HomeMy WebLinkAboutINTERNATIONAL BUS LINES, INC.-.i
INSURANCE NOT ON FILE A-2017-260 � �
WORK MAY NOTPROCEED
CLERK OF COUNCIL i
DATE: OCT 2 4 2017
o �� v A l 5
LICENSE AGREEMENT BY AND BETWEEN THE CITY OF SANTA ANA
AND INTERNATIONAL BUS LINES, INC. FOR USE OF THE SANTA ANA
REGIONAL TRANSPORTATION CENTER FACILITIES t
This LICENSE AGREEMENT ("Agreement") by and between the MY OF SANTA ANA, a
charter city and municipal corporation organized and existing under the Constitution and laws of the State
of California ("City") and INT'ERNATION'AL BUS LINES, INC., a California corporation ("Licensee"),
is dated October 3, 2017 ("Effective Date'). Licensee and City are sometimes individually referred to as
"Party" and collectively as "Parties."
RECITALS
A. On August 1, 2017, the City issued Request for Proposal No. 17-076, by which it sought
operators to provide bus passenger services at the Santa Ana Regional Transportation. Center Facilities,
located at 1000 East Santa Ana Boulevard in the City of Santa Ana ("Facilitics").
B. Licensee is a provider of bus transportation services in the state of California who
submitted a responsive pmpasal that was selected bythe City. Licensee represents and agrees that it is able
and willing to provide the scope of services as described in RFP No. 17-076 and attached herein as Exhibit
A-
C. Licensee desires the use of and access to the Facilities for a bus stop for the purpose of
drop off and pickup of its Invitees (defined below) who utilize Licensee's bus services ('Transit Services'.
City desires to allow Licensee the use of and access to the Facilities for a bus stop for the purpose of drop
off and pick up of its Invitees and allowing its Invitees to utilize the Transit Services. At all times, Licensee
must meet the requirements presented in RFP 17-076 as appearing in Exhibit A.
NOW, THEREFORE, in consideration of the above recitals and the mutual covenants hereinafter
contained and forgood and valuable consideration, thereceipt ofwhieh is hereby acknowledged, theParties
agree as follows:
1. TERMS AND GRANT OF LICENSE
1.1 Facilities Subject to License. City owns the real property commonly known as the Santa
Ana Regional Transportation Center (SARTC). Subject to the terms and conditions of this Agreement,
City hereby agrees to allow Licensee the non-exclusive use of and access to one (1) bus bay at the Facilities
as a bus stop for the purpose of drop off and pick up of its Invitees (defined below). - TIM BUS BAY
SUB)ECT TO THIS LICENSE IS BUS BAY #4 ("License Area"). The parties understand that the City
may unilaterally reassign the License for Bus Bay #4 to another bus bay in the future upon written notice
by the City and that all terms and conditions of this license will likewise apply to any replacement bus bays.
See Exhibit B for description of License Area.
1.2 Grant of License TermsofLicense. City hereby grants to Licensee a non-exalusivelicense
("License"), during the tern of this Agreement, for vehicular and pedestrian ingress to and e' ens from the
Facilities and vehicular and pedestrian use of the Facilities for its regularly scheduled passnger service.
Licensee shall offer patrons the ability to pay in cash or by credit card. THIS AG EMENT IS
INTENDED AND SHALL BE CONSTRUED ONLY AS A REVOCABLE LICENSE 0 USE TIIE
LICENSE AREA AND NOT AS A LEASE OR GRANT OF ANY POSSESSORY OR OTHER
INTEREST.
1.3 Restrictions on Use of Facilities. Licensee shall not use, and shall prohibit its Agents.
(defined as follows) or Invitees (defined as follows) from using, the Facilities or License Area other than
for the purposes specified herein. The term "Agents" shall mean Licensee' officers, directors, members,
agents, employees, invitees, contractors, subcontractors, and any employees of such parties. The term
"Invitees" shall mean Licensee's invitees, guests, customers or business visitors.
1.4 City Approval of International Bus Lines, Inc.'s Buses. International Bus Lines, Inc. shall
provide the City with documentation listing, for each and every bus providing services at the SARTC: (1)
registered owner; (2) VIN number; (3) license plate number; (4) USDOT number; (5) proof of authorization
from the Federal Motor Carrier Safety Administration CTMCSA"),•' (6) proof of insurance; and (7) a list of
all licensed drivers who may operate the bus. Additionally, Licensee shall. ensure that use of the Bus Bay
#4 shall be by clearly marked buses identifying the International Bus Lines, Inc. company name and
USDOT number. Licensee agrees that it will provide the City with a list of buses that will use Bus Bay #4
as a precondition for use of the Bus Bays. Any additional buses must be approved by the City prior to
beginning service. The use of any non -approved bus at the SARTC is a breach of this Agreement and will
result in immediate termination thereof.
1.5 Compensation. As consideration for its use of the Facilities, Licensee agrees to pay
$3,000.00 per month for the term of this Agreement. License fees for any partial month sludl be pro -rated.
Payment shall be made payable to the City of Santa Ana, in advance for each month, no later than the k Om
of the prior month, at the following address: City of Santa Ana M-13, 20 Civic Center Plaza, PO Box 1988,
Santa Ana, CA 92702. A late charge of ten percent (10%) shall be applied to any payment hereunder due
but unpaid after the 10"' of the month. The consideration for this License shall be subject to a CPI
adjustment annually on the anniversary of the effective date during the tern hereof. The parties agree that
no' payment under this Section shall be due, until the completion of all tenant improvements made by
Licensee to the Premises at SARTC that are the subject of the separate lease agreement between'City and
Licensee, as determined by City, provided that the first license payment shall be due no later than 120 days
following City's approval of this License Agreement.
1.6 AS -IS Condition. City makes no representation or warranty of any kind as to the condition
of the License Area or any other matter relating to Licensee's use of the License Area. Licensee hereby
disclaims and waives any and all objections to the physical and other characteristics and conditions of the
License Area. Licensee acknowledges and agrees that the use of the License Area will be on the basis of
Licensee's own investigation of the condition of the License Area. The license to use the License Area
shall be granted on an "AS -IS," "WITH ALL FAULTS" basis, without representation or warranty
expressed or implied by City, or by operation of law. City expressly disclaims, which Licensee hereby
acknowledges and accepts, any implied warranty of condition or fitness for a particular purpose or use.
Licensee's use of the License Area shall be subject to the License Area being in a usable and safe condition
at the time of Licensee's use and Licensee shall be solely responsible for determining whether the License
Area is in such condition. In connection therewith, in the event that the License Area or access thereto is
damaged or obstructed or the use by Licensee is otherwise impaired, prevented or limited, City shall have
no obligation or duty to repair the damage or rectify the condition to make the License Area usable or safe.
1.7 Tenn and Revocation of License. The term of this License shall commence on October 3,
2017, and shall continue for one year. The term may be extended for up to four 1 -year periods by a writing
executed by the City Manager and City Attorney. City may revoke this license at any time by providing
written notice to Licensee.
1.8 No assignment of License. The permission, rights and privileges granted hereunder are
nonexclusive and nontransferable. Licensee shallhot, either voluntarily or by action of law, assign or
transfer this License or any obligation, right, title or interest assumed by Licensee herein without the prior
written consent of the City. If Licensee attempts an assignment or transfer of this License or any obligation,
right, title or interest herein, City may at its option, terminate the License pursuant to Section 1.10 below
and shall thereupon be relieved from any and all obligations to Licensee or its assignee or transferee.
1.9 Agreement to Protect and Maintain Facilities. Licensee, on behalf of its Agents and
Invitees, agrees to take all prudent action to protect the Facilities from any damage or injury caused by the
exercise of this License. Licensee shall immediately notify City of any damage or injury to the Facilities
caused by its use of the Facilities.
1.10 City's Right of Suspension, Termination for Noncompliance. City reserves the right to
suspend all activities or terminate this Agreement upon Licensee' non-compliance with any of the terms or
conditions of this Agreement. Such suspension or termination shall be effective immediately.
1.11 Compliance with Laws: Regulatory Approvals. Licensee shall, at its sole expense, conduct
and cause to be conducted all activities on the Facilities in compliance with all laws, regulations, codes,
ordinances and orders of any governmental or other regulatory entity, and whether or not in the
contemplation of the parties.
1.12 Indemnification. Licensee shall indemnify, defend, and hold harmless City, and its
respective agents, officers, representatives, employees, subsidiaries and affiliates ("Covered Parties') from
and against any and all actions, suits, claims, demands, judgments, losses, expenses, or liabilities, injuries
and damages to persons and property, including death, arising out of or related to Licensee's use of the
License Area, the entry by any Licensee Party on the License Area or any portion of the Property or
surrounding property or Facilities, or Licensee's breach or default in the performance of any of its
obligations under this Agreement. If any action or proceeding is brought against ariy Covered Party by
reason of any such claim, Licensee, upon receipt of written notice from Covered Party, shall defend the
same at Licensee's sole expense with legal counsel reasonably acceptable to Covered Party. Payment shall
not be a condition precedent to recovery under any indemnification in this Agreement, and a finding of
liability or an obligation to indemnify shall not. be a condition precedent to the duty to defend. The
provisions of this Section 1.12 shall survive the termination or expiration of this Agreement.
1.13 Insurance Requirements.
1.13.1 Licensee shall maintain commercial general liability insurance which 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
Licensee's use of the license area, including, without limitation, acts involving vehicles. The amounts 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 $2,000,000 per occurrence
and $5,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents,
volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to
insurance or self-insurauceprograms maintained by the City; and (c) contain standard separation of insureds
provisions.
1.13.2 Licensee shall maintain business automobile liability insurance, or equivalent
form, with a combined single limit of not less than $5,000,000 per occurrence. Such insurance shall include
coverage for owned, hired and non -owned automobiles.
1.13.3 Pursuant to state law, Licensee is required to be insured against liability for
worker's compensation or to undertake self-insurance. Prior to commencing the performance of services
under this Agreement, Licensee agrees to obtain and maintain any employer's liability insurance with limits
not less than $1,000,000 per accident
1.14 Certificates of Insurance: Additional Insured Endorsements. Prior to.execution of this
Agreement, Licensee shall furnish to City certificates of insurance and, if applicable, additional insured
endorsements to each of Licensee's insurance policies, evidencing the foregoing insurance coverages as
required by this Agreement. These certificates shall:
a. provide the name and policy number of each carrier and policy;
b. shall state that the policy is currently in force; and
C. shall promise to provide that suchpolicies will not be canceled, suspended, voided, reduced
in coverage or in limits, or modified without thirty (30) days prior written notice of City;
and
Licensee shall maintain the foregoing insurance coverages in force throughout the tern of this
Agreement. City or its representatives shall at all times have the right to demand the original or a copy of
all these policies of insurance, which Licensee shall provide within five (5) days of City's request.
2. MISCELLANEOUS TERMS
2.1 Notices. Demands and Communications between the Parties.
2.1.1 Any notice, tender, demand, delivery, 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, or sent by fax or other telegraphic communication in the manner
provided in this Section, to the following persons:
TO LICENSEE:
International Bus Lines, hie.
2088 West Hillcrest Dr., 413208
Newbury Park, CA 91320
Attention: Richard Gomez
TO CITY:
Public Works Agency
City of Santa Ana
20 Civic Center Plaza (M-21)
Santa Ana, California 92701
Attention: Executive Director
AND
City of Santa Ana
Clerk of Council
20 Civic Center Plaza
Santa Ana, California 92701
2.1.2 A party may change its address by giving notice in 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 (3) days after it has been deposited
in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above.
If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after
the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set
forth above. For purposes of calculating these time frames, weekends, federal, state, County or City
holidays shall be excluded.
2.2 Amendment. With the exception of a reassignment of the License Area as described in
section 1.1, this Agreement may be amended at any time by the mutual consent of ;the Parties by an
instrument in writing signed by both Parties.
2.3 Further Actions and Instruments. Each of the Parties shall cooperate! with and provide
reasonable assistance to the other to the extent contemplated hereunder in the performance of all obligations
under this Agreement and the satisfaction of the conditions of this Agreement.
2.4 Counterparts. This Agreement may be signed in counterparts, each of which shall
constitute an original.
2.5 Time is of the Essence. For each provision of this Agreement which states a specific
amount of time within which the requirements thereof are to be satisfied, time shall be deemed of the
essence.
2.6 Governing Law. This Agreement shall be governed by the laws of the Stale of California
without regard to conflicts of laws principles. Any litigation or other legal proceedings which arise under
or in connection with this Agreement shall be conducted in a federal or state court located within or for
Orange County, California. The Parties consent to the personal jurisdiction and venue in federal or state
court located within.or for the County of Orange, California and hereby waive any defenses. or objections
thereto, including defenses based on the doctrine of forum non conveniens.
2.7 Litieation Expenses. If either party to this Agreement commences an action against the
other party to this Agreement arising out of or in connection with this Agreement, the prevailing party shall
be entitled to recover reasonable attorneys' fees, expert witness fees, costs of investigation, and costs of
suit.from the losing party.
2.8 References: Captions. Any term referencing time, days or period for performance shall be
deemed calendar days and not work days, except as otherwise specified in this Agreement. All references
to City include all officials, officers, employees, personnel, and agents of City, except as otherwise specified
in this Agreement. All references to Licensee include its official's, officers, employees, personnel, agents,
volunteers, contractors and subcontractors, except as otherwise specified in this Agreement. The captions
of the various articles and paragraphs in this Agreement are for convenience and ease of reference only,
and do not define, limit, augment, or describe the scope, content, or intent of this Agreement.
2.9 Waiver. No delay or omission in the exercise of any right or remedy of a non -defaulting
Party on any default shall impair such right or remedy or be construed as a waiver. Either Parties' consent
or approval of any act by the other Party requiring its consent or approval shall not be deemed to waive or
render unnecessary its consent to or approval of any subsequent act of the other Party. Any waiver by either
Party of any default must be in writing and shall not be a waiver of any other default concerning the same
or any other provision of this Agreement. '
2.10 Rights and Remedies are Cumulative. Except with respect to rights and remedies expressly
declared to be exclusive in this Agreement, the rights and remedies of the Parties are cumulative and the
exercise by either Party of one or more of such rights or remedies shall not preclude the exercise by it, at
the same or different times, of any other rights or remedies for the same, default or any other default by the
other Party. All warranties and promises to indemnify shall survive the termination, abandonment, or
completion of this Agreement.
2.11 Severability. In the event that any one or more of the phrases, sentences, clauses,
paragraphs, or sections contained in this Agreement shall be declared invalid or unenforceable by a valid
judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect
any of the remaining phrases, sentences, clauses, paragraphs, or sections of this Agreement which are
hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder.
2.12 Binding Effect. The terms of this Agreement shall inure to the benefit of, and shall be
binding upon, each of the Parties and their respective successors and assigns.
2.13 Authorized Representatives. The person or persons executing this Agreement on behalf
Licensee and City warrants and represents that he/she has the authority to execute this Agreement on behalf
of that Party and that he/she has the authority to bind that Party to the performance' of its obligations
hereunder.
2.14 Entire Agreement. This Agreement constitutes the entire and integrated agreement of
Licensee and City with respect to the subject matter hereof and supersedes any and all prior and
contemporaneous oral or written negotiations, representations or agreements.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and
through their authorized officers the day, month and year fust written above.
ATTEST:
`JY164voi Z:)-
MARIA D. HUIZAR
Clerk of the Council
APPROVED AS TO FORM:
Sonia R. Carvalho
City Attorney
By:
John Onk
Assistant City Attorney
CITY OF SANTA ANA
Interim City Manager
RE 11411 NDED F R APPROVAL: INTERNA ON A BUS LINES, INC.
eRE MO SAVIPOUR By: r a Paleo
Executive Director Title: President
Public Works Agency Tax ID # 4.7-2774101
EXHIBIT A
SCOPE OF SERVICES
BUS PASSENGER SERVICES
AT THE
SANTA AMA REGIONAL TRANSPORTATION CENTER
RFP NO.: 17-076
1. Introduction and Descrintion of Work
The Santa Ana Regional Transportation Center.(SARTC), 1000 East Santa Ana Boulevard, was built in
1985. It is a Spanish colonial structure serving Amtrak and Metrolink, is a hub for the Orange County
Transportation Authority bus system, and is also a terminal for interstate bus services. The SARTC also
leases office space to the State of California Economic Development Department, County of Orange Social
Service Agency, and the Santa Ana Work Center.
The City of Santa Ana is searching for a bus passenger service provider to offer departures seven days a
week while providing a positive overall experience by ensuring an excellent and professional service is
provided to all patrons of SARTC. SARTC has the capacity for a total often (10) bus bays, of which five
(5) are licensed to the Orange County Transportation Authority, two (2) are licensed to. Greyhound Lines
Inc., and two (2) are licensed to Tres Estrellas de Oro. This RFP is to enter into a license agreement for the
one (1) remaining bus bay.
Please note that ticket counter space is not part of this RFP. At the selected Proposer's request, the City
will enter into negotiations for ticket counter office space at market lease rates. There is currently no ticket
counter space readily available. However, up to 580 sq. ft. of ticket counter office space can be created
from space currently occupied by Greyhound Lines Inc. The Proposer will be responsible for all tenant
improvements and must obtain all necessary permits for construction.
2. Scone of Services (but not limited to):
The City is interested in licensing one (1) bus bay for bus passenger service providers
The responses should clearly describe the Scope of Services to be provided. Provided below in general
terms are the expectations and deliverables. Proposers are encouraged to expand and elaborate in a manner
that reflects its understanding of SARTC and demonstrates its expertise and ability to perform all elements
of the proposed Scope of Services. Generally the Scope of Services includes, but is not limited to the
following:
• Licensee will provide best -in -class local/regional transportation services to SARTC patrons.
• Licensee, at its expense, shall comply with all applicable federal, state, and local laws, ordinances,
regulations, riles, and orders with respect to the use of any permitted areas.
• Licensee shall maintain all vehicles in neat, clean, mechanically sound, and painted condition at all
times.
• Licensee shall adhere to a transit schedule and provide on-time pick-up and drop-off to SARTC
patrons.
• Licensee shall maintain all proper registration for its vehicles.
• Licensee shall maintain all proper insurance for its vehicles.
• Licensee must meet or exceed all governmental requirements regarding the inspection and
maintenance of its vehicles and provide a monthly log upon request.
• Licensee shall have a strong financial background with a multi-year successful operating history
and the resources to pay any fees promptly and in full.
• Licensee shall adhere to all rules and regulations regarding the flow ofbus/shuttle traffic at SARTC.
• Licensee shall work with SARTC management to ensure all safety protocols are strictly adhered
to.
• Licensee shall work with SARTC management to manage ridership during peak and high volume
hours.
• Licensee shall employ best -in -class drivers with all proper credentials necessary to operate a
bus/shuttle service.
• Licensee shall employee the appropriate security protocols to operate for the public good within a
facility of the scale and prominence of SARTC.
• Licensee shall receive payment from patrons via cash and/or debit/credit card.
• Selected Proposer must ensure their business name and DOT number is clearly identified on all
buses accessing SARTC. Buses with a business name and DOT mtmber different'from the Proposer
will not be allowed.
• Provide, if any, information regarding online ticket purchase capabilities for patrons.
• Licensee must notify the City as soon as the Federal Motor Carrier Safety Administration
classifies high alert statuses of any reason.
8
EXHIBIT B
Santa Ana Regional Transportation Center
Policy Number 73APS073685 Date Entered: 08/17/2017
m
CERTIFICATE OF LIABILITY INSURANCEDATE(MMIOLffYM
LIR
TYPE OF INSURANCE
10/24/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFUM11VELY 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 pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
if SUBROGATION IS WAIVED, subject to the teens and conditions of the policy, cortnin policies may require an endorsemont. A statement on
this certificate does not confer rights to the certificate holder In ,feu of such endomement(s).
PRODUCER Interstate Trans Insurance Broker Inc.
P.O.BO]C 911094
Commerce, Ca 90091 323-728-0003
vN,0NTAcT Sa= SX #OG22050
PH FAX
oNE . (323) 728-0003 323) 888-2331
No
Ii -MAIL it3b2O000aol. com L:Lc# OG22050
-Amems
INSURER S AFFORDING COVERAGE NAICN
X
I A•A'1'&IN SPECIALTY INSURANCE COMPAW 17159
INSURED xxTo22iA.TIONAL ws X<nws INC
INSURER 0: IM=CML LIABILITY a BMW =SURAt1'C.Ei CORS 20052
07/02/2019
INSURER C: z9wSTCN SCE CcmpANY 37362
2088 WEST BII+LCREST DR B208
NEYMOR7L PARR, CA 91320
INSURER D: 35076
INSURERE•
INSURER F:
GEM AGGREGATE LWJTAPPLIES PER:
POLICY ❑ im M LOC
OTHER
L:UvEkALatD liCK11F1[:AI C NdamtlCK: RFVIRICIM M"Rffn=®.
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.
LIR
TYPE OF INSURANCE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
SUBR
POLICYRUMBER
PM CYEFP
POIDDA1110'
LIMITS
A
COMiE:RCIALGENERALLIABILITY
CLAIMS -MADE ® OCCUR
X
I
CXP322974
1
07/02/2017
07/02/2019
EACH OCCURRENCE $2,000,000.00
-PREMI ® $ 500,000.00
MEDEXP An ,son S 5,000.00
PERSONAL & ADV INJURY S
GEM AGGREGATE LWJTAPPLIES PER:
POLICY ❑ im M LOC
OTHER
GENERA. AGGREGATE $2,000,000.00
PRODUCTS -COMPIOPAGG S
3
B
AUTOMOBILE LIABILITY
ANYAum
D K71
AUTOSONLY AUTOS
AAUUTOS ONLY ED A OS ONLY
X
73APSO73685
06/22/2017
06/22/2019
INGLE acrtdantl IMff $5,000,000.00
BODILYINJURY(Perpersal) $
BODILY INJURY(Paraceldenl) S
CaW WRW GE $
$
C
UMBRELLA LIR
EXCESSLIAS
OCCUR
CLAIMS—MADE
x
XDBW7268517
EXCESS GLIMIiAL LTAB
09/16/2017
7/02/20x9
EACH OCCURRENCE $3,000,000.00
AGGREGATE $
DED I I RETEMION
EXESS FIRE LGL S 500,000.00
Li
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY
ANYPROPRIEfOR/PARTNE1RMOUTNE YIN
OFFtCEWMEMSEREXCLUDEC? Q
(Mandatary In NH)
0d0W"'
PC'OFOPERATIONS
N/A
9170728
06/19/2017
06/19/2019
- . -
EJ_EACHACCtDENT $1,000,000.00
E L. DISEASE -EA EMPLOYEE $1,000,000.00
E.L. DISEASE -POLICY LIMIT 31,000,000.00
DESCRIPTION OF OPERATIONS/ LOCATIONS! VEHICLES (ACORO 101, AdsOUonal Remand Schadula, maybe attaches! Umom apaca, Is mgalmd)
Commercial Livery Packaged Policy.
*** certificate holder Is named as additional insured ***
New Location: SANTA ANA, CA 92701
l E\�€EWED BY: 6� EUNICE HEREDIA (FC, OF
.._... ......... _ N --- . ........
Kai =491=10F.12 x:16101 *]=I: N.�a r.I d ■ �:r. ra.�
CITY OF SANTA ANA PUBLIC WORKS AGENCY
SANTA ANA REGIONAL TRANSPORTATION CENTER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
1000 E. SANTA ANA BLVD. SUITE 108
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
SANTA AIM, CA 92701
VAX -714-565-2692
AUTHo REPRESENTATIVE
SALE x xMM INC
cv 1588.201EACORD CORPORATION. All rights reserved.
ACORD 26 (2016103) The ACOR13 name and logo are registered marks of ACORD
Produced using Forms Bass Pius software. www.FormsBass.com: lmoresslve Publishina 800-208-1977
ADDITIONAL INSURED ENDORSEMENT
EOR_CONDAER.CIAL GENERAL LIABILITY POLICY
Insurance Company ATAIN SPECIALTY INSURANCE COMPANY
This endorsement modifies such insurance as is afforded by the provisions of policy
# CIP322974 relating to the following:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701;its
Officers, employees, agents, volunteers and representatives are named as additional
insureds ("additional insured") 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 he 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 to the additional insureds, this insurance shall not be cancelled, or
materially reduced in coverage or limits expect 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 07/02/2017 this endorsement form as a part of
Policy# CIP322 74
Issued to INTERNATIONAL BUS LINES INC.
Named Insured —
Countersigned bv' �Repre�sentativ�e��Ahorized
BY: _ � E UNICE FIEREDIA (Pr cap
Policy Number: Nrw PREsl;o T_-_RjaNmL
AGENCY CUSTOMER ID -
DATE (!AWDDrtyM
VEHICLE SCHEDULE :L 'w ON'
AGENCY 10/06/2017
CARRIER N
Interstate Trans Insurance Braker Inc. NAC CODE
E EFFEC,TnIvE IfE NAMEDORED%NAL BUS L11,7ES
PP C
011 INTE AT INC
POLICY NUM13ER FO 6 /E2 2 /E2'0 17
NW FRMSX0 TERM11TAL
1fF;I4Ir'I;= nr:_Qr'PI0TIr'iXI
VEHN
I YEAR Pwm.-MCI-3500 BODYB S
VEHICLE TYPE
r 2
0'
SY411AGIEZ
SYMIAGE CO) s p !
Y,
07
CDL,_
S
2001 mcDEL:-UN1T#58
01
PP Fj SPEC
M
USLY-11
..V.LN.:3BMKHH3A71S090042
CO IL
%
CO."'
-7-
7-
GARAGING I S-MEET(Raquinid In" CITY I COUNTY
STATE XIP
ADDRESS 1140 �-RnslTO
STREET k�NTLTRA
LIC
021 Qq7nCZ
37 0
STATE TERR GVW I GCW CLASS sic, ;:ACTOR ISFATOPI RADIUS FARTHESTTERMINAL
COST
COST NEVJ
CA 033 50,000 55
. Boo
USE HIRE I CHECK
ERAGES
14'
S
FA 'L q 0 - U N D RI RENT
AUL MOTOR F Lj LSP
T
P RD "IC MOTOR
Mo 0
To
DEOU01"IBLE S C SP
ID90,51"REISIP—SIC
COMM`LHFOR
PLEASURE ,�AJJJL LIAB
W11
To ""I — R EIMB
_D ING
4F &L " go FT PC
MEDPAY T&OL'ASOR OTC
ACV OT C SFL
AA
FARM SERVICE NO
FAU rr
'N
UN INS �.PEC
MOTOR OF1 FTW COLL
DRIVETO <15 MILES 15 MILES+ NE7VEH
COLL
DRICR;
TOM PREM: S
YEAR
.MCI-102X)L3
1JEA"DEL-UNIT02
B)DYB
IYPE* US
VEHICLE TYPE ISYMIAGE
C OMPI
OTCSYM
DIX
L
v.ix:1M8PDMTA8VP049Z_31 ::�
Ov2EHO
1997
= 17
SYM
PP SPEC X1 COML
7-
7
7 -7-
GARAGING STREBT(RaquImdInKY)
CITY
COUNTY-
STATE
XIP
ADDRESS SAME
ATE
STATEI...
TERR
GVW1GCW CLASS
150
IC
FACTOR
SEATCP
RADIUS
FARTHrSTTERMINAL COST
'
CA
1
56
LD
Soo .---
BE $
RE: _S COMP/
DEDUCTIBLES cc h" SPEC
SPEC
USE
_000
_-, FOR HIRE
C EC
co ERAGES
ADD No-
FAULT
UNDRINS
MOTOR
F
LSP
PLEASURE
RCO:LIL
ri
LIAB
�MQTQR
MED PAY
T
&CMANR
Fr
Co.,
OTC
REIMS ACV OT _L
C COFL
re AA ST MT -0 -
FARM
SERVICE
NO.
-illy
UNINS
SPEC
FTW
cc
$_o
S
0
S-0-
S COLL
;TAL
DRIVETO_ E!`Vt�
WORKISCHOOL is MILES 16 MIUES+
I
DRICR
:
PREM: $
MA" -MCI 102DL3
VEHICLE TYPE S
/AGE
-C-6ViP_J 0
moo - T#75
I w,N.:1M8P1)MPA3TP047819
03 1996
pp PEC �Z] COM
.0 BY
-7- 7-
GARAGING STREET (Raqulmd In PM CITY COUNTY
STATE MP
ADDRESS SAbdE
SAE TERR GVTI GCW CLASS sic FACTOR _.sEArcPRADIUS FARTHESTTERMINAL
COSTNEW
CA 033 50,000 LD 500
R HIRE CHECK
USE CK DD' NO. U14DRINS
COMM -L " FOR F COMP 6
cov DEDUCTIBLES
XGES' FAULT MOTOR LP_ FED
ACV OTC COFL
PLEASURE LIAB MED PAY TOWING FT COMP/
& LABOR OTC 0 -
AA-, STAMT
NO
FARM -1 UMNS SPEC
OF
JSMILIES+ NMI vull COLL
J�fgCHO L is MILES DRIC
VEHO YEAR MAXIE:VAN BOOL -T2145 ROD BTJS TOTAL PRE J. S
E L ' TYPE S COMP/
VEHICIrTYPE SYMIAGE
V .. C r AIA OF COLL
BY"
04 2000 MoDr .uNiT#86 SW4
TELL
.L V.LN.:Yr.2TC12B6Y2043949
SPECCC L
pp SPEC COML 7- 7 -
7-
GARAGING
STREET (Requlmd In"
CITY,
COUNTY
COUNTY
ADDRESS
SANIE I
STATE
STATE
Zip
ZIP
STATE
1033
TERR
150,
Gvw I Cow
CLASS
1
sic
FACTOR
sSATcp
RADIUS
FARTHESTIERMINAL
I EM
COSTNLTW
NL
V
CAO
000
62
00
- N RI COMP/
USE COM%VL HA G UNDRINS r LSP DEDUCTIBLES COMP/ S—PEC
�T ..
FOR HIRE CHECK ARAUDLLTNO MOTOR S S E
EE INMT3 ACV OTC C OF L
C �L
R CrFL
RETAIL 3 FT COMPI 18
, At
PLEASUREMED PAY, TOWNG J.G
X LIA OTC
& LVABOR'
2�
AA ST AMT
FARM NO UNINS P5,
SERVICE SPEC
rTW COLL
MOTOR *-o-
DRIVE To 15 MILES 15 MILES + NETVF_H COLL
WORKISCH
TOTAL PREM: S
VPH 4 YEAR
—11
t.-I-mvp
SYM co"'I" COLL
[Fn:VMHO0L-T2145
X2_� VEHICLE TYPE COLL
05 1999 L.UNIT#90 _7
OE OTC sy" 7�
JOI)v I - OTC SYM SYM
1 I P7/n
:YE=-�6:�3B20�432 PP
V.LN. 0 SPEC COIAL 7- 7
I 7- 7-
GARAGING
MEET (Requlmd In KY)
CITY
CITY
COUNTY
COUNTY
ADDRESS
I SAtdE
STATE
STATE
Zip
ATE
TERR
150,000
GVW I GcW CLASS
CLASS
SI
FACTOR
SFATCP
RADIUS
'U'
FARTHESTTERMINAL
OF
OOSTNEW
.TN.v,r
CA 033
5
-5oo
goo
$
USE
COMMIL FOR
RAGES
ADD1 NO- S LSP RRENT
0' UN ......
FAULT MOTOR LSP
AMIA
nr
DEDUCTIBLES SPEC
PLEASURE
RETAIL
LLAB
I J"
REJMB
TOWING FT COMPJ� G
MED PAY P, FG
V OTC COFL
FARM
SERVICE
NO-
LABOR rlTrl.
0,
UNINS SPEC
11
aT COLL
COLL
TOM PREM: $
D74TOCgOoL 1-15��ASMLES+ I NETV9H
�WQ_PKIS DR/Cg:
At'r%MM 4')o ')INnO14.4
'Zluz"'3_Awuu AtuK'J L;uKI'UKA_FIQN- All rights reserved.
The ACORD name and logo are registered marks of ACORD
toad 11sina Forms Bos% plus saftare. V=.FormsBoss.com: Impressive Publishino 800-208-1 977
EUNICE I fEREDI
Policy Number: nmq imEsiqo TER SZ Tl T,
AGENCY CUSTOMER ID:
VEMCLE SCHEDULM E DA(M=DtYYYY)
-G- 10/06/2017
AGENCY CARRIER NA1c CODE
Interstate Trans Insurance Broker Inc.
POUCY NUMBEREFFECIIVC DATE I NAMED IRR
MW FMSWO TEPIaNAL 106/22/2 INTERNATIONAL BTJS L11, ES INC
NIP141r'l iz n1=ArPH3T1nM
vrHo
YEAR
MAKE:VAN HOOL 4"204511
.. .. ......... --
ICLE TYPE SYM
SYM
7A GE
I AGE
of"
OM
OTC
OTC SM
OLL
mooLL-UNIT#91 1213712045618
06
2001
SPEC I K'7
_CML
'�' I COMI.
7-
7 -
S YM
5
7_
7
GARAGING S7REET(RaquIwdInKY)
CITY
—
couN
TATE
STATE
ZIP
ZIP
ADDRESS ri ST
S11TO
NTURA
CA
9 6
93706
STATE
10.33
TERR
I Gcw CLASS
1.50, roo
sic,
FACTOR
SEATCP
RADIUS
FAR-w�—s�-TE=NAL
co_N.w
COSTNEW
CA
A
0'Vw
58
Boo
USE
COM11IL FOR ���
ES
ADD'L NO.
FAULT
OR
MOTOR
F
RE NT
REIMS
DED BLEs
UCTI
ACV
COI/
/?I
PLEASURE
RETAIL
MED PAY
TOWING
& LABOR
FT
To
FG
AA L'�SJSTAMT
0 Cc
OTC C OF L
75,000
FARM
SERVICE
T
LININS
mnT.Qa
SPEC
CoFL
-'PV
r
cl-'
5 1 000 COLL
DRIVE TO
i 1-15M'LES I 1 15 MILEZ+ I
LNEjTA!H
WORK I SCHOOL
TOTALPREM:
VEH it
I YEAR
W
P
,TY E
MAKE:VOLVO VEHICLE TYPE SYMIAGE
SYMIAGE
CO
COMPI
MPI
OTC SYM
SyM
"!7
COLL
COLL
07
2010
---I
MOLIEL.UNIT#515 VIN-3CET2X620A5139735 SPEC R/
C COML
COML
-7
7-
8Y
SYM
-
7-
GARAGING
CITY
COUNTY
STATE
ZIP
ADDRESS
157REET(Requ(rodInKY)
SA14E
STATE
TERR
GVW I GCw CLASS
150,000
sic
FACTOR, SEATCp
RADIUS
FAR'THESTTERMINAL
COSTNEW
CA 033
Boo
B
USE HEC
HIRE C
cov RAGES
ADRLTNC� UNDRINS F LSP RENT
PAU MOTOR REIMB
E DUCTI.LE. M;M SPEC
DEDUCTIBLES ACV
AS", C'0MM'LHFOR
PLEASURE RETAIL LIAR
—
TOWING P1
FT com
MED PAY & LABOR OTC
— FG
J!!—
OTC
OTC COFL
AA 5 OTC
'
AA -ST'VAT $5,000
ST"T 000
FARPA SERVICE I
LININS SPEC Frw COLL
I
s�200,0
00,000. 00 $5, 000
00.00 $5,000
DRIVETO I � 15 MILES 16MILES+ NETVEi
COLL
COLL
WORKISCHOOL ORICR:
TOTAL PREM: $
VETTg
I YEAR
SCA NIA duuy
J)TE!
�m
VEHICLE TYPE
1AGE M
OTC s
COLL
L-LWIT#8225 V.I,N.:YS2X4X208D1882938
0 8
2013
PP SPEC COML I
SYM
GARAGING,
I STREET (RaqLlmd In KY)
CITY
COUNTY
STATE-
XIP
ADDRESS
SANE I
I
LIC
STATE
1033
TERR
GVW I GCW CLAS.
150,000
sic FACTOR
1
-P]
1.121ATC RADIUS
FARTHESTTEMMINAL
—
COSTNEW
CA
1
-900
$
USE
IN
COMM'L FOR HIRE I
CHr F
--CK
LCOVERAG _S
ADDIL No-
FAULT
UNDRINS
MOTOR
F
q
--
LSP
RENT
DIZ �� �-'Cv
—
9P SPEC
>D—COV, TXICOFL
PLEASURE
RETAIL
LIAB
MED PAY
FT
COMP/
REIMS
FG
�DAA [�sTAw,
OTC
OT
FARM
SERVICE
NO
1r
UNINS
R
PEC
FTW
OTC
COLL
—
200000W
$ ,
0000
$5000 COLL
I
DRIVETO NO
WORKI pERdTCREH
ISCROOL 1415LES 15 MILES i
TOTALPREM: 3
VEHO YEAR
MAKB:MCj I SCoY]BTTS
I
VEHICLE TYPE mm7j;ZE
-----I-V.I.N.:3BbIXSbdPA12SO80173
T-.0
COMP/
Tc SYM
COLL
SYM
CO 9 2002
MoDEL,-XJN1T#1055
PP E] SPEC P�] COML
GARAGING
I STREET (Roqulmd In KY)
CITY
COUNTY
--;�F
STA
ZIP
ADDRESS
SAbM
STAT
TERR 150,000
GVWIGCW CLASS
SIC
FACTOR
SEATCP
RADIUS
FARTHESTTER
COST NEW
CA0331033
55
00
0 " A
USE C L FOR HIRE CHECK 0. UNDRIN ITI.E.
REEI C
Cne"ES
FAULT LSP IIEDU COTMMCPP11
COVERAGES CoLL N MOTOR
REIMB �SE
ACV CP
PLEASURE RETAIL TOWNG cov, COFL
LIAR MEDPAY FG
EOL
I
AA
OTC STAMT $ —0—
FAM NO- LININS SPEC 0 C
CAttlYCOLL $-0—
DRIVE TO IN + NETVE COLL
WORKISCHOOL DRIGR�
VEHO YEAR MAKEMCI I BoDY13US TOTAL PREM: S
VEHICLE TYPE SYMIAGE L
— 1: OTC SYM SYM
10 12002
MODEL. LWIT#105 6 7f12111,1:3BMXSbWAX2S080219 PP 7 SPEC COML 0— 0—
GARAGING
STREET (Raqulmd In KY)
CITY
COUNTY
ADDRESS
I SAJM
STATE
ZIP
LIG
STATE
1033
TE :RR
150
VWOI'Icw CLASS
SIC
FACTOR
SEATCP
RADIUS
FARTHESTTFRIAINAL
COSTNFW
CA
, OGO
55
500
$
USE 111. FOR HIRE I CHECK
COM CO ERAGES
ACD'L UNDRINS F ENT
PAUL MOTOR LSP 111r-Ime
DUCTIBLIES COMP! SPEC
PLEASURE
W11 RFTA' 'L LIAR
_
TOwING FT OTC --G
t,4=D P &LABOR
AG V OTCL
AA
SERVICE NO
_
UNINS SPEC
STA
MT $
DRtVE 7OjS MILES + NETVEH
15MILES DRICR:
COLL
TOTALPREM:
U 1 �UJ-4uuu /AkUKU L;UKtUKA I KIN. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Produced using Forms Boss Plus software. www.FonnsBoss.com: Impressive Publishina 800-208-1977
711
. . . .......... .
E U N1 CE HEREDIA
- ---- --------
LR�IF�jD Y
Policy Number fit' raEsno mix,
AGENCY CUSTOMER 10:
AVEHICLESCHEDULE0/066/201
AMOY CARRIER NAlo coli
Inte=atate Mrana Snsnraaae Sroker Sae.
POLICY NUMBER EFFECRYE RATE NAMED s
NEW FRESNO TppidIZZAL 106/22/2017 xNTE�NAL HUS T,T�S Ib7C
VCYIIuLft L ezutut' I [Uri
VENA YEAR
MAKS bSCI
YHBS
VEHICLE TYPE
SYMIAGR
OTC
11 2002
MoBmj=T#1057
vLN:3HtQ}C31APA12SO80223
PP SPEC M COML
jy_
0_
GARAGINd I STREET(RaquImdInKY)
CITY
COUNTY
STATE 13P
ADDRESS Ip STREET
SNOWXTURA
CA 3706
TERR
GVWIGCW
150,000
CLASS
Ste
FACTOR
BEATCP
RADIUS
FARTHESTTERMNAL
cOBTNEW
CA
5
00
$
USE
COMA41
FOR HIRE
'HECK
qp
FAULLLNa
�p��
F
L8P
RENT BEBUCTIDLEB
ACV
C
PLEASURE
RETAIL
LIAR
MED PAY
TM01URN8
JM%
FT
0OrGP/
FG AA
STAMT
C
S` -0 -
OF L
FARM
SERVICE
FfW
COLL
$_Q_
$_Q_
COLI.
B
<SB MlLta; 16 NDIES+ML�t
TOTAL PREM: S
ma YEAR I
MAKIWO7LVO
BUS
VEW=Tme
SYMIAGE
12 2013 1
I
MoDEI.:MqXT#024
v.LN.:3CET2S2271)5157700
PP SPEC R1 COML
ICT�OSYYM�W
7
GARAGING
ADDRESS
I 111HEETIRa4ulmdInKY7
CITY
COUNTY
STATE
2IP
TrUi7Y
1500OGvowlem
CLASSR
SPAT CP
RADIUS
FARTHESTTERM1NAL
NEW
CA
033
55
00
$
7='
LtsE
COMML
FOR HIRE
aBSr
0.OTDES
F
LSA
RF1M8
DEDUCTffiLES
ACV
sAEC
PLPASURE
RETAIL
LW8
MED PAY
�py�q�
&LABOR
Fr
OTIC I
FG
AA
6TAMT
x5000
COP L
FARM
SERVICE
c
FTW
COLL
$200,000
$5000
DRIVE
IS
a 16 MtLEB 18 M(LES+
B
TOTAL PREY E 8
r>at7
VEHp I YEAR
MAMWIMMIMS
Y.HUS
VERIcwTYPE
SYMIAGE
oTosYle
13 2014
ucBm-WIXT0.051
I u►.N.:WDZPE8CC9E5821161
PP SPEC ED COML
QARACING
ADDRESS
STREET(RequkedlnM
CITY
COUNTY
STATE
IMP
END
TERR
amid W
CLASS
SIC
FACTOR
SEATCP
RADIUS
FARTHESTTERMINAL
COSTNRIIV
CA
033
6500
5
00
$
USE
COWL
FOR HIRE
CHEMADBL
4WERWES
NO-
FAULT
UNDEiI 6RENT
MOTOR
F
LSP
REIMB
ACV
SPEC
PLCOPIL
EASURE
RETAIL
LLAB
MED PAY
30l 60
� /
FG
AA
STAMT
OTD
$5000
FARM
SERVICE
NO
INS
SPE
�yy
COT(
$25�QQQ
$5000
TO
<t6MILES 16MILES+
COLI
VM6
1 YEARW-1
I HUS
TgrALPiiEM: S
VERICLETYPE
SIAM
OTC SW
14
2002
McDmjV IT#1052
vjx:1b28PDDMRA72P054381
PP SPEC X1 COML
SYld
QARAG@IG
ADDRESS
STREFrjRegwmdIn"
CITY
COUNTY
STATE
I 11P
STATE
MR
GVW IGOW
CLASS
87C
FACTOR
SEATCPI
RADIUS
FARIHESTTERMLU.
CC8TNEW
CA
033
g
QQ
S
USE
COMML
FOR HIRE
CI[eGK
GES
AODL NO-
FAULT
LINO 1
MCIDR
F
LSP
R DEDUCTIBLES
RM&la
ACV
COMP
EPEC
PLtABURE
RETAU
LIAR
MED PAY
&LABOR
FT
RIF,
07C f
FG AA
STAMT
CTC
$"0—
COFL
FARM
SERVICE
O
UNtNB
FTW
COLL
$-0—
$_(j_
<"MILES 1SMU
KET
COLL
DRICM
ALPRsat
V5
pb2Ci
�
VEHICLE TYPE
WIJIAGM
OrC,
15
99YEA
1998
MoorzUNiT 1054
V. I.N.:PDb�A0WP051122
PP ElPEC COML
SYM
GARAGAIG
STREET(Requtmd In KY)
ISAM
CITY
COUNTY
STATS
MP
'ADDRESS
STATE
LK�CA
TERR
Gvwlc W
CLASS
SIC
FACTOR
SEATCP
RADIUS
FARTNESTTEIMtNAL
COSTHEW
033
53000
56
00
$
USE
COMNrL
FOR HIRE
CHECK ES
qqpp
FAN.T 0•
UMNUOiDIUR
FLLSPREtMe
USACV
RJrTA(L
AOR
FT
'
AAL�j
STAMT
OTCPLEASURE
$-0"FARM
SERVICE
0
UM8)sAY
RTW
S 0
S -0-
E
<16MILa 16 MILES+
NBT
H
COLL
AL PFURW, $
ACORD 129 (2009111)
01993-2008 ACORD CORPORATION. All fthts rexewaei.
Tne AGORD name and logo are registered marks of ACORD
Pmducad usina F=Ym Bass Plus software. www.Formsl3=.COrrr. Imnresslve Publlshino 800-208-1977
EI. NICE HEREC)1A (PCSE;Os y!
✓ E"�
Policy Number Izr EMSHO THPICOIAL
AGENCY CUSTOMER ID:
lv
'VEHICLE SCHEDULE Q;` 2"" T'y'
AGENCY CARRIER HAIG CODE
Interstate Trans Insz=ance Broker Inc.
POLICYNWSER EFFEC NEGATE NAMED��sstuRE
NWVRESx0 TEiocauT 06/22/2017 INTEk�NA.T'%NAL BUS LINES INC
VENO YEAR MAKE -VOLVO wpgl S
- *1593,2009 ACORD CORPORATION. All rights reserved,
The ACORD name and logo are registered marks of ACORD
Produced us(na Fcmts Boss Plus sof mre. v wwyormsBo8s.cam: Imuresslve Publishina 800-208-1977
[[-Hy ...E�_ _._...j
EUNICE HEREDIA(E7F� J
VEHICLE sYM/aGE
OTc
016 2016 HoDEL: #1058 v.LNa3CZT2V226G5472808
PP SPEC�Zj COML
GARAGWGSYREET(Raq:dmdMKY)
CnY
COUNTY
sTATB
YIP
ADDS
STREET
SNO
SRA
: A
37Q6
STATE
1033
7F3iR
GVWlGCW CLASS
SIC
FACTOR
SEATCp
RADIUS
FARTHESTTERMENAL
co"KM
CA
50000
0
00
$
USE COWL FOR HIRE C
q�pppp��
FAULTN0- B F L8P ��
DEDUCnBIEBAOV
PLEASURE RETAIL 7ES
TkplOyT{�OlT
MED PAY S &NGF7 CcOTCompt FG
C OF L
AA STAhrr S5QQ0
FARM SERVICE
UW113 FTW COLL
$300 000 Isscoo COLL
1SMILE8+ ETA
RIC COL.<iSMILFS
TOTALPREM- S
VENO YEAR I MAKMXCI BVS
VEHICLE Type SYMIAGE
OTCsYAt!
COIy
SYht
07.7 1998 1 Iuoneu vjA:UaXvDMRA.7WP050825
PP 17 SPEC COME
GANAGING
STREET (Rogalmd In KYj
CTIY
COUNTY
STATE
YIP
ADDRESS
[SRR
GVWIGCW
CLASS
SIC
FACTOR
SEATCP
RADIUS
FAR7HESTTERMINAL
COSTNEW
�0
$
USE
CCWLHFORHIRE
COVERAGES ECK
PA&NO-
u�
MO01O�R
F
L&P
RElMB
DE carIBLES ACV
CO
am
PLEASURE
RETAIL
LAB
MED PAY
�P
Ff
OC P!
FG
AA STAMT
C
C L
S00
FARM
SERVICE
FTW
COLL
:d$00
-
$OO
!-DrAVET
<16MILER 1bINiLE8+ DWORs
TOTALPREM: S
VM0
YEAR
MAKEwr
VMMETYPE SYMIAGE
OTC
MOWL: VJA: I
IPP F1 SPEC COML
Sm
GARAGING
STREET(RegalmdlnKY)
CITY
COUNTY
STATE
ZIP
ADDRESS
IIADstB
I
8TABTEHR
T
amIGCW CLASS
Sr- FACTOR
SEATCP
FARTHESTTERMINAL
COSTKEW
$
USE COMMT. FORHIRE CC EERAGES F�7Na F ' REI DBDU6118LE8 ACV CO !
�MpOyTyO��Rp FT COMP/ FG QTC OF L
PLEASURE RETAIL LIAB MED PAY
LABOR
NO- LININS $ OTC AA BTAOdT S
FARM SERVICE FTW COLS
$ S COLL
MILES t8 M11E8+ T
.MRKISCHOOL<18
7T7TALPREM: $
VENO YEAR
MAKE: VEHICLE TYPE B WAGE OTOOM
MODl3: V.LN.: PP SPEC COME
GARAGING
STREET(Rtigcdmd 1nKY)
CITY
COUNTY
ADDRESS
8TAT'@
ZIP
STAis
TERR
GVWlGgY
CLASS
SIC FACTOR
SEATCP
RADIUS
FARTHFSTTERMSULL
COSTNEW
$
A ULTNOD NM
OMPJ
USE COLOrpL FOR HERE C F.8 CRMXAFADULT MUOrOR NS F LSP REIMS DEDUCTTSLEfs�TAM'VT
CV
PLEASURE RETAIL 6W8 PAY TOWING COMP/ RE COFL
AA $
FARM SERVICE NO- LIN SpE R
FAULT A FTW COLL
$ S
TO COLI
DOL<iBMiLEB tSM1LE8+ VEH
VELIO YEAR MA143s Bogy TOT REM: $
VEt TYPE SYMIAGB OTc
MODEL V.m PP SPEC COML
GARAGING
6'RmT(R°gulmdlnKY)
CITY
COUNTY
ADDRESS
STATS
xIP
STATE
YERR
OVWlGCW CLASS
SIC
FACTOR
[7CPI
MILis
PARTNESTTERMINAL
COSTNEW
USE COMML FOR HIRE RAGES PDLL NO•HjN8 F LSP DE�JCTIBLFS
FAULTR
RRETMS ACV ToTc L
PLEASURE RETAIL LIAR MlB7 PAYG FT �GMPI FIB
FARM 8ERVICE Na LININS°R AA STAMT $
PTW COLE s
[dVs <i6 MELEE 1S MILER+ NET $ COLE
TOTAL PREM: $
ACORD 129l200WIII__ ____ _ _ ___._ _
- *1593,2009 ACORD CORPORATION. All rights reserved,
The ACORD name and logo are registered marks of ACORD
Produced us(na Fcmts Boss Plus sof mre. v wwyormsBo8s.cam: Imuresslve Publishina 800-208-1977
[[-Hy ...E�_ _._...j
EUNICE HEREDIA(E7F� J