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HomeMy WebLinkAboutSUSY PARTY RENTAL, INC.�., City of Santa Ana Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes _ No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with OF THE COUNCIL 32 '2 No. N-2019-114 was completed on I� S JQOj CC and final payment has been made. (List all amendments. Use space below if needed.) Department: P RC,,SA Phone/Ext.: Signature:Date: Revised: INSURANCE NOT ON FILE N-2019-114 WORK MAY Nff PROCEED CLERK OF COUNCIL ® DATE: JUN 2 a 2019 ®:�R.trS�<,.� AGREEMENT WITH SUSY PARTY RENTALS FOR PROVISION OF CANOPIES AND TABLES FOR S IM& CwWR FOURTH OF DULY EVENT THIS AGREEMENT is made and entered into this 3rdday of June, 2019 by and between Susy Party Rental, Inc., a California Corporation ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing tinder the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a contractor to provide party supplies including tent canopies, tables and related equipment for the Fourth of July event that the City is hosting on July 4, 2019 at Centennial Park ("Event"). B. Contractor represents that Contractor 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 in this field and that any services performed by Contractor under this Agreement will be performed hi compliance with such standards as may reasonably be expected from aprofessional firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SERVICES Contractor shall provide, set-up, and remove thirty-five (35) tent canopies and fourteen (14) 6ft tables, at the City's Fourth of July Event at Centennial Park, as described in Exhibit A. All equipment shall be delivered and set up by I2 noon on the day of the Event and removed immediately following conclusion of Event (after 9:30 PM) but no later than July 5, 2019 at 9am. City is not responsible for equipment left overnight at Centennial Park. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services and equipment, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed Two Thousand Six Hundred and Seventy Two Dollars ($2,672.00). This amount includes a 10% contingency of $243.00 to be used at the City's clection. b. Payment shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to accounting procedures. Payment need not be made for work, which fails to meet the standards of performance set forth in the Recitals, which may be expected by the City. Page I of 8 3. TERM This Agreement shall commence on July 4, 2019 and terminate on July 5, 2019, unless terminated earlier in accordance with Section 12, below. 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 employer -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 insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE 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, and $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insured's provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. c. Worker's Compensation Insurance. In accordance with the provisions of California state law, Contractor, if Contractor has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. Page 2 of 8 d. 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 full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form 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. e. If Contractor fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to 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 light 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 and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the direct or indirect operations of Contractor or its contractors, 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 terns of, or effects, wising from this Agreement. Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terns of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Contractor's Services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. This indemnification provision No. 6 shall survive any expiration or termination of this Agreement. Page 3 of 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. 8. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. 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 Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: (714) 647-6956 With copies to: and Parks, Recreation and Community Services Agency City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 Fax: (714) 571-4221 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Fax: (714) 647-6515 To Contractor: Susy Party Rental, Inc. 1517 S. Sycamore Santa Ana, CA 92707 Phone: 714 543-9556 wL�nw. s usy-art yrcntal s. com Page 4 of 8 A party may change its address by giving notice in writing to the other party. 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 tithe 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. 10. 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. hi the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Contractor. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terns and conditions hereof, shall not bind or obligate Contractor nor 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. 11. ASSIGNMENT Inasmuch 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 Contractors retained by City. 12. 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. 13. NON-DISCRIMINATION 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 related to this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. Page 5 of 8 14. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Contractor shall, throughout the tern 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. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective panties 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 audrority 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: Norma Mitre Acting Clerk of the Council APPROVED ASTOFORM: By: +-' , �SSt (I t Laura Rossini Senior Assistant City Attorney [Signatures continue on the next page] CITY OF SANTA ANA I��riitine �._ __ _. City Manager CONTRACTOR Na e Title: / , /r/w, Page 6 of 8 RECO MENDEDFO ROVAL: Li Ru off, xec�Director Pa ecreation, and Community Services Agency Page 7 of 8 EXHIBIT A SCOPE OF SERVICES/FEES AND COSTS Page 8 of 8 1517 S. Sycamore EXHIBIT A Santa Ana, CA 92707 714.643.9666 (office) 714.329-103(ceii) 714.643.4614 (fax) www.s usypartyrentals. com Chairs*Tables*Tents*Portable Bath rooms*Jumpers*Linens & much morel Sillas*Mesas*Cdrpas*Banos *Pistas de Baile*Jumpers*Manteles v mucho mast NV01C #�_ r s Todav's Date 613/19 Event Date: 7/4/,18 �Cltent Name Soma Satres Deliver Iocatwn Cenkennial Park 3900 W Edinger Company Name: City of Santa Ana _ Santa Ana CA Phone # 714-671.4227 _. D_eliv_e_ry time &date: 713 at 2pm Phone # cell : Pickup time & date: 715 at gam _ Email address: sbatres Santa-ana.org Driver's License Date Out: Date In: OutCescdptian of 8gutpment Ckuanti_ _ -Tow_. Amdunt't ' 1 Tents 35 $67.00 $2 345.00 2 Rect Eft tables 14 $6.00 $84.00 4 7 L B _ 14 I` 1o�Jt-•��xb '� � �", c+ �Subtgtal �,'� �.z=`y.'T theck,��c� t� z` � ,� -� $2�4t�9DQ� M Rr9 a�yv }" �wT�'1 t. �r"�`� �zk s� rt,13t✓ '`ECG � R msa � 3,a i zf�.% b°�Sy� ��' ��t°"�'z�t W�'y'A^.i /�'+ P p.1R1 u . "4 iN ACC)RhP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 06/21 /2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), 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 NON AMEA T Ray Mclure r_ P6lCItONE t31n.0211I (714) 664 8911 I FAixc No ; (714) 664 0011 McLure Insurance Brokerage, Inc. EApo 'IutAILESS, service®mclureins.com 17731 Irvine Blvd. Suite 104 INS, URER(S AFFORDING COVERAGE NAIC N INSURERA: COLONY INSURANCE COMPANY 39993 Tustin CA 92780 INSURED INSURER : SECURITY NATIONAL INSURANCE COMPANY INSURER C INSURER D : SUSY PARTY RENTALS INSURER E : 1517 S. SYCAMORE STREET INSURER F SANTA ANA CA 92707 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. ILTR TYPE OF INSURANCE INSOADD U9R POLICY NUMBER POLICY EF'F OfotCY E P LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 f CLAIMS -MADE " I OCCUR PA�ILI amuq@ $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL BACV INJURY $ 1,000,000 A Y 101 PKG0044107-04 0610512019 06/05/2020 GEN'LAGORFWe LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECOT �LOC PRODUCTS-COMP/OPAGG $ INCLUDED $ OTHER: AUTOMOBILE LIABILITY CO let➢BINED SINGLE LIMrr $ ANYAUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE LPerawdenll $ $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTLONS $ WORKERS COMPENSATION X PER dTH- B AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? O (Mandatory In NH) N I Y TWC3805782 06/0712019 06/07/2020 E.L. EACH ACCIDENT $ 1,000,000 E.L, DISEASE - EA -EMPLOYEE $ 1,000,000 If yyes, describe under nFsCRIPTION OF OPERATIONS below r l DISEASE- POLICY UMI r $ 1,000,000 PROPERTY LIMITS $450,000 A 101 PKG 0044107-04 06/06/2019 06/05/2019 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA, CALIFORNIA 92701; ITS OFFICERS, EMPLOYEES, AGENTS AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS ("ADDITIONAL INSUREDS") WITH REGARD TO LIABILITY AND DEFENSE OF SUITS ARISING FROM THE OPERATIONS AND USES PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. REVIEWED B CERTIFICATE HOLDER CANCELLATION KISR Iviancigemenf UIV1510 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Santa Ana Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLAZA c SANTA ANA CA 92701 r, Annn n r+ conrihn A'.12%_12 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:101PIiG0044107-04 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Locatlon(s) Of Covered Operations Any person or organization that you are required to add as an additional insured on this policy, under a wxitten contract or agreement cuxxently in effect, or becoming effective during the term of this policy. The additional All insured premises and operations. insured statue will not be afforded with respect to liability arising out of or related to your activities ae a real estate manager for that person or organization. City of Santa Ana, Risk Management 20 Civic Centex Plaza Santa Ana, CA 92701 A. Section II - Who Is An Insured Is amended to Include as an additional Insured the person(s) or organlzation(s) shown In the Schedule, but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or emissions of those acting on your behalf; In the performance of your ongoing operations for the additional Insured(s) at the locations) deslg- nated above. B. With respect to the Insurance afforded to these additional insureds, the following additional exclu- sions apply: This Insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, Including materials, parts or equip- ment 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 In- tended use by any person or organization other than another contractor or subcontractor en- gaged In performing operations for a principal as a part of the some project. Al 1l� lV ` RE ptvlslan R�Sk�a"d9 CG 20 10 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ❑ 101 PKG 0044107-04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- SCHEDULED PERSON OR ORGAN➢ZAT11ON This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s) (Additional Insured): AS DESIGNATED IN WRITTEN CONTRACT WITH THE NAMED INSURED Location(s) of Covered Operations: AS DESIGNATED IN WRITTEN CONTRACT WITH THE NAMED INSURED The insurance afforded by this Coverage Part for the additional insured shown in the Schedule is primary insurance and we will not seek contribution from any other insurance available to that additional insured. A. SECTION 11 —WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above, A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability "Bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations at Work "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. Negligence of Additional Insured rf' WVpJ Y.,e _�15 9()vl v I:Jv-VJ IV II Ild 41UGa wNyllyilicu iila 6cilal vi ivv I ivNcl u:u, ni•,., ��j� 1y�1• with its permission. �ti5k a CERTIFICATE OF LIABILITY INSURANCE °A 7101/2 19 o7ro1/za1 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 INSURERS►, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder Is an ADDITIONAL INSURED, the policy{ies) must have A001TiONAL 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 NAµEAOT David I Reyes _ St3teFarm David I Reyes PRONE 714-527-5103 IWc, ue): 714-527-4365 .(AK: ttu JexLl 2840 W Lincoln Avenue reyes.b88j@slatefarm.com Anahelm, CA 92801 INSURER AFFORDING COVERAGE NA1C # ,,,,,,. a. State Farm Mulual Aulomoblie Insurance Company 25178 INSURED INSURER B FELIPE SOSA DBA SUSY PARTY RENTAL INC. INsuRER c 1517 S SYCAMORE ST INSURER O: SANTA ANA CA, 92707 INSURER H: Y•nnVICIPAT=LIIIRR000. RRVISInN WEIMRFRE 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. LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. irJSR TYPE OF INSURANCE ADDL 9t --- - POLICY NUMBER P CY EFF POLICYDE P COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE OCCUR T7A�ENT{:i] EMiLES_(c f MED EXP A one rwn $ ~ PERSONAL S AOV INJURY f GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ PRODUCTS -COMPIOPAGG $ POLICY ❑ jEF LOC $ OTHER AUTOMOBILE LIABIUTY Y G eBI�r051 LELI 3 1,000,000 BODILY INJURY (Per person) $ ANY AUTO 553 0052-C20-75A 06/26/2019 12/25/2019 BODILY INJURY (Per aoddenl) S A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY I 635 6634-D19-75 04/19/2019 •10119/2019 PROPER AGE $ $ ( COLL 1000 UMBRELLA LIAB OCCUR EACH OCCURRENCE f AGGREGATE S EXCESS LIAR CLAIMS -MADE DEO RETENTION S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERTIEMBER EXCLUDED? (Mmdatory In NH) N r A H- TOTE $ E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yyees, de.5aibe "order D!_5CR1, 14N OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarlca Schedule, may be attached It more apace Is required) 1999ISUZU NPR BOX VIN:JALB4B149X7015770 n,�j7 2005ISUZUNQRBOX VIN:JALE6J16567903323 /�},/ !!I �6A(��8" V y ` CERTIFICATE HOLDER IS THE ADDITIONAL INSURED R�vvl rRRTIRr'ATFi4nI rlt=rd CANCELLATION mu'" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE D RED IN CITY OF SANTA ANA RISK MANAGEMENT ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA AUTHORD:EDRF.PR TiVf: SANTA ANA, CA 92701 All rirrht rpcarvnrl ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD 1001486 13284012 0316-2016 1� QR VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE DATE{MMlDD/YYYY) Oalzsrzols THlB CERTIFICATE 19 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 13ETWEP-N THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. This form is used to report coverages provided to a single specific Vehicle or equipment. DO not use NS form to report liability coverage provided to multiple vehicles under a single policy. Use ACORD 25 forthat purpose, PRODUCER David I Re B David 1 Reyes, Agent r (14 527-5103 F x 7NQ Ex 14 5214385 2840 W Lincoln Avenue �•n AIL - davkl,l.r1B .bllS ✓�3latetamLcom Anaheim, CA 92801 art -- INSURED SOSA, FELIPE 1517 S SYCAMORE ST SANTA ANA CA 92707-2230 nr--nu wrtlrq — INAIL State Farm Mutual Automalrlla Insurance Company 2G178 DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MAKE IMANUFACTURER MODEL BODY TYPE VEHIOLI:IDENTIFICATION NUMBER 1999 ISUZU NPR BOX JALB4B149X7015770 DESCR11MON SERrAL NUMBER_ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY-niATTHE POUCY(IES) OF INSURANCE LISTED nc-Lo HASMVE HEEN ISSUED TO T}IE INSURED NAMEDAUOVE FOR THE POLICY PERIOD($) INDICATED, NOTWiTI1STANDINO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTH1 R OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE ArFORDEA BY THE POLICY(IES) DESCRIBED HEREIN I3/ARE SUEIJECTTO ALL 'fHE TEtIl4iS, EXCLUSIONS ANO COND)TIONS OF SUCH POLICY(ICS). INSR AVOL ADLICY i±Y•Tmnvr- PDLIey explRATION LTR HreuD TYPE OF INSURANCE POLICY NUMBER DATC (ArAVDDFYYYV) DAT: {L6pyngiYYyY) LIMITS v� �1 VEHICLE I.IADI LITY COMBINEDSINOLE LiM175 1,ODODQO A 350 2175-F25-75A 06125r2019 12/2512019 BODILY INJURY (Par ryemon) S BODILY INJURY (Fora, a tur)q 8 _ _ PROPERTY DAMAGE S OENERALLIABILITY - EACHOC.CURENCE OCCURRENCE flENERALA6eRmAYE $ CLAIMS MADE 5 INSR L96S POLICYEWEC M POLICY EXPIRATION LTR AYE;¢ TYPE OF INSURANCE POLICY NUMBER DATE (MM70DIVYYY) BATE {NMNgrYYYYI LIMITS I DEDUCTIBLE VEH COLLISION LOSS [I ACV AGREED AMT II LIMrr -- CI L.I STATEDAMT S pEq __ VEH COMP VEH OTC ❑ ACV © AGREED AMT $ LIMIT - © © STATED AMT S QED PROPERTY ❑ ACV [I AGREED AMT BASIC BROAD 6 LIMIT © RC ❑ STATED AMT -- SPECIAL © $ DIED REMARKS (INCLUDING SPECIAL CONDITIONS / i>•THER CQyERAOB51 (Attach ACORV 101, Addhlonat Remarks achadula, It more space le mqulred) DEDUCTIBLE, COMP 1000 COLL 1000 ADDITIONAL INTEREST CANCELLATION t sSnFppS one or the following;8HO01.ri ANY OF THE At�OVE The addlllonat interest descfibad below tme been added to the II ies I10lod horeil b E4 num DD CANCELLEB Po �( i Y pa Y I1EM{I ). BEFOITI_ THE LXPIRATION DATE EOF, NOTICE WILL BE A u sI nau I2a submigRd I0 ads Iha odUiEnnal Interest door below to the po➢typos) DELIVERP�7 IN ACCORDANCE WITH THE POLICY PROVISIONS. .hv'Lb x[i5xJlumbarf➢l VEHICLE IEOUIPMENTINTERBaT: LEASED FINANCED DE5CRLPYIONDPT}IEADDITIONAL INTEREST -~ NAME AND ADDRESS OF ADDITIONAL INTEREST � ADDITIONAL INSURED LOSS PAYEE 4 LIY EDER'S LOSS PAVER CITY OF SANTA ANA RISK MANAGEMENT LOAN I LEASC NUM 20 CIVIC GENTER PLAZA SANTA ANA, CA 92701 o1RITJAREPRESCNTATIV6 - 1907 to ACORD 23 (2010105) The ACORD name and logo am ronintarArt marim ..r nrnpn 1004361 142W7.2 01-211-2013 VEHICLE OR EQUIPMENT C1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON CERTIFICATE ODES NOT AFFIRMATIVELY OR NEGATIVELY AMEN[ BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITI. REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, This form Is used to report novgraget. provided to a single specloo vehi, provided to multiple vehicles ukWer a single policy. Use ACORD 25 for t PRoouCER INSURED David t Reyes, Agent 2$40 W Lincoln Avenue Anahelm, CA 02601 SQSA, FELIPE 1617 5 SYCAMORE ST SANTA ANA CA 92707-2230 DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MAKE IMANUFACTURER 2005 ISUZU NPR DESCRIPnoN ;RTIFICATE OF INSURANCE 1ODATE (M W251201AgvDDrYrrv) .Y AND CONFERS NO RIGHTS VpON THE CERTIFICATE HOLDER. THIS EXTEND OR ALTER THE COVERAGE AFFORDED DY THE POLICIES TE A CONTRACT BETWEEN T14E ISISUING INSURER(S), AUTHORIZED le or equipment. Do not use this form to report liability coverage lat purpose. David I Re es IIo a 744 527-f5103 EMAIL ,�jC, I.Vnll 714-527-4WW5 A - daVltl.i.rsye5.48s tate(DmLcarn P Op C6R sraM tNSU 8 AFFDRgINOCOVCRAGR HNC/ INSURER A: Slate Farm Mutual Autotnoblfa Insurance Company 25178 INR�IR a EISiI ERC IN5l1RER D : - I uHrrtt±: MODEL BODY TYPE VEHICLE IDENTIFICATION NUMBER BOX JALE5J18567903323 SERIAL NUMBER THIS I$ TO O[ R f1FY THAT THE POLICY(lE8) QF INSURANCE LISTED Ba4)W RASIHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY OF ANY TERNI CIAANCE CEAFFORDEO WFICHIT'HIS CERTIFICATE MAYBE BY THEDITION NITWITH � OR OTHER HER ISSUEn R MAY PERTAW. TNY HE INSURpp dy[l ALL THE TERMS. EXCLUSIONS AND S) DESCRIBED IN IWAfjE SVSJEG O CONOI•IIONS OF SUCFI POLICY(WM, INSR ADDY LTR WRD TYPE OP INSURANCE POLICYEPrwnv& POLlCYE%PIRATION POLICY NUMBER DATBrh1Ml♦WYYYY} DATA(MMMOlYYYY) LIMITa 7xj VEHICLE LIABILITY COMSINEDSINGLELIMIT ; 1,000,000 A 538 5534 bt9-7a� OV1912019 1011912DI O BODILY INJURY BODILY INJURY (Poracaidehl) $ PROPER - PROPERTY DAMAGE $ GENERAL LIABILITY OCGURENGE � OCCURRENCE GENERALAGOREGATE $ CLA1M3 WMADE — fN11tt LTR in" 0ANIM TYPE OF INSURANCE S POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER DATE11AW IYYYY) DATEIMId1D011M) LIMITS1DEDUCTIBLE ❑ ACV ❑ AGRPDAMT ; LIMIT VEHCOLUSIONLOSS ._. _ ❑ ❑ STATEI)AMT ; DEC ❑ ACV ❑ AOREEDAMT ; LIMIT VEH COMP VEHl71'C „ — d ❑ STATEDAMT $ DED PROPERTY - -----•-�_.--_._� ElAQREEDAMT BASIC BROAD❑ACV ; LIMIT Q Rtt ❑ STATEDAMF —SPECIAL © ; DIED REMARKS (INCLUDINQ Sr'ECIAL COND171tlNS ! OTHER COVERAGES) (Attach AGORD AddltIonal Vim.( lei, Roma, ka schedule, IF morn spoon )s rwlulrod} DEDUCTIBLE: COMP 1000 COLL 1 GOD jt I J ADDITIONAL INTF.FII ST— Select one or uie tonow)ng: The eddltlonal Interest described below hao been added to the polley(les) Ileted heroin by Polley ntsnber(s)• A rerM1 Dal has hasn s¢Ipniaed to add Weaddllkmal Interest doscdbed below to the popoypeo) _ hoeeln pti acNev aural ksr[nf. VEHICLEIEQUIPMENT INTEREST: LEASED FINANCED � - NAME AND ADDRESS OF ADDITIONAL INTEREST CITY OF SANTA ANA RISK MANAGEMENT 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 ACORD 23 (2010/03) SHOULD ANY OF THE Ala jl`ff6& gBECANCELLED BEFORE THE ExinRAT N Oita►& �IEOr. NOTICE WILL BE DELIVERED IN ACCOROAN L N11 THE POLICY PROVISIONS. DESCRIPTION OF THE ADDITIONAL INTEREST ADDITIONAL INSURED LOESPAYI3B LENDER'S LOSS PAYEE LOAN t LEASE NUMRETir� REPRESENTATIVE The ACORD name and lOgO are realstered marks of ArORn 1004361 142987.2 01-26-2013