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HomeMy WebLinkAboutBRIGHTLIFE DESIGNS, LLC.INSURANCE ON FILE o WORK MAY PROCEED N-2021-186 N UNTIL1NSURA E EXPIRES N CLERK OF COUNCIL °- DATE: vc'i AGREEMENT WITH BRIGHTLIFE DESIGNS LLC TO PROVIDE �i ShcttfpSN�� HOLIDAY DECOR IN DOWNTOWN SANTA ANA O C� THIS AGREEMENT is made and entered into on this 15C day of September, 2021, by and between BRIGHTLIFE DESIGNS, LLC, a California limited liability company ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a contractor having special skill and knowledge in the field of: installation and storage of various holiday decor such as garland, bows, holiday decor lights for light posts, the installation of a 10 foot LED lit holiday bear, and other holiday decor in Downtown Santa Ana. B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional contractor in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Contractor shall perform 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 Exhibit A, attached hereto and incorporated herein by reference. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services for City, the rates and charges detailed in Exhibit A, attached hereto and incorporated herein by reference. The total amount to be expended during the term of this Agreement shall not exceed $31,125. 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. Page 1 of 9 3. TERM This Agreement shall commence on October 1, 2021, and continue until June 30, 2022, unless terminated earlier in accordance with Section 15 below. 4. INDEPENDENT CONTRACTOR Contractor shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. 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 Contractor under this Agreement ("Documents & Data"). Contractor 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. Contractor represents and warrants that Contractor has the legal right to license any and all Documents & Data. Contractor makes no such representation and warranty in regard to Documents & Data which were provided to Contractor 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 Consultant shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder and the results of that work by the Consultant, its agents, representatives, employees, or subcontractors. a. MINIMUM SCOPE AND LIMIT OF INSURANCE Coverage shall beat least as broad as: 1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $2,000,000 per occurrence. If a general aggregate limit Page 2 of 9 applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: Insurance Services Office Form Number CA 0001 covering, Code I (any auto), or if Consultant has no owned autos, Code 8 (hired) and 9 (non -owned), with limit no less than $1,000,000 per accident for bodily injury and property damage. 3. Workers' Compensation: insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. 4. If the Consultant maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Consultant. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. Other Insurance Provisions — The insurance policies are to contain, or be endorsed to contain, the following provisions: 1. Additional Insured Status: The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts, or equipment furnished in connection with such work or operations. General liability coverage can be provided in the form of an endorsement to the Consultant's insurance (at least as broad as ISO Form CG 20 10 11 85 or if not available, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 forms if a later edition is used). 2. Primary Coverage: For any claims related to this contract, the Consultant's insurance coverage shall be primary coverage at least as broad as ISO CG 20 0104 13 as respects the City, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Consultant's insurance and shall not contribute with it. 3. Notice of Cancellation: Each insurance policy required above shall state that coverage shall not be canceled, except with notice to the City. 4. Waiver of Subrogation: Consultant hereby grants to City a waiver of any right to subrogation which any insurer of said Consultant may acquire against the City by virtue of the payment of any loss under such insurance. Consultant agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. 5. Self -Insured Retentions: Self -insured retentions must be declared to and approved by the City. The City may require the Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses and related Page 3 of 9 investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self - insured retention may be satisfied by either the named insured or City, 6. Acceptability of Insterers: Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City. 7. Claims Made Policies: If any of the required policies provide coverage on a claims -made basis: 1. The Retroactive Date must be shown and must be before the date of the contract or the beginning of contract work. 2, Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work. If coverage is canceled or non -renewed, and not replaced with another claims -made policy form with a Retroactive Date prior to the contract effective date, the Consultant must purchase "extended reporting" coverage for a minimum of five (5) years after completion of contract work. 8. Verification of Coverage: Consultant shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Consultant's obligation to provide them. 9. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. INDEMNIFICATION Contractor 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 Contractor, 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) 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 Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including Page 4 of 9 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 Contractor's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Contractor 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 Contractor to the City pursuant to this Agreement. 9. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Contractor shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Contractor under this Agreement. 10. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. Page 5 of 9 11. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 12. NON-DISCRIMINATION Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this Agreement. Contractor 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 Contractor, 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 Contractor. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Contractor or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other contractors s retained by City. 15. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Contractor to deliver to the City all work product(s) completed as of such date, and in such case Page 6 of 9 such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work 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 Contractor 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. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 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: 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 Page 7 of 9 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 Contractor: Joseph Castro Owner BrightLife Designs, LLC 16351 Gothard St., K Huntington Beach, CA 92647 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. A/HSCELLANEOUS 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. Where any terms in the Exhibits conflict with terms set forth in this Agreement, the language of the Agreement shall prevail. (Signatures on following page] Page 8 of 9 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year fast above written. ATTEST: �aisy Gomez;�1< lerk of the Council APPROVED O' SONIA R. CARVALHO City Attorney Ryan O. Hodge Assistant City Attorney RECOMMENDED FOR APPROVAL: -fD1 N/ G--_ Steven Mendoza Executive Director Community Development Agency CITY OF SANTA ANA io✓ Kristine Ridge City Manager CONTRACTOR: Q.ea4�t ¢zme Josep Castro Owner BrightLife Designs, LLC Page 9 of 9 August 16, 2021 Contact Name: Julie Castro -Cardenas Title: Economic Development Specialist II Client Name: City of Santa Ana Email: jcastro-cardenas@santa-ana.org Phone: (714) 647-6585 City of Santa Ana Holiday Proposal 2021 "PROPOSAL" Installation, Removal & Storage of Customer Owned Decorations Labor for all rental decorations included F31 r�I_"WIT-4afTft1 t Bow and Garland Decor on Lamp Posts Lighted Elements, Enhancement options (see separate - Spec Sheet). City Wide Decor DETAILED REPORT: Existine LamD Post Decor — on 4th Street (from French St. to Ross St. Installation of seventy-nine (79) Light Posts with 10' sections of decorated garland two (2gty) per pole. Customer owned decorations. Price includes Labor for installation, removal & storage of customers decor. (158) total of 24" Red Bows with gold trim. Each Light Post will have a bow on either side, (2) bows per pole. Labor Cost Per kit is $175 each. Labor Installation, Removal Cost $10,625.00 Storage Cost $3,800.00 $13,825.00 Purchase of New Light Pole Kits Five (5) New 24" Double Bow Accent Kit with Red Bows, 10' of Mountain Pine Garland with Red and Gold Decor. Unlit. Labor & storage for Five (5) New 24" Double Bow Accent Kit (2) Gold bows, 10' of Mountain Pine Garland with Red and gold decor. Unlit. Purchase of New Kits Price Per Each $495.00 Labor Installation, Removal & Storage Per Each $175.00 Total $3,350.00 10' Lighted Seating Teddy Bear - One (1) 10' Lighted Giant Teddy Bear, installation and removal at Plaza Calle Cuatro. Lease Price $11,795.00 Holiday Cafe/Patio Lights S4 Lights- Plaza Calle Cuatro Installation and Removal of LED RGB color changing patio lights. Lights will be strung from lamp post to lamp post. There is six lamp posts in Plaza Calle Cuatro, approximately 150' of string cables and lights. RGB Lights are BrightLife Designs LLC 16351 Gothard St, STE C, Huntington Beach, CA 92647 Phone: 714-326-8326; Direct : 714-372-2274 www, Brigh tlifedesigns.com 54 color changing lights. Lights will be hung over head to enhance the plaza. Rental Price $2,155.00 Timing and Agreement: This Agreement shall commence on October 30, 2021, the date first written above for a One (1) year term with the option for the City to grant up to a two-year renewal, exercisable in writing by the City Manager and the City Attorney, unless terminated earlier in accordance with Section 15, below. Rental: Yes, Installation & Removal Services, Holiday Decor Purchase: N/A Installation Date: First week of Nov. 1st 2021- Working Hours: Business Hours & Night Hours Strike Date: First Week of January 2022 Installation Address: Downtown, Santa Ana, CA 90745 City Permits: * Price does not include city permits, additional cost for required permits. To execute this agreement, sign this proposal and the Terms and Conditions. Please note the payment schedule above, in addition any delinquent accounts with a past due balances are subject to a $90.00late fee. Upon receipt of initial payment, the dates of installation & removal will be secured. This quote is valid for 30 days. Thank you. Sincerely, /p v Joe Castro Confirmed By and on Behalf of City of Santa Ana Authorized Signer Printed Name BrightUfe Designs LLC 16351 Gothard St, STE C, Huntington Beach, CA 92647 Phone: 714-326-8326; Direct : 714-372-22.74 www.Brightlifedesigns.com Date Francine R. D1111ally signed by Francine R. Villareal Villareal Date: 2021.09.1615:00:29 -07'00' ACIl® CERTIFICATE OF LIABILITY INSURANCE la.� DATE (MMI°D YY 1 08/19/2021 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 pollcy(ies) must have ADDITIONAL INSURED provislons or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER B2 Insurance Services 1426 Aviation Blvd, Suite 203 Redondo Beach, CA 90278 CONTACT NAME: NiceLLOfin PHoni E (424)266-9400 aC No: 424 886-7660 npoa'ess: nica@b2insurance.com INSURE S AFFORDING COVERAGE NAICN License #: 0122551 INSURER A: Mesa Underwriters Specialty Insurance 36838 INSURED INSURER B: AmGUARD Insurance Comoanv 42390 Brightlife Designs LLC INSURERC: 16351 Gothard St, Ste C Huntington Beach, CA 92647 INSURER D: INSURER E: INSURER I, COVERAGES CERTIFICATE NUMBER: 00006370-591763 REVISION NUMBER: 69 THIS IS TO CERTIFYTHAT 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. INSR LTR TYPE OF INSURANCE ADOL INSD SUBR INVID POLICYNUMBER POUCYEFF MMIDOM'YY POLICY EXP fMMODiYYYY1 LIMITS A X I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ®OCCUR Y Y MP0004016006613 08/10/2021 08/10/2022 EACH OCCURRENCE $ 1000000 PREMISES E.occurance $ 100000 MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ 1009000 GENL AGGREGATE LIMIT APPLIES PER: X POLICY JR,0T LOC OTHER: GENERAL AGGREGATE $ 2009000 PRODUCTS -COMPIOPAGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY Y Y BRAU048580 10/09/2020 10/09/2021 EaaRcdtlEtSINGLELIMIT $ 1009000 BODILY INJURY (Per person) $ BODILY INJURY Per accident) ( ) $ PROPERTY DAMAGE Per acoident $ Comp/Coll Deduc $ $1000 UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY OFFICERIMEMBEER PROPRIETOTPARTNEREEXCLUDED?ECUTIVE ❑ (Mandatory In NH) If yes, tlescrlbe antler DE SC RIPTIONOFOPERATIONSbelow NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE EA EMPLOYE $ E.L. DISEASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General Liability and Auto Liability per the attached endorsements or as required by written contract. Insurance is Primary and Non -Contributory City of Santa Ana - Risk Management Division 4th Floor 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Printed by NI y RiskMRnagemaltDivteion REVIEWED & APPROVED BY: 54ll1Lll '' '�Risk Management Analyst MUS 01 0120128 0316 Insured Copy MESA UNDERWRITERS SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Al - PRIMARY NON-CONTRIBUTORY - WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Blanket Additional Insureds - As Required By Contract A. Subject to the Primary and Non -Contributory provision set forth in this endorsement, SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization whom you have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury" or "property damage" or, to the extent applicable under the Coverage Part to which this endorsement applies, "personal and advertising injury" caused, in whole or in part, by: 1. Your ongoing operations, "your product", or premises owned or used by you; With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage' or, to the extent applicable under the Coverage Part to which this endorsement applies, "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services by or for you, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrong -doing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or, to the extent applicable under the Coverage Part to which this endorsement applies, the offense which caused the "personal and advertising injury", involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. 2. Your maintenance, operation or use of equipment, other than aircraft, "auto" or watercraft, rented or leased to you by such person or organization. A person or organization's status as an additional insured under this endorsement ends when their contract, or agreement with you for such rented or leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the rental agreement or equipment lease expires. The provisions of this coverage extension do not apply unless the written contract or written agreement has been executed (executed means signed by the named insured) or written permit issued prior to the "bodily injury" or "property damage" or, to the extent applicable under the Coverage Part to applies, "personal and advertising injury". �,�c We(eManagemenEDMslm F REVIEWED&APP'RIIOeV'ED By., Risk Management Analyst Primary and Non -Contributory Provision The following is added to Paragraph 4.Other Insurance, b. Excess Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance shall be excess with respect to any person or organization included as an additional insured under this policy, any other insurance that person or organization has shall be primary with respect to this insurance, unless: 1) The additional insured is a Named Insured under such other insurance; 2) You have agreed in a written contract, written agreement or written permit to include that additional insured on your General Liability policy on a primary and/or non-contributory basis; and 3) The written contract or written agreement has been executed (executed means signed by the named insured) or written permit issued prior to the "bodily injury" or "property damage" or, to the extent applicable under the Coverage Part to which this endorsement applies, "personal and advertising injury". Waiver Of Transfer Of Rights Of Recovery The following is added to Paragraph 8. Transfer of Rights Of Recovery Against Others To Us under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: We will waive any right of recovery we may have against a person or organization because of payments we make for "bodily injury" or "property damage" arising out of your ongoing operations or "your work" done under a written contract or written agreement and included in the "products -completed operations hazard", if: 1. You have agreed to waive any right of recovery against that person or organization in a written contract or written agreement; 2. Such person or organization is an additional insured on your policy; or 3. You have assumed the liability of that person or organization in that same contract, and it is an "insured contract". The section above only applies to that person or organization identified above, and only if the "bodily injury" or "property damage" occurs subsequent to the execution of the written contract or written agreement. All other terms and conditions of this policy remain unchanged. MUS 0101 20128 0316 AiskMMWmadDW[an �'- Risk Managownt Analyst 01 POLICYHOLDER COPY SP P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-23-2021 GROUP: POLICY NUMBER: 9282984-2020 CERTIFICATE ID: 84 CERTIFICATE EXPIRES: 10-22-2021 10-22-2020/10-22-2021 CITY OF SANTA ANA SP 20 CIVIC CENTER PLZ 10-22-2020 SANTA ANA CA 92701-4058 HO This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated._ This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer We will also give you 10days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative/ President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2021-08-23 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: CITY OF SANTA ANA ENDORSEMENT H2572 ENTITLED BLANKET WAIVER OF SUBROGATION EFFECTIVE 2020-10-22 IS ATTACHED TO AND FORMS A PART OF THIS POLICY ENDORSEMENT N1851 - CASTRO,JOE MGR-MEMBR - EXCLUDED. ENDORSEMENT X1951 - PETERSON,MATTHEW MGR-MEMBR - EXCLUDED. ENDORSEMENT N1851 - ANNIGONI,JOSEPH MGR-MEMBR - EXCLUDED. EMPLOYER BRIGHTLIFE DESIGNS, LLC SP 16351 GOTHARD ST STE C HUNTINGTON BEACH CA 92647 ,, R1ek M1l°"'grnuaiDtwel°" <Y Y�°.. REVIEWED&ryAP'PR0VW8y.' I 8?bL0Yk4 a R V cif AFAS (REV.7-20141 PRINTED 0NEW Risle 4lmiagement Analyst