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HomeMy WebLinkAboutN. DURANT TRAINING AND CONSULTING SERVICES 1 - 2018] City of Santa Ana E4' Clerk of the Council COTC Office Use Only AGREEMENT TERMINATION FORM '0 .IR 30 3 7 Please complete this form in its entiretywhen the attached agreement and dl i' 5 p g �-,{ ; �f �"r kJ—, I,i� amendments (if any) are no longer in effect. -~R? O� f, . I L.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 J•R Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with i 'ic -,r.1 `rra- N INc, 9i C-c'N N14r. Ltd No. 2 C>1 ' • dqS was completed on f":.5a1 lel and final payment has been made. (List all amendments. Use space below if needed.) Department: ivdA- Phone/Ext.: Signature: l'.41011Letdr\----• Date: Revised: 10-18-16 (INSURANCE MON FILE ,WORK MAY NOT PROCEED N-2018-098 CLERK OF COUNCIL DATE: 11W , 5 2016 AGREEMENT WITH NOEMI DURAN of rWACX) TO PROVIDE SAFETY TRAINING SERVICES 41fL1/t%ty THIS AGREEMENT is made and entered into this 1st day of May, 2018, by and between N. Duran Training &,C.onsulting_ $ery=ices, ("Contractor"), and the City of Santa Ana, a charter city and municipal. corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a contractor to provide on-site safety training services for Water Resources Division. In addition, contractor may provide risk control evaluations, risk control action plan, safety program development, job taskanalysis; and compliance reviews & reports services.as needed. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking 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 a professional consulting firm in 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: 1. SCOPE OF SERVICES a. Consultant shall perform during the term of this Agreement, the tasks and obligations for the on-site safety training services for the Water Resources Division including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in Exhibit A, attached hereto and incorporated by reference. b. Consultant shall provide, at the sole discretion and request of the City, services related to risk control evaluations, risk control action plan, safety program development, job task analysis, and compliance reviews on an as needed basis for the City. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the rates and charges identified in Exhibit A. The total amount to be expended under this Agreement shall not exceed $25,000; which includes any additional costs for work performed at the sole direction of the City. Page 1 of 9 Non -Fed Funding (9.20.2017) b. Consultant shall provide separate quotes, upon request by the City, for services regarding Section I.b. above which shall be approved by the City's Public Works Agency prior to commencement of services. c. Payment by City shall be made within 45 days (forty-five) 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 which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date stated above and continue through -April 30, 2019, unless terminated earlier in accordance with Section 16, below. The exact date(s) of the course shall be scheduled to occur during the term of the Agreement by mutual agreement by the parties. 4. PREVAILING WAGES Consultant is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), 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. 5. INDEPENDENT CONTRACTOR 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 nor 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 security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, 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 Page 2 of 9 Non -Fed Funding (9.20.2017) drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("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 insured(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, and representatives as additional insured(s); (b) be primary and not contributory 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. C. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 of the 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 to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. 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 canceled or reduced in coverage or changed in any other material aspect without thirty Page 3 of 9 Non -Fed Funding (9.20.2017) (30) days prior written notice to the City. iv. Consultant shall supply City with a fully executed additional insured endorsement. e. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses 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 be paid 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. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, 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, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 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 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 out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, 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 Page 4 of 9 Non -Fed Funding (9.20 2017) 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 care. "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 a publicly available source; (c) 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. 12. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, 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 employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, 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 any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument Page S of 9 Non -Fed Funding (9 20.2017) 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 is 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. 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 termination, 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(s) 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 deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 17. 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. 18. 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 may be brought or arise out of, in connection with or by reason of this Agreement. Page 6 of 9 Non -Fed Funding (9.20.2017) 19. 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. 20. 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 attorney'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. 21. 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 With courtesy copies to: Edwin "William" Galvez, P.E. Acting Executive Director, Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, California 92702 Fax: 714- 647-5635 Page 7 of 9 Non -Fed Funding (9 20.2017) N-2018-098 To Contractor: N, Duran Training & Consultant Services Attn: Noemi Duran 15491 Yorba Avenue Chino Hills, CA 91709 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. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: n Maria D. Huizar Clerk of the Council SONIA R. CARVALHO City Attorney Ey: �a — John nk Assistant City Attorney Edwin "William" Galvez, P Acting Executive Director Public Works Agency AL: CITY OF SANTA ANA r Raul Godinez 11 City Manager 919W�111 IN Noel Duran Title:Pres idents Page 8 of 9 Non -Fed Funding (9.20:2017) EXHIBIT A SCOPE OF SERVICES - COMPENSATION Exhibit A QUOTE January 24, 2018 Forklift classes are 4 hours in length for up to 10 participants. They are either in English or Spanish. Bilingual classes are highly discouraged due to adult learning patterns and time constraints. The first two hours of class -time are spent in a classroom setting. Class objectives will cover a brief history of OSHA, forklift fatality statistics, differences between a car and a forklift, worksite hazards, safe use of the forklift, data plates, refueling or recharging of the forklift, center of gravity, rated capacity, fire extinguisher use and inspection (this applies to mounted extinguishers on the forklift) and reviewing any OSHA regulations that are applicable to the forklift operator(s). Classroom training is not limited to the above as there are many requirements by OSHA for training. There is a pretest at the start of the class and a final exam given at the end of the two hour class session. Following classroom training, employees are guided on how to conduct a thorough inspection of the forklift -which consists of "key -off' and "key -on" inspection. Once the inspection has been completed, employees will be demonstrating (on an obstacle course) safe driving practices on the forklift. Each employee will be evaluated at this time. All employees are given a certificate upon successful completion of the class. Employees who have successfully completed the class will also receive an operators card identifying the forklift which they are certified to use. My fee is $500.00 per class. Should you have any further questions please contact me at 909-247-9503. I would be happy to come down and meet with you to discuss your needs. I look forward to hearing from you. Regards, Noemi Duran Safety Instructor COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DATEIMMIDDIYYYY) II CERTIFICATE OF LIABILITY INSURANCE °6'19'2D,6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT GENERAL LIABILITY NAME: Pian Administrator Hays Companies PHONE FAX (AIC. No. EO: 1-888-767-2159 lac, Na): 612-4864795 IDS Center, Suite 700 EMAIL 80 South 8H Street ADDREeS: Programs@hayscompanies.com Minneapolis, MN 55402 INSURER(S) AFFORDING COVERAGE NAICN INSURERA: Certain Underwriters at Lloyds 15792 INSURED INSURER B: N. Duran Training & Consulting Svcs. INSURER c: Noemi Duran INSURER D: INSURER E: 15491 Yorba INSURER F: Chino Hills, CA 91709-3189 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION. OF ANY 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 �L POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MIWDDn LIMITS GENERAL LIABILITY EACH OCCURENCE 8 Two,wo A X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 PREMISES Ea occurrence X CLAIMS -MADE 1:1 OCCUR MED EXP IAny one person) $ 2,500 X 1805MFA004084 05/28/2018 05/28/2019 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ EXCLUDED POLICY PROCT LOC JE $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ E. accident) BODILY INJURY (Per person) $ ANY AUTO BODUY INJURY (Per accident) $ ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS PROPERTY DAMAGE (Peraccident) $ NON OWNEDAUTOS $ UMBRELLA UAB OCCUR EACH OCCURANCE $ EXCESS LIAR CIAIMEMADE AGGREGATE $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY wCSTATU- OTH- TORY OMITS ER YIN EL EACH ACCIDENT $ ANYPROPRIETOWPPRTNEML% COTNE NIA OFFICEWMEMeER EXCLUDED, E.L. DISEASE - EA EMPLOYEE $ (Mena, b, NHI E.L. DISEASE -POLICY LIMIT $ If yes, desctlbe under DESCRIPTION OF OPERATIONS below A Professional Liability 1805MFA004084 05/28/2018 05/28/2019 PERCLAIM $ 1,000,000 AGGREGATE $ 1000,000 DESCMPTION OF OPEMTIONSI LOCATOW I VEHICLES (AMch ACORO 101, AddNonal Remah& Sch".0 , if,mm space is required) The City of Santa Ana, it's officers, employees, agents, and representatives are named Additional Insured per the following 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 ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Kathie Reyes 220 S. Daisy, M-85 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92703 iw*l ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ��� U�2 S/1 B P'" / Off" 7 Additional Insured Endorsement Insured: N. Duran Training & Consulting Svcs. / Noemi Duran Policy Number: 1805MFA004084 Effective Date: 05/28/2018 In consideration of the premium charged, it is hereby understood and agreed that the following is listed as an additional insured, solely with respect to Professional Services performed by the Named Insured: The City of Santa Ana, it's officers, employees, agents and representatives 220 S. Daisy, M-85 Santa Ana, CA 92703 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Date: June 19, 2018 i HAYS AFFINITY A MEMBER OF HAYS COMPANIES (a/is/I`8 /V- moi y - 0il4Y AccuTD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/ODYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 6/7/2018 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 NAME: Auto Insurance Specialists PHONE.g66-570-7335 FAX 800.498.3293 A C No: 17785 Center Court Drive ADDRiESS, commercial@aisinsurance.com Suite 500 INSURERS AFFORDING COVERAGE NAIL# Cerritos CA 90703 INSURER A: California Automobile Insurance Company 38342 INSURED INSURERS NoemiDuran INSURER C DBA: N. Duran Training & Consulting Svcs INSURER D 15491 Yorba Ave INSURER E Chino Hills CA 91709 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSLTR LTR TYPE OF INSURANCE ADDL INSD BUBR MID POLICY NUMBER MMIDDPOLICYEFFIYYYY MMIDOPLICYEXP LIMITS COMMERCIALGENERALLIABILITYLi EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-❑ LOC JECT PRODUCTS-COMPIOPAGG $ $ OTHER: A AUTOMOBILE LIABILITY BA040000045974 06/07/2018 06/07/2019 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ ANYAWO OWNED SCHOSEDULED AUTOS ONLY AUT BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB HOCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN STATUTE I ER ANYPROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ EIF7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) The City of Santa Ana, it's officers, employees, agents, and representatives are listed as an additional insured as per attachedfendors6ment. Should the above policy cancel, a notice of cancellation will be sent to the additional insured in accordance with the policy provisions. 111 L-1 st p q;� Clerk of the City Council City of Santa Ana 20 Civis Center Plaza (M-30) PO Box 1988 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. (919Ba-2075 ACUKD CUKPUKA I RUN. All fights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Web Software. www.FormsBoss.com (c) Impressive Publishing 800-208-1977 N • 2-019 6y2 WORKERS' COMPENSATION DECLARATION NOEMIDURAN I hereby affirm under penalty of perjury, the (Name/Title) following declaration I certify on behalf of N. Duran Training & Consulting that during the term of my (Organization Name) contract with the city or Santa Ana , 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. DATE: June 20, 2018 By: Noemi Duran Name: Title: Consultant Telephone: 909/247-9503 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. Paye ��