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HomeMy WebLinkAboutWALK 'N ROLLERS (2) A-2O 2, 74-01 MAYOR , ACTING CITY MANAGER Valerie Amezcua / Alvaro Nunez MAYOR PRO TEM CITY ATTORNEY Thai Viet Phan _ �f;a: Sonia R.Carvalho COUNCILMEMBERS CITY CLERK Phil Bacerra Jennifer L.Hall Johnathan Ryan Hernandez Vie~ Jessie Lopez „ David Penaloza '! $ Benjamin Vazquez CITY OF SANTA ANA INSURANCE ON FILE WORK MAY PROCEED PUBLIC WORKS AGENCY UNTIL INSURANCE EXPIRES 20 Civic Center Plaza•P.O.Box 1988 lb I I I202`i Santa Ana,California 92702 CITY CLERK www.santa-ana.orq DATE: JUL 2 5 2024 Pv,"r41.z-? June 4,2024 cGa,ic � A SkDaa> James Shanman,Executive Director Walk n'Rollers 8800 Venice Blvd.,Suite 301 Los Angeles,CA 90034 Re: Extension of Agreement(A-2022-174)to Provide Safe Routes to School Education Program Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by Walk n' Rollers ("Consultant"),and the City of Santa Ana,dated September 6,2022,the time period of the Agreement is hereby extended for an additional one-year period through September 5,2025. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement,as amended,remain unchanged and in full force and effect. Sincerely, 4 -Nabil Saba,PE Executive Director, Public Works Agency CITY OF A ANA/ : ATTEST AtA ' � _ � � varo Nunez =u er . • Acting City Manager City Clerk — --T APPROVED AS TO FORM WALK N'RO• , Kyle Nellesen James Shanman Assistant City Attorney Executive Director SANTA ANA CITY COUNCIL Valerie Mmezaa Thai Viet Phan Benjamin Vazquez Jesab Lopez Phll Bacerra Johnathan Ryan Hernandez DaNtl Peia:oza Mayor Mayor Pro Tern,Weld 1 Ward2 Wad 3 Ward Wards Wards vzrzaalpanta-era.e;g (pianaaanSace.aau d zauo WEa!do,6nasl9 les**4y''l�'rraata-ananro pbace .4T rM1:ma do htaa zgsa .reg danr»myy}mrttaanr.on; ACc RD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 40.------ 9/22/2023 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 DNACONTACT Arthur J. Gallagher Risk Management Services, LLCME: • lec r Ilman - FAX 500 N. Brand Boulevard lE t t 1 : o d (A/C,No): Suite 100 • ADD Ess: Alec Gf'llman©. ..com Glendale CA 91203 Ie ` , S}fRE NAICfi License#:C' ;sbAIjR(S)AFFORDINGCovERAGE I U I ''Insurance Alliance of CA 10023 INSURED WAI 1 '0-01 INSURER B: WalkAl€eve d o 8800 800 Venice Be Blvd Suite 301 Los Angeles CA 900 'NSURER D: eied Q D :2024.07.08 GOVERAGES1141 REVISION NUMBER: THIS IS TO NDICATED.CERTIFY THAT THE NOTTW NOTWITHSTANDING ANYIES OF REQUIREMEN'I,ITF IM OR CONDI STED TIO V AN� /IliER CORE F DQaL1�dENNT WITHR THE RESPECT TOLICY WHICH PERIOD THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, I-IF ,NSURANCE 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYYUMM/DD/YYYY), LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 2023-75250 10/1/2023 10/1/2024 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $20,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 X PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: I $ A AUTOMOBILE LIABILITY 2023-75250 10/1/2023 10/1/2024 CEOs accident)B DSINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS x HIRED x NON-OWNED PROPERTY DAMAGE - AUTOS ONLY AUTOS ONLY (Per accident) $ _ $ A X UMBRELLA LIAB X OCCUR 2023-75250-UMB 10/1/2023 10/1/2024 EACH OCCURRENCE $3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNERIEXECUTI VE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Directors&Officers 2023-75250-DO-NPO 10/1/2023 10/1/2024 Each Wrongful Act $1,000,000 Annual Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Policy:Improper Sexual Conduct Policy Term:10/01/2023 to 10/01/2024 Policy Number:2023-75250 Carrier:Nonprofits Insurance Alliance of California Each Claim:$1,000,000/Aggregate:$2,000,000 RE:A-2022-174 Certificate holder is named additional insured with respect to the operations of the named insured.Waiver of Subrogation on General Liability applies in favor of certificate holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC\ City of Santa Ana o�w,rt;P Risk Managenlastnivisinrt 20 Civic Center Plaza A AUTHORIZED REP ESENTATIVE a i & ` REVIEWED APPROVED BY: Santa Ana CA 92702 R /)_-- —'- ( 'I ft� 1� r,�;e vxAAneti ) Risk Management Specialist ©1988-2015 ACORD/ \ ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYI Y) �--� 12/05/2023 _ 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 Tower Insurance Associates, Inc. NAME: Andrew Wasowicz 4244 Overland Avenue A/CC,No.Ext): (310)837-6101 FAX No): (310)837-7559 Culver City, CA 90230 ADDRESS: Andrew@Tower90230.com License#: 0229561 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: RIC Insurance General Agency INSURED INSURER B: Walk'N Rollers, Inc DBA Walk N Rollers INSURERC: 8800 Venice Blvd Ste 301 INSURER D: Los Angeles, CA 90034-3263 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00010006-566307 REVISION NUMBER: 9 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN SD WvD POLICY NUMBER ,.IMM/DD/YYYY),MM/DD/YYYY)_ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION PER OTH- A AND EMPLOYERS'LIABILITY Y r N Y 9262601 10/26/2023 10I26/2024 X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N IA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: City of Santa Ana,20 Civic Center Plaza,20 Civic Center Plaza Santa Ana,CA 92701 its officers,employees,agents,volunteers and representatives are named as Additional Insureds with regards to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRI\ THE EXPIRATION DATE THEREOF,NO City of Santa Ana ACCORDANCE WITH THE POLICY PRC RisItDivision 20 Civic Center Plaza, 4th Floor eiREVI &APPROVEDBY:. EWED � O= �� Santa Ana, CA 92701 AUTHORIZED REPRECCNTATIVE a. Risk Management Specialist ©1988- A RD€ORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by APW on 12/05/2023 at 10:43AM POLICY NUMBER: 2023-75250 COMMERCIAL GENERAL LIABILITY Named Insured: Walk N Rollers, Inc. CG 20 10 12 19 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) Or Organization(s) Location(s) Of Covered Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect,or becoming effective during the term of this policy.The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II—Who Is An Insured is amended to 2. If coverage provided to the additional insured include as an additional insured the person(s)or is required by a contract or agreement, the organization(s)shown in the Schedule, but only insurance afforded to such additional insured with respect to liability for"bodily injury", "property will not be broader than that which you are damage"or"personal and advertising injury" required by the contract or agreement to caused, in whole or in part, by: provide for such additional insured. 1. Your acts or omissions; or B. With respect to the insurance afforded to these 2. The acts or omissions of those acting on your additional insureds, the following additional behalf; exclusions apply: in the performance of your ongoing operations for This insurance does not apply to"bodily injury"or the additional insured(s)at the location(s) "property damage"occurring after: designated above. 1. All work, including materials, parts or However: equipment furnished in connection with such 1. The insurance afforded to such additional work, on the project(other than service, insured only applies to the extent permitted maintenance or repairs)to be performed by by law; and or on behalf of the additional insured(s)at the location of the covered operations has been completed;or Risk ManagementDtvision �h yy REVIEWED&APPROVED By: lama Risk Management Sped alist CG 20 10 12 19 ©Insurance Services Office, Inc.,2012 / raye I uI Z. 2. That portion of"your work"out of which the 2. Available under the applicable Limits of injury or damage arises has been put to its Insurance shown in the Declarations; intended use by any person or organization whichever is less. other than another contractor or subcontractor engaged in performing operations for a This endorsement shall not increase the principal as a part of the same project. applicable Limits of Insurance shown in the Declarations. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III—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 ert_e Risk MAnagentenEDivision YY ,'„ REVIEWED&APPROVED BY: 1�,•;F Acevad iimmeara Risk Management Specialist CG 20 10 12 19 ©Insurance Services Office, Inc.,2012 '� raye c ul c MLANONPROFITS POLICY NUMBER: 2023-75250 FORM: NIAC-E26 11 17 INSURANCE NAMED INSURED: Walk N Rollers, Inc. ALLIANCE OF CALIFORNIA A Head for Insurance.A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. Risk Mwtng m n±D'cviston fitREVIEWED&APPROVED n r A1:e Aceve' Risk Management Specialist NIAC-E26 1117 / rayC I vl l �'