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HomeMy WebLinkAboutFIELDMAN, ROLAPP & ASSOCIATIONS, INC.-2014INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES H -1 -/H CLERK OF COUNCIL DATE: FEB,1 12014 p'. F MSCt PROFESSIONAL SERVICES AGREEMENT FOR FINANCIAL ADVISOR N- 2014 -018 This agreement has been entered into this /'-day of February, 2014 by and between the City of Santa Ana, a charter city and municipal corporation (the "City ") and Fietdman, Rolapp & Associates, Inc. (herein, the "Consultant "). WHEREAS, the City desires independent financial advisory services to be performed in connection with refunding of outstanding debt, namely the 1994A and 2004A Lease Revenue Bonds (herein, the "Project "); and WHEREAS, the City desires to retain the professional and technical services of the Consultant for the purpose of debt issuance, (herein, the "Services "); WHEREAS, the Consultant is well qualified to provide professional financial advice to entities such as the City; NOW, THEREFORE, in consideration of the above recitals and the mutual covenants and conditions hereinafter set forth, it is agreed as follows: Section 1 Financial Advisory Services. As directed by the City, Consultant will provide financial advisory services with regard to the 1994A and 2004A Lease Revenue Bonds (Police Administration and Holding Facility) (the "Project ") as fully described in Exhibit A attached to this Agreement. Consultant is engaged in an expert financial advisory capacity to the City only. It is expressly understood that the Services rendered hereunder are rendered solely to the City of Santa Ana. Consultant does not undertake any responsibility to review disclosure documents on behalf of owners or beneficial owners of bonds or debt which may arise from the Consultant's work hereunder. Section 2 Additional Requested Services. The City may request that Consultant provide additional services beyond the scope of those referenced in Section 1 above and specifically listed in Exhibit A to this Agreement. Services performed for the City by Consultant that are not otherwise specifically identified in Exhibit A to this Agreement shall be Additional Services. Additional Services include, but are not limited to, the following: 2.01 Assisting the City in obtaining enabling legislation or conducting referendum elections. 2.02 Extraordinary services and extensive computer analysis in the structuring or planning of any debt issue or financing program. 2.03 The repeat of any element of a service described in Exhibit A to this Agreement which is made necessary through no fault of Consultant. CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Page 1 FRA Project No. 14123 00087124 2.04 Financial management services, including development of financial policies, capital improvement plans, economic development planning, credit analysis or review and such other services that are not ordinarily considered within the scope of services described in Exhibit A to this Agreement. 2.05 Services rendered in connection with any undertaking of the City relating to a continuing disclosure agreement entered into in order to comply with Securities and Exchange Commission Rule 15c2 -12 or other similar rules. 2.06 Services rendered to the City in connection with calculations or determination of any arbitrage rebate liability to the United States of America arising from investment activities associated with debt issued to fund the Project. Section 3 Contingent Compensation 3.01 For Consultant's performance of Services as described in this Agreement, including Additional Services requested by the City, the Consultant's compensation will be as provided in of Exhibit B attached to this Agreement, 3.02 Payment of Consultant's expenses is contingent upon the successful closing of the financing and approval by the City Council. 3.03 Unless otherwise specified, payment of Consultant's compensation and expenses is due thirty (30) days after submission of Consultant's invoice for services after City Council approval. 3.04 In the event the Services of the Consultant are abandoned prior to completion of Consultant's work, Consultant shall be compensated for Services performed to the point of abandonment as if such Services were an additional service pursuant to Section 2 of this Agreement, subject to a maximum fee of 0. An act of abandonment shall be deemed to have occurred when no action has been taken by the City relative to the services of the Consultant for a period of three (3) months from the date of the initial performance of a service, and there has been a written notification to the Consultant of an abandonment of the Project by the City. 3.06 The schedule of Consultant fees set forth in this Agreement and Exhibits is guaranteed by Consultant for a period of twelve (12) months from the date of this Agreement. Section 4 Personnel. Consultant has, or will secure, all personnel required to perform the services under this Agreement. Consultant shall make available other qualified personnel of the firm as may be required to complete Consultant's services. The City has the right to approve or disapprove any proposed changes in Consultant's staff providing service to the City. The City and Consultant agree that such personnel are employees only of Consultant and shall not be considered to be employees of the City in any way whatsoever. CITY OF SANTA ANA /FIELDMAN, ROLAPP & ASSOCIATES Page 2 PRA Project No. 14123 000871.24 Section 5 Term of Agreement. This Agreement shall continue in full force and effect for a period of twenty -four (24) months from the date hereof unless terminated by either party by not less than thirty (30) days written notice to the other party except that the Agreement shall continue in full force and effect until completion of Consultant's services or until an abandonment shall have occurred as described in Section 3.04 hereof. This Agreement may be extended by one year option as agreed by the City and the Consultant. Section 6 Modification. This Agreement contains the entire agreement of the parties. It may be amended in whole or in part from time to time by mutual consent of the parties. This shall not prohibit the City and Consultant from entering into separate agreements for other services. Section 7 Work Products. All work products or any form of property developed by the Consultant in providing the Services shall be provided to the City on request. Work products developed by the Consultant shall be the property of the City, provided that Consultant may use such work products developed for the City and may employ those work products to develop refinements or additional work products in the course of its business. Section 8 Assignment. The rights and obligations of the City under this Agreement shall inure to the benefit of and shall be binding upon the successors and assigns of the City. This agreement may not be assigned by the Consultant without the consent of the City except for compensation due Consultant. Section 9 Disclosure. Consultant does not assume the responsibilities of the City, nor the responsibilities of the other professionals and vendors representing the City, in the provision of services and the preparation of the financing documents, including initial and secondary market disclosure, for financings undertaken by the City. Information obtained by Consultant and included in any disclosure documents is, by reason of experience, believed to be accurate; however, such information is not guaranteed by Consultant. Section 10 Confidentiality. The Consultant agrees that all financial, statistical, personal, technical and other data and information designated by the City as confidential shall be protected by the Consultant from unauthorized use or disclosure. The City acknowledges that the Consultant is required to comply with applicable laws governing disclosure of public information. CITY OF SANTA ANA/PIELDMAN, ROLAPP & ASSOCIATES Page 3 PRA Project No. 14123 00087124 Section 11 Indemnification. The City and Consultant shall each indemnify and hold harmless the other from and against any and all losses, claims, damages, expenses, including legal fees for defense, or liabilities, collectively, damages, to which either may be subjected by reason of the other's acts, errors or omissions, except however, neither will indemnify the other from or against damages by reason of changed events and conditions beyond the control of either or errors of judgment reasonably made. Section 12 Insurance. 12.01 Consultant shall maintain workers' compensation and employer's liability insurance during the term of this Agreement. 12.02 Consultant, at its own expense, shall obtain and maintain insurance at all times during the prosecution of this contract. Such insurance must be written with a Best Guide "A" -rated or higher insurance carrier admitted to write insurance in the state where the work is located. 12.03 Insurance coverages shall not be less than the following: A. Workers' Compensation 1. State worker's compensation statutory benefits 2. Employer's Liability -policy limits of not less than $1,000,000. B. Comprehensive General Liability coverage with policy limits of not less than $1,000,000 combined single limit for bodily injury and property damage and including coverage for the following: 1. Premises operations 2. Contractual liability 3. Products 4. Completed operation C. Errors and omissions with policy limits of $2,000,000. 12.04 Certificates of insurance naming the City as an additional insured with primary coverage shall be submitted to the City evidencing the required coverages, limits and locations of operations to which the insurance applies, and the policies of insurance shall contain a 30 day notice of cancellation or non - renewal. Section 13 Permits/Licenses. The Consultant shall obtain any permits or licenses, as may be required for it to complete the services required under this Agreement. CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Page 4 FRA Project No. 14123 00087124 Section 14 Binding Effect. 14.01 A waiver or indulgence by the City of a breach of any provision of this Agreement by the Consultant shall not operate or be construed as a waiver of any subsequent breach by the Consultant. 14.02 All agreements contained herein are severable and in the event any of them shall be held to be invalid by any competent court, this Agreement shall be interpreted as if such invalid agreements or covenants were not contained herein, and the remaining provisions of this Agreement shall not be affected by such determination and shall remain in full force and effect. This Agreement shall not fail because any part or any clause hereof shall be held indefinite or invalid. 14.03 Each party hereto represents and warrants that this Agreement has been duly authorized and executed by it and constitutes its valid and binding agreement, and that any governmental approvals necessary for the performance of this Agreement have been obtained. Section 15 Arbitration. 15.01 Any controversy, claim or dispute arising out of or relating to this Agreement may be settled by non - binding arbitration in Irvine, California. 15.02 Such arbitration shall be conducted in accordance with the then prevailing commercial arbitration rules of JAMS /Endispute ( "JAMS "), with the following exceptions if in conflict: (a) one arbitrator shall be chosen by JAMS; (b) each party to the arbitration will pay its pro rata share of the expenses and fees of the arbitrator, together with other expenses of the arbitration incurred or approved by the arbitrator; and (c) arbitration may proceed in the absence of any party if written notice (pursuant to the JAMS rules and regulations) of the proceedings has been given to such party. 15.03 Each party shall bear its own attorneys fees and expenses. 15.04 All such controversies, claims or disputes may be settled in this manner in lieu of any action at law or equity; provided, however, that nothing in this Section shall be construed as precluding the bringing of an action for injunctive or other equitable relief. 15.05 The arbitrator shall not have the right to award punitive damages or speculative damages to either party and shall not have the power to amend this Agreement. The arbitrator shall be required to follow applicable law. 15.06 EACH PARTY, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, HEREBY IRREVOCABLY WAIVES ALL RIGHT TO TRIAL BY JURY AS TO ANY ISSUE RELATING HERETO IN ANY ACTION, PROCEEDING, OR COUNTERCLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT OR ANY OTHER MATTER INVOLVING THE PARTIES HERETO. CITY OF SANTA ANA /FIELDMAN, ROLAPP & ASSOCIATES Page 5 FRA Project No. 14123 00087124 IN WITNESS Whereof, the parties have duly executed this Agreement as of the day and year first above set forth. ATTEST: IA D. MARIA D. HUIZA R Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By:�.eCa Lisa Storck Assistant City Attorney CITY OF SANTA ANA Q DAV CAVAZOS City Manager CONSULTANT Fieldman, Rolapp & As daI ,, Inc. Anna V. Sarabian Vice President Address: 19900 MacArthur Blvd. Suite 1100 Irvine, CA 92612 CITY OF SANTA ANAfFIELDMAN, ROLAPP & ASSOCIATES Page 6 FRA Project No. 14123 00087124 EXHIBIT A TO PROFESSIONAL SERVICES AGREEMENT FOR FINANCIAL ADVISOR BY AND BETWEEN THE CITY OF SANTA ANA AND FIELDMAN, ROLAPP & ASSOCIATES Scope of Services A. General Services. The Consultant shall perform all the duties and services described in Section 1 of this Agreement and shall provide such other services as it deems necessary or advisable to accomplish the Project, consistent with the standards and practice of professional financial advisors prevailing at the time such services are rendered to the City. The City may, with the concurrence of Consultant, expand this Agreement to include Additional Services not specifically identified within the terms of this Agreement. Any Additional Services may be described in an addendum to this Exhibit A and are subject to compensation described in Exhibit B to this Agreement. B. Transaction Services. The Consultant shall assume primary responsibility for assisting the City in coordinating the planning and execution of each debt issue relating to the Project. Insofar as the Consultant is providing Services which are rendered only to the City, the overall coordination of the financing shall be such as to minimize the costs of the transaction coincident with maximizing the City's financing flexibility and capital market access. The Consultant's proposed debt issuance Services may include, but shall not be limited to, the following: • Establish the Financing Objectives • Develop the Financing Schedule • Monitor the Transaction Process • Review the Official Statement, both preliminary and final • Procure and Coordinate Additional Service Providers • Provide Financial Advice to the City Related to Financing Documents • Compute Sizing and Design Structure of the Debt Issue • Plan and Schedule Rating Agency Presentation and Investor Briefings • Conduct Credit Enhancement Procurement and Evaluation • Conduct Market Analysis and Evaluate Timing of Market Entry • Recommend Award of Debt Issuance • Provide Pre- Closing and Closing Assistance CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 1 FRA Project No. 14123 00087124 Specifically, Consultant will: 1. Establish the Financing Objectives. At the onset of the financing transaction process for the Project, the Consultant shall review the City's financing needs and in conjunction with the City's management, outline the objectives of the financing transaction to be undertaken and its proposed form. Unless previously determined, Consultant shall recommend the method of sale of debt and outline the steps required to achieve efficient market access. 2. Develop the Financing Timetable. The Consultant shall take the lead role in preparing a schedule and detailed description of the interconnected responsibilities of each team member and update this schedule, with refinements, as necessary, as the work progresses. 3. Monitor the Transaction Process. The Consultant shall have primary responsibility for the successful implementation of the financing strategy and timetable that is adopted for each debt issue relating to the Project. The Consultant shall coordinate (and assist, where appropriate) in the preparation of the legal and disclosure documents and shall monitor the progress of all activities leading to the sale of debt. The Consultant shall prepare the timetables and work schedules necessary to achieve this end in a timely, efficient and cost - effective manner and will coordinate and monitor the activities of all parties engaged in the financing transaction. 4. Review the Official Statement. a. Upon direction of the City, the Consultant shall review the official statement for each debt issue relating to the Project to insure that the City's official statement is compiled in a manner consistent with industry standards. b. The Consultant shall post the official statement on its website at www.fieldmati.com. 5. Procure and Coordinate Additional Service Providers. Should the City desire, the Consultant may act as City's representative in procuring the services of financial printers for the official statement and related documents, and for the printing of any securities. In addition, the Consultant may act as the City's representative in procuring the services of trustees, paying agents, fiscal agents, feasibility consultants, redevelopment consultants, or escrow verification agents or other professionals, if the City directs. 6. Provide Financial Advice to the City Relating to Financing Documents. Simultaneous with the review of official statements for each debt issue relating to the Project, the Consultant shall assist the managing underwriters, bond counsel and /or other legal advisors in the drafting of the respective financing resolutions, notices and other legal documents. In this regard, the Consultant shall monitor document preparation for a CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 2 FRA Project No. 14123 00087124 consistent and accurate presentation of the recommended business terms and financing structure of each debt issue relating to the Project, it being specifically understood however that the Consultant's services shall in no manner be construed as the Consultant engaging in the practice of law. 7. Compute Sizine and Design Structure of Debt Issue. The Consultant shall work with the City's staff to design a financing structure for each debt issue relating to the Project that is consistent with the City's objectives, that coordinates each transaction with outstanding issues and that reflects current conditions in the capital markets. 8. Plan and Schedule Rating Agency Presentation and Investor Briefings. The Consultant shall develop a plan for presenting the financing program to the rating agencies and the investor community. The Consultant shall schedule rating agency visits, if appropriate, to assure the appropriate and most knowledgeable rating agency personnel are available for the presentation and will develop presentation materials and assist the City officials in preparing for the presentations. 9. Conduct Credit Enhancement Evaluation and Procurement. Upon the City's direction, the Consultant will initiate discussions with bond insurers, letter of credit providers and vendors of other forms of credit enhancements to determine the availability of and cost benefit of securing financing credit support. 10. Conduct Market Analysis and Evaluate Timing of Market Entry. The Consultant shall provide regular summaries of current municipal market conditions, trends in the market and how these may favorably or unfavorably affect the City's proposed financing. a. Competitive Sales. For all types of competitive sale of debt, the Consultant shall undertake such activities as are generally required for sale of securities by competitive bid including, but not limited to the following: • Review and comment on terms of Notice of Sale Inviting Bids • Provide advice on debt sale scheduling • Provide advice on the use of electronic bidding systems • Coordinate bid opening with the City officials • Verify bids received and make recommendations for acceptance • Provide confirmation of issue sizing, based upon actual bids received, where appropriate • Coordinate closing arrangements with the successful bidder(s) b. Negotiated Sales. CITY OF SANTA ANA /FIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 3 FRA Project No. 14123 00087124 In the case of a negotiated sale of debt, the Consultant shall perform a thorough evaluation of market conditions preceding the negotiation of the terms of the sale of debt and will assist the City with the negotiation of final issue structure, interest rates, interest cost, reoffering terms and gross underwriting spread and provide a recommendation on acceptance or rejection of the offer to purchase the debt. This assistance and evaluation will focus on the following areas as determinants of interest cost: • Size of financing • Sources and uses of funds • Terms and maturities of the debt issue • Review of the rating in pricing of the debt issue • Investment of debt issue proceeds • Distribution mix among institutional and retail purchasers • Interest rate, reoffering terms and underwriting discount with comparable issues • Redemption provisions 11. Recommend Award of Debt Issuance. Based upon activities outlined in Task 10(a) and 10(b) above, the Consultant will recommend accepting or rejecting offers to purchase the debt issue. If the City elects to award the debt issue, the Consultant will instruct all parties and help facilitate the actions required to formally consummate the award. 12. Provide Pre - Closing and Closing Activities. The Consultant shall assist in arranging for the closing of each financing. The Consultant shall assist counsel in assuming responsibility for such arrangements as they are required, including arranging for or monitoring the progress of bond printing, qualification of issues for book -entry status, signing and final delivery of the securities and settlement of the costs of issuance. CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit A, Page 4 PRA Project No. 14123 00087124 EXHIBIT B TO PROFESSIONAL SERVICES AGREEMENT FOR FINANCIAL ADVISOR BY AND BETWEEN THE CITY OF SANTA ANA AND FIELDMAN, ROLAPP & ASSOCIATES Compensation and Expenses Transaction Based Compensation For Services referenced in Section 1 of this Agreement, the Consultant will be compensated as described in the table below: New Money and /or Refunding: $1 to $15,000,000 $40,000 Lease Revenue Bonds, $15,000,001 to $30,000,000 $50,000 Certificates of Participation, _$30,000,001 to $60,000,000 $60,000 Enterprise (Revenue Bonds) and $60,000,001 and above $70,000 To, A11 ,,.t;,,,, $150.00 Associate............................................ ............................... Payment of compensation earned by Consultant pursuant to this Part 1 shall be contingent on, and payable at the closing of the debt issue(s) undertaken to finance the Project. IIourly Compensation For Services and Additional Services referenced in this Agreement, the Consultant will be compensated at the then current hourly rates. The table below reflects the rates in effect as of the date of execution of this Agreement. Personnel Hourly Rate Executive Officers ............................. ............................... $300.00 Principals ................... ............................... ........................ $290.00 Senior Vice President ........................ ............................... $275.00 Vice Presidents .................................. ............................... $225.00 Assistant Vice President .................... ............................... $195.00 Senior Associate ................................ ............................... $150.00 Associate............................................ ............................... $125.00 Analyst................................................. ............................... $85.00 Administrative Assistants .................... ............................... $65.00 Cl erical................................................. ............................... $35.00 Hourly Compensation will be billed on a monthly basis. CITY OF SANTA ANA/FIELDMAN, ROLAPP & ASSOCIATES Exhibit B, Page 1 FRA Project No. 14123 00087124 Expenses Expenses will be billed for separately and will cover, among other things, travel, lodging, subsistence, overnight courier, conference calls, computer, and fax transmission charges. Advances made on behalf of the City for costs of preparing, printing or distributing disclosure materials or related matter whether by postal services or electronic means, may also be billed through to the City upon prior authorization. Additionally, a surcharge of 6% of the compensation amount is added to verifiable out -of- pocket costs for recovery of costs such as telephone, postage, document reproduction and the like. Limiting Texans and Conditions The above compensation is based on completion of work orders within six months of the City's authorization to proceed, and assumes that the City will provide all necessary information in a timely manner. The fee shown above in Part 1 presumes attendance at up to 8 meetings in the City's offices or such other location within a 25 -mile radius of the City place of business as the City may designate. Preparation for, and attendance at City Council meetings on any basis other than "by appointment" may be charged at our normal hourly rates as shown in Part 2, above. Abandonment If, once commenced, the services of the Consultant are terminated prior to completion of our final report for any reason, the Consultant will be compensated for professional services and reimbursed for expenses incurred through the time of receive notification of such termination at the standard hourly rates shown above, subject to a minimum charge of $0. CITY OF SANTA ANA /FIELDMAN, ROLAPP & ASSOCIATES Exhibit B, Page 2 FRA Project No. 14123 00087124 AII H CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DDI YYY) 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 pollcy(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 endorsement(s). PRODUCER Wood- Gutmann & Bogart/111B 940 Calle Negocio, Ste. 240 San Clemente, CA 92673 www.integrityint.com —CONTACT NAME: PRONE O ac No: EMAIL ADDRESS: INSURER (S) AFFORDING COVERAGE NAIC e INSURER A: HartfDrd Casualty losu[aoQe Compan LIMITS INSURED Fieldman, Rolapp & Associates Redman, Rolapp Financial Services, LLC Applied Best Practices, LLC 19900 MacArthur Blvd, #1100 Irvine CA 92612 INSURER B: ance Company ✓ INSURER C: 72SBAAF9892 Y�p,.>� 24 e���t5 it y`'1 V O •�B Gb� INSURER D: INSURER E: $ 1,000,000 INSURER F $ 300,000 COVERAGES CERTIFICATE NUMBER: 1a14i9cA RPVIRION NIIMRPP- 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDOIYVYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCURgy2p ✓ 72SBAAF9892 Y�p,.>� 24 e���t5 it y`'1 V O •�B Gb� 4/1 p131F`!;(1%T/2'14 rrt1-jK EACH OCCURRENCE $ 1,000,000 MAGE TO RENTED EMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 CIO E' PgSISta nt O- pttortleY Ity GEN'L AGGREGATE POLICY LIMIT APPLIES PER: PRO- LOC PRODUCTS - COMP /OP AGG $ 2,000,000 Deductible $ 0 A AUTOMOBILE LIABILITY 72SBAAF9892 411/2013 411/2014 Ee MB tleDtSINGLE LIMIT 5 1,000,00 BODILY INJURY (Per person) 5 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ ✓ NON OWNED HIREDAUTOS ✓ AUTOS PROPER Y DAMAGE Per acclent 5 Comp/Coil Ded. 01i s ✓ Hired PD $ A UMBRELLA LIAB `/ OCCUR 72SBAAF9892 411/2013 4/1/2014 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 EXCESS LIAB CLAIMS -MADE DED ✓ RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? N/A WC STATU- TI{ TORY LIMITS OER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS below I I B Errors & Omissions- Claims Made ELU132492 -13 12/20/2013 1212012014 $2,000,000 Aggregate Retro Date 12/20104 $250,000 Retention DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace Is required) City of Santa Ana is named as Additional Insured with respect s General Liability ATIMA per the attached carrier policy endorsements. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Clerck of the Council ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza (M -30) Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Dan Gorman © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CURT NO.: 19193294 Vail Brady -Roe 2/7/2014 10:31:56 sN Page 1 of 7 Fieldman, Rolapp & Associates Fieldman, Rolapp Financial Services, LLC 72SBAAF9892 IV it 2/7/2014 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 1, I N 4; This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM We waive any right of recovery we may have against: 1. Any person or organization shown in the Declarations, or 2. Any person or organization with whom you have a contract that requires such waiver. Form SS 1215 03 00 0 2000, The Hartford CER'P NO.: 19192294 Vail Brady -Roe 2/9/2011 10:31:56 AN Page 2 of 7 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM C. Who is an insured in the BUSINESS LIABILITY COVERAGE FORM is amended to Include as an Insured the person or organization shown in the Declarations but only with respect to liability arising out of the operations of the named Insured. Form 95 04 49 05 93 Printed in U.S.A. (NS) For losses Covered under the BUSINESS LIABILITY COVERAGE of this policy this insurance is primary to other valid and collectible insurance which is available to the person or organization shown in the Declarations as an Additional Insured. Copyright, Hartford Fire Insurance Company, 1993 CERT NO.: 19193299 Vail Brady -Roe 2/7/2019 10:31:56 AM Page 3 of 7 (6) When You Are Added As An Additional Insured To Other Insurance That is other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional insured by that 'J surance; or (7) hen You Add Others As An dditional Insured To This That is other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non - Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non - contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under this Coverage Part to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit ". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. Form SS 00 08 04 05 CENT NO.: 1919229" Vail Biady -Roe 2/7/2019 10:31:56 AM Page 4 of 7 BUSINESS LIABILITY COVERAGE FORM When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self - insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 8. ransfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. This condition does not apply to Medical Expenses Coverage. b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. Page 17 of 24 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED COVERAGES If listed or shown as applicable In the Declarations, one or more of the following Optional Additional Insured Coverages also apply. When any of these Optional Additional Insured Coverages apply, Paragraph 6. (Additional Insureds When Required by Written Contract, Written Agreement or Permit) of Section C., Who Is An Insured, does not apply to the person or organization shown in the Declarations. These coverages are subject to the terms and conditions applicable to Business Liability Coverage in this policy, except as provided below: 1. Additional Insured - Designated Person Or Organization WHO IS AN INSURED under Section C. is amended to include as an additional insured the persons) or organization(s) shown in the Declarations, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing operations; or I In connection with your premises owned by or rented to you. 2. Additional Insured - Managers Or Lessors Of Premises a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the persons) or organization(s) shown in the Declarations as an Additional Insured - Designated Person Or Organization; but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Declarations. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: (1) Any 'occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. Page 18 of 24 CERT NO.: 19193294 Vail 0rady -Roe 2/9/2414 10;31;56 A Page 5 of 7 3. Additional Insured - Grantor Of Franchise WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured - Grantor Of Franchise, but only with respect to their liability as grantor of franchise to you. 4. Additional Insured - Lessor Of Leased Equipment a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured — Lessor of Leased Equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any 'occurrence" which takes place after you cease to lease that equipment. 5. Additional Insured - Owners Or Other Interests From Whom Land Has Been Leased a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the persons) or organization(s) shown in the Declarations as an Additional Insured — Owners Or Other Interests From Whom Land Has Been Leased, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land leased to you and shown in the Declarations. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: (1) Any 'occurrence" that takes place after you cease to lease that land; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. 6. Additional Insured - State Or Political Subdivision — Permits a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Insured — State Or Political Subdivision - (e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products; additional exclusions apply: (f) Demonstration, installation, This insurance does not apply to: servicing or repair operations, (1) "Bodily injury", "property damage" or except such operations performed "personal and advertising injury" at the vendor's premises in connection with the sale of the arising out of operations performed for product; the state or municipality; or (9) Products which, after distribution o u "property or ama e (2 ) "Bodily in � �' d " g or sale by you, have been labeled included in the "product- completed or relabeled or used as a operations" hazard. container, part or ingredient of any 7. Additional Insured — Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C. is the vendor; or amended to include as an additional (h) "Bodily injury" or "property insured the person(s) or organization(s) damage" arising out of the sole (referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However, this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendor's (1) The exceptions contained in business and only if this Coverage Part Subparagraphs (d) or (f); or provides coverage for "bodily injury" or "property damage" included within the (ii) Such inspections, "products- completed operations hazard ". adjustments, tests or servicing b. The insurance afforded to the vendor is as the vendor has agreed to make or normally undertakes subject to the following additional exclusions: to make in the usual course of (1) This insurance does not apply to: business, in connection with (a) "Bodily injury" or "property the distribution or sale of the damage" for which the vendor is products. obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products. (b) Any express warranty 8. Additional Insured — Controlling Interest unauthorized by you; WHO IS AN INSURED under Section C. is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor; Declarations as an Additional Insured — (d) Repackaging, unless unpacked Controlling Interest, but only with respect to solely for the purpose of inspection, their liability arising out of: demonstration, testing, or the a. Their financial control of you; or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container; Form SS 00 08 04 05 Page 19 of 24 CENT NO.: 19193294 Vail Bxady -Roe 2/7/2019 10:31:56 AM Page 6 of 7 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural The limits of insurance that apply to additional alterations, new construction and demolition insureds are described in Section D. — Limits Of operations performed by or for that person or Insurance. organization. How this insurance applies when other insurance 9. Additional Insured — Owners, Lessees Or is available to an additional insured is described in Contractors — Scheduled Person Or the Other Insurance Condition in Section E. — Organization Liability And Medical Expenses General a. WHO IS AN INSURED under Section C. is Conditions. amended to include as an additional G. LIABILITY AND MEDICAL EXPENSES insured the person(s) or organization(s) DEFINITIONS shown in the Declarations as an Additional Insured — Owner, Lessees Or Contractors, 1. "Advertisement" means the widespread public but only with respect to liability for "bodily dissemination of information or images that injury", "property damage" or "personal has the purpose of inducing the sale of goods, and advertising injury" caused, in whole or products or services through: in part, by your acts or omissions or the a. (1) Radio; acts or omissions of those acting on your (2) Television; behalf: (3) Billboard; (1) In the performance of your ongoing (4) Magazine; operations for the additional insured(s); or (5) Newspaper; (2) In connection with "your work" b. The Internet, but only that part of a web performed for that additional insured site that is about goods, products or and included within the "products- services for the purposes of inducing the completed operations hazard ", but sale of goods, products or services; or only if this Coverage Part provides c. Any other publication that is given coverage for "bodily injury" or widespread public distribution. "property damage" included within the However, "advertisement" does not include: "products- completed operations hazard ". a. The design, printed material, information or images contained in, on or upon the b. With respect to the insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance products; or does not apply Y to "bodily " "property damage" or "personal an advertising b. An interactive conversation between or injury" arising out of the rendering of, or among persons through a computer network. the failure to render, any professional 2. "Advertising idea" means any idea for an architectural, engineering or surveying "advertisement ". services, including: 3. "Asbestos hazard" means an exposure or (1) The preparing, approving, or failure to threat of exposure to the actual or alleged prepare or approve, maps, shop properties of asbestos and includes the mere drawings, opinions, reports, surveys, presence of asbestos in any form. field orders, change orders, designs or 4. "Auto" means a land motor vehicle, trailer or drawings and specifications; or semi - trailer designed for travel on public (2) Supervisory, inspection, architectural roads, including any attached machinery or or engineering activities, equipment. But "auto" does not include 10. Additional Insured — Co -Owner Of Insured "mobile equipment ". Premises 5. "Bodily injury" means physical: WHO IS AN INSURED under Section C. is a. Injury; amended to include as an additional insured b. Sickness; or the person(s) or Organization(s) shown in the c. Disease Declarations as an Additional Insured — Co- Owner Of Insured Premises, but only with sustained by a person and, if arising out of the respect to their liability as co -owner of the above, mental anguish or death at any time. premises shown in the Declarations. 6. "Coverage territory" means: Page 20 of 24 Form SS 00 08 04 05 CCRT NO.: 19193299 Vail Brady-Roe 2/7/2019 10:31:56 AM Page 7 of 7 AC DF CERTIFICATE OF LIABILITY INSURANCE pATE(MMIPDIYVYY)�( eLO71"I 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 INSURERS), 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 ondorsement(s ), PRODUCER WITACr Lockton Companies, LLC 5847 San Felipe, Suite 320 alc No.Exft: $es•azasaes AAic, No Houston, TX 77057 -MAIL 'g lLQ v j l PDRESS: INSURET81 AFFORDING COVBRAGE NAIC NSURER -A: ACE American Insurance Cc 22667 INSURED NSURER -B: Insperity, Inc. LIC /F FIELDMAN, ;RQLAPP& ASSOCIATES, INC..DBA APPLIED BEST PRACTICES & FIELDMAN ROLAPP FINANCIAL SERVICES LLC,...._ NSURER -c: y PERSONAL &ADV INJURY NSURER -P: NSURER -E: GENERAL AGGREGATE 19001 Crescent Springs Drive Kingwood, TX 77339 N9URER-F:- PRODUCTS - COMP /OP AGO COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN OR a TYPE OF INSURANCE ADDI, INSR ua o I POLICY NUMBER POLICY EFF MWDDNYYY) IOLICY EXP MMIDDNYYY) LIMITS GENERAL LIABILITY OMMERCIAL GENERAL LIABILITY LAIMS MADE OCCUR 'g lLQ v j l Y� rfi(� J //' "{-° ST�� nti b EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occuneocel ME,DEXP (Anv one pereon y PERSONAL &ADV INJURY GENERAL AGGREGATE EN'L AGGREGATE LIMIT APPLIES PER PRO - OLICY JEGT LOC PRODUCTS - COMP /OP AGO PROFESSIONAL UASILITY $ AUTOMOOILE LIABILITY MY AUTO LO AUTOS SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS �` SS�EiQ I" 1,5finia COMBINED SINGLE LIMIT Ea accident $ - BODILY INJURY EgE,Pereon $ BODILY INJURY Per accident) $ PROPEldent) AGE Per accident. $ MURELLA LIAR XCEEe UAS OCCUR CLAIMS MADE EACHOCCURRENCE $ AGGREGATE $ W ED RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY NY PROPRIETORIPARTNERIEXECU'fIVE YIN NIA - C41934527 ,- 1010112013 1010112014 _ X STATII- ORY LIMITS TH- R FFICERIMEMBER EXCLUGEp7 E.L. EACH ACCIDENT $ 1,0000 MANDATORYINNH) ( yes, describe under E.L. DISEASE -EA EMPLOYEE -y00 $ 14000,000 DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONSILOCATIONSATHICLES (Attach Acord 101, Additional remarks Schedule, if more space is required) FIELDMAN, ROLAPP & ASSOCIATES, INC, APPLIED BEST PRACTICES & FIELDMAN ROLAPP FINANCIAL SERVICES, LLC (9076300) 19 INCLUDED AS A.NAMED INSURED THROUGH ENDORSEMENT. CITY CITY OF SANTA ANA CLERK OF THE COUNCIL 20 CIVIC CENTER PLAZA CM -30) SANTA ANA, CA 92701 --- ____.. .,.. _- THE EXPIRATION DATE THEREOF, . NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE - -- P -- ,.. :ORD 25 (2010/05) 01988.2010 ACORD CORP Arr.tft: 11 R95fi5 Tho Ar.OPn name anH Inn^ nw renic+n A , I, ^t APMOM Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Insperity, Inc. FIELDMAN, ROLAPP & ASSOCIATES, INC. DBA APPLIED BEST PRACTICES CITY OF SANTA ANA;CLERK OF THE COUNCIL; & FIELDMAN ROLAPP FINANCIAL SERVICES LLC 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 19001 Crescent Springs Drive Policy Symbol Poly Number Policy Period Effective bete of Endorsement RWC 047934527 10/01/2013 TO 10/01/2014 02/07/2014 lasued sy (Name of Insurance Company) Ace American Insurance Co. ineen the polmy numoer. The remalnoor of the Information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy, NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES A. If we cancel the Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule set out below (the "Schedule "). You or your representative must provide us with both the physical and e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. C. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. D. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with the information necessary to complete the Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. E. We may arrange with your representative to send such notice in the event of any such cancellation. F. You will cooperate with us in providing, or in causing your representative to provide, the e-mail address and physical address of the persons or organizations listed in the Schedule. G. This endorsement does not apply in the event that you cancel the Policy. SCHPr]III r- Name of Certificate Holder E -Mail Address Physical Address CITY OF SANTA ANA;CLERK OF THE COUNCIL; 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 All other terms and conditions of the Policy remain unchanged. ALL -32688 (01/11) Acct #: 1169655 ~, Ike Authorized Representative Page 1 of 1 AC DF CERTIFICATE OF LIABILITY INSURANCE pATE(MMIPDIYVYY)�( eLO71"I 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 INSURERS), 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 ondorsement(s ), PRODUCER WITACr Lockton Companies, LLC 5847 San Felipe, Suite 320 alc No.Exft: $es•azasaes AAic, No Houston, TX 77057 -MAIL 'g lLQ v j l PDRESS: INSURET81 AFFORDING COVBRAGE NAIC NSURER -A: ACE American Insurance Cc 22667 INSURED NSURER -B: Insperity, Inc. LIC /F FIELDMAN, ;RQLAPP& ASSOCIATES, INC..DBA APPLIED BEST PRACTICES & FIELDMAN ROLAPP FINANCIAL SERVICES LLC,...._ NSURER -c: y PERSONAL &ADV INJURY NSURER -P: NSURER -E: GENERAL AGGREGATE 19001 Crescent Springs Drive Kingwood, TX 77339 N9URER-F:- PRODUCTS - COMP /OP AGO COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN OR a TYPE OF INSURANCE ADDI, INSR ua o I POLICY NUMBER POLICY EFF MWDDNYYY) IOLICY EXP MMIDDNYYY) LIMITS GENERAL LIABILITY OMMERCIAL GENERAL LIABILITY LAIMS MADE OCCUR 'g lLQ v j l Y� rfi(� J //' "{-° ST�� nti b EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occuneocel ME,DEXP (Anv one pereon y PERSONAL &ADV INJURY GENERAL AGGREGATE EN'L AGGREGATE LIMIT APPLIES PER PRO - OLICY JEGT LOC PRODUCTS - COMP /OP AGO PROFESSIONAL UASILITY $ AUTOMOOILE LIABILITY MY AUTO LO AUTOS SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS �` SS�EiQ I" 1,5finia COMBINED SINGLE LIMIT Ea accident $ - BODILY INJURY EgE,Pereon $ BODILY INJURY Per accident) $ PROPEldent) AGE Per accident. $ MURELLA LIAR XCEEe UAS OCCUR CLAIMS MADE EACHOCCURRENCE $ AGGREGATE $ W ED RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY NY PROPRIETORIPARTNERIEXECU'fIVE YIN NIA - C41934527 ,- 1010112013 1010112014 _ X STATII- ORY LIMITS TH- R FFICERIMEMBER EXCLUGEp7 E.L. EACH ACCIDENT $ 1,0000 MANDATORYINNH) ( yes, describe under E.L. DISEASE -EA EMPLOYEE -y00 $ 14000,000 DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONSILOCATIONSATHICLES (Attach Acord 101, Additional remarks Schedule, if more space is required) FIELDMAN, ROLAPP & ASSOCIATES, INC, APPLIED BEST PRACTICES & FIELDMAN ROLAPP FINANCIAL SERVICES, LLC (9076300) 19 INCLUDED AS A.NAMED INSURED THROUGH ENDORSEMENT. CITY CITY OF SANTA ANA CLERK OF THE COUNCIL 20 CIVIC CENTER PLAZA CM -30) SANTA ANA, CA 92701 --- ____.. .,.. _- THE EXPIRATION DATE THEREOF, . NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE - -- P -- ,.. :ORD 25 (2010/05) 01988.2010 ACORD CORP Arr.tft: 11 R95fi5 Tho Ar.OPn name anH Inn^ nw renic+n A , I, ^t APMOM Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Insperity, Inc. FIELDMAN, ROLAPP & ASSOCIATES, INC. DBA APPLIED BEST PRACTICES CITY OF SANTA ANA;CLERK OF THE COUNCIL; & FIELDMAN ROLAPP FINANCIAL SERVICES LLC 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 19001 Crescent Springs Drive Policy Symbol Poly Number Policy Period Effective bete of Endorsement RWC 047934527 10/01/2013 TO 10/01/2014 02/07/2014 lasued sy (Name of Insurance Company) Ace American Insurance Co. ineen the polmy numoer. The remalnoor of the Information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy, NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES A. If we cancel the Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule set out below (the "Schedule "). You or your representative must provide us with both the physical and e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. C. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. D. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with the information necessary to complete the Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. E. We may arrange with your representative to send such notice in the event of any such cancellation. F. You will cooperate with us in providing, or in causing your representative to provide, the e-mail address and physical address of the persons or organizations listed in the Schedule. G. This endorsement does not apply in the event that you cancel the Policy. SCHPr]III r- Name of Certificate Holder E -Mail Address Physical Address CITY OF SANTA ANA;CLERK OF THE COUNCIL; 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 All other terms and conditions of the Policy remain unchanged. ALL -32688 (01/11) Acct #: 1169655 ~, Ike Authorized Representative Page 1 of 1 A1—,,?o14- ,0191 ,nc Fhlla CERTIFICATE OF LIABILITY INSURANCE DAT3 /26 /2OMW) 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 endorsement (s). PRODUCER Wood- Gutmann & Bogart/IIIB 940 Calls Negoclo, Ste. 240 San Clemente, CA 92673 NAME' PHONE 049 542 -7800 PAC No • 949 542 -7804 EMAIL O s INSURER (S) AFFORDING COVERAGE NAIL N 4/1/2015 INSURER A: SentlnellnsuranceCom an Lttl AXV 11000 www.Integrityint.com INSURED Fleldman, Rolapp & Associates Fieldman, Rolapp Financial Services, LLC Applied Best Practices, LLC 19900 MacArthur Blvd, #1100 Irvine CA 92612 INSURER e: Indian Harbor Insurance Company AXV 36940 INSURERC: $ 10,000 INSURER D; INSURER E: $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY jEG ❑ LOG OTHER: OENERALAGGREGATE $ 2,000,000 INSURER P: $ 2,000,000 �N�\ r{ gNeltl3: �Ma: ��IMINe \�idUerH- larfiL•GiT,C�LX r {pr16Y1�1. MDILhW: {y ^� 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 LT TYPE OF INSURANCE A DL SUER PGLICYRUMBER POWCV EPF TIMID YY POLICV EXP MMDO LIMITS A COMMERCIAL GENERAL LIABILITY CLAIM84AOE © OCCUR �/ 728BAAF9892 4/112014 4/1/2015 EACH OCCURRENCE $ 1,000,000 PREMUS"'crou"mrI $ $00,000 MED ENO (Any one arson $ 10,000 PERSONAL &ACV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY jEG ❑ LOG OTHER: OENERALAGGREGATE $ 2,000,000 PRODUCTS COMP /OP AGG $ 2,000,000 Deduotlble $ 0 A AUTOMOBILE ✓ LIABILITY ANY AUTO ALLOWNED SCHECULED AUTOS AUTOS HIREDAUTOO ✓ ADN60WNED LIT S fired PD 72SBAAFOB92 4/112014 4/1/2016 BINEOSINGLE LIMIT $ 1000,000 BODILY INJURY (Per parson) $ BODILY INJURY (Per ecdtlenq $ PROPERTY DAMAGE $ Como/Coll Ded. Q1.00 0 $ A ,/ UMBRELLA LIAR EXCESS LIAO ✓ OCCUR CMMS -MADE 72SBAAr9892 4/1/2014 4/112015 EACHOCCURRENCE $ 3,000,000 AGGREGATE S 3,000,000 DEO I ✓ I RETENiION$10,000 $ WORKER$ COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY OFF ICERIMEMWER EXCLUDED7�CUI'IVe ❑ (Mandatory In NH) If yyess describe under DESCRIPTION OF OPERATIONS below NIA I PER OTH- a ER E,L.EACM ACCIDENT $ E,L, DISEASE. EA EMPLOYEE $ E.L. DISEASE. POLICY LIMIT $ B Errors & Omissions- Claims Made Retro Date 12/20/04 ELU132492.1a 12/2012013 12120/2D14 $2,000,000 Maximum Aggregate $250,000 Retention DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (ACORD 101, Additional somerAs Schedule, may be attached If more spaoa Is required) City of Santa Ana Is named as Additional Insured with respect s General Liability ATiMA per the attached carrier policy endorsements. City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Clerck of the Council ACCORDANCE WITH THE POLICY PROVISIONS, 20 Civic Center Plaza (M -30) Santa Ana CA 92701 AUTHORI2ED REPRESENTATIVE I Dan Gorman ©1988.2014 ACORD CORPORATION. All rights reserved ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD �%� (�� CER1' NO., ;9501223 Vail 5Yady-HOa 3/25/2014 10:44,15 AN Page 1 of 7 MAR 2 5 2014r / ✓ � "'"' / / , 6c Z`® llk. - ✓ V % r CERTIFICATE OF LIABILITY INSURANCE Acct4:1169655 DATE(MMIDDIYYYY) 09/02/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIV EG AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFIC 1- fA�TIVdgELL�Y A CONTRACT BETWEEN THE ISSUING INSURER(S), PRESENTATIVE OR R PRODUCER, AND HE CERT FICAT HOLDERS IMPORTANT: If the certificate holder is ''tt�� I AI��$$ RED the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the 'ain pull ,p�mj(tuire an endorsement. A statement on this certificate does not confer right to the certificate holder in lieu • d *01(6'1 '+ . PRODUCER Lockton Companies, LLC 5847 San Felipe, Suite 320 1/ Houston, TX 77057 ONT CT NAME: SHONE FAX A/C N Ex1): 888- 828 -8366 (A /C, No): DDRESS: INSURER(S) AFFORDING COVERAGE NAIC INSft INSURED ,✓NSURER -A: Ace American Insurance Co. 22667 Insperity, Inc. L /C /F FIELDMAN, ROLAPP & ASSOCIATES, INC. NSURER-13: R 19001 Crescent Springs Drive INSURER -C: INSURER -D: Kingwood, TX 77339 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. IN ADDL 3UBR SOUCY EFF SOUCY EXP s INSft We MMIDDIYYYY) MMIOD/YYYY) R LT R TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PREMISES Ea occurrence MED EXP (Any one pers an $ PERSONAL & ADV INJURY GENERAL AGGREGATE ENT AGGREGATE LIMIT APPLIES PER'. PRO- PRODUCTS — COMP/OP AGO POLICV JECT LOC PROFESSIONAL LIABILITY $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED Ea accident $ BODILY INJURY Per Person $ AUTOS AUTOS NON -OWNED BODILY INJURY Per acoldent $ PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ ED RETENTIONS ORKERS COMPENSATION ✓ WC STATU- OTH- A ND EMPLOYERS' LIABILITY X ORV LIMITS R NY PROPRIETORIPARTNERIEXECULVE / IN ✓ C4819087A 10/01/2014 10/0112016 FFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT $ 1,000,000 NIA MANDATORY IN NH) f yes, describe under E.L. DISEASE —EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE — POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES (Attach Acord 101, Additional remarks Schedule, if more space is required) FIELDMAN, ROLAPP & ASSOCIATES, INC, APPLIED BEST PRACTICES &FIELDMAN ROLAPP FINANCIAL SERVICES, LLC (3076300) IS INCLUDED AS A NAMED INSURED THROUGH ENDORSEMENT. BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE CITY OF SANTA ANA DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE CLERK OF THE COUNCIL 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 r „ ✓ �' -�^ ACORD 25 (2010105) ©1988 -2010 ACORD CORPORATION. All Rights Reserved. The ACORD name and logo are registore0 marks of ACORD J Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Insperity, Inc. FIELDMAN, ROLAPP & ASSOCIATES, INC. CITY OF SANTA ANA, CLERK OF THE COUNCIL 19001 Crescent springs Drive 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 Kingwood, TX 77339 Policy Symbol Policy Number Policy Period Effective Dale of Endorsement C4819087A 10/01/2014 TO 10/0112015 10/01/2014 Issued By (Name of Insurance Company) Indemnity Insurance Co. of North America Insert the policy number. The remainder of the infonnatlon Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES A. If we cancel the Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule set out below (the "Schedule "). You or your representative must provide us with both the physical and e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. C. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. D. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with the information necessary to complete the Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. E. We may arrange with your representative to send such notice in the event of any such cancellation. F. You will cooperate with us in providing, or in causing your representative to provide, the e-mail address and physical address of the persons or organizations listed in the Schedule. G. This endorsement does not apply in the event that you cancel the Policy. SCHEDULE Name of Certificate Holder E -Mail Address Physical Address CITY OF SANTA ANA, CLERK OF THE COUNCIL 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 All other terms and conditions of the Policy remain unchanged. Acct#: 1169655 ALL -32688 (01/11) tvw_ 1k Authorized Representative � 1 _ r , / Page 1 of 1 AC ___`s1`1 e llm. � V( ur 1� r" CERTIFICATE OF LIABILITY INSURANCE GATE (MMIDDIYYYY) 1110412014 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 DONTACT Lockton Companies, LLC 5847 San Felipe, Suite 320 POLICY EXP A/C No.Ext): 888. 828.8365 E -MAIL Houston, TX 77057 INSR DDRESS: INSURERS) AFFORDING COVERAGE NAIC MMIDDIYYYY) NSURER -A: ACE American Insurance Co 22807 TYPEOFINSURANCE INSURED f. YF` M f^AJ, Insperlly, Inc. L /C /F FIELDMAN, ROLAPP & ASSOCIATES, INC. dba APPLIED BEST PRACTICES & FIELDMAN ROLAPP FINANCIAL SERVICES LLC NSURER -B: POLICY NUMBER NSURER -C: NSURER -D: NSURER -E: LIABILITY 19001 Crescent Springs Drive INSURER-F: Kingwood, TX 77339 COVERAGES CERTIFICATE NIIMBFR' REVISION NIIMRFR• 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 ACCORDANCE WITH THE POLICY PROVISIONS ADDL Ua SANTA ANA, CA 92701 POLICY EFF POLICY EXP SR LT INSR 0 MM /DDIYYYV) MMIDDIYYYY) R TYPEOFINSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED OMMERCIAL GENERAL LIABILITY LAIMS MADE OCCUR PREMISES Ea occurrence $ VIED EXPAn one person) PERSONAL &ADV INJURY GENERAL AGGREGATE ENT AGGREGATE LIMIT APPLIES PER: PRO - PRODUCTS — COMP /OP AGG OLICY JECT LOD PROFESSIONAL LIABILITY $ COMBINED SINGLE LIMIT AUTOMOBI LE LIABILITY N AUTO Y LL OWNED SCHEDULED Ea accident $ BODILY INJURY Per Person $ UTOS AUTOS NON OWNED BODILY INJURY Per accident $ PROPERTY DAMAGE RED AUTOS AUTOS Per accident $ MBRELLA LIAB XCESS LIAB OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ EO I I RETENTIONS ORKERS COMPENSATION WC STATU- DTH- A AND EMPLOYERS' LIABILITY NV PROPRIETOR /PARTNER /EXECUTIVE Y/N C4819087A 1010112014 10/01/2016 X ORV LIMITS ER FFICER /MEMBER EXCLUDED? EL EACH ACCIDENT $ 1,000,000 N/A a MANDATORY IN NH) f yes, describe under E. L. DISEASE — EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E. L. DISEASE — POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES (Attach Acord 101, Additional remarks Schedule, if more space Is required) FIELDMAN, ROLAPP A ASSOCIATES, INC, APPLIED BEST PRACTICES &FIELDMAN SCUFF FINANCIAL SERVICES, LLC (3076300) IS INCLUDED AS A NAMED INSURED THROUGH ENDORSEMENT. RE: PROFESSIONAL SERVICES AGREEMENT FOR FINANCIAL ADVISOR #N- 2014018 I�I�:UIi PfG \�ia�l�kl�: N! \OIMO��e \�I�r� AL:URU 2b (ZU1 U /Ub) 91983 -2010 ACORD CORPORATION. All Rights Reserved. Acct #: 1169655 The ACORD name and logo are registered marks of ACORD / NOV - 4 2014 1,> V�' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CLERK OF THE COUNCIL ACCORDANCE WITH THE POLICY PROVISIONS 20 CIVIC CENTER PLAZA (M -30) AUTHORIZED REPRESENTATIVE SANTA ANA, CA 92701 AL:URU 2b (ZU1 U /Ub) 91983 -2010 ACORD CORPORATION. All Rights Reserved. Acct #: 1169655 The ACORD name and logo are registered marks of ACORD / NOV - 4 2014 1,> V�' Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Insperity, Inc. FIELDMAN, ROLAPP & ASSOCIATES, INC. dba APPLIED BEST PRACTICES & CITY OF SANTA ANA;CLERK OF THE COUNCIL; FIELDMAN ROLAPP FINANCIAL SERVICES LLC 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 19001 Crescent Springs Drive Policy Symbol Policy Number Policy Period Effective Date of Endorsement RWC C4819087A 10/01/2014 TO 10/01/2015 10/01/2014 Issued By (Name of Insurance Company) Ace American Insurance Co. Insert the policy number The remainder of the information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES A. If we cancel the Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule set out below (the "Schedule "). You or your representative must provide us with both the physical and e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. C. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. D. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with the information necessary to complete the Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. E. We may arrange with your representative to send such notice in the event of any such cancellation. F. You will cooperate with us in providing, or in causing your representative to provide, the e-mail address and physical address of the persons or organizations listed in the Schedule. G. This endorsement does not apply in the event that you cancel the Policy. SCHEDULE Name of Certificate Holder E -Mail Address Physical Address CITY OF SANTA ANA;CLERK OF THE COUNCIL; 20 CIVIC CENTER PLAZA (M -30) SANTA ANA, CA 92701 All other terms and conditions of the Policy remain unchanged. ALL-32688 (01111) Acct #: 1169655 I va 1kp� Authorized Representative Page 1 of 1 --g iV - ,Za14- 0/9 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD 3/ 12/2015 15 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 b fjdoil9ed.[ If�Sl�q[tOgATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement un this Ce4tI icate Hogs not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER .Millennium Corporate Solutions License (% OC13480 5530 Trabuco Road Irvine CA 92620 NAMEACT June L444n0F /5 I,' °`A PHONE E,ol. (94 r 60715'- _''FAX (949)679 -6607 M..jlarson@=sins.com INSURERS AFFORDING COVERAGE NAIC N INSURER A:Banover Insurance AXV 2292 7 IN RED Fieldman, Rolapp & Associates, Inc. ieldman, Rolapp Financial Services, LLC Applied Best Practices, LLC 19900 MacArthur Blvd. Suite 1100 Irvine CA 92612 INSURER B.Lloyds of London A +XV) 85202 I INSURER C: NSURER O: :N NSURER E: $ 1,000,000 INSURER F: $ 1,000,000 COVERAGES CERTIFICATE NUMBER:15 -16 AI 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 TYPE OF INSURANCE City Of Santa Ana J= POLICY NUMBER POLICY EFF IMMIDDfYYYYI POLICY EXP (MMIDDfYYYY) LIMITS Santa Ana, CA 92701 GENERAL LIABILITY c -- - June Larson /JANI EACH OCCURRENCE $ 1,000,000 PREMISES Ea ocovrrence $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR H3 A578667 00 /1/2015 /1/2016 MED EXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGO $ 2,000,000 X POLIGY I PRO 7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS OH3 A578667 00 /1/2015 /1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE fPer accident $ HIRED AUTOS X NON -OWNED AUTOS X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 3,000,000 AGGREGATE $ A EXCESS LIAR CLAIMS -MADE DELI I I RETENTION $ H3 A578667 00 /1/2015 /1/2016 WORKERS COMPENSATION I WC STATUS OTH- AND EMPLOYERS! LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA / N ER E.L. EACH ACCIDENT $ E . DISEASE - EA EMPLOYE $ (Mandatory in NH) / N yes, describe under ' DESCRIPTION OF OPERATIONS below E . DISEASE - POLICY LIMIT $ B Errors 6 Omission SUANS200491401 12/20 /2014 12/20/2015 Aggregate $2,000,000 Retro date 12/20/2004 laims Made Policy Retention $250,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) The City of Santa Ana, it's officers, employees, agents and representatives are named as additional insured as per form attached. 30 days notice shall be mailed for policy cancellation. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010/05) C 1988 -2010 ACORD CORPORATION. is reserySIR. INS02519nim5%n1 Tho Annion nama nnA Innn nna ronicta ad nn,s Arc of ACr1Rr1 _ -s - - -- Tev,ler�w _n SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Santa Ana Finance & Management Services Agency AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza Santa Ana, CA 92701 c -- - June Larson /JANI ACORD 25 (2010/05) C 1988 -2010 ACORD CORPORATION. is reserySIR. INS02519nim5%n1 Tho Annion nama nnA Innn nna ronicta ad nn,s Arc of ACr1Rr1 _ -s - - -- Tev,ler�w _n ADDITIONAL INSURED ENDORSEMENT Insurance Company��SeC This endorsement modifies such insurance as is afforded by the provisions of Policy relating to the following: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative 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 the additional insureds, this insurance shall not be cancelled, 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 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 4— \— \5 this endorsement form as part of Policy#�'�+3QS����� Issued tot i -�c\0�_z� Name Insured rredd POLICY NUMBER: OH3 A57866700 BUSINESSOWNERS BP 04 97 07 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE* Name Of Person Or Organization: As per written contract * Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Decla- Paragraph K. Transfer Of Rights Of Recovery Against Others To Us in Section III — Common Policy Conditions is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the 'products- completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. BP 04 97 07 02 © ISO Properties, Inc., 2001 Page 7 of 1 ❑ A00R°® CERTIFICATE OF LIABILITY INSURANCE �' ­DATE 11 /24 /201 Y) 11/24/2015 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 JUr10 Larson NAME: Millennium Corporate Solutions License # OC13480 PHONE ExO� (949)679 -6606 NC No: (949)679 -6706 ADDRESS, 3 E -MAIL Larson @mcsins. com 5530 Trabuco Road INSURERS AFFORDING COVERAGE NAIC# INSURER A:Hanover Insurance 22292 Irvine CA 92620 INSURED INSURER B.Underwriters at Lloyds 15792 INSURERC: CLAIMS -MADE ❑X OCCUR Fieldman, Rolapp & Associates, Inc. INSURER D: 19900 MacArthur Blvd. Suite 1100 INSURER E: _ PREMISES O(Ea.mourni $ 1,000,000 INSURER F: MED EXP(Any one person) Irvine CA 92612 COVERAGES CERTIFICATE NUMBER:CL15112431173 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. ILTR TYPE OF INSURANCE IN SD VD POLICY NUMBER PMIDDDIYYYVY MMIDOIYY %VY LIMITS AUTHORIZED REPRESENTATIVE X COMMERCIAL GENERAL LIABILITY June Larson /JUNE EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR PREMISES O(Ea.mourni $ 1,000,000 MED EXP(Any one person) $ 10,000 OH3 1,578667 00 4/1/2015 4/1/2016 PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER', POLICY �jECT LJ LOC GENERAL AGGREGATE $ 2,000,000 GEN'L X _ PRODUCTS- COMPIOPAGG $ 2,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE L MIT (Es nccMant $ 1,000,000 BODILY INJURY $ A ANY AUTO ALLOWNED SCHEDULED SCHEDULED AUTOS AUTOS OH3 A578667 00 4/1/2015 4/1/2016 BODILY INJURY(Peraccident) $ Perr accident AMAGE $ X HIRED AUTOS X AUTOS WNED ✓ $ X No Owned Autos X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 3,000'.000. AGGREGATE $ A E %CESS LIAB CLAIMS -MADE DE O RETENTION$ $ OH3 1,578667 00 4/1/2015 4/1/2016 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X I I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E,L, DIBEASE -EA EMPLOYE $ (Mandatory in NH) If yes, describe under - - - DESCRIPTION OF OPERATIONS below EL DIBEASE - POLICY LIMIT $ B Errors & Omissions SUA11811CYB1502 12/20/2015 6/19/2017 Aggregate $2,000,000 Retro date 12/20/2004 Claims Made Policy Retention" $250,000 v/ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of Santa Ana, it's officers, employees, agents and representatives are named as additional insured as per form attached. 30 days notice shall be mailed for policy cancellation. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101) INS02512014011 ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD v/ V/ I/ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE /City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Finance & Management Services Agency 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa. Ana, CA 92701 June Larson /JUNE ACORD 25 (2014101) INS02512014011 ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD v/ V/ I/ Policy No. OH3 A57866700 HThv Insurance Group- BUSINESSOWNERS LIABILITY SPECIAL BROADENING ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SUMMARY OF COVERAGES Limits Page 1. Additional Insured by Contract, Agreement or Permit 1 2. Additional Insured — Broad Form Vendors 2 3, Alienated Premises 2 4. Bodily Injury Redefined 2 5. Broad Form Property Damage — Borrowed Equipment, Customers 2 Goods and Use of Elevators 6. Incidental Malpractice (Employed Nurses, EMT's and Paramedics) 3 7. Personal and Advertising Injury — Broad Form 3 8. Product Recall Expense $25,000 Occurrence $50,000 Aggregate 3 9. Unintentional Failure to Disclose Hazards 5 10. Unintentional Failure to Notify 5 This endorsement amends coverages provided under the Businessowners Coverage Form through new coverages and broader coverage grants. This coverage is subject to the provisions applicable to the Businessowners Coverage Form, except as provided below. 1. Additional Insured by Contract, Agreement or Permit Under SECTION II — LIABILITY, C. Who Is An Insured, Paragraph 4. is added as follows: a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract, agreement or permit that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf, but only with respect to: (3) "Your work" for the additional insured(s) at the location designated in the contract, agreement or permit; or (4) Premises you own, rent, lease, control or occupy. This insurance applies on a primary basis if that is required by the written contract, agreement or permit. b. This provision does not apply: (1) Unless the written contract or written agreement has been executed or permit has been issued prior to the "bodily injury ", "property damage" or "personal and advertising injury "; (2) To any person or organization included as an insured by an endorsement issued by us and made part of this Policy; (3) To any person or organization included as an insured under Item 1.a.2, of this endorsement; (4) To any lessor of equipment: (a) After the equipment lease expires; or (b) If the "bodily injury ", "property damage" or "personal and advertising injury" arises out of the sole negligence of the lessor; (5) To any: (a) Owners or other interests from whom land has been leased which takes 391.1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 5 place after the lease for that land expires; or (b) Managers or lessors of premises if: (1) The occurrence takes place after you cease to be a tenant in that premises; or (it) The "bodily injury', "property damage' or "personal and advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor; or (6) To "bodily injury', "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services. c. Additional insured coverage provided by this provision will not be broader than coverage provided to any other insured. d. All other insuring agreements, exclusions, and conditions of the policy apply. 2. Additional Insured - Broad Form Vendors Under SECTION II — LIABILITY, C. Who Is An Insured, paragraph 5. is added as follows: 5. Any person or organization with whom you agreed, because of a written contract or written agreement to provide insurance, but only with respect to "bodily injury" or "property damage' arising out of "your products" which are distributed or sold in the regular course of the vendor's business. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage' for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instruction from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspection, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the product; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any thing or substance by or for the vendor: or h. "Bodily injury' or "property damage' arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in paragraphs 5.d. or 5.f.; or (2) Such inspections, adjustments, test or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 3. Alienated Premises Under SECTION II — LIABILITY, B. Exclusions, paragraph 1.k.(2) is replaced in its entirety with the following: (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises and occurred from hazards that were known by you, or should have reasonably been known by you, at the time the property was transferred or abandoned. 4. Bodily Injury Redefined Under SECTION II — LIABILITY, F. Liability and Medical Expenses Definitions, definition 4. is replaced in its entirety by the following: 4. "Bodily injury" means bodily injury, disability, sickness or disease sustained by a person, including death resulting from any of these at any time. "Bodily Injury" includes mental anguish or other mental injury resulting from "bodily injury". 5. Broad Form Property Damage — Borrowed Equipment, Customers Goods, Use of Elevators 391 -1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 5 6. FI 91 a. Under SECTION II — LIABILITY, B. Exclusions, paragraph 1.k., the following is added: Paragraph (4) does not apply to "property damage" to borrowed equipment while at a jobsite and not being used to perform operations. Paragraph (3), (4) and (6) do not apply to "property damage" to "customers goods" while on your premises nor to the use of elevators. b. Under SECTION II — LIABILITY, F. Liability and Medical Expenses Definitions, the following additional definition is added: "Customers goods" means property of your customer on your premises for the purpose of being: a. Worked on; or b. Used in your manufacturing process. c. The insurance afforded under this provision is excess over any other valid and collectible property insurance (including deductible) available to the insured whether primary, excess, contingent or on any other basis. Incidental Malpractice — Employed Nurses, EMT's and Paramedics Under SECTION II — LIABILITY, C. Who Is An Insured, paragraph 2.a.(1)(d) does not apply to a nurse, emergency medical technician or paramedic employed by you if you are not engaged in the business or occupation of providing medical, paramedical, surgical, dental, x- ray or nursing services. Personal and Advertising Injury — Broad Form Under SECTION II — LIABILITY, F. Liability and Medical Expenses Definitions, definition 15, "Personal and Advertising Injury", paragraph h. is added as follows: h. Discrimination or humiliation (unless insurance thereof is prohibited by law) that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is: (1) Not done intentionally by or at the direction of: (a) The insured; or (b) Any officer of the corporation, director, stockholder, partner or member of the insured; and (2) Not directly or indirectly related to an "employee ", nor to the employment, prospective employment or termination of any person or persons by an insured. Product Recall Expense Hanover Insurance Group- a. Under SECTION II — LIABILITY, B. Exclusions, Paragraph 1. o. is replaced in its entirety by the following: o. Recall of Products, Work or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product "; (2) "Your work "; or (3) "Impaired property'; If such product, work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it, but this exclusion does not apply to "product recall expenses' that you incur for the "covered recall" of "your product ". The exception to the exclusion does not apply to "product recall expenses' resulting from: (1) Failure of any products to accomplish their intended purpose; (2) Breach of warranties of fitness, quality, durability or performance; (3) Loss of customer approval, or any cost incurred to regain customer approval; (4) Redistribution or replacement of "your product" which has been recalled by like products or substitutes; (5) Caprice or whim of the insured; (6) A condition likely to cause loss of which any insured knew or had reason to know at the inception of this insurance; (7) Asbestos, including loss, damage or clean up resulting from asbestos or asbestos containing materials; or (8) Recall of "your products" that have no known or suspected defect solely because a known or suspected defect in another of "your products" has been found. b. Under SECTION II — LIABILITY, C. Who Is An Insured, paragraph 4.c. is added as follows: c. "Bodily injury" or "property damage" do not apply to "product recall expense' arising out of any withdrawal 391.1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 3 of 5 or recall that occurred before you acquired or formed the organization. c. Under SECTION II — LIABILITY, E. Liability and Medical Expense General Conditions, 2. Duties in the Event of Occurrence, Offense, Claim or Suit, paragraph e. is added as follows: e. You must see to it that the following are done in the event of an actual or anticipated "covered recall" that may result in "product recall expense ": (1) Give us prompt notice of any discovery or notification that "your product" must be withdrawn or recalled. Include a description of "your product" and the reason for the withdrawal or recall; (2) Cease any further release, shipment, consignment or any other method of distribution of like or similar products until it has been determined that all such products are free from defects that could be a cause of loss under this insurance. d. Under SECTION II — LIABILITY, F. Liability and Medical Expenses Definitions, the following additional definitions are added: "Covered recall" means a recall made necessary because you or a government body has determined that a known or suspected defect, deficiency, inadequacy, or dangerous condition in "your product" has resulted or will result in "bodily injury" or "property damage ". "Product recall expense(s)" means: a. Necessary and reasonable expenses for: (1) Communications, including radio or television announcements or printed advertisements including stationary, envelopes and postage; (2) Shipping the recalled products from any purchaser, distributor or user to the place or places designated by you; (3) Remuneration paid to your regular "employees" for necessary overtime; (4) Hiring additional persons, other than your regular "employees "; (5) Expenses incurred by "employees" including transportation and accommodations; (6) Expenses to rent additional warehouse or storage space; (7) Disposal of "your product ", but only to the extent that specific methods of destruction other than those employed for trash discarding or disposal are required to avoid "bodily injury" or "property damage" as a result of such disposal, you incur exclusively for the purpose of recalling "your product "'; and b. Your lost profit resulting from such "covered recall ". e. Under SECTION II — LIABILITY, D. Liability and Medical Expenses Limits of Insurance, the following is added: 5. The Limits of Insurance and rules stated below fix the most that we will pay under this Product Recall Expense Coverage. (1) The Aggregate Limit is the most that we will reimburse you for the sum of all "product recall expenses" incurred for all "product recall expenses" initiated during the policy period. (2) The Occurrence Limit shown on the Summary of Coverages is the most we will pay in connection with any one defect or deficiency. (a) All "product recall expenses' in connection with substantially the same general harmful condition will be deemed to arise out of the same defect or deficiency and considered one "occurrence ". (b) Any amount reimbursed for "product recall expenses" in connection with any one "occurrence" will reduce the amount of the Aggregate Limit available for reimbursement of "product recall expenses" in connection with any other defect or deficiency. (c) If the Aggregate Limit has been reduced by 391 -1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 5 4 Ha7n� nover Insurance croup® reimbursement of "product recall expenses" to an amount that is less than the Occurrence Limit, the remaining Aggregate Limit is the most that will be available for reimbursement of "product recall expenses" in connection with any other defect or deficiency. 6. A deductible of $500 applies per each "Occurrence". 9. Unintentional Failure to Disclose Hazards Under SECTION II — LIABILITY, E. Liability and Medical Expenses General Conditions, paragraph 6. is added as follows: 6. Representations We will not disclaim coverage under this Coverage Form if you fail to disclose all hazards existing as of the inception date of the policy provided such failure is not intentional. 10. Unintentional Failure to Notify Under SECTION II — LIABILITY, E. Liability and Medical Expenses General Conditions, 2. Duties in the Event of Occurrence, Offense, Claim or Suit, paragraph f. is added as follows: Your rights afforded under this Coverage Form shall not be prejudiced if you fail to give us notice of an "occurrence ", offense, claim or "suit ", solely due to your reasonable and documented belief that the "bodily injury" or "property damage" is not covered under this Policy. 391 -1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 6 of 6