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HomeMy WebLinkAboutKARMINA RESTAURANT AND GRILL - 2010I .� AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. 6Sw Return form to the Deputy Clerk of the Council (M-30). Call 647-cif you have any questions. The agreement with No. A—Wo-- hcq was completed on and final payment has been made. Department: pK6A Signature:A. aG7 Date: City of Santa Ana Clerk of the Council Revised 05-22-08 City of Santa Ana C;'Irk of the Council INSURANCE C:',' FILr A-2010-149 VORK RAY PROCEED NTIL 1'4SJP.A;NCE EXPIRES CLERK C : COUNCIL CONCESSION AGREEMENT DATE; SEP 2 0 2010 4 THIS AGREEMENT, made and entered into this 3rd day of September, 2010 by Karmina `3 Restaurant & Banquet Hall, a California Limited Liability Company (hereinafter "Contractor"), 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 (hereinafter "City"). RECITALS -e LJ A. The City desires to retain a Contractor having special skill and knowledge in the field of foods service concessions comparable with "high-level" industry practice. U - - B. Contractor represents that Contractor is able and willing to provide such services to the City. CJ t1 C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional "high-level" contractor 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 Contractor shall perform those services as set forth in the Scope of Services (Exhibit "A") as well as Contractor's proposal on file with the City. In the event of a conflict between the terms of this Agreement and any Exhibits or Attachments hereto, the terms of this Agreement shall prevail. 2. COMPENSATION In consideration for the concession rights granted by this Agreement, Contractor agrees to pay the City a monthly concession fee of $600 per month plus 10% of gross revenue during the term of this Agreement. The payment is due on the 1 Oth of each month. For example, the payment for November is due November 10 and should include the $600 plus 10% of October's gross receipts. For the initial month only, services for a partial month shall be prorated on a daily basis. 3. TERM This Agreement shall commence on the date first written above and terminate on the last day of the month two years following the date set forth for the above, unless terminated earlier in accordance with Section 11, below. At the sole discretion of the City, the term may be extended an additional 2 two-year terms. 4. INDEPENDENT CONTRACTOR Contractor 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 Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to its employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance naming the City, its officers, agents, volunteers, and employees as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Contractor shall supply City with a fully executed additional insured endorsement in substantially the form as set forth in Exhibit "B" attached hereto upon execution of this Agreement. Said endorsement shall be approved in form by the City Attorney. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Contractor is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Contractor is or employs a licensed professional such as an architect or engineer Contractor must obtain and maintain Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. e. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. 2 (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. f. If Contractor fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. 6. INDEMNIFICATION AND HOLD HARMLESS Contractor agrees to indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, lost profits, restitution, judicial or equitable relief or any other type of damage whatsoever arising out of claims for the same, which may arise from the direct or indirect actions of the Contractor or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates in any way to the services provided by Contractor under this Agreement; and (2) from any claim that personal injury, damages, just compensation, lost profits, restitution, or judicial or equitable relief or any other type of damage whatsoever is due by reason of the terms of or effects arising from this Agreement or of the Contractor's actions hereunder. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, lost profits or any other judicial or equitable relief or damages 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 Contractor 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, relative to any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, lost profits, or judicial or equitable relief or any other type of damage whatsoever has arisen by reason of the terms of, or effects arising from this Agreement or Contractor's actions hereunder. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 8. 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 telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 3 Santa Ana, CA 92702-1988 telefacsimile (714) 647-6956 With copies to: Executive Director of Parks, Recreation and Community Services City of Santa Ana 26 Civic Center Plaza (M-75) P.O. Box 1988 Santa Ana, California 92702 and Office of the City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6515 To Contractor: Karmina Restaurant & Banquet Hall 515 N. Main Street Santa Ana, CA 92701 Telefacsimile: 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 telefacsimile, 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. 9. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive agreement between the City and Contractor, 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 Contractor. 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 Contractor nor 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. 10. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior M 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 Contractors retained by City. 11. TERMINATION AND DAMAGES This Agreement may be terminated by the City upon thirty (30) days written notice of termination and by the Contractor upon thirty (30) days written notice. In the event of termination by the City, City shall be entitled to receive compensation for all activities by Contractor prior to receipt of such notice of termination. The City shall give the Contractor ten (10) days written notice of any deficiency before it may exercise its right of termination if the reason is for breach by the Contractor. 12. DISCRIMINATION Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in recruitment, selection, training, utilization, promotion, termination or any other employment related activity. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. 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 by the parties hereto or arises out of, or in connection with or by reason of this Agreement. 15. LICENSES & PERMITS Contractor 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. These shall include but not be limited to the following: a California State Board of Equalization Seller's Permit; City of Santa Ana Business Tax Receipt; Certified Food Handler Permit; and County of Orange Heath Department Permit. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said failure shall be cause for termination of this Agreement by the City in accordance with Section 11, above. 16. 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. 5 b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: MARIA D. HUIZAR Clerk of the Council AS TO FORM: JOS RECOMMENDED F R APPROV GERARDO MOUETI " Executive Director o the Parks Recreation and Community 3 CITY OF SANTA ANA: 7 DAVID N. REAM City Manager CONTRACTOR: Carlos Madriles Owner Tax ID# '-)7-53cq6 U EXHIBIT "A" SCOPE OF SERVICES A. GENERAL Contractor agrees to serve as a quality concessionaire to provide food service at the Santa Ana Stadium, 602 N. Flower Avenue. The City will provide the concession building and pay all electrical, gas, and water utilities, and trash service in return for a base rent amount and a percentage of gross sales. The West -side Stadium concession building totals 1,800 sq. ft. with approximately 70 linear feet of counter space. The East -side concession area totals 156 square feet and has approximately 16 linear feet of counter space. Annual attendance at the Stadium ranges from 180,000 to 210,000 with the busiest months being September through December. Stadium events include high school and community college football games, boxing, soccer tournaments, and other sporting and cultural events. Significant daily foot traffic around the Stadium results from the government employees, jurors and public walking between the multi -level parking structure and the numerous government and business buildings in the Civic Center. A calendar of Stadium events that occurred in 2009, including estimated attendance, is attached (Attachment "G"). Concessionaires are encouraged to complete their own market survey. B. SPECIFICATIONS 1. The West -side Stadium concession facility is a full service facility that is capable of providing a variety of hot and cold meal items, beverages, and snack food items. It is equipped with a refrigerator, walk-in freezer, changing room and staff restroom. The concessionaire shall provide stove, soft drink dispensers, grills, deep fat fryers, microwave ovens, coffee makers, popcorn machines and all other equipment not listed above. 2. The West -side Stadium concession facility has three service windows, two that serve the Stadium visitors inside of the Stadium grounds and one that opens to the street immediately in front of the Stadium entrance to serve non -Stadium patrons. The concessionaire shall provide sealed concrete tables and seating for customers outside the Stadium in the area designated by Staff. The Administrative Services Manager shall approve the quantity, manufacturer and installation of these fixtures. The concessionaire is required to meet all Planning and Building requirements for all installations. 3. The East -side Stadium concession facility has one service window, one sink, and approximately 17 linear feet of counter space. The East -side concession facility is approximately 156 square feet. 4. In addition to special event service, the concessionaire is expected to operate during non- event hours to provide weekday early morning breakfast service and noon lunch service. Concessionaire may also add additional dates and times. The City understands that limited hours and menu items may be available during hours that are less profitable. Contactor shall 7 provide hours of operation, which shall be subject to the reasonable approval of the Administrative Services Manager. 5. A maximum of one electrical business sign may be installed on the outside of the concession building. The concessionaire shall meet all Planning and Building codes and permit requirements before installing. The design of the sign shall be pre -approved by the Administrative Services Manager. 6. Professionally manufactured pricing boards are to be installed inside the concession building and not on the outside of the building or on windows. Pricing boards are to be pre -approved by the Administrative Services Manager. 7. Potted Plants or small trees may be installed in sealed concrete planters within the eating area or next to the concession building at the concessionaire's expense. These trees, plants, shrubs or flowers shall be kept neat and trimmed. These materials are to be pre -approved by the Administrative Services Manager. 8. The concessionaire is required to keep the working and eating areas clean at all times. Trash bags shall be provided and placed in trash bins by the concessionaire. Trash bags shall be dumped into the City's trash container when they become full and at the end of each day. 9. The concessionaire shall maintain neat, clean and safe surfaces in the concession area and power wash the concrete and asphalt within 20 feet of the concession building and in the eating areas a minimum of once per month. 10. If graffiti appears on any of the concessionaire's equipment, signs, or fixtures, or any other surface, it is to be removed daily at the concessionaire's expense. The City will remove graffiti on the exterior of the building. 11. For the safety of the public and protection of the facility, restrictions may be placed on items sold, type of packaging, location of portable carts, etc. The City must approve all menu items, packaging and cart locations (or changes to the above). No cans, bottles or gum shall be sold at the Stadium. 12. No tobacco products shall be sold or advertised. 13. The concessionaire is required to apply for and retain an annual ABC license or ABC caterers permit for use at the Stadium. License shall be in place within six months of execution of agreement. Alcohol may only be served at special events approved by the Executive Director of Parks, Recreation and Community Services. It cannot be sold on a regular basis to customers inside or outside the Stadium. 14. The concessionaire shall be responsible for continual trash removal during the concessionaire's operating hours. 15. Concessionaire shall tightly control the quality of the work performed by in-house staff and/or sub -consultants. Incomplete or poor quality work will not be accepted. 16. The food concession operation shall be run in an efficient, courteous manner by staff that is clean and neatly dressed, presenting a positive image for the Stadium. Food concession staff shall wear a uniform approved by the Administrative Services Manager. The standard uniform shall include a collared shirt, and matching pants and shoes. Special consideration will be offered to bidders able to demonstrate superior customer service. 17. The concessionaire shall attend meetings with City staff as required. 18. The concessionaire shall coordinate with other agencies as required. 19. The concessionaire shall complete the plan check processes with the City of Santa Ana and other agencies as required. 20. The concessionaire will be required to apply for and retain a City business license and all applicable Orange County Health Department permits. Concessionaire will be required to use certified food handlers in the concession operation. 21. The City retains merchandizing rights for all Stadium business. 22. In cases where the City determines that a special event warrants a specialized type of catering service, the City reserves the right to hire different caterer. Concessionaire will be given a 10-day notice of such events. 23. Contractor shall not enter into any other revenue sharing arrangement with other Stadium users, unless approved by City. 24. The concessionaire shall provide annual audited financial statements to the City. Statements are due on May 1 of each year for the previous year. C. CITY RESPONSIBILITIES The City will provide the following: l . Staff for cleaning non -concession areas during Santa Ana Stadium events. 2. Assistance with plan check coordination within the City. 3. Maintenance of concession building exterior and roof, refrigerator and freezer. 4. Payment of utilities, including water, electricity, gas and trash service (limited to the concession operation). 5. Staff liaison for communication and problem resolution. 0 Exhibit "B" ADDITIONAL INSURED ENDORSEMENT Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents and volunteers are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be canceled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Issued to this endorsement form as a part of Policy # Named Insured Countersigned by 10 Authorized Representative ` �� -0 A CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/(YYY) 08-17-2010 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 FIESTA AUTO INSURANCE CENTERS 31721 RIVERSIDE DRIVE LAKE ELSINORE CA 92530 CONTACT NAME: PHONE A/C 951-245-7624 AC951-245-7658 o E-MAtL ADD PRODUCER CUSTOM ER ID : INSURER(S) AFFORDING COVERAGE NAIC # INSURED KARMINA RESTAURANT 515 N. MAIN ST SUITE B SANTA ANA CA 92701 INSURER A: LLOYDS OF LONDON INSURANCE CO INSURER B : INSURERC: INSURER D INSURERE: INSURER F : CAVFRAGFS CFRTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AINSRDDL SUBR POLICYNUMBER MMIDDIYYYY MMIDD/YYYY LIMITS GENERAL LIABILITY COMMERCIALGENERALLIABILITY FQMFT 08/16/2010 08/16/2011 EACH OCCURRENCE $ 1,000,000 DAMA E TO ENT PREMISES Ea occurrence $ 50,000 CLAIMS -MADE 7 OCCUR MED EXP (Any oneperson) $ 51000 PERSONAL & ADV INJURY $ 1,000,000 A GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS -COMP/OPAGG $ 1,000,000 S PRO- POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS Apt P OVED AS FORM BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS $ UMBRELLA LIAB EXCESS LIAR HCLAIMS-MADE OCCUR N Y EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ $ RETENTION $- WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / NW ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEN S E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RESTAURANT WITH NO SALES OF ALCOHOL BEVERAGES WITH TABLE SERVICE TE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLMY-2RROVISIONS. AUTHORIZED C 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD FROM MINA BRIDAL FAX NO. : 714 541 1345 Aug. 11 2010 07:01PM P1 AT)QUIONAL INSURED ENI)ORSUIVIEN'r FOR COMMEACIAL GENERAL LIABILITY POLIC'Y Insurance Company FIi;ST4 IN5 UpgvG& I`his endorsement modifies such insurance as is afforded by the provisions of Policy # ro ( _F 7 relating to t e40llowing: 1. The City of Santa An , and the City of Santa Ana, located at 20 Civic Center Plaza, Santa Ana, California 2701; and their respective officers, employees, agents, volunteers and representativ�s are named as additional insureds ("additional insureds") with regard to liability an3 defense of suits arising from the operations and uses performed by or on behalf of tive named insured. i i 2. With respect to claimis arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or ciontributi%g with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance appli 's separately to each insured against whom claim is rn. ade or suit is brought except with espect to the company's limits of liability. The inclusion of any person or organizat; on as an insured shall not affect any right which such person or organization would have is a claimant if not so included. i 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in overage or limits except after thirty (30) days written notice has been given to the Community Redevelopment Agency of the City of Santa Ana, 20 Civic Center Plaza (M-25),jSanta Ana; California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective _ �8%6 ll�o�� , this endorsement fozm as a part of Policy M-r�---i # �QIn1 � CC DD Issued to Namcd .Insured Countersigned by A ized Representative from Insurance Provider A ca CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08-19-2010 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 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 FIESTA AUTO INSURANCE CENTERS 31721 RIVERSIDE DRIVE LAKE ELSINORE CA 92530 CONTACT NAME: PHONE 951-245-7624 FAC No: 951-245-7658 E-MAIL ADDRESS: PRODUCER C O ER ID #: INSURERS AFFORDING COVERAGE NAIC# INSURED KARMINA RESTAURANT 515 N. MAIN ST SUITE B SANTA ANA CA 92701 INSURER A: LLOYDS OF LONDON INSURANCE CO INSURERS: SOUTHERN INSURANCE CO INSURER C : INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL I R SUER POLICYNUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Z OCCUR FQMFT 08/16/2010 08/16/2011 EACH OCCURRENCE S 1,0001000 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 5,000 PERSONAL &ACV INJURY $ 11000,000 A GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 11000,000 PRO LOC POLICY JECT $ AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT (Ea accident) —' $ ANY AUTO BODILY INJURY (Per person) $ - ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A WSI00044454- APP D AS F FORM WC STATU- OTH- MI E.L. ETCH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 11000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I S 1,000,000 EPH FLETC ER DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES (Aft h ACORD dtli Iona em s I , if more space is required) CERTIFICATE HOLDER ADDED AS ADDITIONAL INSURED ONLY AS THEIR INTEREST MAY APPEAR UrK 111-it A I t MULutK CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDR,fARES TATIVE ' c ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD