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HomeMy WebLinkAboutKIMLEY-HORN AND ASSOCIATES, INC.City of Santa I a Clerk of the Council CO&6 Mice Use (&-'/ r AGREEMENT TERMINATION FORM i�Ct�y'A Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes _ No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with l"L Pv�' — 61�1 ''" No. el7 — was completed on Lj / and final payment has been made. r � (List all amendments. Use space below N needed.) C C _ Department: G'V /� — ee �t � _ O Phone/Ext.: Signature: rfascll Cru r,�r Date: Revised: 10-18-16 / MAYOR Miguel A. Pulido INSURANCE NOT ON FILE WORK MAY NQF PROCEED, CLERK OF CONC! MAYOR PRO TEM Michele Martinez DATE: MAY. 01 2018 COUNCiLMEMBERS P. David eenavidas "� Q 0Vj k1 Vicente Sarmlenta J Jose Soiodo Sal TinaJero Juan Vllfegas CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza M-36 o P.O. Box 1988 M-36 Santa Ana, California 92702 Www.santa-ana.orn .April 11, 2018 Kimley-Horn and Associates, Inc. 765 The City Drive South, Suite 200 Orange, CA 92868 Attn: Darren Adrian, Vice President Re. Extension of ConsultantAgreementNo. A-2017-108, A-2017-108-01 CITY MANAGER Raul Godinez 11 CITY ATTORNEY .Sonia R. Carvalho CLERK OF THE COUNCIL Marla D. Hulzar Pursuant to Section 3 i"Term") of Agreement No. A-2017-108, entered into by Kimley-Horn and Associates, Inc. and the City of Santa Ana, dated May 2, 2017, the time period of the Agreement is hereby extended for an additional one (1) year period, from May2, 2018 through May 1, 2019. 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. t dwin"Williamnalvee'I'.E. Acting Executive Director, Public Works Agency CITY OF SANTA ANA aul Godinez 11 — s City Manager APPROVED AS TO FORM #�� i 3 M. Funk, Assistant City Attorney ATTEST 44' � G Ir Maria Ml-luizar clerk of 4 SANTA ANA CITY COUNCIL Miguel A. PWido Michele Me l es Vicente Sarn*wto Jose Solodo - P. David aefaNdes _ -Juan Wisps - Mayor Mayor pro Tem. Ward2 Wartl1 Wartl3 Wartl9 ` - -Ward5 maul) 1pj�u 1 - )_tilpi¢,Lyir Oa(b75anlaana orn vs8rmienloitlsantaanB.Org Isolor'0(Nsanla-aaa nub_tiofia�tlesf@saAlSenbnm—=udlleda4(a7senfps0ne pfg Client#: 25320 KIMLHORN ACORD_ CERTIFICATE OF LIABILITY INSURANCE DATE/YYYY) 7/30/201/2018 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Greyling Ins. Brokerage/EPIC 3780 Mansell Road, Suite 370 Alpharetta, GA 30022 CONTACT Jerry Noyola P/C,ONE 770-552-4225 FAX L°' EXt : (A/C, N° : 866-550-4082 ADDRESS: jerry.noyola@greyling.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins. Co. � 19445 INSURED Kimley-Horn and Associates, Inc. 421 Fayetteville Street, Suite 600 Raleigh, NC 27601 INSURER B : Aspen American Insurance Company 143460 New Ham shire Ins. Co. INSURER C : P I23841 INSURER D : Lloyds of London 085202 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 18-19 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 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. LTRR TYPE OF INSURANCE NSRLSUBR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X, COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 5268169 4/01/2018 04/01/2019 EACH OCCURRENCE $1 00,000 PREMISESOEaoccurrDence $500 000 X MED EXP (Any one person) $25 OOO Contractual Liab. PERSONAL & ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY nX JECT X LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY 4489663 4/01/2018 04/01/2019 id.nIINGLELIMIT Ea acccS $1,000,000 BODILY INJURY (Per person) $ Xi, ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X NON -OWNED AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTYnt DAMAGE Per accide $ B X UMBRELLA LIAB X I OCCUR CX005FT18 4/01 /2018 04/01/2019 EACH OCCURRENCE s5,000,000 AGGREGATE s5,000,000 EXCESS LIAB F_ICLAIMS-MADE DED X. RETENTION$0 $ C A C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYSTATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 015893685 (AOS) 015893686 (CA) 039326820 (ME) 4/01 /2018 4/01 /2018 4/01 /2018 04/01 /201 04/01/2019 04/01 /201 X PER OTH- IER E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE $1 000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 _ D Professional Liab P070831800 4/01/2018 04/01/2019 Per Claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: On -Call Agreements A-2015-171, A-2017-108, A-2016-344, A-2017-273, A-2017-025, A-2009-212, A-2018-159 01 & A-2018-160-01. The City of Santa Ana, its officers, employees, agents & representatives are named as Additional Insureds with respects to General Liability where required by written contract. The above referenced liability policies with the exception of workers compensation & professional liability are primary & nonoc 'tributory (See Attached Descriptions) REVIEWED BY: EUNICE HEREDIA (PG 1 OF ) l..Crl 1 IF- 1 G City of Santa Ana Purchasing Department 20 Civic Center Plaza Santa Ana, CA 92701-0000 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 �4/�1 ACORD 25 (2016/03) 1 of 2 #S1150205/M1017400 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JNOY1 DESCRIPTIONS (Continued from Page 1) where required by written contract. Separation of Insureds applies to the General Liability Policy. Umbrella Follows Form with respects to General, Automobile & Employers Liability Policies. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' written notice (except 10 days for nonpayment of premium) will be provided to the Certificate Holder. SAGITTA 25.3 (2016/03) 2 of 2 #S1150205/M1017400 REVIEWED BY: EUNICE HEREDIA (PGZOF ) POLICY NUMBER: 5268169 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION PER THE CONTRACT OR AGREEMENT, WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section If - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law: and 2. If coverage provided to the additional insured is required by a contract or agree- ment, the insurance afforded to such addi- tional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insu- rance shown in the Declarations; whichever is less. This endorsement shall not increase the appli- cable Limits of Insurance shown in the Decla- rations. CG 20 37 04 13 O Insurance Services Office, Inc„ 2012 Page 1 of 1 p REVIEWED BY: EUNICE HEREDIA (PG OF L ) This page has been left blank intentionally. REVIEWED BY: EUNICE HEREDIA (PG of ) Client#: 25320 KIMLHORN ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYV) 6/18/2019 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. iMPORTAN f: 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER : CoN Jerry Noy ola Greyling Ins. Brokerage/EPIC PHONE I-AX (41C, Nc Ext , 770-552-4225 {wc, NuI; 866-550-4082 3780 Mansell Road, Suite 370 ADORIES , Jerry. noyoia@greyling.com Alpharetta, GA 30022 INSURER St AFFORDING COVERAGE NAIC # INSURER A; National Union Fire Ins. Co. 19445 INSURED Kimley-Horn and Associates, Inc. Fayetteville Street, Suite 6O0 Raleigh, NC 27601 Raleigh, INSURER B ; Aspen American Insurance Company 43460 New Ham INSURER C ; shire Ins. Co. P 23841 INSURER D : Lloyds of London 085202 INSURER E: INSURER F : COVERAGES CFRTIFIRATF MIIMRFR• to-9n ocvlc In �I . 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 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. INSRpT7L5UHR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMMD/YYYV MM/DD/YYYV LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �� OCCUR 5268169 4/01/2019 04/011202C EACH OCCURRENCE $ 1,000000 _ $500000 DAMAGET RENTED PREMISES Ea occurrence X Contractual Liab. MED EXP (Any oneperson) $25 000 _ PERSONAL & ADV INJURY $ 1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY, ER JECOT LOC GENERAL AGGREGATE s2,000,000 PRODUCTS - COMP/OP AGG $2,000 000 $ OTHER: A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY 4489663 4/01/2019 04/0112020 COMBINED SINGLE LIMIT 1,000i 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PRCi}"+FA 5 WAdE -{Pur acCidenl) $ $ $5000000 ,�t� B UMBRELLA LIAB OCCUR 4/01/2019 04/01/202 CX005FT19 EACH OCCURRENCE X -X EXCESS LIAR CLAIMS -MADE AGGREGATE DED X RETENTION O _ _$5,000,000 $ C A WORKERS COMPENSATION AND FJIAPLOYERS' LIABILITY YIN ANYPROPRIET4 WPARTNER/EXECUTIVE OFFICERIMFMIlF.R EXCLUDED? � N I A 015893685 AOS ( ) 015893686 (CA) 4/01l2019 4/01/2019 04/01 /202 04/01/202 PER OTH- X E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 00O 000 (Mandatory In NIi) If yes, describe under DESCRIPTION OF OPERATIONS below I I B0146LDUSA1904949 E.L. DISEASE - POLICY LIMIT 1 $1,000,000 D Professional Liab 4/01/2019 04/01/2020, Per Claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may bo attached if more space Is required) Re: On -Call Agreements A-2015-171, A-2017-108, A-2016-344, A-2017-273, A-2017-025, A-2009-212, A-2018-159 01 & A-2018-160-01. The City of Santa Ana, its officers, employees, agents & representatives are named REVIEWED & APPRO Additional Insureds with respects to General Liability where required by written contract. The above By Risk MANAGEMENT DIVIS referenced liability policies with the exception of workers compensation & professional liability are primary & non-contributory where required by written contract. Separation of Insureds applies to the 7 201f1 la (See Attached Descriptions) �Im A 0 VCR I I F§LM I C nyt_UCM is AN GE LLA TIUN FDA hI!'IhIC n lkru t Are City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 In ACORD 25 (2016103) 1 of 2 #S1641449/M1513917 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JNOY1 DESCRIPTIONS (Continued from Page 1) General Liability Policy. Umbrella Follows Form with respects to General, Automobile & Employers Liability Policies. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' written notice (except 10 days for nonpayment of premium) will be provided to the Certificate Holder. REVIEWED & APPROVEL, By Risk MANAGEMENT DiVi$iON 272019 FRANCINE R. VILLAREAL SAGITTA 25.3 (2016/03) 2 Of 2 #S1641449/M1513917 POLICY NUMBER: 5268169 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Addifional Insured Person(s) Location And Description Of Completed Operations Or Organization(s) ANY PERSON OR ORGANIZATION PER THE CONTRACT OR AGREEMENT, WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO, Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as at) additional insured the person(s) or organizations) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard", However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and which you are required by the contract or agreement to provide for such additional insured, B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance; 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insu- rance shown in the Declarations; whichever is less. 2. If coverage provided to the additional i insured is required by a contract or agree- This endorsement shall not increase the appli- I meal, the insurance afforded to such addi- cable Limits of Insurance; shown in the Decla- ! tional insured will not be broader than that rations, REVIEWED & APPRpOV b 1 By RIs G 272019 CO 20 37 04 13 © Insurance Services Office, Inc., 2012 FRANCI E R. VILLA EAF This page has been left blank intentionally. REVIEWED & APPROVEL By Risk MANACtEMENT DIVISION