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HomeMy WebLinkAboutRICHARDS, WATSON & GERSHON 3A - 2012Ilv�d��NpL ON FILE �O��c la(AYl R�RpGEED N- 2011 - 103 -001 �hIV�r1E INISUR6IN�E EXPIRES _ /O'/ —/� '�- ��F��iN��2012 �'AifEa. AMENDMENT TO LEGAL SERVICES AGREEMENT o: C,4o C2� Z THIS AMENDMENT TO LEGAL SERVICES AGREEMENT, made and entered into this �� day of January, 2012, by and between, Richards, Watson, Gershon, a California professional corporation (hereinafter "Attorneys ") 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 and Attorneys previously entered into a Legal Services Agreement CN -201 1 -103) ( "Agreement ") on August 1, 2011, for Attorneys to provide legal services to City. B. The parties hereto now desire to amend the start date of said Agreement. 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 . The start date for Attorneys to begin providing legal services to the City shall be amended to July 1, 201 1, rather than August 1 , 201 1 . 2. All other terms and conditions included in said Agreement shall have the same force and effect IN WITNESS WHEREOF, the parties hereto have executed this Amendment the date and year first above written. ATTEST: Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: JOSEPH STRAKA Interim City Attorney BY= z�iLs Lisa Storck Assistant City Attorney CITY OF SANTA ANA Paul Walters Interim City Manager RICHARDS, WATSON, GERSHON A P�rJofessional CorpQo�ration Kevin G. Ennis Shareholder Tax ID# RICHWAT -01 JCAMOMILE CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 10/25/2012 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 CONTACT NAME: Peter C. Foy & Associates Insurance Services Inc. PHONE 818 703 -8057 Fax 818 703 -0935 21650 Oxnard St. Arc No EXt : ( ) (arc, No): ( ) Suite 1900 E -MAIL Woodland Hills, CA 91367 ADDRESS: INSURED INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Chubb Insurance Company 41386 _ INSURER B: Federal Insurance Company 20281 INSURER C: INSURER D Richards, Watson & Gershon 355 S. Grand Avenue, 40th Floor Los Angeles, CA 90072 -3101 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 TYPE OF INSURANCE AD L UBR POLICY EFF • POLICY EXP LTR INSR WVD POLICY NUMBER MM /DD/YYYY MM /DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X 35293250 10/1/2012 10/1/2013 pREMISES KLNI occurrence) $ 1,000,000 tU CLAIMS -MADE � OCCUR MED EXP (Any one person) $ 10,000 _ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER : PRODUCTS - COMP /OPAGG $ Included POLICY PE X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 B ANY AUTO 74967929 1011/2012 10/1/2013 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS _ AUTOS ( ) X HIRED AUTOS X NON -OWNED PROPERTY DAMAGE AUTOS PERACCIDENT $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ �r DED RETENTION $ $ WORKERS COMPENSATION - WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N X TORY LIMITS ER B ANY PROPRIETOR /PARTNER/EXECUTIVE 71726476 10/1/2012 1011/2013 E.L. EACH ACCIDENT $ 1,000,000 OFFICER. /MEMBER EXCLUDED9 � N /A (Mandatory in and — E.L. DISEASE - EA EMPLOYEE; $ 1,000,000 If yes, describe under — __ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is named as Additional Insured as their interest may appear. Subject to policy terms, conditions and exclusions. Coverage is considered primary & non - contributory. 10 days notice doff cancellation applies for non-payment of premium. CERTIFICATE HOLDER E� Sisl , CANCELLATION City of Santa Ana Office of the City Attorney Twenty Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT�HORIIZE,D' REPRESENTATIVE © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD '`� " CERTIFICATE OF LIABILITY INSURANCE DATE (12012 YYVY) ,01,0120,2 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 cpnfer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh Risk & Insurance Services CA License #0437153 777 South Figueroa SfPet Los Angeles, CA 90017 CONTACT _NAME___ PHONE W.C. 149 • EX0 [A/C, No): —_ - ADDR ADDRESS: "� — -- -- - - - - -- - - - - -- 1 COMMERCIAL GENERAL LIABILITY INSURER(S) AFFORDING COVERAGE NAIC # _ INSURER A_: Nautilus Insurance Company _ 17370 502512 - FINPR -F &012 -13 _ _ INSURED Richards, Watson & Gershon INSURER B: AXIS Surplus Insurance Company -- — 26620 -- - - -- INSURER C : -- - -- 355 South Grand Avenue 40th Floor Los Angeles, CA 90071 -3101 - - - -- - -- -- _INSURER D : - - - -- - -- - PERSONAL & ADV INJURY INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: LOS - 001448649 -24 - REVISION NUMBER_ 1 THIS IS TO CERTIFY 1HAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE HE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CON OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TH ICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN ViffrED B PAID CLAIMS. INSR ADDL SUBR - D- -- -POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/ Y 'MM/ D/YYYY LIMITS GENERAL LIABILITY _ EACH OCCURRENCE $ 1 COMMERCIAL GENERAL LIABILITY 1.� C. ' DAMAGE TO RENTED PREMISES Llia occurrence MED EXP (Anyone person) $ CLAIMS -MADE E] OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ _ PRODUCTS - COMP/OP AGG _ $ GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY' INJURY (Per person) I $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED - AUTOS _ PROPERTY DAMAGE Per accident $ - $ - - - UMBRELLA LIAB OCCUR EACH OCCURRENCE $ L $ EXCESS LIAB - CLAIMS -MADE DED F71RETENTION $ _AGGREGATE $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PART NEH /EXECUTIVE OFFICER /MEMBER EXCLUDED? N / A __ Y ___ I ER E.L. EACH ACCIDENT -------- $ ___ -__ .L. DISEASE - EA EMPLOYEE [E.LDESCRIPTION $ (Mandatary in NH) If yes, describe under . DISEASE -POLICY LIMIT $ OF OPERATIONS below A Lawyers Professional Liability PLP 1600238 P -2 t0i0812012 10108/2013 Limit of I lability 5,000,000 B Lawyers Professional Liahlil EGN721261/01/2012 11010812012 10108/2013 $250,000 Retention Claims Made Policy DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is require PRU V Lll AS TO FORM w Laura Stitt Szt/Kdy Assistant City Atlornev • • •• •••• • •� • •........ -• • l.N1YL.CLLA I IUIV CITY OF SAN FA ANA OFFICE OF THE CITY ATTORNEY TWENTY CIVIC CENIER PLAZA SAN FA ANA, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk 8 Insurance Services Pat Fritcher ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD RICHWAT -01 JCAMOMILE AC"RO9 CERTIFICATE OF LIABILITY INSURANCE `- �-�''� 10/29/2013 D10 /29/2 3 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 CONS) NTar.(+ CONTR�Q,CTBGTWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDEf ) -- ' 7 ff "" i . // 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 sltat" f ton this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - Peter C. Foy & Associates Insurance Services Inc. 21650 Oxnard St. Suite 1900 Woodland Hills, CA 91367 ' NTAUI NAME: BONN E :t:1818) 703.8057 ac No : (818) 703 -0935 E -MAIL ADDRESS: INSURERIS) AFFORDING COVERAGE NAIC k INSURER A: Vigilant Insurance Company 20397 INSURED INSURERS: Federal Insurance Company 20281 INSURER C: $ 1,000,000 Richards, Watson & Gershon INSURER D: X 355 S. Grand Avenue, 40th Floor Los Angeles, CA 90072 -3101 INSURER E: 10/112014 INSURER F: $ 1,000,000 MED EXP(Any one person) 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. LTR TYPE OF INSURANCE AUTHORIZED A , REPRESENTATIVE Santa Ana, QA 92701 POLICY NUMBER MM/DDY EYFVY MMIDOIYYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR X 35293250 1011/2013 10/112014 pREMSE$ Ea occurrence $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGO $ Included POLICY IRI- IFCT X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ 1,000,00 BODILY INJURY (Par person) $ B ANY AUTO 74967929 10/112013 10/1/2014 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPER DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Ya OFFICER /MEMBER EXCLUDED? IN andatory In NH) N/A /'IlL 4(o 'IU /1 /ZU1.1 `I UTT/204 X TORY OEH _ EL. EACHACCOENT $ 1,000,00 E, L. DISEASE - EA EMPLOYEEI $ 11000,000 If yes, describe under DESCRIPTION OF OPERATIONS bal, I EL .DISEASE - POLICY LIMIT $ 1,000,000 I 7 - DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is named as Additional Insured as their interest may appear. Subject It to onditions {�expl Coverage is considered primary & non - contributory. 10 days notice of cancellation applies for non - payment lJ Y"i. /RC -AVA �° L,a11Ie StitC 5IL Cay AssiStant City Attornev CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010105) © 1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana Office of the City Attorney THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Twenty Civic Center Plaza AUTHORIZED A , REPRESENTATIVE Santa Ana, QA 92701 ACORD 25 (2010105) © 1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD lu CFiUBB Liability Insurance Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: GENERAL LIABILITY OCTOBER 1, 2013 TO OCTOBER 1, 2014 OCTOBER 1, 2013 3529 -32 -50 PLE RICHARDS WATSON & GERSHON VIGILANT INSURANCE COMPANY OCTOBER 24, 2013 Under Who Is An Insured, the following provision is added: Who Is An Insured Scheduled Person Or Subject to all of the terms and conditions of this insurance, any person or organization shown in the Organization Schedule, acting pursuant to a written contract or agreement between you and such person or organization, is an insured; but they are insureds only with respect to liability arising out of your operations, or your premises, if you are obligated, pursuant to such contract or agreement, to provide them with such insurance as is afforded by this policy. However, no such person or organization is an insured with respect to any: assumption of liability by them in a. contract or agreement. This limitation does not apply to the liability for damages for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. damages arising out of their sole negligence. Schedule CITY OF SANTA ANA OFFICE OF THE CITY ATTORNEY TWENTY CIVIC CENTER PLAZA SANTA ANA, CA 92701 Liability Insurance Additional Insured - Scheduled Person Or Organization Form 80-02-2367 (Rev. 8 -04) Endorsement continued Page 1 IcPolicy Conditions caiuse Schedule of Forms Policy Period OCTOBER 1, 2013 TO OCTOBER 1, 2014 Effective Date OCTOBER 1, 2013 Policy Number 3529 -32 -50 PLE Insured RICI-IARDS WATSON & GERSHON Name of Company VIGILANT INSURANCE COMPANY Date Issued OCTOBER 24, 2013 C �.PW\V. ttP.,,.WiY4A� .\�Y / /.,,�.SWNi �.#�'/ / / //. !'./ .././////i % /.f�'�� ii.✓..'�IDY�/ /.NY//i49S.T \ \ \Y /i. / / %hSRa // /ham '., //RhU:0.\/ /�' „',t The following is a schedule of forms issued as of the date shown above: Form Number Edition Date Form Name Effective Date Date Issued 80 -02 -9001 6 -98 HOW TO REPORT A LOSS 10/01/13 10/11/13 80 -02 -9090 6 -05 COMMON POLICY CONDITIONS 10/01/13 10/11/13 80 -02 -9717 12 -11 CALIFORNIA MANDATORY - CANCELLATION & NONRENWAL 10/01/13 10/11/13 80 -02 -9800 12 -08 INSURING AGREEMENT 10/01/13 10/11/13 99 -10 -0732 12-07 NOTICE TO POLICYHOLDERS- TRIPRA 10/01/13 10/11/13 99 -10 -0792 9 -04 IMPORTANT NOTICE - OFAC 10/01/13 10/11/13 99 -10 -0872 6 -07 AOD POLICYHOLDER NOTICE 10/01/13 10/11/13 last page Form 80 -02 -9999 (ED. 6 -95) schedule of Forms Page 1 NE criuee Property Insurance Schedule of Forms Policy Period OCTOBER 1, 2013 TO OCTOBER 1, 2014 Effective Date Policy Number Insured Name of Company Date Issued OCTOBER 1, 2013 3529 -32 -50 PEE RICHARDS WATSON & GERSHON VIGILANT INSURANCE COMPANY OCTOBER 24, 2013 The following is a schedule of forms issued as of the date shown above: Form Number Edition Date Form Name Effective Date Date Issued 80 -02 -0005 7 -03 PROPERTY DECLARATIONS 10/01113 10/11/13 80 -02 -0221 12.07 LF SUPPLEMENTARY DECLARATIONS PROPERTY 10/01/13 10/11/13 80 -02 -0226 4 -05 LF SUPPLEMENTARY DECLARATIONS BT/EE 10/01/13 10/11/13 80- 021000 6 -05 BUJLDING AND PERSONAL, PROPERTY 10/01/13 10/11/13 80 -02 -1017 7 -03 ELECTRONIC DATA PROCESSING PROPERTY 10/01/13 10/11/13 80 -02 -1048 7 -03 ACCTS REC, FINE ARTS, MONEY & SEC, VAL PAPERS 10/01/13 10/11/13 80- 021095 7 -03 IMPAIRMENT OF COMPUTER SERVICES - MALICIOUS PGM 10/01/13 10/11/13 80 -02 -1097 6 -05 PROPERTY/BI CONDITIONS & DEFINITIONS 10/01/13 10/11/13 80 -02 -1101 4 -05 LP BUSINESS INCOME WITH EXTRA EXPENSE 10/01/13 10/11/13 80 -02 -1102 12 -07 LF EXTENSION FOR PROPERTY INSURANCE 10/01/13 10/11113 80 -02 -1313 6 -05 ADDITIONAL EXCLUSIONS 10/01/13 10/11/13 80 -02 -1372 10 -06 EQSL LIMIT OF INSURANCE /DEDUCTIBLE 10/01/13 10 /11/13 80 -02 -1644 5 -04 ELECTRONIC DATA AND PERIL CHANGES 10/01/13 10/1.1/13 80 -02 -1658 12-07 CAP ON CERT. TERRORISM LOSSES (ALL PREMISES) 10/01/13 10/11/13 80 -02 -5250 6 -08 ORD OR LAW & EXISTING GREEN STANDARDS LPB 10/01/13 10/11/13 80 -02 -5310 2 -12 MUCH. OR ELECT. SYSTEM OR APPARATUS DEF AMEND 10/01/13 10/11/13 last page Form 80 -02 -1999 (ED. 6 -95) Schedule of Forms Page 1 IcLiability Insurance ct�ues Schedule of Forms Policy Period OCTOBER 1, 2013 TO OCTOBER 1, 2014 Effective Date OCTOBER 1, 2013 Policy Number 3529 -32-50 PLE Insured RICHARDS WATSON & GERSHON Name of Company VIGILANT INSURANCE COMPANY Date Issued OCTOBER 24, 2013 T y�y .:�,u\\\ \ \V•: AW(J . i \ \� ✓i. � . :. / / / / / /FMY //Ai:A:. �:R \ \\ i... /.V/.�MO" ✓ / / /J.tt�Yi n \s�W.:!. /.h\\U:4\ The following is a schedule of forms issued as of the date shown above: Form Number Edition Date Form Name Effective Date Date Issued 80 -02 -2367 8 -04 ADDL INS - SCHEDULED PERSON OR ORGANIZATION 10/01/13 10/24/13 80 -02 -6403 12 -07 CAP ON CERTIIIED TERRORISM LOSSES 10/01/13 10/11/13 80 -02 -2000 4 -01 GENERAL LIABILITY 10/01/13 10/11/13 80 -02 -2012 6 -98 EMPLOYEE BENEFPIS ERRORS OR OMISSIONS 1.0 /01/13 10/11/13 80 -02 -2319 4 -01 AGGREGATE LIMITS OF INSURANCE PER LOCATION 10/01/13 10/11/13 80 -02 -2328 4 -01 CUMIS - CALIFORNIA 10/01/13 10/11/13 80 -02 -2362 4 -01 CONDITION- WAIVER OF TRANS./RIGHTS OF RECOVERY 10 /01/1.3 10/11/13 80 -02 -2373 4 -94 CONTINUAT'I'ON OF 80 -02 -2362 10/01/13 10/11/13 80 -02 -2423 4 -05 EXCL LF INSDS OR AFFILIATES /LEGAL PROF SERV 10/01/13 10/11/13 80 -02 -2651 4 -01 CUMIS - CALIFORNIA 10/01/13 1.0/11/13 80 -02 -2653 4 -01 OTHER INSURANCE - PRIMARY ADDT, INSURED 10/01/13 10/11/13 80 -02 -2668 8 -01 EXCL, BIOLOGICAL AGENTS, TOTAL 10/01/13 10/11/13 80 -02 -6528 4 -05 EXCLUSION - INFORMATION DISTRIBUTION LAWS 10/01/13 10 /11/13 80 -02 -6541 3 -05 CONDITION - PREMIUM AUDIT 10/01/13 10/11/13 80 -02 -6595 5 -06 DEDUCTIBLES 10/01/13 10/11/13 last page Form 80 -02 -2999 (ED. 6 -95) Schedule of Forms Page 1 � ® AC CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDI)NYYY) 1010712014 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 CER E IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain olilipS may FgSre an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . lCr� i TT (1{' /� PRODUCER O CO Marsh Risk & Insurance Services CA License (10437153 777 South Figueroa Street Los Angeles, CA 90017 Atm Nadine Romero (213) 346 -5885 CT ._ PHONE FAX INC. No Exit, A/c No: AD RIESS, INSURER(S) AFFORDING COVERAGE NAIC p INSURER A, Nautilus Insurance Company 17370 INSURED Richards. Watson 8 Gershon 355 South Grand Avenue INSURER B: AXIS Surplus Insurance, Company 26620 INSURER C : DAMAGE O RENTED PREMISES Ea occurrence INSURER D: MED EXP (Any one person) 49th Floor Los Angeles, CA 90071 -3101 I� INSURER E: CLAIMS -MADE ❑ OCCUR _ __ rnsaoco. I r1C001AAARA0.9T RFVISION hKAWRER -i L,VVcwwaaoa .111 .. .....— ......... —••. ______.__.. 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. _ IN,rA TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDDM/YY POLICY EXP MMID IYYYY LIMITS M Marsh Risk & Insurance Services GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY Nadine Romero!''�df' -.L *`mss° n rnoonowTlnu All nnHle msenrved EACH OCCURRENCE $ DAMAGE O RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ CLAIMS -MADE ❑ OCCUR PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ Ee eDl$INGLE LIMIT $ POLICY PRO LOC AUTOMOBILE LIABILITY amid BODILY INJURY (Per person) $ ANY AUTO �O BODILY INJURY (Per amioenl) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS �YgpVED �Q V O PROPERTY DAMAGE Per accitlent $ UMBRELLA LIAB EXCESS LIAB CCLAMS -MADE �{ ECitY A0tY18`i EACH OCCURRENCE $ AGGREGATE $ OED RETENTION$gg WORKERS COMPENSATION VJC STATU- OTH- $ E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE� OFFICERIMEMBER EXCLUOED4 (Mandator, in NH) NIA E.L. DISEASE - EA EMPLOYE S fyas desontoeunder DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ A Lawyers Professional Liability PLP 1000236 P-4 1010812014 1010812015 Each Claim 7,500,000 B ENN 72126110112014 10108/2014 1010812015 Self- Insured Retention 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (AUach ACORD 101, Additional Remarks Sch"ide, It more apace Is required) CERTIFICATE MULUEI< CITY OF SANTA ANA OFFICE OF THE CITY ATTORNEY TWENTY CIVIC CENTER PLAZA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE M Marsh Risk & Insurance Services Nadine Romero!''�df' -.L *`mss° n rnoonowTlnu All nnHle msenrved v Pau -w w......,... ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD