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HomeMy WebLinkAboutRACE CENTRAL (2)City of Santa Ana =�±.•�t Clerk of the Council COTC Office Use Only 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TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect.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. CLERK OF THE COUNCIL Is the agreement(s) a permanent record? Yes No MG 2'21 PM3:Q.1 Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with No. N-2019-153 was completed on (List all amendments. Use space below if needed.) Revised: 10-18-16 tot 101 111 and final payment has been made. Department: �xv ��—�� I ����C,V� Phone/Ext.: S' l Signature: Date: INSURANCE NOT ON FILE WORK MAY NET PROCEED CLERK OF COUNCIL N-2019-153 DATE: AUG 2 6 2019 AGREEMENT FOR RACE TIMING SERVICES FOR DOWNTOWN 5K RUN EVENT (2019) THIS AGREEMENT is made and entered into this 12'h day of June, 2019 by and between Race Central, LLC., a California Limited Liability Company ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a Contractor having special skill and knowledge in the field of race timing services to provide such services for the City's Downtown Santa Ana (DTSA) 5K Run event to be held in the City on October 19, 2019 ("Event"). B. Contractor represents that it is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Contractor shall perform race timing services for the Event as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed $7,130.00 during the term of this Agreement. This amount is comprised of (1) the sum of $6,200.00 and (2) a 15% contingency of up to $930.00 for additional services as may be performed by Contractor at the sole direction of the City. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work that fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date stated above and continue through October 19, 2019, unless terminated earlier in accordance with Section 13, below. Certain specified terns shall survive the expiration and/or termination of this Agreement. 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, with $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 insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the California Labor Code, 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 2 to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Contractor is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City, (iv) Where the amounts or coverage provided by the certificates of insurance provides coverage greater than those listed by this Agreement, the amounts provided by the certificates of insurance shall be incorporated by reference into the Agreement. (v) Contractor shall supply City with a fully executed additional insured endorsement. 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 right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Contractor agrees to and shall indemnify, defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Contractor or its, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terns of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. This section survives expiration or termination of the Agreement. ` EMMUMODTIRM Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Contractor shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Contractor under this Agreement. 8. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information' shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. This section survives expiration or termination of this Agreement. 9. 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 4 Agreement. 10. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 With courtesy copies to: Lisa Rudloff Executive Director Parks, Recreation, and Community Services Agency City of Santa Ana 20 Civic Center Plaza M-23 P.O. Box 1988 Santa Ana, California 92702 To Contractor: Race Central 229 S. Olive Ave Rialto, CA 92376 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) clays after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 11. 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. hr 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 or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 12. ASSIGNMENT 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 consultants retained by City, 13. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Contractor to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. 14. NONDISCRIMINATION Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities or in connection with any activities tinder this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 15, JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, 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. This section survives expiration or termination of this Agreement, 16. PROFESSIONAL LICENSES Contractor shall, throughout the tenor of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 17. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. C. This section survives the expiration or termination of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. DAISY GOMEZ COUNCILCLERK OF THE APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By:. 40'. Laura A. Rossini Senior Assistant City Attorney [Signatures continue on the next page] CITY OF SANTA ANA Kristine Ridge City Manager CONTRACTOR: Judy Ike berry Owner RECOMMENDED F�APPROVAL 'sa dloff E cutive Director, Parks, Recreation, and Community Services Agency EXHIBIT A SCOPE OF SERVICES VENDOR NAME: Race Central EVENT: Downtown Santa Ana (DTSA) 5K Run SERVICE DATE, (S): Saturday, October 19, 2019 COMPENSATION DUE TO THE VENDOR: $7,130.00 (includes 15%contingency). Check made out to Race Central. Billing address is 229 South Olive Avenue, Rialto, CA 92376. BREAKDOWN OF COMPENSATION: $2,000 base fee + $4,000 chip charges (based on 2000 runners) + $200.00 pre -packet pickup (includes one staff) = $6,200.00. Additional 15% contingency of $930.00 added for a total of $7,130,00. Balance to be paid after. event and upon receipt of final invoice. DESCRIPTION: Infinity Tinting will be providing timing services at the City of Santa Ana's 2019 Downtown Santa Ana (DTSA) 5K Run on October 19, 2019 from 8:00 a.m. — 10:00 a.m. BREAKDOWN OF SERVICES: Base Timing Services Costs and Inclusions • $2,000 Base Timing Fee (includes up to 1,000 frill color bibs) Clrip Charges • $1.00 per registered Wainer + $1.00 for each tinting B-Tag prepped Equipment & Staffing Included: • Start/finish line set up (4 Meters ca.) • 1 LED Clock, 1 Oeucr<ttor, Live Services • Wireless card & computer kiosks for Registration/Results • Manual Stop Watches & Time Machine for back-up • Announcer computer & PA System • Two 20' inflatable arches ADDITIONAL EQUIPMENT & CHARGES Travel and Staff: • 1 Staff (u} $200 per stafflper day (a),, Packet Pick -Up ( Week of October 14-18, 2019; date to be agreed upon with City) • Rowidtrip NLileage: INCLUDED • Safety Pins (INCLUDED) EQUIPMENT & SERVICES TO BE PROVIDED BV RACE CENTRAL: • "fent for scoring to be placed close to registration • 2 chairs inside scoring tent • 1 Table inside scoring tent • Tables for rogistration i packet pickup area 0 Power (a, Finish Line &. Registration by event (if possible) CERTIFICATE OF LIABILITY INSURANCE DATE(MMOD"") THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H 11 512019 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COLDER. THIS OVERAGE 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 auch endorsements N. PRODUCER CD ACT RITA M PRICE INSURANCE AGENCY INC. N � PNON-- - --- — E 909 337.2518 PO Box in.MUL - we x P (9091336.6989 Ao RE r, rlc INSURfarmersaaent.com ____ Lake Arrowhead, CA 92352 ERISI AFFORDING COVERAGE 0544472 -- — xAlc e INSURED RACE CENTRAL LLC JUDYIKENBERRY 229 S. OLIVE AVE COVERAnFa I_NBURER D : - INSURERE: .a,arocn• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW REVISION NUMBER: HAVE BEEN ISSUED TO THE INSURED NAMED ASOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY INSR - -_ _ 'AD —.-- PAID CLAIMS. R TYPE OF INSURANCE POLICY NUMBER N�pCY EFF X DOMNERCIAL GENERAL LIABILITY __ _ _ _ IPaOLICDY E%P LNJITS __- CLA1A13-MADE X OCCUR 'EACH OCCURRENCE ,S 11000,000 G O PREMISEl S 100,000 A —� ---..— X HSD10015218029 112712019 MEOEXP(Any one pe ) $ 5000 1127/2020 GENL AGGREGATE LIMIT APPLIES PER: PERSONAL & ADV INJURY f 1.000OQQ POLICY _ PRO- LOC JECT— GENERALAGGREGATE S - 2,000,000 OTHER. PRODUCTS-COMPIOPAGG S 1000000 AUTOMOBILE LIABILITY $ LI I MY AUTO fEe aBlN aF-0atgINGLE f OSCHEDULED BODILY INJURY(Parpenom S AUTOS ONLY AUTOS HIREDIRED —� NM-OWNED'BODILY —'--_ -- '-- INJURY (PeraxMsnll S __ AUTOS ONLY AUTOS ONLY PROPERTY D— gMpOE '--r- If f UMBRELLA UMBRELLA LUB OCCUR f EXCESS use ._ CLAIMS -MADE EACH OCCURRENCE $ DED RETENTIONS AGGREGATE S -- -- WORKERSCOMPENSATION S AND EMPLOYERS' LIABILFTY YIN PER OT I STATUTE ER ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA 'ESL EACH ACCIDENT BEACH ACCIDENT q (Mmtlenry In NN) Oyee, tlIFI uMer DESCRIPTION OF OPERATIONg Oelaw E.L. DISEASE - EA EMPLOYE S E.L. pISEASE- POLICY LIMB I E I I REVIE DESCRIPTION OFOPERATIONS ILOCATIONSIVEHICLEa(AC00.0 1e1, Atltlltlonal RemarNa SchetlWe, may WaNecMdXmonepeu len ( �t�S 1ANAYEMEW CertiBrale holder Is listed as aasiNonal insured: ' n I)iVISION The City of Santa Ana, Risk Management, Its of icers, employees, agents, volunteers and representatives as atilt nal insured. CedIFORt011 12 CertiRcate of Inaunnca shall pmvitle lhldy (70) dry prior wmen notice of oanmllation 2019 SAM NTHA M, LAMBERT CERTIFICATE HOLDER City of Santa Ana, Risk Management 20 Civic Plaza, 4th Floor Santa Ana CA 92702 ecnlxn �c nn�mnm 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 REPaBBENTATIVE 1090 are mglsrerea marks of ACORD All Monte THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES t-ollicy unan a Number 2 POLICY NUMBER POLICY CHANGES COMPANY HBD 10015218 3 EFFECTIVE Hudson Specialty Insurance Company 09/09/2019 NAMED INSURED COVERAGE PARTS AFFECTED General Liability AUTHORIZED REPRESENTATIVE CHANGES FOLLOWING ADDITIONAL INSURED IS HEREBY ADDED PER FORMS CG2015,CG2010 AND HUD-GL- CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND EMPLOYEES 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 FOLLOWING FORMS ARE HEREBY ADDED: CG2010 HUD-GL-2006 PREMIUM CHANGE $ 402.00 OTHER CHARGES Surplus lines Tax $ 12 00 Stamping Fee $ 0.80 Total: $ 412.80 HUD -IL 2003 0912 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission 0 THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. PRIMARYAND NON-CONTRIBUTORY WORDING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Additional Insured Name CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND EMPLOYEES 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 It is agreed that such insurance as is afforded by this policy for the benefit of the Additional Insured shown in the Schedule above shall be primary insurance, but only as respects any claim or "suit' arising out of "your work', and only if such claim or "suit" is determined to arise out of the sole negligence of the Named Insured. Any other insurance maintained by the Additional Insured, shall be excess and non-contributory as respects any such claims or "suit". All other terms and conditions of this policy remain unchanged. HUD-GL 2006 0912 V4_� Page ] of 1 POLICY NUMBER: HBD 10015218 3 COMMERCIAL GENERAL LIABILITY CG 2010 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) CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND EMPLOYEES 20 CIVIC CENTER PLAZA SANTA ANA, CA 02701 not 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, 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 omissions of those acting on your behalf; in the performanoe of your ongoing operations for the additional Insured($) at the location(s) designated above, CO 2010 07 04 Location(s) Of Covered Operations B. V1Ath respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "Property damage" occurring after: I. 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. OISO Properties, Inc„ 2004 Page 1 of 1 O POLICY NUMBER: HBD 10015218 3 COMMERCIAL GENERAL LIABILITY CG 20 15 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -VENDORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS=MPLETED OPERATIONS LIABILITY COVERAGE PART Name Of Additional Insured Persons) Or Your Products CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND EMPLOYEES 20 CIVIC CENTER PLAZA MINI DIGITAL CLOCKS SANTA ANA, CA 82701 A. Section II — Who Is An Insured is amended to Include as an additional insured any person(s) or organization(s) (referred to below as vendor) shown in the Schedule, but only with respect to "badly Injury" or "Property damage" arising out of'your products" shown in the Schedule which are distributed or sold In the regular course of the vendor's business, subject to the following additional exclusions: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have In the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made Intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container, e. Any failure to make such Inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; CG 2016 07 04 111 Demonstration, Installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily Injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on As behalf. However, this exclusion does not apply to: (1) The exceptions contained In Sub- paragraphs d. or f.; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering Into, accompanying or containing such products. © ISO Properties, Inc., 2D04 Page 1 of 1 O 01211essoans.2s+o¢eo Infinity Commercial Auto 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Customer Services (5U0) 7pp3391 Underwritten by: Infinity Select Insurance Company r COMMERCIAL AUTO DECLARATION Claims service. (800)334-ieai POLICY NUMBER: 504-61011-4301.001 RACE CENTRAL LLC POLICY PERIOD: 01/24/2019 To: 01/24/2020 229 S OLIVE AVE RIALTO CA 92376-6507 This policy is effective no earlier than the date and time on which the application is accepted by the Company and shall ex ire at 12:01 a.m. on the last day of the policy on cancelled for nonpaymentlit a tmay begconttinuedpwithy or without a lapse in coverage, contingent upon valid Payment and accordance with our underwriting gin rules. describedwvehicle0vyasgshowndbelow each Caverageslre condif ons conta new in the policy bnncludingthamendments and endorsements. No changes will be effective prior to the time changes are requested. # Year Make / Model 2 12 MERCED S SPRINTER V1N Number Deductible 250 Wllepc�rr•0-, _ rnr rr...... _' - LIMITS OF LIABILITY I nt WvERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED e1/PD Uadllty �� 000 CSL Medi I B Ce enefils Uninsured Motorist - el Comprehensive Collislon Roadside Assistance $100.000 CEL 500 wfCDW $75 per disablement $5,000 Umit Five dleeblemerdslanrual term PREMIUM BY ENDORSEMENTS MADE A PART OF THIS POLICY: SN61AE701; 50461AE201. 50461PDE01; 50461POL02; 50000RBE01; 50461SEEOt 1500/ PREMIUMS FOR VEHICLES VEH 1 VEH 2 12e6 12W 30 30 24 124 117 138 381 390 25 25 1943 1993 reverse for fee schedule aL POLICY PREMIUM $ 120.00 $ 4056.00 This Policy provides reduced liability coverage limits when an insured auto is being operated by a regular the policy application or otherwise as a driver to be covered by this policy, or was not disclosed within (30) days after becoming the data of application. Liability limits drop to the minimum California Statuto �000 five driver who was not disclosed on for BOdily Injury per accident, and $5.000 for Property Dama e ry Liability Limits which are D15,000 for DEFIBodil Ia driver subsequent to A ONLY, Paragraph 1.6 and PART A -LIABILITY EXCLUSION 27. per accident, See PART A -LIABILITY, ADDITIONAL OEFINITlIONS USED IN PART 0 SEE REVERSE FOR ADDITIONAL INFORMATION A IlvbUKLD COPY 50400DCPG02 AMEND DATE: 0 Page 1 Cq aq ENDORSEMENT: 1-3 POLICYHOLDER COPY STATE ! P,O. BOX 8192, PLEASANTON, CA 94588 SP FUND! CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-01-2018 GROUP: POLICY NUMBER: 1110288-2018 CERTIFICATE 10: 10 CERTIFICATE EXPIRES: 12-01_2019 12-01-2018/12-01-2019 CITY OF SANTA ANA PARKS RECREATION AND COMMUNITY SERVICES SP 20 CIVIC CENTER PLZ SANTA ANA CA 92701-4088 This is to certify that we have issued a valid Workers' COmpensatio� insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the Polic y Y period intllcatetl. This policy ie not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance "mice should this policy be cancelled prior to its normal expiration. Tnis certificate of insurance is not an insurance by the policy listed herein. Nwvwjhstnidin@ any requirement, term or condition of an y contract 01 with respect 10 Which this certificate of insurance omay ba ssuey and does tl or to whichot amend it ma or alter the coverage afforded afforded by the policy described herein is subject to all the terms, exclusions, and li pertain, a ouch policy her ant terms, /. a Y Pertain, the insurance Authorized Representative UNLESS INDICATED OTHERWISE BY ENDORSEMENT, President and CEO THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EEMPLOYER R THIS DORCA HUSBAND BANDSgNDEWI ELEMPLOYER; EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES E%CINSURLUDED UNDER POLICY CALIALSO WORKERS' COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $ "000,000 PER OCCURRENCE. ENDORSEMENT N0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2017-12-01 IS ATTACHED TO AND FORMS A PART OF THIS POLICY CITY OF SANTA ANA . NAME OF ADDITIONAL INSURED; ENDORSEMENT N206S ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12-01-1998 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER IKENBERRY, DENNIS AND IKENBERRY, .IUDY 229 S OLIVE AVE SP RIALTO CA 92376 (REV-7 2014) [PlM,HOJ PRINTED : 08-09-2019