HomeMy WebLinkAboutPHIL MARTIN AND ASSOCIATES, INC - 2018A-2017 265-23
INSURANCE NOT ON FILE
WORK MAY N2 PROCEED
CLERK OF COUNCIL
DATE: MAR 2 9 7018
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AGREEMENT TO PROVIDE ON -CALL
ENVIRONMENTAL SERVICES
RELATED TO CEQA AND NEPA
THIS AGREEMENT is made and entered into this 15th day of March, 2018 by and between Phil
Martin & Associates ("Consultant"), and the City of Santa Ana, a charter city and municipal
corporation orgw&od and existing under the Constitution and laws of the State of California
("City").
A. On June 7, 2017, the City issued Request for Qualification No, 17-0 43, by which it
sought Consultants to provide on -call environmental services for the Planning and
Building Agency of the City of Santa Ana. The scope of work may include any and
A work efforts related to analysis of a proposed project for compliance with
California Environmental Quality Act (CEQA) and National Environmental Policy
Act (NEPA). This may include preparation of required technical studies, peon
review of technical studies prepared by others, preparation of initial Studies,
Negative Declarations, Mitigated Negative Declarations, Environmental Impact
Reports, Environmental Assessments, Environmental Impact Statements services
on an as -needed basis.
R Consultant submitted a responsive proposal that was among those selected by the
City. Consultant represents that it is able and willing to provide the services
described in the scope of work that was included in RFQ No. 17-043 and attached
as Exhibit A.
C. Consultant has been selected as one of the thirty-one (31) vendors which qualified
for this engagement. Only those consultants approved by the City Council on
October 3, 2017, shall be eligible to be engaged by the City for these services.
D. In undortaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably
be expected from aprofessional contracting firm it the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows.
I. SCOPE OF SERVICES
On an as -needed basis, and at the sole discretion of City, Consultant shall perform the
services that are described in Exhibit A. Consultant's proposal is incorporated by reference as
though fully set forth herein. When the need for services arise, City may initiate services through
use of a letter agreement, executed by the Executive Director of the Planning and Building Agency
and the Consultant.
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2. COMPENSATION
a. City neither warrants nor guarantees any minimum or maximum compensation to
Consultant under this Agreement. Consultant shall be paid only for actual services
performed under this Agreement at the rates and charges identified in Exhibit B.
The total compensation for services provided for development projects is
determined upon submission of payment to the City for the full cost of the services
from a developer. The Consultant shall perform the services and when the
environmental report is completed, the City will pay the consultant for the
completed work based upon the costs paid to the City by the developer, minus
administrative costs.
b. Payment by City shall be made within forty-five (45) days following receipt of
proper invoice evidencing work performed, subject to City accounting procedures.
Payment need not be made for work which fails to meet the standards of
performance set forth in the Recitals and Scope of Work, which may reasonably be
expected by City.
3. TERM
This Agreement shall commence on the date first written above and continue until October
2, 2020, unless terminated earlier in accordance with Section 17, below. The term of this
Agreement may be extended upon a writing executed by the City Manager and the City Attorney.
4. PREVAILING WAGES
Consultant is aware of the requirements of California Labor Code Section 1720, at seq.,
and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, at seq.,
("Prevailing Wage Laws'l, which require the payment of prevailing wage rates and the
performance of other requirements on "public works" and "maintenance" projects. If the services
being performed are part of an applicable "public works" or "maintenance" project, as defined by
the Prevailing Wage Laws, and the total compensation is $1,000 or more, Consultant agrees to
fully comply with such Prevailing Wage Laws, Consultant shall defend, indemnify and hold the
City, its elected officials, officers, employees and agents free and harmless from any claim or
liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. .
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City, This Agreement is not intended not shall
it be construed to create an employer -employee relationship, a joint venture relationship, or to
allow the City to exercise discretion or control over the professional manner in which Consultant
performs the services which are the subject matter of this Agreement; however, the services to be
provided by Consultant shall be provided in a manner consistent with all applicable standards and
regulations governing such services. Consultant shall pay all salaries and wages, employer's social
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security taxes, unemployment insurance and similar taxes relating to employees and shall be
responsible for all applicable withholding taxes.
6. OWNERSMP OF MATERIALS
This Agreement creates a non-exclusive and perpetual license for City to copy, use,
modify, rouse, or sublicense any and all copyrights, designs, and other intellectual property
embodied in plans, specifications, studies, drawings, estimates, and other documents or works of
authorship fixed in any tangible medium of expression, including but not limited to, physical
drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or
caused to be prepared by Consultant under this Agreement e Documents & Data"). Consultant
shall require all subcontractors to agree in writing that City is granted a non-exclusive and
perpetual license for any Documents & Data the subcontractor prepares under this Agreement.
Consultant represents and warrants that Consultant has the legal right to license any and all
Documents & Data, Consultant makes no such representation and warranty in regard to
Documents & Data which were provided to Consultant by the City. City shall not be limited in
any way in its use of the Documents and Data at any time, provided that any such use not within
the purposes intended by this Agreement shall be at City's sole risk.
7. INSURANCE
Prior to undertaking Performance of work under this Agreement, Consultant shall maintain
and shall require its subcontractors, if any, to obtain and maintain insurance as described below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the City, its officers, employees, agents,
volunteers and representatives as additional insurcd(s) and shall include, but not be
limited to protection against claims arising from bodily and personal injury,
including death resulting therefrom and damage to property, resulting from any act
or occurrence arising out of Consultant's operations in the performance of this
Agreement, 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 $1,000,000 per occurrence, with $2,000,000 in the
aggregate. Such insurance shall (a) name the CITY, its officers, employees, agents,
volunteers and representatives as additional insured(s); (b) be primary with respect
to insurance or self-insurance programs maintained by the CITY; and (c) contain
standard separation of insureds provisions,
b. Business automobile liability insurance, or equivalent form, with a combined single
limit of not less than $1,000,000 per occurrence. Such insurance shall include
coverage for owned, hired and non -owned automobiles.
e. "Worker's Compensation Insurance. In accordance with the California Labor Code,
Consultant, if Consultant has any employees, is required to be insured against
liability for worker's compensation or to undertake self-insurance, Prior to
commencing the performance of the work under this Agreement, Consultant agrees
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to obtain and maintain any employer's liability insurance with limits not less than
$1,000,000 per accident,
d. if Consultant is or employs a licensed professional such as an architect or engineer:
Professional liability (errors and omissions) insurance, with a combined single limit
of not less than $1,000,000 per claim with $2,000,000 in the aggregate.
e. The following requirements apply to the insurance to be provided by Consultant
pursuant to this section.
(i) Consultant shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement,
(ii) Certificates of insurance shall be furnished to the City upon execution of
this Agreement and shall be approved by the City,
(iii) Certificates and policies shall state that the policies shall not be cancelled
or reduced in coverage or changed in any other material aspect, by
consultant, without thirty (30) days prior written notice to the City.
(iv) Consultant shall supply City with a fully executed additional insured
endorsement.
£ If Consultant fails or refuses to produce or maintain the insurance required by this
section or fails or refiuses to furnish the City with required proof that insurance has
been procured and is in force and paid for, the City shall have the right, at the City's
election, to forthwith terminate this Agreement. Such termination shall not affect
Consultant's right to bepaid for its time and materials expended prior to notification
of termination. Consultant waives the right to receive compensation and agrees to
indemnify the City for any work performed prior to approval of insurance by the
City.
8, INDEMNIIFICATIQN
Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers,
agents, employees, consultants, special counsel, and representatives from liability: (1) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for
personal injury, including death, and claims for property damage, which may arise from the
negligent operations of the Consultant or its Consultants, subcontractors, agents, employees, or
other persons acting on their behalf which relates to the services described in section I of this
Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution,
judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement.
This indemnity and hold harmless agreement applies to all claims for damages, just compensation,
restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the
events referred to in this Section or by reason of the terms of, or effects, arising from this
Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the
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defense of the City, including fees and costs for special counsel to be selected by the City,
regarding any action by a third party challenging the validity of this Agreement, or asserting that
personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal
or property rights arises by reason of the terms of, or effects arising from this Agreement. City
may make all reasonable decisions with respect to its representation in any legal proceeding.
Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code
Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section
2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful
misconduct of the Consultant.
9. INTELLECTUAL PROPERTY INDEMNIFICATION
Consultant shall defend, indemnify and hold harmless the City, its officers, agents,
representatives, and employees against any and all liability, including costs, and attorney's fees,
for infringement of any United States' letters patent, trademark, or copyright contained in the work
product or documents provided by Consultant to the City pursuant to this Agreement.
10, RECORDS
Consultant shall keep records and invoices in connection with the work to be performed
under this Agreement. Consultant shall maintain complete and accurate records with respect to
the costs incurred under this Agreement and any services, expenditures, and disbursements
charged to the City for a minimum period of three (3) years, or for any longer period required by
law, from the date of final payment to Consultant under this Agreement. All such records and
invoices shall be clearly identifiable. Consultant shall allow a representative of the City to
examine, audit, and make transcripts or copies of such records and any other documents created
pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all
work, data, documents, proceedings, and activities related to this Agreement for a period of three
(3) years from the date of final payment to Consultant under this Agreement.
11. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees that
it shall not use or disclose such information except in the performance of this Agreement, and
further agrees to exercise the same degree of care it uses to protect its own information of like
importance, but in no event less than reasonable cam. "Confidential Information" shall include all
nonpublic information. Confidential information includes not only written information, but also
information transferred orally, visually, electronically, or by other means. Confidential
information disclosed to either party by any subsidiary and/or agent of the other party is covered
by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any
information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the
Consultant disclosed in apublicly available source; (e) is in rightful possession of the Consultant
without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e)
is independently developed by the Consultant without reference to information disclosed by the
City.
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12. CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interest and shall not have interests, direct or
indirect, which would conflict in any manner with performance of services,
13. NOTICE
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 City: Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Fax: 714- 647-6956
Executive Director
Planning and Building Agency
City of Santa Ana
20 Civic Center Plaza (M-21)
P.O, Box 1988
Santa Ana, CA 92702
Fax: 714-647-5897
To Consultant: Phil Martin & Associates
4860 Irvine Blvd.
Suite 203
Irvine, CA 92620
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.
14. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant regarding the subject matter herein, and supersedes any and all other agreements, oral
or written, between the parties. In the event of a conflict between the terms of this Agreement and
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any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be
modified except by written instrument signed by the City and by an authorized representative of
Consultant. The parties agree that any terms or conditions of any purchase order or other
instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not
bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no
representations, inducements, promises or agreements, orally or otherwise, have been made by any
party, or anyone acting on behalf of any party, which are not embodied herein.
15. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without
the City's prior written consent shall be considered null and void. Nothing in this Agreement
shall be construed to limit the City's ability to have any of the services which are the subject to
this Agreement performed by City personnel or by other consultants retained by City.
16. WAIVER
No waiver of breach, failure of any condition, or any right or remedy contained in or
granted by the provisions of this Agreement shall be effective unless it is in writing and signed by
the party waiving the breach, failure, right or remedy, No waiver of any breach, failure or right, or
remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not
similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies.
17. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of
temunation, subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to
deliver to the City all work product completed as of such date, and in such case
such work product shall be the property of the City unless prohibited by law, and
Consultant consents to the City's use thereof for such purposes as the City dooms
appropriate.
b. Payment need not be made for work which fails to meet the standard of
performance specified in the Recitals of this Agreement.
18. NON-DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, rotation, sex, marital status,
sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by
applicable law, in the recruitment, selection, training, utilization, promotion, termination or other
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employment related activities or in connection with any activities under this Agreement.
Consultant affirms that it is an equal opportunity employer and shall comply with all applicable
federal, state and local laws and regulations.
19. JURISDICTION -VENUE
This Agreement has been executed and delivered in the State of California and the validity,
interpretation, performance, and enforcement of any of the clauses of this Agreement shall be
determined and governed by the laws of the State of California. Both parties further agree that
Orange County, California, shall be the venue for any action or proceeding that maybe brought or
arise out of, in connection with or by reason of this Agreement.
20, PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder
and required by the laws and regulations of the United States, the State of California, the City of
Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and
in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and
exemptions. Said inability shall be cause for termination of this Agreement.
21, MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature herein below has the
power, authority and right to bind their respective parties to each of the terms of
this Agreement, and shall indemnify City fully, including reasonable costs and
attoiney's fees, for any injuries or damages to City in the event that such authority
or power is not, in fact, held by the signatory or is withdrawn.
b. All exhibits referenced herein and attached hereto shall be incorporated as if fully
set forth in the body of this Agreement.
-- signature page to follow --
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above written,
ATTEST:
CITY OF SANTA ANA
M IAD.HUIZAR Raul Godin Iir 2
Clerk of the Council City Manager
APPROVED AS TO FORM(
SONIA R. CARVALHO
City Attorney
By; r
Lisa Storck
Assistant City Attorney
FOR APPROVAL
4�` ,
CANDIDA NEAL
Interim Executive Director
Planning and Building Agency
CONSULTANT
'�&A'N\sn—vt�
Title`.
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Title`.
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FEE SCHEDULE (OR) RATES AND CHARGES
Page 11 of 11
Scope of Services — Phil Martin & Associates has the experience and expertise to provide tite scope of the
Environmental Services listed in Section III.A. and includes:
➢ Initial Study
➢ Notice of Preparation
➢ Notice of Availability
➢ Notice of Determination
➢ Categorical Exemption
➢ Negative Declaration
➢ Mitigated Negative Declaration
➢ Environmental Impact Report (Program, Focused, Master, Staged)
➢ EIR Addendum, Supplemental MR, Subsequent EIR
➢ Mitigation Monitoring Progratta
➢ Response to Comments
➢ Statements of Overriding Considerations
➢ NEPA compliance documents
In addition, Phil Martin & Associates will complete the following tasks along with and as part of the above
services:
➢ Prepare, mail, and file with the respective public agencies all CEQA envimmucand noticing
documents (Notice of Preparation, Notice of Completion, Notice of Availability, Notice of Intent to
Adopt a Negative Declaration, Notice of Determination),
➢ Findings of Pact.
➢ Attend and present at planning Commission and City Council hearings.
Phil Martin & Associates through their sub -consultants will also have prepared the Technical Studies listed in
Section 1113 when requested by the City, The Technical Studies that will be prepared include;
➢ Air Quality Study
➢ Noise impact Study
➢ Biological Resource Assessment
➢ Cultural Resource Study
➢ Enviroomental Site Assessments
A Geological/Soil Study
➢ Greenhouse Gas Assessment
➢ Health Risk Assessment
➢ Historical Resource Assessment
➢ Hydrology/Water Quality Study
➢ Water Supply Assessment
➢ M metal Resource Study
➢ Utility/Sewer Study
➢ Traffic Study
BFFBCT7V J NUARY 1, 2017
Principal............................................................................................................................... $175.00
Gtapluc Artist ............ .......... ...................... ............................. .............................................. $40,00
Sulu-Consu tants
Sub -Consultants ......
Cost
Cityo£Santa.Ana Paget
&quart for Proposal — Environmental snd Planning Services
A� ®® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
03/12/2018
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
CONTACT Elizabeth Lee
NAME:
SelectSolutions Insurance Services
Ni (866)500-6359 AC (925)951-0077
Est), No:
1350 Carlback Avenue
E-MAIL elizabethl@ppibselect.com
ADDRESS:
Suite 100
INSURER(S) AFFORDING COVERAGE
NAIC9
Walnut Creek CA 94596
INSURER A: The Hanover Insurance Company
22292
INSURED
INSURER B : Travelers Casually and Surely Company of America
31194
PHIL MARTIN & ASSOCIATES INC
INSURER C :
4860 IRVINE BOULEVARD,
INSURER D :
SUITE 203
INSURER E :
IRVINE CA 92620
INSURER F:
COVERAGES CERTIFICATE NUMBER: 17-18 GL 17-19 EO 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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
ADULISJUK
WVD
POLICY NUMBER
POLICY EFF
MMIDDNYYY
POLICY EXP
MM/DDIYYYY
LIMITS
X
COMMERCIAL GENERALLIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE � OCCUR
DAM E REN
PREMISES Ee occurrence
$ 300,000
MED EXP(Any one person)
$ 5,000
PERSONAL &ADV INJURY
IS 1,000,000
A
Y
OH39105405
06/01/2017
06/01/2018
GEN'LAGGREGATE LIMITAPPLIES PER:
X POLICY ❑ jECT El TOO
GENERALAGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
(COM BINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
ANVAUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
OH39105405
06/01/2017
06/01/2018
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
HIRED V NON -OWNED
AUTOS ONLY /� AUTOS ONLY
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DED
I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE El
OFFICERIMEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS be.
E.L. DISEASE -POLICY LIMIT
$
B
Professional Liability
106787710
09/05/2017
09/05/2019
Per Claim
Aggregate
$1,000,000
$2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
As per contract on file with Insured. City of Santa Ana is included as Additional Insured on General Liability policy per the attached
endorsement.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Santa Ana Planning and Building Agency I M20
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 1988
AUTHORIZED REPRESENTATIVE
Santa Ana CA 92702
%r '
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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cgs�,,� Hanover
]nsurance roue_
OH39105405 5701628
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY SUPPLEMENTARY ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
A. Additional Insured by Contract, Agreement or
njury and advertising injury".
Permit
2 To an person or organization included
() y
The following is added to SECTION II -
as an insured by another endorsement
issued b and made
Y us part of this
LIABILITY, C. Who Is An Insured:
Coverage Part.
Additional Insured by Contract, Agreement or
(3) To any lessor of equipment:
Permit
a. Any person or organization with whom you
(a) After the equipment lease expires;
agreed in a written contract, written
or
agreement or permit that such person or
(b) If the "bodily injury", "property
organization to add as an additional insured
damage", or "personal and
on your policy is an additional insured only
advertising injury" arises out of sole
with respect to liability for "bodily injury",
negligence of the lessor
"property damage", or "personal and
(4) To any:
advertising Injury" caused, in whole or in
part, by your acts or omissions, or the acts
(a) Owners or other interests from
or omissions of those acting on your behalf,
whom land has been leased if the
"occurrence"
but only with respect to:
or offense takes lace
after
or the offense is committed
(1) "Your work" for the additional insured(s)
the lease for the land expires; or
designated in the contract, agreement
or permit including "bodily injury" or
(b) Managers or lessors of premises if:
"property damage" included in the
I The
(1) place or
"products -completed operations hazard"
the offense is committed after
only if this Coverage Part provides such
you cease to be a tenant in that
coverage.
premises; or
(2) Premises you own, rent, lease or occupy;
(ii) The "bodily injury", "property
or
damage", "personal Injury" or
(3) Your maintenance, operation or use of
"advertising injury" arises out of
structural alterations, new
equipment leased to you.
construction or demolition
b. The insurance afforded to such additional
operations performed by or on
insured described above:
behalf of the manager or lessor.
(1) Only applies to the extent permitted by
(5) To "bodily injury", "property damage" or
law; and
"personaland advertising injury"arising
(2) Will not be broader than the insurance
out of the rendering of or the failure to
which you are required by thecontract,
render any professional services.
agreement or permit toprovidefor such
This exclusion applies even if the claims
additional insured.
against any insured allege negligence
(3) Applies on a primary basis if that is
or other wrongdoing in the supervision,
required bythe written contract, written
hiring, employment, training or
agreement or permit.
monitoringpof others by that insured, if
(4) Will not be broader than coverage
the "occurrence" which caused the
"bodily injury" or "property damage" or
provided to any other insured.
the offense which caused the "personal
(5) Does not apply if the "bodily injury",
and advertising injury" involved the
"propertydamage" or "personal and
rendering of or failure to render any
advertising injury" is otherwise
professional services by or for you.
excluded from coverage under this
d. With respect to the insurance afforded to
Coverage Part, including any
these additional insureds, the following is
endorsements thereto.
added to SECTION II - LIABILITY, D. Liability
c. This provision does not apply:
and Medical Expense Limits of Insurance:
(1) Unless the written contract or written
The most we will pay on behalf of the
agreement was executed orpermit was
additional insured for a covered claim is the
issued prior to the "bodily injury",
lesser of the amount of insurance:
"property damage", or "personal
391-1586 0816 Includes copyrighted material of Insurance Services Offices, Inc., with its permission. Page 1 of 2
1. Required by the contract, agreement or
permit described in Paragraph a.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations
B. Aggregate Limits of Insurance per Project or per
Location
The following changes are made to SECTION II -
LIABILITY:
1. The following is added to SECTION II -
LIABILITY, D. Liability and Medical
Expenses Limits of Insurance, paragraph 4:
The Aggregate Limits of Insurance apply
separately to each of "your projects" or each
"location" listed in the Declarations.
2. For the purpose of coverage provided by
this endorsement only, the following is
added to SECTION II - LIABILITY, F. Liability
And Medical Expenses Definitions:
1. "Your project' means:
a. Any premises, site or 'location" at,
on, or in which 'your work" is
not yet completed; and
b. Does not include any"location" listed
in the Declarations.
2. "Location" means premises involving the
same or connecting lots, or premises
whose connection is interrupted only by
a street, roadway, waterway or
right-of-way of a railroad.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED.
391-1586 08 16 Includes copyrighted material of Insurance Services Offices, Inc., with its permission. Page 2 of 2
I 1 " r r hereby affirm under penalty of perjury, the
(Name/Title)
following declaration
I certify on behalf o G that during the term of my
(Consulmt/Company ame)
contract fore\\ services with the City of Santa Ana, I will
not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions and provide proof of workers' compensation coverage.
DATE::341
� �c4
t; t
$y:
� i t Name: s ,
Title: It
Telephone: e "i 0p
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR
IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
FrancineR.
e
Villareal Dace, M20MOS 100e:a2
A41cl CERTIFICATE OF LIABILITY INSURANCE
�i
DATE(M /202YYY)
7/31 /2020
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
Assured Partners I Hall & Company
A/E Insurance Services
1966010th Ave NE
CONTACT
NAME: Julia Ardon CA Lic #OF83966
PHONE FAX
Alc No Ext: 360-626-2956 LAIC No:360-626-2956
ADDRESS: julia.ardon@assuredpartners.com
INSURER(S)AFFORDING COVERAGE
NAIC#
Poulsbo WA 98370
INSURERA: Argonaut Insurance Company
19801
INSURED PHIILMAIR-02
INSURER B: RLI INSURANCE COMPANY
13056
Phil Martin & Associates
1809 E. Dyer Road, Suite 301
INSURER C:
INSURER D:
Santa Ana CA 92705
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 2147050361 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
OF INSURANCE
ADDLSUBRTYPE
INSO
MO
POLICYNUMBER
POLICY EFF
MMIDDYYYY
POLICYEXP
MMIDDYYYY
LIMITS
B
X
COMMERCIAL GENERAL LIABILITY
PSB0008850
6/1/2020
9/5/2020
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE 1XI OCCUR
DAMAGE TO 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
Fyl POLICY PEP LOC
PRODUCTS-COMP/OP AGO
$2,000,000
$
OTHER:
B
AUTOMOBILE
LIABILITY
PSB0008850
6/1/2020
9/5/2020
COMBINED SINGLE LIMIT
Ea accident
$1,000,000
BODI LV I NJURY(Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTO$
BODI LY I NJURV(Per accident)
$
X
HIRED N NON -OWNED
AUTO$ ONLY AUTO$ ONLY
PROPERTY DAMAGE
Per accitlenl
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
PER OTH-
STATUTE ER
ANYPROPRIETOMPARTNER/EXECUTIVE
EL EACH ACCIDENT
$
OFFICEPoMEMBER EXCLUDED? ❑
N/A
E. L. DISEASE - EA EMPLOYE
$
(Mandatory in NH)
If as, describe under
DESCRIPTION OF OPERATIONS below
I
E.L. DISEASE -POLICY LIMIT
$
A
Professional Liab, Claims Made
121 AE0154726-00
9/5/2019
9/5/2020
PerClaim
$1,00Q000
Aggregate
$2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
The certificate holder is an additional insured per the attached.
City of Santa Ana, officer, agents employees and volunteers are an Additional Insured on the Commercial General Liability and Auto Liability when required by
written contract or agreement regarding activities by or on behalf of the Named Insured. The Commercial General Liability insurance is primary insurance and
any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance. A waiver of subrogation applies to the
Commercial General Liability and Auto Liability in favor of the Additional Insured. Certificate of Insurance shall provide thirty (30) day prior written notice of
cancellation to the Additional Insured.
CERTIFICATE HOLDER CANCELLATION
City of Santa Ana
Risk Management Divison
20 Civic Center Plaza, 4th Floor
Santa Ana CA 92701
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 RRREEPRESENTATNE
Jkvt�
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Risk Mansgslnent Diuisian
ram.
REVIEWED &{APPRO�V�ED By.,
oll lli111-1� /-z' rb6HlM�e vdt i t¢bl.
® Risk Management Analyst
Policy Number: PSB0008850 RLI Insurance Company
Named Insured: Phil Martin aAsaoolates
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
RLIPack® FOR PROFESSIONALS
BLANKET ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies insurance provided underthe following:
BUSINESSOWNERS COVERAGE FORM - SECTION II — LIABILITY
1. C. WHO IS AN INSURED is amended to include as
an additional insured any person or organization that
you agree in a contract or agreement requiring
insurance to include as an additional insured on this
policy, but only with respect to liability for "bodily
injury", "property damage' or "personal and
advertising injury" caused in whole or in part by you
or 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 "product -completed operations
hazard".
2. The insurance provided to the additional insured by
this endorsement is limited as follows:
a. 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 policy.
b. This insurance does not apply to the rendering
of or failure to render any "professional
services'.
c. This endorsement does not increase any of the
limits of insurance stated in D. Liability And
Medical Expenses Limits of Insurance.
3. The following is added to SECTION III H.2. Other
Insurance — COMMON POLICY CONDITIONS
(BUT APPLICABLE ONLY TO SECTION II —
LIABILITY)
However, if you specifically agree in a contract or
agreement that the insurance provided to an
PPB 304 02 12
additional insured under this policy must apply on a
primary basis, or a 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 that other insurance,
provided that:
a. The "bodily injury" or "property damage' for
which coverage is sought occurs after you have
entered into that contract or agreement; or
b. The "personal and advertising injury" for which
coverage is sought arises out of an offense
committed after you have entered into that
contract or agreement.
4. The following is added to SECTION III K. 2.
Transfer of Rights of Recovery Against Others to
Us — COMMON POLICY CONDITIONS (BUT
APPLICABLE TO ONLY TO SECTION II —
LIABILITY)
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 and advertising injury' arising
out of "your work' performed by you, or on your
behalf, under a contract or agreement with that
person or organization. We waive these rights only
where you have agreed to do so as part of a
contract or agreement with such person or
organization entered into by you before the "bodily
injury" or "property damage" occurs, or the "personal
and advertising injury" offense is committed.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
Rink Mvugzment Dwil
rREVIEWED &{APPR�i
O�Vlm BY.'
,. r �Fm P. V*
® Risk Management Analyst
CITY OF SANTA ANA
RISK MANAGEMENT a dsvra<am 4 HUMAN RESOURCES
Managing Risk Positive Change
WORKERS' COMPENSATION DECLARATION
r�
I hereby affirm under penalty of perjury, the
(Name/7it1eJ
following declaration:
I certify on behalf of %I � � c�IKT�-.s that during the term
(Consultant/Cott pany Name)
of my contract forservices with the City of Santa Ana,
(Type of service provided)
I will not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with the provisions and provide proof of workers' compensation coverage
immediately.
D'*n'
Print Na
Print T
Signat
Telephc ,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
1:}Risk Mgmtllnsurance RequirementslWCDedaration 08152019
RiskMmWmentDMsian
REVIEWED&APPROVED BY:
f�W� R. vd,44d
'� Risk Management Analyst