Loading...
HomeMy WebLinkAboutMEKONG PRINTING, INC.INSURANCE NOT ON FILE WORK MAY NOT PROCEEJ023 A-2023-087 CITY CLERGY 3 0 DATE, �1�'SYi' c a� SECOND AMENDMENT TO AGREEMENT WITH MK PRINTING Vi('rSGhlo) CF TO PROVIDE OFFSET PRINTING SERVICES THIS SECOND AMENDMENT to the above -referenced agreement is entered into on May 16, 2023, by and between Mekong Printing dba MK Printing, Inc. ("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"). QNMII:�IG� A. On June 4; 2019, the City and the Consultant entered into Agreement #A-2019-083 ("Agreement), to provide printing and packaging services for the City. The term of the Agreement was set for a three (3) year period with an option to extend the term for two (2), one (1) year renewals. B. The parties entered into a First Amendment to the Agreement (#A-2020-172) on August 18, 2020, to increase the overall compensation to the Agreement. C. The parties opted to extend the Agreement for an additional one-year term on June 22, 2022 (#A-2019-083-01). Accordingly, the Agreement now runs through June 3, 2023, with one remaining option to extend the tern by one-year. The Agreement is current and in effect. D. The parties wish to further amend the Agreement to increase the overall compensation to cover expenses for unforeseen large volume printing services incurred during the first extension of the Agreement. E. The parties further wish exercise the second and final option to extend the term of the Agreement, as well as to add an additional 26 days to the second and final extension of the Agreement to run through June 30, 2024. The Parties therefore agree: Section 2.a., Compensation, is amended to increase the annual amount established for the first extension period to the Agreement (#A-2019-083-01) by an additional $30,000 to compensate Consultant for unanticipated large volume printing services performed during the first extension period and is further amended to increase the annual amount established for the second extension period to the Agreement by an additional $30,000. The total amount to be expended during the term of this Agreement shall not exceed $675,000. 2. Section 3, Term, is hereby extended for the optional one-year period and is further extended by an additional 26 days through June 30, 2024. The parties understand this is the second and final extension allowed pursuant to Section 3 of the Agreement and that the annual amount of compensation for this second and final one-year period has now been increased by $30,000, pursuant to the above amendment regarding Section 2.a. of the Agreement. A-2023-087 3. Except as modified by this Second Amendment, all terms and conditions of the Agreement, as amended, shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to the Agreement on the date and year first written above. ATTEST Jennifer. . al City Clerk APPROVED AS TO FORM SONIA R. CARVALHO, City Attorney By: `` J than T. Martinez Assistant City Attorney RECOMMENDED FOR APPROVAL • �w.r Xalvyn oemnxlMaP.xovruae Forl Kathryn Downs, CPA Executive Director Finance and Management Services Agency CITY OF SANTA ANA �i� Kristine Ridge City Manager MK PRINTING, INC. Suzanne Ste ens-Truong VP, Sales & Marketing Herschleb, Dan From: City of Santa Ana <certificate-request@ctraxjdidata.com> Sent: Wednesday, May 31, 2023 1:50 PM To: Herschleb, Dan; csr@mkprintinginc.com; ruth@piascins.com Subject: Internal Notice of Compliance NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Mekong Printing, Inc. Name: Project TBD (073) Number: Project Second Amendment To Agreement With MK Printing To Provide Offset Name: Printing 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: TYPE OF INSURANCE POLICY EXPIRATION COI DATE FILE NAME NUMBER DATE Mekong Printing, Inc. AUTOMOBILE LIABILITY AW39147434 05/19/2024 05/31/2023 Certificate of Insurance for The City of Santa Ana.pdf Mekong Printing, Inc. GENERAL LIABILITY ZH3914586511 05/19/2024 05/31/2023 Certificate of Insurance for The City of Santa Ana.pdf Mekong Printing, Inc. WORKERS COMPENSATION AND EIG287806903 07/01/2023 05/31/2023 Certificate of EMPLOYERS' LIABILITY Insurance for The City of Santa Ana.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 5/31 /2023 4:49 PM NOTICE OF COMPLIANCE MY w M U U U U U°°IHS PAGE AND MLUDE GNU U FII AGREEMEM M UFIE CLERK OF U U IIIC COMM Contractor Mekong Printing, Inc. Name: Project A-2023-087 Number: Project Second Amendment To Agreement With MK Printing To Name: Provide Offset Printing 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: TYPE OF INSURANCE POLICY EXPIRATION COI DATE FILE NAME NUMBER DATE Mekong Printing, Inc. AUTOMOBILE LIABILITY AW39147434 05/19/2024 05/31/2023 Certificate of Insurance for The City of Santa Ana.pdf Mekong Printing, Inc. GENERAL LIABILITY ZH3914586511 05/19/2024 05/31/2023 Certificate of Insurance for The City of Santa Ana.pdf Mekong Printing, Inc. WORKERS COMPENSATION AND EIG287806903 07/01/2024 05/31/2023 Certificate of Insurance EMPLOYERS' LIABILITY for The City of Santa Ana.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 6/19/2023 5:15 PM MEKOPRI-01 ./"'"PC " CERTIFICATE OF LIABILITY INSURANCE DATE(M/202YYY) 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 PIASC Insurance Se �ces, Inc. 5800 S. Eastern AV Suite 400 n a I e Los Angeles, CA INSURED Mekon Printing, Inc. Hoan T ng 2421 stcte v e o Sant C 9270 22292 Financial Benefit 41840 re e I 10346 C(1VFRA(,FC CERTIFICATE P'/IRP <FR• RFVICInKl NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSUP..,NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X ZH3914586513 5/19/2024 5/19/2025 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ X MED EXP (Any oneperson) $ 10,000 GL BROADEN ENDT PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PELT LOC PRODUCTS - COMP/OPAGG $ Included Emp. Ben. $ 1,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ X BODILY INJURY Perperson) $ ANY AUTO AW3914743413 5/19/2024 5/19/2025 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X PROPERTY DAMAGE ccident Per accident) $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS -MADE UH3909155012 5/19/2024 5/19/2025 AGGREGATE $ 1,000,000 DED X RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A EIG287806904 7/1/2023 7/1/2024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE- EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ A Printers E&O ZH3914586513 5/19/2024 5/19/2025 Ded: $1000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, it's officers, employees, agents and representative are named as Additional Insured in regards to General Liability per COMMERCIAL GENERAL LIABILITY SPECIAL BROADENING & ENHANCEMENT ENDORSEMENTS, with respects to services provided and/or performed by the Named Insured as required by written contract, per the attached endorsement. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREO The City of Santa Ana ACCORDANCE WITH THE POLICY PRC RiskMougmumtDMslcrn Attn: Risk Management Division E 20 Civic Center Plaza f REVIEWED & APPROVED BY. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE °% •'j•�;`� .." Aa vN /. /Cw Risk Management Specialist ACORD 25 (2016/03) J © 1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: MEKOPRI-01 LOC #: 1 AANAYA ACOR©" ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED PIASC Insurance Services, Inc. Mekongg Printing, Inc. Hoan Tru POLICY NUMBER 2421 W. Firons} Street EE PAGE 1 Santa Ana, CA 92703 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance APPLICABLE HANOVER COVERAGE FORMS APPLICABLE HANOVER COVERAGE FORMS: COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT 421-2915 06/15: ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT ADDITIONAL INSURED - PRIMARY & NON-CONTRIBUTORY BLANKET WAIVER OF SUBROGATION COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT 421-2916 06/15: ADDITIONAL INSURED - BROAD FORM VENDORS Page 1 of 1 HANOVER PRIMARY & NON CONTRIBUTORY COVERAGE FORM CG 20 01 04 13 HANOVER - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS CG 20 37 04 13 HANOVER PRIMARY AND NON CONTRIBUTORY - OTHER INSURANCE CONDITION CG 20 01 04 13 COMMERCIAL AUTO - BUSINESS AUTO COVERAGE BROADENING ENDORSEMENT 461-0155 (9/97) BLANKET WAIVER OF SUBROGATION oR.N a Risk ManagmumtDMslcrn f ° REVIEWED & APPROVED BY: 1" Risk Management Specialist ACORD 101 (2008/01) © 2008 ACORD The ACORD name and logo are registered marks of ACORD ZH3 9145865 13 1001090 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART C RARAAw rW ftf1V1=RAf:FC 1. Additional Insured by Contract, Agreement or Permit Included 2. Additional Insured — Primary and Non -Contributory Included 3. Blanket Waiver of Subrogation Included 4. Bodily Injury Redefined Included 5. Broad Form Property Damage — Borrowed Equipment, Customers Goods & Use of Elevators Included 6. Knowledge of Occurrence Included 7« Liberalization Clause Included 8. MedicalPayments — Extended Reporting Period Included 9. Newly Acquired or Formed Organizations - Covered until end of policy period ............_. Included ........... 10. Non -owned Watercraft 51 ft. 11. Supplementary Payments Increased Limits _ �....... _ ........ Bail Bonds $2,500 - Loss of Earnings $1000 12. Unintentional Failure to Disclose Hazards Included 13. Unintentional Failure to Notify Included This endorsement amends coverages provided under the Commercial General Liability Coverage Part through new coverages, higher limits and broader coverage grants. 1. Additional Insured by Contract, Agreement or Permit The following is added to SECTION II — WHO IS AN INSURED: Additional Insured by Contract, Agreement or Permit a. Any person or organization with whom you agreed in a written contract, written agreement or permit that such person or organization to (1) "Your work" for the additional insured(s) designated in the contract, agreement or permit; (2) Premises you own, rent, lease or occupy; or (3) Your maintenance, operation or use of equipment leased to you. b. The insurance afforded to such additional insured described above: add an additional insured on your policy Is an (1) Only applies to the extent permitted by additional insured only with respect to liability law; and for "bodily injury", "property damage", or "personal and advertising injury" caused, in (2) Will not be broader than the insurance whole or in part, by your acts or omissions, or which you are required by the contract, the acts or omissions of those acting on your agreement or pe behalf, but only with respect to: additional insurec E RAManagmumtDMsian f ° REVIEWED & APPROVED BY. 421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permissic RiSk Management sped,list ZH3 9145865 13 1001090 (3) Applies on a primary basis if that is advertising injury' involved the rendering required by the written contract, written of or failure to render any professional agreement or permit. services by or for you. (4) Will not. be broader than coverage d. With respect to the insurance afforded to provided to any other insured. these additional insureds, the following is (5) Does not apply if the "bodily injury", added to SECTION III — LIMITS OF "property damage" or "personal and INSURANCE: advertising injury" is otherwise excluded The most we will pay on behalf of the from coverage under this Coverage Part, additional insured for a covered claim is the including any endorsements thereto. lesser of the amount of insurance: c. This provision does not apply: 1. Required by the contract, agreement or (1) Unless the written contract or written permit described in Paragraph a.; or agreement was executed or permit was 2. Available under the applicable Limits of issued prior to the "bodily injury", "property Insurance shown in the Declarations. damage", or "personal injury and This endorsement shall not increase the advertising injury". applicable Limits of Insurance shown in the (2) To any person or organization included as Declarations. an insured by another endorsement 2. Additional Insured — Primary and Non - issued by us and made part of this Contributory Coverage Part. The following is added to SECTION IV — (3) To any lessor of equipment: COMMERCIAL GENERAL LIABILITY (a) After the equipment lease expires; or CONDITIONS, Paragraph 4. Other insurance: (b) If the "bodily injury", "property Additional Insured — Primary and Non - damage", "personal and advertising Contributory injury" arises out of sole negligence of If you agree in a written contract„ written the lessor agreement or permit that the insurance provided to (4) To any: any person or organization included as an (a) Owners or other interests from. whom Additional Insured under SECTION II — WHO IS land has been leased which takes AN INSURED, is primary and non-contributory, place after the lease for the land ex- the following applies: pires; or If other valid and collectible insurance is available (b) Managers or lessors of premises if: to the Additional Insured for a loss covered under Coverages A or B of this Coverage Part, our (i) The occurrence takes place after obligations are limited as follows: you cease to be a tenant in that a. Primary Insurance premises; or (ii) The "bodily injury", "property This insurance is primary to other insurance that is available to the Additional Insured damage", "personal injury" or which covers the "advertising injury" arises out of structural alterations, new con- Additional Insured as a Named Insured. We struction or demolition operations will not seek contribution from any other performed by or on behalf of the insurance available to the Additional Insured manager or lessor. except: (5) To "bodily injury', "property damage" or (1) For the sole negligence of the Additional "personal and advertising injury" arising Insured; out of the rendering of or the failure to (2) When the Additional Insured is an render any professional services. Additional Insured under another primary This exclusion applies even if the claims liability policy; or against any insured allege negligence or (3) when b. below applies. other wrongdoing in the supervision, If this insurance is primary, our obligations are hiring, employment, training or monitoring of others by that insured, if the not affected unless any of the other insurance "occurrence" which caused the bodily is also primary. The injury" or "property damage" or the offense that other insurance E Risk Mougmumt DMslcn which caused the "personal and in c. below. A ReMeWED&APPROVED BY. 421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permissir j` Ri5k Management specialist ZH3 9145865 13 1001090 b. Excess Insurance (1) This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (b) That is Fire insurance for premises rented to the Additional Insured or temporarily occupied by the Additional Insured with permission of the owner; (c) That is insurance purchased by the Additional Insured to cover the Additional Insured's liability as a tenant for "property damage" to premises rented to the Additional Insured or temporarily occupied by the Additional with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I — COVERAGE A — BODILY INURY AND PROPERTY DAMAGE LIABILITY. (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (3) When this insurance is excess over other Insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self insured amounts under all that other insurance. insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers 3. Blanket Waiver of Subrogation The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damage under this coverage form. The damage must arise out of your activities under a written contract with that person or organization. This waiver applies only to the extent that subrogation is waived under a written contract executed prior to the "occurrence" or offense giving rise to such payments. 4. Bodily Injury Redefined SECTION V — DEFINITIONS, Definition 3. "bodily injury" is replaced by the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person including death resulting from any of these at any time. "Bodily injury" includes mental anguish or other mental injury resulting from "bodily injury". 5. Broad Form Property Damage — Borrowed Equipment, Customers Goods, Use of Elevators a. SECTION I — COVERAGES, COVERAGE A — BODILIY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions subparagraph j. is amended as follows: Paragraph (4) does not apply to "property damage" to borrowed equipment while at a jobsite and not being used to perform operations. We will share the remaining loss, if any, Paragraphs (3), (4) and (6) do not apply to with any other insurance that is not "property damage" to "customers goods" while described in this Excess Insurance on your premises nor do they apply to the use provision and was not bought specifically of elevators at premises you own, rent, lease to apply in excess of the Limits of or occupy. Insurance shown in the Declarations of b. The following is added to SECTION V — this Coverage Part. DEFINTIONS: c. Method Of Sharing 24. "Customers goods" means property of If all of the other insurance permits your customer o contribution by equal shares, we will follow this purpose of being: ", RAManagmumtDMsian method also. Under this approach each f °x RemeWED&APPROVED BY. 421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permissic Ri5k Management Specialist ZH3 9145865 13 1001090 a. worked on; or b. used in your manufacturing process c. The insurance afforded under this provision is excess over any other valid and collectible property insurance (including deductible) available to the insured whether primary, excess, contingent 6. Knowledge of Occurrence The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit: e. Notice of an 'occurrence", offense, claim or "suit' will be considered knowledge of the insured if reported to an individual named insured, partner, executive officer or an "employee" designated by you to give us such a notice. 7. Liberalization Clause The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: Liberalization Clause If we adopt any revision that would broaden the coverage under this Coverage Form without additional premium, within 45 days prior to or during the policy period, the broadened coverage will immediately apply to this Coverage Part. 8. Medical Payments — Extended Reporting Period a. SECTION I —COVERAGES, COVERAGE C — MEDICAL PAYMENTS, Paragraph 1. Insuring Agreement, subparagraph a.(3)(b) is replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident; and b. This coverage does not apply if COVERAGE C — MEDICAL PAYMENTS is excluded either by the provisions of the Coverage Part or by endorsement. 9. Newly Acquired Or Formed Organizations SECTION II — WHO IS AN INSURED, Paragraph 3.a. is replaced by the following: a. Coverage under this provision is afforded until the end of the policy period. 10. Non -Owned Watercraft SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions, subparagraph g.(2) is replaced by the following: g. Aircraft, Auto Or Watercraft (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person who, with your consent, either uses or is responsible for the use of a watercraft. 11. Supplementary Payments Increased Limits SECTION I — SUPPLEMENTARY PAYMENTS COVERAGES A AND B, Paragraphs 1.b. and 1.d. are replaced by the following: 1.b.Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 1.d.All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1000 a day because of time off from work. 12. Unintentional Failure to Disclose Hazards The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 6. Representations: We will not disclaim coverage under this Coverage Part if you fail to disclose all hazards existing as of the inception date of the policy provided such failure is not intentional. 13. Unintentional Failure to Notify The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit: Your rights afforded under this policy shall not be prejudiced if you fail to give us notice of an '"occurrence", offense, claim or "suit', solely due to your reasonable and documented belief that the "bodily 'injury" or "property damage" is not covered under this policy. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. oR.N a RA Mougmumt DMslcn f °; REVIEWED & APPROVED BY: � °Aezv 421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permissir j` Risk Management Specialist ZH3 9145865 13 1001090 C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill Limits Of Insurance: 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 contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. "age 2 of 2 @ Insurance Services Office, Inc., 2012 oR,N a RA ManagementDMslcrn °� f ' REVIEWED & APPROVED BY. Aezv 1" Risk Management Specialist MEKOPRI-01 ALORRAINE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(M 6/20/202YYY) 2024 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 NAME: PIASC Insurance Services, Inc. PHONE FAX 5800 S. Eastern Avenue C-N Ellt 32 ) 00-6705 pvc, No): Suite 400 E' I f i Los Angeles, CA 90040 w INSURERISI AFFORDING COVERAGE NAIC it INSURED Mekong Printing, Inc. Hoan Truong 2421 W. First Street Santa Ana, CA 9h03 urance Co MSURER C: EnnDlovers Preferred Ins. Co. 110346 1 IN. 'RER E : THIS IS TO CERTIFY THAT THE POLICIES OF I U21-$TH ABOVE FOR THE POLICY PERIOD OI INSURANCE OYSREQUIREMENTRESPECT I�JRNAFFOR E E�ICERTFICATE MAY ISSUED OR MAYPERTAIN, TFDr N IS SUBJECT ALLTHE TERMS, Y EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. L' AITF SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X ZH3914586513 5/19/2024 5/19/2025 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ X MED EXP (Any oneperson) $ 10,000 GL BROADEN ENDT PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT LOC PRODUCTS - COMP/OPAGG $ Included Emp. Ben. $ 1,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ X ANY AUTO AW3914743413 5/19/2024 5/19/2025 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS -MADE UH3909155012 5/19/2024 5/19/2025 AGGREGATE $ 1,000,000 DED X RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE [Y] OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A EIG287806905 7/1/2024 7/1/2025 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE- EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ A Printers E&O ZH3914586513 5/19/2024 5/19/2025 Ded: $1000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 1D1, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, it's officers, employees, agents and representative are named as Additional Insured in regards to General Liability per COMMERCIAL GENERAL LIABILITY SPECIAL BROADENING & ENHANCEMENT ENDORSEMENTS, with respects to services provided and/or performed by the Named Insured as required by written contract, per the attached endorsement. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCFLLFD RFFnRF The City of Santa Ana THE EXPIRATION DATE THEREO Y ACCORDANCE WITH THE POLICY PR( Risk MeagernentDivisbn Attn: Risk Management Division a " "�F 20 Civic Center Plaza o=' REVIEWED & APPROVED BY. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE °I, fil Aecv44 ( ® Risk Management Specialist ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD