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Home My WebLink AboutSIRIUS K9 ACADEMYINSURANCE ON FILE WORK MAY PROCEED N-2012-052 UNTIL INSURANCE EXPIRES 02-/ ( -/3 CLERK OF COUNCII DATE: 2, 3 2012 0 .S s?Q??Z? LICENSE GRANTING RIGHT OF ENTRY Lai' ? The CITY OF SANTA ANA, a charter city and municipal corporation duly organized and ?+fal/1M- existing under the Constitution and laws of the State of California ("City"), does hereby grant to SIRIUS K9 ACADEMY ("SIRIUS"), the right to enter the Santa Ana Police Department K9 Training Facility located at 600 East Memory, in the City of Santa Ana, County of Orange (the "Property"), and hereby grants to the City anon-exclusive and revocable license with respect to the following: RECITALS A. SIRIUS provides personal canine search and protection training ("Program"). As part of its Program, SIRIUS offers discounted pricing for the training of dogs from rescue centers and shelters, as well as to law enforcement, fire and military personnel. B. The City believes the services offered by SIRIUS in operating this Program benefit the community members and safety personnel. It therefore wishes to accommodate SIRUIS's desire to temporarily utilize the Property to provide its Program to community members by granting a temporary right of entry to the property upon the following terms and conditions. NOW, THEREFORE, SIRIUS and City do hereby agree as follows: 1. Right of Entry. Provided that all of the terms and conditions of this License are fully satisfied, the City hereby grants to SIRIUS and its employees, agents and contractors the nonexclusive, nonassignable, and revocable personal right to enter upon the Property with prior consent from the Chief of Police via his designee, Sergeant M. Kozakowski, unless otherwise notified by the Chief of Police or his designee, for the purpose of operating the program and for no other purposes. It is expressly understood that this License does not in any way whatsoever grant or convey to SIRIUS any rights of possession, easement or other cognizable property interest in the Property. 2. Conditions. By execution of this License, SIRIUS agrees for itself and on the behalf of its employees, agents, consultants and contractors as follows: (a) SIRIUS shall only be granted the nonexclusive right to enter and occupy the Property at a day and time that is approved in advance by Sergeant M. Kozakowsk. SIRIUS shall at all times coordinate the availability of the facility with Sergeant M. Kozakowski or his authorized designee and obtain his consent to utilize the Property prior to entering the Property. (b) This License 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 operates its Program; however, the services to be provided by SIRIUS while utilizing the Property shall be provided in a manner consistent with all applicable standards and regulations governing such services. Page 1 of 6 (c) SIRIUS will not permit any dangerous condition to be created on the Property. (d) All acts and things done by SIRIUS on the Property will be done in a careful and reasonable manner, in accordance with all federal, state and local laws. (e) SIRIUS shall ensure that (1) the Property is maintained and kept free of litter, debris and waste at all times; (2) no personal belongings or similar items remain after SIRIUS vacates the Property after each use, and; (3) the property shall be returned to its original condition after each use. (f) SIRIUS shall enter and occupy the Property entirely at its own cost, risk and expense. (g) Prior to undertaking performance of any operations or services under this License, SIRIUS shall maintain and shall require its contractors and/or subcontractors, if any, to obtain and maintain insurance as described below in Section 4. (h) Prior to undertaking performance of any operations or services under this License on or around the Property, SIRIUS shall require each participant to sign a waiver and release of liability form, attached hereto as Exhibit A, releasing the City from any and all liability that may arise from his/her participation in the Program. 3. Termination, Modification and Suspension (a) Term. This right of entry shall commence on the date written below and terminate six (6) months from that date, unless terminated earlier in accordance with subsection (b) below. The term of this license may be extended upon written agreement between the City and SIRUS. (b) Modification and Termination by City without Cause. This right to enter the Property is subject to immediate temporary termination or modification upon verbal notification by the Santa Ana Police Department Chief of Police or his designee. Additionally, SIRIUS understands and agrees that the City or the Chief of Police, or his designee, may immediately and permanently terminate this license and revoke the right of entry for whatever reason, but will make best efforts to give two (2) weeks notice before doing so. 4. Insurance (a) Commercial General Liability Insurance. SIRIUS shall maintain cocninercial general liability insurance which 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 SIRIUS's operations in the performance of this License, including, without limitation, acts involving vehicles. The amounts Page 2 of 6 of insurance shall not be 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 and agents as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. (b) In accordance with the provisions of Section 3300 of the Labor Code, SIRIUS, if it has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance and as such, prior to the commencement of this License, SIRIUS agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. (c) The following requirements apply to the insurance to be provided by SIRIUS pursuant to this section: • SIRIUS shall maintain all insurance required above in full force and effect for the entire period covered by this License. • Certificates of insurance shall be furnished to the City upon execution of this License and shall be approved in Form by counsel for the City. • 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. (d) If SIRIUS 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 its election, to forthwith terminate this License. 5. Indemnity- SIRIUS hereby agrees to defend, indemnify and hold the City of Santa Ana and its respective officers, officials, members, employees, agents, volunteers and representatives, harmless from and against any and all loss, damage, injury, liability, claim, cost or expense (including, without limitation, reasonable attorneys' fees, expert witness fees, court costs, and expenses) arising from or attributable to the activities of SIRIUS or any of its officers, officials, members, employees, agents, volunteers and representatives upon the Property pursuant to this License. All use of and entry upon the Property shall be at the sole cost, risk and expense of SIRIUS. 6. No Assignment- The rights herein granted to SIRIUS are exclusive, and SiRiUS agrees not to assign, transfer, lease, pledge, or otherwise dispose of its License and Right of Entry without the prior expressed written approval of the City. Page 3 of 6 7. lvliscellaneous. (a) Choice of Law. This License is to be governed by, and construed in accordance with, the laws of the State of California. (b) Remedies. Either party shall, in addition to all other rights provided herein or as may be provided by law, be entitled to the remedies ofspeciYic performance and injunction to enforce its rights hereunder, except to the extent expressly provided to the contrary in this License. All rights and remedies under this License are cumulative and no one of them shall be exclusive ofany other, and each party shall have the right to pursue any one or all of such rights and remedies or any other remedy which may be provided by law, whether or not stated in this License, except to the extent expressly provided to the contrary in this License. (c) Counterparts. This License may be executed in two (2) or more counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument. (d) Non-Liability of Public Officials. No officer, employee, member, agent or representative ofthe City shall be personally liable to SIRIUS, or any successor in interest, in the event ofany default or breach by the City, or for any amount which may become due to SIRIUS or its successor, or for any breach ofany obligation of the terms of this License. IN WITNESS WHEREOF, the parties hereto have entered. into this License as of the date first set forth above. Date: `?` 0`202 ATTEST • ?i MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO Cit ttorney eresa L. Judd Assistant City Att ey 2012 THE CITY/ IOF SANTA ANA PAUL M. WALTERS Interim City Manager S[RIUS K9 ACADEMY A? -?_ CAROLINE HALDEMAN Owner Page 4 of 6 EXHIBIT A Page 5 of 6 WAIVER AND RELEASE OF LIABILITY FORM To the extent permitted by law, (?}'Qp]?y,J[- ?A'Z,i?y??i? hereby agrees to RELEASE, NAIVE, DISCHARGE, AND HOLD HARMLESS the City of Santa Ana, its officers, employees, agents and assigns (hereinafter collectively referred to as the "City") from any and all claims, demands, damages, rights of action, or cause of action, present or future, whether the same be known, anticipated, or unanticipated, resulting from or arising from his/her voluntary participation in the SIRIUS K9 Academy training program ("Program") andlor his/her presence on or around City property. The above named person shall enter and occupy the Property entirely at his/her own cost, risk and expense, and further acknowledges and understands that the Program is not maintained, operated, or sponsored by the City and that SIRIUS K9 Academy is in no way acting as an employee, agent or representative of the City of Santa Ana in conducting its Program_ IN WITNESS WHEREOF, the party named above has voluntarily and knowingly executed this Waiver and Release of Liability Form as of the date and year written below. Participant: Date: OS-[tl I:Z L?/?Rol??Jt= l'?F?u?!'7HnJ Name: Address: !('o ?,x 7s? Guardian, if Participant is a Minor Name: Address: Relationship to Minor: ?_.?> Page 6 of 6 '4?? °® CERTIFICATE OF LIABILITY INSURANCE TE / 1 OS 15 201 2 THIS CERTIFICATEIS 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 BV 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 ADDITIONALINSURED,the policy(ies) must be endorsed. If SUBROGATIONIS 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: MOURER-FOSTER SNC/PHS ON 151520 P A NO Ea: (866) 467-8730 1a/c, NOI: (704) 921-4658 : (866)467-8730 Fc (704)921-4658 E-MAIL PO BOX 2 9 6 11 ADDRESS: CHARLOTTE NC 2 8 2 2 9 TOMER ID p: INSURER(S) AFFORDING COVERAGE NAIC p /NSUREO INSURER A S'2IIt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oL/GY XP /MM/00/YYYY/ L/M/TS GENERAL L/AB/L/TY EACH OCCURRENCE 3 2 O O O O O O COMMERCIAL GENERAL LIABILITY PREMISES IEa occurrence) 5 1, 0 0 0, 0 0 0 A CLAIMS-MADE ? OCCUR MED EXP IAny one person) 5 1 O , O O O X General Liab 81 SBA SR4222 02/16/2012 02/16/2013 PERSONAL&ADVINJURY 9 2, 000, OOO GENERAL AGGREGATE 9 4, 0 0 0 r O O O EN'L AGGRE ATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG 5 4, O O O r O O O ? PRO- ? POLICY LOC S A[/T OMOB/LE L/AB/L/TY COMBINED SINGLE LIMIT (Ea eccitlent) s ANY AUTO BODILY INJURY (Per parson) 5 ALL OWNED AUTOS BODILY INJURY (Per accident) 9 SCHEDULED AUTOS PROPERTY DAMAGE 5 HIRED AUTOS (Per accitlentl NON-OWNED AUTOS ? 9 UMBRELLA L/AB OCCUR EACH OCCURRENCE 9 EXCESS L/AB CLAIMS-MADE AGGREGATE 9 DEDUCTIBLE 9 RETENTION 5 9 WORKERS GOMPENSAT/ON WC STATU- OTH- ANO EMPLOYERS' L/AB/L?Y , T RY LIMIT ER ? / N ANY PROPRIETOR/PARTNER/EXEC UTIVE? OFFI R M M N/A E.L. EACH ACCIDENT 9 / BER EXCLU DEDP a CE E /Manda[ory m NM/ E.L. DISEASE - EA EMPLOYE 9 If yes, Describe und¢r DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 9 OESCR/PT/ON OF OPERAT/ONS / LOCAT/ONS / VEH/CLES /Attach AGGRO )O 1, Addi[iona/ Ramai*s Se/redu/e, iI more space u iaOUiiad/ A?O??? i? ; Those usual to the Snsured's Operations. 'i'gRES:1 1 ..1 %DD CERTIFICATE HOLDER CANCELLATION ???? `?????_1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City Of Santa Ana BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE 2 O C1V1C Center Plaza DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1 9 S 8 A(/TMOR/ZED REPRESENTAT/VE SANTA ANA , CA 9 2 7 0 2 ?a-i_ ?a_.?C.4,..?? ® 1 988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD REGIONAL OFFICE INSTRUCTION SHEET POLICY NUMBER: 81 SBA IR4222 DD CHANGE NUMBER : O O 1 CHANGE EFF DATE: 05/07/12 ROUTING I NSTRUCT I ONS _SEND TO RECORDS . TRANSFER CORR I F APPLICABLE . TERMINAL SD: R001V4XA OPER INIT: LDW 05/07/12 81 SBA IR4222 DD (02/16/13) PAGE 1 POLICY FACE SHEET 22 42 INSURED: IR SENTINEL INSURANCE COMPANY, LIMITED SBA CHANGE NO. 001 CHANGE EFF DATE: 05/07/12 POLICY NO. 81 SBA IR4222 DD RECORDS RETENTION - PERMANENT DECLARATIONS ITEMS 1 . NAMED INSURED AND S I R I US K9 ACADEMY & S 2 R IUS K9 MAILING ADDRESS : TRAINING 1216 CARRIAGE LN _ CORONA, RIVERSIDE CA_ 92880 2 POLICY PERIOD: 02/16/12 02/16/13 1 2NCE PT I ON EXPIRATION YEAR AGENT'S CODE: 151520 AGENT ' S NAME : MOURER -FOSTER INC / PHS PREVIOUS POLICY NO. 81 SBW IR4222 3 THE NAMED INSURED IS: INDIVIDUAL POLICY S TATUS : ACTIVE LOB LEVEL OF SUPPORT: SP-S TRADEMARK : NON -PAR MARKET S EGMENTAT I ON . 8 1 0 SELECT CUSTOMER AGENT SALES AGREEMENT (COMMISSION STATUS ) DIRECT ACCOUNT BILL NUMBER - 12853281 DEDUCTIBLE ADDITIONAL INSUREDS) CODING ENTRY NOT REQUIRED TRANS TYPE: ENDT CNTL#: 004 POLICY FACE SHEET TERMINAL I D : R O O 1V4 XA PAGE 2 05/07/12 H1 SBA IR4222 DD (02/16/13) THE HARTFORD Select Customer Insurance Center 8711 UN=VERSSTY EAST DRIVE CHARLOTTE NC 28213 Policyholder, please call us at: (866) 467-8730 Agent, please call us at: (877) 853-2582 INSURANCE ENDORSEMENT ATTACHE D PLEASE REVIEW THE CHANGE """ Enclosed is an endorsement for your business insurance policy. Please review it at your convenience. If you have questions or need to make further changes: Policyholder, please Call uS at. (866) 467-8730 Agent, please call us at: (877) 853-2582 between 8 A_M_ and 6 P.M. EASTERN T2ME. The premium billing will be mailed to you separately. You can expect to receive it soon. Thank you for allowing us to service your business needs. MOVRER-FOSTER 2NC/PHS THE HARTFORD SELECT CUSTOMER INSURANCE CENTER Tha Hartford Insurance Group Hartford Fire Insurance Company and its Affiliates Hartford Plaza, Hartford. Connecticut 06'1 ? 5 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGE This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated below: Policy Number: a1 SBA IR4222 DD Named Insured and Mailing Address; SIRIUS K9 ACADEMY & SIRIUS K9 TRAINING 1216 CARRIAGE LN CORONA CA 92880 Policy Change Effective Date: os/o?/12 Effective hour is the same as stated in the Declarations Page of the Policy. Policy Change Number: 001 Agent Name'_ MOURER-FOSTER INC/PHS Code: 151520 POLICY CHANGES: SENTINEL INSURANCE COMPANY, LIMITED ANY CHANGES I N YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT . I F YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT , CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS . THIS IS NOT A BILL. NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE BUSINESS L IAB 2 L 2 TY OPTIONAL COVERAGES ARE REVISED ADDITIONAL INSURED (S) ARE ADDED THE FOLLOWING ARE ADD I T 2 ONAL INSURED FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATION 001 BUILDING 001 PERSON/ORGANIZATION: SEE FORM IH 12 00 PRO RATA FACTOR: 1.000 THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN . Form SS 12'1'1 0405 T Page 001 (CONTINUED ON NEXT PAGE) Process Date: os/o?/12 Policy Effective Date• 02/16/12 Policy Expiration Date: 02 / 16 / 13 POLICY CHANGE (Continued) Policy Number: a1 SBA IR4222 Policy Change Number: 001 FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT ISSUE: SS 04 22 07 OS IH12001185 ADDITIONAL INSURED - PERSON-ORGANIZATION Form SS 12 11 04 05 T Page o o z Process Date: 0 5 / o ? / 12 Policy Effective Date: 0 2 / 1 s / 12 Policy Expiration Date: 0 2 / 15 / 13 POLICY NUMBER: a1 sBA IR4222 -? THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON-ORGANIZATION THE C 2 TY OF SANTA ANA 20 CIVIC CENTER PLAZA PO BOX 1988 SANTA ANA, CA 92702 Form IH 12 00 11 85 T SEQ. NO. 002 Printed in U.S.A. Page 001 Process Date: O 5 / 0 7 / 12 Expiration Date: O 2 / 16 / 13 PRODUCER ' S FACT SHEET NAMED INSURED: SIRIUS K9 ACADEMY F S2R2US K9 TRAINING POL #: 81 SBA IR4222 DD PRODUCER ' S NAME : PRODUCER ' S CODE : 1 S 1 5 2 O AGENT SALES MOURER-FOSTER 2NC/PHS POL EFF DATE: 02/16/12 POL EXP DATE: 02/16/13 TRANS EFF DATE: 05/07/12 DIRECT ACCOUNT BILL NUMBER - 12853281 TRANSACTION TYPE : ENDORSEMENT CHANGE NO . O O 1 ENDORSEMENT PREMIUM: $0.00 NON -PREMIUM BEARING FORM TITLE SS 12 11 04 OS POLICY CHANGE SS 04 22 07 OS F2NE ARTS IH 12 00 11 85 ADDITIONAL INSURED - PERSON-ORGANIZATION PRODUCER ' S FACT SHEET PAGE 1 05/07/12 81 SBA IR4222 DD (02/16/13) MOURER-FOSTER INC/PHS PO BOX 2961 7 CHARLOTTE NC, 28229 The City o £ Santa An a 20 Civic Center Plaza PO BOX 1988 SANTA ANA , CA 9 2 7 0 2 ACORD 25 (2009/09)