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HomeMy WebLinkAboutSANTA ANA BUSINESS COUNCIL INC. 1B - 2015INSURANCE NOT ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL DATE; $_�Q_1� SECOND AMENDMENT TO OPERATING ACRE+ EMMNT THIS SECOND AMENDMENT TO OPERATING AGREEMENT, made and entered into on f �,",(A 13 , 2015, by and between the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California, hereinafter referred to as "City," and Santa .Ana Business Council Inc., a California non-profit corporation, hereinafter referred to as "SABC." RECITALS A. City and SABC entered into Operating Agreement #A-2013-151, dated September 17, 2013, to (1) confirm that SABC will receive 50% of the assessments collected each calendar year for which an assessment is levied, (2) to provide that SABC's use of the assessment fields will be consistent with the requirements of NS-1715, generally, and the approved calendar year's assessment report specifically, (3) to provide for auditing of SABC BID Funds, and (4) ensure that SABC meetings are compliant with the Ralph M. Brown Act [Government Code Sections 54950, et seq.). B. City and SABC entered into Amended and Restated Operating Agreement #A-2014- 020, dated January 9, 2014, hereinafter referred to as "said Agreement". C. In accordance with the terms and conditions of said Agreement, the Parties desire to increase the amount of and add finads to the "revolving fund" and address the reimbursement process. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions of said Agreement, except as herein modified, the parties agree as follows: 1. Section 2.01(f) shall be deleted in its entirety since the applicable timeframe has expired. 2. Section 2.01(g) shall be amended to increase the maximum amount of the "revolving fund" account from $20,000 to $40,000. Consistent with the increase, in the maximum amount of this fiord, the City shall add an additional $20,000 to the "revolving fund" for a maximum total of $40,000. Section 2.01(m) shall be amended to provide the City with three (3) weeks to process reimbursement requests from SABC, which shall commence upon the City's receipt of notice and all required documentation. 4. Except as hereinabove modified, all terms and conditions of said Agreement shall remain. in full force and effect. A-2015-145 IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to Operating Agreement the date and year first above written. ATTEST: MARIA D. HUIZAR r% Clerk of the Council APPROVED AS TO ]FORM: SONIA R. CARVALHO SANTA ANA BUSINESS COUNCIL, INC. Ago 20 2015 4:45AM HP LASERJET FAX 17145?226E" p.2 poi 11mumbac 605503396 EGLIFn�lorOcA< 0. CERTIFICATE C F�I"€ILINi"9i1 �37sdel t�L+•,.).::. OnT:f f`At T •1'Y.f __ .. THI$ CECiTIFICAi'E 15 ISSUED AS A IstiATTER OF INFORMAT CERTIFICATE 1L/7(261A M ONLY APIO CONFERS NO RIGHTS UPON THE :ER71fIOATE HOLDER ifiFIC TE HO -11 DOES NOT AFFIRMATIVELY OR NEGATIVELY BELow. ER TI' AMEND, EXTEND OR ALTER THE COVEnAr Ak FO , THIS CERTIFICATE OF INSURANCE DOES NOT REPRESENTATIVE OR PRODWER, M0 THE CERTIFICATE H.)LOER. NSTITUTE A CONTRACT ©ETVlEEN THE ISaUIWI; IN5URER(S}, AUTHORI S O IMPgRTANT: ff tha calUflwka Holtler is an ADDIT(ONAL.INS the farms.'And conditions of the pWley, earYaln ppltcias may f8 EO, the pq(Icy M) must be endorsed. If SUBROGATtOtV IS WkNEp, su4)act. afrs an endorsement. o secURCRlII 110(d0f In Ilau OTsuch 8ndnmemantfa}. A statement an tills certiticatr- dons not confer ri0ltts tot e PanOuntTx 'like Rodgi.cY. Innuraneez coenncr------'-- Mike Roe1gX C7e —' _... •_ 196 2ochnol4gy Drive, Suite B PHONE ...__._ � asfnllF(949)753 9555 19497753 Trvina, CA 92615 `._ _..._ Iusunsa(J7 nvPoanalr, covers .e t I - ..._._ _ ...__.. msua_c .manta S'ma Suaistaae Counevl, Inc _ w411RrnY asmF s iasu arrx Sr ch ng .. ER2 - GEatz' Coicoez Z-vsu.i, IIIWRE a a�io.: :2Ei nd 35076 Cnrina Madriles ((LEaIEEeG rx Jolers __ _. ..-.__,..__. _., 3+i.91 G00 B. Sth Street Same FSrr3, CA 92701 _., _..___ _. _ .... .._ .. _., .. IIFLqkUER o; INMUReaRfiP. COVERAGES CERTIFICATE NCI3't)3EE2; THIS IS TO CERTIFY TPIAT THE POLICIES OF IN$UFIANCU LISTED INDICATED. NO'PNrrHBTANDIN a ANY ARQUIREMENT, TERN OR C ftE\li51QN i UdfrBER: ELOW HAVE BEEN ISSUED 7O THE i`dSUNED IAMIED n VE FOR THE POf F;t' uE tit NDRION `OP4.IR(t9T p CERTb'IGATE MAY BE ISSt1E0 OR MAY PERIAIH, THE INS➢RArdH Of ANY OR OTHER. ➢OCUMr PIT -I,-,rH RESPECT TO lNr71C:'I Tt AFFORDED HY THE POLICIES DESCRIBED HEHCIN IP IC EXCLUVOPIS AN➢ CON➢ITIONS OF SUCH POLICIE5. IJNIIT85ROV%'N ......_.._. ._.._.,_ _....."""a21pL SL12J-CT TO ALL TI it lF"i Y HAVE OESN REDUCED BY PAUD CLAIMS. IS, LTR T(PCL'Flusdrifi AUaK .._.._._ 0 POUR ._.. �� �OpFYLFFPTPi}1AL{fl%P R1PoEfR M4Ve0 _ A CQNMERnnL CEHLRN. LIM14,"ft ( I.RjmsllYYt LJdtTa I '----�� -: __ �CI r0.N.hlnGk `'T CC(.Ln �,/ /\ i6➢.JJp3346 Lf,Cr+CL ua NCE L1UOO,OQO �2Po9/2014 2/a7/ 0 3 Ioh de'tCN Ufi@p"' i IPRetUHe9lEa:obJJiVYF I_L06r O0C Lo etro -'� -�� 1 aso lrLx >YI Lo ?. 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L•s Ldc1IIa1&9 ---�....�..,� AUritpRcce 9L'nkC5elLAYv - �� 1 f .t: t7 Ld - } AC Ui¢CI 29 (201r!lClij The FiCORD nente'a f989 st0 f4S.CORn EO tie ?RArIQN- NI rl,hs R. dle(;o - arb rl+tjistored marks Of ACOR,D ,U-�Qy �':ra � n�aos; Pws swr:m,o ,m.m• I*o,m,rm,ce_uom mu=Y-,Iva P,mscmrp eau.;: a.r4r• Policy Number°, 605503396 Date Entered: 12/7/2014 ACCMV CERTIFICATE LIABILITY INSURANCE r12 /ATE 12f77IfAIakIT)OPYYYa; /2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE 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(l'es) 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). PRooUCER CONTACTMike Rod s.ck...... 146 Mike Techngick Insurance NA 'PHON(9 a5 .5._., ology Drive, Suite a E-MAIL 99i73 9555 �ac,rlI.{9491753 5559 Irvine, CA 92618 ntabREss: INSURERA:Farmers Insurance Exchange 121652 INSUREU S a nta.. Ana Business Council, Inc. II4SiURER8:State CosmpensatioIp Insurance Fund 35076 Carlos Madriles INSURER C:Travelers ;311.94 400 S. 4th. Street INSURErIo _ _ Santa Ana, CA 92101 INSURER E: �ITiT►fT7sTrTrF w1i 1.4 11 rd KiNtmill M111]IICIAs T1AwikI[rTZ111116Td:i-d. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IND1CArED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF .ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED Oil MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT' TO ALL THE T RNI S, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS St -TOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IkISR ._ _m_,.,w.._.. __......... ........ Abe tbibft' LTR 'TYPE OF INSURANCE � N � b POLICY IdUMOER POLMYTEdF "POLICYEXP MMdb'bMYYY MMitlrb/arYYY . , ..� ...,„„ . LIMITS... . p, �, COMMERCIAL GENERAL LIABILITY ...,. a �-" EACH OCCURRENCE $1 , 000 000 _ ....... "s.• 'J"i CLAIMS -MADE � C `MADE i OCCUR � ._._.�_._. �.`wJ �"'� 606503396 2/07/2014 2/0"1/2015 r�"'�, eP ,r.i a,r :•�? IUV UC10 PREMISS_I�aoccwrrrrsaop $+ . MFb E CP IAray umu Pc rrsun} ;10 000 __... ? ................ .. .... _. PERSONAL & ADV INJURY S 1, 000 000 ,.0O, CR:GR CAPPLIES Ccik �^iNERALAGGRCDAT& I 0f.00}. PRO- [ d"1i{CI" W �Jewy JI.L(. 0Oi0FRi7GCT sriC 1 w,, OTHER A AUTOMOBILELMEIL1TY � 60550339 2/07/2014 2.107/2015 COMBINEE) SINGLE LIMIT Eta afCedf3nll, f9G1fSC1YNNIUIEY(Per $ 1 r n 000 000 $ �!'nld"aACJ7Ct _ Person) ALI O)PINEl SCHEDULED i AGrTOS AUTOS BODILY+I IIURYIPrdr icgirlrarli➢ S NON•OWNEL> - „ IdRk'tG L'F AV)1'G a ,� \ AUTOS PROTrERTY DAIrIAGE. UMeREILALIAB OCCUR d ! EACH OCCURRENCE S I XI.ESS LIAR QLa MIS M D '.' _... A'Gr'".vREG ATE I..S {{ r ..._....Y P irEC I RETENTION S CGMPENSA7YbN r + I PER 1 YRI H" srnT UC ( rR AND EMPLOYERS"LIABILITY YIN- _ _ B a 10RIt6RS I'tPRC?RIE"Ii7RfdrfwRTrdcelu�.+.i=CllT9rtE i � OfFICERIMEMSEREXCLUDED7 ;NIA; 9081384-2014 a.2i1.LY/2£'D7.�I 2i10/2,bfl5 F L'e'hl.'F6AC.GIG7�RIS 51,000,000 , "..." .__ .__....,.... I , INi (.�Idanr2aluri in � NH)1 } I E L DISEASE, E: EMPI OYEEr S 1, 000, 000 if y dla,"Rb a under DESCRtPTIOIT OF OPERATIONS Ybel aw i .._. ........._.. .. , _ 1 El DISEASE -POLICY LIMIT I 31,000,000 C !Fidelity Bernd 106032811 12/07/2014 t2/07/2015 15,000 SIR 500,000 C I D&O 106032911 12/07/2014 12/07/201.5 1,000 SIR 1,000,000 C E1' 106032t311 12/07/2014 L2/07/2015 !1, 000 SIR 1,000,000 bESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Re rnar*.n Schedule, may be allached H neare space Is required) % The City of Santa Ana, its officers, agents and employees are named as additional insureds for Oda oral Liability purposes. City of Santa Ana I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELRIERED 1N ACCORDANCE WITH THE POLICY PROVISIONS. Santa .Ann, CA 92702 Attn: Risk Management: - Briza Morales AU11TORVEDREPRESENTATIVE 108R.W)irt AC:ORTT i:CSPF+P],PATIONL All rinlOr rngpnocerl ACORD 25 (2014/01) The ACORD narno and logo are registered marks of ACORD F''rrurlax:eGl �am+"ry CCrrwv,a l3o ; Plws sttllw.var, es�nsnF rrrrie dHr,4 ,,,, wnrar to upatsree. aer I-e'uVali.'Ihifrp NiEi417i➢8I^i"iJ�7P POLICY NUMBER: 605503396 BUSINESSOWNERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSUR■ED - STATE OR POLITICAL I SUBDIVISIONS - PERMITS RELATING TO PREMISES This endorsement modifies insurance provided under the following: BUSIN�ESSOWNERS POLICY State or Political Subdivision:: City of Santa Ana, Its officers, agents & Employees Thi%; " rNOAH -0, WAIg Is ad-lde d to Paragraph Gi. '00,10 IS A nM 114 INSURED in the Businessowners Liability Coverage Form: 4. Any state or political subdivision shown, in the Schedule is also an insured, subject to the follow- Ing additional provision: This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with premises you own, rent, or control and to which this insurance applies: 111T11 1�1 1� 111 1! 11 a. I Ine exisitunce, motainWenance, repair, conathu-0- ton, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hols- taway openings, sidewalk vaults, street ban- ners, or decoration and similar exposures-, b. The construction, erection, or removal of eW vators; or c. The ownership, maintenance, or use of any elevators covered by this Insurance. BP'04 07 0187 Copyright, Insurance Services Office, Inc., 1985 Page 1 of I A 11„ Policy Nurnber:605503396 Date Entered:12/7/201.5 ACOORV DATE (MMY�DIYYYYI CERTIFICATE OF LIABILITY INSURANCE 12/7/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terrns 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 endorsornent(s). P'RooulaER 196 Technology rcanr"�sE: Mike �trtd �.I k Mike ttodgick Insurance '� ., _ .. ology Drive, Suite B (AIP-�l^#k.E, Il, (`D5)^i5S.9555_"_"_..,..... Jaac,"Nal: (94tD) 753-9559 EMAIL .... _. Irvine, CA 92.618 ADDRESS;_ INSURED Santa Ana Business Council, Inc, Carlos Madriles 400 E. 4th Street Santa Ana, CA 92701 INSURER(S) AFFORDING COVERAGE NA4C p I INSURER A :Fasters Insurance Exchange _._ .. �21.652 INsuRERB;StatEs Compensation InsurancFund 135076 INSURER C . "frav.....elElrs _ ...... e 31194 COVFRAnFS rFPTIFIr..'ATB NIIRMPIPP cat=t,rlclE" M I'll 1"Q9=ca. THIS IS "rO CERTIFY THAT THE POLICIES OF INSURANCE, LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY R5QUIREMENT, 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 . ............ {AD[SLISuRR ..POLICY NUMBER MMIDDdIYYYY .fNDD/YYYY i � ........ ...-LIMITS _.. _ ... j COMMERCIAL GENERAL (LIABILITY j ,51i�+4-8.?ebr ! OCCUR l'4. f F.,,a�..�"k,,i' iN1 9 71,2✓Ib'7/2QY£� ,2/IJ7/2kki& EACH OCCURRENCE DAMAGE TO RENTED S1,000,000 � �. . .. , _ 0 000 I r r _ o MED EkR (Ally C341L RC1r5en), I S 1D 000 I PERSONAL & ADV INJURY � E 1 000 , 000 tl ENLAI,GRCrmAI r LIMIT APPLIES PER GENERAL AGGREGArF, s2,000,000 PRO- J5 cT L ti, PRODUCTS • COMPIOP ACC, ,... s 1 000 000 QTHER- I S AUTOMOWLE LIABILITY �... 605503396 2/07/2p15�2/17/2416 i COMBINED SINGLE LIMIT BODILY INJURY (Per 000a 000 1s1,_ htEL•IVOVV"1D SCIDULELAuu (ASA{J,o5 ( '. IUNiVIdC �.! RercaiblAUC ...... _. BOL 1luY INJURY RW (Per ❑ecid n1} tif�ANr1AGE h i -RCCAUTOS \1AUTOS 6#�cckT�dTaWntDl _ S " I ! UMBRELLA LIAR I OCCUR .._..._ 1 EACH CCC RRENCF S EXCESSLMB CLAIMS' MADE' AGGREUA rE S aEu RETENTION s WORKERS COMPENSATION .I �..... { � RER 1 OTH, AND EMPLOYERS` LIABILITY YIN,:. STAT UJtI- - ER " ANY RI'dC)�ItIE:TCT�,lWAHTIIIiTiIc"„ I',2;r11'14YEa '�- � �. ,.o �, il2'/1i7/2Ct15 'L2/1p"f2t116 0 h1CF:r MEMMER EXCLUDED? NIA E L EAM-1 ACCIDENT $ 1, 000 , 000 ... _ fWBaedaCosr In E L_ DISEASE - EA E.Mi'�0.mdl"fcE Uoel�alelS1,000,000 1 C rSCl21w'TIG:9�1 CE QRE.RA'I'IDh151*wlc,,}rr s I 7 1 E L- OI:SEASE - POLICY LIMIT .. ... i S1,000,000 C Fidelity Bond I106032811 112/07/2015 L2/07/2016 15,000 SIR 500,000 C D&O 1106032811 12/07/2015 12/07/2016 1,000 SSR, 1,000,000 C EP 106iD32'$11 �2/47/2015 12/07/2016 l 000 SIR 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS d VEHICLES (ACORO 101, Additional R.ernasks Schedule, may be attached If more space Is regWrod) ;ey The City of Santa Ana, its officers, agents and employees are named as additional insureds for General Liability purposes. CERTIFICATE HCII_r]Fk" r ANr` I I ATIriN City of ,Santa; Ana, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Santa Ana, CA 92702 .1?.'ttn:. Risk Management _. Briza Morales AUTHORIZED REPRESENTATIVE C.� I 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101), The ACORD n,arne and logo are registered marks of ACORD Produced usilig Foram Boss Phis software, v^vw.Foj Tnsl oss.conn; Impressive Publishing 800-208-1977 POLICY NUMBER: 605503396 BUSINESSOWNERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS -- PERMITS RELATING TO PREMISES This endorsement modifies insurance provided under the following; BUSINESSOWNERS POLICY SCHEDULE* State or Political Subdivision: CITY OF SANTA ANA, ITS OFFICERS, AGENTS & EMPLOYEES The following is added to Paragraph C. WHO IS AN iSU itie isiressowners Lla3111t/ C@VerageNMUiiB Form: 4. Any state or political subdivision shown in the Schedule is also an insured, subject to the follow- Ing additional provision: This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with premises you own, rent, or control and to which this insurance applies: a. The existence, maintenance, repair, construc- tion, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hois- taway openings, sidewalk vaults, street ban- ners, or decoration and similar exposures; b. The construction, erection, or removal of ele- vators; or c. The ownership, maintenance, or use of any elevators covered by this insurance. * Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Decla- rations. BP 04 07 0187 Copyright, Insurance Services Office, Inc., 1985 Page 1 of 1 ❑ CERTIFICATE OF LIABILITY INSURANCE I DATE 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 INSUREDS), 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 ileu of such ondorsement(s). PRODUCER Michael Rodgick(971832A) 196 Technology Dr Ste B INSURED SANTA, ANA BUSINESS COUNCIL, �IN uREn c: Mid Centurry nsurar 400 E, 4TH STREET _URERD: State FuuRER E, Travelers Insurance r474:iif367�ii�dlillTifl�:i 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. _ INSRPOLICY F POLICYEXP 7 (MWDD TR TYPEOF INSURANCE POLICY NUMBER OIYYY(I^ UNITS LIABILITY I��-G---E; EACH OCCURRENCE S 1,000,000 yNyERAL XICOMMERCIAL GENERAL LIABILITY DAMAGE OWeNfESI " PREMISES dt4gerom-FE) I B ` r LLj CLAIMS -MADE E OCCUR k Y N' Bp5503395 I ! 12107t2018 j 12/07/2019 MEtl EXP Any one arson PERSONAL &ACVINJURY S 10,000 9 1,OOQ,000 i GENERAL A44REGATE S 2,000,000 GEN'LAGORC4ATE LIMIT APPLIES PER: FRO- I PRODUCTS AGO S 2,000,000 POLICY IF JECT LOC ( S B AUTOMOBILE LIABILITY ANY AUTO __ ALLOWNED SCHEDULED AUTO$ _ AUTOS X NON•OWNED HIRED AUTOS /\ AUTOS I - ( 605503396 112107/2018, I 12/07/2019 COMBINED SINGLE LIMIT L(Ea-mp t)--------- BODILY INJURY (Per Pemon} i �6000.Y1NJURv iPar aeddant) PROPERTY NAMAGE 1Per occidon9___ I S 1,pp0,Qp0 S "— —" s $ _ s UMBRELLA UAa I 'OCCUR C I I EACH OCCURRENCE IS EXCESSUAa CLAIMa•MADE ...__-a ,.. ' ___._._1 1 I I I ! '. I -AGGREGATE _. !S j 9ED RETENTION S I WORKERS COMPENSATION I AND EMPLOYERS' LIABILITY YIN, I V WC STATU- OTH� _ �S9RY.IJMITS. D ANYCCMALETOR EXCLUDED? CUTIVE _CF7ICEorymN REXCLUOEDi , NIA 9Q81384 1271 pj2p18 12/1 Ql2Q19 E L EACH ACCIDENT — — S 1 p00,p00 — - - -(Mandatory In NN) ! 1 ( I pl bIBEASE-FA EMPLOYERS 11006600 Ryes, daocriunder DEBDRIPTIGNOF OPERATIONS babes ) I I ` E.L. DISEASE POLICY LIMITIS 1,pQp,000 Fidelity Bond 5,000 SIR $500,000 E D&O ( 1 100032811 12/10120181121i Qt2019 1,OQ6 SIR $1,000,000 EPL I 1,000 SIR $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attend, ACORN 101, Additional Remarks Scl o ludo, it more space is required) 400 E. 4TH STREET, SANTA ANA, CA 92701 CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS FOR GENERAL LIABILITY PURPOSES. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY, WITH THIRTY (30) DAYS NOTICE OF CANCELLATION, EXCEPT 10 DAYS FOR NONPAYMENT OF PREMIUMS \ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLZ ACCORDANCE WITH THE POLICY PROVISIONS. ....-..._�.�n...,e............... AUTHORIZED REPRESENTATNE SANTA ANA CA 92701 ..-., _ - - - , // rrJ - f 25 (2010105) ©1988-2010 ACORD 01 The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 605503396 BUSINESSOWNERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS RELATING TO PREMISES This endorsement modifies insurance provided under the following: POLICY SCHEDULE* State or Political Subdivision: CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS The following is added to Paragraph C. WHO IS AN a. The existence, maintenance, repair, construc- INSURED in the Businessowners Liability Coverage tion, erection, or removal of advertising signs, Form: awnings, canopies, cellar entrances, coal 4. Any state or political subdivision shown in the holes, driveways, manholes, marquees, hois- Schedule is also an insured, subject to the follow- taway openings, sidewalk vaults, street ban- ing additional provision: ners, or decoration and similar exposures; This insurance applies only with respect to the b. The construction, erection, or removal of ele- following hazards for which the state or political vators; or subdivision has issued a permit in connection with c. The ownership, maintenance, or use of any premises you own, rent, or control and to which elevators covered by this insurance. this insurance applies: Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Decla- rations. BP 04 07 0187 Copyright, Insurance Services Office, Inc., 1985 Page 1 of 1 0 POLICY NUMBER: 60550-33-96 BUSINESSOWNERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY SCHEDULE" Name Of Person Or Organization: CITY OF SANTA ANA " Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations. The following is added to Paragraph C. Who Is An Insured in the Businessowners Liability Coverage Form: 4. Any person or organization shown in the Sched- ule is also an insured, but only with respect to liability arising out of your ongoing operations or premises owned by or rented to you. BP 04 48 01 97 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 ❑ Attach to your policy with the same policy number shown on this endorsement. ENDORSEMENT Effective Date08/17/17 60550-33-96 Policy Number of the Company designated in the Declarations CITY OF SANTA ANA. ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS IS ADDED AS ADDITIONAL INSURED FOR PRIMARY AND NON CONTRIBUTORY COVERAGE USING THE FORM "ADDITIONAL INSURED - OWNERS, LESSEE OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION. This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise subject to all other terms of the policy. COUNTERSIGNED (Date) @RMFRS /iRIURRN[@ �L'Q cR�raxna®6c.�r 91-0002 NE 0002) 1ST EDITION 0-88