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HomeMy WebLinkAboutDEKRA-LITE 7A - 2011NgSURANGE ON RLE WORK 10AY PROCEED UNTIL INSURANCE EYcPR CLERK OF COUNCIL DATE: APR 1 0 2013 (c , Coo. CI?aY3 AMENDMENT TO AGREEMENT FOR LIGHTING SERVICES N-2011-151-001 Te3f' `V-)- THIS AMENDMENT, made and entered into this 30r' day of December, 2012 by and between DEKRA-LITE, a California corporation (hereinafter "Contractor"), and the City of Santa Ana, a charter city and municipal corporation (hereinafter "City"). RECITALS IV., A. In September 2011, the City entered Agreement # 2011 - I "said Agreement") with Contractor for the manufacturing, removing and installing decorative street banners and lighting services. B. City desires to amend said Agreement to extend the Term thereof, and Contractor is able and willing to continue to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is Imowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting fret in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions said Agreement as hereby amended, the parties do hereby agree as follows: 1. Section 3, Tenn, shall be amended and extended through December 31, 2013. Pursuant to Section 3 of said Agreement, the term of this Agreement may be extended upon a writing executed by the Executive Director and the City Attorney. 2. Except as hereinabove modified, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Amendment to Agreement the date and year first above written. APPROVED AS TO FORM: Sonia R. Carvalho City Attorney By: 10,L4, c?iLf3t 4- Lisa Storck Assistant City Attorney DEI{RA-LITE MIKES EALING General Manager AM". Recommended for Approval: Nancy T. Ed a s, Interim Executive Director Community lopment Agency ARIAD I lI7 W <- CLERK OF THE COUNCIL ACORD =CE RTIFICATE OF LIABILITY INSURANCE I DATE(MMIDDIYYYY) 04/12/2012 Spectrum Risk Mgmt CA Lic. #OC77485 74 Discovery Irvine, CA 92618 FAX 949.756.: & Insurance Services INSURERS AFFORDING COVERAGE INSURERA: Golden Eagle Ins Coy NSURER B: INSURER C: THE 3102 W. Alton Ave, Santa Ana, CA 92704 E: NAIC # V 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSR LTR ADD' NSR TYPE OF INSURANCE POUCYNUMBER DAOTECMMFDDNYYY DATE MMIDDIIYYVYO LIMITS GENERAL LIABILITY CBP8903147 04/08/2012 04/08/2013 EACHOCCURRENCE $ 11000,00 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) _ $ 500,000 =CLAMS MADE ® OCCUR MED EXP (Any one person) $ 10,00 A PERSONAL & ADV INJURY $ 11000100 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,00 POLICY PRI LOG AUT OMOBILE LIABILITY - BA8903247 04/06/2012 04/08/2013 COMBINEOSINGLE LIMIT X ANY AUTO (Ea aco[dent) $ 1,000,00 ALL OWNED AUTOS BODILY INJURY $ SCHEDULEDAUTOS (Per person) A X _ HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per acdcanl) PROPERTY DAMAGE (Per accident) $ ' GA RAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY'. AGG $ EXCESS I UMBRELLA LIABILITY CU8903347 04/08/2012 04/08/2013 EACH OCCURRENCE $ 2,000,00 OCCUR CLAIMS MADE AGGREGATE _$ 2,000,00 A S DEDUCTIBLE $ X RETENTION $ ® S WOR AND KERS COMPENSATION EMPLOYERS' LIABILITY T: TORY LIMITS ER YIN ANY PROPRIETORIPARTNERIEXECUTIVE? 71 . EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If Yyes describe under SPEGIIAL PROVISIONS below E, L. DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS he Community Redevelopment Agency of Santa Ana is named as additional insured if required y written contract per attached CG2037 0704 °Re: Notice below: 10 days notice for non-payment of premium GERTIFIGATE HOLDER CANUhLLA I ION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL "30 DAYS WRITTEN City of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO OO SO SHALL Downtown Development Division IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 Civic Center Plaza REPRESENTATIVES. M-25 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 Alfnnsn Calves/PATH -'F~ U 1888-YUU9 AGURU CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD APPROVED AS TO FORM LISA E. STORCK /S Assistant City AttnrnP„ /A IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. April 09, 2012 DEKRA-LITE INDUSTRIES INC. 3102 W ALTON AVE SANTA ANA, CA 92704-6817 AHwan Remo Mwwgaa Conpaay Re: Barrett Business Services, Inc. ("BBSI") Letter of Self-Insurance for Workers' Compensation Coverage Self As the named addressee of this Letter, your company's required workers' compensation coverage is provided through BBSI's state approved Self-Insured Workers' Compensation Plan by way of your co-employment contract with BBSI. BBSI's California customers can also verify BBSI's state certification at htto://www.dir.ca.gov./SIP/sip.html; next, click on "Self Insured Employers"; then "Rosters"; then scroll down to Barrett (the list is alphabetical by company name). Additional information is as follows: 2246 Washington: Delaware: Maryland: Number: Other Comments (place an "X" if applicable): ® Named "Letter Holder": Santa Ana Downtown Development P.O. Box 1988 M25 Santa Ana, CA 92702 0 Other: Additionally, BBSI's self-insured program is further supported by an excess workers' compensation insurance policy with National Union Fire Insurance Company of Pittsburgh, PA. Copy of certificate is available upon request. For additional information, please contact your local BBSI office at: (909) 605-6862 . Very truly yours, Michael L. F_lich BBSI Office: ONTARIO President and Chief Executive Officer dog: Lost-2 8100 NE Parkway Drive, Suite 200 Vancouver, Washington 98662 800.4945669 360.828.0100 Fax 360.828.0701 www.harrelthusiiiess.com PARTNERS IN PROFITA81LITY LISA E. STORCK Assistant City Attorney dl-l. ACORPM .-CEE-RTIFICATE OF LIABILITY INSURANCE Spectrum Risk Mgmt. & Insurance Services CA Lic. #OC77485 74 Discovery Irvine, CA 92618 3102 W. Alton Ave. Santa Ana, CA 92704 INSURERS AFFORDING COVERAGE INSURERA: Golden Eagle Ins Cot INSURER D: NAIC # 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN , POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I ADD' Nea TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE MMIDDIYYYY POLI YEXPIRATION DATE MMIDOIYYW LIMITS GENERAL LIABILITY CBP8903147 04/08/2012 04/08/2013 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea oocccurrrrence $ 500,000 CLAIMS MADE ® OCCUR MED EXP (Any one person) $ 10,000 A PERSONAL &ADV INJURY $ 1,000,00 GENERAL AGGREGATE 5 2,000,0010 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGO $ 2,000,0010 POLICY jECOT LOC AUT OMOBILE LIABILITY BA8903247 04/08/2012 04/08/2013 COMBINED SINGLE LIMIT .? ANY AUTO (Ea accident) $ 1,000,00 ALLOWNEDAUTOS BODILY INJURY $ (Per person) SCHEDULEDAUTOS A HIRED AUTOS BODILY INJURY $ X NON-0VvNEO AUTOS (Peraccldent) PROPERTY DAMAGE $ (Per accident) GA RAGE LIABILITY AUTO 0NLY-EAACCI DE NT $ ANYAUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESS/ UMBRELLA LIABILITY CU8903347 04/08/2012 04/08/2013 EACH OCCURRENCE $ 21000,00 OCCUR CLAIMS MADE AGGREGATE $ 2,000,00 A $ DEDUCTIBLE 5 X RETENTION $ _ $ WOR KERS COMPENSATION ' - TORY LIMITS ER AND EMPLOYERS LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECIJ IVE E.L. EACH ACCIDENT $ ? OFFICERIMEMBER EXCLUDED? (MandatoW In NH) El DISEASE - EA EMPLOYEE $ ff es, describe under SPECIAL PROVISIONS Delow E.L. DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS 'LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS he City of Santa Ana its officers, employees, agents, volunteers and representatitives are named as additional insured if required by written contract per attached CG2037 0704 °Re: Notice below: 10 days notice for non-payment of Premium CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL "30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Santa Ana REPRESENTATIVE 20 Civic Center Plaza AUTHORIZED REPRI Santa Ana, CA 92701 Alfonso Gal The ACORD name and logo are registered marks of ACORDAYYROWD AS TO g't?" ea LISA E. STORC`4 Assistant City Attorney/ ?, ADDITIONAL INSURED ENDORSEMENT Insurance Company: Golden Eagle Insurance Corporation This endorsement modifies such insurance as is afforded by the provisions of Policy #CBP: 8903147 relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be canceled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective: 4/812012 to 4/8/2013 , this endorsement form as a part of Policy #:CBP-8903147 Issued to: Dekra-Lite Industries, Inc. Named Insured Countersigned by- . ? ttherized-Represep ive LISA E, STO 2Ctt Assistant City Attorney APP ` rID AS TO FORM IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. A'pROVE" , AS To FORIA Assistant City Attorney r?? April 09, 2012 DEKRA-LITE INDUSTRIES INC. _ 3102 W ALTON AVE SANTA ANA, CA 92704-6617 An"mn Re rm mamPmnt compmy Re: Barrett Business Services, Inc, ("BBSI") Letter of Self-Insurance for Workers' Compensation Coverage As the named addressee of this Letter, your company's required workers' compensation coverage is provided through BBSI's state approved Self-Insured Workers' Compensation Plan by way of your co-employment contract with BBSI. BBSI's California customers can also verify BBSI's state certification at http://www.dir.ca,gov./SIP/sip.html; next, click on "Self Insured Employers"; then "Rosters"; then scroll down to Barrett (the list is alphabetical by company name). Additional information is as follows: Self Insurance Certification California: 2246 Oregon: 1068 Washington: 706, 116 Delaware: 152 Maryland: 11365 Colorado: 463 Number: Other Comments (place an "X" if applicable): ® Named "Letter Holder": City of Santa Ana 20Civic Center Plaza M-25 Santa Ana, CA 92701 Other: Additionally, BBSI's self-insured program is further supported by an excess workers' compensation insurance policy with National Union Fire Insurance Company of Pittsburgh, PA. Copy of certificate is available upon request. For additional information, please contact your local BBSI office at: (909) 605-6862 . Very truly yours, Michael L. Elich BBSI Office: ONTARIO President and Chief Executive Officer doc: LOSI-2 8100 NE Parkway Drive, Suite 200 Vancouver, Washington 98662 800,494.5669 360.828.0700 Fax 360.828.0701 www.harrottbusiness.cam - ------------ PARTNERS IN P R O F I TA 81 L I T Y ----- ------ APPROVED AS 'P.O FORM br- - I f?gA E. uT©;2CI4 ?? ,Assistant City Attorney /