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HomeMy WebLinkAboutTRES ESTRELLAS DE ORO- 2015MAYOR Mgml A. �ulido MAYOR PRO TEM Michete Martinez COON 0LMEMSERS P, Nvid Semavides Virente Samilento Jose solmlo Sal Tinalero Juan vlflrjqas Jose GLIZIllan Tres Estrellas de Oro, Inc. 2414 E, FlorcnoAvellue Huntington Park, CA 90255 CITY OF SANTA ANA PUBLIC WORKS AGENCY ?0 Civir, Center maza m-29 o P.O. Box 1988 m,,29 Santa Ana, Cafilomia 92702 January 18, 2017 Re. Mist Extension the (-'jti, of s de 0�to lite N -201-5-284 � o A � Dear Mr, Guzrywn: A - Z-0 15- �-;z r2L4 -cp I Ana CITY MAN SER David Cat ozas CITY ATT C RNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria 0. Htjizar As permitted by Scetion 5 of the abtWe-rdemiced lease agreement dated Dcccmber li"), 2015 ("Loase"), the City lijs provided TreS Estrclks de 01-() the Option (o extend the ten,n of flie Lease I'm a onc-year period. Tres Fstrelfas de Oro hls [Igrccd to this option period. Accordingly, 1he term of the 1,cisc is licreby cNteadcd for the ont,-year period from January 1, 20.17 throup.11 Decembl�r 31, 2017. The ms-urance �11'c reqUired to be extelided a,ndlor renewed . 0 cover this cxMision. All other wrim, and conditions of [1) 1;j-efmu-Tm-rtjrj-�Ujd and ill ft 11 force and effect. 11 4 Mousavipour, E,-wcutive Director'C,,V41mllsav Public Works Agency CITY OF SANTA� A ROB�R T 6-.'O R T E Z , Deputy ( f APPROVED AS TO rORM Assistant Crtv Attorney TRES EST111U.A. S DE ORO 10SC, Title: x, —I ATTE,ST 'N'laria D. )-1UI,ZrAr, Clerk of(I-ic Council Cr.: N1,111 (31W11114M, GOWN; 'C GrOUJ) SANTA ANA CITY COUNCIL Mgvol A PuMo hkcheta, Mekninez VIE Gnte SamiAnto 5oPGrio P DwW Fjo0avrdem, Juan vllwps Mayor Wyof Ne Tem, WaW 2 ward I w-wd F, 2mlt m& -k 1pgfA�!�f._eag A�� �Banq-Anff ofq asm_qq 11 4 CERTIFICATE OF LIABILITY INSURANCE D0n�rznl 410 512 0 1 YYI r 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 COVE=RAGE 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(fes) must be endorsed, If SUBROGATION iS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A Statement an this certificate does not confer rights to the certificate holder in Ileu of such endorsemont(s), PRODUCER CHRISTOPHER FERRARO JRX 5tatehrm 25909 PALA STE 160 ` MISSION VIEJO CA 92691 _ IN�&OWNTe�OTChris Ferraro _ 4 ,949-586-7060 �x�Np;949.58t3 1227 A OAR19 . chrls@ChrIsferrarojr,com 1. INSURE1. RS AFFORDINOMVERAGE NA1Cq INSURER A.State Farm General insurance Company 26161 INSURED TRES ESTRELLAS DE ORO 2414 E FLORENCE AVE HUNTINGTON PARK, CA 90255 INSURER B: INSURER C;— INSURER D: INSURER E: INSURER F COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER! TMS 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 N MAY HAVE BEEN REDUCED BY PAID CLAIM$, INTR TYPE. OF INSURANCEAD KN POLICYNUMeER POLICY EFF MM100 PO 1 Y EXP M tap LIMITS A X CQMMFRCIAL 0ENERAL LIABILITY CLAIMS -MADE 7V7 CCCUR 52EMFG279 06/1412016 06110/2017 EACH OCCURRENCE $ 3,000,000 PREMIS laoevrreen e ' a 300,000 GeNT MED EXP Ary onepersonS 6,000 _ PERSONAL SADV INJURY $ 3,000,000 AGGREGATE LIMIT APPLIES Ppii POLICY Ll dECf F LOC OTHER: GENERAL AGGREGATE $ 0,000,000 PRODUCTS-CCMPIOPAGG $ 6,000,000 Business Property $ 10,000 A AUTOMOWLE W � LIABILITY ANYAUTO ALLOWNED SCHEDULED AUTO$ AUTOS AUTOS 1JED HfREDAllTOS AUTOS 92EMF6279 06110/2016 0611012047 EP M_ SI L LI t g 1,000,000 1100ILY INJURY (Perperwnl S 1,000,000 E 1 T,000,000 aOOILY INJURY Per aceldonl $NON-M PROPERTY pAMA E er cci t S S U47eRELLAL1AeOCCUR EXCESS LIAR HCLAIMS-MADE -EACH OCCURR5NGE S AGGREGATE S OED I J RETENTION G. WORKERS COMPENSATION AND EMPLOYERTUABILITY YIN ANY PROPRIETOWPARTNERIEXEGUTIVE OFFICER/MFMOCR ECGUtIDED? ILI (MandatorylnNN) 11 yyes descdbe under 17ESRIPTION pF pPERMONS below NIA 92 -EP -J387_0 00/Q2/2016 0610212017 x PER STATIiTE ER !IL. EACH ACCICENTb 1,000,000 E,t.DISEASE - PA EMPLOYEE S 1,000,000 ----- E.L. DISFA.SppE • POLICY LIMIT $ 1,000,000 REVIEWED BY: EUNiCE HEREDIA (PG .l OF. J) DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Addittonal Remarks Schedule, may be altachnd It more ppagp in roqulred) reference license A-2015-283 and lease 2015"-284 I1= YIi31,.Ljmm THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES AND AGENTS 20 CIVIC CENTER PLAZA (M21) SANTA ANA, CA. 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL Brr DELIVERED IN AC,0ClRDANGF WITH "IF POLICY PROV[81ONS--� A(l't"iQ}"RZE' RR+F.'M �:E(NNT�A^T�I^VE r t^ DTgitally{yl�nod by C1151 rara.Jr Chi >i 1 I �7 1 e I f a 1� �„� 1 DN: cn�Chrls Fmrr&ro Jr, a, au, amail�chrta,tarrara jrrxttar�stmararm.com, c�US Hata: znl.a.s�.ao is�2a::I� -0sno Q1 ACORD 25 (2014101) The AGORD name and logo are registered marks of ACORD 1001488 132849,0 02-04-2014 SIA Policy No. 92EMFE279 FERRARC-JR, C9RISTOPEER 3991.-F CMP -4860,1 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CMP -4860.1 ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 92EMT'6279 Named Insured: GUZMAN, FOSE DSA TRES ESTRELLAS DE ORO Name And Address Of Additional Insured Person Or Organization: THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES & AGENTS 20 CIVIC CENTER PLAZA STE M21 SANTA ANA CA 92701--4058 1. SECTION It --- WHO IS AN INSURED of SECTION 11 LIABILITY is amended to in- clude, as an additional insured, any person or organization shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", or "personal and advertis- ing injury" caused, in whole or in part, by: a, Premises And Ongoing Operations Your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connection with your premises; or (2) In the performance of your ongoing operations; or b. Products–Completed Operations "Your work" performed for that additional insured and included in the "products - completed operations hazard". However, Paragraph 1, above is subject to the following: a. The insurance afforded to the additional insured only applies to the extent permit- ted by law; b. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance provided to the additional insured will not be broader than that which you are required by the con- tract or agreement to provide for such ad- ditional insured; and c, If the contract or agreement between you and the additional insured is governed by California Civil Code Section 2782 or 2782,05, the insurance provided to the additional insured is the lesser of that which: (1) Is allowed for the satisfaction of a de- fense or indemnity obligation by Cali- fornia Civil Code Section 2782 or 2782.05 for your sole liability; or (2) You are required by contract or agreement to provide for such addi- tional insured. We have no duty to defend or indemnify the additional insured under this endorsement I.tn- til a claim or "suit" is tendered to us. C�, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of InSUrenGe Services Office, Inc- with Ifs permission. CONTINUED RE�IiEt lEU BYE -UNICE € t -REQ[A (Pr. CaF . AL COR© `tea..•.—' CERTIFICATE OF LIABILITY INSURANCE DATE 15/ 2017 Y) 68/15/2017 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 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 CHRISTOPHER FERRARO JR StateFarm 25909 PALA STE 160 MISSION VIEJO CA 92691 CONTACTChris Ferraro Jr NAME: PHONE 949-586-7060 ac No ;949-586-1227 ADDRESS: chris@chrisferraroir,com INSURERS AFFORDING COVERAGE NAIC4 INSURER A:State Farm General Insurance Company 25151 INSURED TRES ESTRELLAS DE ORO 2414 E FLORENCE AVE HUNTINGTON PARK, CA 90255 INSURER B: INSURER C: INSURER D: INSURER E; INSURER F; CnVF_RAGF9 CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE D L SUBR POLICY NUMBER MM ODfLICY'lYYY POLICY M DDmYY LIMITS A I X COMMERCIAL GENERAL LIABILITY CLAIMS MADE �X OCCUR92-EM-F627-9 Date: 20t5.12,3018:24:47 -08'00' 06/10/2017 06/10/2018 EACH OCCURRENCE $ 3,ODO,000 DAMAGE TO REN - PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 3,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY LlPRO JECT ❑ LOC OTHER: GENERAL AGGREGATE $ 6,000,000 PRODUCTS-COMPIOP AGG $ 6,000,000 Business Property $ 10,200 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON-OWNED HIRED AUTOS AUTOS Ix 92 -EM -F627.9 06110/2017 06/10/201$ Ea acctNED accident) LIMIT $ 3,000,000 BODILY INJURY (Per person) $ 3,000,000 BODILY INJURY (Per accident) $ 3,000,000 PROPERTY DAMAGE $ Per accident $ l UMBRELLA LIAR EXCESS LIAB HOCCUR CLAIMS -MADE EACH OCCURRENCE It AGGREGATE $ DEP RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABIL TY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMSEREXCLUDED? Y❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 92 -EP -J387-0 0$(0212017 0$!021201$ X SEATUTE ETH IR E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) REFERENCE LICENSE A-2015 AND LEASE 2015-284 REVIEWS[ BY:X EUNICE HEREDfA (PC OF� ) r`.FRTIFICATF 14r11 r1FR CANCELLATION ADDITIONAL INSURED' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AND AGENTS Al: DANC): WITH T POLICY PROVISIONS. 20 CIVIC CENTER PLAZA (M21) SANTA ANA, CA. 92702 RIZEp REPRESENTATIVE Digitally i ed by Chris Ferraro Jr `fiJr ON: cn=Chris Fenaro Jr, o, ou, Ferraro Vemail=chris.ferrarro Arl Se ir.rktf@statefarm.com, c=US Date: 20t5.12,3018:24:47 -08'00' O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 RM Policy No. 92 -EM -F627-9 AGT 3991- FA64 CMP -4860.1 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CMP -4860.1 ADDITIONAL INSURED -•-- DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 92 -EM -F627-9 Named Insured: GUZMAN, JOSE DBA TRES ESTRELLAS DE ORO 2414 E FLORENCE AVE HUNTINGTON PK CA 90255.5727 Name And Address Of Additional Insured Person Or Organization: THE CITY OF SANTA ANA ITS OFFICERS EMPLOYEES & AGENTS 20 CIVIC CENTER PLZ STE M21 SANTA ANA CA 92701 4058 1. SECTION II ---- WHO IS AN INSURED of SECTION II --- LIABILITY is amended to in= clude, as an additional insured, any person or organization shown in the Schedule, but only with respect to liability for "bodily injur)r", "property damage", or "personal and advertis- ing injury" caused, in whole or in part, by: a. Premises And Ongoing Operations Your acts or omissions or the acts or omissions of those acting on your behalf: (.1) In connection with your premises; or (2) In the performance of your ongoing operations; or b. Products—Completed Operations "Your work" performed for that additional insured and included in the "products - completed operations hazard". However, Paragraph 1. above is subject to the following: a. The insurance afforded to the additional insured only applies to the extent permit- ted by law; b. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance provided to the additional insured will not be broader than that which you are required by the con- tract or agreement to provide for such ad- ditional insured; and c. If the contract or agreement between you and the additional insured is governed by California Civil Code Section 2782 or 2782.05, the insurance provided to the additional insured is the lesser of that which: (1) Is allowed for the satisfaction of a de- fense or indemnity obligation by Cali- fornia Civil Code Section 2782 or 2782.05 for your sole liability; or (2) You are required by contract or agreement to provide for such addi- tional insured. We have no duty to defend or indemnify the additional insured under this endorsement un- til a claim or "suit" is tendered to us. (0, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CONTINUED REVIEWED BY: EUNICE HEREDIA (PG 2GF� ) 2. Any insurance provided to the additional in- sured shall only apply with respect to a claim made or a "suit' brought for damages for which you are provided coverage. This endorsement shall not increase the ap- plicable Limits Of Insurance shown in the Declarations. 3. With respect to the insurance afforded to the additional insured, the following is added to SECTION If — LIMITS OF INSURANCE: If coverage provided to the additional insured is required by contract or agreement, the most we will pay on behalf of the additional insured will be the lesser of the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits Of Insurance shown in the Declarations. This endorsement shall not increase the ap- plicable Limits Of Insurance shown in the Declarations. 4. With respect to the insurance afforded to the additional insured, the following is added to Paragraph 3. Duties In The Event Of Occur. rence, Offense, Claim Or Suit of SECTION II — GENERAL CONDITIONS: The additional insured must: a. See to it that we are notified as soon as practicable of an "occurrence or an of- fense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the `occur- rence" or offense took place; (2) The names and addresses of any in- jured persons and witnesses; and CMP -4860,1 Page 2 of 2 (3) The nature and location of any injury or damage arising out of the "occur- rence" or offense; b. Tender the defense and indemnity of any claim or "suit' to us and to all other insur- ers who may have insurance potentially available to the additional insured; and c. Agree to make available any other insur- ance the additional insured has for de- fense or damages for which we would provide coverage under SECTION 11 — LIABILITY. 5. With respect to the insurance afforded the ad- ditional insured, the following replaces SEC- TION 11 — LIABILITY of Paragraph 7. Other Insurance of SECTION I AND SECTION II — COMMON POLICY CONDITIONS: a. This insurance is primary to and will not seek contribution from any other insur- ance available to the additional insured, provided that the additional insured is a named insured under such other insur. ance. b. Regardless of any agreement between you and the additional insured, this insur- ance is excess over any other Insurance whether primary, excess, contingent or on any other basis for which the additional In- sured has been added as an additional in- sured on other policies. There will be no refund of premium In the event this endorsement is cancelled. All other policy provisions apply. CMP -4860.1 1007042 148020 08-26-2014 0, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. REVIEWED BY: EUNICE HEREDIA (PGS p )