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Home My WebLink AboutWM CURBSIDE, LLC. 5A-2016INSURANCE ON 1`11.6 WORI(MAY PROCEED A 2016-102 l NTIL INSURANCE EXPIRE; CLERK Or COUNCIL DATE: FIRST AMENDMENT TO AGREEMENT TO PROVIDE RESIDENTIAL UNIVERSAL WASTE COLLECTION THIS FIRST AMENDMENT TO AGREEMENT is entered into this 4TH day of May, 2016, by and between WMCurbside, Inc. ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation duly organized and existing tinder the Constitution and laws of the State of California ("City"). RECITALS A. The parties entered into Agreement A-2008-062 dated April 7, 2008, to provide universal waste collection. B. In accordance with the terms and conditions of the Agreement, the parties desire to amend the compensation and extend the Term of the Agreement. WHEREFORE, in consideration of the covenants contained in the Agreement, and subject to all the terms and conditions of the Agreement, the parties agree as follows: 1. Section 2, COMPENSATION, shall be amended to increase compensation in the amount not to exceed $25,000.00, to pay for the additional services during the extended term. 2. Section 3, TERM, shall be amended to extend the term of said Agreement period to June 30, 2018. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement the date and year first above written. ATTEST: MARIA D. HUIZAR Cleric of the Council APPROVED AS TO FORM: CITY OF SANTA ANA L1 l DAVID CAVAZOS City Manager Page 1 of 2 NZ* Sonia R. Carvalho, City Attorney Y:OVkL ef Assistant City Attorney ?NDED FOR APPROVAL: CONSULTANT FREDNOUSAVIPOUR, P.E. Executive Director of Public Works Agency By: Title: s/Jlll 144^ 46X Page 2 of 2 CERTIFICATE OF LIABILITY INSURANCE _ I oATE — THI5 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 holdor is an ADDITIONAL INSURED, the POINY(als) must be endorsed. It SUBROQATIOR IS WAIVED, subject to the terms and conditions of the policy, certain Policies may require on endorsement. A Statement on this certificate does not confer rights to the PRoouceR LOCXTON ANIES 5947 SAN FELIPPEI , SUITE 320 INDICATED. NO ANY UI OMOI,V PERIOD TERM OR CONDITION OF ANY CONTRACT OR INDICATED. NOAY DOCUMENT WITH RESPECT TO WHICH THIS TO WHICH FIOUSTONTX 77057 866-2.60.3538 EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMP SHOWN MAY HAVE BEEN REDUCEDBYPAID CLAIMS. Imauna) WASTE MANAGEMIENT HOLDINGS, ENC, &ALL APE 1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING: Wbl CURBSIDE, LLC 3gi i NUB ANAHEIM CA 92870 I`NCIVFRAP9C IS TO CERTIFY THAT THE POLICIES INSURANCE LISTED HAVE BEEN ISSUEDACT THE INSURED NAMED ABOVE FOR THE INDICATED. NO ANY UI OMOI,V PERIOD TERM OR CONDITION OF ANY CONTRACT OR INDICATED. NOAY DOCUMENT WITH RESPECT TO WHICH THIS TO WHICH BE ISSUr PERTAIN. THE CERTIFICATE MAY DE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED SV THE POLICIES DECLAIMED HEREIN IS SUBJECT 117 ALL THE TERMS, SCRIB EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMP SHOWN MAY HAVE BEEN REDUCEDBYPAID CLAIMS. ryry ILTB TYPE OFIF19UgANCB DWVU THE POLICY PROVISIONS, POLICY NUMBER PUDp YYY P060Y YVY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y HDO 627403311 111/2016 1/1/2017 EACH OCCURRENCE S 5,000,000 CL1IMB MADE a OCCUR PRE 9„'gbEA�TJ n< S DQD 000 X XCU INCLUDED MED EKP n no orlon $ xxxxXXX XJ ISO FORM C0000 10413 PERSONAL a ABV INJURY S 5,000.000 GW'L AGGREGATE LIMIT APPLIES PER: a jECI'IXI GENEPALAGGSESDATE S 6000 QQO PPGDDGiS-CphIPIOP Map 9 6 000 000 POLICY LDC OTH^P: 9 A AUTOMOBILE LIABILRY y y hIMT HORR66326 1/1/2016 1/1/2077 Ea nctldunlglNGl'c LIMIT = IQQQ QDQ X ANY ASO _ OOOtLY INJU RY[Pw,.Faq) g xX3=XX X ALL COINED SCHEDULED BODILY INJURY (Pm dcdltlanQ S X AUTOS AUTOS HIRED AUTO. X AUTOS PflOPF� o DAMAGE S XXXXi X MCS -90 g Xxxxxxx C X UMBRELLA LIAR X' OCCUR Y Y X00027929242001 1/!14.016 1/1/2017 FAC41OCCURRENCE S15,000000 ENCEa9 EIAs CLAIMS MADE AGGREGATE S I5 00Q Q Q DEO RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN CURVE ANYPROPIRCIOOFFK;EPIM Y WLRC43596769(((AOS) bl\) 1/1/2016 f2016 1/1/1017 1/112017 ST�iDT EPR D FIMREPE CWDE04 NIA SCP C48596R4R0(yl) I/U2010 1/1120❑EL EACH ACCIDENT s 3,000,000 E.L.OIBEADE F1p Eq P1.0YEE 5 3 000 000 (Mandatory 1-M, IIvea d.P1IA6 undor DESCRIPTION OF DPEPATID9B Colow E,L. OIBEABE- POLICY L1Mn 83000000 _ _ A EXCESS ALTOY Y XSA HOS866314 1/112016 Ut/2517 COMBINED SINGLE LLNI'1' LIABILI'T'Y .$9,000,000 (EACH ACCIDEN't) IN II mereapaaa la .',,plod) 3LANKPT1V NER OFSURR/LOCATIOFIS ORANILea FAVACWTIaal CKIIPR LEROmayL POLICIES ¢ W1NKti1' WAIVER OF SUHROOATION IS URAN'I'ED IN FAVOR OF CL'Itl'IRICAI'R HOLDER ON ALL POLICIES V/II¢ON AND TO'I'HE E.X'I'ENP DEQUIRen EY WRITTEN CDMI'lb CT WHERE PERMISSIBLE BY LAW CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL NSUR¢D (EXCEPT POR WORKERS' COMPIfiL) WHERE AND'EOTIIE EXTENT REQUIRED ¢Y WRITTEN CONTRACT. ADDITIONAL INS IIR¢D N FAVOR OF CITY OF SAMA ANA, IIS OFFICERS, EMPLOYEES, AGEN73, VOLUNTEERS AND RFPRESUNTATTVE5 (ON ALL POLICIES EXCRFT 101ICERS- COM PENSATIONJEL) WIERB REQUIRE'U EY Warm 2N CON'mACr. WA NU OF SLID ROCIATION IN FAVOR OF CITY OF SANTAANA, T'I'9 OFFICERS, EMPLOYEES, AGENT'S, VOLUN'IEBItS AND REPRESENTATIVES ON ALL PO LICKS All WRE REQUIRED BY WR G1T?N CONT'RACr WIROR PERMISSIBLE RY LAW. THE INSURANCE AFFORDED TO THE ADDITIONAL INSURED AS DLSCRIB ED TWICE CL'RTIRCATE OF INSURANCE FOR WORK PERFORMED BY TI IE NAMED INSURED IS PRO&URY AND NON-CONTR MOTO RY TO ANY SI MILAIt COVERAGE NIIDITNNED GY TI IC ADDITIONAL INSURED WHERE AND To Ti!R EXTENT RUQUIRED R\' CON'VRACL 11D76601 CITY OP SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES UP CANCELLED BEFORE DEPARTMENT OI'PUBLIC WORKS THE EXPIRATION DATE THEREOF, NO'T'ICE WILL ME DELIVERED IN ACCORDANCE WITH ATTN: CHRISTYIffiNDIG THE POLICY PROVISIONS, 20 CIVIC CENTPR PLAZA, M-21, AUTHOn1ZCD 9EPH8TENTA1DW- SANTA ANA CA 92702 vnrvnNIIVIV, All rignte roserved. ACCRUE 25 (2014/01) The ACORD name and logo Bre registered marks of ACORD LE\/IEIP✓ED E3'C_ EUl`iICE tiE'rZEDIA (PG /or- ) POLICY NUMBER; HDO G27413311 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization; ANY OWNER, LESSEE OR CONTRACTOR WHOM YOU HAVE AGREED TO INCLUDE AS AN ADDITIONAL INSURED UNDER A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR To THE DATE OF LOSS. (if no entry appears above, information required to complete this endorsement would be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section il) Is amended to include as an insured the person or organization shown In the Schedule, but only with respect to liability arising out of "your work" for that insured by or'for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 AM7ohmeaf Code: D446557 MastorLD; 1366006, Certificate rD: 1107d601 REVIEWED BY: _EUrJICE HER_D1.1 (aG 2OFS ) POLICY NUMBER; HDO G274033'11 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modltlea Insurance provided under the inllowing; COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name ur parson or Organization: ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS, The following is added to Paragraph 8, Transfer Of Rights Of Racovory Agalnst Others To Us of Section IV • Conditions; We waive any right of recovery vee may have against the person or organization shown in the Schedule above because of payments we Malta for injury or damage arising out of your ongoing operations or "you work" done under a contract with 1175t person or organization and Included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in [he Schedule above, CG 24 04 05 09 Copyright, insurance Services Office, Inc„ •1984 Attachment Code; 174,13223 Certificate ID: 11076601 i REVi�PdED _ EUPIICI_FIEP,EDL4 PG>OF-2 C j V 'L �� ( 3 J) AC"R& CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) �._.- 1/l/2018 12/7/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). LOCKTON COMPANIES 5847 SAN FELIPE, SUITE 320 HOUSTON TX 77057 866-260-3538 CONTPRODUCER NAME: T P o A/C, NE No, F Ext): AIC, No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 INSURED WASTE MANAGEMENT HOLDINGS, INC. & ALL AFFILIATED, 1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING: WM CURBSIDE, LLC 5101 E. LA PALMA AVENUE ANAHEIM CA 92870 INSURER B: Indemnity Insurance Co of North America 43.575 INSURER C: ACE Property & Casualty Insurance Co 20699 INSURER D: ACE Fire Underwriters Insurance Company 20702 INSURER E: INSURER F: nnVFRAQFR CFRTIFICATF NIIMRFR• 11076601 RFVIRIAN NIIMRFR• XXXXXXX 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL OE NERAL LIABILITY Y Y HDOG27860825 I/I/2017 1/1/2018 EACH OCCURRENCE 5,000,000 CLAIMS -MADE OCCUR 1 DAMAGE TO RENTED PREMISES Ea occurrence $ 5,000,000 MED EXP An one person) XXXXX X XCU INCLUDED X ISO FORM CG00010413 PERSONAL & ADV INJURY s 5,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO - LOC GENERAL AGGREGATE s 6,000,000 PRODUCTS - COMP/OP AGG s 6,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y MMT 1-109052884 1/1/2017 1/1/2018 Ea COMBINED I EDSIN LE MIT $ 11000,000 BODILY INJURY (Per person) $ XXXXXXX 1xxxANYAUTO AAUTOSDONLY AUTODULEDBODILY INJURY (Per accident $ XXXXXXX AUTOS ONLY X AUUTOS ONLYY Pe�accltlenDAMAGE$ XXXXXXX $ XXXXXXX MCS -90 C X UMBRELLA LIAB}{ OCCUR Y Y XOOG27929242002 1/1/2017 1/1/2018 EACH OCCURRENCE $ 15000,000 AGGREGATE $ 15,000,000 EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ XXXXXXX S A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBEREXCLUDEDP N❑ (Mandatory In NH) N/A Y WLR C49106944 (ADS) WLR C49106907(AZ,CA,&MA SIZE C49106981 (WI) 1/1/2017 (/1/2017 1/1/2017 1/1/2018 1/1/2015 I/1/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 3'000"000 E.L. DISEASE - EA EMPLOYEE $ 3,000,000 If yes, describe under DESCRIPTION OF OPERATIONS baiow E.L. DISEASE- POLICY LIMIT 3,000,000 A EXCESS AUTO LIABILITY Y XSAH09052872 1/1/2017 1/1/2018 COMBINED SINGLE LIMIT S9,ODU,000 �_y (EACH ACCIDENT) DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' C'ObIP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. ADDITIONAL INSURED IN FAVOR OF CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS. VOLUNTEERS AND REPRESENTATIVES (ON ALL POLICIES EXCEPT WORKERS' COMPENSATION/EL) WHERE REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION IN FAVOR OF CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW. THE INSURANCE AFFORDED TO THE ADDITIONAL INSURED AS DESCRIBED IN THIS CERTIFICATE OF INSURANCE FOR WORK PERFORMED BY THE NAMED INSURED IS PRIMARY AND NON-CONTRIBUTORY TO ANY SIMILAR COVERAGE MAINTAINED BY THF. ADDITIONAL INSURED WHERE AND TO THE EXTENT REQUIRED BY CO TRACT REVIEWED BY-, NICE 4 VE REDIA (M.,, � OF �� ) 11076601 CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS ATTN: CHRISTY KENDIG 20 CIVIC CENTER PLAZA, M-21 SANTA ANA CA 92702 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988-2015 ACORD CORPORATI All rinhta racprvprf The ACORD name and logo are registered marks of ACORD POLICY NUMBER: HODG27VUO825 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES KJR CONTRACTORS (FORM 13\ This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name ofPerson orOrganization: ANY OWNER, LESSEE DRCONTRACTOR WHOM YOU HAVE AGREED TO INCLUDE AS AN ADDITIONAL INSURED UNDER A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TOTHE DATE OFLOSS. (If no entry appears 8bOVe. iOfOnn8UOD required to complete this endorsement would be shown inthe Declarations 8Sapplicable tOthis endOrSnnnent] WHO |8/\N INSURED (Section ||\iSamended t0 include ae8n insured the person or organization Sh0vvD in the Schedule, but only with respect to liability 8hSiDg Out of "your work" for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Auudooco Code :D446j57 REVIEWED BY: EUNICE HERE. -HAA (PG f. POLICY NUMBER: HDOG27880825 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Name Of Person Or Organization: ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following inadded (nParagraph B.Transfer Of Rights Of Recovery Against Others ToUsnf Section K/ -Conditions: VVawaive any right ofrecovery wmmay have against the person ororganization shown inthe Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under ocontract with that person ororganization and included inthe ^pmduots-comp|etod oporaUonohazan1^ This waiver applies only to the person or organization shown in the Schedule above. CG24O4OSOS Copyright, Insurance Services Office, |no,1984 Attachment Code :D448223 REVIEWED BY: ACORO° CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DDNYYY) 1/1/2019 12/11/2017 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 have ADDITIONAL INSURED provisions or 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 LOCKTON COMPANIES 3657 BRIARPARK DRIVE, SUITE 700 HOUSTON TX 77042 866-260-3538 NCONTACT AME: AIC No,Ext): AIC No: E-MAIL ADDRESS: INSURER(Sl AFFORDING COVERAGE NAIC # HDOG27873091 INSURER A: ACE American Insurance Company 22667 1/1/2019 INSURED WASTE MANAGEMENT HOLDINGS, INC. & ALL AFFILIATED, 1306000 RELATED & SUBSIDIARY COMPANIES INCLUDING: WM CURBSIDE, LLC 5101 E. LA PALMA AVENUE ! 03 INSURERB : Indemnity Insurance Cc of North America 43575 INSURERC: : ACE Fire Underwriters Insurance Company 20702 INSURER D : INSURER E: ANAHEIM CA 92870 / / OWI �4A INSURERF: COVERAGES CERTIFICATE NUMBER: 11076601 REVISION NUMBER: XXXXXXX 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 INSD SUER WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y HDOG27873091 1/1/2018 1/1/2019 EACH OCCURRENCE 5,000,000 CLAIMS-MADEFyl OCCUR X DAMAGE TO RENTED PREMISES Ea occurrence 5,000,000 MED EXP (Any oneperson) XXXXXXX X XCU INCLUDED PERSONAL & ADV INJURY $ 5,000,000 X ISO FORM CG00010413 GEN'L AGGREGATE LIMIT APPLIES PER: POUCYF�E� LOC GENERAL AGGREGATE $ 61000000 PRODUCTS-COMP/OPAGG $ 6,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y MMT H25097890 1/1/2018 1/1/2019 Eeaecld DISINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ XXXXXXX X AAUTOS ONLY SCHEDULED BODILY INJURY (Per accident $ XXXXXXX X AUTOS ONLY X AUUTOS ONLY Pe�accldenDAMAGE $ XXXXXXX X MCS -90 $ XXXXXXX A X UMBRELLA LIABX OCCUR Y Y XOO G27929242 003 1/1/2018 1/1/2019 EACH OCCURRENCE $ 15,000 000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 15 000,000 DED I I RETENTION $ $ XXXXXXX 1 B A C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIEfOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N❑FN/ (Mandatory In andNH) If yes, describe under DESCRIPTION OF OPERATIONS below Y WLR C6462278A (AOS) WLR C64622778 AZ,CA,&MA SCFC64622791 (WI) 1/1/2018 1/1/2018 1/1/2018 1/1/2019 1/1/2019 1/1/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 3,000,000 E.L. DISEASE - EA EMPLOYEE $ 3,000,000 E.L. DISEASE - POLICY LIMIT 3 OOO,OOO A EXCESS AUTO LIABILITY Y XSA H25097889 1/1/2018 1/1/2019 COMBINED SINGLE LIMIT $9,000,000 (EACH ACCIDENT) DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED (EXCEPT FOR WORKERS' COMP/EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. ADDITIONAL INSURED IN FAVOR OF CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES (ON ALL POLICIES EXCEPT WORKERS' COMPENSATION/EL) WHERE REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION IN FAVOR OF CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ON ALL POLICIES WHERE REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW. THE INSURANCE AFFORDED TO THE ADDITIONAL INSURED AS DESCRIBED IN THIS CERTIFICATE OF INSURANCE FOR WORK PERFORMED BY THE NAMED INSURED PRIMARY AND NON-CONTRIBUTORY TO ANY SIMILAR COVERAGE MAINTAINED BY THE ADDITIONAL INSURED WHERE AND TO THE EXTENT REQU BY CONTRA/CT�. 44A CERTIFICATE 11076601 CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS ATTN: CHRISTY KENDIG 20 CIVIC CENTER PLAZA, M-21 SANTA ANA CA 92702 ACORD 25 (2016/03) T16K • See U' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988-2015 ACORD CORPORATI0% All rights reserved The ACORD name and logo are registered marks of ACORD Attachment Code : D446557 Master ID: 1306000. Certificate ID: 11076601 POLICY NUMBER: HDO 627873091 Endorsement Number: 37 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS LESSEES OR CONTRACTORS - (Form B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Any Owner, Lessee or Contractor whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. CG 20 10 1185 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 Attachment Code : D448223 Certificate ID : 11076601 POLICY NUMBER: HDO 627873091 Endorsement Number: 50 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 O,r!I lz Yv'YLe'0f4 ��. �0