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HomeMy WebLinkAboutNOVA ACADEMYINSURANCE ON FILE A-2 0 2 2-0 5 7 WDRK MAY PROCEED UNTIL INSURAtNCE IX�� Z ; DATEOF COUNCIL LICENSE AGREEMENT WITH NOVA ACADEMY DATE: This LICENSE AGREEMENT ("Agreement") is dated as of April 19, 2022, and entered into by and between the CITY OF SANTA ANA, a charter city and municipal corporation existing under the Constitution and laws of the State of California ("City"), and NOVA Academy, a California non-profit corporation ("Licensee"). o : PKe kfaKema k) (3M� 1 RECITALS A. The City is the owner of that certain real property located in the City of Santa Ana, County N of Orange, California, more specifically identified as 210 N. Birch Street, also known as Birch Park, and N 502 W. Santa Ana Boulevard, also known as Sasscer Park, as depicted in Exhibit A ("License Area"). era c� B. Licensee desires to use the License Area for purposes of an evacuation relocation site for Licensee in the event of an emergency and for emergency drills as they may be scheduled by Licensee from Qtime to time during the License period ("Permitted Uses"). C. The City has agreed to grant Licensee a license to use the License Area, on the terms and conditions set forth in this Agreement. NOW THEREFORE, for and in consideration of the mutual covenants and agreements herein contained and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto agree as follows: 1. License. The City hereby grants to Licensee a nonexclusive license for the right to enter and use the License Area beginning on April 19, 2022, for the Permitted Uses described in Recital B, upon the terms and conditions set forth herein ("License"), subject to Licensee's performance of all of its obligations under this Agreement. This License shall remain in effect until June 30, 2025. The term of this License may be extended for two (2) one-year periods upon a writing executed by the Executive Director of the Parks, Recreation, and Community Services Agency, or his or her designee. The License may be terminated by City upon thirty (30) days written notice. This Agreement is intended and shall be construed only as a revocable license to use the License Area and not as a lease or grant of any possessory or other interest. To facilitate NOVA's Permitted Use under this License, City will provide the Administrative Director of Licensee five (5) keys for the gate at Birch Park to be distributed to and used by Licensee personnel designated by the Administrative Director of Licensee. These keys shall be returned to City at the expiration or earlier termination of this License. 2. Restoration and Clean Up. At its sole cost, Licensee shall, after each use of the License Area, restore the License Area to its original condition in which it existed immediately prior to the Agreement, leave the License Area in a neat and clean condition to the sole satisfaction of the City, free of trash and debris, and remove all property and materials of Licensee. Licensee shall cause the License Area to be cleaned, with such work to be completed no later than the times specified in the License as stated in paragraph I above, and the License shall be extended to such time for the limited purpose of allowing the cleaning work to be completed. 3. Compliance with Laws. Licensee shall cause all activities of Licensee under this Agreement and all activities on the License Area to be performed in compliance with all applicable federal, state, and local laws, ordinances, and regulations, and permits. Page 1 of 5 4. Damage. In the event that Licensee damages any portion of the License Area or the improvements or equipment therein, Licensee shall immediately repair the damage at Licensee's sole cost. Alternatively, the City may, at its election, repair the damage in which case Licensee shall reimburse the City for its cost within fifteen (15) days of receipt of written demand from City. 5. Licensee Parties, Licensee, together with its employees, subcontractors, agents, representatives, students, and all persons entering the License Area, by or through or at the direction of Licensee, are collectively referred to herein as the "Licensee Parties." Licensee shall be responsible for the Licensee Parties and shall cause the Licensee Parties to comply with the terms of this Agreement. 6. Fee. Because the City finds the protection of students in the event of an emergency to be of public benefit, City shall not charge and Licensee shall not pay a fee for this License. 7. AS -IS Condition. City makes no representation or warranty of any kind as to the condition of the License Area or any other matter relating to Licensee's use of the License Area. Licensee hereby disclaims and waives any and all objections to the physical and other characteristics and conditions of the License Area. Licensee acknowledges and agrees that the use of the License Area will be on the basis of Licensee's own investigation of the condition of the License Area. The license to use the License Area shall be granted on an "AS -IS," "WITH ALL FAULTS" basis, without representation or warranty expressed or implied by City, or by operation of law, City expressly disclaims, which Licensee hereby acknowledges and accepts, any implied warranty of condition or fitness for a particular propose or use. Licensee's use of the License Area shall be subject to the License Area being in a usable and safe condition at the time of Licensee's use and Licensee shall be responsible for determining whether the License Area is in such condition. In connection therewith, in the event that the License Area or access thereto is damaged or obstructed or the use by Licensee is otherwise impaired, prevented or limited, City shall have no obligation or duty to repair the damage or rectify the condition to make the License Area usable or safe. 8. Insurance, NOVA Academy shall procure and maintain for the duration of this License insurance against claims forigj uries to persons or damages to property that may arise from or in connection with NOVA's use under this License. Such insurance coverage shall be at least as broad as: 8.1 Commercial General Liability ("CGL" ): Insurance Services Office Fonn CG 00 O1 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence. If a general aggregate limit 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. 8.2 Workers' Compensation: as required by the State of California, with statutory limits, and employer's liability insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease. 8.3 Broader Coverage: if Licensee 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 Licensee. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. 8.4 Primary Coverage: for any claims related to this license, the Licensee's coverage shall be primary insurance coverage at least as broad as ISO CG 20 O1 04 13 as respects to the City, its officers, officials, employees, agents and volunteers. Page 2 of 5 8.5 Notice of Cancellation: each insurance policy required shall not be canceled, except with thirty (30) clays written notice to the City. 8,6 Waiver of Subrogation: Licensee hereby grants to City a waiver of any right to subrogation, which any insurer of said Licensee may acquire against the City by virtue of the payment of loss under such insurance. Licensee 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. 8.7 Self -Insured Retentions: self -insured retentions must be declared to and approved by the City. The City may require the Licensee to purchase coverage with a lower retention or provide proof of ability to pay losses and related 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. 8.8 Acceptability of Insurers: insurance is to be placed with insurers authorized to conduct business in the state of California with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City. 8,9 Verification of Coverage: Licensee 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) 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 use contemplated by the License begins shall not waive the Licensee's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements require by these specifications at any time. 9. Indemnity. Licensee shall indemnify, defend, and hold harmless City, and its respective agents, representatives, employees, subsidiaries and affiliates ("Covered Parties") from and against any and all actions, suits, claims, demands,judgrnents, losses, expenses, or liabilities, injuries and damages to persons and property, including death, arising out of or related to Licensee's use of the License Area, the entry by any Licensee Party on the License Area or surrounding property, or Licensee's breach or default in the performance of any of its obligations under this Agreement; provided, however, that Licensee will not be obligated to indemnify the Covered Parties from any claims arising solely from the gross negligence or willful misconduct of a Covered Party. If any action or proceeding is brought against any Covered Party by reason of any such claim, Licensee, upon receipt of written notice from Covered Party, shall defend the same at Licensee's expense with legal counsel reasonably acceptable to Covered Party. Payment shall not be a condition precedent to recovery under any indemnification in this Agreement, and a finding of liability or an obligation to indemnify shall not be a condition precedent to the duty to defend. The provisions of this Section 9 shall survive the termination or expiration of this Agreement. 10. Miscellaneous, 10.1 Entire Agreement, Waiver and Amendments. This Agreement incorporates all of the terms and conditions mentioned herein, or incidental hereto, and supersedes all negotiations and previous agreements between the parties with respect to the subject matter of this Agreement. All waivers of the provisions of this Agreement must be in writing and signed by the appropriate authorities of the party to be charged. Any amendment or modification to this Agreement must be in writing and executed by the appropriate authorities of the City and Licensee. Page 3 of 5 10.2 Severabilitv. If any term, provision, covenant, or condition of this Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the retraining provisions of the Agreement shall continue in full force and effect, unless and to the extent the rights and obligations of one or both parties has been materially altered or abridged by such holding. 10.3 No Assi went. Licensee shall not assign or transfer or otherwise convey any interest in this Agreement to any party without the express prior written consent of City, which consent may be withheld in City's sole and absolute discretion. 10.4 Applicable Law. This Agreement shall be construed and enforced in accordance with the internal laws of the State of California. 10.5 Litigation Expenses. If either party to this Agreement commences an action against the other party to this Agreement arising out of or in connection with this Agreement, the prevailing party shall be entitled to recover reasonable attorneys' fees, expert witness fees, costs of investigation, and costs of suit from the losing party. 10.6 Authort . The persons executing this Agreement on behalf of the parties hereto represent and warrant to the other party that they are duly authorized to execute and deliver this Agreement on behalf of such party, and by so executing this Agreement, said party is formally bound to the provisions of this Agreement. 10.7 Notices. Any notices, requests, or approvals given under this Agreement from one party to another shall be in writing and shall be personally delivered or deposited with the United States Postal Service for mailing, postage prepaid, by certified mail, return receipt requested, to the addresses of the other party as stated in this section, and shall be deemed to have been received at the time of personal delivery or three (3) days after the deposit for mailing, Notices shall be sent to: If to Licensee: NOVA Academy Attn: Renee Lancaster, CEO 500 W. Santa Ana Blvd. Santa Ana, CA 92701 If 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 10.8 Execution in Counterpart. This Agreement may be executed in several counterparts, and all so executed shall constitute one agreement binding on both of the parties hereto, notwithstanding that both parties are not signatories to the original or the same counterpart, [signahire page to follow] Page 4 of 5 IN WITNESS WHEREOF, City and Licensee have entered into this Agreement as of the day and year first written above. CITY OF SANTA ANA Kristin" a Ridge - City Manager ATTEST i Daisy Gomez Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Attorney By: Br n Salvatierra Deputy City Attorney RECOMMENDED FOR APPROVAL Lisa Rudloff Executive Director Parks, Recreation, and Community Services Agency 111[OLUM DI y "w�Renee Lancast r CEO/Founder Page 5 of 5 EXHIBIT A tab 41 7 � •7uai�oi'-Ar1Y.� 1. Balmer l 2 Carnes dy 3 Dann `M -w cc Uc �.. = ]ry_.-�• 4 Deigaado 6 Fong 'J Jaheci 10 Jimenez ' r Tj - 12 Lemtouni Ramberg l c Santiiian L`ara Vt lie; ir>j, awws �� 9 •�� _ NiRosslSt N R�'oss St o tJ,Ross St SASSCER PARK Primary Reunification Point: Sasscer Park Fountain Exit the building using the nearest stairwell. Make sure year entire class makes it safely to the fountain. Safety Captains: Lee (2nd floor), Bahner (3rd Floor), Goodheart (4th Floor) NOVA Academy —License Agreement_FINAL_3. 24.22 - signed Final Audit Report 2022-05-07 Created: 2022-05-06 By: Emerson Frankston (EFrankston@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAAEYwJCZgnccr/-dL4Mr3FCToPbGC5-Yg1 "NOVA Academy —License Agreement_FINAL_3.24.22 - signed" History Document created by Emerson Frankston (EFrankston@santa-ana.org) 2022-05-06 - 7:51:17 PM GMT 24 Document entailed to Lisa Rudloff (Irudloff@santa-ana.org) for signature 2022-05-06 - 7:51:50 PM GMT Email viewed by Lisa Rudloff (Irudloff@santa-ana.org) 2022-05-06 - 9:51:31 PM GMT d© Document e-signed by Lisa Rudloff (Irudloff@santa-ana.org) Signature Date: 2022-05-07-1:12:47 PM GMT - Time Source: server Agreement completed. 2022-05-07 - 1:12:47 PM GMT Q Adobe Acrobat Sign A ninitally cinncrl i_'eei ® AiCiOR o CERTIFICATE OF LIABILITY INSURANCO by ArgiMM2o2z "' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO H/SJ/fl �f§',' ER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER H 1CD��A R¢� ��ge.yy THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINi INSb1��`�„ .'.'.ITHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 202.OS. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ITIONAL If1S1,RED proyl�f0�40 eq(fgrr��I If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain poll'; may req�.im an endorsl Va W1wlLAr6l§tehlent�dd this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Arthur J. Gallo er & Co. Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. LIC #0726293 PHONE FA1c . 949-349-9800 AJG N 949-349-9900 ADD E-MAIL 18201 Von Korman Ave Suite 200 Irvine CA92612 INSURERS AFFORDING COVERAGE NAIL# INSURER A: Califomia Charter Schools JPA INSURED CALICHA-03 INSURERS: Safety National Casualty Corporation 15105 California Charter Schools Joint Powers Authority Nova Academy INsuRERc: Scottsdale Insurance Company 41297 INSURER D: 500 W. Santa Ana Blvd Santa Ana CA 92701 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: 1394643413 REVISION NUMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AODL SUBR POLICY NUMBER POLICY EFF MMIUDY�P LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx1 OCCUR CCSJPA MOC 2021-22 7/1/2021 7/1/2022 EACHOCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES fE. ..,a $1,000,000 X MED EXP (Any oneperson) $10,000 Sexual Abuse' X I Educators E&O PERSONAL& ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 X POLICY ❑JET LOG PRODUCTS - COMP/OP AGO $Included Crime $1,OGO,000 OTHER: A AUTOMOBILE LIABILITY CCSJPA MOC 2021-22 7/1/2021 7/1/2022 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ ANYAUTO OWNED X ASCHEODULED AUTOS ONLY UTS IAUTOS BODILY INJURY (Par accident) $ X PROPERTYOAMAGE (Forsook! $ HIRED X NON -OWNED ONLY AUTOS ONLY 8 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN CCSJPA MOC 2021-22 SP4064881 7/1/2021 7/1/2021 7/1/2022 7/1/2022 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 ANYPROPRIETOMPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED2 ❑ NIA E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 C A Employment Practicas(Claims-Made) Oirectors & Officers(Claims-Made) Fiduc ary(Claims-Made) EKS3337444 CCSJPA MOC 2021-22 7/1/2021 7/l/2021 7/1/2022 7/1/2022 Each Wrongful AWAgg Each Wrongful AcYAgg Each Wrongful ActlAgg $1,000,000 $1,000,000 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached K more space is required) 'Sexual Abuse Coverage is an Claims Made basis. Evidence of Coverage pursuant to and subject to policy terns, definition, conditions and exclusions as respects: Event Date: April 19. 2022 -June 3D. 2025. Waiver of Subrogation is included. This Insurance is primary and all other insurance is noncontdbutary City of Santa Ana Emy Frankston 20 Civic Center Plaza Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT�HORIZErD� REPRESENTATIVE ©1988.2015 ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD rr RiskMmagcnadDtvlsbrl t q tt REVIEWED & APPROVED BY ��' Air Auoado ®' Risk Management Specialist ENDORSEMENT attaching to and forming part of MEMORANDUM OF COVERAGE #CCSJPA-MOC-2021-2022 NAMED INSURED: CALIFORNIA CHARTER SCHOOLS JOINT POWERS AUTHORITY Effective date of this endorsement: July 1, 2021 Expiry date of this endorsement: July 1, 2022 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SECTION I — GENERAL LIABILITY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SCHEDULE Named Member: Nova Academy Names(s) of Person(s) or Organization(s): City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 The Salvage, Recovery, Subrogation and Right of Reimbursement Condition applies to the person(s) or organization(s) shown in the Schedule above, but only to the extent that the NAMED MEMBER is required to obtain this waiver in a written contract, and subrogation is waived prior to the OCCURRENCE or the loss under a contract with that person or organization. Except as amended in this Endorsement, this coverage is subject to all coverage terms, clauses piekM�ageMmtolviami Coverage Document to which this Endorsement is attached. t�Renerreo 6 APPROVE] Br.. Risk Management Speaalist ENDORSEMENT attaching to and forming part of: MEMORANDUM OF COVERAGE #CCSJPA-MOC-2021-22 NAMED INSURED: CALIFORNIA CHARTER SCHOOLS JOINT POWERS AUTHORITY Effective date of this endorsement: July 1, 2021 Expiration date of this endorsement: July 1, 2022 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WORKERS' COMPENSATION WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US ENDORSEMENT SCHEDULE Named Member: Nova Academy Names(s) of Person(s) or Organization(s): City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 The Salvage, Recovery, Subrogation and Right of Reimbursement condition applies to the person(s) or organization(s) shown in the Schedule above, but only to the extent that the NAMED MEMBER is required to obtain this waiver in a written contract, and subrogation is waived prior to the OCCURRENCE or the loss under a contract with that person or organization. Except as amended in this Endorsement, this coverage is subject to all coverage terms, Coverage Document to which this Endorsement is attached. RtviewEo 6 APPRov® By., A,.p Ac4A4 Risk Management Specialist Digitally signed ACCORD® CERTIFICATE OF LIABILITY INSU&ngie by DD/YYYY) 7/18/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE C_R �� DER..THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTEE�11IEicP1tTJI�Ili`SSfv���191OKIZ BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT B REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ' ' IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INJURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Arthur J. Gallager & Co. Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. LIC #0726293 PHONE FAX vC No Ext : 949-349-9800 vc, No): 949-349-9900 ADDRESS: 18201 Von Karman Ave Suite 200 INSURER(S) AFFORDING COVERAGE NAIC# Irvine CA 92612 wsURERA: California Charter Schools JPA INSURED CALICHA-03 INSURERB: Safety National Casualty Corporation 15105 California Charter Schools Joint Powers Authority Nova Academy INSURERC: Scottsdale Insurance Company 41297 INSURERD: 500 W. Santa Ana Blvd Santa Ana CA 92701 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER:72391117 REVISION NUMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CCSJPA MOC 2022-23 7/1/2022 7/1/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence)$ 1,000,000 X MED EXP (Any one person) $ 10,000 Sexual Abuse* X Educators E&O PERSONAL & ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY JECT ❑ LOC X PRODUCTS - COMP/OP AGG $ 2,000,000 Crime $ 1,000,000 OTHER: A AUTOMOBILE LIABILITY CCSJPA MOC 2022-23 7/1/2022 7/1/2023 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N CCSJPA MOC 2022-23 SP 4066643 7/1/2022 7/1/2022 7/1/2023 7/1/2023 X PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICE R/M EMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Employment Practices(Claims-Made) EKS3435051 7/1/2022 7/1/2023 Each Wrongful Act/Agg $ 1,000,000 A Directors & Officers(Claims-Made) Fiduciary(Claims-Made) CCSJPA MOC 2022-23 7/1/2022 7/1/2023 Each Wrongful Act/Agg Each Wrongful Act/Agg $ 1,000,000 $ 1 ,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) *Sexual Abuse Coverage is on Claims Made basis. Evidence of Coverage pursuant to and subject to policy terms, definitions, conditions and exclusions as respects: Event Date: July 1, 2022 — June 30, 2025. Waiver of subrogation is included with respects to General Liability. This insurance is primary and all other insurance is non-contributory. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana -Att: Emy Frankston 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 IZISIZ kluagment DlRR810R REVIEWED & APPROVEDBY: © 1988-2015 ACORD °( ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management specialist ENDORSEMENT attaching to and forming part of: MEMORANDUM OF COVERAGE #CCSJPA-MOC 2022-2023 NAMED INSURED: CALIFORNIA CHARTER SCHOOLS JOINT POWERS AUTHORITY & Nova Academv Effective date of this endorsement: July 1, 2022 @ 12:01 am Expiry date of this endorsement: July 1, 2023 @ 12:01 am THIS ENDORSEMENT CHANGES THE MEMORANDUM OF COVERAGE. PLEASE READ IT CAREFULLY. SECTION I — GENERAL LIABILITY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Names(s) of Person(s) or Organization(s): SCHEDULE City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 If required by a written contract or written agreement, we waive any right of recovery we may have against the person or organization named in the schedule above, because of payment we make for injury or DAMAGES arising out of your ongoing operations or YOUR WORK done under such written contract or written agreement for that person or organization, or included in the PRODUCTS -COMPLETED OPERATIONS hazard, provided that the injury or DAMAGES occur subsequent to the execution of the written contract or written agreement. Except as amended in this Endorsement, this coverage is subject to all coverage terms, clauses Risk MmugemadDivisian exclusions in the Coverage Document to which this Endorsement is attached. ;I i o' RE�AEWEo & APPROVED Bv: e Azvd4� '�--'Risk Management Specialist