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HomeMy WebLinkAboutGRUVER, ERIC PH.D.INSURANCE NOT ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL DATE: A-2022-190 AGREEMENT TO PROVIDE PSYCHOLOGICAL EVALUATION SERVICES FOR THE CITY OF SANTA ANA POLICE DEPARTMENT � I THIS AGREEMENT is made and entered into this 4th day of October, 2022 by and between Eric a Gruver, Ph.D., ("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 C'City"). RECITALS - A. On July 12, 2022, the City issued a Request for Proposal ("RFP") No. 22-031 for the purpose of retaining a consultant having special skill and knowledge in the field of providing psychological evaluation and counseling services for the City's Police Department. B. The City received numerous responses to the RFP. Consultant is one of the three parties selected by the City. Consultant represents that he is able and willing to provide the services described in the scope of work that was included in the RFP and attached as Exhibit A. Consultant's proposal is incorporated by reference as though fully set forth herein, C. In undertaking the performance of this Agreement, Consultant represents that he is knowledgeable in its field and that any services performed by Consultant under this Agreement will .be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the psychological evaluation services described and set forth in Exhibit A, attached hereto and incorporated by reference. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the rates and charges identified in Exhibit B. The total sum to be expended under this Agreement shall not exceed $30,000, b. Payment by City shall be made within 45 days (forty-five) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be madefor work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on October 4, 2022, and continue through September 30, 2025, with the option the City to grant up to two (2) one (1) year renewals, exercisable by a writing by the City Manager and the City Attorney, unless terminated earlier in accordance with Section 13, below. City shall recognize any services provided since October 1, 2022. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below. Coverage shall be at least as broad as: 1, Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence, If a general aggregate limit applies, either the general aggregatelimit shall apply separately to this project/looation (ISO CG 25 03 or 25 04) or the generalaggregate limit shall be twice the required occurrence limit. 2, Automobile Liability: Insurance Services Office Form Number CA 0001 covering, Codet (any auto), or if Consultant has no owned autos, Code 8 (hired) and 9 (non - owned), withlimit no less than $1,000,000 per accident for bodily injury and property damage. 3, Workers' Compensation insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. (Not required if consultant Provides wrdtten verlfteation they have no employeeslt 4. Professional Liability (Errors and Omissions) Insurance. appropriates to the Consultant'sprofossion, with limit no less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. 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 contractor, Any available insurance proceeds in excess of Page 2 of 9 the specified minimum limits of insurance and coverage shall be available to the City Other Insurance Provisions 'The insurance policies are to contain, or be endorsed to contain, the following provisions: Additional Insured Status The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts, or equipment furnished in 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 CO 2010 11 85 or both CG 2010, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 forms if later revisions used). Primary Coverage For any claims related to this contract, the Consultant's insurance coverage shall be primary insurance 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 insuranceand shall not contribute with it. Notice of Cancellation Each insurance policy required above shall state that coverage shall not be canceled, except with notice to the City. Waiver gfsubrogation Consultant hereby grants to City a waiver of any right to subrogation which any insurer of said Consultant may acquire against the City by virtue of the payment of any loss under such insurance, Consultant agrees to obtain any endorsement that may be necessary to affect this waivorof subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer, Self-1'nsured 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. Acceptability oflnsurers Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Bost's rating of no less than A:VII, unless otherwise acceptable to the City, Claims Made Policies If any of the required policies provide coverage on a claims -made basis: Page 3 of 9 J , The Retroactive Date must be shown and must be before the date of the contract or the beginning of contract work, 2, Insurance must be maintained and evidence of insurance must be provided,for at least five (5) years after completion oj'the contract of wor1c, 3. If coverage is canceled or non -renewed, and not replaced with another claims - made policy form with a Retroactive ,bate prior to the contract effective date, the Consultant must purchase "extended reporting" coverage for a minimum of five (5) years after completion of contract work. Verification oJ'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 roquired by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins, However, failure to obtain the required documents prior to the work. beginning shall notwaive the Consultant's obligation to provide them.The City reserves the rightto require complete, certified copies of all required insurancepolicies,including endorsements required by these specifications, at any time. Subcontractors Consultant shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure that City is an additional insured on insurance required from subcontractors, 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. b. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability; (1) for personal injury, damages,just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section I 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 thisyAgreemeat. 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 Page 4 of 9 shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 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 periocl of three (3) years from the date of final payment to Consultant under this Agreement. 8, 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 City. 9. CONFLICT OF INTEREST CLAUSE Consultant 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. NON-DISCRIMINATION Consultant 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 Page 5 of 9 Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations, 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, 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 terns 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 is not embodied herein, 12, 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, 13. 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(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use 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, 14, WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by tile. 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 Page 6 of 9 similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies, 15, 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. 16. 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, 17. 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: Cleric 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 With courtesy copies to: Chief of Police Santa Ana Police Departrgent 20 Civic Center Plaza (M•97) P.O. Box 1981 Santa Ana, California 92702 Fax;714.245.8090 Page 7 of 9 To Consultant: Eric Gruver, Ph.D. 2021 E. 4'1' Street Suite 116 Santa Ana, CA 92705 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 ar 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 timeframes, weekends, federal, state, County or City holidays shall be excluded. 18, TYUSC7 LLANE+ OUS 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 filly, 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, The Agreement is the final and complete agreement and any prior or contemporaneous agreements for similar services between the parties is superseded by this Agreement. This shall not apply where the Parties are currently engaged and. Consultant is providing services not contemplated by this Agreement C. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. [signature page to follow] Page 8 of 9 1N WT'17NESS 1x HLREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Clerk of the Cotuicil APPROVED AS TO FORM: SANTA R. CARVALT-10 City Attorney 'raniara 56gosian Senior Assistant City Attorney RECOMMENDED FOR APPROVAL: O ALii,N'fIN Chief oorPolice CITY OF SANTA ANA Kristine Ri go City Manager Eric Gruver, Ph.D. Page 9 of 9 EXMBPf A SCOPE OF SERVICES - Exf�Ir3Tr z J SCOPE OF SERVICES, I. SCOPE OF SERVICES The City of Santa Ana is seeking a professional and experienced company to pre -employment psychological evaluation services, peer support training, and crisis counseling. Specific responsibilities Include, but are not limited to: A. Complete Pre -Employment Psychological Evaluations Perform a complete pre -employment psychological evaluation for the City's Police Department applicants. Said psychologicai evaluation shall comply with the California Peace Officer's Standards and Training (POST) Psychological Screening Manual, as well as any additional psychological suitability criteria specified by the City's Police Department. A complete pre -employment psychological evaluation includes, but Is not limited to a clinical interview, administration of necessary tests, scoring of tests and preparing verbal and written recommendation for employment, Consultant shall: Provide the City's Police Department a list of available appointment times for psychological evaluations; the appointment times must be provided 24 hours prior to pre -scheduled Commander oral interviews, The psychological evaluations shall be administered within seven business days of the Commander oral Interviews. 2. Provide the City's Police Department with verbal recommendation of the candidate's psychological suitability for the classifications of Police Officer as well as other classifications within the Police Department within two (2) working days of said candidate's clinical interview. 3. Provide the City's Police Department with a written report of the candidate's psychological suitability for the classification of Police Officer as well as other classifications within the Police Department within five (5) working days of the candidate's clinical interview. This report must be received by the PD within five working days via US Mail, or may be sent in a pdf document via a -mall. 4, Complete the necessary Police Officer Standards and Training (POST) Continuing Professional Education (CPE) required for psychologists conducting pre -employment peace officer evaluations. The initial CPE requirement of six hours must be completed by May 6, 2019. Evaluators will need to complete 12 hours of POST -approved CPE every two years. The CPE Tracking System will calculate the required hours based on the effective date of this requirement (September 1, 2014) and the date the psychologist RFP No, 22-081 Psychological Evaluation and Counseling Services Page 18 of 36 CITE( OF SANTA ANA began conducting peace officer evaluations, B. Complete Post -Traumatic Psychological Incident Evaluation Provide City's Police Department employees involved in violent Incidents, such as a life - threatening and/or serious injury or death to any person, complete post -traumatic psychological evaluation. A complete post -traumatic psychological incident evaluation includes, but is not limited to, clinical interview and past -traumatic counseling. Consultant shall provide; 1. Initial psychological service contact with Involved officer(s) shall be made immediately if possible, but no later than forty-eight (48) hours following the Incident. 2. A minimum of three (3) follow-up counseling sessions shall follow, If the Consultant deems those sessions necessary. Such follow-up sessions shall, whenever possible and practical, be scheduled by Consultant at Consultant's office location, unless otherwise agreed by involved officer(s). 3. one (1) follow-up session within a period of not less than fourteen (14) days and not more than thirty (30) days following the traumatic incident with the involved officer(s) to assess whether additional sessions shall be deemed necessary. Following such sessions, provide City's Police Department with verbal recommendation as to the necessity of additional sessions and an assessment of officers) recommended duty status within forty-eight (48) hours. A written psychological assessment of the officer(s) evaluated shall be submitted within five (5) calendar days to the City's Police Department upon completion of such follow-up counseling session(s). 4. A verbal recommendation to the City's Police Department for return of said officer(s) involved In traumatic Incidents to full or modified duty status as soon as possible and in no case later than forty-eight (48) hours following the Incident. 5. A written psychological assessment to the City's Police Department of officer(s) in question and a recommendation as to their suitability to return to active duty, full or modified, and need for follow-up treatment within five (5) days following the post- traumatic counseling session. 8. At the direction and with consent of City's Police Department, similar post -traumatic incident counseling services may be requested for Immediate family members of involved officer(s) adversely impacted by the Incident. The goal of such services shall be to stabilize external factors which might otherwise affect officer(s) return to duty or recovery and to determine if referral to other privateLservlce providers is warranted. Verbal consultation with City's Police Department is recommended but no written reports of family member counseling sessions are required unless otherwise indicated or where the fitness for duty of the officer(s) comes Into doubt. RFP No. 22-061 Psychological Evaluation and Counseling Services Page 19 of 36 0 CITY OF SANTA ANA C. Review of Fitness for Duty Review background investigations, clinical interviews, administrative reports and/or other relevant documents to determine an employee's psychological fitness for duty, when so directed by the City. Fitness for duty review includes, but is not limited to, clinical interviews, administration of necessary tests, scoring of tests, and preparation of verbal and written recommendations for employment. Consultant shall: 1, Outline all psychological concerns resulting from that review and submit to City's Police Department a recommendation concerning further testing and or evaluation which may be deemed appropriate. 2. Provide City's Police Department with verbal notification as to the above within forty- eight (48) hours, and with a complete written report concerning reviews of fitness for duty within ten (10) working days following receipt of documents or the last clinical interview of employee(s) in question. Note: The City may elect to enter Into two agreements to allow for a separate psychologist to conduct fitness for duties. D. Crisis Intervention Counseling Conduct crisis intervention counseling with authorization and approval of City's Police Department when a Department employees) is believed to be suffering from a psychological disorder or emotional disturbance and unable to perform any or all of the full range of duties of an employee's classification. Consultant shall: 1. Obtain authorization from City's Chief of Police or designate prior to conducting crisis Intervention counseling of City's Police Department employee(s). Should intervention be requested by employee and not Department, consultant agrees to obtain authorization from City's Chief of Police or designate prior to conducting crisis intervention counseling. E. Crisis Incident Stress Management The work of law enforcement professionals exposes them to significant Incidents that can have a lasting effect on their mental health and well-being. The Santa Ana Police Department recognizes the importance of routine and pest-inoldent debriefings to assist employees In processing events in a healthy and productive manner while minimizing the risk of post Incident stress that can lead to physical and psychological disorders. Therefore, at the request of the Chief of Police or his/her designee, the consultant shall: 1. Conduct routine group debriefings with units that are regularly exposed to high levels of RFP No. 22-081 Psychological Evaluation and Counseling Services Page 20 of 36 =r CITY OF ANTA ANA stress (i.e. child abuse investigators, crime scene Investigators, and dispatchers) to ensure the group's ongoing well-being. Hold a post -critical incident meeting ahead of a formal debriefing to discuss normal reactions to stress and healthy methods to process stress. When necessary, such meetings shall be conducted prior to the affected employee's end of watch. 3. Facilitate post -incident group debriefings with affected employees following a critical Incident, Such debriefings should ideally be held within 24-72 hours of the incident but, given the need to coordinate varying work schedules, shall be conducted as close in time to the incident as practical. F. Consultation Services On -call status is required to respond to criminal incidents such as SWAT call -outs or major investigations as requested. Consultant shall: 1, Consult with the Department's management regarding psychological profiles and recommended approach to addressing specific suspects, 2. Assist in interpreting Intelligence data in reference to criminal Incidents and/or suspect. G. Psychological Training Services Provide City's Police Department employees with relevant psychological training to assist in the providing organizational wellness services. Consultant shall; 1, Provide training to members of Police Department including, but not limited to, peer support services, crisis Intervention stress management, and suicide intervention/prevention training. RFP No, 22-081 Psychological Evaluation and Counsefing Servlces Page 21 of 36 EXIHBIT B COMPENSATION (RATES) N Exhibit B - Costs VL Cost Proposal Total Cost Not to Exceed $96,000 over a 3-year period Service _ Pricing T A. Preemployment psychological evaluations $450 per applicant S. Complete Post -Traumatic Psyoholagic'al Incident Evaluation $175 pper hour C. Review of Fitness for Duty $175 per hour 5, Crisis intervention Counseling-- $175 per hour E, Critical Incident Stress Management � $175 per hour F. Consultation Services 175 per Hour U, Psychological Training Services � $175 per hour H. Testimony In court and court preparation $250 per hour^ d ACiORV PATr:(MM/qD/YYYY) CERTIFICATE OF LIABILITY INSURANCE _ os�oe�2)20 THIS CFAY101CATF IS ISSUED AS A MATTER OP INFORMATION ON LYAND CONFEks No RIGHTS U pON TOE CklfTIFICATE HOLDER.THIS CERTIFICATE DOES N&(AFFIRMATIVELY OR NEGATIVELY AMEND,EKTENDOR ALTERTHE COVRRAGRAFFORDED BYTHE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUkrsk(s) AUTHORIZED REPRESENTATIVE OR PRODUCVR,ANDTHE CERTIFICATE HOLDER. IMPORTANT:III the cardRoots holder In en AbbIYIONALINSURED,the pOIICV(lee)must hevs AODTTIONAL INSUREb prov(slons or boendor"d.If SUBROGATION IS WAIVED,subJact to the terms and condition of the policy,certain pollelos may requireanandaMMant.Astatementonthlscardficata does not confer rights to thecerti leato holdarin Reu ofsuchondomornent(s). PRObUCER ^T CONTACT NAME: PHIL DONG Phli Dong(9720660) PHONE pA1i 16626 arookhurst St (A/C,No,I! r):714-5B7-6777 V►/c,No):088-866-9567 F-MAIL Westminster CA 92683-7673 ADDRIES5; commerolal9phlldong9genoy.com INSURER($)AFFORDING COVERAGE k"C R INSURED INSURERA: Trucklnsuranae Exchange 21709 1NSURERO: Farmers Insurance Exchange 21662 GFTUVER,ER1C INsuRERC: Mid Century insurance Company 21131217 2021 E 4TM ST INSURERM �. STE 116 — SANTA ANA CA 92706 INSUR M IN5UkERER A F: COVERAGES - CfrtTIFICATE NUMBER, — REVISION NUMBERS THIS ISTOCERTIFVYHATTHEP041CIESOF INSURANCE LISTED BELOW HAVE BeEN15SUEOTOTHE INSURED NAMEABOVEFORTHEPOLICY PERIOD INDICATII0,NOIWITHSTANDINGANY - REQUIREMENT,YERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE I$$UEp OR MAY PERTAIN,THE INSU RANCEAFFORDEO BYTHE POLICIES DESCRI130D HEREIN IS SUBJECT TO ALLTH E TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDTL SUER POLICY Err POLICYEXP �- LTR TYPEOFINSURANCE INSR vivoPOLICYNUMBER (MM/DD/YYYV) (MM/DO/VYVY) LIMITS COMMERCIAL GENERAL LIABILITY �- EACHOCCURRENCE $ 1000000 7 CLAIMS•MMA 11�I OCCUR DAMAG$70 RENTED $PREMISES(EaOccurrence) 75,000 MEDSXP(Any one potion) $ 5000 A Y Y 016044007 00/2512025 06/2612026 PERSONAL&ADV INJURY S 1,000,000 GEN'LAGGREOATELIMITAPPLIGSPER: GENERAL AGGREGATE $ 2000000 POLICY L] PROJECT LOC PRODUCTS-COMP/OPA00 3 1 )00,000 OTHER; $ AUTOMOBILE LIABILITY �•_--� COMBINCIPSINGLELIMIT $ (Eauddent) ANYAUTO _BODILY INJURY(Porparson) S OWN EDAUTOS SCHEDULED ONLY AUTOS BODILY INJURY(Per eccldant)$ p HiRED AUTO$ NON-OWNED PROPERTY DAMAGE $ µ ONLY AUTOSONLY (Peroccldent) $ UMBRELLAUAII HCLAIMS-MADE OCCUR 6ACHOCCURRENCE $ EXCBSSLIA9 AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTHER $ AND EMPLOYERS'LIABILITY STATUTE ANY PROPRIETOR/PARTNER/ Y/N E.L.EACH ACCIDENT $ EXECUTIVE OFFICER/MEMBER N/A �--� EXCLUDED?(Mandatory In NH) E,L,DI$tA5F.FA EMPLOYEE 1103,descrlbo under DESCRIPTION OF OPERATIONSbelow E1,0ISEASE-POLICYLIMIT $ Tt t Iran Digi ally signed by By Tu Tiara Nguyen at 9:rC a „Seta 10,2025 Tu T an Nguyen --------------------------------------------- Dat :2025.09.10 DESCRIPTION OFoPERATIONS/LOCATIONS/VEHICLES(ACORD 101,AddltlQnal RemarkaSchedule,maybe attached If more space Is ragUlred) LOCATION,2021 E FOURTH STE 110,SANTAANA,CA 92705 ADDITIONAL INSURED:CITY OF SANTA ANA,ITS CITY COUNCIL,OFFICERS,OFFICALS,EMPLOYEES,AGENTS,AND VOLUNTEERS CERTIFICATE HOLIER CANCELLATION w- CITY OF SANTA ANA SHOULD ANY OPINE ABOVE DESCRIBED POLICIES BE CANCELLED 0EFORETHEEXPIRATION ATTN;SANTA ANA POLICE DEPARTMENT DATE Y14CAROR NOTICE WILL BE 131:LIVERBDINA000RDANCE WITH THE POLICY PROVISIONS, 60 CIVIC CENTER PLAZA,M-18 AUTHORIZED REPRESENTATIVE SANTA ANA CA 92701 ACORD'25(2016/03) 01988 2015 ACORD CORPORATION.All Rights Reserved 31-1769 11.15 TheACORD name and logo are registered marks afACORD 0 /Z d LED4# VO0LT7996PGZ ZIG11f]Lr� "zQ 6E 1 L 9Z0z'G0 LO THIS ENIDOItSIEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, POLICYNUMBER; 015044007 j7238 1 st Edition FARMS RS INSURANCE ADDITIONAL INSURED— DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: SUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COVERAGE FORM APARTMENTOWNERS LIABILITY COVERAGE FORM CONDOMINIUM LIABILITY COVERAGE FORM SCHEDULE Name of Additional Insured Person(s)Or Organiza4ion(s): ;1fis CiTY OUNCIL, TS; EMP'L':0Y ES, VOLUNTEE♦ZS Information required to complete this Schedule,if not shown above,will be shown In the Declarations, A. The following is added to Paragraph C,Who is An insured of the applicable Coverage Form: Any person(s) or organization(s) shown in the Schedule is also an additional insured, but only with respect to liability for"bodily injury", "property damage"or"personal and advertising injury" caused,In whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf In the performance of your ongoing operations or in connection wlthyour premises owned byorrented to you. However: a. The Insurance afforded to such additional insured only applies to the extent permitted by law;and b. if coverage provided to the additional Insured Is required by a contractor agreement,the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide forsuch additional insured. 0. With respect to the insurance afforded to these additional Insureds, the following is added to Paragraph D. Liability And Medical EKpanses Limits Of Insurance of the applicable Coverage Form: If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf of the additional insured Is the amount of insurance: 1. Required by the contractor agreement;or 2. Available under the applicable Limits Of Insurance shown in the Declarations; whichever Is less, This endorsement shall notincrease the applicable Limits Of Insurance shown in the Declarations. This endorsement Is part of your policy, It supersedes and controls anything to the contrary. It is otherwise subject to all the terms of the policy. 7238-ED102-19 Includes with Its permission, PageIof1 1 937238 17238101 E /8 d LE64# 600L6986T76T Ui311MD 'aa PERT 520E-60-Lo