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JOLLY BOUNCERS, INC. (2)
N-2019-217 �zo OCT 1 5 2019 CONSULTANT AGREEMENT © L,�D �� CITY OF SANTA ANA 1 PS,m L Cw73'IHIS AGREEMENT is made and entered into on this 9te day of October, 2019 by and between JOLLY BOUNCERS. INC. ("Consultant"), 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 consultant having special skill and knowledge in the field of: providing three jumpers and necessary materials for the jumpers for the City's 150t" Anniversary Celebration on Sunday, October 27, 2019. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant 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 Consultant shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in Scope of Services - Exhibit A, attached hereto and incorporated by reference. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the rates and charges identified in Compensation - Exhibit A. The maximum amount to be expended for this Agreement shall not exceed $1,490.50 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 which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. ►�Ys1.7u1 This Agreement shall commence on the date first written above through October 28, 2019, unless terminated earlier in accordance with Section 15, below. Page 1 of 8 4. INDEPENDENT CONTRACTOR Consultant 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 Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant 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. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant 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 Consultant'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, 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. Page 2 of 8 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 Section 3700 of the Labor Code, Consultant, if Consultant 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, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant 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 Consultant pursuant to this section: i. Consultant 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. Consultant shall supply City with a fully executed additional insured endorsement. f. If Consultant 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 forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 7. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, 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 Consultant, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (2) Page 3 of 8 from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant 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. Notwithstanding the foregoing, to the extent Consultant'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 Consultant. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant 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 Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant 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. Consultant 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 Consultant under this Agreement. 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant 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 Page 4 of 8 information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 11. CONFLICT OF INTEREST CLAUSE Consultant 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. 12. NON-DISCRIMINATION Consultant 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. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant 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 is not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant 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. 15. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant Page 5 of 8 compensation for all services performed by Consultant 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 Consultant to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 17. 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. 18. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant 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. 19. 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: Page 6 of 8 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: Steven Mendoza, Executive Director, Community Development Agency City of Santa Ana 20 Civic Center Plaza (M-25) P.O. Box 1988 Santa Ana, California 92702 To Consultant: Jolly Bouncers, Inc. 930 Chambers Lane Simi Valley, CA 93065 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 20. 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. Page 7 of 8 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. 5s�1� /Daisy Gomez Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO RECOMMENDED FOR APPROVAL: Steven Mendoza, Executive Director Community Development Agency CITY OF SANTA ANA istine Ridge City Manager 1411)0i11)NKW IF. Mark Sanders Owner Page 8 of 8 IN WITNESS WHEREOF, die parties hereto have executed this Agreement the date and year first above written. ATTEST: Daisy Gomez Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City ,Art7y By:( j' .- Ryan 0. ge Assistan ity coney RECOMMENDED FOR APPROVAL: Steven Mendoza, Executive Director Community Development Agency CITY OF SANTA ANA Kristine Ridge City Manager CONSULTANT: Mark Sanders Owner Page 8 of 8 SCOPE OF SERVICES & COMPENSATION Jolly Bouncers, Inc. 930 Chambers Lane, Simi Valley, CA 93065 Phone: 805-955-9802 Fax: 888-559-7519 Website: www.jollybouncem.com Email: jollybouncem6yahoo.com Delivery Location City of Santa Ana 2 Stephanie Garcia 20 Civic Center Plaza Santa Ana, CA 92701 Phone.(714)647-5379 Cell Phone:(714)392-1178 InvNo Name OW Total TB261 24 FT Double lane dry 1 400.00 B217 23 R Double Lane Slide dry 8296 1 $375.00 TB265 Combo 13: Rock Climb slide and 35 It obstacle 1 $450.00 B40 Generator- Double Circuit 2 $130.00 Order Subtotal: $1,355.00 Damage Waiver (10.00%): $135'50 Delivery charge- $0.00 TOTAL. $1,490.50 Amount Paid: Balance Due: Order No: 37876 Order Date: September 10, 2019 Written by: Start Date/Time: Sun, Oct 27, 20193:00 PM Delivery Time: Delivery 11 am to ipm End Date/Time. Sun, Oct 27, 20199:00 PM Pick-up Time: 9:00 pm Surface: Grass Additional Notes: wanted delivered between 10-11 $O.DO 714-673-3619 $1,490.50 Julie Castro jcastra-cardenas@santa-ana.org CERTIFICATE OF LIABILITY INSURANCE DATE(MMJDDIYYYY) 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 endorse, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on PRODUCER Liberty United Insurance Services, Inc�� 704 S Victory Blvd, Suite 204 ss EsuL Burbank, CA 91502 License M OF89841 _ __SUR,___ED. ._.. ._—-_.------ _..__..__ ------------------ ----- _INsuxMen.;_ IN Jolly Bouncers, Inc. INSURER S DBA Allstar Event Rentals INSURER c; 930 Chambers Lane INSURERD. Simi Valley, CA 93065 NSDRERa 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. A I V I COMMERCIAL GENERAL LIABILITY Y I N I CA000030302.02 I0410812019 10410812020 EACH CLAIMS -MADE OCCUR p.R@M 'LAGGREGATE UMITAPPLIES PER: POLICY ❑ JECT ❑ LOC ANYATC BODILY INJURY (Per pereon) $ OWNED UTO$ONLY AUUTOSULEO ci (gPer acdent) $ BODILY INJUDRpY HIRED M OF E $ TOS ONLY ®,. AUOTOSONLOY $ UMBRELLAUAB OCCUR EACHOCCURRENCE 3 EXCESS LIAR n. A,MR,MAnF Annome— e YIN DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ADDED IS, Additional Remarks Schedule, may ce attached if more apace le requlred) City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy 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, µpi i Wif)yI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana, its officers, employees, agents, and THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN representatives ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza -- Santa Ana, CA 92701 J AUTHORIZED RRPRBSENItINk vtiaoo•<vi:Y MiVYCU`t.unrvrvufViv.'nni`iyi,in rVeef vB ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Printed by SMS on July 03, 2019 at 10:12AM PalteyNumber: CA000030302.02 CG 20 26 0413 Effective Date: 6/13/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE, City of Santa Ana Risk Management 20 Civic Center Plaza Santa Ana, CA, 92702 A, Section II— 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 your acts or omissions or the acts or omissions of those act- ing on your behalf: 1. In the performance ofyottr ongoing operations; or 2, In connection with your premises owned by or rented to you. 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 re- quired by a contract or agreement, the insurance af- forded 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. shown IT, With respect to the insurance afforded to these addi- tional insureds, The following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is re- quired by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of in- surance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Lim- its of Insurance shown in the Declarations. CG 20 26 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000030102-02 Issued Date; 06/25/2019 AD 06 57 0217 .Effective Date: 06/13/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY/NON-CONTRIBUTING INSURANCE ENDORSEMENT This endorsomont modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE City of Santa Ana Risk Management 20 Civic Center Plaza, Santa Ana, CA, 92702 It is agreed that Commercial General Liability Coverage Form CG 00 01 Section IV paragraphs 0, and 4.c. do not apply with respect to other valid and collectible Commercial General Liability insurance, whether primary or excess, available to the person or organization shown in the Schedule and: 1) Who is an insured under an Additional Insured -Owners, Lessees or Contractors endorsement attached to this policy; and 2) Who requires by specific written contract that this insurance is to be primary and/or non-contributory to other valid and collectible insurance available to that person or organization. This endorsement does not change the scope of coverage provided to the person or organization by any Additional Insured endorsement, AD 06 57 02 17 Page 1 of 1 0 AOYtiCEItS' COMP RN$ATION AECIAIt ATTON I 6w is' hereby affirm under penalty of perjury, the utot following declaration I certify on behalf of 2, 1 Ce = that during the term of my to„u ut1C ply Noma) contract for u f't w services with the City of Santa Ana, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should became subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof of workers' compensation covorage, DATE: 1' ti""— Name: Title: wE'+ Telephone: , O �-� _ t Q WARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL: FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, i o��`�t 9 mo�j plvl tts� e CERTIFICATE OF LIABILITY INSURANCE ODWYC oArE(NM2 g 9/9 019 THIS CERTIFICATE Is ISSUED AS A MATTER Of' INFORAwrGN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER: THIS -CERTIFIOATB DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFPORD90 BY THE POL101E8 SEL,OW, THIS CERTIPIOATS OF INSURANCE DOES NOT CONSTITUTE A 00NTRACTBETWEEN THE ISSUING INSURER(S), AUTHORInD REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT,- It the card(ibataholder is an ADDITIONALNSURED, thepalloytles) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, aupJoot to the terms and conditions of the Polley, certain policies may require an endorsement. A statement on tills aert(HsatJi dose net confer YI h10 to lhs serlifkafe holder In lieu of anh endaraerrinni a, PRODUCER Cresoenla Valley Insurance Where Davy _ 3180 Foothill Blvd. Ste A 010 2aN acVo *gy �e7Sl2au Seboa 1. ovIno.agm La Crescents, CA 91214 __dakota ............,..__ LIO®nS911; gC91996 I1N URERtajAPPOROINGCOVBNAGE NAIC __ M� 0 At Californla.A,uko _ .. INSUNEO INSURER BY Jolly Bouncers SURE 4788 Promenade St MVNR Simi Valley, CA 93083.0411 INSURERMI COVERAGES CERTIFICATENUMI 00005000424204 REVISION NUMBER; 24 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TITHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANYREQUIREMENT, TERM ORCONDITIONOF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO 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 POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, }} TYPSCPINeURANCE 9 POUCYNUM R. P OCP 1.1111118 EAOHOCCURREt:CEAefi TW11MLERCIALGENERALUAWLITN' ❑ 000URH6TIE MfiO E%P One r60P $_ PERSONA4 aAWINJURY $ ..� MR ASPRE(G�AI1MUTaND�'APPLIE8 PER: OENERALACOREOATE $ PRODUOTS•COMROPA00 POCCYL_JJECT ❑LOG -- a A AVrOMOBILELIABILIIY Y BA04000OD14994 oswanols a6116/2e20 .N NN ANYAUTC WDILYINJURY(POYp.M" $ Sgf1aULE0 BODILYINJURY(Pm occlden4 $ V tUTYDONLY eSL A EA90NLY AU�TpONLY 5 UMaRELLALIAB OCCUR EA CH OCCURRENCE__ _ „, a%CEee LIAe GLAIM MA E AOGRECWTE —WORKERBCOMPENSATION OED E TIC,,.,, $ O ' ANC EMPLOYBRIP LIABIDTY YIN ANY PROPRIETOWPARTNEUXECUTIVE E.L. EACH ACCIOEff $ 0FFMEPoME AH RF$OLQ0W ++MMtlalerylnNII alwy1eunder NIA ELINeEASE. FA EMPLOYE --"'---- $ — If IFIION 4FgPEPATK%ie hOloYY EA. DISEASE• POMCY LIMIT ..,..wr D68CRIP'IION OI'DRERAIIONSJLOGATIONe lVkI1NJLEa(peqnD Tat, AddUO,fpllina(ntko Sehedulo, may lwakao-Ned if inmoapone lO railuhuel) City of Santa Ana Is named as additional Insured per Insureds operations, Primary and Nonoontdbutorywordlog a Ites por attaohad ondorsolnont I O ; R SHOULD ANY OF 1HE ABOVE DESCRIBED POLICIES NE CANCELLED DEPORR Oity of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL DE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLCY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92702 AutHoNn 11R 4 rrcatly YY'1 T A,k ACORD 26 (2018103) Tito ACORD name and logo are registered marks of ACORD .- !! It 11Zt C ¢YARD AGENCY CUSTOMER IG: 000 VEHICLE SCHEDULE NAIC CODE POLICY NUMBER I EFFECTIVE DATE I NAMED INSUREDIS) I MAKE 1 V 7 V H LYP� YIGK !O I VEHICLE TYPE SYMI AGE OiC 6YM 6VM 1 i 2008, MODELTUNDRA 4_X2 CREWMAX vLN 5TFEV58138XO63825_i_LP_PijSPre DM1„ GgRA01NG� STREET (Roy d In KY) CITY COUNTY STATE IZIP ADDRESS 14758 Promenade St 1 Slml Valley_ CA 1 93063 041 STATE TERR I ELM IGCW CLASS SIC FACTOR BEAT RADIUS FARTHEST TERMINAL COSTNEW _ - 1000 Q _-_ _ _ 100 { $ 39,010 'r "'J GHHCK Ar]G'L No -"- uN__N_E ti Nf� DsoucTlGLEs -I' ! ToMPrj' 7SPl:c USE OOMM'L FOR HIREg,�ERgGES _ FAULT __ MOTOR r LSP X REIMU X 1 ACV! K.I prC 4 ,C t1F PLEASURE !RETAIL X LIAR MED PAY yTg00R FT COMPI FG I s i._ _ X oTc AN I { STAMr s 500 NO- UNINS SPEC FARM SERVICE I QQF� _ FPN X COLL $ _ _ g SOOCDL ._ 1 ( AU6T_.L MC2S2Lr_�.-_ -OR}VETp --- e15 MIf EB 15MILE8« NETa, TOTAL FRM: R C 00 VEH0 YEAR I MAKE: RAM rypp; T r u CIS VEHICLE TYPE SYMI AGE CO QTCSYMCOMPJ I SYM 2 _2015 MGOEL:RAM TRUCK 1500 ST ry 1C6RR6FTXFS762581 _ PP ��sPEb COME GARAGING STREET(R q l od lr KY) CITY COUNTY STATE ZIP ADOREfi. 4758 Promenade St ( Simi Valley CA 193Cs3-D411 a no TERR GVW lGCW CLASS sic FACTOR (SEAT CPI RADIUS 1 FARTHEST TERMINAL I COST NEW _ 10,000 _ 100 3 s 29,6A5 USE TX COMM'L T 1 FOR NIRE [ CHECK ApOL NU i UNORINs T F L5P R� 02OUCTIGLEB f TCOMFII 61 I- CUVC1iAPF&.,__J FAULT 1,_I MOTOR ( X REIMS } X ACV X� OTC 1 IC OF PLEASUIE RETAIL 1 10WINb E 40MPI 1 ' X LIgS 1 . a MED PAY i .� R LABOR E X Orc G I A ( ST ANT $ 500 FARM SERVICE NO' X UNINS j SPEC 33 I--- " - uLi L...- .htazsu.+_.---Lcg€lv [ FDuv X Gou s -- s _-SOOCOL DRIVEV 15 MILES 16MILES+ NEI'YEH R: TOTAL PROM. VEHR YEAR ',MAKE DODGEfi.Other VEHICLE TYPE SYMIAGE OTP srM srmL 3 2011�MooEL RAM 3500 PICKUP l6 MN 3D73M4CLXBG624553 .) �PP �sPEccoML GARAGING i STREET IR q d it KY) CITY COUNTY STATE 21P ADDRESS 4758 Promenade St _LSlm--lCl-VVaa11� _ __ CA 93063-04.1.1 STATEI TERR '� GVWIGCW CLAS$ 1 61C FACTOR SEATCP RADIUS FARTHEST TERMINAL COSTNEW _ 20,000 _ 1 100 y s 52,405 USE COMML� TFORIIIRCrQ ANL7RAOS�Le>,MRTtDAtw� � FOR �. .q FT yl 1C IFUR� SEUUv110F ISTAMTV GO C'15�QCOF PA I CDLI PLEAS ltETML 1 tJ� WING Y/\ COMPI t FARM 1 SERVICE FPN b COIL ... __. ,....,._. ,._ ,... . L�. kRNE'O (( 15 MILES I 15 MILES NET VEK W�RK�SCNbDL i { D{uDR 10TAt,r REM' $ VEMN ! YEAR MAKE. NISSAN OdQY PICICU VEHICLE 7YPE SYM IAGEI OTC SCOMPI COLL SYM YMI 4 L2004 MaDEL FRONTIER CREW CAQ SC I vIN 1N6MD27T84C451907 PP� �sPEr I COM1. 11 E ; GARAGING ?STREET (R qu d NV) -CITY I COUNTY STATE � ZIP P°DHE55 ' 4758 Promenade St ._ - Siml Valle l 93063 0411 -- 6TATE TERR GVWIGCW CLASS eIC I FACTOR (SEATCP RADIUS r FARTHEST TERMINAL COSTNEW 10 000 _ 100 I __ a 24,420 UBE COMML FDR HIRE CHECK "- AGi3I AQ` llNi]RINS F LSP RENT DEDUCTIBLES t 1GbMPl1 SPFC &OYERAOE9 __{ gULT I MOTOR e REIMG _ , ACv _ OTC C OF I PLEASURE RETAIL qy LIAR MET PAY TOWING ; FT COMP? FO { &LAGOR AA -.., 9TAMT $__ None FARM BE IC NN'O I _.. UNINS t SPFC FIW DOLL fALR.T X MOTOR _ !COPE _ ,,... S S NOneCOLI C0 KTO I ifiMILES i MILES T PTVER VEH6 YEAR I MAKE DODGE I yF Pickup VEHICLE TYPE ;SYM IAOE S i L ._ __ ___ �. TV — — ._ OTCSYM SYM 20031 MODEL RAM 1500 PICKUP V8 I vl N 1 D71HA16D53J635509 ] Pr ��sPE �coML GARAGING STREET Req b din KY) ITT COUNTY STATE ZIP ADDRESS 4758 Promenade St Simi Valley _ �CA 9300 0411 S IA1E TERR GVWIGCW CLASS SIC FACTOR SEAT CP� RADIUS PAR7HPST TF.RMiNh4 COST NEW _ 10,000 i 1 100_ 1 _ _ s 2_2,040 USE GOMML I FORHIRE CHECK ARYL NO- jUNDRINS F LSF BENT DLDUCTIDL ON tj CMOMP/ 6Prc I_ rgfl CRAGES __z FAULT MOTOR F REIMU ACV .. OTC .i:!)FL PLEASURE RETAIL �r LIAR MED PAY TOWING FT COMPI PC + S LABOR I OTC I AA I ST AM7 I $ None FARM SERVICE h0• DRI G NSPCC FTW COLL 1 ] 1lNVLI .X. MWOA .DOFL .._.... t_ 1 ,s NonecaL 911VE r9-...„.. I < 15 MILES I i 15 MILFS NETV@H y ,_ - ACORD fRV II,,D OO 1993,2009 ACORD CORPORATION. Ali rights reserved, . B The ACORD name and logo are registered marks of ACORD Printed by JAB on July 03, 2019 at 01 29PM Risk Management Division AGENCY CUSTOMERID; 00011400 coR®® VEHICLE SCHEDULE - - DATE(MMIDDNYYY) 07/03/2019 AGENCY CARRIER NAIC CODE Crescenta Valley Insurance California Auto 38342 POLICY NUMBER EFFECTIVE DATE NAMED IN6UHEDI61 MAKE VIVA. _ 1yPg,van VEHICLE TYP�^E--� -SYMI AGE 6 OTC SYM SYM j 2002 MODEL DENALI XL K15pp M N: 1 GKFK66U 12J 102989 1 PP SPEC I COML GARAGING STREET (Roqulrodl KY) CITY COUNTY STATE ZIP ADDRESS 4758 Promenade St _ _ S_ml Valley _ CA jj 93063 0411 _.__.. ppp._� LK ..... ED PAY I_. (FT 1 1 pp µ.y FRENT I UE OCT-E i $ coMPl BIPED STATE TERR GVWIGCW CLASP SIC FACTOR SEATCP RADIUS FARTHEST TERMINAL } COST NEW USE U GOMM'L l FOR HIRE CHECK � FAULAD&T NO. 11NURIN3 FTW COLL CYM9 X� I _j tl Cp jCOf, MejVERACE& _ FAVI T (j(j MOTOR !� $ J ACV $ .AeyGULI PLFASURE �IiETAIL I TOWING (OMPI �' a SLADOR X OTC M 6TAMT 8 500 FARM SERVICE I N(}- UNINS SPHC DRIVE-fP _ .._ ... hi.tl.0 .X PA4?FS113�_ C,0E-L .1_..,t,_,. ..XI. __ j <15 MILEG I15 MILESa NETV6N - Di�hh TOTA4 PHEM: i VIED ; YEAR MAKE FORD BODY CpMp rm�oLr TYPE P CI(UP VEHICLE TYPE SYM I AGE OTC BYM SYM 7 2004 MODEL F250 SUPER DUTY VIN 1 FTNF20L84EA38319 PP [ SPEC cCML _- -- _ __ GARAGING STREET (R,u rod n KY) CITY COUNTY l STATE ZIP ADDRESS 4758 Promenade St j Sim[ Valley I l CA 193063-0411 LIT I TERR GVWIGCW CLASS 310 FACTOR BEAT CP RADIUS FARTHESTTERMINAL COST NEW STATE 1p,Op0 T100 RCIMB i 18tC9OM59 F<}VERAGES pAF OEUUCTIDLEXUSE ORHIRECHECK ANLNCj P ACVI J OTCPh COA PLEASURE RETAIL 1 X LIAR ME PAY rOWINO PT yy PpOMP! F' 1 1 a_. it _ G IAROR ,� M I_ 1 T AMT S 500 FARM ERVICE i11 p�� li X VNINS 1 Sf+FG X tr.. .__ J. AQ1.1: MQtW3. J_ gQFi..._.. _ Fnv GULL $ S_ 6000ou GR�NE , c tS MILES 1E MILE6 a DFUCIe '" - "' R A la VE11N YEAR MAKE DORY VEHICLE TYPE .MMIAGE COMP11 eoLL _. iYp :.� OTCSYMI sYM {PP F.aria GARAOING i STREET (R g Irntl In KY) CITY COUNTY STATE 21P ADDRESS { _i. ._.. _�. .. .._ ..._.... STATE TERR GVWIGCW i CLASS SIC FACTOR SRATC1 RADUS 1 FARTHESTTERMINAL COST NEW _ _ t $ USE COMM FOR HIRE BECK AnIJI NC5 UMt RIN6 1 LSP RCN7u UEUUCTIeLEe 7-`OL�MP/ Arm I{I ,¢ 4ttAtSE3 FAULT -XI MOTOR I F NEWS _ f AGV OTC {.OF L 1 PLEASURE REtAIL LIAG MED PAY LAUGH 1 _1 Fr COMPI FG IftWING —1 LOgO M Si FARM SERVICE NO-V ppNINS SPE[. I 1 FIW ' OroLL �yEAUi7 ,fx htGFW! <._ ..C9t6 COLL ORIVE'fIP T<i6 MILF9 1S MILES NETVEN�� W K t 1 TAL PRBMi VEHO 1 YEAR MAKE; BODY VEHICLE TYPE SYM 11AGE UUMP TSYM jMUDEL IN, �PP �_ SPEC- CGML ! GARAGING ; STREET(Rnqu lmtl In KY) ! CITY COUNTY £STATE' ZIP ADDRESS t L— .. _— _ _..,..,_. —_ ------- STATE TERR GVWIGCW CLASS i SIC FACTOR TSEpT CPS RADIUS FARTHEST TERMINAL COSTNEW _. CHEC Use )COMML FDHHIHE IQw, A004 NO MOTORN1 F LGP FE p OEOUCTIDLES ACV �COMI 761'NG &pVERAGEE�_ rAUIT ._�, OTC ICGFL PLEASURE RETAIL JILIAB MED PAY 1 ALABOR FT OiC P!�FG AA STAMT I$_. _..._ p FARM SERVICE IIIYtk UNINS SPEC I FTVJ COLL tY 4 __ I (FAULT �.X. MOTOR I .COPE t - $ 1S LOLL WRIT. D . 15 MILES 15 MILES !!!!!!I kY VEH 7 AL RM: VENp YEAR MAKE U. VEHICLE TYPE SYM IAGE UMP C� .. _.-1--1:-_ ......_.__...(Y-`! ,GTCSVM SYM MODEL V.1 N.� PP L__J SPFC COWL ! .�_.....� _._..i ......... GARAGING ! 9MLHT (RogNitadiP l4TI CITY COUNTY I STATE ZIP ADDRESS —_ STATE TERR BMW I DCW CLASS SIC FACTOR 1mATCPI RADIUS 11 FARTHEST TERMINAL COST NEW FAriMGURE �SEHAV/641( ._._I IbV NOOFSAl ;.v DECPAYiFAULT��51 aDROR i!OrMPIR MTB. * M ... SIAMrACV LOTC COFL. USE GOMM'l. FQR9 iE F LSP DEDUCTIBLES COMP( -SPEC ni �yjikAQORD name and logo are registered marks of ACORD 1{�' Printed by JAB on July 03, 2019 at 01:29PM Risk enfi Dtuisk� t POLICY NUMBER: BA040000014964 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Business Auto Broadening Endorsement This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I, NEWLY ACQUIRED OR FORMED ENTITY (BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS III. AUTOMATIC ADDITIONAL INSURED IV. EMPLOYEE HIRED AUTO LIABILITY V, SUPPLEMENTARY PAYMENTS VI. FELLOW EMPLOYEE COVERAGE VII, ADDITIONAL TRANSPORTATION EXPENSE VIII, HIRED AUTO PHYSICAL DAMAGE COVERAGE IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE X. LOAN/LEASE GAP COVERAGE XI. GLASS REPAIR —DEDUCTIBLE WAIVER XI I. TWO OR MORE DEDUCTIBLES XIII, AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS XIV, WAIVER OF SUBROGATION XV, UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS XVI, EMPLOYEE HIRED AUTO PHYSICAL DAMAGE XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIIL HIRED AUTO— COVERAGE TERRITORY XIX, BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Office, Inc., with Its Permission of 5 'RCV � c il Risk Management Division POLICY NUMBER: BA040000014964 NEWLY ACQUIRED OR FORMED ENTITY (Broad Form Named insured) SECTION II - LIABILITY COVERAGE, A. Coverage, 1, Who Is An Insured, the following Is added; d. Any business entity newly acquired or formed by you during the policy period provided you own 50%or more of the business entity and the business entity Is not separately insured for Business Auto Coverage. Coverage Is extended up to a maximum of 180 days following acquisition or formation of the business entity. Coverage under this provision Is afforded only until the end of the policy period. Coverage does not apply to an "accident" which occurred before you acquired or formed the organization. IT, EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: e, Any "employee" of yours is an "Insured" while using a covered "auto" you don't own, hire or borrow In your business or your personal affairs. III. AUTOMATIC ADDITIONAL INSURED SECTION II - LIABILITY COVERAGE, A. Coverage, 1, Who Is An Insured, the following is added; f. Any person or organization that you are required to include as additional Insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is In effect during the policy period Is an "Insured" for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "Insured" underthe Who Is An Insured provision contained in Section II, IV. EMPLOYEE WIRED AUTO LIABILITY SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following Is added: g. An "employee" of yours Is an "Insured" while operating an "auto" hired or rented under a contract or agreement In that "employee's" name, with your permission, while performing duties related to the conduct of your business. V, SUPPLEMENTARY PAYMENTS SECTION II -- LIABILITY COVERAGE, A, Coverage, 2, Coverage Extensions, a. Supplementary Payments, Subparagraphs (2) and (4) are replaced by the following; (2) Up to $3,000 for cost of ball bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We are not obligated to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance services Office, Inc., with Its Permisslon Page 2 of 6 ,R�/IEEC� Y: IN Risk Management Division POLICY NUMBER; BA040000014064 VI. FELLOW EMPLOYEE COVERAGE: SECTION II — LIABILITY COVERAGE, B. Exclusions, S. Fellow Employee This exclusion does not apply If you have workers' compensation Insurance In -force covering all of your "employees". Coverage Is excess over any other collectible insurance. VII. ADDITIONAL TRANSPORTATION EXPENSE SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses, Is replaced with the following: We will pay up to $50 per day to a maximum of $1000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage, We will pay for temporary transportation expenses Incurred during the period beginning48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" Is returned to use or we pay for Its "loss". if your business shown in the Declarations is other than an auto dealership, we will also pay up to $1,000 for reasonable and necessary costs Incurred by you to return a stolen covered auto from the place where It Is recovered to Its usual garaging location. VIIL HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION It — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, the fallowing is added: c, If Liability Coverage is provided In this policy on a Symbol 1 or a Symbol 8 basis and Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this coverage form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire, subject to the following Ilmit: (1) The most we will pay for "loss" to any hired "auto" is $50,000 or Actual Cash Value or Cost of Repair, whichever is less (2) $500 deductible will apply to any loss under this coverage extension, except that no deductible shall apply to "loss" caused by fire or lightning Subject to the above limit and deductible we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own of similar size and type. This coverage extension is excess coverage over any other collectible insurance. IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions, 3.a, Is amended to add the following: This exclusion does not apply to the accidental discharge of an airbag. Copyright 2017 Mercury Insurance Services, I.I.C. All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Sorvices0fflce, Inc, with Its Permisslon Page3 [off}'6�//�I Risk Management Division POLICY NUMBER: BA040000014964 X. LOAN/LEASE GAP COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE C. Limit of Insurance, the following is added: 4, in the event of a "total loss" to a covered "auto' shown in the schedule or declarations for which Collision and Comprehensive Coverage apply, we will pay any unpaid amount due on the lease or loan for that covered "auto," less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) overdue lease/loan payments atthetimeofthe"loss"; (2) Financial penalties Imposed under a lease for excessive use, abnormal wear and tear or high mileage. (3) Security deposits not returned by the lessor; (4) costs for extended warranties, Credit Life Insurance, Health, Accident or Dlsablllty Insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases, The most we will pay under Auto Loan/Lease Gap Coverage for an insured auto is 25%of the actual cash value of that Insured auto at the time of the loss. XI. GLASS REPAIR— DEDUCTIBLE WAIVER SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible, the following Is added: No deductible applies to glass damage if the glass is repaired rather than replaced, XII. TWO OR MORE DEDUCTIBLES SECTION Ili -PHYSICAL DAMAGE COVERAGE, D, Deductible, the following is added: If two or more "company" policies or coverage forms apply to the same accident: 1. If the applicable Business Auto deductible is the smallest, it will be waived; or 2. If the applicable Business Auto deductible is not the smallest, It will be reduced by the amount of the smallest deductible; or 3. If the loss Involves two or more Business Auto coverage forms or policies the smallest deductible will be waived. For the purpose of this endorsement "company" means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies. XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement In SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit, Or Loss, a., In the event of "accident", you must notify us of an "accident" applies only when the "accident" Is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, If you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation, Copyright 2017 Mercury lnsurance.Servlces, LLC, All rights reserved. MCA85100817-CA Includes copyrighted material of Insurance Services Off ice, Inc., with Its Permission age 4of6 .... . . _ , .... '..' E6YICvttr'"t4gt'„tV�11¢ Risk Management Division POLICY NUMBER: BA040000014964 XIV, WAIVER OF SUBROGATION SECTION IV - BUSINESS AUTO CONDITIONS, A. Lass Conditions, 5. Transfer of Rights Of Recovery Against Others To Us, section is replaced by the following: S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed priorto any "accident" or "loss", provided that the "accident" or "loss" arises out of the operations contemplated by such contract, The waiver applies only to the person or organization designated in such contract. XV, UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepresentation, or Fraud, the following Is added: Any unintentional omisslon of or error In Information given byyou, or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance, However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery, This provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal, XVL EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV —BUSINESS AUTO CONDITIONS, B. General Conditions, S. Other Insurance, b. For Hired Auto Physical Damage Coverage, is replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: 1. Any covered "auto" you lease, hire, rent or borrow; and 2. Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV —BUSINESS AUTO CONDITIONS, B. General Conditions, 5.Other Insurance, the following is added and supersedes any provision to the contrary: e. This insurance Is primary to and will not seek contribution from any other insurance available to an additional Insured under your policy provided that: (1) The additional Insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this Insurance would be primary and would not seek contribution from any other insurance available to the additional insured, Copyright 2017 Mercury Insurance Services, I.I.C. All rights reserved MCA85100817-CA Includes copyrighted material or Insurence Services Office, Inc., WIth Its Permisstory Page 5 of 6 19) Risk Management Division POLICY NUMBER: BA040000014964 XVIII, HIRED AUTO -COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, B, General Conditlons, 7. Policy Period, Coverage Territory, e. Anywhere In the world if:, is replaced bythe following: e. Anywhere In the world if; (1) A covered "auto" fs leased, hired, rented or borrowed without a driver for a period of 30 days or less; and (2) The "Insured's" responsiblllty to pay damages Is determined In a "suit" on the merits, In the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or In a settlement we agree to. XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANTMENTALANGUISH SECTION V— DEFINITIONS, C, "Bodily Injury" Is amended by adding the following: "Bodily Injury" also includes mental anguish but only when the mental anguish arises from other bodily Injury, sickness, or disease. Copyright 2017 Mercury Insurance Services, LLC, All rights reserved, MC485100817-CA Includes copyrighted material of Insurance services Office, Inc, with its Permission , Page6 of 6 Management Division POLICY NUMBER: BAD40000014904 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, BLANKET ADDITIONAL INSURED This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The following Is added to the Section 11-- Liability Coverage, Paragraph AA. Who Is An Insured Provision: Any person or organization that you are required to Include as additional Insured on the Coverage Form In a written contract or agreement that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is In effect during the policy period is an "Insured" for Oublilty Coverage, but only fordamages to which this Insurance applies and only to the extent that person or organization quaiiftas as an "Insurell under the Who Is An Insured provision contained In Section 11, MCA20480711 RE�1EiN f� t_.,AA .v .A vo!n�