HomeMy WebLinkAboutGOODIES, LLCINSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
�XZ7no�
CLERK OF COUNCIL
DATE:
Exhibit 2 A-2020-032
Pd l»rnc�r. c'obw�- ckrro It d.,
AGREEMENT WITH GOODIES, LLC TO PROVIDE UNIFORMS
AND EQUIPMENT TO THE SANTA ANA POLICE DEPARTMENT
THIS ACREEVI ENT is made and entered into this 181 day of February, 2020 by and
between Goodies, LLC, a California Limited Liability Corporation, ("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").
v
RECITALS
F� A. On November 4, 2019, the City issued a Request for Proposal #19-104 C RFP'� in which
o it sought proposals by qualified vendors to purchase and provide alteration services of
IV
cm police uniforms, accessories, and miscellaneous equipment for its civilian and sworn
employees.
B. On November 20, 2019, Consultant submitted atimely responsive proposal which was one
of two selected vendors to provide the services described in the scope of services that was
included in the RFP and attached hereto as Exhibit A.
C. Consultant represents that Consultant is able and willing to provide such services to the
City.
D. Tn 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, and incidental customary work required to fulfill the services
described in Exhibit A. Consultant's proposal is incorporated by reference as though fully set
forth herein. Exhibit B provides the estimated quantity of items to be used for evaluation purposes
only. The estimated corresponding amounts do not alter the not to exceed amount set forth in
paragraph 2 below.
2, COMPENSATION
a, City agrees to pay, and Consultant agrees to accept as total payment for its services the
rates and charges set forth in Exhibit B. The total annual sum to be expended under
this Agreement shall notexceed $22,000 during each year of the three-yearterm of this
Agreement. This yearly sum includes a 10% contingency amount to fund any work
directed at the sole discretion of the City. The total -amount to be expended during the
term of this Agreement shall not exceed $66,000.
Page I of 8
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b. Payment by City shall be made within 45 days (forty-five) 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.
3. TERM
This Agreement shall commence on the date first written above for a three (3) year term,
unless terminated earlier in accordance with Section 13, below.
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. 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 Iess 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.
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
#25797vl
to be lrrsmed agalust liability for worker's compensation or to undertake self-
insurance. prior to eornmoneing the performance of fhe work upder this
Agreement, Consultant agrees to obtain and maintain any ethployer's "liability
insurance wlth limits not less than $1,000,000 per accident.
d. If Co tsultattt is or omplaps a licensed prbfessionai such as an architect or engincer:
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:
1, Consultant shall maintak all insurance required above in fulFfarce and
effect for the entice period covered by this Agreement
11. Certificates of insurance shall be furnished to the City upon "ution of
this Agreement and shall be approved by the City;
III, Certificates and policies 4hall. state that the pollcles shall not be oanected or,
reduced in coverage or changed In any other material aspect without thirty
(3 0) days prior written notice to the City.
iv. Where Cite 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.
Y. Consultant shall supply City with a fully executed additional insured
endorsement,
f. If, Consultant'fa is or refuses to produce or maintain the insurance required by this
section or tails or refuses:to furnish the City with required proof that lnsuranee
has been procured and is in force and paid for, the City shall have the right, at the
City's election,'tu forthwith terrnhuate this Agreement. Suchferrninalion shall not
,affect Consultant's Tight to be paid for its time and materials expended ,prior to
d: ISM DSMISIMiCA'TfON
Consultant agrees to defend; and shall indemnify and hold harmless the City, its officers,
agents, emp1cyees,vomm, ctors, speoiul counsel, and representatives from liability- (t) for porsonal
injury, damages,; just compensation„ restitution, judicial or equitable relief arismg outof claims for
persorad 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 whleh relates to the services described in section. t ofthis Agreement; Iand (2)
from any claim tbatpersonal injury, :damages, just compensation, restitution, judioiaj or equitable
relief Is due by reason of the terms of or effects,arising from this Agmement. This indemnity and
hold harmless agreement applies to all claims for damages; just compensation,, restitution, judicial
or gquitablorelie:f au£eored, or alleged ttihave been sutforod, by reasotroftbe eventel'efetscd to in
this Section or by reason oftlie 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
#2V97vl
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fees and costs for special counsel to be selected by thc. City, regarding any action lay athlyd party
6hallonging the validity of this Agreement, or asserting that petsonal injury, damages, just
eemporisation, re titution, judicial or equitable rsllefdue to personal of property rights`arises by
reason of the terms of, or effects arising from this ;Agreement,. City may make all reasonable
decisions with respeot:to its reprosoratation in any legal_proceeding, Notwithstanding the foregoing,
to the extent Consultant's services arc subject to Civil Code Section 2782,8, the above Indemnity
shall he limited, to the extentxequired by Civil Code Section2782,8, to claims that arise out of,
pertain to, or relate to the negligence, recklessness, or willfulrnisconductof the Consultant,
7RE CORDS
Consultant shall keep records and invoices in connection with the work to be performed
under this Agreement. Consultant shaft maintain oompleto and accurate records whth respeot to
the costs incurred `under this Agreement and any services, CxponditUrw, and disbursements
cIhargcd 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 seeurds anti
: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 ducing regular,business hours. Consultant shunt allow inspection of all
work, data, documents, proceedings, and activities related to this Agreement for a peri6 d of three
(3) years. from the date of fWat payment to Consultant under this Agreeinont.
s, CONFIDLi NTI ALITY
if Consultant receives from the City information which due to the Iiature of such
infbiTnation is reasonably understood to:bo confidential and/or limprietnry, Consultivafagrees that.
it shalt riot -use or disclose such information except in theperformauoe of this Agreement, and
further agrees to exer`else the same dogroe of care it uses to protect its own h ilbrinathon of like
importance, i but ino event,less than reasonable care,, °'Confidential information" shallinchide all
nonpublic -Information. Confidential Information includes not only written information, but also
informatiou transferred orally, visually, electronically, or by other means. Coofadenthaf
information disclosed to either party by any subsidiary audios agent of the otherparry is covered
by this Agreement; The foregoing obligations ofnon»use and nondisolosure shall not apply to any
Information that (ta) has beau disclosed in publiolyavailable sources, (b) is, through tic'; faultofthe
Consultant disclosed in a publicly available source, (c) is in rightful possession of the Causuitant
without an obligation of coiit"identiality; (d) is required to be disclosed by operation o� law; or (o)
is indopeodontly developedby the Consultant without returerico to information disclosed by the
City.
9, Cfk1Vl!LiCTOFIN E1WOTCLOSE
Consultant covenants that It presently has no interests and shall not have interests, direct
or lndlrect, which would conflict in away manner with performance of services specified under this
Agreement.
#25797vi
1.0, NON-DISCRIMMAT14N
Consultant shall not discriminate because of race, color, creed, religion, sex, Marlud status,
sexual orientation, gander identity, gender expression, gender, medical conditions, gonetio
information, or military, slid veteran status, age, stational origin, ancestry, or disability, as defined
and prohibited by applicable law, in the recrultmcm; selection, teaching,training, alilizatlon,
promotion, termination or other 'enaploymentrelated activities or any services provided under this
Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all
applicable federal; state and local laws and regulations,
11. lvXCgLCJSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the Cityand
Consultant, and supersedes any and all other agreements, oral or written, between the �.arties. Tn
the, event of a conflict between the terns 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
addWosito,thetermsandconditionshereof,shallnotbindorobligateConsultantortheGity,l ach
party to this Agreement acknowledges That no representations, inducements, promises or
ageeentents, orally or otherwise, have been made by any patty, or anyone acting on behalf of any
party, which is not embodied herein,. 3
3
12, ASSIGNMENT
Inasmuch as; this .Agreement is intended to secure the specialized services of Oonsultaiit;
Consultant may not-asstgn, transfer, delegate, or subcontract any interest heroin witho�itthe prior
Written consent of the City and any such assignment, transfer, delegation or subcontract without
tho City's:priorwritten consent shall be considcred Paull and"id. Nothinglts this Agre6vom ahalt
be construed to limit the City`s ability to have any of the services which are thesn8,t'cet to this
Agr4ementperformed by City personnel or by other consultants retained by City. 1
131 AIRtyILN1TIflN
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
compensation for all services performed by Consultant prior to receipt of such notice o
termination, subject to the following conditions:
a. As a condition of queh,payment,theLxeeutive Director may require Consultant to
deliver to the City all worl� 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 thorcof for such purposes as the£City deems
approprlate.
b. Payment need not be made For work which fails to mect the standard of
per£armance specified in the Recitals of this Agreement.
1i25757v1
i
714. WA1t ' R
No. waiver of breach, failure o£.aq condition, or any Tight or remedy contained in or
granted hy'the provisions of this Agreement shall be offective finless it is in writing and signed by
the partywaivingthe breach, failure, rightor remedy; Na 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
shnitar, not shall any waiver constitute a continuing waiver unless the writing so specifies.
15. JMISDICTION-W
This Agrecmenthas been executed and delivered inthe State of California and the validity,
interpretation, performance, and enforcement of any of the olauses 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 prooceding that may be broughtor
arise out of, in connection with or byreason of this Agreement.
16, PROFASSIONALLICFNSES
Consultant a
permits, approvals,
and required by the
SantaAna and all of
In writing of its in<
exemptions. Said it
throfl&ut"the term of this
urs, alfd exemptions necessa
to obtain or maintain such
shall be cause for terminat
all necessary lioenses,
rimediately and
s, walvors, and
17, MISGELLANGOUS I'l OVISTONu
a, }each undersigned reprosetrta and warrants that its signatti>e herein below has the
powcrz:autbority and tighttobirtd their respective parties to each oftheterms_of
ibis -Agreement, and shall Indemnify City fully, including roasonable costs and
attorney's fees, for any njuries or damages to Citym the event thatsuch authority
or powor is not, in fact, held by the signatory or is withdrawn;
b, 'rho Agreement is the final and complete agreement raid ;any prioi, or
contornporaocous agreements between the parties is superseded by this,Agreomcnt
c, All Exhibits referenced herein and attached hereto shall be incorporated as If fully
set forth in the body of this Agreement
18. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to thisAgreement
shall be in writing and shall bo deemed to be property given if delivered hi person or mailed -by
first class or certified mail, postage prepaid, or sentby fax or other tot egraphic commimloation in
the mariner provided in this Section, to the following persons:
W25797YI
To City,
Cleric of the City Council
City of Santa Ana
20 CIAO Center Plaza (M.30)
P.O. Box 1988
Saint Ana, CA 92702.1988
Pax_ 714- 647-6956
With courtesy copies to;
Chief of Police
City of Santa Ana
60 Civic Center Plaza (M-97)
EA. Box 1988
Santa Ana,-611forrila 92702
Face: 714-245.4007
To Compliant,,
Goodies, LLC
Attw Paulajoan Engleman
32,W Firestone Blvd,
Norwaik, CA 90650
A;party may change its address by.giviog notice in writing to the other party. Theroafl'er,
any communicatioxl phall to addressed and transmitted to the now address. If se6t by mail,
eanmunleailon shall be offective or deemed to have been given three (3) days aiterlt has been
deposited in the, United States mail, truly registered or certified, with postage p�alZ610, and
addressed as set forth above:, If sent by fax, coriummicatlon shall be effective or deemed to have
been given twonty-foui (24) hours alto the time sot forth ou the transmission repot issued by the
transmitting facsimile msohine, addressed as set forth above,. for purposes of calcul**log these
Limo frames, wevkcndst federal, state, County or City holidays shall be excluded,
[signature page to follow]
1125797V1
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year fast
above written.
ATTEST:
Daisy Gomez, .-
Clerk of the Council
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
Bn
T AOGOSIAN
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
� VALENTIN
Chief of Police
#25797vl
CITY OF SANTA ANA
Kristine Ridge �—
City Manager
GOODIES, LLC:
A
B, .SPSCIFICATIONA
1. Uniforms and Equipment'
Description of Goods to be Purches�t See Attachment B for a detailed listing of uniforms and
equipment to be provided. Unifo and eouipment orders shall be compirtted wthin a two (M week
turnarountt imp,
a. Location and Hours
Vendors must provide a full retail location no further than 30 miles from the city of Santa Ana Police
Department, Vendors that maintain a retail location within 15 miles of the Santa Ana Police Department
will be given additional consideration, Please provide list of locations.
The store must be open a minimum of 5 days a week from at least 8:00 a.m:. — 5100 p.m.; Monday-
Criday, and 8:00 a.m. — 12:00 pm. on Saturday. Wait times during personnel store Visits shall be
reasonable as deemed Nthe Clay:
3. Samples
Upon request, vendor shall supply within 7 days, samples of all uniform items for inspection and
approval prior to contract award, During the term of the contract, if any items I!$tedtls Attachment 13 are
discontinued, the Vendor Is responsible for notifying the CDC Supervisor and prodding samples of a.
comparable substitute for inspection and approval. No sub stitutians will be authorized wikRouf prior
approval from the 00C Supervisor. No costs will be ineurrad due to substitutions being issued without
poor approval, I
4. Services ;
Successful vendor(s) must agroo to provide the following services;
Initial tailoring to include any necessary alterations to provide a professional fit. "Tailoring shall be
completed within five (5) working days of fitting for all standard alterations and (15) working days for
non-standard alterations, All alterations will be stitched and bound to match the manufacturer's quality
and Color of thread. Vendors are required to submit pricing for the alterations described. proposers
shall specify whether charges are included in the original Item price or are separate charges. Any
pricing not provided shall be assumed to be included in the purchase price.
Alterations most be completed at the retain site.
All uniform articles are to be processed in such a manner to render the finished product professional in
appearance. This shall be completed on first visit and shall not require numerous alteration repairs.
Send representative(s) to Santa Ana police Department in cases where five or more employees are in
peed of being fitted for hotly armor;
CITY OF SANTA ANA
Vendor must assign on account representative or pointof contact forthe Santa Ana Police Department.
The account representative shall be assigned to manage the City's contract for specified services and
be the main contact for Police Department. personnel, Account representative shall ensure proper
tracking of orders, invoices, and any other activities related to the awarded contract are handled In'a
timely manner and In accordance with the specifioatlons of this'RFP.
6. pricing
Pricing shall remain firm for the entire, Agreement, Thereafter, any proposed pricing adjustment for follow-
on renewal periods shall be submitted to the City purchasing 'contact in writing at least ninety (90) days
prior to the now Agreement term, City reserves the right to negotiate any pricing adjustments;
a. Material Release
A "material release" form will be used by City employees to purchase against this agreement. The number
shown on the material. release MUST appear on your invoice.
7. No Partial Orders
Vendor shalt not invoice until the entire material release order has been fulfilled.
FA
Reportl Invoicing
Invoices for completed orders mustcontain the following inrormatioltr
Date ofinvotce;
■ item # per contract;
Description;
Price,
Quantity;
Material, Release Number; and
Employee name.
Paymentwill be made in approximately 30 days from the
unless alternate terms are proposed and accepted by th
of each order,
Contractor must provide a monthly printed transaction status report listing completed, partial, and/or
pending orders with employee name, associated material release number, Item quantities, dollar totals,
and completed delivery and/or expected due date, The report shall be sent to Santa Ana Police
Department Cps Supervisor in orderfor payment to be processed for completed orders.
9. No Guarantee of Usage
Any quantities listed In this RFP am estimated or projected and are provided for tabulation and
reference purposes only, No guarantee of quantities is given or Implied by the City, supplier must
furnish the City's needs as they ariso. No minimum order proposals will be accepted.
10. Use of Other Governmental. Contracts
The City reserves the rightto reject any part or all of any proposals received and utilize other available
governmental contracts.
11. Substitution
If Supplier elects to propose an alternate manufacturers item that is of the same or better quality,
samples of the items to be substituted are to be submitted with the Proposal by the RFP deadline;
RFP No,10-104 Police Department uniforms and Equipment
CITY OF SANTA ANA
Samples must be readily identified With the manufacturer's name, model number br order number,
along with the supplier's name, phone number, and contact name. All substitutions rhust be proposed
as options and clearly Identified as a substitution, The City reserves the right to accept or reject any
proposed substitution items.
i2.Guarentee of Continuity and Availability of Products
Unless the manufacturer discontinues the goods/commodities, all goodelcommoditles specified by the
Supplier in their RFP shall be available to the City during the life of the contract and extensions. All
material, color, labor, and construction shall equal or exceed the standards set forth in these
specifications as accepted by the City;:
43, MisceltaneouslAdditional Items and Upgrades
The City has provided a list of frequently purchased Itemsft
may require additional Items of similar nature not specifical
an Item upgraded from that proposed by the Supplier thr(
event, the Supplier shalt provide the City with a -price for
procedure or formula, which is the same, or very similar
contained in the Supplier's proposal,. If the price offered is
cannot be resolved to the satisfaction of the City,the City sh
other Suppliers or shall cancel the contract upon giving thi
Supplier.
idson purposes. However, the fifty
In the contract of wish to purchase
the term of the 'contract, In such
v ,or upgraded item based upon a
used In establishing the prices as
,eptable to the City, and the matter
irethe new or upgraded items from
calendar days' written notice to the
please specify percentage dlscountthe Clty will receive and/or markup charged for Items not separately
listed In this RrP in Cost Proposal. '
CADET ROCKEWS (2 % X V4 -)
CPL. FTO CHEVKON
MOTOR W14P-,M W/ARROW
EA-PD UNIGNIADIREGfORY
CPI,. CHEVRON W/STAR
EXP l,0PBR RO CKERS (4 % x a/, ")
MOTOR WHEWWWNGS
19
(In OP Oren 0180)
S,GT. OFIEVRONS
CHEVRON
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CITY OF SANTA ANA
STANDARD SHOULDER PATCH STANDARD CLOTRBADUE,
SWAT SHOULDERVATCH SWAT CLOTH BADGE
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City of Santa Ana
MA MMMementDivision
20 Clvk, Center Plaaa, d"' floor
Santa Ana, CA 92702
To Whom it " Cancern;
This letter is to inform you of the, "traving differences from the items in the original
Goodies, LLC does not own any companV ueiaklc ; Cormotty, We wig not bane and
the fulfillment of this contract, We will not be deltverirg any items to the City and
items will be either picked up frarn our retail stare of dom shipped pia a comman
Goodie,, LLC MR not hire any professionals to 64 ri €l any part of this cra ct:
Kind Reprds,
df 1 L
ta,�aFdlean €agleman
owner, Goodies UC
12158RTVVGnathd,
REVIEWED APPROVED
By Risk MANntr£NIENr C}iuis ON
AP ItIt"D
ANgii€E AcFvFdca
t€a I=Or SCMCC fUld f)ttafity
Yet (1,M) Ae3.1702 Fas (562) 007�381 Emtail`
used for
L All
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CERTIFICATE OF LIABILITY INSURANCE, att9M Y �
'nos criv iFICATE 1s t884BD AS h MATTER OF [-FORMATION ONLY AND CON ItERSNOPIONTSUPON THE CER IF(CATE HOLUER,THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGAIMILY APARM, ENTUNU OR ALTER THE COVERAGE APPORDED sy THE POLICIES
SELOW. THIS C XPRIFICATE OF rNSURANCe DOES NOT CONSTITUTE A CONTRACT' PI • N THE ISSUING IPBSURERRI), AMORIZED
R11PRESENTATAIF 00 PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: If the cartnicata fndderis sat AOatTIONAL INSURED, the paltry{lasj musk have, ADDITIONAL INSURED Provisions or He Brulanutd.
If SSRROOATION 18 WAIVED, sooloct BD dra terms and canalRkan9 of the V*My,.cartaln PaHalaa rerlIAM an anGoraamoat, Astdealent on
UIRa CRtu tio_cs not coniorrl hie Itt 4lta cat4lReata iwldar 6n itpst of naafi endorsemsp z .
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:VIEWED 6 APPROVED
THE rERMS.
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____ 1S'DULD AYY OF THE A. DkSCRIUD POLICIES BEC LLED BEFORE
_ THII i(PRAMON DATE , NOTICE WILL an DELrfBntSl ad
CH ACCORdANWITH TIM POLICY PROVt 9.
�,NClE,d4CEVE£I0
AUTHO l2Ea neracsrrrrArM .
0INS-2013 ACOAD CORPORATIOM Alt rwl s r4s fv '
The ACORD nano and logo are molatared marks of ACORO
d
THIS ENDORSEMENT ORANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY CHANGES
PollcyPovl*& Fmm09/27/2019 To 09/2,7/2020
This endorsomeat mod(fies Insuponce iNtmd" mfujef tfm MeMog:
Cuuurler'--idl a�ne"J r'Uv�raf4e
Endomemunt Number I
Policy Number WS3 89882
changes Effactivo
Chang"
In comaido--altian OF no charIQA !.f% premium, i L [VI linrmby
a41'f-ocld thlt- ",h�l rollowinq add-,'"ona.. in,14kirorl !.a act-aed t'n tiln policy
vine forma CO201.2 and SPM,(;-C�'�
C'My of 8-anta j'wo
Rink xanw3nmnt vjvtnion
20 Cotntor plaz�'
Sazit—t Ana, C4 927')2
All. terma and anndtinns rLiraiu uncliiniftd.
The fellwMnil fono(a) is ADDED to tho poiley:
62'71t�-CC '4/lh) Amenielmo,i,', OF Other Tlnsurinsn Primary
rviquranc" f,,�r Add-,'tion,�l r "aured
Cc, '-,0 1."dos{:}3r Additional TnmurAd - Si,ata nr Governuvimal Agency
yr Subdiviull.on or Polit,Lo-al- sabdjvjgjczs - porjr,1t_-
AuthorizationA
The follwM09 RMSED fom(s) 4m ATTACHUM
r2q4D-01 ?9/'W7j ("vmAevciall GTJ CDVc"r::tq': 0eclarationg
NEW TERM PREMIUM
5ltn-k
two
Nc chancit-
REVIEW ED & APPROVED
By %kMANACfEMENTt)tVjSj0N
5 202p
A,4qiE AcFvFdo
2
Effective 151tm U 3 / 13 / 2 U 2 0 1101 AN, at your Mailing address polICYNG: wsae'-19'92
Named Insurach
Gk7odi�a LLC
LIMITS OF PISURANCE
Each Occurrence UnIt o on
Damage To Premises Rented To You Limit S 10 0, 0 00 Any One Promises
Methcal Ex sea Limit S . ........ S 0 00 Any One Person
Personal and Advarising Injury Limit S Any One Person or Organization
General Aggregate Limit a AQ'Q"'9"Q2R.
Prodtiot3lCatnomed Operations, Atigregale Limit $ _CXCLUDED
rorm of Businesw F' Trust
0 Joint Venture [3 Partnership W Urrifted Useffily Company
Organization, including a Corporation (but not including a padnc (p, joint vemime, trust or
limited lialiffity company,)
Lor-4 Address of All Promises (Including ?jp Code) That You own, Rent or Ctocupy
1215�4 Flr'A8"Onq KlVd Nn rw'l I, k CA 9D`5n
Wo, Rate
rF cla3lification Cride No, Premim Miss Prk() Alf Other
�,5bAed ti
Subline Premiums s
Totin Advance Prom4irn
The Schedule of cloveraim, dederalrons,
the effective dateahown above.
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FOIZTJ(je ANG PuRM,
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d. fslunraaaat or sevcvnnce payments $xCept ter mvni wriamiul or
camPlUbal ahfmlto'-Aw
,Turd Vacoser;
4, Far erhire buiftlih�a. by nlulool Intl Ole sedan! of too toraantal
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f i he Payroll of saabr ori, Pollouli id ur orprin elm vAra work
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2. Par tan the In this
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cats, tdareffol er rover they ptxu#ay same r mmar as
far the Uhruma lag#m4uaf,
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rho won ooalofall work Mkt Or Section ,it connrewF4nvffii1'east, somcntim
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prpJatd avci Wl�P
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g. Tv paaym(f eat drstafa and thr:Pr he am it Warr firfeal m't du*.tms
asckada Ven U' 33i of € otation equipmeM Installed bu;no- PUnr afted
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ntrrber Of hours r-vnitaty Worked or
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haunt, in any week, or
sP Yay for hdtidaYa. vaczd3t#aas rx pmrakfa +y' S arsaa;
fS, Payrztattt oY an flnlfdaydr rxf amounts AthCPWisd udrJAB>d by Iaav its
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ourniatutti formoocy, Veterans Pe nuoployeto all part oP #troll ¢try.
no lades
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#ua�xxk.d to the if46frCR B Ask ANArlififfe
18. Pyynlp dCSY :u9 include '1
tttF�W�tM�r
HH--ti.%�"{�'__'tP',��c11 �� Ul Dli e ef-
Ek}W-10+trr or „in of roams shentloo for Omrimn�:+ ae
fivinj
..xHIMIs quarters by a Inamly. try a done zsf .rifa�fkted
A. l la 9nitl dth.^f dYahat4a:F €Ai;$ai4aif 41}'.ftk'f7Plpysfen, to as Ilon tot CLnt'.f. Or .y I San ifin b
h. Payments by it employer to gang anauuanotn Inc isor a .i Fenton g hue:. The anion
�, ;erex unit
#s#aisn i„nrdtrpicyaee trifler tneti Pa4'mmn. rwvarvc fzyar
h a amot,
Pwhlegn Vsvis arrbot t mon"n llhhf f6 ciasalttca#tta dkhs'Bpkun,
Ai tFAcFVEd()
S21640-UG i9,147i :nUu4*s creGYr r`md state inio'IE€vEiEe+rca 5mnrimes ixace<6�., wont 8a p.nnss n t'atiu-Z pew
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REAL) IT CAREFULLY,
AMENDMENT OF OTHER INSURANCE CONDITION -
PRIMARY INSURANCE FOR ADDirrioNAL INSURED
-Entry optional if shown al the commoel Polley It " ofty iz shown, tho effiscevo eant of trio 41njohi"roo"i
19 trio saftle as the offectivo data of tile rlolor,,
Thle irrialorsemeilt m0dilliar Irclufance provld�d tindor tile fogssaIifi;
C0MMl'-'R(1'lAt, WWRAI, LIASILITY COVERArE PART
OindlInanid AddIflortat 11159AOrd
Cil�y of Sanue Ana, tZiv% RaWA9o1R1Ntt 2-0 Ccmtcr Plaza,
:'Iant-,n Ann, ^A 92702
Dovagnattar Pronlines
1pl-V,A Pirosv-.�mA
The 16"Oviffail is addod to, Paragraph 4,a- PrileAPY litsurm tics of SrCTION IV » COMMfIRCIAL GENLRAL LIABILITY
CONDMONS:
Thai Inquirmuid le mulary itwul liflue ho fho Prius0h of 04 statelt3ilun sleQmw as the 01-Sionabid Aaldalonal Inswed I" the
'griledilie, but only PkMM in an Addjlftxnafln' erred,
Scheduto, than the priflowV imparwa for the Disalonafed Additional reined aliP&M ONY With recr>f to Kability atiallval
[fool Auch onsignaled I-reollass,
REVIEWED S APPROVED
By Risk MANAqFMCM J)jpj5j0N
WA 52020
- .
ANq!E Acmdo
5271ii-CO lariat y 201F� Snob MaRy r¢xVaay, Aldghts mm�f.
POLICYNUMMR: WS389a62
COMPAriRCIAL GFNERM, WASILITY
CO 20 12 06 09
THIS ENDORSEMENT CMAMGCS THE POLIGY. PLEASE READ IT CAREFULLY.
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZATIONS
Thim ondorssmant nwiros lftqur@nY. provato-1 lgwof tho lotowng ,
COMMERCIAL GENCRAL UAWI.ItY 'COWRAGE PART
-naw Qr Aftom'y or Suladivislon or Poinical
(NI'Y' Of' Son!Ll AnaR-4sk Div R��mjj, a0 cjv�,t'jc,-,n,
ffii� ScliochtlK, It not xMrn n abovj. oil of,
84afib'N 91 - W140 Is An Insured w amerelod to incWL cm
an insured any "to or a0ency w
lubdanakie or PrAgltat tund;vjmk;n shwon in the schedwe
4ubjoict to tha foltmving p �,Worja:
ffna in8maoce apfAi"s wvty With nxwevt to vtx�rowv),K
peffolfrmd by you or C41 your bctsef for wbirl) III" more
Or 90vern"MUA agunCy (a subdi-449" or poWwl
pubdivim)" I t6a,,Wda pernIll oraultx flgjllon.
2. llws ioguranuo does not apply to:
e. "00flity Irttury" 'ferty 'Joeqdars, or -W 'oe)"al &,0
a6larvaing injvfy` ona'ns olit of 'prati"If
parfo"nod for am fodefal govemm'm, stale 41C
rrjunlcirwllity; or
the -products-,vullptated clpvwslions hm?,Wl"
REVIEWED & APPROVEO
By WAMANACENIENT OMSION
52020
--w--
ANqiEACEvEdo
C43 Z0 12 04 09 copyr,Q111, lnsormnop s4rr,,, 0o'c" I"'o- PC,,, � a Pane I or 1
CERTIFICATE OF LIABILITY INSURANCE 0312712020
THIS CERTIFICATE 15 ISSUED AS A MATTER Of NIFORMTION ONLY AND CONFERS NO RfOHTS UVO—NMC CRTIMAiF
HOLDER, THIS CRAMPICAT9 DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE
AFFOROM ay Y"E POCK AES BELOM TIME CCATWICATF OF INOWMACE 00110 NOT CONSUTRFM A CONTRACT BETWEEN THE
IS
SUING AND THE
MVOjil`Aili: Viet orliftate leader Us An ADOMINAL INSURED, Lee lnaleythmit ran Ina OAVICIML tt SUBROMMUM WAWM
subject to the seem and condIflons of the pdky, C0001" fmit4m may Mausee an of meld. A $($Meant on due aerdErato duos
not caaof!sr rf is totho teaftleato holder In flou of such endorsements
AP MM-00 INSLMANCE GROUP LLC
M23" . J12,&W�939 PAX '-Tun -mm,g
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F)MRPORIrMfI4460 ik.�APLAPUMM
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MITCHOATE M" 09 MUED OR MAY MATAM. THE MRANCE AMWIDED By TILE P00NM DUCRNED HAMM 4) SUeMKOT TO ALL Toe
IfWXUN=g AM =nTMaM OFI6OCP FOLI4S5. LIMMS SHOk" MAY HAVg Re" RVD=,o Hy PAID CLMM,
Alma-lu'sal
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MrOrsl THE EXPIRATION DATE THEMOK NOTOFEMLL be tMUWRf!a
20 CIM CENTER PLZ FL 4
M ACOURDAM0.9 MTN THE POLCY mansteus,
SANTAANACA92704066
REVI-M-M-9 TVOVE9988-201S ACOM CORPORATI&i. Aft ri ht; reserve
ACORD 25 (20IM31
reaft of ACORD
ANqlc AcEwdo
Digitally signed by Francine R.
Francine R. Villareal Villareal
Date 2 020.10.29 09 13 33 -07'00'
DATE ePJ?4iDDffVY`Yl
THIS CEIRT[PICA]'L IS ISSUIED AS A MATTER OF INFQRMATIION QNL,Y AND CONFERS NO RIGiH,rs UPON THECERTIFICATE HOR.,DER. THIS
CERTIFICATE 00ES NOT AFFIRMATIVELY OR NEOATIVELY AMEND, EXTEND OR Al TER THE, COVERAGE AFFORDED BY THE POLIC1ES
BELOW. 'THIN CER'1'11VICATE OF lNSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER,($), AUTHORIZED
R E P R ESE NTATI VE OR. P'ROID UCER, AND TKE CER TIF I CAT E HIOLQ E R �
.. . .... ..... ....... . . ........... ....... .............
IMPORTANT: If tllp certifiicale holUdor is an ADDITIONAL INSURED, the policy(kis) must hawle ADDITIONAL INSURED provisions or baertdorsad-
11 SLISROGATION IS WAIVED, siubjecl to, the, terms and conditions of the I)OJJCY,, Gomain, palicies, rmay rOCILIke an endQrs,ernent, A Statement on
this certiffoate does not confer r
W . . ........... .. .. . .......... . .... . ... . .......
P R 0 111 Ill C� r5 R, Lirense # alll 0131 GQNTAC I Victoria Foster
NAM�::
Moirneniou,i Insurance Brokerage, A Marsh & IMIGLeninan Agency LLC PHONE
Company W�n(8 1 �) 93 3-9 868 (811 2287
599'a #550
Van Ku Y,5:, CA 4) 14 11 MMRER'(S) I,FFORDING COVERAGE NAIL 0:
m2 ')!Y$PRER A Northfield lnsur�q,ncc., Coppqy 7981
MUR El D
Goodies LLC
12 158 FI raslorlia Soulavard
Units Ai, B. C & D INGURER 0
Norwalk, CA 904350 ,N-LI-SRENR E
..... ...... . ... ............................... -.--I lKsukUk r . . . . . . ...............................
. ..............................
COVERNOR5, . . .. ... ... 9RTIrICATE NUMBER; . . .. .. ..... .............
EVIL tQ ',R-
kP _Mg!g
1111a IS 10 CFRFIr,Y jlrN IA1 PIE PCLIC�ES OF INSIJIFRANCE USTED BEI-0141 HA'1JE RiEM TitE IWsivo:'LI)
NAMEDABOVE FOR THEPOLICY PERIC,10
INDNCATED, NOTHITHSTANDING ANY REQI flRE.XJ�ENT', I EIRM OR C)NDI NON 01" AN'e CCIN I 13AC I OR' 11 H�R DOCUMENT MPH RE&PEGT' TO Ti duz
CERTIFICATE MAY BE G381JED OR MAY F`PRTAIN, I'Hl,-,' BY IFIE FOLK.111S DESCRIBED HEREWnSlJF1JEC.7 ['0AU-1)-iiElLmos
INADOL SUORf FoUCV KFF pn�, ICY
INL_ 7YPEOF�NSURAKCE "mill P.. �Yj U Q7YYsF`VjI
(MM!.F 1--�MN10
LVA17S
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A X c oM MERGIAL GENERAL UABILITY
. ....... .. . .. ......
17
EAGI I OCCLIRIMACE
(A.ARA; ma)r k r.,ccur( S432097 q;2'7f2020 9127�2021
DAMACE I RE Isl I EL)
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GENT ASGRE (,A117 IledlIA11:11JE:S11," 11
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biyob beduct.
'J71 jr . .... . ..... ............
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kJ7()FA-MrE LIARII ITY
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��QMINNED 5*I(L,..E LDAI I
1.) !.'U IEOUI. DO
Al..176s 'A"13 MIMS
D D LY IN.1 IRY -:�:dm0
I - - L �P�m, S
I HIRF, M701 OVMR I
WkWE'Ji � y I)AMAIZ
Ai ")MLY AIY'Oza'OI�LY
................. .........
UNIRRELLA L IAB (XXI.P1
. . .. . ........ . ......
EAC.Ij
EXCESS UAB (AiWASMADE
I)Eu) H �: I h.,N I iol,� 3
...................... . ............... .. ... . ... . .......... .. . ... .. .. ....... .
. . ..................
,'A' 0 11 Xr R S C' , 0 rA I' L N SA I 10 N
AND F= KIP U�YfliR,9: LkAWL I T Y
. . ...... . ....
I 'I:H C)Tl
y i,N
soler F�R(blamlll Rl 14FR�FX�";X Vl:
NiIA
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Ail`�irOM°Pi�.itury In kill
GO S
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a sr. m P rrivi or cii:srR, r M4 . . . ...............
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. . . . . .. . . . ........ . ............ .......... ...... . .. . ...... .......................... ......... . ......
FIEKRIP71CIN CF GPERA71ONS rr VEHICLES MCORD B01, Addifiumi� Re -marks SC1101,11LAn, 1111-V Itma,limcmM H var.? rx rpa, Is roclor(id:i
01ty of Santa 4a, officois. agonts, ornployoUS,illld VOILIOINkOM are named as additionally insured on this polloy pursuant to writton Contract, ag.reernent, or
memnolandum Of Understanding. Suc4 insurance as is afforded by this pnlicy.9hall be pffinvy, and any Insma(10) Ctafriod by City shall be excess and
non,contribulory.
Curtificato of lmil.trance shall pravide thifty 1301 day prior wriften nafice of canC�II,ajInn,
. . . . . . . .............. . . . ........ . ........ . .... . .. . .................... . ..... . . ..... ..... .... .... . . ............................
. . . . .......... . .
'SHOULD ANY OF1'HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Santa Anin
THE EXPIRATION DATIE T"FRFQF, NOTICE WILL
BE DELIVERED IN
Risk Wanageirn en t D i w is ion
AC CORDAN CE W11'RTH E I)CLIC Y PROM
ON$,
20, Civic, Center Flake, F 14
. . ...................... . . ........... .
......... ...........
Santa Ana, CA �12702
AUTHORIZED REPRESE N7ATYVE
RJAMwagmedE)Msiun
. .... . ...... ................ .. ....... . . .... ........ ........
1°
REVIEWED & APPROVED BY. -
ACCORD 25 �2010,103�
CQ 198B-2015 ACORD CO
.
P, v, &*,a
The ACORD name and logo are registered marks of ACORD
Risk Pjanagement Analyst
THIS ENDORSEMENT CHANGES T'RE'POLICY, PLEASE, R,EAO IT CAREFULLY.
"Tlv, umdvmsmmlcAni is FrECrIVIE (19/ C,
�am,l is part cif flo4c-v Nm-,[,�er drJ. .:1- 3 -14,1 d� a --7
'Ero:ov c'lplicnal li o;hokeloll iH MU F:,uhGy 11 m) arfiy o,i shovvn, the efrechve rlahcdf the
is as U-1c, cffaaivo datc, gal lho pcd,CY.
This, endray sevreM rnodifies irs(.IN71ACe J:A-cavidecl urlder thc"
GPWkAl LIABNAlY FF, FARJ
SCHEDULE
Additional h i-5ured
�i y SIC, K::A r I V 1, �D I I,
e`vil
Plvd, th.l.ins 4., ��, C, 'K D, P.Inr , w
Tho fAlomn( , �� is, �addod townlragr.-:kph 4.a.., Prrlu iary Insurance, nf 9EQTNON� J'V � COMM.CMI., GENERAL LIA811-11TY'
c ONFrl D 0 N S �
hi., imim-anr,,e it -a prirnaiy iraurance. Iry the 1�,-erscw% cm c-grcjanu;ratpcxn shc.rom as, lhc., ln�.aajled Wi the
but --anly to the extem". "'hat suc,�ri joen,.;co us A.Adi6orlal llv��U.lre,.A 10 a Prelrakawi 11.5 51low1 jaj tile
Sul won me ppllmdlly klsurs:lnco1�m lhe 1115111-led applies oyllywiLh tc.) N104)u,My
Prf--.mlis.es.
7 1 �5 C (4 �' 11 W,, I G I ra vF,�A F., I r? Ind ariri� ty C ci np aroo, N I rig M is a eservo�
ep ..cF RAMompmedDiMsian
Jy? N,�q REVIEWED & APPROVED BY.-
F04c"�" P, vk"
Risk Management Analyst
COMMERCIMIL GENERAL IWABILn"Y
CG 20 12 05 09
TFUS, ENDORSEMENT CKANGES THE POLACK PLEASE READ IT CAREFUCILY.
xnEwri(xNAL INSURED - STATE OR GOVERWAincrALL
AGENCY OFT SU B DAVI SION OR POLITICAL
SUBDIVISION - PERMITS, ORAUTHORIZATIONES
I No and"mernen! =wAs inywai Gc,,e prcwidc, d u',riclor tho fa:jllawuog:
COMMERCIA! GFNERN- UAR11 IT'Y'(-',0VEFVNGE PAR1
REfflumalm
5tate Or Govorrinwnhi Agoncy or Subdivision Of POlAiiCill 89Ubdivision:
City at Santa Ana, Risk Management Divisimi, 20 MvLc WnCex JKLaza,
w) 2 2
if not 5�h(:vvvn @lw.wowild lvvr u i I -I I C ie Garu L"-Jr¢j 1� j c7"j �s
. .. . ........ . ....... J
SmAian III - MW Is An Kswvd 1 amwow 0 hwhon as 2. Ws bawmae cims nol apW"o.
�All f'OiUIE?d W-Mly '.-Aale oi gcwernrnental agency or
suhAvision or paMOW sWdIv&on,,shcwn, in, 1.ho a. "I-31c"r.lHy injury'% -�rclpedy (al
SU4JO'cl tar lho rollowiriq ndvensir),g injury" au i�,iiMg oui� of c,)I:)eratioris
peift)rrned fcp- lhe fedr..,ral ,governmoill, 1.31"ltk4 01
1. Ws Isurawe aaWs Wy wW1 uqmc;1 w operaiinns nlunic�ipaMyrii
rm0brinmi by YOU m on yvH belmif kv which We Watt,
Or gOVEIFMY)c�lltal '.".�lgellcy Of SUI:xlivisk.)n ol pulil.k"Al 1). dlanwagc�"'
mWWOM"ns Knumi a pennif ni wNwrizahcm, We "yoduawnulAmwd iWaivalkwis hazaW",
COG 20 12 05 09 (3yyypm humonm SmOwn 010w, W, 2008
ep ..cF RAMwagmedDiMsiun
Kk REVIEWED & APPROVED BY.-
pwvo�?- P, ull"Awn
WA Pjanagement Analpt
DATE (M Mili
% A ft Ili`
CERTIFICATE OF LIABILITY INSURANCE 09/0712020
THIS CERTIFICATE IS ISSUED AS A MAT'rER OF INFORMATION ONLY AND CONIFER'S NO RIi UPON THIECERTWICATE
HOLDER. THIS GERTIFICA r,E DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER TH:F, COVERAGE
AFFORDED BY THE POLICIES BELOW. THIS CEIRTWICA78 OF INSURANtE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURIER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CFRTIFI(,ATF HOLDER,
. . ... ... ...... . . ... . ... ......... . .
IMP OR rAN F, if If, tmificta holi is an, ADDITIONAL IN$Uii the poficy(iiess) i be endlor5ed. If $LIBIROGATIGNIS WAIVED,
subioct to tho turi aui coillffition$ of the pi certain policii i require an eridor-51pirri A 9taternem on this cerfificato duos
not 4onler rights to the certificate holder in lieu Of ei ell d0jr!ie _nt(.�L
PROIDUCER CONTACT NAME:
AP INTEi IW3URANGE GAROUP L.I..:C PHO— -- — - ---- 8. . .... .8 . . ............ . .................. .
NE (888) 289-2939 FAX �888) 289�2�3
713250846 JA4, kxl): i
375 WCIDDi DRIVE STE $0 1-1---,,--- . ..... ............ ............. .. ... - ----- --
i ADI)i
FAIRPORT NY 14450 . ..... .. . . . . .......... .... .. ..... . . . . . ....... .................
INSi AFFORPIN6, COVti NAICIII
.. ............. ..
INSi PrOl'N"I i 'M lid Cz-iskjal ly I I mi uar ic4.,i Oni npany C41 HIji ford
............ . .. .. .. .... . . . . . . . . ..............
.. . . . .. . . . ......... . ...................................................................................................... . . ... . ............
(ji kjN1 I -i Ii (", �
1',C158 FIRF,'.1iT )NF B1,W)
INS
. .. . . ........
IN s
C E R T I F I CA T E REVISION NUMBEfli
THIS IS TO CERTII,=Y 71-Wrl HE FIOLVCIES OF INSURANCE LIS7,,D i HAV�2EEIN �SEAA"DTO I HE INSUi N.Ai Ar6i i i PF'RKID
ANY 014 1]("'9eiu I ii (>7 ANY (:,()ii ()II OTHER `,)O,.'IJVENr I RESP�_-CT TO 'NIqJ41CId 711�E-'�
CEI37FICATE 4MY BE 13,GIJED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DE3CRI21113 i IS Si TO ALL. rHL
TERKIS, EXCLUSIONSAND CONDITIONS OF SUCH POL,'i LlklffS S'Hi MAY HAVE BY PAID
... . . . .... . ..... .......... . .. ..... .... .. . . .. . .....
TYPE DIF INSURANCE Ai SURR POLICY i POLICY EFF Pi
mmior')+'vyy!La ew yyy
GIJ-4V- i I, IAIJ� J 7 Y i I CCCURFIENCE
i I I k
NIED i (Aj iiy m x! ,xwmr�i
... .. .. . .... . .. . ... .................. . ........... ........ .
Pi A. AAV Iil,,,1UN)1
Gi L AGGi LI&C I Ai Pi �0-'NEKAL AGCREGA I E
PROIDUCTS, COIlAi
X111i FCi . ........ . ..........................................
AdrOMOBILE LI.Ai
. ...........
ANY Ad 10
.. ..... . . ....
ALl. CNINCID DUI Er",
Ai AU I u's 15,A)Iii wIJI14y P16� a�dca< 1;
HIRED NCN I)V.NFJ,a iW1MbxM- E
Ai AUTOS, (prsm.:,-. dinfi
. . . . . . . . . ................................ .... . ....... . .... .. .. .... . ... . . . . ... ... . ................................
iJMi, ULA 11i, IAR t� XCH QC R �4C E
EXCESS LIAII Ci E
........ . ... LI �IAuii
. .. . .... . . . ............
w, I rmq $
............
THI
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AND EMP LOYERS'LIABILTV TAI,I EF--
ANIF WIN P� 19 0 0
A PROPRIETOWPARTNE 1710117 NJA .. .. .. . .. .... ... . . .... .............
ERmam6i i uju
E . ... ........ ....... .. . ..
IMandauji In i
11 ca&co i kwchA' I-, L Sii-'AbE
I NP f;GR Ii Gd;: OK kA 11: )WL t
Lu— .......... . ........... . ...................................................... . .... .
DeSCRWRON i OPERA ri i t,W,,Arji i I p 1. Arldii 11 Rmirkski may be, ai 4 rardea *qm CA Is requirem
ThOG-j UGUY, tO IhO hlGi Opi No1A�o of Gani wfll bo pi in accordAlli;ii vvilh I"i W09W,11,3144,, attwhed to tbts Poli7�
. . .... . ......................
CERTIFICATE HOLDER CANCELLATION
. ......... ', ................... . . . ..................
Cityi So PbAna $HOULD ANY OF THE ABOVE: DESCRIBED POLICIES BE CANCELL
Risk Manchgomcn�, Div'rsion BEFORE THE EXPIRATION DATE THEREOF, N011i BE DELIVERED
2 C1 C ,V C C E NTE R PLZ 1:1- 4 IN ACCORDANCE WITH THE PO I -MY i I-SIi
---ll � - . ....... .... .. - 11 . ......... —...
SAN I ANA ii �J210 I - 4 �)58 AijlHoi ftrF1RE$ENrAjfVi
'2j
. . .... . . . ....... .
CL) 11988-2015 Ai CORPORATIGN. All rights vorwirvi
AC 0 RD 2 5 � 2,016103) The ACORD narne and logo are registered rnarks of AGORD
cF RAMwwgemedDMsi[un
Jy? �k�q REVIEWED & Api BY.-
vk"
i Management Ai
rTvvdAe)s,
city of Santa Art
10"A
2.0 0-4v (p,ofor Mu"a, �111 Mum
S,mota Ana, CA 92,1401.
To whofn R Mly Corl(%04'0�
1pjtor is lo Ynfl,rm yclu r,)f the foflo�,vin",u,l d i lffo:rxw�n ce ,; frovrVrhe IY te 1. n's Oil , t I �f", u 6glir."I'l Cori t
I LC ahun my rlmllpany vq,hieJos currefay, '(0,11,! VAO, not ll,Pjv any hir#�,rj
h", cont(act We "A&I nol he del�Vopimg any ito,.krns to 4 ke ("� y uodmr
b�%, PMu.,,r pu&A„�rt ull, fiiofAll ffifl' 0 sUp a"or fjtjp�,,*!cj d,�A Fj CArl'k-
GooW l l , I 'p, C , vii I I not � i I ri.,,, a r, iyt pi o fe ssio vw, 1!1 t rl fi d, 1: �d V I ""ally p"'s I'T 41 � I b i ";, cy) rlt,, I 'I I
f6od koqgw'ds,
LLC
F t
NIPY
or slervicx:,Illad (")wthly
J
Risk MmRgmerdDMsiun
REVIEWED & APPROVED BY.-
F04c"�" P, vk"
Risk PjanagementAnalyst