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HomeMy WebLinkAboutPLACEWORKS, INC. (8)INSURANCE NOT ON FILE MAYOR WORK MAY NOT PROCE�- Valerie Amezcua CITY CLERK MAYOR PRO TEM DATE: Jessie Lopez COUNCILMEMBERS Phil Bacerra Johnathan Ryan Hernandez David Penaloza Thai Viet Phan Benjamin Vazquez (:r.VilIto wtal)F-fi— :V July 24, 2023 C1.r PlaceWorks, Inc. Attn: Contracts Manager 3 Mac Arthur Place, Suite 1100 Santa Ana, CA 92707 I All" 1101ST.11 i lk WIT.Irk".1 Planning and Building Agency 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 wWW.santa-ana.orB A-2020-241-33A CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CITY CLERK Jennifer L. Hall Re: Extension of Agreement (A-2020-241-33) for on -call environment and planning services related to CEOA and NEPA Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by PlaceWorks, Inc. ("Contractor") and the City of Santa Ana, dated December 1, 2020, the time period of the Agreement is hereby extended for an additional one (1) year until November 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 John Funk Chief Assistant City Attorney Valerie Amezwa Jessie Lopez Thai Viet Phan Mayor Mayor Pm Tom, Ward! 3 Ward 1 va .. R',ra.m.pre lohan@santaana om ATTEST Jennifer L. Alal Ci PLACEWORKS, INC. Keith McCann CEO/CFO SANTA ANA CITY COUNCIL Benjamin Vazquez Phil Become Johiminin Ryan Hamandez Bavitl Pone.. War,12 Ward Ward! 5 Ward b a - pb i,smatclime rvanhemardspiasanlaana.ora doenaloza0sanlz-sra or 8 DATE (MM/DDIYYYY) '"RO CERTIFICATE OF LIABILITY INSURANCE 07/01/2024 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 Marsh Risk & Insurance Services NAME: PHONE FAX 17901 Von Karman Avenue, Suite 1100(A/C, No Ext : A/C, No): (949) 399-5800; License #0437153 E-MAIL Irvine, CA 92614 ADDRESS: Attn: NewportBeach.CertRequest@marsh.com/F: 212-948-4323 INSURER(S) AFFORDING COVERAGE NAIC # CN115158923-01-01-24-25 INSURERA: 'rumMt i t n e • 20 INSURED :rsNeOIe a U m ca 74 PlaceWorks, Inc 3 MacArthur Place, Suite 1100 INSURER C Santa Ana, CA 92707 I INSURER D : • INSURER E L) Y 1-% Acevedo- CnVFRAnFR CFRTIFICATF NIIMRFR- — I n.¢_nr> _ t _ RFVMIAW'1411MAFRr%i r7 `% 0% THIS IS TO CERTIFY THAT THE ICIES�.QLIINS AN E LI ED LOW E B r ISSUED ^ y7 Q P4 RIOD INDICATED. NOTWITHSTANDIN A Y Vuulml F Civ i RACT OR O ,, :-o DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED ERT E R OR D T POLICIES EXCLUSIONS AND CONDITION OF S C MIT HO Y t UCED S1P&11 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, �L • 07100 INSR LTR OF INSURANCE ADDL�SUBRTYPE INSD WVn POLICY NUMBEF MM DDIYYPOLICYFF 07/01/2024 P /� 07/01/2025 • AM ITS EACH OCCURRENCE $ 5,000,000 A X COMMERCIAL GENERAL LIABILITY X X EPK148300 CLAIMS -MADE X� OCCUR DAMAGE TO FIR SES Ea occurrDe... $ 100,000 X MED EXP (Any one person) $ 10,000 BI & PD Ded. $5,000 PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 ❑ JECT PRO ❑ LOC NPOLICY PRODUCTS - COMP/OPAGG $ 5,000,000 Contractors Pollution $ 5,000,000 OTHER: B AUTOMOBILE LIABILITY X X BA-1N96406A-24-43-G 07/01/2024 07/01/2025 COMBINED Ea accidentent)S LE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Comp/Coll Deductibles $ 1,000 B UMBRELLALIAB X OCCUR EX-6J328756-24-43 07/01/2024 07/01/2025 EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) N / A UB-7K728676-24-43-G 07/01/2024 07/01/2025 PER OTH- X 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 Errors & Omissions -Claims Made EPK148300 07/01/2024 07/01/2025 Each Claim/Aggregate 5,000,000 Retro Dates: See 2nd Page DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Operations performed by the named insured for the certificate holder City of Santa Ana, its officers, agents, employees, and volunteers are included as additional insured where required by written contract with respect to General and Auto Liability. This insurance is primary and non- contributory over any existing insurance and limited to liability arising out of the operations of the named i nsured and where required by written contract with respect to General Liability. Waiver of subrogation is applicable where required by written contract with respect to General and Auto Liability. CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Division THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza, 4th Floor ACCORDANCE WITH THE POLICY PRC Santa Ana, CA 92701 Risk MougmumtDiviaian AUTHORIZED REPRESENTATIVE z REVIEWED & APPROVED BY: i ��/�r"�``� 'GGt�i¢K Risk Management Specialist @ 1988-2016 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Policy Number: BA-1N96406A-24-43-G Effective Date: 07/01/2024 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect Burin the olic eriod to be named as an addi- H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and g p y p 1 (2) Any covered tional insured is an "insured" for Covered Autos your "emplo RAMougementDiviaian LiabilityCoverage, but only for dama es to which" - "`e g y g an "employ REMEWED & APPROVED BY. ®� A Aawa: CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. �f Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc. with its permission Policy Number: BA-1N96406A-24-43-G Effective Date: 07/01/2024 COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States. its ter - partners (if you are a partnership), members ritories and poss (if you are a limited liability company) or Canada. RAMeagementDrnawn members of their households. I aaEvleo&APPROVED BY. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. �r Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc. with its permission Policy Number: BA-1N96406A-24-43-G Effective Date: 07/01/2024 COMMERCIAL AUTO You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.S., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered "auto" of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS : The following is added to Paragraph AA., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap- signed and execute parel and other personal property which is: or "loss", provided th RAMwugementDiviaian (1) Owned by an "insured"; and arises out of oper = REVIEWED&APPROVED BY. CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Risk Management Specialist Includes copyrighted material of Insurance Services Office, Inc. with its permission Policy Number: BA-1N96406A-24-43-G Effective Date: 07/01/2024 COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. oR,N F Risk ManagementDMslcrn REVIEWED & APPROVED BY. o, z f Ag,�z Acev44 Page 4 of 4 © 2015 The Travelers Indemnity Compa ny. All rights reserved . — rusk Management specialist Includes copyrighted material of Insurance Services Office, Inc. with its permission Policy Number: EPK148300 Term: 07/01 /2024-07/01 /2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED WITH WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organization(s) Blanket when specifically required in a written contract with the named insured. A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but solely with respect to "claims" caused in whole or in part, by "your work" for that person or organization performed by you, or by those acting on your behalf. This insurance shall be primary and non-contributory, but only in the event of a named insured's sole negligence. B. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for "damages" arising out of "your work" performed under a designated project or contract with that person(s) or organization(s). C. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies. EN0118-0211 ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. "_—," Risk ManagementDMslcrn A REVIEWED & APPROVED BY. tQ� tQceva�c; ter— Risk Management Specialist Page 1 of 1 WORXERS C0011131SATION TRAVELERS] - AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC"63 76 ( A) - ooi POLICY UB-7K72867624-43-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORN (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 2. 00 mium . Schedule Person orOrganlzatlon ANY PERSON OR ORGANJ. ZATIO FOR WHICH THE 1NBQRED RAS AGREED BY WRITTEN CONTRACT EBECU1111ro PRIOR TO LOSS TO FURNJ:SH TRIS i0►IVER . % of the California workers' compensation pre - Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the pollcy.) Endorsement Effective Insured Insurance Company Policy No. DATE OF ISSUE:07/01/2024 ST ASSIGN: Endorsement No. Premium RAMougementDMsian % REVIEWED & APPROVED BY: R tlfaN44 — Risk Management Specialist