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HomeMy WebLinkAboutSTAGE PLUS EVENT STAGING SERVICESCity of Santa A �q Clerk of the Council corc Office Use o�y AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Cify of Santa Ana Note: If your agreement is grant related, please ensure that all grant retention requirements I have been satisfied prior to signing the termination form. `; j o 2 2' Is the agreement(s) a permanent record? Yes _ No Clerk of the Council Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with No. was completed on t ';J311) al and final payment has been made. (list all amendments. Use space below if needed.) i�/—� p � c t Department: ��PAWiK `O� _Q Phone/Ext.: Signature: fG&A) a Qk�(Vftn Date: 71ac-I la-� Revised: 10-18-16 1MVItrAURMEN MAYOR Miguel A. Pulido MAYOR PRO TEM Juan Milegas COUNCILMEMBERS Cecilia Iglesias David Penaloxa Raman Rayne Vicente Sarmienta Jose Solorio 1M# fDATEJA,N 14 2019 vAL2,40 St\+l'u. Uvv'-j CITY OF SANTA ANA PARKS, RECREATION AND COMMUNITY SERVICES AGENCY 20 Civic Center Plaza M•23 a P.O. Box 1988 Santa Ana, California 92702 Anmian December 13, 2018 CITY MANAGER Raul Godirfez II CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria O. Holzer Stage Plus Event Staging Services 2330 S, Susan Street Santa Ana, CA 92704 Re: Second Extesion of Contractor Agreement No. A-2017-056 to install, maintain and remove stage equipment for various City hosted events Dear Mr. Iluarte: Pursuant to Section 3 ("Tenn") of Agreement No. A-2017-056 entered into by Stage Plus Event Staging Services and the City of Santa Ana, dated March 21, 2017, the time period for said Agreement is hereby extended for an additional one (1) year period„ from January 1, 2019 to December 31, 2019. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. Sincerely, L a tdlof Executive Director Planning and Building Agency CITY CDC SANTA p�ANA Raul Godinez I1 City Manager APPROVED AS TO CORM I.auris A, Rossini Senior Assistant City Attorney__, _ SANTA ANA CITY COUNCIL STAGE PLUS EVENT STAGING SERVICES4 By: i� Title: ATTEST=� Maria D. Iluizatr % Clerk of Council Mguer A.Pu1ido Jwn vefegas mwte saamenta Oawd Panatozs Jwe SWw(o Rwaan Rwns coopa Basics Wyw Mapes Pm Ten, Ward 5 WaldI Wad2 Wwd3 WWd4 Ward +ia 629A@:928 iti}ieass�sattt&-aro as Y33?2N.#EIiR�8fl41+r'nna �a tle�en3iozatbsSanfaanayxg nCa; pngg{,q R xn k4s£mta „g4 �a n . STAGPLU-01 GLORIAZIMMERMAN DNMI CERTIFICATE OF LIABILITY INSURANCE b 08/3/2123/2018 OB8 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 have ADDITIONAL INSURED provisions of 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 endorsomenhs). PRODUCER CONTACT Gloria Zimmerman NAME; NFP Propertg & Casualty Services, Inc, PHONE _ FAx 1661 North Tustin Avenue (Arc, No, ExU: (714),505.6550 (AIC, Nw (714) 975-8966. Suite 500 E- AiL Santa Ana, CA 92705 Ad"DREss ,... INSURER(S) AFFORDING COVERAGE _ NAIC N_ INSURERA:Ohio Security Insurance Company 124082 INSURED Stage Plus, Inc. P.O. Box 11060 Santa Ana, CA 92711 jq-ac)I-c ,1'01 E: CrVVr`PArd FS r`.Id PTIFIr..ATF MIIMRPP� GGbICInad All Ivan Cti. 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, INSRI ADOLSUBR: TYPE OF INSURANCE p POLICY NUMBER POLICY EFF POLICY EXP -ypyYl; LIMITS W� A X COMMERCIAL GENERAL LIABILITY : EACH OCCURRENCE $ 1,000,000 CI -AIMS -MADE X OCCUR X I,BKS58241997 07I29I2018 07/2912018 '':, DAMAGE TO „ .,,, 600,000 MED EXP(Any one Person) $_. 15,000 _.. ''. PERSONAL & ADV INJURY $ _ 11000,000 GENT AGGREGATE LIMIT APPLIES PER: ! GENERAL AGGREGATE $ 2,000,000 POLICY x VE� '._ LOC E PRODUCTS COMPIOPAGG g... 2'000000 OTFIER 5 B AUTOMOBILE LIABILITY :' COMBINED SINGLE LIMIT 1,0gg gggl aocla4ntl _. 8 _ G ANY AUTO ,AW3D163942 10310512018 03105/2019 `(Ea BODILY INJURY leper person) OWNED : SCHEDULEq X ,5 _; AUTOS ONLY AU BOODILY INJUpRY (Par accident) S_ pT�OpSW p x AUlEOS ONLY x AUTOS 10 arf AMAGE tPe�PER 5 -- - UMBRELLA LIAO i OCCUR EACH OCCURRENCE S_ EXCESS LIAB CLAIMS MADE ... .._ i AGGREGATE DED RETENTION$ S WORKERS COMPENSATION IANDEMPLOYERS'LIASILITY PER OTH- ! STATUTE j FR YIN ANY XCE �RCIMDOER�/EXCWDED9 ECU71VE I NIA EL EACH ACCIDENT ,(mandatory In NN l i E.L. DISEASE - EA EMPLOYEES If Yes, d.o.doe undor - -_"- -__--- .DESCRIPPONOFOPERATIONS below m _ IEL DISEASE-POLICYLIMIT.S-r. DESCRIPTION OF OPERATONS) LOCATIONS IVEHICLES (ACORD 101, Additional Remarks Schedule, maybe altachad If more space is required) City of Santa Ana, its officers, employees, agents and representatives are named as Additional Insured inregards toGenqKliability par att ad CG6810 0413, Includes primary and non-contributory wording... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Santa Ana PRCSA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza, M-23 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) b 1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACe7Ra CERTIFICATE OF LIABILIT`! INSURANCE DATE (MOM DDIYVYY) III.iOB/22/2018 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 CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT, If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 sue h endorsement(s), PRODUCER Co ECT NAME: Dori Jared-Ferrento Assistance Insurance Agency PHONE (714) 245-2777 FAx 714 2 MAIL--"'-'-'"' AICa No): ( ) 45-2758 123 E. 9th Street goORESS: dialed@asslstanceins.com Unit 314 _ INSURERIS) AFFORDING COVERAGE NAICN Upland CA 91786 e.............. INSURER A: State Compensation Insurance Fund INSURED INSURER B : Manuel Huanta, DBA: Stage Plus, Inc. INSURER c: 2330 S. Susan St. INSURERD: INSURER E : Santa Ana CA 92704 - INSURER F COVERAGES CERTIFICATE NUMBER: 18-19 WC 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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDI- INSD DR V POUCYNUMBEft POLICY EFF MMIDDIYYYY POLICYEXP MMIOOIYYYY LIMITS COMMERCIAL GENERAL LIABILITY CMSAtlE CC MOUR EACH OCCURRENCE sLAI A PREMISES Ea AX(TlTE ence § MEd EXP(Any one Person) § PERSONAL &ADV INJURY § GEN'LAGGREGAE UMTAPPLIES PER: POLICY D PRO TOO GENERALAGGREOATE 5 PRODUCTS-COMPIOPAGG § S OTHER' AUTOMOBILE LIABILITY COMBINE -SINGLE LIMIT Ea accident S ANYAUTO BODILY INJURY(P., Oersan) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Par accltlentl $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident UM DRELLA LIAR OCCUR EACH OCCURRENCE §. EXCESSUM5 CLAIMS -MADE AGGREGATE $ DED I I RETENTION S $ m A WORKERS COMPENSATION ANUEMPLOVERTUABILITY YIN ANY PROPRIETOIUPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandotory in NH) I DESCRIPTION Ifw.,d ,I,A OF OPERATIONS below NIA 1786318-18 05/01/2018 ,J, 05/01/2010 PER "OTH- ,STATUTE ER EL EACHACCIDENT 8 1,000,000 E.L DISEASE - EA EMPLOYEE a 1,000,000 E.L. DISEASE- POLICY LIMIT 1,000009 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101,Additionol Remarks Schetlule,may ba attachedif more space is required) Ayt ° The City of Santa Ana, licences, employees, agents, volunteers and representatives Proof of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Santa Ana ACCORDANCE WITH THE POLIOY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92701 I AUTHORIZED REPRESENTATIVE ©1988-2015 All rinhm rncaev.d ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Other Named Insureds Stage Plus, Inc, Additional Named Insureds Doing Business As Z�7 OFAPPINF (02/2007) __ ____ __ ... COPYRIGHT 2007, AMS SERVICES INC COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART §99LE.9T NON -OWNED AIRCRAFT NON -OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY -ELEVATORS EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES AAND B ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALIZATION CLAUSE BODILY INJURY REDEFINED EXTENDED PROPERTY DAMAGE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - ANE) WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Qv 9 PAGE 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 8 © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply If there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision, B. NON -OWNED WATERCRAFT ®_ Under Paragraph 2. Exclusions of Section I - Coverage A • Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: ® This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52feet long: and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following Is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion J. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system]; to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or hhrr�� "Y (it) Contents that you rent or lease as part of a promises rental or lease agree fif�to ri of more than 7 days. P Paragraphs (1), (3) and (4) of this exclusion do not apply to "property d age" obi premises rented to you for a period of 7 or fewer consecutive days. .11' r \� A separate limit of insurance applies to this coverage as described irnoeecti6n0?Limits of Insurance. 6 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, fro., with Its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n, do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of Insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6, under Section III . Limits Of Insurance is replaced by the following; 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision 0. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) • Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of promises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your promises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. Is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Under Supplementary Payments -Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bands. 2. Paragraph 1,d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", Including actual loss of earnings Lip to $500 a day because of time off from work. G. ADDITIONAL INSUREDS • BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization Is an additional insured but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury ca d In� thole or in part by: d `1 a. Your acts or omissions, or the acts or omissions of those acting on your bet 'in the nce of your on going operations for the additional insured that are the subjecjK''pp the written t�t or written agreement provided that the "bodily Injury" or 'property damage" occ h- sonal and advertising injury" is committed, subsequent to the signing of au c �>4tn r�ct or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc„with its permission. Page 3 of 8 I Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (a) The ownership, maintenance, or use of any elevators covered by this Insurance. 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 agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only If the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial Genergl•-,Obility Condi- tions. GG�� I/01\ Q 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance5ervices Office, Ino.,with its permission, Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I -Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. 'Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or falling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", Involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring after: (1) All work, Including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor, engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. 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: a. Required by the contract or agreement; or b. Available under the applicable Limits of insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns, H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV • COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows:, 1` a. The following Is added to Paragraph a. Primary insurance:4a tY� ANe If an additional insured's policy has an Other Insurance provision making �L'poilcy axce ' u have agreed in a written contract or wriiten agreement to provide the additional Insured�+r�6h a primary and noncontributory basis, this policy shall be primary and we will not se C I ut from the additional insureds policy for damages we cover. r \� 0 2013 Liberty Mutual Insurance CO 88 10 04 13 Includes copyrighted material of Insurance Services Office, Ina, with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit Issued by a state or political subdivision between you and an additional Insured does not require this insurance to be primary or primary and non-contributory, this insurance Is excess over any other insurance for which the addi- tional Insured Is designated as a Named Insured. Regardless of the written agreement between you and an additional Insured, this insurance is excess over any other Insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies, I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; Egg I Tender the defense and indemnity of any claim or "suit" to all insurers wham also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional Insured has for a loss we cover under this Coverage Part. d, We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2, The limits of insurance applicable to the additional insured are those specified In a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy, J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS I MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a,('I) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (If you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while In the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or falling to provide professional health care serv6eo Howeve if you are not in the business of providing professional health care services a viding pr s- sional health care personnel to others, or if coverage for providing profession heatryv"ger- vices is not otherwise excluded by separate endorsement, this provision (fagras applyf �� a Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising *Lsed by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity u 0ein means the "employee's" job responsibilities assigned by you, includes the direct supervision ofQer "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and © 20131-Iberty, Mutual Insurance CG 88 10 04 13 includes copyrighted material of Insurance Services Office, mc.,with its permission. Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily Injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured is replaced by the following; 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or 'property damage" that occurred before you acquired or formed the organization; and a. Coverage B does not apply to 'personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d, Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV -Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences" is not intentional. -- -- - -- - M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section 11 - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee", N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O, BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3, is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physiig6injury, sick. ness or disease. 6 20131.1heny Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a, of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIASILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property, Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have agalnst a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the 'products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. 0 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 8 of a ACaRa' STAGPLU-01 CERTIFICATE OF LIABILITY INSURANCE NAOMIPAVLIKOWSKI DATE (MMIDDIYYYY) $1212019 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 endorsements . PRODUCER CONTACT Taml O'Neill NFP Property & Casualty Services, Inc. 1551 North Tustin Avenue Suite 500 PHONE F x Arc, Nn, Est). (858) 677-9409 (A�c,.l;(603) 875-1213 5_5_,_ i.oneill@nfp.com Santa Ana, CA 92705 INSURER(, AFFORDING COVERAGE NAIC t? INSURERA:OhIo SeCUri Insurance Com an 24082 INSURER B: INSURED A-2017-056 _ Stage Plus, Inc. A201705602 P.O. Box 11060 - - - Santa Ana, CA 92711 INSURER C INSURER D : INSURER E WSURERF: 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. INSR I TYPE OF INSURANCE ADDINSDL SUS POLICY NUMBER POLICYEFF POMMQDMYYI LICY EXPLTR DOMMI LIMITS A X I COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 $_ 5001000 CLAIMS -MADE X I OCCUR X BKS58241997 7/29/2019 7/29/2020 DAMAGE TO RENTED _2REMI$.FS.(Faos4rrP,n.rA_ $ 15,000 MED EXP. (Any. one parson)__ ,fl $ 1,000,000 ADV INJURY_ Cde_N'LAGGREGAT ` LIMIT APPLIES PER: 1 POLICY J JPof El LOC _PERSONAL& _GENERALAGGREGATE �,. PRO12UCTS-COMPIOPAGG, 2,000,000 $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY �yOMBI ED SINGLE LIMIT .FEE! dgr1O- — — $ $ ANY AUTO BODILY INJURY JPerperson) BODILY INJURY Per acciden $ _ OWNED SCHEDULED AIURTEO�S ONLY AUTOS SSWNEp AUTOS ONLY LAUTOS ONLY i!9QN AGE $ UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE EXCESS LIAB CLAIMS -MADE pp REVIEWED APPROVED CX $ $ —OCCUR ` DED RETENTION $ WORKERS COMPENSATION EMPLOYERS' LIABILITY ' ANY PROPRIETOR/PARTNER/EXECUTIVE f ' OFFICER/MEMBER EXCLUDED? � (Mandatory In NH) N I A PER I E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOY $ S If yes, describe under QESCRIPTION OF OPERATIONS below ffl E.L. DISEASE - POLICY LIMIT FRAN61NE R. VILLAkEAL DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schaduler may be attached if more space Is required) City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured in regards to General Liability per attached CG8810 0413 pursuant to written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory. 30 Days' notice of Cancellation applies. City of Santa Ana Risk Management 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 REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG88100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 3 ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU REVIEWED & APPROVEL'y By RISk MANAgEMENT DIVISION 2 019 FRANCINE R. VILLAREAL © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in F"I RI5 MI111 1PI�ROVED Insurance. ANAgEMENT DIVISION © 2013Liberty Mutual Insurance 6022019 CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission FOANC N R. VILLAREAIL b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of 1R9VF*9EF%11AWR0VED written agreement; or By Risk MANAGEMENT DIVISION © 2013 Liberty Mutual Insurance UO 02 2019 CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 3 f FRANCINE R. VILLAREAL b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, �— hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. 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 agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. REVIEWED & APPROVED By RISk MANAgEMENT DIVISION G 0 2 019 FRANCINE R. VILLAREAL © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. 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: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. REVIEWED & APPROVED By Risk MANAgEMENT DIViSiON © 2013Liberty Mutual Insurance AU 02 2019 CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissio . FR NCINE . VILLAREAL b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: -- An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injO"vl� aAFiRQVED By Risk MANAGEMENT DiViSiON © 2013 Liberty Mutual Insurance �' `�� CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. U Ag&NV ILLAREAL advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior 'occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an 'occurrence", offense, claim or "suit' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. 'Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. RE VIEWED & APPROVED By AUG 0 2 Z019 © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissio `p REAL tURANc« l P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a —' contract with that person or organization and included in the "products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and r -- 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. REVIEW & APPROVED PP °s o° ay RtSkEDp U J2LUI3 FRANCINE R. VILLAREAL © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8 Cl CW A021011 CERTIFICATE OF INSURANCE This certificate is issued for informational purposes only, It certifies that the policies listed In this document have been issued to the Named Insured, It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other contract, such as between the certificate holder and the Named Insured, The limits shown below are the limits provided at the policy inception,. Subsequent paid claims may reduce these limits. Certificate Holder. TILE, TY OF : NTA ANA, RISK MA {AGMENT, "PTS OFFICERS EMPLOYEES, AGENTS, AND REPRESENTATIVES CIVIC CE TITER P=2 SA!'.I'A ANA, PA USA 92"10 4058 Named Insured: STPI"", Z. r.l"1: 1c PC BOX i 1060 S-ANITA ANA C-A 32%11-1060 Automobile Liability Insurer Name: Allstate Insurance Company Polic Number: 64883529;' X 1 Any Auto 2 - Owned Autos Only 3 - Owned Priv. Pass. Autos Only 4 -- Owned Autos Other Than Priv. Pass. Autos Only 5 - Owned Autos Subject to No Fault 6 - Owned Autos Subject to a Compulsory UM Law X 7 - Specifically Described Autos X 8 - Hired Autos Only X 9 -- Nonowned Autos Only Policy Effective Date : 1 t -2 9-12.01 B 1 Policy Expiration Date; Limits of C 0, 0t•0 Combined Single Limit (each accident) Insurance: BI Per Person I BI Per Accident PD Per Accident Description of Operations/ Locations/Vehicles/ Endorsementsl Special Provisions Interested Part T pe: Adk,.i i t:ienas ['I_-; THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST EITHER BE ENDORSED ORCONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer. Authorized Repre ative: - _ Date: 08-02-19 vollc' REVIEWED & APPROVED y /'' By Risk MANAGEMENT DIVISION VML4vi e, .00 A G 02 20% 'n4V (([lIS��ncl dies cop igttted material of Insurance Services office. Inc., with its permissr inn au FRA CRE R. VILLAREAL Cl CW A02 10 11 Allstate Insurance Company Page 1 of 1 1A) U91 rb - (04. 0/1 - V - SJA `iI POLICY NUMBER: 6 8835292 COMMERCIAL AUTO CA 20 48 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: STAGE PLUS, INC. Endorsement Effective Date: 0 8— 0 2— 2 01 9 SCHEDULE Name Of Person(s) Or Organization(s): T14E CITY OF SANTA ANA, RISE MANAGMENT, 1OFFICIREIMI'LViEES, AG YSS, AN✓REPRESENT".A`S IVES 20 CIVIC CENTER PI,Z pp SAN �'.i'x ANA, CA SA 92f 0-1 4101-58 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an 'insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section 11 — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Forrn. CA20481013 C Insurance Services Office, Inc„ 2011 REVIEWED & APPROVED By Risk MANAGEMENT DIVISION ,�V�t�Q 02 2019 FRANCINE R. VILLAREAL Page 1 of 1 ACO oa/o2//201 CERTIFICATE OF LIABILITY INSURANCE DATE (M) 019 s 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: Dori Jared-Ferranto Assistance Insurance Agency PHONE (714) 245-2777 FAX (714) 245-2788 MC No Et : APC No 123 E. 9th Street E-MAIL S: djared�assistantx3ins-oom _ADDRE Unit 314 INSURERIS) AFFORDING COVERAGE NAIC # Upland CA 91786 INSURERA: State Compensation Insurance Fund INSURED INSURER B : Manuel Huante, DBA: Stage Plus, Inc. INSURER C : 2330 S. Susan St. INSURER D : INSURER E : Santa Ana CA 92704 INSURER F : r'OVFRArrA r.FRTIFI('ATF NIIMRFR• 19-20 WC REVISION NUMRER- 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. 1L7R TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDD�Y LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE 1-1 OCCUR PREMISES Ea occurrence $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ POLICY PRO ❑ LOC JECT PRODUCTS - COMP/OPAGG $ $ OTHER; 1 AUTOMOBILE LIABILITY COMBINED SINGLE UMFF Ea accident $ BODILY INJURY (Per person) ANYAUTO $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE s AGGREGATE EXCESS LIAB CLAIMS -MADE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIR/PARTNERIEXECUTIVE OFFICER/MEMBMB ER EXCLUDED? (Mandatory in NH) NIA 1786318-19 05/01/2019 05/01/2020 PER OTH- STATUTE I IER $ 1.000,000 EL EACH ACCIDENT E.L DISEASE- EA EMPLOYEE $ 11000.000 it yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE- POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) By RISk MANAGEMENT DIVISION The City of Santa Ana, its officers, employees, agents, volunteers and representatives Proof of Insurance (� O �a z,_ FRANCINE R. VILLAREAL LLKlit-[ :AIL HULLlth( City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana 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 CA 92702 I Z�1d4G rcl 4QRR-9n15 ACORr1 ('ORPORATION All rinhtC rPCPmarl ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD