Loading...
HomeMy WebLinkAboutMARK THOMAS & COMPANY (2)P� City of Santa Ana ' ` '�. t Clerk of the Council corc Office usa only AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in e!fect. ng DEC 123 AM 9- fig Note: If your agreement is grant related, please ensure that all grant retention requiremet t have been satisfied prior to signing the termination fcrm. ll::!! Y OF q t ! TAANA CLERK i��G(TtJN {( Is the agreement(s) a permanent record? Yes _ No Return form to the Clerk of the Council Office (M-30).. Call 647-1520 it you have any questions / } n t The agreement with 1 f�'l� ✓ `1 rS _ c`` ! "j63, No. /%_l a�s — / 7 3 was completed on 0 S and final payment has been made. (List aU amendments. Use space below if needed.) 71� _ r 73 --0 Ra,!sed: 10-13-16 Department: LIlUIT (-?/v Phone/Ext.: Signature: Date: MAYOR Miguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorlo Sal Tinajero Juan Villages CITY OF SANTA ANA 20 Civic Center Plaza Y P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.org July 5, 2017 Robert A. Himes, PE President/Principal in Charge Mark Thomas & Company 16795 Von Karman Avenue, Suite 200 Irvine, CA 92506 Reference: First Extension of Consultant Agreement No. A-2015-1.73 Dear Mr. Himes: A-2015-173004 ACTING CITY MANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar Pursuant to Section 3 of Agreement No. A-2015-173, entered into by Mark Thomas and Company and the City of Santa Ana, dated August 5, 2015, the term of the Agreement is hereby extended for an additional one (1) year period from August 6, 2017 to August 5, 2018 to cover existing services that are on-going on the date of this extension. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Since red Mousavipour Executive Director Public Works Agency CITY OF SANTA ANA Cynttla J. Kurtz Acting City Manager APPROVED AS TO FORM Jo . Funk Assistant City Attorney ATTEST ��i v Maria D. Huizar / Clerk of the Council SANTA ANA CITY COUNCIL INSURANCE ON FILE WORK AMY PROCEED UN11L INSURANCE. EXPIRES CLERK Or CUNCiL DATE: 7' �li 7 Miguel A. Pulido Michele Martinez Vicente Sarmiento Jose Saluda P. David eenavides i Juan Villages i Sal Tinajero "Awrof I Mayor Pro Tem, ward 2 I 6Iard1 ward3 i Wardd i wards i Ward tv, d sania-gn�� l�Mari � a t ora tb_am,ter o�santa-ena wa i, .�' aanta ryna-� i ate° r it�nta-ane oo 7 JVi ��san#a-ana o� S�j# roCa�sanla-snp.clq ACG►RU0 CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DDYYYY) r �. 9/15/2017 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 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). Asero Insurance Services 200 N. Almaden Blvd. 3rd Floor San Jose, CA 95110 CONTPRODUCER NAME: Asero Insurance Services PHONEFAX (A/C. No Ext): 866-966-8928 A/c No): 408-271-1802 E-MAIL ADDRESS: certs@aseroins.com INSURER(S) AFFORDING COVERAGE NAIC # 680-28548914 _ INSURER A: Travelers Property Casualty Co of Alner 25674 www,aseroins.com License No. OA91339 INSURED Mark Thomas & Company Inc. 2290 North First Street, Suite 304 INSURERB: Travelers Indemnity Company of CT ' 25682 INSURER C INSURER D: San Jose CA 95131 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER 3773R9C1R RFVISION NIIMRFR- 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. TIL TYPE OF INSURANCE ADSL BR POLICY NUMBER EFF MMIDD YYYV MMIDDYPOLICY POLICY YY IY LIMITS B ✓ COMMERCIAL GENERAL LIABILITY �/ �/ 680-28548914 9/15/2017 9/15/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑✓ OCCUR DAMAGES ( RENTED PREMISES Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY✓❑ JE� ❑✓ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY BA -68189707 9/15/2017 9/15/2018 Ea sBINEDtSINGLE LIMIT $ 1,000 000 BODILY INJURY (Per person) $ ✓ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED ✓ AUTOS ONLY ✓ AUTOS ONLY ( Perr ac is den DAMAGE $ Comp/Coll Ded: $1,000 $ A ,/ UMBRELLA LIAB �/ OCCUR SCUP -9E095562 9/15/2017 9/15/2018 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 '.. EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? ❑ N / A ✓ XJUB4342T25017 9/15/2017 9/15/2018 �/ STATUTE EERH EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEEI E.L. DISEASE - POLICY LIMIT — $ 1,000 000 1$ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Job #IR -15103 On -Call Engineering Services The City of Santa Ana, its officers, employees, agents, volunteers and representatives NOTE: 30 DAYS NOTICE OF CANCELLATION WILL BE GIVEN EXCEPT 10 DAYS FOR NON-PAYMENT. REV9 WED BY: ,0 E. UNICE I-IERE:DIA (PG OF ) L.tK 1 It-IUA I C riULUCK L ANI;t LLA I IUN Job #IR -15103 City of Santa Ana 20 Civic Center Plaza 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'^ Joe Longwello ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 3773;296I HARKT-1 1 17/18 10a:3ter Certificate ' Stephanie Scheller 1 9/15/2017 10:21.:21 All (PD7') I Page 1 of 10 AGENCY CUSTOMER ID: MARKT-1 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Asero Insurance Services NAMED INSURED Mark Thomas & Company Inc. 2290 North First Street, Suite 304 San Jose CA 95131 POLICY NUMBER CARRIER JRAIC CODE EFFECTIVE DATE: AUDI I IUINAL KtIV1AKMb THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Santa Ana ADDRESS: 20 Civic Center Plaza Santa Ana CA 92702 General Liability Waiver of Subrogation / Primary & Non -Contributory as required by written contract per form CG D3 81 09 07 Commercial Auto Liability Additional Insured / Waiver of Subrogation as required by written contract per form CA T3 53 02 15 Workers' Compensation Waiver of Subrogation as required by written contract per form WC 99 03 76 (A)-001 General Liability Additional Insured per form CG 20 10 10 01 REVIEW EI BY V E UNICE HEREDIA (PG OF C ACORD 101 (2008/01) Q 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHMENT 377;P296 1 HARRT-1 117/18 Meat C-Tt1.`.ioat8 I S ephan,, S hellY 19/15/2017 10:21:21 AM (PDT) I Fagg 2 of 10 AGENCY CUSTOMER ID: MARKT-1 LOC #: Page of AGENCY Asero Insurance Services NAMED INSURED Mark Thomas & Company Inc. 2290 North First Street, Lte 304 Suite San Jose CA 95131 POLICY NUMBER CARRIER I NAIC CODE I I EFFECTIVE DATE: ---I I lwllmM� THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Santa Ana ADDRESS: 20 Civic Center Plaza Santa Ana CA 92702 THIS PAGE INTENTIONALLY LEFT BLANK REVIEWED BY: zLJNICE HEREDIA (PG3 OF AUUKL) 1U1 (ZUUZ51U1) @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHMENT 37739296 1 HARFI-1 [ 1"7/18 M8.5ter Certificate I Stephanie Scheller 1 9/15/2017 10:21:21 AIH (PLIT) I Page 3 of 10 GENERAL PURPOSE ENDORSEMENT OFFICE PAC PLUS INSURED: Maris Thomas & Company, Inc. POLICY NUMBER: 680-21-1548914 ISSUE DATE: 09/15/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION THIS ENDORSEMENT MODIFIES INSURANCE PROVIDER UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON OR ORGANIZATION: CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES 20 CIVIC CENTER PLAZA, SANTA ANA, CA 92702 (IF NO ENTRY APPEARS ABOVE, INFORMATION REQUIRED TO COMPLETE THIS ENDORSEMENT WILL BE SHOWN IN THE DECLARATIONS AS APPLICABLE TO THIS ENDORSEMENT.) A. SECTION II - WHO IS AN INSURED 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 ONGOING OPERATIONS PERFORMED FOR THAT INSURED. B. WITH RESPECT TO THE INSURANCE AFFORDED TO THESE ADDITIONAL INSUREDS, THE FOLLOWING EXCLUSION IS ADDED: 2. EXCLUSIONS THIS INSURANCE DOES NOT APPLY TO "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURRING AFTER: (1) ALL WORK, INCLUDING MATERIALS, PARTS OR EQUIPMENT FURNISHED IN CONNECTION WITH SUCH WORK, ON THE PROJECT (OTHER THAN SERVICE, MAINTENANCE OR REPAIRS) TO BE PERFORMED BY OR BEHALF OF THE ADDITIONAL INSUREDS) AT THE SITE OF THE COVERED OPERATIONS HAS BEEN COMPLETED; OR (2) THAT PORTION OF "YOUR WORK• OUT OF WHICH THE INJURY OR DAMAGE ARISES HAS BEEN PUT TO ITS INTENDED USE BY ANY PERSON OR ORGANIZATION OTHER THAN ANOTHER CONTRACTOR OR SUBCONTRACTOR ENGAGED IN PERFORMING OPERATIONS FOR A PRINCIPAL AS A PART OF THE SAME PROJECT. CG 20 10 10 01 ISO PROPERTIES INC., 2000 CG T8 02 09 14 PAGE 1 OF 1 REVIEVVED BY: [EREDIA (PG Insured: Mark Thomas & Company, Inc. Policy: 680-21-1548914 Commercial General Liability CG D3 81 09 07 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLREASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERICAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to include as an additional insured on this Coverage Part but only with respect to liability for "bodily injury", "property damage", or "personal injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing operations b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products -completed operations hazard" Such person or organization does not qualify as an additional insured for "bodily injury", "property damage", or "personal injury" for which that person or organization has assumed liability in a contract or agreement. The insurance provided for such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. e. This insurance does not apply to the rendering of or failure to render any "professional services". f. The limits of insurance afforded to the additional insured shall be the limits which you agreed in that "contract or agreement requiring insurance" to provide for that additional insured, or the limits showing in the Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section 111) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIAIBLITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Coverage Part must apply on a primary basis, or primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance". But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer of Rights of Recovery Against Others To Us in COMMERICAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage", or "personal injury: arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with such person or E F_VIEVVE D BY: E: JNIC;E I-IEREDIA (FSG 6F J ) 37738296 1 MARKT-1 117/7.8 Master Certificate I Stephanie S21-11er 159/15/2017 10:21:21 P1✓, (PDT) I Page 4 of 10 organization entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. D. The following definition as added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract Commercial General Liability CG D3 81 09 07 Page 2 of 2 or agreement under which you are require to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and C. Before the end of the policy period. REVIEWED BY: .....--EUNICE HEREDIA (PG ,,OF" 3773:1295 7 MARHT-1 1 1-1/15 Master Cert ificat_e I Stephanie scl-iI— 19/1_i/2U17 10:'2].:21 AM (PDT) I Page 5 of 10 TRAVELERS, WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: (XJUB-4342T25-0-17) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 3 .0 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date Issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 09/15/2017 Policy No. XJUB4342T25017 Endorsement No. Insured Mark Thomas & Company, Inc. Premium Insurance Company Countersigned by DATE OF ISSUE: 09-15-17 ST ASSIGN: Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (PG 7OF� 37738296 1 MARKT-1 1 17/18 Master Certificate I Stephanie Scheller 1 9/1.5/2017 Acc a® CERTIFICATE OF LIABILITY INSURANCE 9/292017 DIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Dealey, Renton & Associates P. O. Box 12675 Oakland, CA 94604-2675 NAMEACT Doris A. Chambers PHONE 510 465-3090 FAx (� No�)' laic Ne)' EMAIL , dchembers@deafeyrenton.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:XL Specialty Insurance CO. 37885 INSURED MARKTHOMA INSURER B: Mark Thomas & Company, Inc. 2290 N. First Street INSURERC: EACH OCCURRENCE $ San Jose CA 95131 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 223923456 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. INT R TYPE OF INSURANCE I SD D POLICY NUMBER POLICY EFF MMIODIYYYY POLICY EXP MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FIOCCUR EACH OCCURRENCE $ DAMAGETORE E PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO. POLICY FI PRO- LOC GENERAL AGGREGATE $ PRODUCTS-COMPIOPAGG $ $ OTHER: AUTOMOBILE LIABILITY IN�D SINGLE LIMIT Ea accident $ _ BODILY INJURY (Per person) $ A`NY AUTO H AUTOS NED AUTOSULED HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DA AGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? N / A OTH- REVIEWED BY: EUNICE HEREDIA (PG DOF � ER E.L. EACH ACCIDENT $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYE $ E.L, DISEASE • POLICY LIMIT $ A ProfessionalLlability DPR9915552 7/1/2017 7/1/2018 $2,000,000 Per Claim $2,000,000 And Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) REF; MTC's Job #IR -15103 On -Call Engineering Services. Cancellation provisions are solely as shown on this certificate. SEE CANCELLATION SECTION of Certificate for 30 Days Notice of Cancellation. w.cr[Irri%,mi c nui-Lim c I:HNGCLLHI IVN ov vdy vo-)ut Iv vay IVr IVUnrav Of r'rem City of Santa Ana 20 Civic Center Plaza 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 U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD