HomeMy WebLinkAboutBAY AREA DRIVING SCHOOLINSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
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CLERK`WT6 2022
N-2022-219
RECREATION SERVICES AGREEMENT FOR ONLINE DRIVNG CLASSES WITH
BAY AREA DRIVING SCHOOL, INC.
THIS AGREEMENT is made and entered into on this L day of May, 2022 by and
between Bay Area Driving School, Inc., a California Corporation ("Provider"), 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"). City and Provider may be
collectively referred to as the "Parties" or individually as a "Parry."
RECITALS
A. The City desires to retain a service provider having special skills, resources and knowledge to
provide an online, interactive, educational course for driver education, in accordance with the
guidelines set by the California Department of Motor Vehicles.
B. Provider represents that it is able and willing to provide such services to the City.
C. In undertaking the performance of this Agreement, Provider represents that it is
knowledgeable in their field and that any services performed by Provider under this
Agreement will be performed in compliance with such standards as may reasonably be
expected.
D. The Parties acknowledge that the City intends to provide recreational activities to the public
but must balance the need to comply with all COVID-19 guidance and restrictions.
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. Provider shall perform those services as set forth in Exhibit A to this Agreement.
B. Provider shall comply with the City's recreation class policy manual and any other
City rules and regulations regarding the operation of recreation classes.
2. COMPENSATION
a. In consideration for the provision of the programs set forth in Exhibit A, City agrees
to pay, and Provider agrees to accept as total payment for their services for the City,
seventy percent (70%) of all gross revenue received from program participants. Total
revenue to Provider shall not exceed Twenty -Five Thousand Dollars and Zero Cents
($25,000).
a. Payment to Provider shall be made monthly within thirty (30) days following
completion of the last class taught by Provider the prior month. City shall be
responsible for collecting all fees from program participants. Provider shall not collect
fees but will refer all interested participants to City for registration information.
Provider agrees that City shall retain thirty percent (30%) of all gross revenue received
from program participants as an administrative fee.
3. TERM
This Agreement shall commence on July 1, 2022 and end on June 30, 2023 unless
terminated earlier in accordance with Section 14 below. The term of this Agreement may be
extended by a writing executed by the City Manager and the City Attorney.
4. INDEPENDENT CONTRACTOR
Provider 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 manner in which Provider performs the services
which are the subject matter of this Agreement; however, the services to be provided by Provider
shall be provided in a manner consistent with all applicable standards and regulations governing
such services. Provider 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. Provider is not an agent, representative or employee of City and
Provider shall have no authority to act on behalf of the City.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Provider shall maintain
and shall require its subcontractors, if any, to obtain and maintain insurance as described below:
a. Minimum Scope and Limit of Insurance:
Commercial General Liability Insurance. Provider shall maintain commercial
general liability insurance which shall include, but not be limited to protection
against claims arising from bodily and personal injury, including death resulting
therefrom and damage to property, resulting from any act or occurrence arising out
of Provider's operations in the performance of this Agreement, including, without
limitation, acts involving vehicles. 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. Such insurance shall (a) name the City, its officers, employees,
agents, volunteers and representatives as additional insured(s); (b) be primary and
not contributory with respect to insurance or self-insurance programs maintained
by the City; and (c) contain standard separation of insured's provisions.
2. Broader Coverage. If the Provider 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 Provider. 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 on the CGL
policy with respect to liability arising out of work or operations
performed by or on behalf of the Provider including materials, parts, or
equipment furnished in connection with such work or operations.
General liability coverage can be provided in the form of an
endorsement to the Provider's insurance (at least as broad as ISO Form
CG 2010 11 85 or if not available, through the addition of both CG 20
10, CG 20 26, CG 20 33, or CG 20 38; and CG 2037 if a later edition is
used).
2. Primary Coverage: For any claims related to this contract, the
Provider's insurance coverage shall be primary coverage at least as
broad as ISO CG 20 0104 13 as respects the City, its officers, officials,
employees, and volunteers. Any insurance or self-insurance maintained
by the City, its officers, officials, employees, or volunteers shall be
excess of the Provider'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: Provider hereby grants to City a waiver of any
right to subrogation that any insurer of said Provider may acquire
against the City by virtue of the payment of any loss under such
insurance. Provider agrees to obtain any endorsement that may be
necessary to affect this waiver of subrogation, but this provision applies
regardless of whether or not the City has received a waiver of
subrogation endorsement from the insurer.
5. Self -Insured Retentions: Self -insured retentions must be declared to
and approved by the City. The City may require the Provider 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.
3
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.
Verification of Coverage: Provider 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 all policy endorsements to
City before work begins. However, failure to obtain the required
documents prior to the work beginning shall not waive the Provider'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 anytime.
8. Subcontractors: Provider shall require and verify that all
subcontractors maintain insurance meeting all the requirements stated
herein, and Provider shall ensure that City is an additional insured on
insurance required from subcontractors.
9. Special Risks or Circumstances: City reserves the right to modify
these requirements, including limits, based on the nature of the risk,
prior experience, insurer, coverage, or other special circumstances.
6. INDEMNIFICATION
Provider agrees to and shall indemnify, defend 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 Provider or its contractors, 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,
to the extent that the injury, damages, just compensation, restitution, judicial or equitable relief is
caused by the negligence of the Provider. This indemnity and hold harmless agreement applies to
all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or
alleged to have been suffered, by reason of the events referred to in this Section or by reason of
the terms of, or effects, arising from this Agreement. City may make all reasonable decisions with
respect to its representation in any legal proceeding. In no case will Provider be required to
indemnify or hold harmless the City from injury, damages, just compensation, restitution, judicial
or equitable relief caused by the negligence of the City.
7. CONFIDENTIALITY
If Provider receives from the City information which due to the nature of such information
is reasonably understood to be confidential and/or proprietary, Provider 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, including but not limited to student records. 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 Provider disclosed in a publicly available source; (c) is in
rightful possession of the Provider without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Provider without reference
to information disclosed by the City.
8. COVID-19 ASSUMPTION OF RISK AND WAIVER
Provider acknowledges that Provider could be exposed to persons that may have COVID-
19 providing services pursuant to this Agreement. Provider understands that interacting with any
person currently comes with the inherent risk of exposure to COVID-19 and that COVID-19 is
highly contagious. Provider assumes the risks associated with providing services pursuant to this
Agreement, namely potential exposure to COVID-19. Provider acknowledges that while some
people have no symptoms or mild symptoms from COVID-19, some people have become seriously
ill requiring hospitalization and that some people have died from COVID-19. Provider
acknowledges that persons over the age of 65 and persons with underlying health conditions are
at greater risk of contracting COVID49 and are potentially risking serious injury or death.
Provider is agreeing to provide classes pursuant to this Agreement and does so of Provider's own
free will.
Provider intends to be legally bound by this assumption of risk, release and waiver and to
bind Provider's heirs, personal representatives, next of kin and anyone who may make a claim on
Provider's behalf. Provider knowingly releases and waives any and all claims that Provider may
have or could have in the future and includes any claims resulting from potential exposure or actual
exposure to COVID-19, this includes claims for personal injury, transmittal of COVID-19 to
others, and/or wrongful death. Provider agrees to hold harmless, defend and indemnify the City,
its public officials, officers, employees, volunteers, and agents from any and all claims for liability
or damages, including those for exposure to or diagnosis with COVID-19 as a result of providing
services pursuant to this Agreement.
5
9. CONFLICT OF INTEREST
Provider covenants that it presently has no interests and shall not have interests, direct or
indirect, which would conflict in any manner with performance of services specified under this
Agreement.
10. BACI{GROUND CHECK
Provider shall ensure that all employees, subcontractors, and any volunteers are
fingerprinted and background checked prior to conducting any work pursuant to this Agreement.
Provider shall not assign any employee, agent, subcontractor, volunteer or the Provider personally
to provide services pursuant to this Agreement, if that employee, agent, subcontractor, volunteer,
or the Provider personally are required to register as a sex offender under California Penal Code
Section 290 et seq, have a conviction for any crime of moral turpitude, have a conviction for a
sexual based crime, have a conviction for a violent felony as defined in California Penal Code
Section 667.5(c), or has a conviction for a serious felony as defined in California Penal Code
Section 1192.7(c). Disqualifying convictions include but are not limited to, violations of California
Penal Code Sections 37, 128, 136.1 with Section 186.22, 187, 190490.4 and 192(a), 205, 206,
207-209.5, 211, 212, 212.5, 213, 214, 215, 218-219, 220, 236.1(b) or 236.1(c), 243.4, 261, 261.5,
273.5, 262, 264.1, 266, 266c, 266h, 266i, 266j, 267, 269, 272, 273a, 273ab, 273d, 285, 286, 288,
288a, 288.2, 288.3, 288.4, 288.5, 288.7, 289, 290, 311.1, 311.2, 311.3, 311.4, 311.10, 311.11, 314,
347(a), 368, 417(b), 451(a),518 with 186.22, 647.6, 653f(c), 664 and 187, 667.5(c), 18745, 18750,
or 18755, 12022.53, 11418(b)(1) or (b)(2); Business and Professions Code Section 729.
11. 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 Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
With copy to:
Santa Ana, CA 92702-1988
Fax (714) 647-6956
Executive Director of Parks, Recreation and Community Services
City of Santa Ana
20 Civic Center Plaza (M-23)
P.O. Box 1988
Santa Ana, California 92702
Fax (714) 571-4211
To Provider: Bay Area Driving School, Inc.
Attn: Erika Vieyra
10970 A Street
Hayward, CA 94541
Email: info bayareadriving.com
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.
12. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Provider 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
Provider. 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 Provider 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 parry, which is not embodied herein.
13. ASSIGNMENT/SUBSTITUTES
a. Assignment. The experience, knowledge, capability and reputation of Provider were a
substantial inducement for City to enter into this Agreement. Therefore, Provider 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.
b. Substitutes. In the event Provider is not able to teach a class due to illness or some other
cause beyond Provider's reasonable control, Provider must procure, at its sole expense, a qualified
substitute instructor to teach the class at its regular time and place. Provider shall ensure that
substitute instructors are at least twenty-one (21) years of age and comply with the City's insurance
and live scan requirements contained herein. Evidence of compliance with City's insurance and
live scan requirements shall be provided upon request. Provider must immediately notify the City
of the substitute instructor's name, qualifications, address and phone number. If Provider cannot
procure a qualified substitute and the City is unable to assist in this regard, then the class shall be
canceled and a make-up class must be added to the session. Provider must notify participants as
soon as possible of any class cancellation and make-up class. Provider must personally teach at
least seventy-five percent (75%) of its offered classes.
14. TERMINATION
a. This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Provider shall be entitled to receive, and City shall pay Provider,
compensation for all services rendered prior to the effective date of termination.
b. Termination or cancellation of classes by the Provider outside of Section 1 Lb. must be
given to the City at least thirty (30) days prior to termination/cancellation. Failure to provide
adequate cancellation notice to the City may put future contracting of business with the City at risk
and will result in the City's retention of ten (10%) percent of the final payment to Provider.
15. RECORDS
Provider shall use attendance sheets generated and supplied by the City to record
attendance in each class. Provider shall keep these and any other records in connection with the
work to be performed under this Agreement and shall permit City, upon request, to review such
records for a period of three (3) years from the date of final payment to Provider under this
Agreement.
16. NON-DISCRIMINATION
Provider shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, gender identity, gender expression, gender, medical conditions, genetic
information, or military and veteran status, age, national origin, ancestry, or disability, as defined
and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization,
promotion, termination or other employment related activities or any services provided under this
Agreement. Provider affirms that it is an equal opportunity employer and shall comply with all
applicable federal, state and local laws and regulations.
17. JURISDICTION —VENUE
This Agreement has been executed and delivered in the State of California and the validity,
interpretation, performance, and enforcement of any of the clauses of this Agreement shall be
determined and governed by the laws of the State of California. Both parties farther agree that
Orange County, California, shall be the venue for any action or proceeding that may be brought or
arise out of, in connection with or by reason of this Agreement.
18. LICENSES
Provider 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.
19. SEVERABILITY
In the event that one or more of the phrases, sentences, clauses, paragraphs or sections
contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree
of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the
remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be
interpreted to carry out the intent of the parties hereunder.
20. EXHIBITS
All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in
the body of this Agreement.
21. AUTHORITY
The person(s) executing this Agreement on behalf of the parties hereto warrant that they are
duly authorized to execute this Agreement on behalf of said parties and that by so executing this
Agreement, the parties hereto are formally bound to the provisions of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and
year first above written.
ATTEST:
AL
Daisy Gomez
�Clerk of the Council
APPROVED AS TO FORM:
SOMA R. CARVALHO
City Attorney
By:
Btanlron Salvatierra
Deputy City Attorney
RECOMMENDED FOR APPROVAL:
Steven Mendoza (May 26, 202215:57 PDT)
Lisa Rudloff
Executive Director of Parks,
Recreation and Community Services Agency
CITY OF SANTA ANA
v
Kristine Ridge
City Manager
PROVIDER:
Name. v j Al t
Title: Zri�'ue (Owrv4X
EXHIBIT A
Exhibit A
A. Provider shall provide an online, interactive, educational course for driver's education
in accordance with the guidelines set by the California Department of Motor Vehicles.
This course is required for teens to obtain their learner's permit.
B. Provider shall teach such or similar classes (1) at the times below at facilities to be
designated by the City or (2) on a schedule agreed upon by the parties for each class
session or term, including the location, specific days and hours when classes will be held,
and holidays to be observed, in accordance with City's needs.
ONLINE DRIVER'S EDUCATION COURSE
The DMV allows teens to receive their Learner's Permit at age 15%2, and a license at age
16. This class is the FIRST, required step that must be completed. This is an online
course with videos, animated driving scenarios, and sample test questions. Learn the rules
of the road, major causes of traffic collisions. DMV procedures and much more. A
licensed instructor is available to answer any questions. Receive DMV-approved
Certificate of Completion.
INSTRUCTOR: Bay Area Driving staff
LOCATION: At home, on your computer
SESSIONS: Available daily, 24/7
Provider shall provide all materials, supplies, equipment, records and personnel.
Provider shall be responsible for clean-up of the facilities and materials and shall ensure
the safety and effectiveness of instruction.
CLASS SIZE
A. There is no minimum class is taught online.
B. No registration accepted after the second meeting of class.
C. If the minimum registration has not reached by the second class, class will be
canceled. Provider will be under no obligation to provide services for the
canceled classes, and the City will have no further obligations to pay Provider
compensation for the remaining classes that were canceled in that session.
CLASS FEES
A. Each participant shall pay class registration fees as established by City.
B. Provider may not waive class participation/registration fees.
C. Only registered participants may participate in class.
D. Any refunds to participants will be made in accordance with City policy.
E. Any materials fee shall be established by mutual agreement of City and Provider
and shall be payable directly to Provider.
COVILD-19 REQUIREMENTS
A. Instructor and participants shall wear a mask at all times to participate.
B. Temperature will be taken at the beginning of the class for instructor and
participants.
C. Social Distancing should be adhered to at all times.
E. State of California COVID-19 regulations shall apply.
Bay Area Driving School Final Draft Agreement
Final Audit Report 2022-05-26
Created: 2022-05-26
By: Emerson Frankston (EFrankston@santa-ana.org)
Status: Signed
Transaction ID: CBJCHBCAABAAMxChePXgLphO_i206TywRWjvutq-e6Dz
"Bay Area Driving School Final Draft Agreement" History
Document created by Emerson Frankston (EFrankston@santa-ana.org)
2022-05-26 - 10:53:49 PM GMT
�y Document entailed to Steven Mendoza (smendoza@santa-ana.org) for signature
2022-05-26 - 10:54:42 PM GMT
Email viewed by Steven Mendoza (smendoza@santa-ana.org)
2022-05-26 - 10:56:44 PM GMT
d® Document e-signed by Steven Mendoza (smendoza@santa-ana.org)
Signature Date: 2022-05-26 - 10:57:08 PM GMT -Time Source: server
Agreement completed.
2022-05-26 - 10:57:08 PM GMT
Q Adobe Acrobat Sign
Client#: 669445
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ACORD. CERTIFICATE OF LIABILI ��1:! ANC ngieAceved
DATE(MMIDDNYYYI
6/0912022
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CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND O QQT�L��pp,, ($q g .q)3t9@q'®@THE POLICIES
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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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
COOryNTACT Tara Doyle AAI
Marsh & McLennan Agency LLC
PHONE
Lakefield Drive
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AIC No Ext: AIL No):
ADDRESS: Tara.Doyle@MarshMMA.com
Suite
Suite 100
Johns Creek, GA 30097-1508
INSURER(S) AFFORDING COVERAGE
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INSURER A: Penn -Star Insurance Company
10673
INSURED
INSURER B: United Financial Casualty Company
11770
Bay Area Driving School Inc. dba
Bay Area Driving School
INSURERC:
1070 A Street
INSURER D :
Hayward, CA 94541
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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 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.
INSRR
TYPE OF INSURANCE
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POLICY NUMBER
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(GL)ADDITIONAL INSURED -Automatic Status When Required in Contract or Agreement (other than construction)per
form EPA1746
(GL)ADDITIONAL INSURED (Primary and Non -Contributory) perform S2154
City of Santa Ana Risk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
20 Civic Center Plaza, 4th Floor
Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVES
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4� o® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMI202n2 Y)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be 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 Automatic Data Processing Insurance Agency, Inc.
Automatic Data Processing Insurance Agency, Inc.
PNCON o E.e : 1-800-524-7024 A/C No:
EMAIL
ADDRESS:
1 Adp Boulevard
INSURERS AFFORDING COVERAGE
NAIC#
INSURER A: State Compensation Insurance Fund
35076
Roseland NJ 07068
INSURED Bay Area Driving School Inc
INSURER B:
INSURER C :
INSURER D :
1070 A St
INSURER E :
Hayward CA 94541
INSURER F:
COVERAGES CERTIFICATE NUMBER: 2333928 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
SD
SUER
MID
POLICY NUMBER
POLICYEFF
WMIDDAYNIR
POLICYEXP
IMMdDDfYYYYILIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
$
PREMISES Eaoccurmnce
$
MEDEXP(Anyonspeman)
$
PERSONAL&ADV INJURY
If
GEML
AGGREGATE LIMIT APPLIES PER:
POLICY ❑PET LOG
OTHER:
GENERALAGGREGATE
$
PRODUCTS - COMP/OP AGO
It
$
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea aoddent
$
J
BODILY INJURY (Par person)
$
BODILY INJURY (Per ecd)
tlent
$
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAS
EXCESS LMB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED
I
I RETENTIONS
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y
MY ECUTIVE �
OFFICEMMEMe R EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
N
1507366-2021
12116/2021
12/16/2022
PER OTH.
STATUTE ER
E.L. EACH ACCIDENT
§ 1,000,000
E.L. DISEASE -EA EMPLOYE
§ 1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
Insured Copy
1070 A St
Hayward
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
CA 94541 1 7�.-..)J)t1
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
_ RlekMaugemadDMsiDn
c+g'o^i•¢R�' REVIEWED&APPROVED By.
A41u' Auv44
Risk Management Spedalist
MARSH & MCLENNAN
200 BROOKSTNE PKY 118
COLUMBUS, GA 31904
BAY AREA DRIVING SCHOOL
INC.
BAY AREA DRIVING SCHOOL
1070 A STREET
HAYWARD, CA 94541
Additional insured endorsement
Name of Person or Organization
CITY OF SANTA ANA
PO BOX 1988
SANTA ANA, CA 92701
PROGRE111YE
COMMERCIAL
Policy number: 00615583-3
Underwritten by:
United Financial Cas Co
Insured:
BAY AREA DRIVING SCHOOL
April 18, 2022
Policy Period: Apr 15, 2022 - Apr 15, 2023
Mailing Address
United Financial Cas Co
PO Box 94739
Cleveland, OH 44101
1.800-444.4487
For customer service, 24 hours a day,
7 days a week
The person or organization named above is an insured with respect to such liability coverage as is
afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of
another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this endorsement will be primary for any power unit specifically described on the
Declarations Page.
Limit of Liability
Bodily Injury
Property Damage
Combined Liability
Not applicable
Not applicable
$500,000 each accident
All other terms, limits and provisions of this policy remain unchanged.
This endorsement applies to Policy Number: 00615583-3
Issued to (Name of Insured): BAY AREA DRIVING SCHOOL
INC.
BAY AREA DRIVING SCHOOL
Effective date of endorsement: 04/15/2022
Form 1198 (01104)
Policy expiration date: 04/15/2023
s' REwEwED&� W®Br;
AemenAuv4lo
�' Risk Management Spends[
*00A
* Group**
STANDARD CHANGE ENDORSEMENT NO
Endorsement effective
Named Insured
05/01/2022
Bay Area Driving School Inc DBA Bay Area Driving
School
12:01 am standard time
Policy No.
Countersigned by
PAV0321970
is corrected to read as listed below (continued from Page 1)
In consideration of no change in Premium, it is hereby agreed and understood thatthe following Additional Insured
and form has been ADDED to the policy as follows:
S2154-ADDITIONAL INSURED PROVISION
City of Santa Ana
Risk Management Division
20 Civic Center Plaza, 4th Floor
Santa Ana, CA 92702
S1004 (10/2013)
SOL
1tlek TMnagmumt DMslan
RIMEWED & APPROV®Br.
RM Management Specialist
*�oA
* Group**
*
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED PROVISION
This endorsement modifies insurance under the following
Commercial General Liability Coverage Part
With respect to the Additional Insured and the Project shown in the schedule below only,
paragraph 4. Other Insurance of SECTION IV- COMMERCIAL GENERAL LIABILITY
CONDITIONS is deleted and replaced by the following:
This insurance is primary and will not contribute with any other insurance if a loss we
cover arises out of the sole negligence of the Named Insured.
Schedule
Additional Insured
Connecting Waters Charter School
City of Santa Ana
Risk Management Division
S2154 (04/08)
Project
12420 Bentley Street, Waterford, CA 95386
20 Civic Center Plaza, 4th Floor, Santa
Ana, CA 92702
o .4 yon••
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RiekMmrgti111attDlvleton
RtwiE & APPROVm BY:
A�:r Aawuto
Risk Management Spewhit �