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HomeMy WebLinkAboutMERCHANTS BUILDING MAINTENANCE 1b - 2012City of Santa P a t_ Clerk of the Couw,-d AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Clerk of the Council Office (M-30). Call 647-6520 if you have any questions. The agreement with Cify of Santa Ana r. 02 2621 Cicrk of the Council No. A-2008- )q�2 was completed on 5131114 and final payment has been made. PC -a©® �--oCAa 0 � Revised 12-07-07 Department: Phone/Ext.: ja n1 Signature: `C�CuwOLo Date: % A-2012-093 NORK Ml' PH T! SECOND AMENDMENT TO AGREEMENT THIS SECOND AMENDMENT TO AGREEMENT is entered into this 2 1' day of May, 2012, between Merchants Building Maintenance Company, a California corporation (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: A. The parties entered into Agreement A-2008-092 dated May 23, 2008, hereinafter referred to as "said Agreement" by which Contractor provides park rest room maintenance services for Santa Ana park districts I and 2. B. By Amendment dated June 1, 2010, the City exercised its first option to extend the term for an additional two-year period. C. In accordance with the terms and conditions of said Agreement, the City desires to exercise 6 its second option to extend the term for an additional two year period. WHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this Second Amendment to Agreement, the parties agree as follows: 1. Section 4, TERM, shall be amended to reflect City's exercise of the second option to extend the term for an additional two year period, through May 31, 2014, in an annual amount not to exceed $92,823. 2. Except as herein amended, all terms and conditions of said Agreement shall remain in ftffl force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to Agreement the date and year first above written. CITY OF SANTA ANA ATTEST: MARIA D. 14UIZAR PAUL M. WALTERS Clerk of the Council Interim City Manager APPROVED AS TO FORM: �y Karturra'S e Assistant City Attorney MERCHANTS BUILDING MAINTENANCE COMPANY GE DIZIGUEZ ,0anch Manager ir A� D® CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDOM/YY) 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 Bolton & Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107- CONTACT NAME: _ PHONE INC. No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers www.boltonco.com 0008309 INSURED Merchants Building Maintenance LLC 1190 Monterey Pass Road Monterey Park CA 91754 INSURER B : Safety INSURER C: Federal Insurance Company INSURERD: INSURER E : INSURER F : 1.--I COVERAGES CERTIFICATE NUMBER: 12929958 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 OF INSURANCE ADDLTYPE In& SUER POLICY NUMBER MMIDDYlYYYN MW DDlYYYY LIMITS A GENERAL LIABILITY 6308043N684TIL 6/1/2011 6/1/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES occurrence $ 300 000 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FvI OCCUR MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPlOP AGG $ 2.000,000 $ POLICY PRO- LOC A AUTOMOBILE LIABILITY 810329D1831TIL 6/1/2011 6/1/2012 Ee acc,,En SINGLE LIMIT $ 11000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED e SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PerOPER (DAMAGE $ $ A UMBRELLA LIAB OCCUR CUP8043N684TIL 6/1/2011 6/1/2012 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION$0 $ $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PRCPRI'c'OR/PARTNEP✓EXECUTIVE r OFFICERIMEMBER EXCLUDED? u (Mandatory In NH) NIA SP4046075 Excess WC (CA) YUB598M6011'12 (AOS) 4/24/2012 1/1/2012 4/24/2013 1/1/2013 7H WC LATU- OER E.L.EACH ACCIDENT $ 4 B0Q 000 E.L. DISEASE - EA EMPLOYEE $ 1 00,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C EmplyeeTheft /Forgery 81585028 6/1/2011 6/1/2012 Limit $1 MIUDed. $25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Workers Comp is Self -Insured under California Certificate of Consent to Self Insure #1793 for California operations. Job: Operations of the Named Insured. Additional Insured(s): City of Santa Ana. CERTIFICATE HOLDER /` + - 'CANCELLATION MBM CA, Operations of the Named Insured SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC Center Plaza (M-30 Santa Ana, CA 92702-198a ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �r "•`" Cheryl Feia ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 12929958 CLIENT CODE: MERCH-1 Elizabeth Foster - Direct 626-535-1433 4/25/2012 11:42:26 AM Page 1 of 3 Z 6308043N684TIL COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided. to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: I. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. CG D2 46 08 05 c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: ® 2005 The St. Paul Travelers Companies, Inc. Pagel of 2 CERT NO.: 12929958 CLIENT CODE: MERCH-1 Elizabeth Foster - Direct 626-535-1433 4/25/2012. 11:42:26 AM Page 2 of 3 Z COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and ill. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: 1. Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 ® 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 CERT NO.: 12929958 CLIENT CODE: MERCH-1 Elizabeth Foster - Direct 626-535-1433 4/25/2012 11:42:26 AM Page 3 of 3 o/29/2012 3:141:30 PM PST (GMT-13) FROM: 100005-TO: 17146476956 z6/ �?-0?3 Page: 2 of 5 AcoR�» CERTIFICATE OF LIABILITY INSURANCE °" 6/2g/2°i11f1' nig THIS CERTI CATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICAT DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TREPRESENT I FIVE ORI PRODUCER! AND HE CERTIFICATE F CATE HOLDERTUTE A)t�NF�ACT BETWEEr� THE ISSUING INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(€es) must be endorsed. If SUBROGATION IS WANED, subject to the terms an conditions of the policy, certain policies may require an endpr1grlaent. A statement on this certificate does not confer rights to the certificate he der In lieu of such endorsements . PRODUCER Bolt n & Company `-Ca NAME! 347 E. Foothill Blvd., Suite 100 PHONE799-7666 c No: 6- 5 Pas idena, CA 91107 yw.boitonco.a m 0008309 3URED Merchants andscape Services, Inc. 1190 Monterey Pass Road Monterey F ark CA 91754 Mcv+mnar arilaaMCD• U U`VCI'(AV•[, THIS IS TO C INDICATED. t CERTIFICATE EXCLUSIONS %IGRIIrIVAIG r\1Irf+M F+�• IJ 'T f "-"-'-'- -- RTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OTWrrHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ADCONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR PE OF INSURANCE DD INSR 9 B WVO POLICY NUMBER POLICYEFF 1MMfi3D1YYYYI POLICY EXP (MMIDDIYMI LWDTS A NERALLLABILITY ✓ COMMERCIAL Cu GENERAL LIABILITY IMSJMADE � OCCUR ✓ CBP8699930 7/1/2012 7/1=13 EACH OCCURRENCE $ 1,000,000 PREMISE A ocarrence $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGG GATE LIMITAPPLIES PER: PRODUCTS • COMPIOP AGG ; 2,000,000 EsaaGOMirn[fINGLE IT $ $ i 000000 A POLICY AUTOMOBILJE PRO• 0 LOC 7 LIABILrrY 13A8690031 711/2012 711I2013 BODILYINJURY(Peeperson) ✓ ANY ALTI AALL ON UTOS HIRED:.' O �ED BAUTOSULEO NON_OWNED —OS AUTOS BODILY INJURY (Peracddent) $ eracddenrMAGE $ $ $ B ✓ UMBRE EXCESS LIAB ✓ OCCUR CLANS -MADE UUA1355182907 7/112012 7/1/2013 EACH OCCURRENCE $ 6,000,000 AGGREGATE $ 6,000,000 DED Y RETENTIONSO $ 3 $ C WORKERS C AND EMPLO ANY PROPRI10IRoPARTNER+EXECUTNE OFFICERIME£REXCLUDED'!(Martda[ory iHE.L MPENs"nON RS'LIABILITY YIN N!A SP4046075 Excess WC (CA) 4/24/2012 4/24/2013 TOOCBYLjMrsTATr C (• E.L. EACH ACCIDENT $ 1000000 DISEASE -EA EMPLOYEE $ 1 000 OIfyes,descMunder E.L. DISEASE - POLICY L3AIT $ 1.000 000 DESCRIPTIOOF OPERATIONS bebw D A Employee 1 Business Bus€ness heft -Including 3rd Party ersonal Property se 81585028 CBP8699930 611/2012 7/1/2012 811/2013 7/1/2013 Llmit: $1 MIUDed. $25,000 Limit: $5,000IDed. $1,000 EE SJO d. DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (AllachACORD 101, Addlllond Rsmerke Schedule, If more cpece Is required) GL Primary Wo Additional Insu ding applies per 22-111 01/07 attached. Job: #3011, City of Santa Ana Parks. d(s): City or Santa Ana, Its officers, agents, employees,representatives, and volunteers. CERTIFICATE UJOLDER CANCELLATION MLS CA, 430 t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of San Attn: Clerk- a Ana f the City Coun ' THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 CivicPlaza2101 Santa Ana,, CA AUTHORIZED REPRESENTATIVE � ChwvI Fela v iaoo-cv r�r na.va<c.r a.vnr vrv.++v+•. r.+. .+8.+•0 ,00a. ...... ACORD 25 (20 0105) The ACORD name and logo are registered marks of ACORD i 0/29/2012 3:i I41:30 PM PST (GMT-8) FROM: 100005—TO: 17146476956 Page: 3 of 5 1 POLI Y NUMBER:CBP8699930 COMMERCIAL GENERAL LIABILITY CG 2010 07 04 !THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This ndorsement modifies insurance provided under the following: C MMERCIAL GENERAL LIABILITY COVERAGE PART i SCHEDULE Nance Of Additional Insured Person(s) Or Organ lzations : Locations Of Covered Operations Cit t of Santa Ana MLS CA, #3011 Infor ation required to complete this Schedule if not shown above, will be shown in the Declarations. A. Sgction I II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- or anization(s) shown in the Schedule, but only sions apply: wi h respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury' or damage" or "personal and advertising injury" "property damage" occurring after: cased, in whole or in part, by: 1. All work, including materials, pans or equip- 1 .1 Your acts or omissions; or ment furnished in connection with such work, 2. The acts or omissions of those acting on your on the project (other than service, maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insured(s) at the location of the covered operations has been completed; or the additional insured(s) at the location(s) desig- nE ted above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. AA C)nt.: its officers, agents, employees, representatives, and volunteers, as required by written contract. CG 2� 10 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 D r +�/29/2012 3�41:30 PM PST (GMT-8) FROM: 100005—TO: 17146476956 orI Merchants Landscape Services, Inc. POLICY NUMBER:CBP8699930 ITHIS ENDORSEMENT CHANGES THE POLICY. Page: 4 of 5 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR I CONTRACTORS - COMPLETED OPERATIONS This indorsement modifies insurance provided under the following: C�MMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional insured Person(s) Or Or anization s : Location And Description Of Completed Operations j I 1 City of Santa Ana Inforrriation required to complete this Schedule, if not shown above, will be shown in the Declarations. Secti n II — Who Is An Insured is amended to include as an additional insured the person(s) or orgar ization(s) shown in the Schedule, but only with resp l t to liability for "bodily injury' or "property dam- age" aused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed oper...?ons hazard". A All ont.: its officers, agents, employees, representatives, and volunteers, as required by wri en contract. CG 26 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 6/29/2012 3:�1:30 PM PST (GMT-8) FROM: 100005-TO: 17146476956 Page: 5 of 5 CBP8699930 r Merchants Landscape Services, Inc. I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART I A. The fallowing is added to provision a. Primary Insurance of paragraph 4.Other Insurance under SECTION IV — COM ERCIAL GENERAL LIABILITY CONDITIONS: wever, when an additional insured has been added to this Coverage Part by attachment of an endorsement, we II not seek contribution from the "additional insured's own insurance" provided that: () You and the additional insured have agreed in a written contract that this'insurance is primary and non- contributory; and () The "bodily injury" or "property damage" occurs, or the "personal and advertising injury" is committed, subsequent to the execution of such contract. B. For the purposes of this endorsement the following is added to SECTION V — DEFINITIONS: "Additional insured's own insurance" means other insurance for which the additional insured is designated as a Named Insured. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 /� -'i'�aV AC"R D CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDM'YY) 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(les) 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 endorsomant(s). PRODUCER Bolton & COmpan __CONTACT NAME: 3475 E. Foothill Blvd., Suite 100 — — Pasadena, CA 91107 PRDNE AIC NoExp C261�QQ9 �_ EAX_lac Me ._62&583.292 _ INsuaeo iNsuRERe _Safely Nellonal CasUattySPrp4ratlo.n .._(AXt). Merchants Building Maintenance LLC 1190 Monterey Pass Road NsuRER D _EedQral nsucanae_ComPany__-_.__ fA +Xv) Monterey Park CA 91754 INSURERS; _L_IBerylnu INSURER INSURER F: COVERAGES CERTIFICATE NUMBER: 1Basno99 REVISION NUMRFP- 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. ILTR TYPE Of INSURANCE IADfiCj T�'P'O�L`IC'V EFF POLICY EXP I �----""---"---- —'-- POLICY NUMBER (MMIDDIYYYYI tMMIDDNYYYYYLi LIMITS A I GENERAL LIABILITY I �4 IYV2Z91460650033 i 3/112013 1 EACH OCCURRENCE s_ �. COMMERCIAL GENERAL LIABILITY j pAry1A�E TO RENTED IPREMISES(Eaaccurrenca ,S 300.000 . � CLAIMS MADE !._✓_1 OCCUR 1111112114 MED EXP(Any one person) is 0 -,LGENERALAGGREGAiE PERSONAL& ADV INJURY iS 1,000 QQO .. r S 2,000,000 GE-TN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG iS 2.000090 -- POLICY I ✓ LOC_— i PRO- - A Au7omoslLE uaelLr7Y 'AS2Z91460659023 � 3/1/2013 3/1/2014 eacadel�___ ICUR jS 1 000,000 f ---'{ALL I ANY AUTO ) __ BODILY INJURY (Per person) S I OWNED ISCHEDULEpAUTOS IAUTOS eODILY INJURY (Por acc tlenplS NON -OWNED HIREDAUTOS AUTOS I I PpROPERTY AMAGE , jPar anolden� ILR I i D �,,I_1 UMBRELLA LIAR ' ppcuR `J-{ 1'I'H7Z91460659043 3/1(2013 311/2014 EACH OCCURRENCE �s 10,OOp,000 ---t-E%CESS LIAe I CLAIMS-MAD_EI AGGREGATE `s i0,000 000 DED RETENTION$Q__ g ._ �__ I -- �)S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY SP4048488 Excess WC (CA) 4/24/2013 14/24/2014 t _WD STATU 10TH y DORY LIMITS ER E ANY PROPRIETORIPARTNEwEKECUTiVE viN OFFICER/MEMBER EXCLUDED' NIA -PJUB598M601013 (AOS) ( 1/l/2013 j1/112014 `" ELEACHACCOETr 5 1,ODQ.000 m {Mandatory, In NH) E.L.DISEASE, EAEMPLOYEEj_S Q ' If yea, descrroe under DESCRIPTION OF OPERATION' below L9Q EL. DISEASE -POLICY LIMIT S 1.000,000 C 1EmpreeTheft/Forgery ,81686028 6/1/2013 6!1 /2014 Limit $1 MIL/pad. $28,000 A 1 Rented Equipment I,YV2Z91460659033 3/i12013 3/1/2014 Lim(k $40,DOQlltem; Died. $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) - Workers Camp is Self -Insured under California Certificate of Consent to Self Insure #1793 for California operations. APPROVED AS TO FCC Blanket GL Additional insured per form LG 10 17 09 Job: #33777, Various Santa Ana Parks. 07 attached, only if required by written contract, `" Additional Insured(s): City of Santa Ana, Its officers, agents, volunteers, and employees. t _ CERTIFICATE HOLDER CANCELLATIO L , I CA, #33777 n pp ) 11��rr11}} City Attorney SHOULD ANY OF THE ABOVE DESCRIBED POLICISS 6E'CANCELLED BEFORE { City of Santa Ana" *' 6 i j THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: All Borujerdi ACCORDANCE WITH THE POLICY PROVISIONS. 888 W. Santa Ana Blvd., Suite 200" " Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE 5a i fie' hG f, i' Ilia Che I Feia ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Csrtt VG Ia11 '142 1'?ENS COIJ e MI1Rlfi1-k S Ghan )(5I2011 10:M -10 1N Paue 3 o-'_ 3 YV2Z91460659033 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXPANDED BLANRETADDITIONAL INSURED AND WAIVER OF SUBROGATION -- CONTRACTORS This endorsement modifies insurance provided under the Following: COVIMEliCIAL GENEILAL LIABILITY COVERAGE PAR"I' A, Section 11 - Who Is An Insured is amended to include as an insured any person or otginhnation to whom you are obligated by a avritien agreement to proaue additional insured coverage, peavided that: L the "bodily injury," "property damage;' or "personal and advertising injury" giving list to liability occurs subsequent to the execution of the writ ran agreement; and 1 the written agreement is in effect at the time of the "bodily injury," "property damage.; or "personal and advertising hi - jury" for which coverage is sought. _ Trial person or organization shall be referred to is the additional insured. The coverage afforded to the additional insured is limited to liability caused, in whole or in part, by the negligent acts or omissions of you, your employees, your agents, or your subcontractors, in the performance of yourongoing opexatiolm This insurance does not apply to "bodily injury; or `"property damage;' "personal and advertising injury" arising out of "your work" included in the "products -completed operations hazard" unless you are requieed to provide such coverage for the addition- al Insured by the written agreement, and than only for the period of tiare required by the written agreement and only for liability caused, in whole or in pant, by the negligent acts or, omissions of you, your employees, your agents, or your subcactcacturs. There is no coverage for die additional insured for "bodily injury", "properly damage" or "personal and advertising lnjury" arising out of the sole negligence of the additional insured or by these acting on behalf of the additional insured, except is provided below. If the written agreement to indemniii an additional insured requires that you indemvvfy-the additional insured for its sole negh- genne, then the coverage for the additional insured shall conform to that agreement; provided, however, that the contractual indemnification language of the agreement is valid under the lave of (lne, state where the agceemene was formed. If the written agreement provides that a -particular states law will apply, then suchprovision will be honored. B. Waiver Of gubtogation For ally additional insured that obtains insured status on this policy through paragraph A, above, we waive any right of recov- ery we may have against the additional insured because of payments we make for "bodily injury", "property damage" or "per- sonae and advertising injury" to which this insurance apphes. C, Exclusions With respect to rbeinsumnce afforded to these additional insureds, the following addirional exclusions apply. This insurance does not apply: 1. to "bodily injury", "property damage" at "parsons) and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, Geld orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. 2. to "bodily injury" or "property damage" dmr occurs during the ongoing operations of a project where you have purchased an Owners & Contractors Protective Liability or Railroad Protective Inability policy for the additional insured. LG 10 17 09 07 Page 1 of 2 A?�'C�VFaL) AS TO T'l�.tiM chA SK'ORCK CERT NO.: i63i]923 CLrBt`P CGnd: Y C'a r Jan elan 4)5/2"ll 10a26.:21 AM ?e9e 2 l Assistant City Attorney 3. when coverage is available under a consolidated (wrap up) insurance program in which you are involved. D. Other Insurance Subject to the exclusions above, this insurance shall be excess over any other insurance available to the additional insured, whether -�( such insurance is on an excess, contingent or primacy basis, unless the written agreement with you requires that the insurance �:•" provided for the additional insured be primary concurrent or primary non-contributory, in comparison to the additional insureds own policy or pounies. To the extent that the additional insured has the right to pursue any wher insurance carrier for coverage, including a defense, we shall share that right with the additional insured. 2'h4, wdorecm at is exemned by ,hc 1.I13P.IM WJTt1AL 1711U3 INSURANCH QOMVANY Pmminm $ n/a 1affcaiva l')arc 03/01/2013 Par attachment to J"Acy Na. AcditBasis E larui.e Dote 03/01/2014 YV2-L91-460659-033 IesucdTo I tcahante Building Ni"otranancc Company y i:ounearslwled by padu,necd IIeP �^¢¢nlmmu used LG 10 17 09 07 Sal, Q[0ecend No. CC : et- LG433922 e-ie'.NT MDR#Baca-i J o Ch, n 9 5/3033 10;26a20 AK ¢anc 3 n[ x Find. Sexist No. yyq{ �Yp '�tt'�ttqq��//�r��++yy Page 2of2 F%Ltg RO V ED 12W v3��.✓ �': �.ii_;a LISA L. S 10PGK Assistant Gina Attorney ,fls� iU"-� /17 ill - I "—!Rbr CERTIFICATE OF LIABILITY INSURANCE 1r'� DATE611112OIYYVY) 6/11/2014 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 Bolton & Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 Nq E PHONE Fq% A a e.q (626) 799. 130O _ 626) 583-2117 -M ILINSURERIS) AFFORDING COVERAGE NAICA www.boltOnCoCO _ 0008309 INSURER A: Libery Mutual Fire Insurance Company (A XVZ_ 23035 INSURED LLC Merchants Building Road Rd 1190 Monterey Pass Road INSURER B: Safety National Casualty Corporation A XI)15105 INSURER C; Federal Insurance Company (A++XV) 20281 INSURER D: Liberty Insurance Corporation A XV 42404 Monterey Park CA 91754 INSURER E: Employers insurance Com�an oy fWausau (A XV)_ 21458 INSURER F : COVF_RAGFS CFRTIFICATF MIIMRFR• ann A9COO RCVI41I11M AIIIPanee. 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. ILTR TYPE OF INSURANCE AOOL9 B POLICY NUMBER(MMIDONYYYI POLI,ICY EFF POLICY'EXP IMMAXNYYYYILIMITS A COMMERCIAL GENERAL LIABILITY CLAIM&MADE OCCUR ✓ TB2Z91460659064 311/2014 3/1/2015 EACH OCCURRENCE $ 1,000,000 REMISES IEapaNccurrencaf„_ 300,000 MEDEXP(Arryoneporson) _$ $ 0 PERSONAL& AOV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYE] P�ROT 7LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGO A $ 2.000.000 $ OTHER: A AUTOMOBILE LIABILITY A62Z91460659024 WV2014 3/112015 COMBINED SINGLE LIMIT {Ea aa'dentl $ 1.000000 BODILY INJURY (Pat parson) __ $ ANYAUTO AUTO ED AUTOSULEO CHEO HIREDAUTOS NON -OWNED _. AUTOS BODILY INJURY (Pat eccidant) $ PROPERTY DAMAGE acGtleatf D UMBRELLA LIAS f OCCUR TH7Z91460659044 3/1/2014 3/1/2015 EACH OCCURRENCE $ 10 000 000 AGGREGATE_ $ 10,000,000 exCE3$41A8 CLAIMS -MADE DED RETENTION SO $ B E WORKERS COMPENSATION AND EMPLOYERTUABILITY vlN ANY PROPRIETORMARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDEI (Mandatary in NH) It Yes, describe under OE SC RIPTIONOFOPERATIONS below NIA SP4050764 Excess WC (CA) WCCZ90460659064(AOS) 4/24/2014 1P1/2014 4/24/2015 1/112015 P R TH- srgmrE E.L. EA CH ACCIDENT $ 1,000,000 E.L. DISEASE•EA EMPLOYE 8 11000,000 EL DISEASE-POLICYLIMIT $ 1,000.000 C Emplyee I heft/Forgery 81585028 6/1/2014 6/1/2015 Limit 1 MIL/Ded. $25.0110 A Rented Equipment YM2Z91460659074 3/1/2014 3/1/2016 Limit: $40,000/item; Ded. $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule. may be attached If more apace Is mocked) Workers Comp Is Self -Insured under California Certificate of Consent to Self Insure #1793 for California operations. Blanket GL Additional Insured per form LG 10 17 09 07 attached, only If required by written Contract. 'to Job; #33777, Various Santa Ana Parks. ,��Ify Additional Insufed(s)a City of Santa Ana, its officers, agents, Volunteers, and employees. p,P O i`(LD SA STCRCKnev t City of Santa Ana Attn: All Borujerdi 888 W. Santa Ana Blvd., Suite 200 Santa Ana, CA 92701 ACORD 25 (2014101) CYNT NO.. 2019" 1E2D CIARNT C'oLg, MG.kcll 1 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 SIR The ACORD name and logo are registered marks of ACORD i4ancy Caft"Iider 6/11/2021 4,H0:C8 PIS :PD'PI 0mge t of I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXPANDED Bt.ANRETADDITIONAL INSURED AND WAIVER OF SUBROGATION —CONTRACTORS This endarscmeht modifies insurance provided under the following: COMMERGAL GENERAL LIABILITY COVERAGE PART !i. Section D - Who is An Insured is'mended to include as an insured ally person ur UCgaYilGBd(ni to whom you ate obligated by a written agreemen[ un procure additional insured coverage, provided that: L the "bodily lnjury," "property damage," or "personal and advertising injury" giving rise to liability occurs subsequent to the execution of the written agreement; and 2. the avdttcn agreement is in effect at the time of tire "bodily injury;" "property damage," or "personal and advertising hn- juty" for which coverage is sought. That person or organirntion shall be referred tons the additional insured. The coverage afforded to the additional insured is limited to linhillt'v caused, in whole or in part, by the negligent Arts of omissions o£you, your ea rlptoyees, your agents, or your subcontractors, in the performance of your ongoing operations. This Insurance does not apply to "boddy injury," or "property damage," "personal and advertising injury" arising out of "YouC work' included in she "psoduc[s-uuanploted op tratons haaacd" little$$ you arc required to provide such coverage for the addition - at insured by the written Agreement, and then only for the period of time required by the written agreement and only for liabgigy caused, in whole to in part, by the negligent acts or omissions of you, your amployses, your 'g oats, or your subcontractors. There is no coverage for the addition') insured for "bodily injury", "property damage" or "personal And advertising injury" arising out of the sole negligence of the additional insured or by those acting on behalf of the additional insured, except as provide.) below. If the written agreement to indemnify An additional insured tetluires that you indemnify the Additional insured for Its sale negli- gence, than the coverage for the Additional insured shall conform to that agreement; provided, however, that the contractual indemnification language of the agreement is valid snider the law of the state where the agacemetr wns farmed. If the written agreement provides that a particular state's law wHl apply, then quell provision will be honored. B. Waiver Of Subrogation For Any additional insured sitar obtains insured states on fur policy through paragraph A., Above, Ave wnh a any right of recov- city we may haveagainst the additional insured because of payments we make for "bodily hjucir", "property damage' or "per. sore) And Advertising injury" to which this insurance applies. C. Exclusions With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: '17ais insurance doers not apply: 1. to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the Failure to render, any professional Architectural, engincerhng or surveying services, including: A. 'fhc preparing, approving, or failing to prupare or approve, maps, shop drawhrgs, opinions, reports, surveys, Geld orders, change orders or drawings and speeilications; or b. Supervisory, inspection, architectural or engineering Activities. 2, ten "bodily injuq ' or "property damage" that occurs tiering the ongoing operations of a project where you have purchased an Owners & Corarnctors Protective Liability or Railroad protective Liability Policy for the additional insured. AS To FORM Lc to li ov g7,pgpVD Page a aft LISA �• S-fo'CK stant City Attorney p�5i1-4 I'll no.: CLEZ17 Care; 1e1CH-r Naacy eaawat tare[ S'll/2011 i:aa:oe 2m 1PM tote 2 0: l / „i 3. when Coverage is available under a consolidated.(wmp sip) insurance program in which you are involved. D. Other insurance Subject to the exclusions above, this insurance shall be excess over any other insurance available to the additional insured, whether such insurance is on an excess, contingent or primary basis, unless the written agreement with you requires that the insurance provided for the additional hisured be prhnary concurrent of primary non-contributory, in comparison to the additional insuted's own policy or policies, To the extent that the additional insured has the right to pursue any other insurance carrier for coverage, including a dciense, we shall share that right with the additional insured. '1'hi, cndare n ox is cacmacd by the 1.771Sa'{Y MIl'1'UAI. 9ntl lN;atAG1NC1?. COhfl'A41' Premium .1 n/n iaffrzn-D- 3/1/2014 ll.Pimt;o„ir,a< 3/1/2015 Dnr:mi®hmau w !'Wiry No. TB2G'91460659064 Aoda Rain laavd'ra Muchams Building A9aintcnaacc Company leaned L.G 10 17 09 07 I, cW,,,.rersianaabr nndunlead laprcermause tSakv Office and Nu, ilnd, acrid Nu. rPO .k,( art CAI ps5lst �� Page. 2 of 2 C-11ao.: 20V II2..1 C1aa>7 Cen-f 12RCa-1 pm=/ Cald—ltanar 1/11/2o11 4:%s:na ou :2Ur)