L
#2 Sofia Cruz Bautista Operator:
Driver Status License# Lic.State Date of Birth Gender Marital Status Driver Pts Yrs.Licensed
Excluded Driver XX/XX/1977 Female Married
#3 Cristian Morales Operator: Principal#1
Driver Status License# Lic.State Date of Birth Gender Marital Status Driver Pts Yrs.Licensed
Rated Driver XXX0413 CA XX/XX/2002 Male Married 0 7 US;0 INT'L
#4 Jazly Giselle Morales Operator: Principal#2
Driver Status License# Lic.State Date of Birth Gender Marital Status Driver Pts Yrs.Licensed
Rated Driver XXX0309 CA XX/XX/2001 Female Married 0 8 US;0 INT'L
Insured Vehicle(s)and Schedule of Coverages
#1 2023 NISS KICKS SR VIN:
Usage: Pleasure Prior Term Estimated Annual Mileage:6000
Estimated Annual Mileage:7000
Garaging Location:92704
Coverages Provided Limits I Deductibles Premium
Bodily Injury $30,000 Each Person/$60,000 Each Accident $156.00
Property Damage $15,000 Each Accident $117.00
*SEE IMPORTANT NOTICE SECTION FOR REDUCED LIMITS IN
SPECIFIED SITUATIONS
Other Than Collision $1,000 Deductible $50.00
Collision $1,000 Deductible $459.00
Total For This Vehicle $782.00
#2 2013 FORD EXPLORER VIN:
Usage: Pleasure Prior Term Estimated Annual Mileage: 11000
Estimated Annual Mileage: 12000
10039CA(03012010)
Important Notice
NOTE: THE MAXIMUM AMOUNT PAYABLE FOR BODILY INJURY AND PROPERTY DAMAGE UNDER THE LIABILITY COVERAGE PART
A OF THIS POLICY SHALL BE$30,0001$60,000I$15,000 FOR DRIVERS Not LISTED IN THE DECLARATIONS And UNDERSPECIFIED
SITUATIONS SET FORTH IN THE POLICY And ENDORSEMENTS.
CONTINUING DUTY TO INFORM AS A CONDITION OF COVERAGE UNDER THE POLICY
In order to maintain the coverage described in this policy,the Named Insured has a continuing duty to
notify the Company of ANY changes concerning the following: (1)the garaging location of the listed
vehicle(s) on the policy(ies); (2) member(s) of the Named Insured's household age 14 years and older;
(3) operator(s) of the listed vehicle(s) on the policy; (4)the usage of the listed vehicle (s) on the policy
and 5) marital/domestic partnership status within 30 days of such change.The Named Insured
understands and agrees that this information is material to the risks insured and that the insurance
company may rescind this policy or deny coverage if the Named Insured fails to notify the company of
these changes prior to a loss.
EL DEBER CONTINUO DE INFORMAR COMO CONDICION DE COBERTURA BAJO LA POLIZA
Para mantener la cobertura descrita en esta Poliza, el Asegurado tiene el deber continuo de notificar a la
Campania de CUALQUIER cambio relacionado con to siguiente: (1) la ubicacion del garaje de los
vehiculos enumerados en la (s) peliza (s); (2) miembro(s) de la casa del asegurado de 14 alias o mas de
edad; (3) operador(es) de los vehiculos enumerados en la Poliza,; (4)el use del (de los)vehiculo(s)
enumerados en la poliza y 5)el estado marital o conyugal dentro de los 30 dias posteriores al cambia. El
Asegurado designado entiende y acepta que esta information es importante para los riesgos asegurados
y que la compania de seguros puede rescindir esta poliza o denegar la cobertura si el Asegurado
designado no notifica a la compania de estos cambios antes de una perdida.
If you are a member of a motor club, an RV club, a professional association, an employee
group or other similar type group and would like your policy reviewed to assure you are
receiving the best possible rate, please contact your agent or the company.
Additional Policy Information
Insured Email:
Product CASummit
All fees are fully earned
Disclosure of Possible Additional Charges
The amounts below are authorized for use in this state.However,they are only charged if they apply to your policy.
Cancellation Charge $50.00
Convenience Fee $5.00
FR Filing Charge $20.00
Endorsement Charge-Good Driver $5.00
Endorsement Charge-Non Good Driver $5.00
Late Charge $10.00
Nonsufficient Funds Charge $25.00
Reinstatement Charge-Good Driver $16.00
Reinstatement Charge-Non Good Driver $20.00
SR-22 Reinstatement $10.00
Forms and Endorsements
Endorsement Edition Form Name
CGSAOP 07012015 AMENDMENT OF POLICY PROVISIONS
12500 07012019 EXCLUDED DRIVER ENDORSEMENT-CALIFORNIA
CGSCADRP 09012016 DIRECT REPAIR PROGRAM
CGSCA1001 01012025 PERSONAL AUTO POLICY
10039CA(03012010)
Notice of Premium and Fees
Policy Premium $1,532.00
Policy Fee $16.80
CA Vehicle Assessment and Fraud Fee $2.64
Total Premium + Fees $1,551.44
Club DentPro Membership $18.00
Total Amount Payable $1,569.44
11531 (04012015)