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HomeMy WebLinkAboutORANGE COUNTY EMERGENCY PET CLINIC (2)©; tP6A(t�yqvte; N-2022-375-01 MAYOR Valerie Amezcua MAYOR PRO TEM Jessie Lopez COUNCILMEMBERS Phil Bacerra Johnathan Ryan Hernandez David Penaloza Thai Viet Phan Benjamin Vazquez INSURANCE NOT ON FILE WORK MAY NOT PROCEED CITY CLERK DATE: JUL 2 June 19, 2023 CITY OF SANTA ANA PLANNING AND BUILDING AGENCY 20 Civic Center Plaza • P.O. Box 1988 6 Z023 Santa Ana, California 92702 vJrvw.santa-ana.ora Orange County Emergency Pet Clinic Attn: Elaine Myers 12750 Garden Grove Blvd. Garden Grove, CA 92843 Re: Extension of Agreement (N-2022-375) for emergency veterinary services CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CITY CLERK Jennifer L. Hall Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by Orange County Emergency Pet Clinic ("Contractor") and the City of Santa Ana, dated November 27, 2022, the term of the Agreement is hereby extended for an additional one (1) year period until June 30, 2024. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, Minh Thai Executive Director, Planning & Building Agency CITY OF SANTA ANA Kristine Ridge City Manager APPROVED AS TO FORM ih don Salvatierra Deputy City Attorney Vetere Amezcua Jessie Lopez Thai Viet Phan Mayor Mayor Pm Tom, Ward 3 Ward YpmezcuaOsan iesaieloPena... ls-ana ors IohanrAsanls-ana om ATTEST Clerk Orange County Emerg y Pet Clinic , sine Myers President SANTA ANA CITY COUNCIL Benjamin Vazquez Phil Bacena JohnaMan Ryan Hernandez David Penaloza Ward Ward Ward! 5 W.d6 b I- ob,ra1sQsanaanaom areemanderssanla-anoem dpenalo.asan RC390118 AC40R,br CERTIFICATE OF LIABILITY INSURANCE DAT612712023YY) 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 NAME CONCT Safehold Special Risk, Inc. (916) 589-8000 PHONE FAX In Callfornla,Safehold Special Risk & Insurance Services,lnc. #OG13561 UA& No Exti AIC No: 10940 White Rock Road, 2nd Floor ADDRESS: INSURERS) AFFORDING COVERAGE NAIC# Rancho Cordova, CA 95670-6076 INSURERA: Everest National Insurance Company 10120 INSURED INSURER B: Orange County Emergency Pat Clinic, Inc INSURER C: 12750 Garden Grove Blvd. INSURER D: INSURER E: Garden Grove CA 92643 INSURER F: 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 ADDLSUM! INSD WID POLICY NUMBER POLICY EFF MMICDIYYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR X —SH00000688-231 07/01/2023 07/01/2024 EACH pCCURRENCE $ 1,000,000 DAMAGE TO ftE D PREMISES Eaoccurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL It ADV INJURY !$ 1,000,000 AGGREGATE LIMITAPPLIES PER PRO - POLICY E JECT LOC GENERAL AGGREGATE ,$ 2,000,000 GEN'L PRODUCTS-COMPIOPAGG$ 2,000,000 S Gl"HER: A AUTOMOBILE LIABILITY SH00000685-231 07/01/2023 07/01/2024 COMBINED SINGLE LIMIT I$ 1,000,000 % ANYAUTO BODILY INJURY (Par person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peracc,14 $ A UMBRELLALIAB X OCCUR SH00000689-231 07/01/2023 07/01/2024 EACH OCCURRENCE $ 3,000.000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 3,000,000 DED I X I RETENTION$ 10,000 $ A TION AND EMPLKERSOYERS' AND EMPLOYERS' LIABILITY YERS'LIAILIT YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICEWMEMaEREXCLUDED? ❑ N/A SH00000686-231 07/01/2023 07/01/2024 X STATUTE EERH E.L. EACH ACCIDENT I$ 1,000,000 E.L. DISEASE - EA EMPLOVEEI$ 1,000,000 (Mandatory In NH) tryes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT$ 1,000,000 A Professional Liability SHPLOO1565-231 07/01l2023 07/01/2024 $1,000,DDD Ea oh Occurrence - $3,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 10t Additional Remarks Schedule, may be attached if mere space Is required) ECG 20 590 05 09,WC 04 03 06,CG 00 01 04 13,ECG 04 767 02 16 The City of Santa Ana, its officers, employees, agents, and representatives are named as Additional Insured with respect to General Liability per the attached endorsement. Primary Wording included and attached. Waiver of Subrogation for General Liability and Workers Compensation attached. City Of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza (M-30) - _ ACCORDANCE WITH THE POLICY PROVISIONS. - Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD (D1988.2015 ACORD CORPORATION. All rights reserved. AGUKL1 LO (LU'I UIU3) POLICY NUMBER: COMMERCIAL GENERAL LIABILITY . ECG 20 590 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) 1. Any person or organization for whom you are per- forming operations when you and such person or or- ganization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy but only when such contract or agreement requires an additional insured form other than CG 20 26 04 13; and 2. Any other person or organization you are required to add as an additional insured under the written contract or written agreement described in Paragraph 1. above. Any location for which the Named Insured's work was performed for such person(s) or organization(s). the Declarations. A. Section II — Who Is An Insured is amended to 2. The Limits of Insurance provided by this Cov- include as an additional insured the person(s) or erage Part. organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising Injury" but only to the extent caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for an additional insured(s) at the location(s) desig- nated above. B. The insurance afforded to an additional insured shall only include the insurance required by the terms of the written agreement and shall not be broader than the coverage provided within the terms of the Coverage Part. C. The Limits of Insurance afforded to anadditional insured shall be the lesser of the following: 1. The Limits of Insurance required by the written agreement between the parties; or ECG 20 590 05 09 Copyright, Everest Reinsurance Company 2009 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. INSURED COPY A WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR WHOM ALL OPERATIONS THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER. .1998 by the Workers' Compensation Insurance Raring Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual - 1999. I.F3eaaaeawv 4. Otherinsurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (III) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; or (iv) 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 Injury And Property Damage Liability (b) Any other primary insurance available to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured. (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. (4) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown In the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each 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. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; Page 12 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413 d. After you cease to own a financial interest of more than 50%. E. Fire Damage To Premises Rented To You — Increased Limits Paragraph 6. under Section HI — Limits of Insur- ance is replaced by the following: 6. Subject to Paragraph 5. above, the most we will pay under Coverage A for damages be- cause of "property damage" to any one prem- ises while rented to you or temporarily occu- pied by you with permission of the owner is the greater of: a. $500,000; or b. The Damage To Premises Rented To You Limit shown in the Declarations. F.Notice To Company The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV — Commercial General Li- ability Conditions: G. Unintentional Failure To Disclose Hazards Condition 6. Representations under Section IV — Commercial General Liability Conditions is re- placed by the following: e. Your failure to first notify us of a claim will not invalidate coverage under this policy if the loss H. was inadvertently reported to another insurer. However, you must report any such "occur- rence" to us within a reasonable time once you become aware of such error. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon repoe. sentations you made to us; and c. We have issued this policy in reliance upon your representations. Any unintentional error or omission in the de- scription of, or failure to completely describe, any premises or operations you intend to be covered by this Coverage Part, will not invali- date or affect coverage for those premises or operations. However, you must report any such error or omission tousas soon as reasonably possible after its discovery. Waiver Of Subrogation The following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Commercial General Liability Conditions: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your operations or "your work' done under a written agreement that requires you to waive your rights of recovery. The written agreement must be made prior to the date of the "occurrence'. Page 2 of 2 Copyright, Everest Reinsurance Company, 2016 ECG 04 767 02 16 p Includes copyrighted material of Insurance Services Office, Inc. used with its permission