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JAS PACIFIC
ivSURANCE ON FILE WORK MAY PROCEED UNeIN URANCE EXPIRES -22 CLERK OF COUNCIL DATE: JUL 2 8 2022 A-2022-072-06 AGREEMENT TO PROVIDE ON -CALL BUILDING SAFETY INSPECTION 8 PBAtT;i•DJNLJy%f-V'(Av).& SERVICES THIS AGREEMENT is made and entered into this 17th day of May, 2022 by and between JAS Pacific ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. On March 25, 2022, the City issued Request for Qualification No. 22-050, by which it sought Consultants to provide on -call building safety consultant services for the Planning and Building Agency of the City of Santa Ana. B. The scope of work may include any and all work efforts related to City projects to provide Plan Check and Building Inspection services and customer assistance for the City of Santa Ana. The intent is to minimize response time and improve customer services by supplementing in-house staff with consulting services on an as -needed basis. C. Consultant submitted a responsive proposal that was among those selected by the City. Consultant represents that it is able and willing to provide the services described in the scope of work that was included in RFQ No. 22-050 and attached hereto as Exhibit A. D. Consultant has been selected as one of the fourteen (14) vendors which qualified for this engagement. Only those consultants approved by the City Council on May 17, 2022 shall be eligible to be engaged by the City for these services. E. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional contracting 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 a. On an as -needed basis, and at the sole discretion of City, Consultant shall perform the services that are described in Exhibit A, attached and incorporated by reference as though fully set forth herein. 2. COMPENSATION a. As Consultant is one of fourteen (14) selected vendors selected by the City, City neither warrants nor guarantees any minimum or maximum compensation to Page 1 of 10 Consultant under this Agreement. Consultant shall be paid only for actual services performed under this Agreement at the rates and charges identified in Exhibit A. The total amount to be expended during the term of this Agreement, as approved by Council amongst the fourteen (14) selected vendors, shall not exceed Four Million Six Hundred Thousand Dollars and Zero Cents ($4,600,000). b. Where applicable, City shall recognize and pay for any outstanding invoices for work performed by any of the fourteen (14) selected vendors for building safety consultant services performed by the Consultant for work previously performed for the City. C. 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 and Scope of Work, 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 with the option for the City to grant up to a one (l) year renewal, exercisable by a writing by the City manager and the City Attorney, unless terminated earlier in accordance with Section 16, 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. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Page 2 of 10 Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Minimum Scope and Limit of Insurance 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 $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. 2. Automobile Liability: ISO Form Number CA 00 01 covering any auto (Code 1), or if Consultant has no owned autos, hired, (Code 8) and non -owned autos (Code 9), with a limit no less than $1,000,000 per accident for bodily injury and property damage. 3. Workers' Compensation: 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. Professional Liability (Errors and Omissions): insurance appropriate to the Consultant's profession, with limit no less than $2,000,000 per occurrence or claim. 5. Broader Coverage: 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. b. Other Insurance Provisions 1. Additional Insured Status: The City, its officers, officials, employees, and volunteers are to be covered as additional insureds Page 3 of 10 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 connectionwith 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 notavailable, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 2037 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 01 04 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 provide 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 that 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 theConsultant 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. 6. Acceptability of Insurers: 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 (applicable only to professional liability): i. The Retroactive Date must be shown, and must be before the date of the contract or the beginning of contract work. Page 4 of 10 ii. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work. iii. 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 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 requiredby this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing allpolicy 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. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. 9. Subcontractors: Consultant shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Consultant shall ensure that City is an additional insured on insurance required from subcontractors. 10. Special Risks or Circumstances: City reserves the right to modify these requirements, including limits, based on the nature of therisk, prior experience, insurer, coverage, or other special circumstances. I INDEMNIFICATION Consultant agrees.to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant or its Consultants, subcontractors, agents, employees, or other persons acting on their 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 Page 5 of 10 Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend, indemnify and hold harmless the City, its officers, agents, representatives, and employees against any and all liability, including costs, and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the Page 6 of 10 City. 11. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services. 12. 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 Executive Director Planning and Building Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, CA 92702 Fax: 714-647-5897 To Consultant: JAS Pacific Attn: Christine Champany P.O. Box 2002 Upland, CA 91786 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. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Page 7 of 10 Consultant regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 15. 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. 16. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 17. NON-DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, Page 8 of 10 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. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 18. 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. 19. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 20. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. [signatures on nextpage] Page 9 of 10 A-2022-072-06 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: X ' IR7, DAISY GOMEZ Xow Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Attorney By: 'Ifrandon Salvatierra Deputy City Attorney RECOMMENDED FOR APPROVAL MINH THAI Executive Director Planning and Building Agency CITY OF SANTA ANA KRISTINE RIDGE City Manager CONSULTANT Christine Champany Vice President Page 10 of 10 EXHIBIT A SCOPE OF SERVICES and RATES/COSTS General Description Building Safety Division of the City of Santa Ana foresees the submittal of many construction projects in the near future. Therefore, the City is seeking the services of professional consultants to support the efforts of City staff in the area of Building Safety Services including Plan Check Services, Inspection Services and Technical Services. Scope of Services A. Plan Review Services Consultant shall perform the following services for each assigned building plan review. 1. Detail review of the mechanical, plumbing, electrical and building (architectural and structural) plans. Review supporting documents for industrial, commercial, residential and public buildings and determine compliance with applicable building standards as related to existing and proposed buildings. 2. Review the plans for compliance with California state -mandated regulations for energy conservation, disabled access, green building standards and City adopted ordinances. 3. Review the plans for compliance with Federal Flood Plain regulations for projects in the special flood hazard area designated on the flood insurance rate map (FIRM) as Flood Zone A or AE. 4. Recheck and approval of final plans and supporting documents to be provided without additional charge for recheck. 5. Submittal of approved plans and all supporting documents to the City of Santa Ana. 6. Provide all necessary liaison with applicants via phone, e-mail or in person to expedite the review process and consult on complex code issues with City of Santa Ana Building Official. 7. Plan review report to be customized for each project and be delivered via fax, mail or e-mail to City and the applicant. P .8. Structural portion of the plans to be reviewed by California Licensed Civil or Structural Engineer. 9. Plan reviewer to be consistent, accurate, available and responsive to the City and the applicant via phone, fax, e-mail and meetings. Also, the plan reviewer shall be available to the Building Official and his staff to help answer Code questions arising from review. Plan reviewer shall provide assistance in evaluation of alternate materials, design and methods of construction proposed by applicant. 10. Plan reviewer shall be available, at no expense to the City of Santa Ana, to meet at the City office with owners, architects, engineers and contractors to discuss the Plan Check issues. 11. Plan reviewer to verify that the job description, square footages, occupancy classifications and type of construction, on the permit application agrees with the plans and specifications. Plan reviewer will also verify the building valuation based upon valuation costs used by the City of Santa Ana. 12. Initial Plan review to be complete within ten (10) working days and recheck within five (5) working days. 13. Consultant fee for review services to be 55% of the City of Santa Ana Standard Plan Check Fee, excluding any accelerated plan check fee. 14. Hourly projects including revisions, deferred submittals, trusses, stairs, curtain walls, mechanical, plumbing and electrical plan reviews will be checked on an hourly rate of $100.00/hour when performed by a Certified Plans Examiner and a rate of $130.00/hour when performed by a registered Senior Plan Check Engineer. 15. Expedited Plan Review will be provided when requested for an individual project and will be an additional 30% of the plan review fees above. For Expedited Plan Review, the initial plan review to be. complete within five (5) to seven (7) working days and recheck within five (5) working days. 16. Fee(s) are charged in conformance with the City's Miscellaneous Fee Schedule. 17. Provide in-house temporary staff. 18. Courier service for pickup and delivery of plans to the City shall be provided at no additional cost. 19. Plan review shall be performed electronically using the City's electronic plan review system when requested by the City. No additional fees shall be charged for electronic plan review. B. Building Inspection Services Consultant shall perform the following services. 1. Building inspection services for industrial, commercial, residential and public buildings to determine compliance with approved plans and documents as well as applicable building standards as related to existing and proposed buildings. 2. Building inspection services for compliance with California state -mandated regulations for energy conservation, disabled access, green building standards and City adopted ordinances. 3. Building inspection services for compliance with Federal Flood Plain regulations for projects in the special flood hazard area designated on the flood insurance rate map (FIRM) as Flood Zone A or AE. 4. Building inspectors shall be certified to perform inspections for compliance with applicable California Building Standards Codes. 5. Building inspectors shall complete all necessary City forms and documents, enter results, and follow the City's workflow when an inspection is conducted. Inspectors will provide accurate correction notices and inspection records. 6. Building inspections shall be charged at an hourly rate of $80.00/hour when performed by a Certified Building Inspector and a rate of $100.00/hour when performed by a Senior Certified Building Inspector. Mileage will not be reimbursed by the City. 7.. Provide accelerated building inspection services on an as -needed basis. 8. Provide in-house temporary staff. C. Technical Services Consultant shall perform the following services. 1. Technical services shall be provided as -needed at hourly rates listed in Sections A and B above, based on the qualifications of the consultant that will provide the service. Technical services shall include training and technical studies with reporting, with rates ranging from $80.00/hour to $130/hour. 2. Permit technical services shall be charged at an hourly rate of $60/hour when performed by non -certified permit technicians and $75/hour when performed by Certified Permit Technician. 3. Structural Peer Review services shall be performed by a California registered Structural Engineer who has expertise in the current edition of ASCE 41 and performance -based structural design methodologies. Peer reviewer shall have technical expertise in the evaluation and retrofit of buildings similar to the one being reviewed and shall be familiar with the technical issues and regulations governing the work to be reviewed. Consultant shall provide a lump sum fixed fee for the structural peer review services based on the scope and complexities of the project. This fee shall be subject to the approval of the project applicant as a pass -through fee and shall be paid by the project applicant in conformance with the City's Miscellaneous Fee Schedule. A Digitally signed AC"R o® CERTIFICATE OF LIABILII MINKNCE by Angie A ev °MI00/1'YYY) 07/14/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFE 1yeptTa= V,.- :ti IS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR WKA $[)E BtI S BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE'S`;UING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement($). PRODUCER OONT CT Tina Cowie NAME: Cornerstone Specialty Insurance Services, Inc. N..Nd Ext. (714) 731-7700 FAX Not; (714) 731-7750 14252 Culver Drive, A299 'MAIL tina wrnerstonespecial com AODRESa. @ ty' INSURERS AFFORDING COVERAGE NAIC N INSURERA: Travelers Indemnity Co of Conn 25682 Irvine - CA 92604 INSURED INSURER B: Travelers Property Casualty Co 25674 INSURERC: Travelers Casualty& Surety Co of America 31194 JASON ADDISON SMITH CONSULTING SERVICES, INC., INSURER D: DBA: JAB PACIFIC INSURER E: P.O. BOX 2002 Upland CA 91786 INSURER F: COVERAGES ' CERTIFICATE NUMBER: 21122 COVERAGES 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 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 OFINSURANGE INSD MD POLICY NUMBER POLICY EFF MMmD/YYYY P LOYEXP MMmD/YYYY LIMITS - MERCIAL GENERALLIABIUTY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE ® OCCUR *XAODDITIONAL PREMISES Ea occurrence $ 1.000.000 MED EXPAny one person) $ 5,000 INSURED X BLNKTWVROFSUBRO PERSONAL &ADV INJURY $ 2.000,000 A Y Y 680-1 H359042 08/08/2021 08/98/2022 GENt AGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 4,000,000 - © PRO El PRODUCTS-COMP/OP AGG $ 4,000,000 POLICY ECT LOG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acddent $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED BA-OS426316 08/08/2021 08/08/2022 BODILY I NJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE Peraccidenl $ HIRED NON -OWNED q AUTOS ONLY AUTOS ONLY $ I I UMBRELLALIAS OCCUR - EACH OCCURRENCE $ 5,000,000 B EXCESS LIAR 11 CLAIM3-MAOE CUP-3429T370 08/08/2021 08/08/2022 AGGREGATE IS 5,000,000 DEO I I RETENTION $ $ WORKERS COMPENSATION PER FROTH X EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 B ANY RlEXCLUDEEXECUTIVE 19 NIA Y UB-BK37343A 08/08/2021 08/08/2022 O EXCLUDED? OFFICE MEMB - E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) Mandatory I. NH) Ifyes,descnbeunder 1,000,000 DESCRIPTION OF OPERATIONS be. E.L. DISEASE -POLICY LIMIT $ Each Claim $2,000,000 Professional Liability C Claims Made 107296206 08/08/2021 08/08/2022 Annual Aggregate 99ate 9 $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Santa Ana, its officers, officials, employees, and volunteers are Additional Insured for General Liability but only if required by written contract with the Named Insured prior to an occurrence and as per attached endorsement. Coverage is subject to all policy terms and conditions. *30 days notice of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability coverage, the aggregate limit is the total insurance available for all covered claims reported within the policy period. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92702 V�RAManagemmtDMallnt by REVIEWED fi APPROVED BY: ©1988-2015 ACOF 9� �' o. A+fla AaV44 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management SpeaaBt POLICY NUMBER: 680-IH359042 NAMED INSURED: Jason Addison Smith Consulting Services, Inc. dba ]AS Pacific POLICY PERIOD: 8/8/2021 to 8/8/2022 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury", "property damage" or"personal injury"; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies, or in connection with premises owned by or rented to you. The person or organization does not qualify as an additional insured: c. With respect to the independent acts or omissions of such person or organization; or d. For "bodily injury", "property damage" or "personal injury' for which such person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: e. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. This insurance does not apply to the rendering of or failure to render any "professional services". g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of liability required by the 'Written contract requiring insurance", the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section III — Limits Of Insurance. h. This insurance does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the additional insured under this Coverage Part must apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CG D3 81 09 15 © 2015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permia =s:y; RlskMmagnnml.DlWlon REVIEWED&APPRw By: A+•t Auvetc ��' Ruk Management Specialist COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury' offense is committed. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense committed: a. After you have signed that written contract; b. While that part of the written contract is in effect; and c. Before the end of the policy period. Risk Menegemad Dh Isla Page 2 of 2 © 2015 The Travelers Indemnity Company. All rights reserved. 11 a Renewm&APPRUAD BY: Includes the copyrighted material of Insurance Services Office, Inc., with its permis� 9(:= ? AIIJU Aa*41 ® Risk Management 5pecirdist Jason Addison Smith Consulting Services, Inc. POLICY# BA-OS426316 Effective: 8/8/2021 to 8/8/2022 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A BROAD FORM NAMED INSURED B, BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E SUPPLEMENTARY PAYMENTS -INCREASED LIMITS F. HIRED AUTO - LIMITED WORLDWIDE COV- ERAGE - INDEMNITY BASIS , G. WAIVER OF DEDUCTIBLE - GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1:, Who Is An Insured, of SECTION II - COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II - COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage occurs and that is h effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT J. PERSONAL PROPERTY K AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II - COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2 The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV - BUS[ NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA 73 53 0215 ©2015 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. c' Rick ManagematDWIon RtviE & APPROVED BY. `'JoitS��tf A+.uAawula ® Risk Management Spedafrt COMMERCIAL AUTO perrnlsslon, while performing duties (a) With respect to any claim made or "suit" related to the Conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Roo and Canada: covered "auto". @ You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set - The following is added to Paragraph Al., Who Istie any such claim or "suit" and keep advised of all proceedings and ao- An Insured, of SECTION 1 - COVERED AUTOS bons. ns. LIABILITY COVERAGE: Any "employee" of yours is an "Insured" while as "auto" (11) Neither you nor any other involved "insured" will make any settlement ing a covered you don't ouvn, hire or borrow without our consent n your business or your personal affairs. E SUPPLEMENTARY PAYMENTS - INCREASED (III) We may, at our discretion, participate LIMITS defending the "insured" against, or h ,or in the settlement of, any claim or 1. The following replaces Paragraph A2.a.(2), "suit". of SECTION II - COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) L� to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "properly damage" to which lions) required because of at "accident" this insurance applies, that the "in - we cover. We do riot have to furnish sured" pays with our consent, but these bonds. only up to the limit described i1 Para- 2 The following replaces Paragraph A2.a.(4), graph C., Limits Of Insurance, of of SECTION II - COVERED AUTOS LIABIL- SECTION II - COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up b $500 a day be- with our consent for your investiga- cause of time off from work, tion of such claims and your defense F. HIRED AUTO - LIMITED WORLDWIDE COV- of the "insured" against any such "suitn the only to and included ERAGE - INDEMNITY BASIS d within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph 8.7., Policy Period, Coverage Territory, SECTION 1 _ COVERED AUTOS of SECTION IV - BUSINESS AUTO CONDI- LIABILITY COVERAGE, and rot h TIONS: addition to such limit. Our duty to (5) Anywhere h the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used Ip the applicable limit of bargo, or similar regulation imposed by the insurance h payments for damages, United States of America 'applies to and pro- settlements or defense expenses. hibits the transaction .of business with or (b) This insurance is excess over any valid within such Country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or cn any other basis. without a driver for a period of 3) days or less (c) This insurance is not a substitute for re - and that is not a1 "auto".you lease, hire, rent quired or compulsory insurance h any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Roo and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 © 2015 The Travelers Indemnity Company. At rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. �i e�/ en P` RIAMwugenad Divislan RE MM & APPRwIED BY: ROW Ink Management Speaafst You agree to maintain all required or compulsory insurance h any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are riot an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance h any way with the laws of other counties relating to insurance. G WAIVER OF DEDUCTIBLE - GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III - PHYSICAL DAMAGE COVERAGE: Klo deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. R HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III - PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". L PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT The following replaces the first sentence in Para- graph AA.a., Transportation Expenses, of SECTION III - PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense tn- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph AA., Cover- age Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by at "insured"; and COMMERCIAL AUTO (2) h or cn your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". % deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does rat apply to "loss" to one or more airbags h a covered "auto" you am that in- flate due to a cause other than a cause of "loss" set forth it Paragraphs A ll.b. and A.1.c., but only: a If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss L NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV - BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt -notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is IQ1own to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV - BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to arty "accident' or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T3 53 0215 © 2015 The Travelers Indemnity Company. Al rights reserved. Includes mpyVled material d Inaurarrce Services Office, Inc. wish its permission. ltideMRrugemmtlxWdpn RimE/ED&AwRw Br ftuk Management SpedXis[ �.: COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional an1ss1cn of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. Fbw N UNINTENTIONAL ERRORS CR OMISSIONS ever this provision does not affect our right b col - The following is added to Paragraph B2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV - BUSINESS AUTO CONDITIONS: Page 4 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance services Office, Inc. with its permission. RukManngement Dfuivirnr > Rt:me# o & AW'Rov®Br. A+ fd Aaw44a RA Management SpedAiist NAMED INSURED: Jason Addison Smith Consulting Services, Inc. POLICY NUMBER: BA-OS426316 POLICY TERM: 8/8/2021 TO 8/8/2022 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided underthe following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The fallowing is added to Paragraph A.1.d., Who Is An Insured, of SECTION II - COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury' or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and, only to the extent of that person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph 8.5., other Insurance of SECTION IV - BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is the first named insured when the written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or. "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CA T4 740216 112016 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. WekMmagm*ADM9Im RtinEwao&APPROVED Br. A,C Auvute ® Risk Management Specialist ,' A TRAVELERSJ ONE TOWER SQUARE HARTFORD CT 06163 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A)- 001 POLICY NUMBER: UB-BK37343A WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 2. oo % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR ENGINEERS WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by___ DATE OF ISSUE: 08-01-21 ST ASSIGN: _ R!AMnugemmfDM,1an REvi D 6 AepRovm Bv: �. A-gu Aaw44 ® Risk b7anzgementSpedalist POLICY NUMBER: 680-11-1359042 NAMED INSURED: Jason Addison Smith Consulting Services, Inc. dba JAS Pacific POLICY PERIOD: 8/8/2021 to 8/8/2022 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury", "property damage" or"personal injury"; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies, or in connection with premises owned by or rented to you. The person or organization does not qualify as an additional insured: c. With respect to the independent acts or omissions of such person or organization;,or d. For "bodily injury", "property damage" or "personal injuryfor which such person or organization has assumed liability. in a contract or agreement.. The insurance provided to such additional insured is limited as follows: e. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. f. This insurance does not apply , to the rendering of or failure to _render any "professional services". g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section III — Limits Of Insurance. h. This insurance does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage forthat additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the additional insured under this Coverage Part must apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CG D3 81 09 15 02015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permis. ""t.. '. Risk M tDiidal RevieAED& APPROY®BY: A-ft AcaA4 - Risk Management Speci7is[ 01 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 3., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense committed: a. After you have signed that written contract; b. While that part of the written contract is in effect; and c. Before the end of the policy period Page 2 of 2 m 2015 The Travelers Indemnity Company. All rights reserved Includes the copyrighted material of Insurance Services Office, Inc., with its permis ar�sm� RiskMmugemm I)Msian RWn D&MVRw®BY: A4u Aacaaa Risk Management Specidnt Jason Addison Smith Consulting Services, Inc. POLICY# BA-OS426316 Effective: 8/8/2021 to 8/8/2022 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described h any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A- BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E SUPPLEMENTARY PAYMENTS- INCREASED LIMITS F. HIRED AUTO - LIMITED WORLDWIDE COV- ERAGE - INDEMNITY BASIS, G. WAIVER OF DEDUCTIBLE - GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.I., Who Is An Insured, of SECTION It - COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in AA., Who Is An Insured, of SECTION II - COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is h effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT J. PERSONAL PROPERTY K AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section It. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II - COV- ERED AUTOS LIABILITY COVERAGE: An "employee' of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV - BUS] NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 0215 © 2015 The Travelers Indemnity Company. Al rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. RlskMuagemeniDMslun REMENED & APPROVD BY: ®' Risk Management Specialist COMMERCIAL AUTO pelmiss1on, while performing duties related to the conduct of your busk ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION 1 - COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ng a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E SUPPLEMENTARY PAYMENTS -INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), Of SECTION II - COVERED AUTOS LIABIL- ITY COVERAGE: (2) Lip to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do rat have to furnish these bonds. 2 The following replaces Paragraph A.2.a.(4), of SECTION II - COVERED AUTOS LIABIL- ITY COVERAGE: (a) With respect to any claim made or "suit" brought outside the United States of America, the tenitories and possessions of the United States of America, Puerto Rico and Canada: (I) You must arrange to defend the "in- sured' against, and investigate orset- tie any such claim or "suit" and keep us advised of all proceedings and ac, tions. (it) Neither you nor any other involved "insured" will make any settlement without our consent (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit'. (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured' pays with our consent, but only Lp to the limit described in Para- graph C, Limits Of Insurance, of SECTION 1 - COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) M will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings rp to $500 a day be- with our consent for your investiga- cause of time off from work - ton of such claims and your defense F. HIRED AUTO - LIMITED WORLDWIDE COV- of the "insured" against any such "suit', but only Lp to and included ERAGE - INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph 8.7., Policy Period, Coverage Territory, SECTION 1 : COVERED AUTOS of SECTION IV - BUSINESS AUTO CONDI- LIABILITY COVERAGE, and riot h TIONS: addition to such limit. Our duty to (5) Anywhere h the world, except any country or make such payments ends when we jurisdiction while any trade sanction, ern-- have used Lp the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction .of business with or (b) This insurance is excess over any valid within such country or jurisdiction, :for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on arty other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- ad that is not an "auto' you base, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Moo and (if you are a limited liability company) or Canada members of their households. Page 2 of 4 m 2015 The Travelers Indemnity Company. Al rights reserved. Includes copyrighted material of Insurance Services Office, Inc. wish its permission. ;9 � w.kMougonadDMsinn BEVIEVlED&APPRWS)Br. A. p A6ev44 MA Management Specialist You agree to maintain all required or compulsory insurance in any such coun- try tp to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will riot invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) it is understood that we are not at admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada We assume no responsibility for the furnishing of certificates of insurance, or for compliance h any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE - GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III - PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b, Loss Of Use Expenses, of SEC- TION III - PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". t PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT The following replaces the first sentence h Para- graph AA a., Transportation Expenses, of SECTION III - PHYSICAL DAMAGE COVER- AGE: We will pay Lp to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you. because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph AA., Cover- age Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Personal Property We will pay Lp to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by at "insured", and COMMERCIAL AUTO (2) In or o1 your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". Nb deductibles apply to this Personal Property coverage. K AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Exclusion 3.a, does rat apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss".- L NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a, of SECTION IV - BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" b Ivronm to: (a) You (if you are a1 individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability cony pany); (d) M executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION M - BUSINESS AUTO CONDI- TIONS: 5 Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed aid executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T3 53 0215 © 2015 The Travelers Indemnity Company. Al fights reserved. Includes oopyrighled material of Insurarxe Services 00im, Inc with its permission. RiskMamgemadWslon { � t RFMEWED & APPRMM 8Y: _. A� AaW44 Risk Management SpeciAA nt COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional ardss1al of, or unintentional person or organization designated h such error in, any information given by you shall rat contract. prejudice your fights under this insurance. HaA, N. UNINTENTIONAL ERRORS CR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B2.1 Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV - BUSINESS AUTO CONDITIONS: Page 4 of 4 © 2015 The Travelers Indemnity Company. All rights reserved, Includes copyrighted material of Insurance Services Office, Inc. with its permission. Risk M»tagemvdDi ision eKe,y RrmI SAvxtov®By., A, fi AaWaca Ruk Management spenegist Of NAMED INSURED: Jason Addison Smith Consulting Services, Inc. POLICY NUMBER: BA-OS426316 POLICY TERM: 8/8/2021 TO 8/8/2022 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I11:{g1FAMIGH&9 1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION II - COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and. only to the .extent of that person's or. organization's liability for the conduct of another "insureds'. 2. The following is added to Paragraph 8.5., other Insurance of SECTION N - BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is the first named insured when the written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CA T4 740216 U 2016 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. WA,Ren�o& Risk Mn agenmt Divislan APPROV® By., �. .f Auwetc U Risk Management Spedalirt 0 TRAVELERS) ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY WC 99 Q3 76 ( A)- 0o1 POLICY NUMBER: UB-BK37343A WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named m the Schedule. The additional premium for this endorsement shall be 2. oo % of the California workers' compensation pre- mium. Schedule Person or Organization lob Description ANY PERSON OR ORGANIZATION FOR ENGINEERS WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by +"'•`=e RAM0ag0WdDMs1an Re EWED&APPRovmft DATE OF ISSUE: 08-01-21 ST ASSIGN: A4ju A,,v44 �� Rnk Management SpedAm NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Jason Addison Smith Consulting Services, Inc. Name: Project A-2022-072-06 Number: Project Agreement To Provide On-Call Building Safety Inspection Name: Services The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: EXPIRAT TYPE OF POLICY COI ION FILE NAME INSURANCE NUMBER DATE DATE AUTOMOBIBA0S426308/08/208/09/222_23_COVERAGES_City_of_Santa_Ana_Risk_Management LE LIABILITY 16 023 022 _Division_08092022.pdf GENERAL 6801H3508/08/208/09/222_23_COVERAGES_City_of_Santa_Ana_Risk_Management LIABILITY 9042 023 022 _Division_08092022.pdf PROFESSIO 1072962008/08/208/09/222_23_COVERAGES_City_of_Santa_Ana_Risk_Management NAL 6 023 022 _Division_08092022.pdf LIABILITY WORKERS COMPENSA UB8K37308/08/208/09/222_23_COVERAGES_City_of_Santa_Ana_Risk_Management TION AND 43A 023 022 _Division_08092022.pdf EMPLOYER S' LIABILITY Thank you, City of Santa Ana Risk Management Division in partnership with NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Jason Addison Smith Consulting Services, Inc. Name: Project A-2022-072-06 Number: Project Agreement To Provide On-Call Building Safety Inspection Name: Services The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: POLICY EXPIRATION TYPE OF INSURANCE COI DATE FILE NAME NUMBER DATE City of Santa AUTOMOBILE LIABILITY BA05426316 08/08/2024 08/09/2023 Ana.pdf City of Santa GENERAL LIABILITY 6801H359042 08/08/2024 08/09/2023 Ana.pdf City of Santa PROFESSIONAL LIABILITY CLAIMS MADE 107296206 08/08/2024 08/09/2023 Ana.pdf WORKERS COMPENSATION AND City of Santa UB8K37343A 08/08/2024 08/09/2023 EMPLOYERS' LIABILITY Ana.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 8/11/2023 3:11 PM