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Home My WebLink AboutNATIONAL ASSOCIATION OF STATE BOATING LAW ADMINISTRATORS (NASBLA)A-2016-248-01 ,.aURANCE ON FILE MAYOR WORK MAY PROCEED Miguel A. Pulido UNTIL INSURAN E EXPIRES MAYOR PRO TEM 'LEI I Juan Ville ERK OF COUNCIL Cecilia Iglesias nATE� David PenaSEP 2 2019 loza Vicente Samiento® Jose Solorio '3r tJ,.Ak1 Co,, J, - CITY OF SANTA ANA SANTA ANA POLICE DEPARTMENT 60 Civic Center Plaza Santa Ana, California 92701 www.sant"ruirgm May 15, 2019 National Association of State Boating Law Administrators Attn: Tom Hayward 1648 McGrathiana Parkway, Ste. 360 Lexington, KY 40511 Re: Extension of Agreement NA-2016-248 to provide training course and exercises Dear Mr. Hayward, CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho ACTING CLERK OF THE COUNCIL Norma Mitre Pursuant to Section 4 ("Term") of Agreement No. A-2016-248 ("Agreement") entered into by National Association of State Boating Law Administrators and the City of Santa Ana, dated August 16, 2016, the time period of said Agreement is hereby extended for an additional one (1) year period, from August 16, 2019 to August 15, 2020. 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. Sincere vtd Valentin Chief of Police CITY OF SANTA ANA: 6 ristine Ridge City Manager APPROVED AS TO FORM: Sonia R. Carvalho C Q Attorney n Tamara Bogosian Assistant City Attorney CONTRACTOR Tom Hayward CFO DAISY GOMEZ CLERK OF SANTA ANA CITY COUNCIL Wgaa[A Pulldd Juan V10e9a4 Vmenla Sarmionln Damd Prmabaa low solorio Vacant Cecilia iglas,as Mayo, Mayor Pro Tam Ward Waml Wam2 'Ward) Word Ward6 9 pplgpp vueana om raxnagnu®aenaamaa Coerwloaa®aanip arm ao y mAamlaana or .Naa smaawao INSURED SOLID& Collins insurance Agency =0 Clays Mill. Road Sultelop le),ington, KY 405M 1648 MoGrothisna PkWqte 36a LeAngton,KY405111338 M THE statement an THIS IS TO CERTIFY I !170W HAVE REVISION NUMBER: �HEENIS$UrD "INSURED INDICATED.CE TO ;,I11 I I ABOVE I I 1 1 POLICY �PERIOD NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACTOR OTHER DI WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSLEO 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 PRT BEEN REDUCED 13Y PAID CLAIMS, LT TYPE OF INSURANCE --dY— A 11111ID, 121 Arl! I I, J� (COMMERCIAL GENERAL UAI 1 1 SKS57763682 EFF-` ADD E)I I.IXYYY MI Y LIMITS 02404/2DI 9 ;LAWOMADE 0I 12 1 EACH OCCURRENCE a FT 1 ow off GE-�NL/,GGPEGATE LJMITAP�IES PER POLICY L-, PRO- LOC ECT E 1A 2,000,000 I OTHER I RODUCTS,00APICIPAGG I 2.000,Wo P A A AUTOMOBILE LIABILITY Y SKSWSM 02/04/2019 I-OM/202-0 -7M L I �Imff� a T ANYAUPO �EIIMD I $ 11000,000 —4 Y P 4 v0I SCHEDULED AWOS OWY AUTOS HIRED v Autos OBLY V ZU W0111,ED P M 16 ;BODILY INA.RY(Pw I — IF LY I PR BIN DANVII--- I'm— IA UMBRELLAUAI OCCUR "case LIAS CIAM.MADE EACHOCCURPEOCE OLD RETENOD AGGREGATE $ B JMRKERS OMPENSI ANDEMPLOYERTUABI I IINUS4=Te6O16 YIN TK AWPROPRET0Q?PARrNEME>Cj�ME aMEM D? I I- fINIA( a I onduoiry 10 NN) a eDISEAGE-EA R ONOFOPFR EMPLOYEE] a O Professional Uabih BLDIS P- LICYLM a PC ry L ur 109127/20 8 09/27/2019 � sslonal Liability I profb 11 ty DE afn Cftyof Santa Ana, OffiCanu agents, employess, and M pa ro spo . r1q.1rad) 'spa are named as additfonallf PTI an this PolcYpursuant to Witten contract, agreement, or momerandumof undOrStOr)dlng,Such insurance aalseffordWbythispoi]cyshallb0prirMry,and anyin=anc9carried byC[tyshdI beWCOSSand nOnconinibutury, Insurance Carriers shall provide thirty (30) day Prior Witten r0fiGe Of Cancellation CEIRTILICATE HOLDER E LATION I' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF NOTIOE Cltyof Santa Ana WILL BE DELIVERED IN ACtORDANCE WITH THE POLICY PROVISIONS, Risk Manse Foram IDNislon 20 C Ana, Plaza 4th Floor SA ANTHA m, tAmI3 Santa Ana, CA 92701 DRUIRMENtAnve ACORD 28 5 1988-2016 ACORD CORPORATION. At rights reserved, (2016103) ThOACORD name and 1090 are registered marks of ACORD September 9, 2019 Risk Management Division City of Santa Ana 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92702 SUbj. NASBLA Employment of Licensed Professionals Dear Sir or Ma'am, The National Association Of State Boating Law Administrators' (NASBLA) Boat Operations and Training (BOAT) Program does not employ, hire or use licensed professionals during its BOAT Program Course Deliveries; nor will it employ, hire or use licensed professionals during the contracted course deliveries with the City of Santa Ana, Sincerely David M. Considine NASBLA BOAT Program Director 1648 McGrathlana Parkway, Suite 360 Lexington, KY 40511 & APPROVED ,OrMENT DiVISKA BE ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company Liberty Matual Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # BLS57763682 relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives 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. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective , this endorsement form as a part of Policy # BKS57763682 Issued to NASBLA Named Insured Countersigned by Q / -" � A horized Representative A�Rh® CERTIFICATE OF LIABILITY INSURANCE DAT0827/20019OI 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 endorsemen s). PRODUCER COWACT Joey William, Slade &Collins Insurance Agency PHONE 859.2131121 FAX 859-219.1125 Me): 3320 Clays Mill Road _Lc, eo Eel- (AIC. Suite 109 : Jogt(3O SladeandCdlins.can Lexington, KY 40503 INSURERS AFFORDING COVERAGE N04C0 INSURERA: Liberty Insurance 24082 INSURED NA$BLA INSURERS: Phoenixinsurance Company 25M 1648 MCGrathiana PlgvySte 360 INSURER c: EVANSTON INSURANCE COMPANY 35378 Lexington, KY 405111338 INSURER D: INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INS(RANCE LISTED BELOW WAVE BEEN ISSUED TO THE INSURED WIVED ABOVE FOR TIE POLICY PERIOD INDICATED. NDIWITHSTANDING ANY REOUREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH MS 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 POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NN LTRPOLICY TYPE OF INSURANCE ADLIL:OUR NI9ABER POLICY OFF POUCY EXP N YYY1 (MMUDCVYYYY11 Liens A COMMERaALGERENA UAwUTY CLAMS4ANDE � OCCUR. Y BKS57763682 021DQ2D19 02/04/2020 EACHOCCLRREL+CE $ 1,000,000 PREMSE'O HEATED S Eaacaarerce NED EJP (Aly orb Parapn) $ 1,1100,000 3 15,000 PERSOLNL BADV VERY S GENL AGGREGATE LIMIT APPLIES PER POLICY ❑,ECT LOC OTHER GENERAL AGGREGATE s 2,000,00D PROIXICTS-COMP/OPAGG $ ZDDo,000 S A AurouomLE LABLm NIY AUTO VOVINE ONLY SCHEDULEDmBODILY AUTOHIREAUPOSONlV MDNOO AUT$ Y BKS57763682 02ID4/2019 02/04/2020 .Lae ED SIN s 1,000.000 BODLYNA.RYIPerpswn) s NASRV (Pa ew4ad) s PONLYPROPERTY DAMAGE $ UMBRELLA LAB OCCUR EXCESS LAB CLAMS -MADE EACH OCCURRENCE s AGGREGATE $ DED RETENTION s $ B WORMERSCOMPEMSATION AND EMPLOYERS UASILITY ANY PRCPRIETORPARINEPoEJEOJnVE V I N OFFICER/MEMBER EM1lAEV1 (Mandatoryin MN) r yyos. deeaile Drab DESORIPTIONOFOPERATOSe NIA INUB4022T6W16 12/04/2119 12/0472020 STATUTE EL EACH ACCIDENT $ 1,ODO,000 EL DISEASE - EA EMPLOYEE $ 1.�•� EL DISEASE - POLICY LILT s 1,000,000 C Professional Liability E0973120 092772DI9 09127/2M Professional Liability $1,000,1 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be cMached N moro space la required) Cityof Santa Ana, officers, agents, employees, and wlun Leers are named as additionally insured on this policypursuant to written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance Carried by Cityshall be eycess and noncontributory. Insurance Carriers shall provide thirty(30) day prior written notice of cancellation By RI5 ANAGEMENT DI SIOiWLILD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN Cityof Santa Ana 19 �O�Nr 19 aJ ACCORDANCE WRTH THE POLICY PROVISIONS. RiskManagement Division 4SAAM AUTHORIZED REPRESENTATIVE 20 Center Plaza 4th Floor Santa A santaAna.cAsz7ot AM. IAMB n•/.Jy'�'�`'/) T �V ® 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company Liberty Mutual Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives 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. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 02/04/2019 , this endorsement form as a part of Policy # BKS57763682 Issued to NASBLA Named Insured Countersigned by Authorized Representative & APPROVED mrMENT DIVISION 19 2019 M. LAMBERT Boat Operations And M September 9, 2019 Risk Management Division City of Santa Ana 20 Civic Center Plaza, 41' Floor Santa Ana. CA 92702 Subj: NASBLA Employment of Licensed Professionals Dear Sir or Ma'am, The National Association of State Boating Law Administrators' (NASBLA) Boat Operations and Training (BOAT) Program does not employ, hire or use licensed professionals during its BOAT Program Course Deliveries; nor will it employ, hire or use licensed professionals during the contracted course deliveries with the City of Santa Ana. Sincerely David M. Considine NASBLA BOAT Program Director 1648 McGrathiana Parkway, Suite 360 Lexington, KY 40511 APPROVED MENT DIVISION 2019 LAMBERT