HomeMy WebLinkAboutKNOWLWOOD ENTERPRISES INC. -2010City of Santa Ar
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Clerk of the Councii
AGREEMENT TERMINATION FORM ..... .. ............ .. .. .. .. .. . . .. . ........ ..
COTC Office Use Only
2020-
PH 37
Please complete this form when the attached agreement and all CITY' OF
amendments (if any) are no longer in effect. CL RK SF �" TA ANA
EIOCOUNCIL
Return form to the Clerk of the Council Office (M-30).
Call 6474 if you have any questions.
The agreement with KYK Y-rA
No. PT-2010—Z3q _ was completed on and final payment has been made.
(List all amendments. Use space below if needed.)
Department: P
Phone/Ext.: a\CN_
Signature:
Date:
Revised 04-12-10
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CONCESSION AGREEMENT
A-2010-239
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THIS AGREEMENT, made and entered into this X_ day of M-6 by
Knowlwood Enterprises, Inc, a California Corporation (hereinafter "Con ssionair "), 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
A. The City desires to retain a Concessionaire having special skill and knowledge in the field of
foods service concessions comparable with "high-level" industry practice.
B. Concessionaire represents that Concessionaire is able and willing to provide such services to
the City.
C. In undertaking the performance of this Agreement, Concessionaire represents that it is
knowledgeable in its field and that any services performed by Concessionaire under this
Agreement will be performed in compliance with such standards as may reasonably be
expected from a professional "high-level" food service operator 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
Concessionaire shall perform those services as set forth in the Scope of Services (Exhibit
"A") as well as Concessionaire'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, Concessionaire
agrees to pay the City a monthly concession fee of $2,800 per month, in advance. The payment is
due on the I st of each month. For the initial month only, services for a partial month shall be
prorated on a daily basis. A 3% late fee will be added if payment is not received by the 10th of
the month.
3. TERM
This Agreement shall commence on the date first written above and terminate on the last
day of the month three (3) 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 Council, the term
may be extended an additional 2 two-year terms. Six months prior to the end of any term, City
will provide written notice of its intent regarding its option to extend the term.
4. INDEPENDENT CONTRACTOR
Concessionaire 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
Concessionaire performs the services which are the subject matter of this Agreement; however,
the services to be provided by Concessionaire shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Concessionaire 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, Concessionaire shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Concessionaire 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 Concessionaire'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. Such insurance shall (a) name the City, its officers,
employees, agents, volunteers and representatives as additional insured(s); (b) be primary with
respect to insurance or self-insurance programs maintained by the City; and (c) contain standard
separation of insureds provisions. 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, Concessionaire 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, Concessionaire agrees to obtain and maintain any employer's liability
insurance with limits not less than $1,000,000 per accident.
d. The following requirements apply to the insurance to be provided by Concessionaire
pursuant to this section:
(i) Concessionaire shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement.
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(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.
(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.
e. If Concessionaire 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
Concessionaire 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 Concessionaire or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates in any way to the services
provided by Concessionaire 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 terns of or effects arising from this
Agreement or of the Concessionaire'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 Concessionaire 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 Concessionaire's actions hereunder. City may make all
reasonable decisions with respect to its representation in any legal proceeding.
7. CONFLICT OF INTEREST CLAUSE
Concessionaire 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
Santa Ana, CA 92702-1988
telefacsimile (714) 647-6956
With copy to: Executive Director of Parks, Recreation and Community Services
City of Santa Ana
P.O. Box 1988
Santa Ana, California 92702
To Concessionaire: Knowlwood Enterprises, Inc.
17654 Newhope Street, Suite H
Fountain Valley, CA 92708
Fax: 714-729-9214
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
Concessionaire, 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 Concessionaire.
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
Concessionaire 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
Concessionaire, Concessionaire 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
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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 Concessionaires
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 Concessionaire 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
Concessionaire prior to receipt of such notice of termination. The City shall give the Concessionaire
ten (10) days written notice of any deficiency before it may exercise its right of termination if the
reason is for breach by the Concessionaire.
12. DISCRIMINATION
Concessionaire 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. Concessionaire 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
Concessionaire 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. Concessionaire 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.
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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
CITY OF SANTA ANA:
DAVID N. REAM
City Manager
APPROVED AS TO FORM:
Laura Sheedy
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
GERARDO MOUET
Executive Director of the
Parks Recreation and Community
CONCESSIONAIRE:
-\W M?
Thanh D. Nguyen, Ph.D.
President and CEO
Tax ID # 4 5 - P41 q 510
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EXHIBIT "A"
I. SCOPE
A. PROJECT DESCRIPTION
This specification outlines the service expectations for the food concessionaire that operates the
Santa Ana Zoo at Prentice Park concession building. The concession building totals 2,488 sq. ft.
of which 704 sq. Ft. is provided for food preparation and sales. Friends of Santa Ana Zoo
(FOSAZ) operates the gift shop and has exclusive rights for the gift shop and souvenir items;
however, the food service concessionaire may sell souvenir drink cups and other items approved
by the Zoo Manager. The Zoo concession facility is a full service food operation that is capable
of providing a variety of hot and cold meals, beverages, and snack food items. It is equipped
with a large grill. The successful vendor will be responsible for providing a deep fat fryer, ice
machine, refrigerator and freezer, soft drink dispensers, Icee machines, ice cream freezer,
microwave, coffee maker, popcorn machine, or churro warmer and any other equipment needed.
The Zoo has a large private picnic area and 150-seat amphitheater that is available to the City
and FOSAZ for special events. The City and/or FOSAZ reserve the right to hire another caterer
for special events at the Zoo. Private parties are under no obligation to use the Zoo
concessionaire. Concessionaire may be given the opportunity to bid on food service for those
events and will be given a 10-day notice of such events.
Annual attendance at the Zoo ranges from 250,000 to 275,000 with the busiest months being
March through August. The Zoo is open every day of the year except Christmas Day and New
Year's Day. The Zoo is open to the public from 10:00 a.m. to 5:00 p.m. daily except for
Saturdays and Sundays from Memorial Day through Labor Day when hours are 10:00 a.m. to
6:00 p.m.
B. SATELLITE CARTS
Satellite food/beverage stations are possible at the following locations:
1. Carrousel plaza - between the carrousel line and the train rides.
2. Elephant ring - food stand and carts next to the elephant ride.
Any other satellite stations will have to be pre-approved by the Zoo Manager.
C. OBJECTIVES
1.Provide excellent food service at reasonable prices.
2.Conduct a clean and efficient operation.
3.The food concession operation should be consistent with and enhance the Zoo image.
4.The operating hours shall be consistent with those of the Zoo. Any exceptions to these
hours must be approved by Zoo Manager.
5.Upon Zoo Manager's approval the concessionaire may also sell beyond Zoo hours to
patrons through outside service window.
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D. CITY RESPONSIBILITIES
1. City will maintain the exterior of the structure and landscaping except for trash and debris
around eating area tables and chairs.
2. City will provide paid utilities including water, trash, electricity, and gas.
3. City will communicate with the concessionaire regarding events organized by the Zoo or
Friends of Santa Ana Zoo.
4. City will provide staff contact as liaison for communication and problem resolution.
5. City reserves the right for independent audit of concession operations.
E. CONCESSIONAIRE RESPONSIBILITIES
1. Provide food service to Zoo visitors that meet standards of quality and service as mutually
agreed by concessionaire and Zoo Manager. Fast food menu is acceptable providing there are
varieties of "healthier" menu alternatives.
2. The Zoo Manager must approve all menu items, pricing and marketing material. Some food
items may be restricted due to possible problems related to excessive litter or potential animal
health issues.
3. Provide on-site manager who has current food service handler's certification from the Orange
County Health Department.
4. Meet sanitation and food preparation standards as established by the Orange County Health
Department.
5. Have and maintain Santa Ana City business license.
6. Secure an ABC License for the sale of beer and wine and maintain requirements for same.
Sale of beer and wine will only be allowed at events approved by the Executive Director of
Parks, Recreation & Community Services.
7. Concessionaire is responsible for hiring and compensating employees, including all applicable
payroll taxes and deductions. Concession employees are not considered City employees.
8. Provide adequate staff to meet visitor demands, which vary with season and day.
9. Maintain a regular schedule of cleaning and sanitation of interior of food service facility and
equipment, and proper recycling of deep fat fryer cooking oil. The concessionaire is responsible
for repairs to interior of food service area subject to City approval. The concessionaire is also
responsible for any repairs to any equipment and facilities damaged due to concessionaire's
negligence.
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10. Tenant improvements and move in to be done by concessionaire in conjunction with the OC
Health approval.
11. Continually maintain front of concession stand clean which includes cleaning tables and
chairs, picking up all trash and empting trash cans. In addition, all trash cans must be emptied at
the end of each business day. Trash from inside the facility may be enclosed in proper containers
behind the facility in the service area but must be removed to the Zoo's dumpsters on a daily
basis before closing. No plastic bags of trash or cardboard boxes are to be stacked in the service
area. This is necessary for vermin control.
12. Provide such equipment as necessary for food service operation that is not part of the
permanent fixtures of the facility.
13. Provide supplies for food preparation, cleaning and sanitation, and trash containment.
14.Provide theme based marketing such as graphics, menus, and operational materials.
F. CONCESSION FEE
In consideration for the rights obtained hereunder, Concessionaire shall pay $2,800 per month,
payable on the first day of each month for the following month. For example: rent for October is
due on October 1 st. A 3% late fee will be added if payment is not received by the 10th of the
month.
G. SPECIAL CONSIDERATIONS AT A ZOO FACILITY
Because of special requirements and considerations for Zoo animal safety, special restrictions
may be necessary as far as items sold, food packaging, location of portable carts, etc. The Zoo
Manager must approve all menu items, packaging and cart locations (or changes to above).
H. VISITOR SERVICES
Customer satisfaction and visitor service is of utmost importance. It is mandatory that our food
concessions be run in an efficient, courteous manner by staff that is clean and neatly dressed,
presenting a positive image for the Zoo. Food concession staff will be expected to wear a Zoo
specific `uniform" approved by Zoo Manager.
I. TENANT IMPROVEMENTS
Concessionaire shall provide detailed plans of all tenant improvements to be completed and
submitted to City by 90 days after the commencement of the agreement. All non-structural
tenant improvements shall be completed by six months after the commencement of the
agreement. All structural tenant improvements shall be completed by one year after
commencement of the agreement. Concessionaire shall work with City on a more detailed
timeline once details of tenant improvements are available.
9
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
RIGHT INSURANCE MARKETING ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
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GARDEN GROVE, CA 92840
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INSURED „ 1 RER A: ALLIED P&C INSURANCE COMPANY
NDT, INC.& KNO LWOOD l' (E ...?N{'. „ ZRER 8:
DBA: NDT, INC INSURER C:
17654 NEWHOPE STREET
SUITE H
, INSURER D:
FOUNTAIN VALLEY, CA 92708
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR "im TYPE OF INSURANCE POLICY NUMBER D LIMITS
GENERALLIAtBUTY EACH OCCURRENCE S 2,000,000
COMMERCIAL GENERAL LIABILITY PREMISES Ea oNocurence S 300,000
A CLAIMS MADE R1 OCCUR MED EXP (Any one person) $ 5,000
ACP 7842162960 04/01/2010 04/01/2011 PERSONAL & ADV INJURY S 2,000,000
GENERAL AGGREGATE S 4,000,000
EWL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
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AUTOMOBILE INBA ITY
COMBINED SINGLE LIMIT
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INSUREDS BUSINESS: RESTAURANT
CERTIFICATE HOLDER: CITY REQUIREMENT
BUSINESS MAIN LOCATED: 1801 EAST CHESTNUT AVE, SANTA ANA, CA 92701
*10 DAY CANCELLATION FOR NON-PAYMENT OF PREMIUM
CERTIFICATE HOLDER IS ADDITIONAL INSURED
CITY OF SANTA ANA
20 CIVIC CENTER PLAZA
SANTA ANA, CA 92701
ACORD
BIPOSE NO OBLIGATION OR LIA W47Y OF ANY HMO UPON_IE INSURER, ITS AGENTS OR
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAR '30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
AUTHORQED
0 ACORD CORPORATION 1988
A - CCU -c;? T-5`1)
AGENT ADDRESS: GARDEN GROVE CA 92842 001
POLICY PERIOD: FROM 04-01-10 TO 0401-11 12:01 A.M. Standard Time
EFFECTIVE DATE OF CHANGE: 02-08-11 12:01 A.M. Standard Time
NOT A STATEMENT - YOUR BILLING WILL FOLLOW TOTAL PREMIL
************************** LOCATION / BUILDING ***************** NO. 023000
LOC/BLDG DESCRIBED PREMISES
09 01 1801 E CHESTNUT AVE SANTA ANA CA
RESTAURANT
CHANGED DESCRIPTION
FROM : RESTURANT
TO : RESTAURANT
************************** ADDITIONAL INSURED ****************** NO. 024000
THE CITY OF SANTA ANA AND THEIR RESPECTIVE OFFICERS,
CHANGED OLD ADDRESS
FROM : EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES
TO : SEE BLANK ENDORSEMENT PB2500
****************************** ENDORSEMENT ********************************
ADDED ENDORSEMENT FORM
FORM PB2500 EDITION DATE 0101
A COPY OF THIS FORM IS ATTACHED
AGENT NAME: RIGHT INSURANCE MARKETING 84 51215 NO CHARGE $ .00
Allied
Insurance AMCO INSURANCE COMPANY ALLIED SERIES
a Nationwide' company
On Your Side*
CHANGE OF DECLARATIONS ENDORSEMENT - PLEASE READ CAREFULLY.
POLICY NUMBER ACP BPF 7842162960 PREMIER BUSINESSOWNERS POLICY
NAMED INSURED: NDT, INC. AND KNOWLWOOD ENTERPRISES, INC. - DBA
KNOWLWOOD
MAILING ADDRESS: 17654 NEWHOPE ST STE H
FOUNTAIN VALLEY, CA 92708-4294
A
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PREMIUM
$ .00
$ .00
DIRECT BILL L87M 11041 AGENT COPY 957519450 78 07784
EFFECTIVE DATE: 12:01 AM Standard Time,
(at your principal place of business)
BUSINESSOWNERS
PB 25 00 (01-01)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY NUMBER: ACP BPF 78-42162960
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF OTHER INSURANCE CONDITION:
PRIMARY INSURANCE FOR NAMED INSURED
PRIMARY INSURANCE FOR NAMED INSURED IN THE PREMIER BUSINESSOWNERS COMMON
POLICY CONDITIONS, UNDER CONDITION H. OTHER INSURANCE, THE FOLLOWING IS ADDED:
WITH RESPECT ONLY TO THE PERSONS OR ORGANIZATIONS SHOWN IN THE SCHEDULE OF
THIS ENDORSEMENT, WHO HAVE BEEN ADDED BY SEPARATE ENDORSEMENT AS ADDITIONAL
INSUREDS, THE INSURANCE AFFORDED TO YOU NDT INC AND KNOWLWOOD ENTERPRISES
INC DBA KNOWLWOOD BY THIS POLICY SHALL BE PRIMARY INSURANCE WITH RESPECT TO
ANY CLAIM OR SUIT AGAINST YOU ARISING OUT OF YOUR ONGOING OPERATION
PERFORMED FOR SUCH PERSONS OR ORGANIZATIONS.
WITH RESPECT TO SUCH PERSONS' OR ORGANIZATIONS' LIABILITY ARISING SOLELY
OUT OF YOUR ONGOING OPERATIONS PERFORMED FOR THEM, ANY OTHER INSURANCE
MAINTAINED BY SUCH PERSONS OR ORGANIZATIONS WITH RESPECT TO SUCH LIABILITY
SHALL BE NON-CONTRIBUTING WITH YOUR INSURANCE UNDER THIS POLICY.
SCHEDULE OF PERSONS OR ORGANIZATIONS:
THE CITY OF SANTA ANA AND THEIR RESPECTIVE OFFICERS, EMPLOYEES, AGENTS,
VOLUNTEERS AND REPRESENTATIVES
20 CIVIC CENTER PLAZA
SANTA ANA CA 92701-4058
All terms and conditions of this policy apply unless modified by this endorsement.
PB 25 00 (01-01)
ACP BPF 7842162960 AGENT COPY 78 07785
Allied
Insurance AMCO INSURANCE COMPANY
a Nationwide' company
On Your Side'
ALLIED SERIES
CHANGE OF DECLARATIONS ENDORSEMENT -PLEASE READ CAREFULLY.
POLICY NUMBER ACP BPF 7842162960 PREMIER BUSINESSOWNERS POLICY
NAMED INSURED: NDT, INC. AND KNOWLWOOD ENTERPRISES, INC. - DBA
KNOWLWOOD
MAILING ADDRESS: 17654 NEWHOPE ST STE H
FOUNTAIN VALLEY, CA 92708-4294
AGENT NAME: RIGHT INSURANCE MARKETING 84 51215 NO CHARGE $ .00
AGENT ADDRESS: GARDEN GROVE CA 92842 001
POLICY PERIOD: FROM 0401-10 TO 04-01-11 12:01 A.M. Standard Time
EFFECTIVE DATE OF CHANGE: 02-08-11 12:01 A.M. Standard Time
NOT A STATEMENT - YOUR BILLING WILL FOLLOW TOTAL PREMIUM . 00
PREMIUM
************************** LOCATION / BUILDING ***************** NO. 023000 $ .00
LOC/BLDG DESCRIBED PREMISES
09 01 1801 E CHESTNUT AVE SANTA ANA CA
RESTAURANT
CHANGED DESCRIPTION
FROM : RESTURANT
TO : RESTAURANT
************************** ADDITIONAL INSURED ****************** NO. 024000 1$ .00
THE CITY OF SANTA ANA AND THEIR RESPECTIVE OFFICERS,
CHANGED OLD ADDRESS
FROM : EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES
TO : SEE BLANK ENDORSEMENT PB2500
****************************** ENDORSEMENT ********************************
ADDED ENDORSEMENT FORM
FORM PB2500 EDITION DATE 0101
A COPY OF THIS FORM IS ATTACHED
W
A
O_
O
DIRECT BILL
L87M 11041
AGENT COPY
957519450 78 07784
EFFECTIVE DATE: 12:01 AM Standard Time,
(at your principal place of business)
BUSINESSOWNERS
PB 25 00 (01-01)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY NUMBER: ACP BPF 78-42162960
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF OTHER INSURANCE CONDITION:
PRIMARY INSURANCE FOR NAMED INSURED
PRIMARY INSURANCE FOR NAMED INSURED IN THE PREMIER BUSINESSOWNERS COMMON
POLICY CONDITIONS, UNDER CONDITION H. OTHER INSURANCE, THE FOLLOWING IS ADDED:
WITH RESPECT ONLY TO THE PERSONS OR ORGANIZATIONS SHOWN IN THE SCHEDULE OF
THIS ENDORSEMENT, WHO HAVE BEEN ADDED BY SEPARATE ENDORSEMENT AS ADDITIONAL
INSUREDS, THE INSURANCE AFFORDED TO YOU NDT INC AND KNOWLWOOD ENTERPRISES
INC DBA KNOWLWOOD BY THIS POLICY SHALL BE PRIMARY INSURANCE WITH RESPECT TO
ANY CLAIM OR SUIT AGAINST YOU ARISING OUT OF YOUR ONGOING OPERATION
PERFORMED FOR SUCH PERSONS OR ORGANIZATIONS.
WITH RESPECT TO SUCH PERSONS' OR ORGANIZATIONS' LIABILITY ARISING SOLELY
OUT OF YOUR ONGOING OPERATIONS PERFORMED FOR THEM, ANY OTHER INSURANCE
MAINTAINED BY SUCH PERSONS OR ORGANIZATIONS WITH RESPECT TO SUCH LIABILITY
SHALL BE NON-CONTRIBUTING WITH YOUR INSURANCE UNDER THIS POLICY.
SCHEDULE OF PERSONS OR ORGANIZATIONS:
THE CITY OF SANTA ANA AND THEIR RESPECTIVE OFFICERS, EMPLOYEES, AGENTS,
VOLUNTEERS AND REPRESENTATIVES
20 CIVIC CENTER PLAZA
SANTA ANA CA 92701-4058
All terms and conditions of this policy apply unless modified by this endorsement.
PB 25 00 (01-01)
ACP BPF 7842162960 AGENT COPY 78 07785