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HomeMy WebLinkAboutTRUXAW, JOSEPH C. INC. 1-2014two'ay, E0ur`�` A-2014A00 WNRL INSUf 1A0NCE E'.Xl't�F -t' CONSULTANT AGREEMENT FOR CLEf�KOF C UNC1L� CONSTRUCTION SURVEYING SERVICES WITH DATE: 6 '0 L JOSEPH C. TRUXAW AND ASSOCIATES, INC. THIS CONSULTANT AGREEMENT made and entered into this 15th day of April, 2014 by and between Joseph C. Truxaw and Associates, Inc., a California corporation (hereinafter "Consultant "), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City "). RECITALS A. The City desires to retain a consultant having special skill and Imowledge in the field of construction surveying services. B. Consultant represents that Consultant is able and willing to provide such services to the City, C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. 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: 1. SCOPE OF SERVICES Consultant shall perform construction surveying services for City projects, on an on -call basis, as set forth in the City's Request for Proposals — Scope of Services dated November 4, 2013, attached hereto as Exhibit A, and the Consultant's Proposal, attached hereto as Exhibit B, All Exhibits to this Agreement are incorporated by this reference, 2. DELIVERY OF WORK PRODUCT Consultant shall deliver to City all work product which results from the services provided. Said work product shall be submitted in a hard copy and produced in a form compatible with City's computer system, as agreed between the City's Project Manager and Consultant. In regard to material produced as a deliverable under the Agreement, including but not limited to books, reports, plans, photographs, drawings, videotapes, and computer programs, Consultant agrees, for itself and its affected officers, employees, agents, contractors, and volunteer workers, that the authors of all such material, whether copyrighted or not, award to the City, and to its officers, agents and employees acting within the scope of their official duties, as a condition of payment to the Consultant, a royalty -free, nonexclusive, irrevocable license throughout the world to disclose, publish, translate, reproduce, and use such materials. 3. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit C. The total sum to be expended under this Agreement shall not exceed $250,000.00 during the initial two -year tern of this Agreement. b. The total sum to be expended under this Agreement shall not exceed $250,000.00 during each of the subsequent one -year option periods. a Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made far work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 4. TERM This Agreement shall commence on May 1, 2014 and tenninate on June 30, 2016, unless terminated earlier in accordance with Section 13, below. The City Manager shall have the option to extend the term of this Agreement for up to two (2) additional one -year option periods, on the same terns and conditions set forth herein. 5. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer - employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant 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 Consultant's 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 injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, and in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self - insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. c. 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. d. Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. f I£ Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 7. INDEMNIFICATION To the fullest extent permitted by law, Consultant shall indemnify, defend and hold harnless City, its officers, agents and employees (collectively, the "indemnified parties ") from and against any and all claims (including, without limitation, claims for bodily injury, death or darnage to property), demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's fees, disbursements and court costs) of every kind and nature whatsoever (individually, a claim; collectively, "claims "), which may arise from or in any manner related (directly or indirectly) to any work performed or services provided under this Agreement (including, without limitation, defects in workmanship and /or materials) or Consultant's presence or activities conducted performing the work (including the negligent and /or willful acts, errors and /or omissions of Consultant, its principals, officers, agents, employees, vendors, suppliers, contractors, subcontractors, anyone employed directly or indirectly by any of them or for whose acts they may be liable for any or all of them). Notwithstanding the foregoing, nothing herein shall be construed to require Consultant to indemnify the indemnified parties from any claim arising from the sole negligence or willful misconduct of the indemnified parties. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by the Consultant. 8. CONFIDENTIALITY I£ Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant 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. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and /or agent of the other party is covered by this Agreement. The foregoing obligations of non -use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 10. 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 telefacsimile 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 Facsimile: 714 - 647 -6956 With courtesy copies to: Public Works Agency— Construction Engineering City of Santa Ana 20 Civic Center Plaza (M -22) Santa Ana, California 92702 Facsimile: 714 - 647 -5058 and City Attorney City of Santa Ana 20 Civic Center Plaza (M -29) P.O. Box 1988 Santa Ana, California 92702 Facsimile: 714- 647 -6515 To Consultant: Joseph C. Truxaw and Associates, Inc. Attn: Joseph G. Truxaw 265 S. Anita Drive, Suite 111 Orange, California 92868 Facsimile: 714 - 918 -6277 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. 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, 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. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor the City. 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. 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 13. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 14. DISCRIMINATION Consultant 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. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 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 Comity, 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. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 17. 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 fact, 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 Agreement the date and year first above written. ATTEST: � -- ? i// r MA IA D. HUIZAR Clerk of the Council SONIA R. CARVALHO City Attorney Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: EDWIN "WILLIAM" GA VEZ, P.E. Interim Executive Director - PWA CITY OF SANTA ANA � I DAVID) AVAZOS City Manager TRUXAW AND ASSOCIATES, INC. G. TRUXAW Exhibit A — Request for Proposal — Scope of Services DESCRIPTION AND SCOPE OFWORK The City of Santa Ana is issuing this Request for Proposals (RFP) for Construction Surveying and Map Checking Services. Construction Survevina Services In general„ the Consultant shall perform monument preservation and construction staking for various City projects on an as- needed basis. A California - licensed land surveyor shall be in responsible charge of all survey work performed under the contract.. The Consultants services shall include, but not be Rmited to, the following: A. Research existing County and City records for survey monuments within the project area. Prior to any clearing, removal„ or excavation efforts, perform a diligent search for property line monuments, street centedine monuments, and benchmarks Within the project area, recording their identities and precise locations in reference to monuments or witness monuments that will not be disturbed during construction. The records of these monuments and references shall conform to Section 8771 of the Business and Professions Code of the State of California. After completion of the construction, any monument disturbed or removed' during construction shall be reset, conforming to Section 877I. Each centerline intersection shall be drawn, on a single Corner Record showing local tie points and tie distances. The Corner Records shall be drafted in M'scrostation (version 8 or earlier), and a digital copy of each submitted to the City. C. Provide construction staking for project improvements. Records of the line and grade stakes (cut sheets) shall be on forms provided by the City, and the originals shall become the property of the City upon completion of each survey request. The City will provide digital construction plans and specifications for each project. The consultant shall furnish hiArd copies of plans for field personnel as needed. D. Set line and grade stakes in accordance with the plans and specifications Notify the City immediately of any discrepancies or design errors discovered on the plans during staking or when verifying the line and grade of existing improvements atjoin points_ E. Complete the construction staking within the time frame specified on the Survey Request Form, or (given minimum notice) commence the staking no later than two working days from the receipt of the request, providing continuous service until the request is complete. F. Furnish all office support, labor, materials, equipment, tools„ and incidentals necessary to complete the specified surveys. The costs for these items shall be included in the hourly or lump sum costs and no additional compensation will be allowed therefore. G. Attend meetings with City's sniff as required'. Mara Checking Services H. Information furnished by the City for checking will be roughly as follows: 1 set of Exhibits., title reports, reference documents (Deed, Parcel Map, Tract Map, etc-), traverse closures, and improvement plans. I. Review Exhibits for technical correctness and completeness, consistency with the City guidelines and requirements, compliance with the Subdivision Map Act, and acceptance for recording. J. Review title report and existing easements for correct plotting and references. K. Review improvement plans associated with the project to ensure the Exhibits correctly identify the limits and location as shown on the improvement plans. L. Provide a set of redline check prints showing the redlined comments, and required corrections and information. M. Provide a check Netter covering the major required comments, and corrections and instruction for future submittals. N. Provide a timesheet with items L. and M_ above at the end of every review. The timesheet must include, but is not limited to, project name, review number, dates, review hours, hourly rate, and total cost.. Miscellaneous Services Oa Provide survey services as requested. A detailed scope of work will be outlined when specific project is assigned to the consultant. Services shall include„ but are not limited to, cross - sections, intersection grids, centerline determination, digital terrain models (.dtm), right of way determination, utility profiles and exhibits. P. Generate a computer drawing in Microstation V8 format showing survey per the attached City of Santa Ana CARD Standards (Attachment B) as well as the sample survey drawing on the City of SanL Ana website listed in item 4 below: Q_ All survey needs to be prepared to the satisfaction of the City's Senior Surveyor and meet the following standards: R. Horizontal control shall be based on the 198:3 North American Datum (NAD83), tied to a minimum of two proximate County of Change, CCS83, Zone VI, 1991.35 Epoch Adjustment control points. Project coordinate values shall be provided in U.S. Survey Feet. The County control points shall determine the Basis of Searing for the project. S_ Vertical control shall be based on the North American Vertical datum of 1988 (;NAVD88), tied to a minimum of two proximate County of Change bench marks. Project elevations shall be provide in U.S. Survey Feet. T. Horizontal alignments) for the project shall be tied to the survey centerline monuments within the project area. U. With the coordinate values, a full location and detailed description, including point character with reference(s), shall be provided for all found and set monuments for the project. For this purpose, a sketch of the control network is required. V. Copies of all survey field notes and raw data files shall be provident along with a listing of the final coordinates for all surveyed points. The digital file format for the listing shall be: point number, northing, easting, elevation, description (;comma delineated with no spaces, one point per line). The coordinate precision shall be one hundredth of a foot. W. At any given time the City may need to mobilize survey crews to different project sites„ the consultant shall have a minimum of three (3) survey crews for mobilization. X. All City CAM] standards as well as Microstation configuration files are located at: Y. http:// www. santa- ana .oryfpwa/EngineeringServices.asp II. IMPLEMENTATION A_ City staff shall have the right to modify, reduce, or delete the services as needed' by City. B. The term of the contract shall be for two (2) years which shall commence on the date that City Council approves the award or the date tiiat all required bonds and insurance have been approved by the City Attorney„ whichever occurs last. PERFORMANCE SCHEDULE A. City staff will provide written request for quotes. The consultant will respond, in writing within 3 working days. The City can request lump sum or hourly rate quotes. The consultant shall provide backup documentation for all expenses upon City request. B. Upon approval and within T working days, the City shall issue the Notice to Proceed. Survey work shall begin within 2 working days from the receipt of the Survey Request, Form. Map checking work shall begin as indicated on the Notice to Proceed. C. The City reserves the right to assess liquidated damages or terminate the contrast. D. City staff shall have the right to negotiate the terms of the quote. Exhibit B — Consultant's Proposal MINWIMME 1. IN c Kea r 11" Kral Ana 01 r PREPARED BY: Joseph C. Truxaw and Associates, Inc, 265 S. Anita Drive, Suite 119 Orange, CA 92868 (794) 935 -0265 December 2, 2013 Mr. Carlos Castellanos, PE City of Santa Ana / Public Works Agency, Construction Engineering 20 Civic Center Plaza Santa Ana, CA 82702 RE: Statement of qualifications, Construction Surveying Services, RFP No, 13 -063 Dear Carlos, 1 On behalf of Joseph C. Truxaw and Associates, Inc., I am pleased to respond to your request for Construction Surveying Services. We are in receipt of the RFP dated November 4, 2013 and Addenda 1.3. Truxaw and Associates is uniquely qualified to provide these services for the following reasons: • Recent and relevant experience with exactly the same services requested in the RFP, • 40 years of consistent and favorable working relationships with City of Santa Ana staff and management, + Successfully completed over 180 civil engineering, land surveying, and mapping projects within the City, • Professional land surveyors and engineers with expertise in the requirements expected by the Public Works Department and Construction Engineering Division, • Nearby office within 10 minutes of Santa Ana City Hall, • Will serve the City on short notice and acknowledge that time is of the essence to the City in the performance of our duties for the requested services. 265 S. Anita Dr. Suite III Orange. CA 92868 (714) 935 -0265 FAX (714) 935 -0 106 Joseph O. Truxaw, PLS, President will serve as the Project ManagedPrincipal Agent (single point of contact) for the City of Santa Ana throughout the duration of our agreement. I have over 39 years' experience in land surveying and project management. The Truxaw firm of 23 professionals, including 3 Licensed Land Surveyors, 1 Land Surveyor in Training, 5 Professional Civil Engineers and 1 Engineer in Training, together with an efficient support staff, is optimally sized to handle large projects while maintaining a personalized "small" firm relationship which public agencies have enjoyed for many years. We look forward to working with you and the Public Works Construction Engineering Section. Pf�ase feel free to contact me with any questions. TRUXAW AND ASSOCIATES, INC. O. Truxaw, PLS joetruxaw Otruxaw.com Joseph C. Truxaw and Associates, lnc, Civil Engineers and Land Surveyors (714) 995.0265 I , Construction Surveying Services City of Santa Ana December 2013 TABLE OF CONTENTS Firm and Personnel Experience Firm Profile Organizational Chart Names and Experience ofPersonnel Percentage nf Time Breakdown Implementation Plan and Deliverables Exhibit D—References Exhibit E` Proposers Statement EXhibitF — CadifivatiunofNoDdioorirninubnnbyContruuk)/ Exhibit E)— Responsible Proposer ~ Supplemental Questionnaire Exhibit H— Non-Collusion Affidavit Exhibit I — Sample Additional Insured Endorsement for Commercial General Liability Policy Fee Envelope (Separate Sealed Envelope) Exhibit C — Proposers Statement and Proposal Item Pricing do.sephuTruxow and Associotos, Ine. Construction Civil Engineers and Lmmoxwmw/x {uy^r3onmAim (714) 935-0265 owvwo/ber 2013 FIRM PERSONNEL EXPERIENCE Firm Profile Joseph C, Truxaw and Associates, Inc. is an Orange County based professional corporation of civil engineers and land surveyors. Incorporated in 1975, the firm grew from a private consulting practice founded by Joseph C. Truxaw while he was City Engineer and Director of Public Works for the City of La Palma, California. The organization has a diverse client base, serving developers, public agencies, architects, food service corporations, title companies, and construction firms. Truxaw and Associates' project locations include California, Arizona, and Nevada, giving the firm experience working with and obtaining approvals from over 400 public agencies. The principals of Truxaw and Associates are keenly aware that the keys to client satisfaction are timely communication, quality, accurate plans and specifications, and close attention to schedules and budgets. Organizational Chart The Truxaw and Associates' Organizational Chart is shown on the next page, The key personnel for this RFP are in red text. Joseph C. Twxaw and Associates, Inc, constntctton Surooying services Civil Engineers and Land Surveyots City of Santa Ana (714) 835 -0265 December 2013 C) rA KJ CC Miry cn k4 G. W) e4 bA "it La pk 41 4. IF G i W) e4 bA "it La CL �h pk CL �h Names and Experience of Personnel Under the direction of the Project Manager /Principal Agent, Joseph G. Truxaw, PLS, the following key personnel will be assigned, on an "as- needed" basis for specific tasks or projects for the City of Santa Ana, as requested by the City's Senior Surveyor. As shown on the Organizational Chart, additional qualified Truxaw staff members are available and will be assigned for larger projects as required. All Truxaw staff has current and relevant experience working in the City of Santa Ana. Please see key personnel resumes following this section. Joseph G. Truxaw, PLS, Project Manager /Principal Agent Mr. Truxaw has 39 years of experience in public works land surveying and mapping, construction surveys, ALTA surveys, right -of -way engineering, boundary analysis and project management. He is also responsible for civil feasibility studies, grading and drainage, utility and street improvement design. Mr. Truxaw will be in responsible charge of all surveys and will sign and seal all deliverables for the City of Santa Ana. Joe D. Deal, LSIT, Survey Coordinator Mc Deal has 25 years of experience in the land Surveying. He has spent the last '14 years working at Truxaw & Associates as a party chief, and now in his current position as Survey Coordinator. His responsibilities include scheduling of crews, safety coordination and communicating with clients, survey calculations and CADD drafting. Craig Lee, Survey CADD Manager Mr. Lee has 33 years of experience in survey computations, legal descriptions, mapping and civil engineering design. Mr. Lee has vast knowledge in CADD Engineering /Survey software. He has experience producing and plan checking survey documents for multiple public agencies in Southern California. In his position of Survey CADD Manager, Mr. Lee's responsibilities include supervision of CADD drafters, as well as calculations, production design and drafting. Jesus Guzman, PLS, Crew Chief Mr. Guzman's 15 year survey career includes experience with boundary, topographic, ALTA, construction, control, tunnel, aerial, RTK, DGPS, RTN -RTK, and GPS fast static and conventional surveys. He is also experienced preparing and submitting survey estimates and proposals, administration of survey contracts, preparing and scheduling daily survey field work, drafting of corner records, ALTA Surveys, Record of Surveys, Parcel and Final Maps, downloading and processing daily survey field work, preparing of survey base sheets, legal descriptions and project and survey research. Daniel Rodriguez, Crew Chief Mr. Rodriguez's 12 years as Crew Chief for Truxaw and Associates, includes extensive public works construction surveys, boundary, monument preservation, ALTA Surveys and mapping. Daniel is highly efficient and precise. Joseph C. Truxaw and Associates, h7c. Conshuction Swveying Sarvloes Civil Enginoers and Land Surveyors City of Santa Ana (714) 935 -0265 December 2013 Percentage of Time Breakdown The percentage of time that individual Truxaw and Associates' staff will invest in a particular project for the City of Santa Ana will vary depending on the nature of the requested task and deliverables required. In general, the following guidelines will apply. Project Manager /Principal Agent 10% Interface and meetings with City staff and Quality Assurance Survey Coordinator 10% Survey Crew scheduling, Safety, Office Calculations, Quality Control Survey CADD Manager 10% CADD Drafting, Map Checking, Final Deliverables Survey Crew 70% Field Surveys, Field Data Post Processing, Quality Control Joseph C. Truxaw and Associates, toc. Construction Surveying Services Civil Engineers and Land Surveyors City of Santa Ana (714) 935 -0265 Decernber2013 JOSEPH G. TRUXAW, PLS, PRESIDENT Joseph C. Truxaw and Associates, Inc. rof s Tonal Experie„Jr ce Mi. Truxaw's 39 years experience with Truxaw and Associates encompasses every aspect of the firm's professional land surveying and civil engineering services. Mr. Truxaw specializes in land surveying and mapping, construction surveys, ALTA surveys, right -of -way engineering, boundary analysis and project management. He has effectively implemented state -of- the -art surveying and civil engineering automation including the use of robotic total station -data collectionistakeout field technology and AutoCAD /civil 3D design and drafting software in the office. Professional Registration Professional Land Surveyor No. 6871 (California) Professional Membershios Member of California Land Surveyors Association Member of American Congress on Surveying and Mapping Representative Clients City of Anaheim City of Orange City of Santa Ana City of Mission Viejo Mappin� and Plan Checking Clients City of Tustin County of Orange Disneyland Resort Land America Lawyers Title Insurance City of Anaheim, Anaheim, CA Mr. Truxaw has been responsible for checking and preparing over 100 legal descriptions, record maps, certificates of compliance, and lot line adjustments for the City of Anaheim Public Works Department. Joe has been instrumental in creating Plan Check Lists which are now used by City staff. Additionally, Truxaw and Associates provides surveying services to the City on an on -call basis. Joe Truxaw has directed construction related surveys such as construction staking, pre and post - construction corner records and settlement monitoring on City projects. City of Orange, CA Both the City Water Division and the Public Works Department have called on Joe Truxaw for surveying services. Joe is responsible for chocking legal descriptions submitted by developers to the City of Orange Water Division. For the Public Works Department Joe has prepared legal descriptions and other record documents required by the City to acquire property for street widening projects, City of Mission Viejo, CA The City of Mission Viejo has depended on the expertise of Joe Truxaw in the review of lot fine adjustments, easement legal descriptions and other record documents submitted by developers. The City has expressed their satisfaction with Joe's timely and comprehensive responses to their plan checking requests. Joseph C. Truxaw and Associates, inc. Construction Surveying Services Civil Engineers and Land Surveyors City of Santa Ana (714) 935 -0265 December 2013 JOE DEAL, LSIT, SURVEY COORDINATOR Joseph C. 7ruxaw and Associates, Inc. PROFESSIONAL EXPERIENCE Mr. Deal has twenty-five years of experience in the land Surveying and civil engineering profession. His career started with the County of Orange Survey Division in 1888. While at the County he worked with state of the art equipment on large scale capital projects including roads, bridges, dams and hydrographic surveys, He spent several years working at Orange County's John Wayne Airport as a member of the Divisions airport survey crew. He has spent the last fourteen years working in the private industry at Joseph C. Truxaw & Associates as a party chief, and now In his current position as Survey Coordinator. His responsibilities include scheduling of crews and communicating with clients, survey calculations and CADD drafting. EKOFES,SIii; SL AL QERTIFICATION, LSIT No. ZL006798 Rancho Santiago Survey Program PROFESSIONAL MEMBERSHIP Member of American Congress on Surveying and Mapping Member of California Land Surveyors Association KEY PROJECTS City of Anaheim On -Call Surveying City of Fullerton On -Call Surveying City of Orange On -Call Surveying Disney California Adventure Quality Control and Construction Surveys California Coastal Commission Erosion Control Survey Disneyland Matterhorn Laser Scan Survey El Toro Marine Base RemediationlUtility Survey Newport Harbor Hydrographic Survey Joseph C. 7nexaw and Associates, Ina. Construction Surveying Sarvlom Civil Engineers and Land Sarveyors City ofSeats Ana (714) 935 -0265 December 2013 CRAIG LEE, SURVEY CADD MANAGER Joseph C. Truxaw and Associates, Inc. PROFESSIONAL EXPERIENCE Mr. Lee has thirty -three years of experience in civil engineering and survey design along with drafting experience with increasing levels of responsibility. Mr. Lee has vast knowledge in AutoCAD Engineering /Survey software. In his position of Survey CADD Manager, Mr. Lee's responsibilities include training and supervision of CADD drafters, as well as calculations, production design and drafting. CREDENTIALS Associate in Arts, Rio tlondo College, Whittier, California 1972 KEY PROJECTS City of Anaheim On -Call Surveys, Right -of -Way Engineering and Mapping Prepare hundreds of corner records for monument preservation, topographic surveys, boundary surveys, construction staking calculations, parcel maps, legal descriptions and plats for public utility easements and right -of -way takes, all per City of Anaheim requirements Welt Disneylmagineering, Anaheim, California Prepare legal descriptions and CADD exhibits for street right -of -way dedications and landscape maintenance district for the Disney Resort. City of Fullerton On -call surveys, topographic, right -of -way engineering, monument preservation survey. City of Orange, Orange, California Prepare legal descriptions and CADD exhibits for street right -of -way dedications and temporary construction easements for the improvements along Main Street and Chapman Avenue. Seward RE, L.P. - State College Design Center, Anaheim, California Responsible for tentative and final map preparation, survey and office calculations, processing with local and county agencies, coordination with client, agencies and consultants for subdivision of 12 industrial parcels. DDR Properties, rullerton, California Responsible for the processing and preparation of Record of Survey. CADD topographic and grading plan for the development of a multi -story office complex. Joseph C. Truxaw and Associates, inc. Construction Surveying Services C'MI Engineors and Land Surveyors City of Santa Ana (714) 935 -0265 December 2013 JESUS H. GUZMAN, PLS, CREW CHIEF Joseph C. Truxaw and Associates, Inc. R FE CE Mr. Guzman's 15 year survey career includes experience with boundary, topographic, ALTA, construction, control, tunnel, aerial, RTK, DGPS, RTN -RTK, and GPS fast static and conventional surveys. He is also experienced preparing and submitting survey estimates and proposals, administration of survey contracts, preparing and scheduling daily survey field work, drafting of corner records, ALTA Surveys, Record of Surveys, Parcel and Final Maps, downloading and processing daily survey field work, preparing of survey base sheets in AutoCAD Civil3D, legal descriptions and project and survey research. Mr. Guzman also has civil engineering experience including consultant engineering adjunct staff for the Cities of Buena Park, Diamond Bar, Villa Park, San Gabriel, Stanton. Tasks included agency Parcel Map, Final Map, Lot Merger and Lot line Adjustment plan checking. Public Improvement Plan check, (Street, Storm Drain, Sewer, Street Lighting, Grading), Public Works Inspector, City CIP Administration, Engineer Tech and Permit Technician. PROFESSIONAL REGISTRATION Professional Land Surveyor No. 8646 (California) KEY PROJECTS City of Anaheim On -Call Surveying (corner records, topographic surveys) Apple Store -- Santa Monica, CA Disney's Califroma Adventure, Paradise Pier, Anaheim, CA Disney's California Adventure Buena Vista Street, Anaheim, CA City of Lake Forest On -Call Surveying (centerline tie monumentation) Tustin Airbase Backbone Infrastructure Port of Los Angeles Metropolitan Water District Tunnels (City of Highland) Joseph C. Timaw and Associates, (nc. Construction Surveying Services Civil Engineers and Land Surveyors City or Santa Ana (714) 935 -0265 December 2013 IMPLEMENTATION PLAN Joseph C. Truxaw and Associates, Inc. (Truxaw) is prepared and qualified to provide on -call professional land surveying services to the City of Santa Ana Public Works Agency Construction Engineering Section in all Survey Tasks as identified in the RFP. Please review more specific details of each sub -task below. Our track record, providing land surveying services to many public agency survey departments, proves that we have the necessary knowledge and experience in effective project management skills to successfully support the city's projects with proper management and timely coordination of survey crews, All Truxaw survey personnel have extensive knowledge and experience In Public Works map checking, construction, topographic, boundary, engineering, and geodetic survey control methods. Key personnel are experts at understanding and interpreting construction plans and specifications. Our crews will comply with all Federal, State and local safety regulations and be properly attired and equipped at all times. We have the required knowledge and experience and are very familiar with the typical duties, responsibilities and equipment required of Survey Consultants, as outlined in the RFP. Truxaw surveyors take pride in maintaining open lines of communication and good public relations on all projects and are particularly sensitive to the fact that they represent the City of Santa Ana while performing City consulting services. GENERAL a) Truxaw will thoroughly review the survey request for each project and conduct public record research as required. b) Truxaw will review the project requirements and/or attend a pre - project meeting with the City's Senior Surveyor. c) Horizontal control will be based on the 1983 North American Datum (NAD83), tied to a minimum of two proximate County of Orange, C0883, Zone VI, 1991.35 Epoch Adjustment control points. Project coordinate values will be provided in U.S. Survey Feet. The County control points will determine the Basis of Bearing for the project. d) Vertical control will be based on the North American Vertical Datum of 1988 (NAVD88), tied to a minimum of two proximate County of Orange bench marks. Project elevations will be provide in U.S. Survey Feet. e) Electronic coordinate files will be stored in Point Number, Northing, Easting, Elevation and Description (P,N,E,Z,D) format compatible with Microstation V8. RAW field book data files will be maintained and available to the City, if requested. f) Truxaw will use the City's CADD Standards in Microstation V8 as a standard template. g) Truxaw will provide the City Surveyor representative with weeldy status reports on all ongoing work activities. Joseph C. Truxaw and Associates, Ina. Construction Survoying Services Civil Engineers and Land Surveyors City of Sarda Arita (7'14) 935.0265 Docember 2013 TOPOGRAPHIC SURVEYS a) Truxaw will provide the City with an electronic surface model compatible with Microstation V8. b) Truxaw will provide the City with electronic DNG, PDP, and ASCII files of the completed project. c) Truxaw will perform any other topographic or as -built surveying related work as it becomes necessary. AS -BUILT SURVEYS a) Truxaw will perform surveys as required to locate existing structures for analyzing potential problem areas in engineering works. b) Truxaw will provide the City with field notes, sketches and electronic files as specified in the "General" section above as required to convey as -built data. c) Truxaw will locate potholes as required to determine existing horizontal and vertical location of fixed works (in P,N,E,Z,D format) and provide said information to the City as specified in the "General" section above. CONSTRUCTION LAYOUT a) Truxaw will review construction project plans, details and specifications and attend pre - construction meetings as requested. b) Truxaw will respond to a written request for construction staking within one working day. Truxaw will utilize city's Work Order forms to facilitate communication with the City and contractors as designated by the City. Truxaw will maintain detailed and accurate records of Requests for Construction Staking from the contractor on the City approved farm. c) Truxaw will provide construction staking and quality control according to the staking policy, and per industry standards. All final reports, cut sheets and survey notes are reviewed, signed and sealed by a Licensed Land Surveyor in accordance with state law. d) Truxaw will provide the contractor, the inspector and the City's representative with grade sheets for all staking on the approved form. e) Truxaw will provide the City's Senior Surveyor with weekly status reports on all ongoing work activities. f) Truxaw surveyors take pride in maintaining open lines of communication and good public relations on all projects and are particularly sensitive to the fact that they represent the City of Santa Ana while performing City consulting services. g) Truxaw will perform any other construction surveying related work as it becomes necessary. MONUMENT PRESERVATION a) Truxaw will research existing City tie notes, mapping and filed Corner Records and perform a thorough reconnaissance for existing record monuments in areas of pending construction as directed by the City's Senior Surveyor. b) Truxaw will recover and accurately survey existing monuments and ties and document the results of the survey with a pre - construction Corner Record or Record of Survey, as required in compliance with the State of California's Land Surveyor's Act Section 8771. Joseph C. Truxaw and Associates, Ina. Construction Surveying Services Civic Engineers and Land Sarvoyor.s City of Santa Aria (794) 935 -0265 December 2013 c) New monuments or ties will be set as required, in compliance with the State of California's land Surveyor's Act Section 8771 and customs of the City of Santa Ana. d) Copies of the filed pre and post - construction Corner Records or Record of Survey as required will be provided to the City Surveyor. HORIZONTAL AND VERTICAL CONTROL a) As requested by the City's Senior Surveyor, Truxaw will provide permanent control points for topographic or construction surveys. b) Horizontal control will be based on the 1983 North American Datum (NAD83), tied to a minimum of two proximate County of Orange, CCS83, Zone Vi, 1991,35 Epoch Adjustment control points. Project coordinate values will be provided in U.S. Survey Feet, The County control points will determine the Basis of Bearing for the project. c) Vertical control will be based on the North American Vertical Datum of 1988 (NAVD88), tied to a minimum of two proximate County of Orange bench marks. Project elevations will be provide in U.S. Survey Feet. d) Truxaw will provide the City's Senior Surveyor with copies of field notes, and raw electronic field book showing methodology, closures and any adjustments. e) Final adjusted coordinate points will be stored in Point number, Northing, Easting, Elevation and Description (P,N,E,Z,D) format compatible with Microstation V8. MAP CHECKING a) Information furnished by the City for checking will be roughly as follows: 1 set of Exhibits, title reports, reference documents (Deed, Parcel Map, Tract Map, etc.), traverse closures, and improvement plans, b) Review Exhibits for technical correctness and completeness, consistency with the City guidelines and requirements, compliance with the Subdivision Map Act, and acceptance for recording. c) Review title report and existing easements for correct plotting and references. d) Review improvement plans associated with the project to ensure the Exhibits correctly identify the limits and location as shown on the improvement plans. e) Provide a set of redline check prints showing the redlined comments, and required corrections and information. f) Provide a check letter covering the major required comments, and corrections and instruction for future submittals. g) Provide a timesheet with items L. and M. above at the end of every review. The timesheet must include, but is not limited to, project name, review number, dates, review hours, hourly rate, and total cost. OFFICIAL MAP PREPERATION AND BOUNDARY SURVEYS a) Official Maps, including Records of Surveys, Parcel Maps, Lot Line Adjustments, and Certificates of Compliance will be prepared in compliance with applicable state law and local custom at the request of the City's Senior Surveyor. b) Boundary surveys will be completed in accordance with applicable State law and local custom Truxaw is extremely familiar with the local boundary, tract and mapping nuances in the City of Santa Ana having completed over 180 Josopir C, Truxaw and Associates, 1no. Construction Surveying Services Civil Engineers and Lund Surveyors City of Santa Ana (714) 935 -0265 Docembor 2013 surveys in the past 30 years within the city limits. Our archived files are a valuable supplement to the public records, often expediting control work necessary to complete a boundary task. c) Recorded copies of said maps and documents will be provided to the City Surveyor. To ensure a quality work product for all assignments received from the City of Santa Ana, Truxaw and Associates initially will prepare a Quality AssurancefQuality Control Plan with a Project Time /Cost Proposal including the following information: 1) A work progress schedule with project milestones identified and estimated delivery dates for deliverables, together with an itemized cost estimate to include the manpower resources required to complete each deliverable. 2) The name of the licensed professional in responsible charge of the specific assignment. 3) A roster of the individuals who will be performing the work and the classifications of such individuals. 4) The equipment and procedures to be used to ensure compliance with contract specifications. 5) Each assignment will have constant principal level review and oversight by the Project Manager /Principal Agent, who is also the Land Surveyor in responsible charge of the work. All final deliverables will contain the signature and seal of the Land Surveyor in charge signifying his approval of the deliverables. Joseph C Tmxaw and Associates, tnc. Construction Surveying Services Civil Engineers and Land surveyors City of Santa Ana (714) 935 -0285 December 2019 CITY OF SANTA ANA REQUEST FOR PROPOSAL FOR CONSTRUCTION SURVEYING SERVICES List and describe fully the contracts performed by your firm which demonstrate your ability to provide the supplies, equipment or services included In the scope of the proposal specifications. Attach additionalTages if required, The City reserves the right to contact each of the references listed for additional information regarding your firm's qualifications. Reference CuatomerName:_ CIL ofAnahethn Contactlndividual: Address: 200 S. Anaheim Blvd„ Suite 276 Anaheim, CA 92805 Contract Amount: Time and AMterialslNo Cap Description of supplies, equipment, or services provided: On Call Land Surveys Reference Customer Name: City of Mission Viejo Address: 200 Civic Center Mission Viejo, CA 92691 Conti act Amount: Ttine ancS tvlawdals On Call. $50AD Limit Description of supplies, equipment, or services provided: Ian Easton, PLS Phone Number: (714) 765 -5284 Facsimile Number: Year: 2000 to Present Contact Individual: foe Ames, P.E. Phone Number: �9 <}9 440 -3091 Facsimile Number: Year: 2008 to Present City Surveyor, Map] Plan Checking, On Call Surveys f3& quot Customer Name:fityof Orange -Water Division Address: P.O. Box 449 Contact Individuate. Tuan Cao, P.E. Phone Number: 714) 288 -2475 -)ring- CA 91815 Facsimile Number: Contract Amount: Thne and Materials On Call Year: 1995 to Present Description of supplies, equipment, or services provided: _ On Call Sulve}s and Easement Docurrrentation THIS FORM MUST BE COI PLETED AND INCLUDED WITH THE PROPOSAL, PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. City of Santa Ana - Public Works Agency Construction Surveying Services RFP Page 23 EXHIBIT D — PRIOR EXPERIENCE AND REFERENCES �kKqlect Name gency Agency Contact City of Anaheim Ian Easton, LS On-Call Surveys Public Works Dept. 200 S. Anaheim Blvd., Anaheim, CA 92805 ---- Survey Section 714-765-5284 City smayoi ---- City of Mission Viejo Joe Ames, PE Map & Easement Public Works 200 Civic Center, Mission Viejo, CA 92691 Preparation & Checking.. 9 0-3091 A 49) 470-8419 Tuan Cao, PE Design Surveys City of Orange Son Tran, PE for CIP projects Water Division 180 Water St., Orange, CA 714-288-2476 Karnyar Dibe Harbor Boulevard & Other City of Garden Grove 11222 Acacia Parkway Streets (3 miles) Garden Grove, CA 92842 Santiago Canyon Road City of Orange Paul Tran, PE and Cannon Street Critical PublicWorks 300 E. Chapman Ave., Orange, CA Intersection On-Call Easement City of Orange '714-744-5653 Ramona Takahashi 189 Water St., Orange, CA Checking Water Division 714-288-2475 Anaheim Redevelopment City of Anaheim Greg Hastings Agency: Excess Caltrans Redevelopment 200 S. Anaheim Blvd., Anaheim, CA 92805 Parcels Aqency/Planninq 714-765-6100 Tustin & Meats Critical City of Orange Medel LIanes, PE Intersection Public Works 300 E. Chapman Ave., Orange, CA (1/2 mile)~-__ 714-744-5536 R apman & Prospect City of Orange Maid Farhat, PE Critical Intersection Public Works 300 E. Chapman Ave., Orange, CA _(114 mile) 714-744-4300, ext 5791 On-Call Plan Checking City of Tustin Katy Lee 300 Centennial Way, Tustin, CA 92780 and Map Checking Public Works 714 573-3177 Bastanchury from Rose to Chris Johansen, PE Casa Lorna City of Yorba Linda 4845 Casa Loma Avenue, Yorba Linda, CA (1-1/2 miles) Public Works 92885 714-961-7170 City of Ron Wallin, PE (retired) On-Call Plan Checking Engineering 303 W. Commonwealth, Fullerton, CA I Department 714-738-6962 city of Santa Ana John Gonzalez, Surveyor Personal Reference Public Works 20 Civic Center Plaza, Santa Ana, CA (714) 647-5662 Joseph G. Trvxaw and A,"odatoa, Inc. consbuction Surveying Services 010 Engineers and Land Sutvoyors City of Santa Ana (714) 935-0265 December 2013 Y CITY OF SANTA ANA REQUEST FOR PROPOSAL FOR CONSTRUCTION SURVEYING SERVICES PROPOSER'SSTATEMENT Proposer understands and agrees that this written RFP (or any part thereof specifically designated and accepted by the City of Santa Ana, hereinafter City) shall constitute the entire agreement between proposer and the City only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Executive Director or his duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to proposer or deposited with the United States Postal Service properly addressed to the proposer with the correct postage affixed thereto. Proposer further agrees that upon delivery (as defined above) of the accepted agreement he /she will furnish City all required bonds and certificate of liability insurance within ten (10) days (excluding Saturdays, Sundays and City's legal holidays), or the funds, check, draft, or proposer's bond substituted in lieu thereof accompanying this proposal shall become the property of the City and shall be considered as payment of damages due to the delay and other causes suffered by City because of the fallure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered by City is difficult to ascertain; otherwise said funds, check drafts, or proposer's bond substituted in lieu thereof shall be returned to the undersigned. Proposer understands that a proposal is required for the entire work, that the estimated quantities set forth in the RFP schedule are solely for the purpose of comparing proposals, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. All terms contained In the specifications, t e certification of nondiscrimination by contractors, and the required insurance certificates ara to be Incorporat d by reference into this agreement and are made specifically as part of this RFP. Firm Joseph C. Tru Signed and Printed Name. Title President Date 1 THIS Inc. M City of Santa Ana - Pubfic Works Agency Construction Surveying Services RFP Page 24 NONRESPONSIVE. CITY OF SANTA ANA REQUEST FOR PROPOSAL FOR CONSTRUCTION SURVEYING SERVICES CERTIFICATION OF NONDISCRIMINATION BY CONTRACTOR The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows: 1. The contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin The contractor shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The contractor shall send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The contractor shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to hislher books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or In part and the contractor maybe declared ineligible for further governinont contracts or federally assisted constructionYservices contracts in accordance with procedures authorized In Executive Order 11246 of September 24, 1965,and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. 7, The contractor shall include the portion of the sentence immediately preceding paragraph 1 and the provisions of paragraphs 1 through 7 in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, '1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the contractor becomes Involved in, or is threatened with, litigation by a subcontractor or vendor as a result of such direction by the administering agency, the City of Santa Ana - Public Works Agency Construction Surveying Services RFP Page 25 contractor may requestthatthe United States enter into such I itgation to protect the interests of the United 8, Pursuant to California Labor Code Section 1735, as added by Chaptei,643 Stats. 1039, and as amended, Firm no discrimination shall be made in the employment of persons because of race, religious creed, color national origin, ancestry, physical handicaps, mental condition, marital status, o| sex cf such persons, except av provided |n Section |42O. and any o9p tractor violating iNs^ncUnni: subject io all ii�ependUvoimposed for a violation nf the oh upLar� � /\ Signed and Printed Na/ Title President | THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. | PROPOSALS THAT 00 NOT CONTAIN THIS FORM WILL. BE CONSIDERED NONRESPONSIVE. City of Santa Ana - Public Works Agency Page 26 EXHIBIT G (REVISED) CITY OF SANTA ANA REQUEST FOR PROPOSAL FOR CONSTRUCTION SURVEYING SERVICES RESPONSIBLE PROPOSER — SUPPLEMENTAL QUESTIONNAIRE 1. How many years has your organization been in business in California as a contractor under your present business name and license number? 38 years If you performed same business under a different business name with same ownership and operation management and changed name due to, but not limited to, bankruptcy, loss, or license, please complete an additional and separate questionnaire. 2. What is your firm's average gross revenue for the last three years? $ 3,100,600.00 3. Is your firm currently the debtor in a bankruptcy case? ❑ Yes Eff No If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. Case Number Bankruptcy Court Date Filed 4 Was your firm in bankruptcy any time during the last five years? (This question refers only to a bankruptcy action that was not described in answer to Question 2, above.) ❑ Yes ! No If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. Case Number Bankruptcy Court Date Filed 6. Has any California State License Board license held by your firm or its responsible managing employee � ,spcns4bla Managing oico,' bean auo ended wlt!"In if a' i.., fi u Yes rLff iJu 6. At any time in the last five years, has your firm been assessed and paid liquidated damages after completion of a project, under a services contract with either a public or private owner? ❑ Yes No 7. Has your firm ever defaulted on a contract? ❑ Yes BJ No If "yes," explain on a separate page. 8. In the last five years has your firm, or any firm with which any of your company's owners, officers or partners was associated, been debarred, disqualified, removed, or otherwise prevented from biddinct on, or completing, any government agency project for any reason? ❑ Yes 3U No If "yes," explain on a separate page. State the name of the organization debarred, the year of the event, the owner of the project, and the basis for the action. 9. In the past five years, has any claim against your firm concerning your firm's work on a project, been filed in court or arbitration? ❑ Yes {� No City of Santa Ana - Public Works Agency Construction Surveying Services RFP Page 27 (ADDENDUM NO 3) If "yes," on a separate page identify the claim(s) by providing the project name, date of the claim, narne of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution.) 10. In the past five years, has your firm made any claim against a project owner concerning work on a nfpject or payment for a contract, and filed that claim in court or arbitration? ❑ Yes No If "yes," on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution.) 11, At any time during the past five years, has any surety company made any payments on your firm's behalf as a result of a default, to satisfy any claims made against a performance or payment bond issue on Your firm's behalf In connection with a project, either public or private? El Yes §� ` No 12. In the last five years, has any insurance carrier, for any form of insurance, refused to renew the insurance policy for your firm? ❑ Yes ,,�'f, No 13. Has your firm or any of its owners, officers, or partners ever been liable in a civil suit, or found guilty in a criminal action, for making any false claim or material misrepresentation to any public agency or entity? ❑ Yes 9 No 14. Has your firm or any of its owners, officers or partners ever been convicted of a federal or state crime of fraud, theft, or any other act of dishonesty? ❑ Yes No If "yes," Identify on a separate page, the person or persons convicted, the court case and number, the crimes and the year convicted. 16. If your firm was required to pay a premium of more than one percent for a performance and payment bond on any project(s) on which your firm worked at any time during the last three years, state the percentage that your firm was required to pay. You may provide an explanation for a percentage rate higher than one percent, if you wish to do so. NIA 16. During the last five years, has your firm ever been denied bond credit by a surety company, or has there ever been a period of time when your firm had no surety bond in place during a project when one was required? ❑ Yes Cd No 17, Has Cal - OSHA cited and assessed penalties against the contractor or its associates for any "serious;' "willful" or'7epeat" violations of its safety or health regulations In the past five years? ❑ Yes V Ne (Note: If you have filed an appeal of a citation, and the Occupational Safety and Health Appeals Board has riot yet ruled on your appeal, you need not include information about it.) If "yes," on a separate page describe the citations, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of the project, and the amount of penalty paid, if any. State the case number and the date of any OSHAB decision. 18. Has the Federal Occupational Safety and Health Administration cited and assessed penalties ageing the contractor or its associates in the past five years? ❑ Yes No City of Santa Ana - Public Works Agency Construction Surveying Services RFP Page 28 (ADDENDUM NO. 3) (Note: If an appeal of the citation has been filed and the Appeals Board has not yet ruled, or there is a court appeal pending, you need not include Information about the citation) If "yes," on a separate page describe the citation, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of project, and the amount of penalty paid, if any. State the case number and date of any decision. 19. During the last five years, has there been more than one occasion in which the General contractor or its associates have been penalized or required to pay back wages for failure to comply with the federal Davis -Bacon prevailing wage requirements? ID Yes §r No If "yes," on a separate page, describe the violator, nature of each violation, name of the project, date of its completion, the public agency for which it was constructed, the number of employees who were initially underpaid and the amount of back wages and penalties that were assessed. THIS FORM MUST BE COMPLETED AND INCLUDE ALS THAT DO NOT CONTAIN THIS FORM WILL BE struction Surveying Services RFP Page 29 (ADDENDUM NO. 3) EXHIBIT H CITY OF SANTA ANA REQUEST FOR PROPOSAL FOR CONSTRUCTION SURVEYING SERVICES NONCOLLUSION AFFIDAVIT NON - COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the proposer declares that the proposal is not made in the Interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the proposal is genuine and not collusive or sham; that the proposer has not directly or indirectly induced or solicited any other proposer to put in a false or sham proposal, and has not directly or indirectly colluded, conspired, connived or agreed with any proposer or anyone else to put in a sham proposal, or that anyone shall refrain from bidding; that the proposer has riot in any manner, directly or Indirectly, sought by agreement, communication, or conference with anyone to fix the proposal price of the proposer or any proposer, or to fix any overhead, profit, or cost element of the proposal price, or of that of any other proposer, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the proposal are true; and, further, that the proposer has not, directly or indirectly, submitted his or her proposal price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a Collusive or sham proposal. Note: The above noncollusion affidavit is part of the proposal, Signing this proposal on the signature portion thereof shall also constitute signature of this noncollusion affidavit. Proposers are cautioned that making a false certification\may subject the certifier to criminal prosecution. State of California, County of (`) VkL `� ' Su scribed and sworn to (or (firmed) before me on this day of l'(�t�Y , 20 �' , by u 4-0 n 1711- proved to me on the basis of satisfactory evidence to be the person O who appeared before me. Notar bli ig ure +r LA ° LpU19EN LEE MARTIN commission 0 1917538 ai Notary Public - Calitornla Y Orange County M Comm. Expires Nav 1, 21114 ~ Notary Public Seal THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. City of Santa Ana - Public Works Agency Construction Surveying Services RFP Page 30 ---i Exhibit I A� 0 CERTIFICATE OF LIABILITY INSURANCE ° "TE'MMD ° "YYY' TI 11S 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(ios) 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 eortificale holder in lieu ofsueh ora orsomands), PRODUCER IOA Insurance Services 130 Vanijs, Suite 250 Also Viejo, Viejo, CA 92656 _ CONTACT NAME:.�A�J(_),fj$(ly Tren 3 1LORE_( Afc. nR. Ew :_'34gSi @R:129R....____._. —._. XIGL EtM14. RaCICyiltyf[g9[{;lfq,9}tga,C9m. P NaIYYTP INSURERS) AFFORDING COVERAGE NAIC0 wwwloausa.com CA. Llcense10CE ®7788_.. _ INSURER A_RLI_Insurance IRSUREa Josepph C. TruxaW and Associates, Inc. 265 S. Anita, Suite 111 INSURER U: - -- - - - - -- - -- IRSURERC: INSURER n: Orange CA 92868 1013112014 EAC.H000URRCNi. INSURER IF COVERAGES CERTIFICATE NUMBER: l809 3 REVISION NUMBER: THIS is TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY HE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORUEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. AND CONDITIONS OP SUCH POLICIES, LIMITS SHOWN MAY HAVE SEEN REDUCL -D BY PAID CLAIMS, ryEXCLUSIONS ILTR TYPE Of INSURANCE DDL INGIR W-1 POLICY NUMBER IMMIDDi P NaIYYTP I A GENERAL LIABILITY ,/ PSBDDO1259 10!3112013 1013112014 EAC.H000URRCNi. s 1,000,0.0_0_ � ! COMMERCIAL GENERAL LIABILITY Scheduled At Etdt Tifi1AdE TTqq RCWon, PREMISES 111T,Urro Ce) _ S 1,010D,000 Y"' CI.AIMS -MADE L/IOCCUR OPPS3130510 Prore$SlOnal service$ LTi XP(Fn�ELECsai — $ 1_U,o0 D PERSONAL aAOVINJURY $ , , m—y pnfrlbUlO _ —_ E dY the IRBUfBd are Excluded EERAL AGfRFGAT _- _ S 2000,000 1nr-b �J 1 �- eegalrDn _ PROOUC rS - COMPIOP AGO S 2,000,000 GI °N'L AGGREGATE LIMIT APPLIES PER'. —1 POLICY 2289 - LOC S A7 AVTOMOaiLUMABIUrr J PSAO0(i 10/31/2015 10/3112014 10 RNFOSI cis LIMIT c viv 9 1 000 000 1 / ANY AUTO Designated Designated Insured HOMILY INJURY(i ) ALL OWNED SCHEDULED AUTOS —I dCA204s 1013 BOOBY INJURY nun oDAi PAOAER O�MAOE" Pa au i� 5 BAN- aVMISn NON-O HIRED AVTOS ✓ AU We end elation We NET Of and BIG Ret WeNEibof included in Sunroage "- PfimarylNon- ConidoUtOry F Cnvora9aFormilPPA3000311 a f Waiver of Subra anion A VMHAELLA UAe 1 OCCUR PSE0001215 10/312013 1D(3117,014 EACt10GCURNFNCE _.. S AUDUIUOU ExCE$S UAH CHAINS -MADE Following Form Policy Excludes Professional AGGREGATE -- - -- - s 4 01 ' "- RVIENTo Liability - s 3 A WORKERS COMPENSATION ✓ PSW0001252 10/31/2013 10/9112014 W ,1 TAtu• OT - IIMI,T$- h1i _ IANDEMILGYERWILARRITY YIN Waiver of Srlbrogauon „�_,..rCC ANY f ROPAMTOMPARRIERIOXECUTIVE OFFICMIM Mal-JP ExcumEW NIA Enm R000403050484 FL EACH ACCIDENT $ 109U 000 (m d.Wlh NI /) _— E I DISEASE EA EMPLOYEES _ 1. t)R0,000 EL. DISEASE POLICY EMIT DENCRIPadd OF OPGnA190Na belwr , & 1.000 OW aESCRIPTION OP OPERATIONS [LOCATIONS 'VEHICLES AIIdUII ACORe 1e1, A�lallla,al Ra narNx Saltaavla IrmSro spew IA rnquemn Certificate Holder is an Additional Insured with respect to General Liability (GL) and Automobile Liability but only when required by writhe¢ contract with the Insured prior to an occurrence as pef Endorsements noted above. GL includes Separation of Insureds and Contractual Liability per limitations In the BuslnessOwn[:rs' Coverage form. A Workere Cnmpansatlon Waiver of 8 twogeicn as noted above Is Included for the person or organization named in the Schedule that are parties to a contract requirin this ErldDrSemeOL provided that Contract is executed before the loss. Coverage Subject to all alic tan s wndltio rs timitatlo s and e e u tans 3 D, Notice f CancelNO Does for Non-Payment Idea ll r CERTIFICATE HOLDER C LL TIO JoblProject Reference SHOULD ANY OF THE ABOVE. DESCRIBED POLICIES BE CANCELLED BEFORE - For Proposal Purposes - Note: Non- THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN specific terms such as alqlants, Volunteers, subsidiaries, representatives, successors and ACCORDANCE WITH THE POLICY PROVISIONS. AUTBORIZOD REPRESENTATIVE assigns, etc. cannot be included. Only "specific entity" names Will appear AVC Alicla K. I ram 01088 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010185) The ACORD name and logo are registered marks of ACORD 1AV:a I.... Trap II/re; z J r1 I: dc: rr Or Ii I or , Poticy Number: PS30001250 RLI Insurance Company Named Insured: Joseph C. Truxaw and Associates, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack® FOR DESIGN PROFESSIONALS SCHEDULED ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM - SECTION II — LIABILITY Schedule Name of Person(s) or Organizatlon(s): - For Proposal Purposes - Note: Non - specific terms such as agents, volunteers, subsidiaries, representatives, successors and 1. SECTION 11 C. Who Is An Insured is amended to include as an additional insured the person or organization shown in the schedule above, but only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused in whole or In part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. in connection with "your work" and included within the "product - completed operations hazard ". 2. The Insurance provided to the additional Insured by this endorsement is limited as follows: a. This insurance does not apply to the rendering of or failure to render any "professional services ". b. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. 3. The following is added to SECTION Ill H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION 11 — LIABILITY) However, if you specifically agree In a contract or agreement that the insurance provided to an additional insured under this policy must apply on a PPS 313 00 1 D primary basis, or a primary and non - contributory basis, this insurance Is primary to other insurance that is available to such additional insured which covers such additional Insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION 18 K.2 Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO SECTION I- PROPERTY AND SECTION 11— LIABILITY) We waive any rights of recovery we may have against any person or organization because Of payments we make for "bodily injury ", "property damage" or "personal and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. mvnl n..,vv *���� nonr + /ann ss .,o: n rtu voq. z �c s Page 1 of 1 POLICY NUMBER: PSA0001069 COMMERCIAL AUTO CA 20 40 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies persons) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another elate is indicated below. ',. Named IBSUfed: Joseph C. Tmxaw and Associates, Inc, End orsomont Effective Data; 1 0131 /2 01 3 SCHEDULE Name Of Person(s) Or Organization(s): -For pproporal Pu�poses -Mote: Nor�- sp u[flc t4rms suc as agen s, velun eers, subsidiaries, representatives, successors and Information required to complete this Schedule If not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage In the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Aldo Dealers Coverage Form. CA 20 40 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 IA", ll,r, Trio, 1.011 2011 ..16.19 .I 9 J.' 1 ,4 1 This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Broad Fonn Named insured The following is added to the SECTION it — LIABILITY Coverage, Paragraph A.I. Who Is An Insured Provision: Any business entity newly acquired or formed by you during the policy period, provided you own fifty percent (50 %) or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of one hundred eighty (180) days following the acquisition or formation of the business entity. This provision does not apply to any person or organization for which coverage is excluded by endorsement. S. Employees As Insureds The following is added to the SECTION It — LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured Provision: Any "employee " of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C, Blanket Additional Insured The following is added to the SECTION it — LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured Provision: Any person or organization that you are required to include as an additional insured on this coverage form in a contract or agreement that is executed by you before the "bodily injury" or "property damage" occurs is an `insured" for liability coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualities as an "insured" under the Me Is An Insured provision contained in SECTION 11 — LIABILITY COVERAGE. The insurance provided to the additional insured will be on a primary and non - contributory basis to the additional insured's own business auto coverage if YOU are required to do so in a contract or agreement that is executed by you before the "bodily Injury" or "property damage" occurs. D. Blanket waiver of Subrogation The following is added to the SECTION IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions, S. Transfer Of Rights Of Recovery Against Others To Us'. PPA 300 03 11 I AW) 4 1111— il.W3 C11 A., 4 ".J'e .M P1;1� 1 v[ 1 We waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any 'accident" or "loss'", provided that the "ooeident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. E. Employee Hired Autos The following is added to the SECTION 11 — LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured Provision: An "employee" of yours Is an "Insured" while operating an "auto" hired or rented under a contract or agreement In that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions: Paragraph 6.11a. of the Other Insurance Condition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following: b. For Hired Auto Physical Darnage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that Individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ". F. Fellow Employee Coverage SECTION 11 — LIABILITY COVERAGE, Exclusion B.6. does not apply if you have workers compensation insurance in -force covering all of your employees. G. Auto Loan Lease Gap Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance, is amended by the addition of the following: In the event of a total "loss" to a covered "auto" shown in the Schedule of Declarations, we will pay any unpaid amount due an the lease or lean for a covered "auto ", less: Page 2 of 5 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC O4 0306 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We, have the right to recover our payments from anyone liable for an injury covered by thls policy. We will riot enforce our right against the person or organization named In the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description - For proposal Purposes - Note! Non- Jobs performed for any person or organization that you specific terms such as agents, volunteers, have agreed with in a written contract to provide this subsidiaries, representatives, successors and agreement. This endorsement changes the policy to winch it Is attached and is offeeave on the date issued unless othervriso stated. iThe Information below is required only when this endorsement is Issued subsequent to preparation of the policy.) Endorsement Effective 1 0131/2 01 3 policy NoPSW0001252 Insured Insurance Company Joseph C. Truxaw and Associates, Inc. RLI Insurance Company Countersigned By Endorsement No. AL 7 %rten @1999 by the Wore ors' Cornpetisatlon Insurance Rating Bureau of California, All rights msarved. �i.i, tl ���� .� lei lJtl 11 -M1ti_�l Nry Y ]i ivt 5 q� CERTIFICATE OF LIABILITY INSURANCE OAiF IMM /DOIYYYY) THIS CERTIFICA -rE 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 pokirges) must be endorsed. It SUBROGATION IS WAIVED, euhjeck 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 ]left of such endoisemont(s). PRoDuceR IOA Insurance Services _ CONTACT NAME. (AILDl -4atty 7tAD _ - '130 Vantis, Suite 250 -- - -_.__ -- Aliso Viejo, CA 82658 ensnE 1NR.Np. Eas:.,8Q5 ¢u9- 92J4_._ ..__1eA>iINC Not; gq;ZPg'��Lurz�_ I C.MAIL ADDRESS! @OtlyJGNU@ 4G5UWN)....._....__.. INSURERIET AFFORDING COVERAGE NAICN ~'IoaUSa COm CA License tf0E67750 _ .INSURERA: RLI_IOgylfApfg.ie`91APAny IMJ0Se Josepph C. Truxawand Associates, InQ. 265 S. Anita, Suite 1 1I'I - - -- - - - -- Ruaullu:L _. Orange CA 82866 INSURER D. INSURERS: IN URBRP, S E._ COVERAGES CERTIFICATE NUMBER: 16006447 REVISION NUMBER: - - - - - -- THIS 13 TO CERTIFY THAT IHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATEO. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO VMRICII THIS CERnF]CATE MAY HE 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. IeOR TYPE OF INSURA14VF in st BR POLICY NUMBS ILTR -_ _.. AmflTy EFY lahO Eyy) _ LIMITS GENERAL LAUILOY I EACH OCCURRENCE 9 COMAiERGiAL GCNCMLLIASILITY _ CLAIMS MAD[ .._�000VR ' RrtEMISTSSCd ^ccurre ) MI EXP IA,,.upnr 1 S E._ PCI2SONAI eA1N WJUitt $ _.. GENERAL AGGREGATE $ -_ (EiNi. M01TEGAVE LIMIT APPLIES PER PRODUCTS- C.OMPIOP AUG S —� POLICY 11 I +IidI LOG -- $ AUTOMOBILE LIABILITY _g- Eo ap9ltlOM IMr S BOCILYINdURY ....... -- ._ -" m BOCILYIFh1UriYedd M t) & - -- -- 6 - E ANY AUTO ALL OWNED - SCHEDULED - A41i0S AUTOS NON -OVA ED IiIRESAUT05 _.. AUTOS P PE2TY pADAGE fP o pool+ S UMBRELLA LIAa OCCUR EXCESS 4IA Z CLM4 MMAiE _DSO Nf RNTI04$ EACH OCCURRENCE E — $ _ AGGREGATE 5 AND EM1LS COMPENSATION AND E1dPLOYEN3'L1AtlILIrV YIN OFFICEMM @AtRkREXGLUGEIO'i FCN14E C� NIA O STATU DTfb _TOrtYllt tS _ EH E.L CAfIIA(CIO[Ni. 9 _ (BM.Yd.I.Q M Nlrl - EL OI CAC CA EMPLOY[[ S Ryes, dZo,6 a rmdAr DEUCRIP NOR OF OPERATIONS below E,L DISEASEFO[ICY LIMn "- - - - - -- $ A Professional Liability ROP0011285 71612013 171612014 $2,040,000 Per Claim Claims -Made $2,000,000 Aggregate DESCRIPTION OP OPERA7101191 LOCATIONS f VCH GLP.S (Altnd , ACORO 101, AddIUMBl Rdmnrkn achndelu, II more npndu I +mnulrer 1 Coverage subject to all policy terms, conditions, limitations and exclusions. 30 Day Notice of Concerto Days (or Non- Payment in accordance with policy provisions. CERTIFICATE HOLDER CANCELLATION JoblPmjeet Reference SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE - For Proposal Purposes - NEW Non- THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN specific terms SUCK as ap ents, volunteers, ACCORDANCE WITH THE POLICY PROVISIONS. subsidiaries, representatives, successors and assigns, etc. cannot be Included. Only 'specific entity" names will appear. AUTHORIZED REPRESENTATIVE (AVr.I Alicia K. I ram 01008.2010 ACORD CORPORATION. All rights roserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD .A"I .e... .rn,. In /1n /zm] 11.%II mA r.,90 1 u( 1 Exhibit C — Rates CITY OF SANTA ANA REQUEST FOR PROPOSAL FOR CONSTRUCTION SURVEYING SERVICES Certification • I certify that I have read, understand and agree to the terms and conditions of this Request for Proposals. I have examined the Scope of Services (Exhibit A) and am familiar with the scope of work locations. I am €arniliarwith all the existing conditions and limitation that may Impact work requests. l understand and agree that I am responsible for repor4ing any errors, omissions or discrepancies to the City for clarification prior to the submission of my proposal. Proposal Item Price - Pricing shall be based on an hourly cost for services described in Exhibit A. The required contract provisions need to include the California State Prevailing Wages (Federal "Payment of Predetermined Minimum Wage` applies only to feclaral -aid construction contracts). Prevailing wages will apply to services performed for land surveying, classifications such as chief of party, instrumentman and chainmanlrodman. Fee must be Inclusive of all costs, Including but not limited to, direct and Indirect costs for labor, overhead, incidental supplies, travel, mileage, and fuel. Any special materials will be purchased by the contractor only after discussed and authorized by the City projects manager or designee in writing. CLASSIFICATION HOURLY COST RATE Pilricileal $150.00 Prti ect Surveyor +134.04 Supervising Land Surveyor Surveying Technician $130,40 $100.00 Draflperson 990.00 Chief of Party (Prevailing Wage) $1 to.00 Instrumentman (Prevailing Wage) $Iftoo ChalnmanlRoadman (Prevailing Wage) $'%Go Three Person Survey Crew $235,00 Two Person Survey Crew $210.00 Joseph C. Truxaw and Assodwes, Inc. (714) 935- 0265,14mx 1? 14) 939.0106 LEGAL NAME OF COMPANY PHONE AND FAX NUMBERS 265 S. An.Ila Drive, Suite 1 11, Orange, CA 9288 ADDRESS Joseph G: AGENT IVAN President AGENT DATE E -MAIL ADDRESS 95-2942708 LS 6871 FEDERAL IL NUMBER (IF APPLICABLE) CONTRACTOR LICENSE NUMBER (1F APPLICABLE) THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. A� ®® CERTIFICATE OF LIABILITY INSURANCE DATE MMIDD1a 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 Ron of such endorsement(s). PRODUCER IOA Insurance Services 130 Vantis, Suite 250 Aliso Viejo, CA 92656 www.loausa.com CA License #OE67768 NAMEACT Betty Tren PHONE 949- 297 -5962 FAX Nolte_ 949 -297 -5960 E-MAIL ADDRESS, heft .tran ioausa.com INSURERS AFFORDING, COVERAGE NAIC0 INSURERA: RLI Insurance Company 13056 INSURED Joseph C. Truxaw and Associates, Inc. 265 S, Anita, Suite 111 Orange CA 92868 B: —_v— COMMERCIAL GENERAL LIABILITY INSURER - - - -- INSURER D: INSURER F.: EACH OCCURRENCE INSURER F: COVERAGES CERTIFICATE NUMBER: 20149663 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 ADOL O SO POLICY NUMBER POLICY EFF MMIODIYYYY POLICY EXP MWDO/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑ OCCUR PREMISES Ea owurrande $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ GENT _ POLICY ❑ ERO_ ECT LOC PRODUCTS - COMP /OP AGG $ $ OTHER'. AUTOMOBILE LIABILITY OMBINED IN LEL IT .(Ea accident $ BODILY INJURY (Par person) $ d ANYAUTO ALL AUTOS CIS »T, y/�r fl p+1 yq y 7 ® TO ,... BODILY INJURY (Per acciden) $ PeOPCRTY DAMAGE $ HIREDAUTOS gUTOSVVNEO y �_O S UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE SSA E, ST rs S S {an{ L`I {�r N Att.Orrrey / ^ . ( l! EACH OCCURRENCE s AGGREGATE is DEO RETENTIONS 5 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER qTH- STATUTE ER ANY PROPRIETOR/PARTNERIEXECUTIVE LLEACH ACCIDENT $ OFFICCR/MEMBEft EXCLUDE04 ❑ NIA '—'- (Mandatory inNH) E.L. DISEASE - EA EMPLOYEE $ Ifyee,descnbeunder DESCRIPTION OF OPERATIONS below -- --�"�" E.L. DISEASE -POLICY LIMIT — — $ A Professional Liability RDP0011239 7/6/2013 7/6/2014 $2,000,000 Per Claim Claims -Made $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addltlonal Remark. Schedule, may be ottaahed it more apace ie requimdl Coverage subject to all policy terms, conditions, limitations and exclusions. 30 Day Notice of Cance1110 Days for Non - Payment in accordance with policy provisions. CERTIFICATE HOLDER CANCELLATION City Ot Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. BOX 1988 ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Playa (M -30) Santa Ana CA 92702 -1988 AUTHORIZED REPRESENTATIVE (AVC) Alicia K. [gram © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CEaT NO., 20149669 (AVC) ratty Tron 5/1212014 10:45,52 AM IPbT) Pnge I of i ACGORO® CERTIFICATE OF LIABILITY INSURANCE DATE UMMIDDIYYYY) 5/1212014 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 IOA Insurance Services 130 Vantis, Suite 250 Aliso Viejo, CA 92656 CONTA T NAME: Betty Iran _ PHONE FAx 949 -297 -5962 ac Rol: 949- 297 -5960 E-MAIL ADORass: belt .tran loausa.com INSURER(S) AFFORDING COVERAGE NAICN ,� wsURERA: RLI Insurance Company 13056 waJoausaxom CA License #OE67768 INSURED Joseph C. Truxaw and Associates, Inc. 265 S. Anita, Suite 111 INSURER B: $ 1,000,000 INSURER D CLAIMS -MADE F—AOCCUR Prim /NonCon INSURER D: Orange CA 92868 INSURER E: INSURER F : $ 1,000,000 ✓ COVERAGES CERTIFICATE NUMBER: 20149654 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. QTR TYPE OFINSURANCE ADD p 5 BR POLICY NUMBER POLICY EFF MMIDOfIYYV POLICY EXP MMIDD/1'YYY LIMITS A COMMERCIAL GENERAL LIABILITY ,� �/ PS80001269 10/3112013 10131/2014 EACHOCCURRENCE $ 1,000,000 CLAIMS -MADE F—AOCCUR Prim /NonCon Scheduled Al Each #PPB3130212 Professional Services performed by the Insured —DAMAGE TO IEA re,EDence 9HJ$EeAn $ 1,000,000 ✓ M one ar.nn $ 10,000 Wvr of Subr PERSONAL a ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLI ES PER: GENERAL AGGREGATE $ 2,000,000 GENT are Excluded JECT POLICY 0IRO- ✓�LOC PRODUCTS. COMPIOP AGO $ 2,000,000 S OTHER', A AUTOMOBILE LIABILITY ./ ,/ PSA0001069 10/31/2013 10/31/2014 CO 6INEOSINGLELIMIT Ea accident $ 1,000,000 VV ANY AUTO ALL OWNED BGHEDULED LIT AUTOS — NON OWNED HIREDAUTOS ✓_ AUTOS Designated Insured Endt #CA20481013; Prim /NonCon and Bikt Wvr of Subr included on pg 2 of Form BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ s rim /NonCon War of Subr #PPA3000313 A UMBRELLA LIAR ✓ OCCUR PSE0001215 10/3112013 10/31/2014 EACH OCCURRENCE s 4000000 EXCESS LIAR CLAIMS -MADE Following Form; Excludes Professional Liability AGGREGATE S 4,D00,000 DED RETENTION $ �— 5 A AND WORKERS EMPLOYERS' COMPENSATION AND EMPLOVER$'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMDER EXCLUDED? (Mandatory In Nall byes, describe under DESCRIPTION OF OPERATIONS below NIA PSW0001252 Waiver of Subrogation Endt #WC0403060484 r� 2 1013112013 � .AS 10/31/2014 r�® "C� STATUTE ERH EACH ACCIDENT _ S 1,000,000 E. L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 iSA S ORCK Attorney DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD101,Additional Remark.Sch.dule, a ahedif mare.,ago a,.quired) Certificate Holder Is an Additional Insured with respect to General Liability (GL) and Automobile Liability but only when required by written contract with the Insured prior to an occurrence as per Endorsements noted above. GL Includes Separation of Insureds and Contractual Liability per limitations in the BusinessOwners' Coverage form. A Workers' Compensation Waiver of Subrogation as noted above is included for the person or organization named in the Schedule that are parties to a contract requiring this Endorsement, provided that contract is executed before the loss. Coverage subject to all policy terms, conditions, limitations and exclusions. 30 Day Notice of Cancel /10 Days for Non - Payment In accordance with policy provisions. CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 1988 ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza (M -30) Santa Ana CA 92702 -1988 AUTHORIZED REPRESENTATIVE (AVC) Alicia K. (gram © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 20149654 (AVC) SaLtY Tian 5/12/2014 10:43:37 M (PDT) Page 1 of 5 Policy Number: PSB0001259 RLI Insurance Company Named Insured: Joseph C. Truxew and Associates, Inc. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. RLIPacko FOR PROFESSIONALS SCHEDULED ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: 1W1Pk V:W* �06071x:7[el 3�Ta •III'��Si�1L�7►�len_�elu11r7 Schedule Name of Person(s) or Organization(s): City of Santa Ana 1. SECTION II C. Who Is An Insured is amended to include as an additional insured the person or organization shown in the schedule above, but only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work' and included within the "product- completed operations hazard ". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply to the rendering of or failure to render any "professional services ". b. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. 3. The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary basis, or a primary and non - contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising Injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION III K.2 Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO SECTION I — PROPERTY AND SECTION II — LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury ", "property damage" or "personal and advertising injury" arising out of 'your work' performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED, APPROVED AS TO rORM PPB 313 02 12 ( r Page 1 of 1 Cea, No.: 20l .Sa (nvc) He CCy Tran 5/12 /2014 10:43:37 M (PDT) Page 2 of s LISA E. STORM Assistant City Attorney - /,� POLICY NUMBER: PSA0001069 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Joseph C. Truxaw and Associates, Inc. Endorsement Effective Date: 10/31/2013 SCHEDULE Name Of Person(s) Or Organization(s): City of Santa Ana Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D,2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. APPROV�D AS TO FORM ----^ L 5 E. STORCK__. Assistant City Attorney CA 20 48 10 13 © Insurance Services Office, Inc., 2011 1 Page 1 of 1 CERT NO.: 201496S4 IAVC) Belly Ttan 5/12/2014 10:49:39 AN (MV) Pe9e 3 of 5 f Yom' This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Broad Form Named Insured The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.I. Who Is An Insured Provision: Any business entity newly acquired or formed by you during the policy period, provided you own fifty percent (50 %) or more of the business entity and the business entity is not separately insured for Bus- iness Auto Coverage. Coverage is extended up to a maximum of one hundred eighty (180) days following the acquisition or formation of the business entity. This provision does not apply to any person or organization for which coverage Is excluded by endorsement. B. Employees As Insureds The following Is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any "employee" of yours is an (insured" while using a covered "auto" you don't own, hire or borrow In your business or your personal affairs. C. Blanket Additional Insured The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any person or organization that you are required to include as an additional insured on this coverage form in a contract or agreement that is executed by you before the "bodily injury" or "property damage" occurs is an "insured" for liability coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II — COVERED AUTOS LIABILITY COVERAGE. The insurance provided to the additional insured will be on a primary and non - contributory basis to the additional insured's own business auto coverage if you are required to do so in a contract or agreement that is executed by you before the "bodily injury" or "property damage" occurs. D. Blanket Waiver Of Subrogation The following is added to the SECTION IV — BUSI- NESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any "accident" or PPA 300 03 13 CM NO., 20149654 (AVC) natty Tron 5/12/2014 10,43:39 AM (POT) Page 4 of 5 "loss ", provided that the "accident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. E. Employee Hired Autos 1. The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: An "employee" of yours is an "Insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions: Paragraph 5.b. of the Other Insurance Con- dition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ". F. Fellow Employee Coverage SECTION II — COVERED AUTOS LIABILITY COVERAGE, Exclusion B.5, does not apply if you have workers compensation insurance in -force covering all of your employees. G. Auto Loan Lease Gap Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance, is amended by the addition of the following: In the event of a total "loss" to a covered "auto" shown in the Schedule of Declarations, we will pay any unpaid amount due on the lease or loan for a covered "auto ". less: 1. The amount paid under the PHYSICAL DAMAGE COVERAGE section of the policy; and 2. Any: a. Overdue lease /loan payments at the time of the "loss" APPROVED AS TO FORM Page 2of5 LISA E. RdK Assistant City Attorney WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named In the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description City of Santa Ana Jobs performed for any person or organization that you have agreed with in a written contract to provide this agreement. This endorsement changes the policy to which It Is attached and Is effective on the dale issued unless otherwise stated. (The Information belowis required onlywhen this endorsement Is Issued subsequent to preparation of the pollcy.) Endorsement Effective 10/31/2013 Policy No.PSW0001252 Insured Insurance Company Joseph C. Truxaw and Associates, Inc. RLI Insurance Company Countersigned By Endorsement No. 0199II by the Workers' Compensation Insurance Rating Bureau of California. All rights reser PROT 'AS TO FORM LISA E. STORCK CMT No.: 20145654 (AVC) xeeey Tran 5/1312014 10:43:37 AN (P0T1 Page s of 5 Assistant City Attorney () A-2'014-100 r AC�)Q� CERTIFICATE OF LIABILITY INSURANCE 11%.....- , DACE (MM1DD,cr'YYY) 111612014 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 IINSURED, the policy('ies) midst 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 conifer rights to the certificate holder in lieu of such endorsement(s), PRODUCER IOA Insurance ServV ces 130 Vantis, Suite 250 AIisD Vie jo, CA 92656 CONTACT NAME: Betty Tran PHONE 949.297 -5962 [ArX,N0): 040 -297 -5960 1A EXD� E -MAIL ADDRESS: bett .trait. loausa.com INSURER, 5 AFFORDING COVERAGE NAIC # !p INSURER A : RLI Insurance Company 13056 www,ioausa.com CA License #OE67768 INSVREID Joseph C. Truxaw and Associates, Inc. 265 S. Anita, Suite 111 INSURER 9: $ 1,000,000 NsuRERC: CLAIMS -MADE OCCUR `° Prim /NonCon INSURER D. Orange CA 92868 E -INSURER INSURER F u $ 1,000,000 ✓ rnVFRAr.FR r`FRTiFlr.ATFMIIIVIRFR^ R1=VI,QInKIKlIlKA1Q1=P- 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. IINSR...... LTR TYPE OF INSURANCE ADDL INSD SUBR WV0 POLICY NUMBER POLICY EFF IMM;DDPYYYY POLICY' EXP MWDD1YYYY' LIMITS • V COMMERCIALGENERALLIABILITY !p y/ ':PSB0001259 10/31/2014 10/3112015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR `° Prim /NonCon Scheduled Al Endt #PPB3130212 Professional Services DAMAGE TC� RENTED PREMISES occurrence $ 1,000,000 ✓ MED EXP (Any one person) $ 10,000 ✓ Wvr of Subr PERSONAL BADV INJURY $ 1,000,000 performed by the Insured GEN'L AGGREGATE LtlMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,.000 are Excluded POLICY ® PECCT- I LCC PRODUCTS - COMPIOP AGO $ 2,000,000 $ OTHER: • AUTOMOBILE LIABILITY AUTO ALL OWNED SC-4EDULED AurOS NON-O HIRED AUTOS AUTOSWNED v ✓ PSA0001069 Designated Insured Endt #CA204S1013;. Prim /NonCon and Blkt Wvr of Subr Included on pg 2 of Form 10/31/2014 1013112015 COMBINED SINGLE (LIMIT Eaacciderl $ 1,000,000 _ BODILY INJURY (Peer person)... $ a,/ANY BODILY tlNJURY (Per accident) $ PROPERTY PAINAGE $ $ rim /Non'Con J Wvr of Subr #PPA3000313 A UMBRELLA LAB ,/ OCCUR PSE0001215 10/31/2014(10/31 /2015 EACH OCCURRENCE 5,000000 EXCESS LIAR CLAIMS -MADE DED '... RETENTIION$ Following Form; Excludes Profess'ional Liability AGGREGATE 5,000,000 A WORKERS COMIPENSATION AND EMPLOYERS" LIABILITY Y J N ANY PROPRIETORJPARTNERPEXECUTIE OFFIOERIMEMBER EXCLUDED? ® (Mandatory in NH) N 1 A PSWO001252 Waiver of Subrogatllon Endt. #WC0403060484 10131/2014 10/31/2015 / PEATUTE O-rH- TATUTE ER k E.L. EACH ACCIDIENT 1 ,000,000 E.L. DISEASE - EA EMPLOYE - 1 ,000,000 Iff yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIWIL 1,000,000 I DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) Certificate. Holder is an Additional Insured with respect to General Liability (GL) and Automobile Liability but only when required by written contract with the Insured prior to an occurrence as per Endorsements noted above, GL includes Separation of Insureds and Contractual Liability per (imitations in the BusinessOwners ' Coverage form, A Workers" Compensation Waiver of Subrogation as noted above is included for the person or organization named in the Schedule that are parties to a contract requiring this Endorsement, provided that contract is executed before the loss. Coverage subject to all policy terms, conditions, limitations, and exclusions, 30 Day Notice of Cancell'10 Days for Non- Payment in accordance with policy provisions. JOSEPH C. TPt,J AW & ASSC IATES: AGREEMENT # A-2014-100 REVIEWED BY: . t.. �i'' - "' "'' _.. EUNICE HEREDIA (p9. 1 of 5) CERTIFICATE HOLDER CANCELLATION of Santa Ana, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Its officers and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Purchasing Department 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE ai (AVC) Alicia K. Igram @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CER-T NO.:. 2.223'1) "'i1 1AVC) E.tcy T: -n. 111112X07➢. 7:5(:3(7 5S ^1 YPS'M Pa:9e 3. a= 5 Policy Number-. PSBO801259 RL| Insurance Company Named insured: Joseph C. Tmxew and Associates, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY. � ��N U��ack� FOR PROFESSIONALS SCHEDULED ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM — SECTION 11 — LIABILITY Schedule Name ofPeramn(s) or Organ izadons� City of Santa Ana, its officers and employees SECTION 0C. Who bAo Insured is amended to include as an additional insured the person or organization shown in the schedule above, but only with respect to liability for "'bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf,- a. |n the performance of your ongoing operadona� b. In nommenhmn with premises owned byorrented to you; or o. In connection with "your work" and included within the ~produut-oomp|eted operations hazard". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply to the rendering of or failure to render any "professional b. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits nfInsurance, The following ia added to SECTION III H.2.Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION U — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary baols, or a primary and non-contributory banis, this insurance is primary to other insurance that is available to such additional insured vvhiob covers such additional insured asm named insured, and we will not share with that other insurance, provided that: a. The "bodily injmryr or "property damage~ for which coverage is sought occurs after you have entered into that contract oragreement; or h. The "personal and advertising irjmry' for which coverage is sought arises out of an offense committed after you have entered into that contract nragreement, 4. The following iaaddedtoSECTION N| K.2 Transfer of Rights of Recovery Against Others to Qs — COMMON POLICY CONDITIONS (BUT APPLICABLE TOSECTION | — PROPERTYAND SECTION U—LIABILITY) We vvalve any rights of recovery we may have against any person or organization because of payments we make for "bodily in)ur/'. "property damage"' or "personal and advertising injury" arising out of "your work"' performed by you, or on your behalf, under a contract or agreement with that person or organization, We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily irjur/' or "property donooge^ occurs, or the "personal and advertising injury''offense iscommitted. ALL OTHER TERMS AND CONDITIONS OFTHIS POLICY REMAIN UNCHANGED. JOSEPH C.TRUXAVV& S[)C I TE?:: REEMENT#A-2O14-1O0 REVUEVVED8Y: ,�� ~ EUN|CEHERED|A (pg. 2uf5) PPB31302 12 Page 1 of cs`°u..zoumn (AVC. ==" ``/6/`"",."^."" AY, (ISn °.g°z°,� POLICY NUMBER: PSA0001069 COMMERCIAL AUTO CA 20 48 10 13 This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM VVfth respect to coverage provided by this endoroement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) ororQan|zabnn(s) who are °immunedm" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Fornm, This endorsement changes the policy effective on the inception date of the policy unless another date is indicated Named Insured: Joseph u.Truxaw and Associates, Inc. Endorsement Effective Date: 10/31/2014 SCHEDULE Nonna Of Person(s) OrOqJanizatkzn(m): City of Santa 4mm its officers and employees Information requi d to complete this Schedule, if not shown above, will be h in Each person or organization shown in the Schedule ia an "inaured" for Covered Autos Liability CuwaneQe, but only 10 the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section U - Covered Autos LimbiNty Coverage in the Business Auto and Motor Carrier Coverage Forma and Paragraph U.2. of Section | - CVmonad Autos Coverages uf the Auto Dealers Coverage Form, JOSEPH C.TRU AGREEMENT #A-2D14-100 REVIEWED BY: ^���_ �� , EUW|CE HERE0A (pg� 3 of 5) CA20401U13 Insurance Services Office, |no,2811 Page 1of1 c��21'mn. 22237971 (AV , oEw rran 11/6/2014 71sz.36 um (PSn oag" ` ^^ � JOSEPM{,TRU � AGREEMENT #A-2O14-lOU REV8EVVED BY,- /�� &/ � _ E0NiCE HEREOLA (pg. 4cf5) This endorsement modifies insurance provided under the foUovving� BUSINESS AUTO COVERAGE FORM A. Broad Form Named Insured The following is added to the SECTION U — COVERED AUTOS LIABILITY COVERAGE Para- graph A.1. Who Is An Insured Provision: Any business entity newly acquired or formed byyou during the policy period, provided you own fifty percent (60%)ormmreof the business entity and the business entity in not sepauateyy insured for Bus- iness Auto Coverage. Coverage is extended up to maximum of one hundred eighty (180) days following the acquisition or formation mf the business entity. This provision does not apply 10 any person or organization for which coverage is excluded by endorsement. B. Employees AsInsureds The following is added to the SECTION || — COVERED AUTOS LIABILITY COVERAGE, Para- graph Any "employee" of yours is om "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs, C. Blanket Additional Insured The following i�a added to the SECTION U — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any person or organization that you are required to include as an additional insured on this coverage fmnn in m contract or agreement that is executed by You before the "bodily injury':' or "property damage" occurs is an "insured" for |iab0itycoverage, buicn|y for damages to which this insurance applies and only 10 the extent that person or organization qualifies as an "insured" under the Who is An Insured provision contained in SECTION U — COVERED AUTOS LIABILITY COVERAGE. The insurance provided to the additional insured will be on a primary and non-contributory bmee to the additional ineuned's own business auto coverage if you are required to do so in a contract oragreement that is executed by you before the "bodily injury" or "property damage" occurs. D. Blanket Waiver 0f Subrogation The following ie added to the, SECTION 0—BUS]- NESS AUTO CONDITIONS, A. Loss Cond0ons, 5. Transfer Of Rights Of Recovery Against Others ToUs: VVe waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any "accident" or PPA 300 03 13 a ,�� e�� ^ r n�z.n. �2",p= (m�) a�� s "loss", provided that the "accident" or ^loma^ arises out mf the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. E. Employee Hired Autos Y. The following is added to the SECTION U — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision! An ''ennp|oyoe" of yours is an "insured" while operating an ~mu0o^ hired or rented under m contract or agreement in that "employee's" nannm, with your permiaaiom, while performing duties related to the conduct mf your business, 2. Changes in General Conditions: Paragraph 5.b.mf the Other Insurance Con- dition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos` you mwn� (1) Any covered "auto" you leeoe, hine, rent or borrow: and (2) Any covered "auto" hired or rented by your ^emp|oyem^ under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct mf your business. However. any "auto" that is |eaeed, hinad, rented orborrowed with driver is not o covered ^auin^ F. Fellow Employee Coverage SECTION U — COVERED AUTOS LIABILITY COVERAGE, Exclusion B.5i does not apply if you have workers compensation insurance in-force covering all of your employees, G. Auto Loan Lease Gap Coverage SECTION III — PHYSICAL DAMAGE COVERAGE' C Limit Of Insurance, is amended by the addition of the following: In the event of a total "loss" to a covered "auto" shown in the Schedule nfOec�arationa. we will pay any unpaid amount due on the lease or loan fora covered ^auto~ less: 1. The amount paid under the PHYSICAL DAMAGE COVERAGE section of the policy; and 2. Any'. e. Overdue lease/loan payments at the time of WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed, 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement frorn us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization City of Santa Ana, its officers and employees JOSEPH C."T'RUXAW & ASSOCIATES: AGREEMENT # A-2014-100 REVIEWED BY: k EUNICE HEREDIA Job Description Jobs performed for any person or organization that you have agreed with in a written contract to provide this agreement. This endorsement changes the poficytowhich it is attached and is effective on the date issued unless othenvise stated. (The Information below is required only when this endorsement IS 1SSUed Subsequent to preparation of the policy.) Endorsement Effective 10/31/2014 Policy No. PSWO001252 Insured Insurance Company Joseph C. Truxaw and Associates, Inc. RLI Insurance Company Countersigned By Endorsement No. @1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved, CERI z-o, ; 222 5 19 )1 (AVC� Be .y T­­ 11/6/.7014 7.51 1A AM (PST) Para,,, 5 of � r �.. CERTIFICATE OF LIABILITY INSURANCE DATE (MMJpplY"Y'YYI 7(MMIDD4 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 IOA Insurance Services 1307 Vantis, Suite 250 AIISO Viejo', CA 92656 NAMEEA Betty Tran PHONE 949- 297 -5962 FA�re Na: 949- 297 - 5960 4 E -MAIL ADDRESS: _,.betty.tran@ioausa.com IN SU!RER(S) AFFORDING COVERAGE NAIL # INSURER A: RLI Insurance Company 13056 1hANW.l0au5a.COm CA License i$OE =6776$ INSURED Joseph C. Truxaw and Associates, Inc. 265 S. Anita, Suite 111 INSURER. B.... . INSURER C DAMAGE TO RENTED PREMISES EaaackWrfenc INSURER p Orange CA 92868 ''... INSURER E,,. ''..... INSURER F COVERAGES CERTIFICATE NUMBER: 20838925 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 ADDL SUBR. POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY' NUMBER M....MfDDIYYYY MMIDDJYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES EaaackWrfenc $ MEd EXP (Any one person) $ PERSONAL & ADV'INJURY GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE POLICY ❑ JECT PRO- [::] LOG PRODUCTS .- COMPIOPAGG $ OTHER: AUTOMOBILE LIABILITY CCM�INED SINGLE LIMIT Ea accident! $ PODILY INJURY (Per person) ANY AUTO ALL OWNED SCHEDULED AUTOS .AUTOS POOILY INJURY (Per accident) $ NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE fPeracc'd."J $ v UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION ANIpEMPLOYIERS'LIABILITY YIN PER OTH- STATUTE ER E L. EACH ACCIDENT $ ANY PROPRIETCRJPARTNERdEXECUTIVE OFF IQR,d,MEMBER EXCLUDED) NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatary in NH) If yes, describe under (DESCRIPTION OF OPERATIONS b0ow E.L. DISEASE - POLICY LIMIT $ A Professional I.Jability RDPOO15881 7/612014 71612015 $2,000,000 Per Claire Claims -Made $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks schedule, may be attached If more space !Is required) Coverage subject to all policy terms conditions, limitations and exclusions. 30 Day Notice of Cancelf10 Days for Non - Payment In accordance With policy provisions. J0SEPI°i C. TRUXAW ASS CIA�,TES'. AGREEMENT## A. 2(7'14 -100 REVIEWED B�: � � EUNICE HIEREDIA (Pg. 1 of 1� CERTIFICATE HOLDER CANCELLATION City of Santa Ana RK Box 1988 20 Civic Center Plaza (M -30) Santa Ana CA 92702 -19188 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 (AVC) Alicia K. Igram @ 1988 -2014 ACORD CORPORATION, All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CERT No.: 208384 25 .atty F"k.'t 1lt:ar "7/8/.2011 11:17 31. PM IiDT) ! ?a.;Ja 1. r,,£ 1. AC"IdY CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 7/812015 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 10A Insurance Services 130 Vantis, Suite 250 A61s0 Viejo, CA 92656 CONTACT NAME: Betty PHONE FAX 049- 297 -5962 (A /C, No): 949- 297 -5960 -LQ mN ADDRESS: bett .trait ioa Usa..com INSURERS AFFORDING COVERAGE NAIL IN INSURER A: RLI Insurance Company 13056 www.ioausa.com CA License #0E67768 INSURED Josepph C. TrUxaw and Associates,. Inc. 265 South Anita, Suite 111 INSURER E: $ INSURER C DAMAGE TO RENTED PREMISES Ea occurrence) INSURER D Orange CA 92868 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER; 25506,504 REVISION NtIMRFR- 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, ILTRR TYPE OF INSURANCE ADDL SUBR POLICY' NUMBER MMIDDIYY'YY dMMlaa,IYYYY. LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fl OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence) MED EXP IAny one person) $ PERSONAL & ADV INJURY $ GEN "L AGGREGATE. LIMIT APPLIES PER: PRO- POUCY F JECT LOC GENERAL AGGREGATE $... PRODUCTS - COMPIOP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea aectldert $ BODILY INJURY (Per person) $... ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) '$ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE '.. Per accident $...... $ UMBRELLA LAB OCCUR '.... EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERPMEMBER. EXCLUDED' ❑ NIA E,L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, dosordbe under DESCRIPTIONun OPERA71pNSbeNow j E,L. DISEASE - POLICY LIMIT $ A Proifesslonal Liability RDP0020855 7/6/2015 716/2016 $2,000,000 Each Claim Claims-Made $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additionat Remarks Schoduie, may be attached if more space is required) Coverage subject to all policy terms, conditions, limitations and exclusions. 30 Day Notice of CanceU1 0 Days for Nan - Payment in accordance With policy provisions. JOSEPH C. TRUXAVV AND ASSOCIATES, INC A-2014-100 REVIEWED BY: � ° EUNICE k ERFCt9it (PC 1 OF 'I a.crc. I rr4'L.r,. I r_ r %JL_[.rerc t_ANt„ t=LL/A I I'.V1N City of Santa Ana Pik Box 1988 20 Civic Center Plaza (M -30) Santa Ana CA 92742 -1988 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 (AVC) Alicia K. Igrarn 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 2950CS04 I 7'11ti 16 PL I tPaCty trt.ka I !/9/2015 lli20s12 AM (pnT) I Page t, jt II ACG RbP CERTIFICATE OF LIABILITY INSURANCE NSURANCE �.. ►^' � - P��1 MM /DDIYYYY) 11/3/2015 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 IOA Insurance Services 130 Vantis, Suite 250 Aliso Viejo, CA 92656 CONTACT NAME: Betty Tran PHONE FAX Ex ' 949- 297 -5962 A/C No: 949 297 -5960 E MAIL ADDRESS: bett .tran ioausa.com INSURERS AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑✓ OCCUR Prim /NonCon INSURER A: RLI Insurance Company 13056 www.ioausa.com CA License #OE67768 INSURED Josepph C. Truxaw and Associates, Inc. 265 S. Anita, Suite 111 INSURER B: EACH OCCURRENCE INSURER C INSURER D $ 1,000,009 Orange CA 92868 INSURER E: $ 10,000 ✓ INSURER F: PERSONAL & ADV INJURY $ 1,000,000 GUVtKAUt5 GtK 11FIGAI E NUMBER: 9717RF7F RFVIStI()N NII IMRFR. 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 IN SD SUBR WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A V COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑✓ OCCUR Prim /NonCon ✓ ✓ PSB0001259 Scheduled AIEndt #PPB313nal S Professional Services 10/31/2015 10/31/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE $ 1,000,009 ✓ MED EXP (Any one person) $ 10,000 ✓ Wvr of Subr PERSONAL & ADV INJURY $ 1,000,000 performed by the Insured GEN'L AGGREGATE LIMIT APPLIES PER: POLICY P/ E � ✓/ LOC GENERAL AGGREGATE $ 2,000,000 are Excluded PRODUCTS - COMP /OP AGO $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS ✓ AUTOS ✓ ✓ PSA0001069 Designated Insured Endt #CA20481013; Prim /NonCon and Blkt Wvr of Subr included on pg 2 of Form 10/31/2015 10/31/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ✓ BODILY INJURY (Per person) $ Per accident BODILY INJURY (Per $ ✓ PROPERTY DAMAGE Per accident $ ✓ $ rim /NonCon ✓ Wvr of Subr #PPA3000313 A UMBRELLA LIAB H OCCUR PSE0001215 10/31/2015 10/31/2016 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE Excludes Professional Liability; Follow Form AGGREGATE $ 5,000,000 DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑Y N / A ✓ PSW0001252 Waiver Of Subrogation Endt #WC0403060484---- 10/31/2015 10/31/2016 �/ STATUTE EERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an Additional Insured with respect to General Liability (GL) and Automobile Liability but only when required by written contract with the Insured prior to an occurrence as per Endorsements noted above. GL includes Separation of Insureds and Contractual Liability per limitations in the BusinessOwners' Coverage form. A Workers' Compensation Waiver of Subrogation as noted above is included for the person or organization named in the Schedule that are parties to a contract requiring this Endorsement, provided that contract is executed before the loss. Coverage subject to all policy terms, conditions, limitations and exclusions. 30 Day Notice of Cancel /10 Days for Non -pay tin accordance with policy provisions. w_ �_..._..Y.__ �.......m _ f1Nl(E I1:GtIC)Ilk (Pt t:b_ i � nvw"rX City of Santa Ana, its officers and employees 20 Civic Center Plaza Santa Ana CA 92701 I3T7 ViL2�LRL1■LVAV 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 (AVC) Alicia K. ]gram ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 27178675 1 10/15 -16 GL /AUTO /EXCESS /WC I Patty Felker 1 11/3/2015 3:53:05 PM (PST) I Page 1 of 5 Policy Number: PSB0001259 RLI Insurance Company Named Insured: Joseph C. Truxaw and Associates, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack® FOR PROFESSIONALS SCHEDULED ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM — SECTION II — LIABILITY Schedule Name of Person(s) or Organization (s): City of Santa Ana, its officers and employees 1. SECTION II C. Who Is An Insured is amended to include as an additional insured the person or organization shown in the schedule above, but only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product- completed operations hazard ". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply to the rendering of or failure to render any "professional services ". b. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. 3. The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a PPB 313 02 12 primary basis, or a primary and non - contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION III K.2 Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO SECTION I — PROPERTY AND SECTION II — LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury ", "property damage" or "personal and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. REVIEWED BYE ElJb'` 10E H RED1A (Pcmm: or.._ ?_J Page 1 of 1 27178675 1 10/15 -16 GL /AUTO /EXCESS /WC I Patty Felker 1 11/3/2015 3:53:05 PM (PST) I Page 2 of 5 POLICY NUMBER: PSA0001060 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endoroemont, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) nrorganization(o) who are "inaureda" for Covered Autos Liability under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter ' coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated Named Insured: Joseph C. Truxaw and Associates, Inc. Endorsement Effective Date: 10/31/2015 SCHEDULE Name Of Person(s) Or Organization (s): City of Santa Ana, its officers and employees Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person nr organization shown i the Schedule i an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A1 of Section U Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section | — Covered Autos Coverages nf the Auto Dealers Coverage Form. CA 20 48 10 13 REVEWED BY- K) Insurance Services Office, Inc., 2011 z,z,oms 1 zo/15'mo*^UTo EXCESS /WC | auwFeue, 1 u/,/wo ,.s`.m nw (PST) | page 3 "^ 5 Page 1 of 1 This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Broad Form Named Insured The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any business entity newly acquired or formed by you during the policy period, provided you own fifty percent (50 %) or more of the business entity and the business entity is not separately insured for Bus- iness Auto Coverage. Coverage is extended up to a maximum of one hundred eighty (180) days following the acquisition or formation of the business entity. This provision does not apply to any person or organization for which coverage is excluded by endorsement. B. Employees As Insureds The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Blanket Additional Insured The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Para- graph A.1. Who Is An Insured Provision: Any person or organization that you are required to include as an additional insured on this coverage form in a contract or agreement that is executed by you before the "bodily injury" or "property damage" occurs is an "insured" for liability coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II — COVERED AUTOS LIABILITY COVERAGE. The insurance provided to the additional insured will be on a primary and non - contributory basis to the additional insured's own business auto coverage if you are required to do so in a contract or agreement that is executed by you before the "bodily injury" or ..property damage" occurs. D. Blanket Waiver Of Subrogation The following is added to the SECTION IV — BUSI- NESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any "accident ",,or PPA 300 03 13 REVIEWED BY,- "loss ", provided that the "accident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. E. Employee Hired Autos 1. The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions: Paragraph 5.b. of the Other Insurance Con- dition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto ". F. Fellow Employee Coverage SECTION II — COVERED AUTOS LIABILITY COVERAGE, Exclusion B.5. does not apply if you have workers compensation insurance in -force covering all of your employees. G. Auto Loan Lease Gap Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance, is amended by the addition of the following: In the event of a total "loss" to a covered "auto" shown in the Schedule of Declarations, we will pay any unpaid amount due on the lease or loan for a covered "auto ", less: 1. The amount paid under the PHYSICAL DAMAGE COVERAGE section of the policy; and 2. Any: a. Overdue lease /loan payments at the time of the "loss "; E'l. NIC::E H rREUA (I-G r: F �j Page 2 of 5 27178675 1 10/15 -16 GL /AUTO /EXCESS /WC I Patty Felker 1 11/3/2015 3:53:05 PM (PST) I Page 4 of 5 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA WC 04 03 06 (Ed. 4-84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 of the California workers' compensation premium other-wise due on such remuneration. Person orOrganization City nf Santa Ana, its officers and employees Schedule Job Description Jobs performed for any person cx organization that you have agreed with in a written contract to provide this agreement. This endorsement m`onoro the policy to which Kis attached and |s effective nnthe date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 1O/31/2U15 Insured Joseph C. Truxaw and Associates, Inc. Policy No. PSVV0001252 Insurance Company RL| Insurance Company Countersigned By Endorsement No. mnembv the Workers' Compensation Insurance Rating Bureau ur California. �Itrights REV�EWED BY., AC"IdY CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 7/812015 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 10A Insurance Services 130 Vantis, Suite 250 A61s0 Viejo, CA 92656 CONTACT NAME: Betty PHONE FAX 049- 297 -5962 (A /C, No): 949- 297 -5960 -LQ mN ADDRESS: bett .trait ioa Usa..com INSURERS AFFORDING COVERAGE NAIL IN INSURER A: RLI Insurance Company 13056 www.ioausa.com CA License #0E67768 INSURED Josepph C. TrUxaw and Associates,. Inc. 265 South Anita, Suite 111 INSURER E: $ INSURER C DAMAGE TO RENTED PREMISES Ea occurrence) INSURER D Orange CA 92868 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER; 25506,504 REVISION NtIMRFR- 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, ILTRR TYPE OF INSURANCE ADDL SUBR POLICY' NUMBER MMIDDIYY'YY dMMlaa,IYYYY. LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fl OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence) MED EXP IAny one person) $ PERSONAL & ADV INJURY $ GEN "L AGGREGATE. LIMIT APPLIES PER: PRO- POUCY F JECT LOC GENERAL AGGREGATE $... PRODUCTS - COMPIOP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea aectldert $ BODILY INJURY (Per person) $... ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) '$ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE '.. Per accident $...... $ UMBRELLA LAB OCCUR '.... EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERPMEMBER. EXCLUDED' ❑ NIA E,L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, dosordbe under DESCRIPTIONun OPERA71pNSbeNow j E,L. DISEASE - POLICY LIMIT $ A Proifesslonal Liability RDP0020855 7/6/2015 716/2016 $2,000,000 Each Claim Claims-Made $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additionat Remarks Schoduie, may be attached if more space is required) Coverage subject to all policy terms, conditions, limitations and exclusions. 30 Day Notice of CanceU1 0 Days for Nan - Payment in accordance With policy provisions. JOSEPH C. TRUXAVV AND ASSOCIATES, INC A-2014-100 REVIEWED BY: � ° EUNICE k ERFCt9it (PC 1 OF 'I a.crc. I rr4'L.r,. I r_ r %JL_[.rerc t_ANt„ t=LL/A I I'.V1N City of Santa Ana Pik Box 1988 20 Civic Center Plaza (M -30) Santa Ana CA 92742 -1988 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 (AVC) Alicia K. Igrarn 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 2950CS04 I 7'11ti 16 PL I tPaCty trt.ka I !/9/2015 lli20s12 AM (pnT) I Page t, jt II