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HomeMy WebLinkAboutMADRILES, CARLOS (DBA DOWNTOWN STADIUM GRILL)City of Santa Ana Clerk of the Coule AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. 0 COTC Office Use Only The agreement with ,0Jr % r) "tii % ., x No. N-2016-132 was completed on 12/2,1 /2^-()j(�, and final payment has been made. (List all amendments. Use space below if needed.) Department: MC E)A Phone/Ext.: Ling Signature: Date: Revised' 01-07-16 INSORANCE ON FILE ,, C OCEED , ,L)RANCE EXPIRES r5_-t6_Lf��`. CLERK OF COt1 6 2010 DATE: CONCESSION AGREEMENT N-2016-132 O: PRCS (/ ) THIS AGREEMENT is made and entered into this Is' day of September, 2016, by and 6ttvia Cuevas between Carlos Madriles dba Karmina Restaurant Bar and Grill ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing tinder the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a Contractor having special skill and knowledge in the field of food service concessions. 0, Contractor is already providing such services to the City at Santa Ana Stadharl, and the City wishes to continue these services for a short period of time while it studies longer -term arrangements. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional "high-level" contractor 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 Contractor sliall provide those concession services as fully described in Exhibit A and incorporated by reference in this Agreement. 2. COMPENSATION In consideration for the concession rights granted by this Agreement, Contractor agrees to pay the City 10% of the monthly gross revenues during the term of this Agreement. The payment is due oil the 10th of each month and shall beaccompanied by an accounting of gross receipts during the previous month. For example, the payment for August is due September 10°i and shall include 10% of August's gross receipts. 3. TERM The term of this Agreement shall commence on the date first written above and terminate on December 31, 2016, unless terminated earlier in accordance with Section 11, below. 4. INDEPENDENT CONTRACTOR Contractor 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 Page 1 of shall it be construed to create an employer -employee relationship, ajoint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to its employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and 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 Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The armounts 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 occurrenec, with $2,000,000 in the aggregate. Such insurance shall: (1) name the City, its officers, employees, agents, volunteers, and representatives as additional insureds; (2) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (3) contain standard separation of insured 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 California Labor Code, Contractor, if Contractor 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, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d, The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (it) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. (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. C. If Contractor 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 terminate this Agreement, Such termination shall not affect Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION AND HOLD HARMLESS Contractor agrees to and shall defend, indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability. (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the operations of the Contractors or its subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section I of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. Contractor further agrees to indemnify; hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising fron this Agreement, City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFLICT OF INTEREST CLAUSE Contractor 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. S. NOTICE Any notice, tender, demand, dclivery, 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, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic, Center Plaza (M- 10) P.O. Box 1988 Santa Ana, CA 92702-1988 With copies to: Executive Director of Parks. Recreation and Community Services City of Santa Ana 20 Civic Center Plaza P.O. Box 1988 Santa Ana, California 92702 To Contractor: Carlos Madriles 515 N. Main Street Santa Ana, CA 92701 A party may change its address by giving notice ill 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 (1) days after it has been deposited in the United States mail, duty registered or certified, with postage prepaid, and addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive agreement between the City and Contractor regarding the subject matter heroin, 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 Contractor. The parties agree that any ter' -as 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 Contractor 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, 10. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor 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 troll 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 contractors retained by City. 11. 'TERMINATION This Agreement may be terminated by the City upon fourteen (14) days written notice of termination. In the event of termination by the City, City shall be entitled to receive compensation for all activities by Contractor prior to receipt of such notice of termination that are due to City under Section 2 of this Agreement. 12. NON-DISCRIMINATION Contractor 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 recruitment, selection, training, utilization, promotion, termination or any other employment related activity, or in connection with any services performed under this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. JUR.ISDICTION-VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought by the parties hereto or arises out of, or in connection with or by reason of this Agreement. IC LICENSES AND PERMITS Contractor 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. These shall include but not be limited to the following. a California State Board of Equalization Seller's Permit; City of Santa Ana Business Tax Receipt, Certified food Handler Permit; and County of Orange Health Department Permit. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said failure shall be cause for immediate termination of this Agreement by the City. 15. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City frilly, 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 WPfNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: i MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: Sonia R. Carvalho City Attorney By�____. N M. FUNK ssistant City Attorney FOR APPROVAL: GERARDO MOUET, Executive Director Parks, Recreation and Community Services Agency A ANA: DAVID CAVAZOS City Manager CONTRACTOR Naive: LGiri S /�°tG�C;�eS Title: C}e v e EXHIBITA SCOPE OF SERVICES Contractor agrees to serve as a quality concessionaire to provide food service at the Santa Ana Stadium, 602 N. Flower Avenue, The City will provide the concession building and pay all electrical, gas, and water utilities, and trash service in return for a percentage of gross sales. The West -side Stadium concession building totals 1,800 sq. ft. with approximately 70 linear feet of counter space. The Fast -side concession area totals 156 square feet and has approximately 16 linear feet of counter space. A. SPECIFICATIONS I. The West -side Stadium concession facility is a full service facility that is capable of providing a variety of hot and cold meal items, beverages, and snack food items. It is equipped with a refrigerator, walk-in freezer, changing room and staff restroom. The concessionaire shall provide stove, soft drink dispensers, grills, deep fat fryers, microwave ovens, coffee makers, popcorn machines and all other equipment not listed above. 2, The West -side Stadium concession facility has three service windows, two that serve the Stadium visitors inside of the Stadium grounds and one that opens to the street immediately in front of the Stadium entrance to serve non -Stadium patrons. The concessionaire shall provide tables and seating for customers outside the Stadium in the area designated by Staff. 3, The East -side Stadium concession facility has one service window, one sink, and approximately 17 linear feet of counter space, The East -side concession facility is approximately 156 square feet, R. A maximum of one electrical business sign may be installed on the outside of the concession building. The concessionaire shall meet all Planning and Building codes and permit requirements before installing. The design of the sign shall be pre -approved by the Administrative Services Manager, 5, Professionally manufactured pricing boards are to be installed inside the concession building and not on the outside of the building or on windows. Pricing boards are to be pre -approved by the Administrative Services Manager, 6, Potted Plants or small trees may be installed in sealed concrete planters within the eating area or next to the concession building at the concessionaire's expense. These trees, plants, Shrubs or flowers shall be kept neat and trimmed. These materials are to be pre -approved by the Administrative Services Manager, 7. The concessionaire is required to keep the working and eating areas clean at all times. Trash bags shall be provided and placed in trash bins by the concessionaire. Trash bags shall be dumped into the City's trash container when they become full and at the end of each day. S. The concessionaire shall maintain neat, clean and safe surfaces in the concession area and power wash the concrete and asphalt within 20 feet of the concession building and in the eating areas a minimum of once per month. 9. If graffiti appears on any of the concessionaire's equipment, signs, or fixtures, or any other surface, it is to be removed daily at the concessionaire's expense. The City will remove graffiti on the exterior of the building. 10. For the safety of the public and protection of the facility, restrictions may be placed on items sold, type of packaging, location of portable carts, etc, The City must approve all menu items, packaging and cart locations (or changes to the above.). No cans, bottles or gum shall be sold at the Stadium. 11. No tobacco products shall be sold or advertised. 12. "17ne concessionaire is required to apply for and retain an annual ABC license or ABC caterers permit for use at the Stadium. Alcohol may only be served at special events approved by the Executive Director of Parks, Recreation and Community Services. It cannot be sold on a regular basis to customers inside or outside the Stadiwn. 13. The concessionaire shall be responsible for continual trash removal during the concessionaire's operating hours. 14, Concessionaire shall tightly control the quality of the work performed by in-house staff and/or sub -consultants. Incomplete or poor quality work will not be accepted. 15. The concessionaire shall attend meetings with City staff as required. 16, The concessionaire shall coordinate with other agencies as required. 17. The concessionaire shall complete the plan check processes with the City of Santa Ana and other agencies as required. 18. The concessionaire will be required to apply for and retain a City business license and all applicable Orange County Health Department permits. Concessionaire will be required to use certified food handlers in the concession operation. 19. The City retains merehandizing rights for all Stadium business. 20. In cases where the City determines that a special event warrants a specialized type of catering service, the City reserves the right to hire different caterer. Concessionaire will be given a I0-day notice of such events. 21. Contractor shall not enter into any other revenue sharing arrangement with other Stadium users, unless approved by City. 22. The concessionaire shall provide annual audited financial statements to the City, B. CITY RES ) NSIBILITIFS The City will provide the following; 1. Staff for cleaning non -concession areas during Santa Ana Stadium events. 2, Assistance with plan check coordination within the City. 3. Maintenance of concession building exterior and roof_ refrigerator and freezer, A. Payment of utilities, including water, electricity, gas and trash service (limited to the concession operation). S. Staff liaison for communication and problem resolution. A� CERTIFICATE OF LIABILITY INSURANCE g09129/2015Y) 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 ondorsement(s). PRODUCER CONTACT Sarlah Devereaux-Barrientos, Agent NAME Sarlah De,veraaux-Barrientos 1202 W 1St St 19/G No Est): 714FAX -541-728Q UIC No 714-384-3892 EMAIL stateFarm Santa Ana, CA 92703 ADDRESS $,ariah.devereauX tBlbCtatefarm.com INEURER(S)APPORDINGCOVERAGE ,.. NAICA INSURER A: State Farm General insurance Company 25151 INSURED Carlos Madrlles INSURER B: . _._....-..._... DBA Downtown Stadium Grill INsuRERC. 602 N Flower St, Santa Ana, CA 92703 INSURERD INSU RERE "' �l^ts:�s1' 4 i[,r•4./1 INSURER F: COVERAr FR 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. ILITI TYPEOFINSURANCE ADDL SUER POGcYEFF--POLICYEXP INBR D POLICYNUMBER MMIDDNYYY MMIDDIYYYI' - -' LIMITS A GENERAL LIABILITY G._. Y 92-EDZ9660 I. 09129/2076 09129/2016 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY '.. ----. DAMAGE TO RENTED - - PREMISES (Eaoccprrencej $._ _... 300,000 CLAIMS -MADE _.... OCCUR ..._..._ MEq EXP (Any one person) $ $,000 ___._ ..... ...._. PERSONAL &ADV INJURY ',S 1,000,000 ..... ....._ ........ GENERAL AGGREGATE $ 2,000,000 GE_N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000-- POLICY JE`T LOC KUsin ass Property S 25000 AUTOMOBILE LIABILITY OM81NED SINGLELIMIT ❑�, _(Eacadenl) ,.__.. $ ANYAUTO�a 1 BODILY INJURY (Per person) $ ALLOWNED SCHEDULED - ._: AUTOS AUTOS a BODILY IN -JURY (Perwrimmn $ ..- HIRED AUTOS _ NON-OWNED't� AUTOS PAOPERTY DAMAGE (Per amdmm UMBRELLA LIAR t - OCCUR ❑❑'., Q ��! ''`n, ;\� EACH OCCURRENCE S EXCESS LIgB _.ES CLAIMSMADE. ` / /a,yCt V Q AGGREGATE _. _. $ _. DEC RETENTIONS 5 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY �\ WC STATU OTH TORY LIMITS ER YIN J ANY PROPRIETOWPARTNERIEXECUTIVE OFFICEIMEMBER EXCLUDED' , NIA ❑,. ��+ _ _ -_ ' E.L EACH ACCIDENT S iMandatory In NIH —. E.L. DISEASE If yes, describe under EA EMPLOYEE $ ESC F 02ERATIO Er- DISEASE -POLICY LIMIT $ El.,'I. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more spacers required) Certificate holder, it's officers, agents, and employees are named as Additional Insured in regards to General Liability. *30 days notice of cancellation for nonpayment. Additional Insured: City of Santa Ana, its officers, employees, agents, and representatives PO Box 1988 Santa Ana, CA 92702 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 Sarlah Devereaux-Barrientos ©1988-2010 ACORD CORPORATION. All rights re: AUUMU Zo jAUI u/ub) The AGORD name and logo are registered marks of ACORD 1001486 132849.8 01-23-2013 ADDITIONAL INSURED ENDORSEMENT Insurance Company State Farm Insurance This endorsement modifies such insurance as is afforded by the provisions of Policy #92Eoz9660 relating to the following: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, Including countersignature, is required to make this endorsement effective.) Effective 9/29/2015 policy# 92EDz9660 Issued to Carlos Madrlles ABA Downtown Stadium Grill this endorsement form as part of Name Insured Countersigned by Insurance Ag gnaturc WORKERS' COMPENSATION DE.CLARATIO,N I _ (Carlos Madriles / Ownerhereby affirm trader penalty of perjury, the NnmeTnle) following declaration I certify on behalf of Downtown Stadium Grill that during the tern of my (Collsnlfant/Company Name) contract for Food & Beverage_— services with the City of Santa Ana, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof of workers' compensation coverage. DATE: October 1, 2015_ 7 By: Name: Carlos Madriles Title: Owner Telephone: _714-262-1441______ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES t T P TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, PROOF OF INSURANCE rrcvvr yr nva urwnvc Interinsurance Exchange of the Automobile Club NAIC #: 15598 Named Insured Policy Number: CAA095289036 MADRILES, KATIE AND CARLOS Effective Date: 01-15-2015 Expiration Date: 01-15-2016 This policy provides at least the minimum amounts of liability insurance squired by the CA VEH CODE SECTION 16056 for the specified vehicles and named insureds and may provide coverage for other persons and rther vall as provided by the insurance policy. liter an accident, follow these 5 easy steps: itep 1: Get the names and addresses of all persons evolved In the accident, e.g., pedestrians, witnesses, other passengers, etc. ttep 2: Get the driver's license number and insurance )formation of the driver(s) of the other vehicle(s) vcmwuuw vry rvuv r YEAR MAKE 2001 FORD I w w x o DRIVERS ON POLICY 0 CARLOS MADRILES LL I KATIE MADRILES VEH I.D. It 1 FMNU42FOI EA39349 Step 4: Call our AAA Accident Assist Hotline at 1-800-67-CLAIM (1-800-672-5246) to report the accident and, if necessary, have your vehicle towed to the repair shop or location of your w preference w Step 5: Safely wait for the tow, truck. Our independent service 0 providers' tow trucks always display the AAA emblem LL I Do not admit responsibility for or discuss the circumstances of the accident itep 3: Write down the vehicle(s) license plate, Including with anyone other than the police or an authorized Auto Club claims tale of registration representative. Do not disclose your policy limits to anyone. Coverage subject to policy terms and limits. For questions or changes to your policy, call 1.877-422.2100, Monday through Friday from 7 a. a. to 9 p.m. or Saturday from 8 a.m. to 5 p.m. Place the Proof of Insurance in each vehicle insured under your policy. In addition, we suggest that each listed driver carry a card. Under California law, drivers and owners of a motor vehicle must be able to establish financial responsibility at all times. These cards become invalid on the expiration or termination date of the policy. PROOF OF INSURANCE Interinsurance Exchange of the Automobile Club VEHICLES ON POLICY YEAR MAKE VEH LD. p NAIC#: 16508 2001 FORD IFMNU42FOl EA39349 Named Insured Policy Number: CAA095289036 MADRILES, KATIE AND CARLOS DRIVERS ON POLICYCARLOS ge MADRILESEffective Dale: 01-15-2015 Expiration Date: Ot-15-2016 KATIE MADRILES This policy provdes at least vie minimum amounts of habllilyinsurance required by the CA VEH CODESECTION 16056 forthe specified vehicles and named insureds and may provide coverage for other persons and other vehicles as provided by the Insurance policy. __________________________________________________________________________________ _________.-__-_____--__________-- After an accident, follow these 5 easy steps: Step 4: Call our AAA Accident Assist Hotline at 1-800-67-CLAIM (1-800-672-5246) to report the accident and, if necessary, have Step 1: Get the names and addresses of all persons your vehicle towed to the repair shop or location of your involved in the accident, e.g., pedestrians, witnesses, other w preference passengers, etc. of x Step S. Safely wait for the low truck. Our independent service Step 2: Gat the driver's license number and insurance _u providers' tow trucks always display the AAA emblem information of the driver(s) of the other vehicle(s) 0 1 Do not admit responsibility for or discuss the circumstances of the accident Step 3: Write down the vehicle(s) license plate, including with anyone other than the police or an authorized Auto Club claims state of registration representative. Do not disclose your policy limits to anyone, Coverage subject to policy terms and limits. For questions or changes to your policy, call 1-877-422-2100. Monday through Friday from 7 a.m. to 9 p.m. or Saturday from 8 a.m. to 5 p.m. ____________________________________________ __ LCAA0805A. 620710701 8165 (8n0)