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HomeMy WebLinkAboutCARD METERING SYSTEMS, INC (2).- 2014City of Santa Hua ffice __ s�' 1 Clerk of the Council I —cof OUse Only AGREEMENT TERMINATION FORM 2020 FEB -6 PH 4- 22 Please complete this form when the attached agreement and all CITY OF S ANTA ANA amendments (if any) are no longer in effect. CLERK 01 COUNCIL I Return form to the Clerk of the Council Office (M-30). I Call 647-1520 if you have any questions. I The agreement with No. N-2014-092 was completed on (List all amendments. Use space below if needed.) CQ&jzn and final payment has been made. Department: PP S A Phone/Ext.: `-lalq Signature: ThaG9r,�,u� Date: �� W Ig Revised 10-31-12 INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES ,Sy I _ 45' CLERK OF COUNOIL DATE6 2014 ,� PRcs Cl� EQLTIPMENT, SOFTWARE AND SERVICE AGREEMENT THIS AGREEMENT is entered into on July 1, 2014, by and between Card Metering Systems, Inc., a California corporation ("CMS") and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"), RECITALS: A. The City desires to hire a contractor to install, service and maintain copier and micrographic printers with debit card technology at the Santa Ana Main Library, Newhope Library and Garfield Community Center. B. CMS represents that it is able and willing to provide such services to the City. C, In undertaking the performance of this Agreement, CMS represents that it is knowledgeable in its field and that any services performed by CMS under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the Yield. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SERVICES CMS will provide and install all software and hardware components, listed in "Equipment" of Exhibit A, attached hereto and incorporated by this reference, and will ensure its functionality and operation. City will not after or remove the Diginet Printing network, operating system, servers or client software without prior notification to CMS. City and CMS will perform a pre -installation walk thru. City will complete the pre -installation checklist and return it to CNIS prior to CMS ordering or assembling any equipment or performing services pursuant to this Agreement. 2. WARRANTIES CMS warrants all equipment and software provided by CMS for the Term of this Agreement for all equipment, products and software provided as part of this agreement as either the manufacturer, Dealer, servicing agent or distributor or all products provided. In the event there is a defect, malfunction or failure, CMS will repair, replace or remedy any malfunctioning equipment and software products provided by CMS as part of this agreement. CMS warranty does not cover damage caused by abuse, misuse, mishandling, misapplication and computer viruses, 3. SERVICE HOURS CMS will provide regular maintenance as requested, Monday through Friday SAM to SPM (MST). These hours may be adjusted as deemed appropriate by CMS and approved by the City and/or as mutually requested by the City and agreed upon in writing by both parties, dependent upon volume, workload and other requirements. CMS will provide emergency service response within a 6 hour average for all actual service calls placed by the customer to CMS 800 service line and or electronic e-mail request during CMS business hours. CMS will respond to service calls within this 6 hour average except for reasons attributed to causes not within CMS' control (excluding and not limited to natural disasters, major traffic delays, power outages, out of coin/change, etc.). CMS provides its employees the following holidays, during which service will not be provided: • Christmas Eve and Christmas Day • Thanksgiving Day and following Friday • Independence Day • New Years Eve and New Years Day • Memorial Day • Labor Day • Martin Luther King Jr. Day • President's Day • Easter • Veterans Day • Columbus Day "Weekend Weekend and after -hour services: CMS phone and email support are provided at no charge Monday -Friday 8AM-5PM MST with all other time and support functions billed at $200.00 per hour. 4. COMPENSATION A. Pricing Structure — City shall charge the general public the sum of $0.15 (Fifteen Cents) per black and white copy/print, and $0.50 (Fifty Cents) per color copy/print. City staff copier charges will be $0.03 (Three Cents) per copy. B. City will not guarantee a minimum monthly revenue to CMS. C. City shall be invoiced on a monthly basis for staff copier charges. Payment by City shall be made within fifty (50) days following receipt of invoice, subject to City accounting procedures. D. A late payment fee of 10% for every 30 days will be applied if not received on time. Late fees will be added to the next invoice. E. CMS will provide all of the CMS owned equipment at no cost to the City. F. Compensation for the copier services hereunder shall not exceed Fifteen Hundred Dollars ($1,500.00) annually. Compensation for Services hereunder shall not exceed $25,000 over the multi -year term of this Agreement. Refund Copies Staff is not to use the public access copiers to make staff copies. Staff will be provided with a change fund of $30.00 (Main Branch), $20.00 (Newhope Branch), and $20.00 (Garfield Center) for use in giving refunds to patrons; refund slips must be filled out completely. 5. TERM This Agreement shall commence on July 1, 2014 and continue for a three (3) year period with two 1-year options exercisable by the City Manager and the City Attorney, unless terminated earlier in accordance with Section 13, below. Prior to undertaking performance of work under this Agreement, CMS shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. CMS shall maintain commercial general liability insurance which shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of CMS' operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal inj ury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. 7. INDEMNIFICATION CMS agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the direct or indirect operations of CMS or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. 8. ASSIGNMENT CMS agrees not to assign or transfer any of its obligations under this Agreement without the prior written consent of the City, which consent shall not be unreasonably withheld. 9. VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 10. CONFIDENTIALITY If CMS receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, CMS agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. i t . NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by facsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 Copy to: Parks, Recreation & Community Services Agency City of Santa Ana 26 Civic Center Plaza (M-75) P.O. Box 1988 Santa Ana, California 92702 Fax 714- 571-4221 To CMS: Card Meter System, Inc. Sarah Seltzer 7056 Archibald Ave., Ste. 102-453 Corona, CA 92880 Fax 888-267-1607 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by facsimile, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 12. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and CMS, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 13. TERMINATION This Agreement may be terminated by either party upon sixty (60) days written notice of termination. In such event, each party shall be entitled to receive compensation for all services perfonned prior to receipt of such notice of termination. 14. DISCRIMINATION CMS shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. 15. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of in connection with or by reason of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in Pact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Equipment, Software and Service Agreement on the date and year first written above. ATTEST: MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: Lisa orck Assistant City Attorney RECOMMENDED FOR APPROVAL: A2cr 'GERARDO MOUET Executive Director Parks, Recreation and Community Services Agency CITY OF SANTA ANA _ f DAVID CAVAZOS City Manager CARD METER SYSTEM, INC. a el r Chief Executive Officer EXHIBIT A SCOPE OF SERVICES Equipment Location Quantity Equipment Description Main Library 1 Black and white Digital copier and coin/bill unit (CMS owned 1 Black and white Digital copier CMS owned) 1 Color Digital Copier and coin/bill unit (CMS owned) 3 Black and white HP 4050 laser printer (City owned) and coin/bill unit (CMS owned) 1 Black and white HP 4350 laser printer (City owned) and coin/bill unit (CMS owned) 2 Color HP CP3525 laser printer (city owned 1 Color HP 4700 laser printer (City owned) 4 CMS software: Diginet, Wireless printing (Locations: Main Children Library, Learning Center 2nd floor, Adult Lab, Reference area lsu floor) Newhope Library 1 CMS software: Diginet Server, Diginet, Wireless printing 1 Black and white Digital copier and coin/bill unit (CMS owned) 1 Black and white HP 4350 laser printer (City owned) and coin/bill unit (CMS owned) 1 Black and white HP 4050 laser printer (City owned) 1 Color HP 4700 laser printer (City owned Garfield Center 1 CMS software: Diginet Server, Diginet, Wireless printing for Mac 1 Black and white HP 4050 laser printer (City owned) and coin/bill unit (CMS owned) 1 Color HP 2550 laser printer (City owned Equipment Configurations The above represents the configuration of equipment CMS will provide and install. Models of equipment are subject to change without notice. Services CMS will provide all equipment including toner supplies and paper. CMS and City may add additional services, personnel and/or equipment by amending these agreements. CMS will deliver and install the equipment proposed by CMS at CMS expense. City agrees to provide adequate space, electrical, computer and network requirements. CMS will service the Equipment according to a CMS established service timetable and will deliver toner and paper to City. CMS will collect and count all the money from the equipment provided and CMS will produce a monthly usage report for City. This report shall include a listing of all equipment by location, volume on each piece of Equipment, revenues by piece of Equipment, usage type (public or staff), pricing level and chargeable services if any. City will assist CMS with paper, toner and printer cartridge security. City will load paper, toner, Print cartridges and remove paper jams. Chargeable services It is CMS intent that all fees and charges are included except for items as they relate to taxes, filing fees and other State, Federal and local charges. In the event City requests service outside of the proposed solution, such as causing service issues by changing operating systems, print drivers, network configurations, computer hardware, failures due to viruses and any other such items that would create a service issue, CMS will invoice and the City agrees to reimburse CMS at the rate of $200.00 per hour for calls created in this manner. CMS recommends that any changes of this nature be brought to the attention of CMS prior to implementing so that CMS may assist/guide the customer through the process to avoid any downtime or performance issues. Training CMS will provide all necessary Key Operator training for Library staff so that personnel will be able to effectively operate all equipment provided. Key Operator Responsibilities - Copiers Library will provide Key Operators for the equipment installed by CMS. The Key Operators will do the following: 1. Load Paper 2. Clear Paper Jams 3. Replace Toner Cartridges when out of toner M v3 A{CC&_ CERTIFICATE OF LIABILITY INSURANCE 5/1/2019 DATE 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 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 endarsernent(s). PRODUCER Ambassador Group Inc. 7010 E Chauncey Ln Ste 230 Phoenix AZ 85054 ONOMNT ffT Laurie SCOla PNDNE (4S0)776-6950 FAX No)' (46U)9966931 pppRIE S,lscola@ ambaa a ado riITa. com _ WSURER(S) AFFORDING COVERAGE a INSURER A National Fire Insurance Com Et _NAICk 0478 INSURED Card Meter Systems Inc. dba CMS 7056 Archibald Ave Ste 102-453 Corona CA 92880 INSURERS:Transp2rtation Insurance N� 20494 INSURERCi_Em_plo ers Comoernsation INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 MAster 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 ITR 'rypE OF INSURANCE ADD BR POLICY NUMBERD POLICY EFF POLICY EXP V LIMITS GENERAL LIABILITY EACH OCCURRENCE y�ff $ 1,000,000 $ 300,000 X COMMERCIAL GENERAL LIABILITY A CLAIMS-MAOE lil OCCUR X 4025961553 5/1/2014 /1/2015 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMTr APPLIES PER: _GENERAL PRODUC FS•COMP/OP AGO $ 2,000,000 POLICY 0 PRO X LOC $ AUTOMOBILE LIABILITY COMBINED SI GLE 0191T 1 000 000 BODILY INJURY(Per person) $ B Ix ANY AUTO ALL OWNED SCHEDULED AUTOS X NON OWNED HIRED AUTOS � ALTOS 4025961505 5/1/2014 5/l/2015 BODILY INJURY(Per aeUdeni $AUTOS __ PROPERTY DAMAGE a i n IL $ _ Uninsured moladsl rq prl $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DEB I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPMETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA IG2097823-00 5/1/2014 /1/2015 X WCSTA'I'U OTH. 0@Y1N117 E.L. EACH ACCIDENT $ l 000 000 E.L. DISEASE- EA EMPLOYE $ 11000,000 2es, dasoriUe under SCRIPTION OF OPERATIONS below El DISEASE -POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ADDED 101, Additional Rountree Schedule, Ignore space is required) Coverage subject to policy forma, terms and conditions.City of Santa Ana, its officers, agents and employees and xepreaentatives is Named as Additional Insured - Designated Person or Organization. insurance is primary & non-contributory. 'Fo�A APP'ROVE1� �8 � 4 A tsTORCK City of Santa Ana Parks, Recreation and C Services Agency Attn: Silvia Cuevas 26 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Scola/ARE G `_ ( �`,� _e ._ ACORD25 INS025,9ninneeni Thu Ar.npn namn and Innn .rn rnnl.fnrwd mark. of Ar.nPn rights reserved. POLICY NUMBER - INSURED NAME AND ADDRESS - -- B 4025961553 CARD METER SYSTEMS, INC. 5325 EAST ELENA AVENUE MESA, AZ 85206 FORMS AND ENDORSEMENTS SCHEDULE COMMERCIAL PROPERTY FORM NUMBER FORM TITLE SB1470843 07/2009 Fungi, Wet Rot, Dry Rot and Microbe Exclusion SB300129B 01/2008 Targeted Hacker Attack SB300139B 01/2008 Protective Safeguards SB300146C 01/2008 Cap on Losses from Certified 'Acts of Terrorism SB300179D 07/2009 Choice Endorsement SB300456A 07/2007 Concurrent Causation, Earth Movmnt, Water Excl Chg SB300596A 01/2008 Identity Theft/Recovery Services Endorsement COMMERCIAL GENERAL LIABILITY FORM NUMBER FORM TITLE SE146932D 07/2009 Blanket Additional Insured - Liability Extension SB147079A 01/2006 War Liability Exclusion SB147080A 01/2006 Exclusion - Silica SB147081A O1/2006 Exclusion - Respirable Dust SB147083B 07/2009 Fungi/Mold/Mildew/Yeast/Microbe Exclusion SB147089A O1/2006 Employment - Related Practices Exclusion SB300000C 04/2010 Businessowners Liability Coverage Form SB300113B O1/2007 Additional Insured - Designated Person SB300441A O1/2007 Fiduciary Liability Coverage Form SB300449A O1/2007 Single Limit of Insurance Endorsement SB3004SOA O1/2007 Employment Practices Liability Coverage Form SB300849A 07/2009 Recd and Distribution of Material or information *** PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY *** FORM NUMBER FORM TITLE SB146959G 02/2010 Policyholders Jurisdictional Inspection S3300144C O1./2008 Offer of Terrorism Coverage Notice SB300999A 04/2010 Businessowners GI, Cov Form Policyholder Notice Chairman of Poo Board SB-146895-A (Ed. 01/06) Countersignature �q v77, � p9 Secrnlery A AGENT OSAn S 014CK ge 8 of gssistarit cm pttor 9-/1- SB-146932-D (Ed. 07/09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Policy. 1. ADDITIONAL INSURED— BLANKET VENDORS WHO IS AN INSURED is amended to include as an additional Insured any person or organization (referred to below as vendor) with whom you agreed, because of a written contract or 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, subject to the following additional exclusions: 1. 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, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e� Any failure to make such inspections, 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 products; 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 other thing or substance by or for the vendor; or SB-146932-D (Ed. 07/09) h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omission or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f,; or (2) Such inspections, 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 products. 2. 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. S. This provision 2. does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Policy, 4. This provision 2. does not apply if "bodily injury" or "property damage" included within the "products -completed operations hazard" is excluded either by the provisions of the Policy or by endorsement. F�dii;:'L��ldf�sl�b'7GT►7i�CiI�kT�1. F3117�'i WHO IS AN INSURED is amended to include as an Insured any person or organization (called additional insured) described in paragraphs 2.a. through 2.h. below whom you are required to add as an additional insured on this policy under a written contract or agreement but the written contract or agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the 'bodily Injury," "property damage" or "personal and advertising injury," but Only the following persons or organizations are additional insureds under this endorsement and coverage provided to such additional insureds is limited as provided herein: Foll'A APPROVED AS TO Page 1 of 5 -- LI A S. STOtt Attorney T". Assistant City a. Additional Insured — Your Work That person or organization for whom you do work is an additional insured solely for liability due to your negligence specifically resulting from your work for the additional insured which is the subject of the written contract or written agreement. No coverage applies to liability resulting from the sole negligence of the additional insured. The insurance provided to the additional insured is limited as follows: (1) The Limits of Insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy, whichever is less. These Limits of Insurance are Inclusive of, and not in addition to, the Limits of Insurance shown in the Declarations. (2) The coverage provided to the additional Insured by this endorsement and paragraph p'.9. of the definition of "Insured contract" under Liability and Medical Expenses Definitions do not apply to "bodily injury" or "property damage" arising out of the "products - completed operations hazard" unless required by the written contract or written agreement. (3) The insurance provided to the additional Insured does not apply to "bodily injury," "property darnage," or "personal and advertising injury' arising out of the rendering or failure to render any professional services. b. State or Political Subdivisions A state or political subdivision subject to the following provisions: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with premises you own, rent, or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or SB-146932-D (Ed. 07/09) (b) The construction, erection, or removal of elevators; or (2) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. This insurance does not apply to "bodily injury," "property damage' or "personal and advertising injury" arising out of operations performed for the state or municipality. c. Controlling Interest Any persons or organizations with a controlling interest in you but only with respect to their liability arising out of: (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured. d. Managers or Lessors of Promises A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the premises leased to you and subject to the following additional exclusions: 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 additional insured. e. Mortgagee, Assignee or Receiver A mortgagee, assignee or receiver but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of a premises by you. This insurance does not apply to structural alterations, new construction or demolition operations performed by or for such additional insured. f. Owners/Other interests — Land is Leased An owner or other interest from whom land has been leased by you but only with ret„j liability arising out of the fta maintenance or use of that S6-146932-D %it�®�� Page 2 of 5 (Ed. 07/09) A G1tY A4 nay Aostant specific part of the land leased to you and subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which 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 additional insured. g. Co-owner of Insured Premises A co-owner of a premises co -owned by you and covered under this insurance but only with respect to the co -owners liability as co- owner of such premises. h. Lessor of Equipment Any person or organization from whom you lease equipment. Such person or organization are insureds only with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such person or organization, A person's or organization's status as an insured under this endorsement ends when their written contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply (1) To any "occurrence" which takes place after the equipment lease expires; or (2) To "bodily injury," "property damage" or "personal and advertising injury" arising out of the sole negligence of such additional insured. Any insurance provided to an additional insured designated under paragraphs b. through h. above does not apply to "bodily injury" or "property damage" included within the "products completed operations hazard." 3, The following is added to Paragraph N. of the BUSINESSOWNERS COMMON POLICY CONDITIONS: Otherinsurance `J 4. This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless SB-146932-D (Ed. 07/09) SB-146932-D (Ed. 07109) a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing. 4. LEGAL LIABILITY— DAMAGE TO PREMISES A. Under B. Exclusions, 1. Applicable to Business Liability Coverage, Exclusion k, Damage To Property, is replaced by the following: It. Damage To Property "Property damage" to: 1, Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to anther's property; 2. Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; 3. Property loaned to you; 4. Personal property in the care, custody or control of the insured; 5, That particular part of any real property on which you or any contractors or subcontractors working directly or indirectly to your behalf are performing operations, if the "property damage" arises out of those operations; or 6. That particular part of any property that must be restored, repaired or replaced because "your work" was Incorrectly performed on it. Paragraph 2 of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs 1, 3, and 4, of this exclusion do not apply to "property damage" (other than damage by fire or explosion) to premises: (1) rented to you: (2) temporarily occupied by you with the permission of the owner, or (3) to the contents of premises rented to you for a period of 7 or fewer consecutive da_y . APPROVED AS TOt''66�� Page 3 of 5 L A E, STORCK ... Assistant City Attorney y A separate limit of insurance applies to Damage To Premises Rented To You as described In Section D — Liability and Medical Expenses Limits of Insurance. Paragraphs 3, 4, 5, and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to 'property damage" included in the 'products -completed operations hazard." B. Under B. Exclusions, 1. Applicable to Business Liability Coverage, the last paragraph of 2, Exclusions is deleted and replaced by the following: Exclusions c, d, e, f, g, h, I, k, 1, m, n, and o, do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner or to the contents of premises rented to you for a period of 7 or fewer consecutive days, A separate limit of insurance applies to this coverage as described in Section D. Liability And Medical Expenses Limits Of Insurance. C. The first Paragraph under item 5. Damage To Premises Rented To You Limit of Section D. Liability And Medical Expenses Limits Of Insurance is replaced by the following: The most we will pay under Business Liability for damages because of 'property damage" to any one premises, while rented to you, or temporarily occupied by you, with the permission of the owner, including contents of such premises rented to you for a period of 7 or fewer consecutive days, is the Damage to Premises Rented to You limit shown In the Declaration. 5. Broad Knowledge of Occurrence The following items are added to E. Businessowners General Liability Conditions in the Businessowners Liability Coverage Form: a. Paragraphs a. and b. apply to you or to any additional insured only when such 'occurrence," offense, claim or "suit' is known to: (1) You or any additional insured that is an individual; (2) Any partner, if you or an additional insured Is a partnership: SB-146932-D (Ed.07109) SB-146932-IJ (Ed. 07109) (3) Any manager, if you or an additional Insured is a limited liability company; (4) Any "executive officer" or insurance manager, if you or an additional insured is a corporation; (5) Any trustee, if you or an additional insured is a trust; or (6) Any elected or appointed official, if you or an additional insured is a political subdivision or public entity. This paragraph a. applies separately to you and any additional insured. 6. Bodily Injury Section F. Liability and Medical Expenses Definitions, item 3. "Bodily Injury" is deleted and replaced with the following: "Bodily injury" means bodily Injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the bodily injury, sickness or disease. 7. Expanded Personal and Advertising Injury Definition The following is added to Section F. Liability and Medical Expenses Definitions, item 14. Personal and Advertising Injury, in the Businessowners General Liability Coverage Form: h. Discrimination or humiliation 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 "executive officer," director, stockholder, partner, member or manager (if you are a limited liability company) of the insured; and 2. Not directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person or person by any insured. B. The following is added to Exclusions, Section B.: (15)Discrimination Relating to Room, Dwelling or Premises Caused by discrimination directly or indirectly relate sale, rental, Page 4 of 5 STOORC,1 / 11 Assistant City Attorney t lease or sub -lease or prospective sale, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured. (16)Flnes or Penalties Fines or penalties levied or imposed by a governmental entity because of discrimination. C. This provision (Expanded Personal and Advertising Injury) does not apply to SB-146932-D (Ed. 07/09) SB-146932-D (Ed. 07/09) discrimination or humiliation committed in the states of New York or Ohio. Also, Expanded Personal and Advertising Injury Coverage does not apply to policies issued in the states of New York or Ohio. D. This provision (Expanded Personal and Advertising Injury) does not apply if Personal and Advertising Injury Liability is excluded either by the provisions of the Policy or by endorsement. TO VOW SAP ttotrney Page 5 of 5 psststant City �-- AT CERTIFICATE OF LIABILITY INSURANCE 04izzizors 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 Kristin Raider NAME: Ambassador Group Inc. PHONE E ExO (480)776-6950 FAXINC, No7:_(4eo)776 6961 7010 E Chauncey Ln ADDRiess:kreider@ambassadorins.com Ste 230 INSURERS) AFFORDING COVERAGE NAIC p. Phoenix AZ 85054 INSURER ANational Fire Insurance Company of 20478 _. INSURED INSURER B:Transportation Insurance Company 20494 CARD METER SYSTEMS, INC. DBA CMS INC. INSURERC: Employers Compensation Insurance _. 7056 ARCHIBALD AVE STE 102-453 c,tL�} u INSURER "r� `C_�� I .+.. (CORONA CA 92880 (INSURER F: CnVFRAr FC CFRTIFICATFNIIMRFR-15-16 Master (CAI RFVISIr1NINIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER LTR POLICY NUMBER POLICY EFF POLICY EXF MMIDOIVYYV IMMUDDIYYVY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $.. 300, 000 X 4025961553 5/1/2015 5/1/2016 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY _$ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 R POLICY PRO JECT LOC PRODUCTS-COMPIOP AGG $ __. 2,000,000 OTHER. EPLI $ 10,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea acmdanll_ 1, 000,000 _ _ X ANY AUTO B BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS 4025961505 5/1/2015 5/1/2016 BODILY INJURY (Perewitlenl) $ NON -OWNED R_ PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Perapedent) Uninsured miu nst property $ 3,500 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ _ DED RETENTIONS $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY Y (N STATUTE ER_ ANY PROPRIETORIPARTNERIEXECUTIVE E L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED' NIA - C (Mandatory in NH) -- EIG2097823-01 5/1/2015 5/1/2016 EL. DISEASE - EA EMPLOYEE$ 1,000,000 f yes, describe antler DESCRIPTION OF OPERATIONS below EL.DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Addition at Remarks Schedule, may be attached if more space is required) Coverage subject to policy forms, terms and conditions.City of Santa Ana, its officers, agents and employees and representatives is Named as Additional Insured - Designated Person or Organization. Insurance is primary & non-contributory. e� Al City of Santa Ana Parks, Recreation & Community Services Agency Attn: Silvia Cuevas 26 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANXpP"iHE AE{gJEbE , �t`,O 1LICIES BE CANCELLED BEFORE THE EXPIRATION DAT4r 'I ,, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH TH 1 PROVISIONS. AUTHORIZED REPRESENTATIVE Kristin Raider/KRE -�_- �- ©1988-2014 ACORD CORPORATION. All rights reserve) ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD I NA025 „nf 4nn POLICY NUMBER B 4025961553 101001003'10*AM Z1014OF.1M1 INSURED NAME AND ADDRESS CARD METER SYSTEMS, INC. 5325 EAST ELENA AVENUE MESA, AZ 85206 FORMS AND ENDORSEMENTS SCHEDULE FORM NUMBER FORM TITLE SB147084B 07/2009 Fungi, Wet Rot, Dry Rot and Microbe Exclusion SB300129B 01/2008 Targeted Hacker Attack SB300139B 01/2008 Protective Safeguards SB300146C 01/2008 Cap on Losses from Certified Acts of Terrorism SB300179D 07/2009 Choice Endorsement SB300456A 07/2007 Concurrent Causation, Earth Movmnt, Water Excl Chg SB300596A 01/2008 Identity Theft/Recovery Services Endorsement COMMERCIAL GENERAL LIABILITY FORM NUMBER FORM TITLE SB146932D 07/2009 Blanket Additional Insured - Liability Extension SB147079A O1/2006 War Liability Exclusion S3147080A O1/2006 Exclusion - Silica SB147081A O1/2006 Exclusion - Respirable Dust SB147083B 07/2009 Fungi/Mold/Mildew/Yeast/Microbe Exclusion S3147089A O1/2006 Employment - Related Practices Exclusion SB300000C 04/2010 Businessowners Liability Coverage Form SE3001133 O1/2007 Additional Insured - Designated Person SB300441A O1/2007 Fiduciary Liability Coverage Form SB300449A O1/2007 Single Limit of Insurance Endorsement SB300450A O1/2007 Employment Practices Liability Coverage Form SB300849A 07/2009 Rood and Distribution of Material or information *** PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY *** FORM NUMBER FORM TITLE SE146959G 02/2010 Policyholders Jurisdictional Inspection SB300144C O1/2008 Offer of Terrorism Coverage Notice SB300999A 04/2010 Businessowners GL Cov Form Policyholder Notice 5�\JG5P1Pd Countersignature Secrela Chairman of the Hoard SB-146895-A (Ed. 01/06) AGENT Page 8 of 8 111A .:.i SB-146932-D (Ed. 07/09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - LIABILITY EXTENSION This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Policy. 1. ADDITIONAL INSURED— BLANKET VENDORS WHO IS AN INSURED is amended to include as an additional insured any person or organization (referred to below as vendor) with whom you agreed, because of a written contract or 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, subject to the following additional exclusions: 1. 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, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, 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 products; 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 ingredie t(A.any other thing or substance b Z for the vendor; or C�jA h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omission or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f.; or (2) Such inspections, 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 products. 2. 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. This provision 2. does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Policy. 4. This provision 2. does not apply if "bodily injury" or "property damage" included within the ..products -completed operations hazard" is excluded either by the provisions of the Policy or by endorsement. 2. MISCELLANEOUS ADDITIONAL INSUREDS WHO IS AN INSURED is amended to include as an insured any person or organization (called additional insured) described in paragraphs 2.a. through 2.h. below whom you are required to add as an additional insured on this policy under a written contract or agreement but the written contract or agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury," "property damage" or "personal and advertising injury," but Only the following persons or organizations are additional insureds under this endorsement and coverage provided to such additional insureds is limited as provided herein: SB 146932 D Cj\ GSp��d�\r' Page 1 of 5 SB-146932-D N(Ed. 07/09) a. Additional Insured —Your Work (b) The construction, erection, or That person or organization for whom you removal of elevators; or do work is an additional insured solely for (2) This insurance applies only with respect liability due to your negligence specifically to operations performed by you or on resulting from your work for the additional your behalf for which the state or insured which is the subject of the written political subdivision has issued a permit. contract or written agreement. No coverage This insurance does not apply to "bodily applies to liability resulting from the sole negligence of the additional insured. injury," "property damage" or "personal and advertising injury" arising out of operations The insurance provided to the additional performed for the state or municipality. insured is limited as follows: c. Controlling Interest (1) The Limits of Insurance applicable to Any persons or organizations with a the additional insured are those specified in the written contract or controlling interest in you but only with written agreement or in the Declarations respect to their liability arising out of: of this policy, whichever is less. These (1) Their financial control of you; or Limits of Insurance are inclusive of, and not in addition to, the Limits of (2) Premises they own, maintain or control Insurance shown in the Declarations. while you lease or occupy these premises. (2) The coverage provided to the additional insured by this endorsement and This insurance does not apply to structural paragraph F.9. of the definition of alterations, new construction and demolition "insured contract" under Liability and operations performed by or for such Medical Expenses Definitions do not additional insured. apply to "bodily injury" or "property d. Managers or Lessors of Premises damage" arising out of the "products - completed operations hazard" unless A manager or lessor of premises but only required by the written contract or with respect to liability arising out of the written agreement. ownership, maintenance or use of that specific part of the premises leased to you (3) The insurance provided to the additional and subject to the following additional insured does not apply to "bodily injury," exclusions: '.property damage," or "personal and advertising injury" arising out of the This insurance does not apply to: rendering or failure to render any (1) Any "occurrence" which takes place professional services. after you cease to be a tenant in that b. State or Political Subdivisions premises; or A state or political subdivision subject to the (2) Structural alterations, new construction following provisions: or demolition operations performed by or on behalf of such additional insured. (1) This insurance applies only with respect to the following hazards for which the e. Mortgagee, Assignee or Receiver state or political subdivision has issued A mortgagee, assignee or receiver but only a permit in connection with premises with respect to their liability as mortgagee, you own, rent, or control and to which assignee, or receiver and arising out of the this insurance applies: ownership, maintenance, or use of a (a) The existence, maintenance, repair, premises by you. construction, erection, or removal of This insurance does not apply to structural advertising signs, awnings, alterations, new construction or demolition canopies, cellar entrances, coal operations performed by or for such holes, driveways, manholes, additional insured. marquees, hoistaway openings, sidewalk vaults, street banners, or f. Owners/Other Interests — Land is Leased decorations and similaeo*sures; or An owner or other interest from whom land has been leased by you but only with \eke F,e� respect to liability arising out of the ownership, maintenance or use of that SB-146932-D Gueva \t\ Page 2 of 5 (Ed. 07/09)\��\ �P'(i,C�'(� specific part of the land leased to you and subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which 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 additional insured. g. Co-owner of Insured Premises A co-owner of a premises co -owned by you and covered under this insurance but only with respect to the co -owners liability as co- owner of such premises. h. Lessor of Equipment Any person or organization from whom you lease equipment. Such person or organization are insureds only with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their written contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply: (1) To any "occurrence" which takes place after the equipment lease expires; or (2) To "bodily injury," "property damage" or "personal and advertising injury" arising out of the sole negligence of such additional insured. Any insurance provided to an additional insured designated under paragraphs b. through h. above does not apply to "bodily injury" or "property damage" included within the "products -completed operations hazard." 3. The following is added to Paragraph H. of the BUSINESSOWNERS COMMON POLICY CONDITIONS: SB-146932-D (Ed. 07/09) a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing. 4. LEGAL LIABILITY— DAMAGE TO PREMISES H. Other Insurance �a� 4. This insurance is excess over any insurance naming the additi red as an insured whether primjexcess,f' contingent or on any other basis unless el SB-146932-D Cj\��\ Pa (Ed. 07/09) p�G5P� A. Under B. Exclusions, 1. Applicable to Business Liability Coverage, Exclusion k. Damage To Property, is replaced by the following: k. Damage To Property "Property damage" to: 1. Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; 2. Premises you sell, give away or abandon, if the "property damage" arises out of any pail of those premises; 3. Property loaned to you; 4. Personal property in the care, custody or control of the insured; 5. That particular part of any real property on which you or any contractors or subcontractors working directly or indirectly in your behalf are performing operations, if the "property damage" arises out of those operations; or 6. That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraph 2 of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs 1, 3, and 4, of this exclusion do not apply to "property damage" (other than damage by fire or explosion) to premises: (1) rented to you: (2) temporarily occupied by you with the permission of the owner, or (3) to the contents of premises rented to you for a period of 7 or fewer consecutive days. Page 3 of 5 11111111�.'11 A separate limit of insurance applies to Damage To Premises Rented To You as described in Section D — Liability and Medical Expenses Limits of Insurance. Paragraphs 3, 4, 5, and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to "property damage" included in the "products -completed operations hazard." B. Under B. Exclusions, 1. Applicable to Business Liability Coverage, the last paragraph of 2. Exclusions is deleted and replaced by the following: Exclusions c, d, e, f, g, h, i, k, I, m, n, and o, do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner or to the contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section D. Liability And Medical Expenses Limits Of Insurance. C. The first Paragraph under item 5. Damage To Premises Rented To You Limit of Section D. Liability And Medical Expenses Limits Of Insurance is replaced by the following: The most we will pay under Business Liability for damages because of "property damage" to any one premises, while rented to you, or temporarily occupied by you, with the permission of the owner, including contents of such premises rented to you for a period of 7 or fewer consecutive days, is the Damage to Premises Rented to You limit shown in the Declaration. 5. Broad Knowledge of Occurrence The following items are added to E. Businessowners General Liability Conditions in the Businessowners Liability Coverage Form: e. Paragraphs a. and b. apply to you or to any additional insured only when such ..occurrence," offense, claim or "suit' is known to: (1) You or any additional insured that is p`J individual; vje e (2) Any partner, if you or wae,additional C' insured is a partnership; SB-146932-D (Ed. 07/09) IG5P�Pd Q SB-146932-D (Ed.07/09) (3) Any manager, if you or an additional insured is a limited liability company; (4) Any "executive officer" or insurance manager, if you or an additional insured is a corporation; (5) Any trustee, if you or an additional insured is a trust; or (6) Any elected or appointed official, if you or an additional insured is a political subdivision or public entity. This paragraph e. applies separately to you and any additional insured. 6. Bodily Injury Section F. Liability and Medical Expenses Definitions, item 3. 'Bodily Injury" is deleted and replaced with the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the bodily injury, sickness or disease. 7. Expanded Personal and Advertising Injury Definition The following is added to Section F. Liability and Medical Expenses Definitions, item 14. Personal and Advertising Injury, in the Businessowners General Liability Coverage Form: h. Discrimination or humiliation 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 "executive officer," director, stockholder, partner, member or manager (if you are a limited liability company) of the insured; and 2. Not directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person or person by any insured. B. The following is added to Exclusions, A Section B.: �15)Discrimination Relating to Room, Dwelling or Premises Caused by discrimination directly or indirectly related to the sale, rental, Page 4 of 5 lease or sub -lease or prospective sale, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured. (16)Fines or Penalties Fines or penalties levied or imposed by a governmental entity because of discrimination. C. This provision (Expanded Personal and Advertising Injury) does not apply to SB-146932-D (Ed. 07/09) SB-146932-D (Ed. 07!09) discrimination or humiliation committed in the states of New York or Ohio. Also, Expanded Personal and Advertising Injury Coverage does not apply to policies issued in the states of New York or Ohio, D. This provision (Expanded Personal and Advertising Injury) does not apply if Personal and Advertising Injury Liability is excluded either by the provisions of the Policy or by endorsement. Page 5 of 5 >�. I DATE (MMJDDfYYYY) i`1 L. V c,.....-,. CERTIFICATE OF LIABILITY INSURANCE 4/27,2016 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 INSU'RER(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 Kristin Raider NAME: Ambassador Group Inc. PH Ne,Extl; (480)776-6950 {aPcJAI,A9a),I4a0D776-6951 7010 E Chauncey In ADDRIESS:kreider@ambassadorins.com, Ste 230 INSURER(S).AFFORDING COVERAGE NAIL # Phoenix AZ 85054 INSURER A:'Valley Forge Insurance_ Company 20508 INSURED ."��"Tyy)P,.�.a*"",�,INSURER„B:Transportation Insurance Company _ 20494 CART? METER SYSTEMS, INC. L lNSURERC:Employers Preferred Insurance 7056 ARCHIBALiD AVE STE 102-453 INSURERD: CORONA CA 92880 INSURERF: COVERAGES CERTIFICATE NUMBER-16-17 Master 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 _ .ADDL StJBR. __.. ......... M011CY E' F LTR I D POLICY NUMBER MMdDDfYYYY .... POLICY EXP LIMITS MMIDDlYYYY '.. COMMERCIAL. GENERAL LIABILITY : EACH OCCURRENCE ',.. $ 1,000,000 A ;... _ CLAIMS -MADE _ '.. OCCUR '..... DAMAGE TO RENTED. . PREMISES Ea occurrence $ 4 ) _ ........ 300,000 ...._.... _.. ''. X '.. 4025961..553 5/1/2016 5/1/2017 IVIED EXP (Any one parson) $ 10,000 _ PERSONAL &ADV INJURY $ ,$ 1,000,000 GEN°LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE...... 2,00...0,000 X POLICY' PRO JECT LOG PRODUCTS - CbMPlbPAGG $ ..$ 2,000,000 OTHER:.... : EPLtl 1.0,000... AUTOMOBILE LIABILITY _... COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 X._... ANY AUTO BODILY INJURY (Per person) $ Ed ALL OWNED SCHEDULED 4025961505 5/1/2016 AUTOS AUTOS 5/1/2017 BODILY INJURY (Peraccodenl) $ _.. NON: -OWNED y` PROPERTY G,4.M,4GE PR ..... MIRED AUTOS AUTOS acddent)..... Uninsured motorst property $ 3,500 ''. UMBRELLA LIAR OCCUR EACH OCCURRENCE $ _. ...... EXCESS LIAR CLAIMS -MADE AGGREGATE... $ DED RETENTION$ _.. $ WORKERS COMPENSATION ;.. ERH AND EMPLOYERS" LIABILITY Y ! N SPER TATUTE. I ANY PROPRIETOWPARTNER�EX.ECUTIVE E.L EACH ACCIDENT $ 1, 000, 000 OFFICEWMEMBER EX.CLIJDED7 N f A _... - C (Mandatory in NHI E1G2097823-02 5/1/2016 5/1./2017 E,L DISEASE - EA EMPLOYEE $ 1, 000, 000... If yes, describe under ._ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) e Coverage subject to policy farms, terms and conditions.City of Santa Ana, i eAficers, age and, employees and representatives are included as additional insureds as re d by writte ontract. Insurance is primary 6 non-contributory. ILMq;As 12LW-lvIa;MAIII W—ll9L R4W IIL•1L" City of Santa Ana Parks, Recreation & Community Services Agency M-23 20 Civic Center Plaza Santa. Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE. CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Kristin Reider/KRE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD25 (2014101) The ACORD name and logo are registered marks of ACORD IN'S025 R7nsmn I 1�A SB-146932-E (Ed, 06/11) THIS ENDORSEMENT CHANGESTHE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUS11NESSOWNERS LIABILITY COVERAGE FORM Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Policy. WHO 13 AN INSURED is amended to include as an additional insured any person or organization (referred to below as vendor) with whom you agreed, because of a written contract or 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, subject to the following additional exclusions: 1 . 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, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from: the manufacturer, and then repackaged in the original container; own acts or omission or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f.; or (2) Such inspections, 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 products. 2. 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, This provision 2. does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Policy. 4. This provision 2. does not apply if "bodily injury" or "property damage" included within the "products - completed operations hazard" is excluded either by the provisions of the Policy or by endorsement. 2. MISCELLANEOUS ADDITIONAL INSUREDS e. Any failure to make such inspections, 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 products; 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,,�O as a container, part or ingredient of any o e1 th,inici or substance by or for the vendor; W ' A ), h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for it§ SB-146932-E (Ed. 06/11) WHO IS AN INSURED is amended to include as an insured any person or organization (called additional insured) described in paragraphs 2.a. through 2.h. below whom you are required to add as an additional insured on this policy under a written contract or agreement but the written contract or agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury," "property damage" or "personal and advertising injury," but Rnly the following persons or organizations are -additional ir),96reds under this endorsement and coverag ro i vided to such additional insureds is _q 4 ' )jmit%Ooqs provided herein: G t4ditionall Insured — Your Work �That person or organization for whom you do work is, an additional insured solely for liability Page 1 of 5 due to your negligence specifically resulting from your work for the additional insured which is the subject of the written contract or written agreement. No coverage applies to liability resulting from the sole negligence of the additional insured. The insurance provided to the additional insured is limited as follows: (1) The Limits of Insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy, whichever is less. These Limits of Insurance are inclusive of, and not in addition to, the Limits of Insurance shown in the Declarations. (2) The coverage provided to the additional insured by this endorsement and paragraph F.9. of the definition of "insured contract" under Liability and Medical Expenses Definitions do not apply to "bodily injury" or "property damage" arising out of the "products -completed operations hazard" unless required by the written contract or written agreement. (3) The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or "personal and advertising injury" arising out of the rendering or failure to render any professional services. b. State or Political Subdivisions SB-1 46932-E (Ed. 06/11) This insurance does not apply to "bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality. c. Controlling Interest Any persons or organizations with a controlling interest in you but only with respect to their liability arising out of: (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured, d. Managers or Lessors of Premises A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the premises leased to you and subject to the following additional exclusions: 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 additional insured. A state or political subdivision subject to the e. Mortgagee, Assignee or Receiver following provisions: A mortgagee, assignee or receiver but only (1) This insurance applies only with respect with respect to their liability as mortgagee, to the following hazards for which the assignee, or receiver and arising out of the state or political subdivision has issued a ownership, maintenance, or use of a premises permit in connection with premises you by you• own, rent, or control and to which this This insurance does not apply to structural insurance applies: alterations, new construction or demolition (a) The existence, maintenance, repair, operations performed by or for such additional construction, erection, or removal of insured, advertising signs, awnings, canopies, f. Owners/Other Interests — Land is Leased cellar entrances, coal holes, driveways, manholes, marquees, An owner or other interest from, whom land hoistaway openings, sidewalk vaults, has been leased by you but only with respect street banners, or decorations and to liability arising out of the ownership, similar exposures; or maintenance or use of that specific part of the (b) The construction, erection, or land leased to you and subject to the following additional exclusions: removal of elevators; or (2) This insurance applies only with respect insurance does not apply to: 1;1:,e6 to operations performed by you or on (1) Any "occurrence" which takes place behalf for which the state or p I A ­after you cease to lease that land; or subdivision has issued a permit. e 6e SB-146932-E Page 2 of 5 (Ed. 06/11) �i 21 (2) Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. g. Co-owner of Insured Premises A co-owner of a premises co -owned by you and covered under this insurance but only with respect to the co -owners liability as co- owner of such premises. h. Lessor of Equipment Any person or organization from whom you lease equipment. Such person or organization are insureds only with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their written contract or agreement with you for such (leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional eXCIUsions apply: This insurance does not apply: (1) To any "occurrence" which takes place after the equipment lease expires; or (2) To "bodily injury," "property damage" or "personal and advertising injury" arising out of the sole negligence of such additional insured. Any insurance provided to an additional insured designated under paragraphs b. through h, above does not apply to "bodily injury" or "property damage" included within the "products -completed operations hazard." 3. The following is added to Paragraph H. of the BUSINESSOWNERS COMMON POLICY CONDITIONS: H. Other Insurance 4. This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and 1� V noncontributing. C>11_� 4. LEGAL LIABILITY — DAMAGE TO PREMISES A. Under B. Exclusions, 1. Applicable Business Liability Coverage, Exclusion SB-146932-E (Ed. 06/11) SB-146932-E (Ed, 06/11) Damage To Property, is replaced by the following: k. Damage To Property "Property damage" to: 1. Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; 2. Premises you sells, give away or abandon, if the "property damage" arises out of any part of those premises; 3. Property loaned to you; 4. Personal property in the care, custody or control of the insured; 5. That particular part of any real property on which you or any contractors or subcontractors working directly or indirectly in your behalf are performing operations, if the "property damage" arises out of those operations; or 6. That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraph 2 of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs 1, 3, and 4, of this exclusion do not apply to "property damage" (other than damage by fire or explosion) to premises: (1) rented to you: (2) temporarily occupied by you with the permission of the owner, or (3) to the contents of premises rented to you for a period of 7 or fewer consecutive days. A� s e �pa �e limit of insurance applies to r' r p ' Da e To Premises Rented To You as c c ribed in, Section D — Liability and Wdical Expenses Limits of Insurance. Page 3 of 5 Paragraphs 3, 4, 5, and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to "property damage" included in the "products -completed operations hazard." B. Under B. Exclusions, 1. Applicable to Business Liability Coverage, the last paragraph of 2. Exclusions is deleted and replaced by the following: Exclusions c, d, e, f, g, h, i, k, 1, m, n, and o, do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner or to the contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section D. Liability And Medical Expenses Limiits Of Insurance. C. The first Paragraph under item 5. Damage To Premises Rented To You Limit of Section D. Liability And Medical Expenses Limits Of Insurance is replaced by the following: The most we will pay under Business Liability for damages because of "'property damage" to any one premises, while rented to you, or temporarily occupied by you, with the permission of the owner, including contents of such premises rented to you for a period of 7 or fewer consecutive days, is the Damage to Premises Rented to You limit shown in the Declaration. 5. Blanket Waiver of Subrogation We waive any right of recovery we may have against: a. Any person or organization with whom you have a written contract that requires such a waiver. 6. Broad Knowledge of Occurrence The following items are added to E. Businessowners General Liability Conditions in the Businessowners Liability Coverage Form: SB-146932-E (Ed. 06/11) (2) Any partner, if you or an additional insured is a partnership; (3) Any manager, if you or an additional insured is a limited liability company; (4) Any "executive officer" or insurance manager, if you or an additional insured is a corporation; (5) Any trustee, if you or an additional insured is a trust; or (6) Any elected or appointed official, if you or an additional insured is a political subdivision or public entity. This paragraph e. applies separately to you and any additional insured. 7. Bodily Injury Section F. Liability and Medical Expenses Definitions, item 3. "Bodily Injury" is deleted and replaced with the following: "Bodily injury"' means bodily injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the bodily injury, sickness or disease. 8. Expanded Personal and Advertising Injury Definition a. The following is added to Section F. Liability and Medical Expenses Definitions, item 14. Personal and Advertising Injury, in the Businesso,wners General Liability Coverage Form: h. Discrimination or humiliation 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 "executive officer," director, stockholder, partner, member or manager (if you are a limited liability company) of the insured; and 2. Not directly or indirectly related to the e. Paragraphs a. and b. apply to you or to any employment, prospective employment, additional insured only when such past employment or termination of occurrence," offense, claim or "suit" is known em `went of any person or person by to: insured. (1) You or any additional insured that is ie b following is added to Exclusions, Section individual; G� SB-146932-E (Ed. 06/11) Page 4 of 5 0 i2 (15) Discrimination Relating to Room, Dwelling or Premises Caused by discrimination directly or indirectly related to the sale, rental, lease 9. or sub -lease or prospective sale, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured. (116) Fines or Penalties Fines or penalties levied or imposed by a governmental entity because of discrimination. c. This provision (Expanded Personal and Advertising Injury) does not apply if SB-146932-E (Ed. 06/11) SB-146932-E (Ed, 06/11) Personal and Advertising Injury Liability is excluded either by the provisions of the Policy or by endorsement. Personal and Advertising Injury Re -defined Section F. Liability and Medical Expenses Definitions, item 14, Personal! Advertising Injury, Paragraph c. is replaced by the following: c.The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room dwelling or premises that a person or organization occupies committed by or on behalf of it's owner, landlord or lessor. A0. Page 5 of 5