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Home My WebLink AboutWATER WISE PRO TRAININGINSURANCE ON FILE WORK MAY PROCEED WC Declaration on file. N-2098-158 �NTTIL INSURANCE EXPIRES CLERK OF CO NCI, L .. g" , DATE: G 9 I EEMENT TO PROVIDE WATER TRE ATNIENT TRAINING COURSE PW4 KaW d F1461A AGREEMENT is made and entered into this 16th day of July, 2018 by and between %terWisePro Triiining {"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 an ou, ske.watertreatment-training.comse, B. Contractor represents that it is able and willing to provide such services to the City, C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable i„ its field and ilxat auy scrviocs perforu,ed by CuluaeL01 under this Agrcc veiat will be perforrued in compliance with such standards as may reasonably be expected from a professional contracting firm in the field. NOW T HEREFORE, 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 Contractor shall furnish the services that are described in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sura to be expended under this Agreement. shall not exceed $25,000. 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 that fails to meet the standards ofperfermance 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 June 30, 2019, unless terminated earlier in accordance with Section 13, 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. INDEPENDENT CONTRACTOR Contractor 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 ennployer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment instuance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6� 1►hY1TC74\,�C��1 Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General <Liability Insurance. Contractor 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 Contractor'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) none the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-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. Workers' Compensation Insurance. In accordance with the California, Labor Code, Contractor, if Contractor has any employees, is required to be insured against liability for workers' compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident, d. If Contractor 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 Contractor pursuant to this section: (i) Contractor shall maintain all insurance required above in fall 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 (30) days prior written notice to the City. (iv) Contractor shall supply City with a fully executed additional insured endorsement. If Contractor fails or refixses 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 terminate this Agreement, Such termination shall not affect Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Contractor agrees to and shall indemnify, defend, and hold harmless the City, its officers, agents, employees, consultants, special coumsel, 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 negligence or willful misconduct of the Contractor or its, subcontractors, agents, employees, or other persons acting on their 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 Contractor farther 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 teens of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Contractor's indemnification obligations in this section shall survive expiration of this Agreement. 7. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor 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 Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor 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. Contractor 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 Contractor raider this Agreement. 8. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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 slid nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, director indirect, which would conflict in any manner with the performance of services specified under this Agreement. 10. 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 Courwil City of Santa Ana 20 Civic Center Plaza (1v1-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 With courtesy copies to: To Contractor: Executive Director Public Works Agency City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92702 WaterWisePro Training P.O. Box 772 Watsonville, CA 95078 Attn: Steve Hernandez 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. 11 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor regarding the subject matter therein, 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 instnnrrent 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 Contractor 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. 12. ASSIGNMENT lnasmuclr as this Agreement is intended to secure the specialized services of Contractor, Contractor 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. 13, TERMINATION This Agreement may be terminated by the City upon seven (7) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, City may require Contractor 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 Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. 14. NONDISCRIMINATION Contractor 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 or in connection with any activities under this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 15. 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, N-2018-158 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. 16. PROFESSIONAL LICENSES Contractor 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. Contractor 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. 17. MISCELLANEOUS PROVISIONS a. hacn unaersignea represents and warrants Haat 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. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: _ John Attorney FOR APPROVAL: Fuad S.gw&, PE, PLS Executive Dirctor Public Works eenev CITY OF SANTA ANA Rdauinez�11- City Manager CONTRACTOR: Name:tl��?sh( Title:�� c.�-oa-a eNWP'�,W�'anA Maria ID. Huizar g.t 7ClerkoftheCouncil APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: _ John Attorney FOR APPROVAL: Fuad S.gw&, PE, PLS Executive Dirctor Public Works eenev CITY OF SANTA ANA Rdauinez�11- City Manager CONTRACTOR: Name:tl��?sh( Title:�� c.�-oa-a eNWP'�,W�'anA EXHIBITA'°" N-2018-158 WarterWlsePro Tra lnin,ar Attn: Kathia Reyes / Rudy Rosas City of Santa Ana, Water Resources Division 220 S. Daisy Ave., Santa Ana, Ca 92703 Re: The following scope of work and proposal Is for the requested (2) CaSWRCS Exam -Prep Courses (1 -Distribution and 1 -Treatment). The following scope of work and proposal is for the requested Distribution and 1 Treatment). WaterWisePrc Training will pro of Santa Ana Staff at the City facility on TBD dates. Courses preparing for the California SWRCB Water Distributlo-n Exe Exams Grades 1-4 as well as those that are in nee d'of'8 app' Certification renewal. Courses Includes: 0. 1 -day/ 8hr, o .l`+ul' a'8coi o Lunc • .-1-dayt8hr. o (40) o 8 -col o' Lunc • The class i Irses (1 - for City n i q✓wycco r Treatment. irs for -page WWP; Study Guides for CaSWRCB Grades 1-4 act hour certificate for SWRCB credit for alt attendee and refreshments for the day for all attendees exclusive to City of Santa Ana employees not to exceed 40 -staff members Qualified Trainer: WWP Training hastau0htover 900+operators in the state of California in the past 18 -months and is an Approved Continuing Education Provider in California and Nevada. Our courses are conducted by Steve Hernandez, an 18 -year water professional with 9 -years in management and possessing a D5/T4 certification and currently managing on the Central Coast. He will bring his teachings to your agency with an energetic, informative and up to date course that everyone can relate to and feel comfortable engaging in. His classes have an 80-85% passing rate on all grade levels that attend the courses. EXHIBIT Cost of Services: • The cost of services for professional water operator training is not to exceed $6,000%ach day o Cost is based on: • 40 attendees ■ $150/attendee/8hr. Course • There is No charge for travel • Pricing is 50% lower than comparable competitors and still provides more services Please note that the average cost for this level of training is anywhere from $175 - $400/person for an 8hr. course but does not include: exclusive onsite training, travel expenses and/or lunch. If there are any questions or concerns about the above scope of work, please contact us. Thank you again for this training opportunity, we look forward to building a positive relationship with you and your staff. Sincerely, Steve Hernandez WaterWisePro Traininq ACOR& CERTIFICATE OF LIABILITY INSURANCE `-"` DATE Yl 04/18f2018 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 poiicy(ies) 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 Hiscox Inc. d/bfa/ Hiscox Insurance Agency in CA 520 Madison Avenue 32nd Floor CONTACT NAME: PHONE(888) 202-3007 FAX ADDRESS: contact@hiscox.com INSURERS AFFORDING COVERAGE NAICN New York, NY 10022 INSURERA: Hiscox insurance Company lnc 10200 _ INSURED INSURERS: Steven Hernandez dba Water Wise. Pro 1521 Memorial Drive _ INSURER C INSURER D Apt. C INSURER E: Hollister, CA 95023 N URERF: l2 a'aacretal3�MRill] altlG\r Rl liaj :-f a: ^Mn@lf l\ , 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. INSft LTR TYPE OF A LSUBR-- POLICY NUMBER PO C EFF DNYYY POLICY EXP M /DD YY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE 5.2,000,000 TSAXi Gkl� -PREMISES occurrence) $ 100,000 MED EXP An one arson) $ 5,000 PERSONAL&ADV INJURY $2,000,000 A Y Y UDC -1955669 -CGL -18 04/18/20113 04/18/2019 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑JEC LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGO sSIT Gen. Agg $ OTHER: AUTOMOBILE LIABILITY CO BNEO SINGLE LIMIT $ Ea accitlo d BODILY INJURY (Per person) $ ANY AUTO ALL OWNED F7 SCHEDULED AUTOS AUTOSI H BODILY INJURY Per.oadem S ( ) NOUN HIRED AUTO$ AUT60WNED AUTOS PAOPERTYDAMAGE $ Per accident $ 1 UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MAOE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPMETORIPARTNEMEXECUTIVE OFFICEMMEMBEREXCWDED9 F (Mandatary In NH) 0yaSs describe under DESCRIPTIgN OF OPERATIONS below NIA I PER =0. STATUTE E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD tqt, Additlenal Romarke Schetlule, may be adeched lF more apace is required) City of Santa Ana, its officers, employees, agents and representatives are named as additional insured, Specifically the city water division whose services will .bbe�Ito. g 7/31t1V , pfye, 1 q g - City of Santa Ana its officer Ves 220 S Daisy Ave Santa Ana, CA 92703 employees, agents and representati SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. A(:OnD ZO (ZU14/Vl) The ACORD name and logo are registered marks of ACORD GEICM geioo.cum California Evidence of Liability Insurance 3-800-6,11-3000 GEICO INDEMNITY COMPANY PO BOX 509090 SAN DIEGO, CF NAIC Code: 22055 Policy Number Elle 4188065843 Year Make 2004 CHEV Insured: ROSANA LOMELI STEVEN JASON HERNANDEZ 1521 MEMORIAL DR APT C HOLLISTER, CA 95023-5778 xpiration Date 08-20-18 Vehicle ID No. CEK13T341346582 Tho coverage provided by his policy meets the mmimum roquiromeltla of esclions %MG a f esoo.6 of the Celdom is Vahiela Code, minimum liabllily Emile prescribed by la.v Evidence of Insurance Here are your Evidence of Liability Insurance Cards. One card must be carried in the proper insured vehicle. Proof of Insurance is required to register or renew the registration of your vehicle. A law enforcement officer can ask you to prove that you have liability Insurance meeting the basic requirements of California law, A violation of these requirements can result in a fine of up to: $1,000 for the first time $2,000 for additional times Also, a judge can have your vehicle Impounded. False proof of Insurance may result in a fine up to $750 and 30 days In prison. Due to space limitations on the ID card, only the Named Insured and the Co-insured are listed. For a full list of drivers covered under this policy, please reference the Drivers section of your Declarations Page, which Is Included with your Insurance packet. If you would like additional ID cards you can go online to geico.com or call us at 1-800-841-3000. What to do at the time of an accident. • Do not admit fault. Do not reveal the limits of your liability coverage to anyone. Exchange contact information; get year, make, model, plate number, insurance carrier and policy number of all involved. Also, identify witnesses and collect contact information. • Contact the police or 91'1 if applicable, • Uontact GEI by calling tsao-a4t-oono or visit gelco.corn to report the accident. U -4 -CA (11-09) 7/39h9, PAge- a WORKERS' COMPENSATION DECLARATION I ,O rndW `Hereby affirm under penalty of perjury, the (Name/Title) following declaration I certify on behalf of k 04,y�� 0 Ajl � that during the term of my contract with the (Organization Name) p" d 1�! jLL�✓ r-('ShwY b�ity 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: ' J - ZZ- 741 7J By: 1Nrr m ---x 9v.) �yUO iW Name: <,; M KF 4tyna--,4-eL -- Title: j ti� �Yjv Telephone: ` -31. 150 q 113' 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. GEICO GEICO INDEMNITY COMPANY of 2011 5g Washington DC VERIFICATION OF COVERAGE (SEE BELOW UNDER CAUTIONARY NOTE) INSURED Policy Number: 4188065843 Effective Date: 08-20-18 ROSANA LOMELI Expiration Date: 02-20-19 STEVEN JASON HERNANDEZ Registered State: CALIFORNIA JS21 MEMORIAL OR To whom it may concern: This letter is to verify that we have issued the policyholder coverage under the above policy number for the dates indicated in the effec- tive and expiration date fields for the vehicle listed. This should serve as proof that the below mentioned vehicle meets or exceeds the financial responsibility requirement for your state. This verification of coverage does not amend, extend or alter the coverage afforded by this policy. Vehicle Year: 2004 Make: CHEV Model: SILVER1500 VIN: 2GCEK13T341346582 COVERAGES Bodily Injury Liability Property Damage Liability Uninsured &Underinsured Motorists Comprehensive collision Emergency Road Service Rental Reimbursement Lfenholder Additional Information: Additional Insured LIMITS $1MIL/$1MIL $25,000 $15,000/$30,000 Full $50/DAY-$1,500 Max If you have any additional questions, please call 1-800-841-3000 Interested Party DEDUCTIBLES $250 Ded $500 Ded/waiver Non-Ded tbf3oh?' Page, 11),(3 CAUTIONARYNOTE: THE CURRENT COVERAGES,LAIITS,ANDDEDUCTIBLESMAYDn RFROMTHE COVERAGE$LIPOTS,ANDDEDUCTIBLES INEFFECT AT OTHER TIMES DURING THE POLICYPERIOD. THIS VERIFICATION OF COVERAGE REFLECTS TAE COVERAGES, LHAITS AND DEDUCTIBLES AS OF THE ISSUED DATE OF THIS DOCUMENT WHICH IS SHOWN UNDER -ADDITIONAL INFORMATION" OR MAN ISSUED DATE IS NOT SHOWN, THE DATE OF THIS FACSI N E. U-33 10-07 GEICO GEICO INDEMNITY COMPANY N. 2018 (SF Washington DC VERIFICATION OF COVERAGE (SEE BELOW UNDER CAUTIONARY NOTE) INSURED Policy Number: 4188065843 Effective Date: 08-20-18 ROSANA LOMELI Expiration Date: 02-20-19 STEVEN JASON HERNANDEZ Registered State: CALIFORNIA 1S21 MEMORIAL DR To whom it may concern: This letter is to verify that we have issued the policyholder coverage under the above policy number for the dates indicated in the effec- tive and expiration date fields for the vehicle listed. This should serve as proof that the below mentioned vehicle meets or exceeds the financial responsibility requirement for your state. This verification of coverage does not amend, extend or alter the coverage afforded by this policy. Vehicle Year: 2000 Make: JEEP Model: CHEROKEESE VIN:IJ4FF28S2YL233330 COVERAGES Bodily Injury Liability Property Damage Liability Uninsured &underinsured Motorists UNINSURED MOTORIST PROPERTY DAMAGE Lienholder Additional Information: Additional Insured LIMITS $1MIL/$1MIL $25,000 $15,000/$30,000 $3,500 If you have any additional questions, please call 1-800-841-3000 Interested Party DEDUCTIBLES Non-Ded +W�_- (01301i$, Pdgl- 2a3 CAUTIONARYNOTE: THE CURRENT COVERAGES, LO HTS, AND DEDUCTIBLES MAYDIFFER FROM THE COVERAGES, LIMITS, AND DEDUCTIBLES IN EFFECT AT OTIMR TIMES DURING THE POLICYPERIOD. THHS VERIFICATION OF COVERAGE REFLECTS THE COVERAGES, LIMITS AND DEDUCTIBLES AS OF THE ISSUED DATE OF THIS DOCUMENT WHICH IS SHOWN UNDER "ADDITIONALINFORMATION OR MAN ISSUED DATE IS NOT SHOWN, THE DATE OF TINS FACSI E. U-3310-07 GEICO GEICO INDEMNITY COMPANY washinvaa DC VERIFICATION OF COVERAGE (SEE BELOW UNDER CAUTIONARY NOTE) INSURED Policy Number: 4188065843 Effective Date: 08-20-18 ROSANA LOMELI Expiration Date: 02-20-19 STEVEN JASON HERNANDEZ Registered State: CALIFORNIA 1521 MEMORIAL DR To whom it may concern: This letter is to verify that we have issued the policyholder coverage under the above policy number for the dates indicated in the effec- tive and expiration data fields for the vehicle listed. This should some as proof that the below mentioned vehicle meets or exceeds the financial responsibility requirement for your state. This verification of coverage does not amend, extend or alter the coverage afforded by this policy. Vehicle Year: 2010 Make: AUDI Model: A4 2. OT VIN: WAUWFAFL4AAO 35245 COVERAGES Bodily Injury Liability Property Damage Liability Uninsured &Underinsured Motorists Comprehensive collision Emergency Road Service Rental Reimbursement Lfenholder Additional Information: Additional Insured LIMITS $1MIL/$1MIL $25,000 $15,000/$30,000 Full $50/DAY-$1,500 Max If you have any additional questions, please call 1-800-841-3000. Interested Party DEDUCTIBLES $250 Ded $500 Ded/waiver Non-Ded It'l �Y� Page 3�f3 CAUTIONARYNOTE: THE CURRENT COVERAGES,LUV TS,ANDDEDUCTIBLESMAYDIFFERFROM THE COVERAGES, LIMITS, AND DEDUCTIBLES IN EFFECT AT OTHER TDNLS DURING THE POLICY PERIOD. THIS VERIFICATION OF COVERAGE REFLECTS THE COVERAGES, LURTS AND DEDUCTIBLES AS OF THE ISSUED DATE OF TMS DOCUMENT WHICH IS SHOwN UNDER `ADDMONAL INFORMATION` OR NAN ISSUED DATE IS NOT SHOWN, THE DATE OF THIS FACSnm,E. U-33 10-07