The URL can be used to link to this page

Home My WebLink AboutMLANDEN BUNTICH CONSTRUCTION CO., INC. (2)A-2021-132-02A MAYOR Valerie Amezcua MAYOR PRO TEM Thai Viet Phan COUNCILMEMBERS Phil Became Johnathan Ryan Hemandez 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 0C I d- b ),1-0d- `; Santa Ana, California 92702 CITY CLERK wv wveanta-ana orc DATE: JUL 2 9 2OU p', QWP-Cv) June 13,2024 "Ps)4""M1aden Buntich Construction Co., Inc. 1500 West 9'° Street Upland, CA 91786 Attn: Mladen Buntich Jr., President ACTING CITY MANAGER Alvaro Nunez CITY ATTORNEY Sonia R. Carvalho CITY CLERK Jennifer L. Hall Re: Extension of Agreement (A-2021-132-02) for Sewer System Repair Services Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by Mladen Buntich Construction Co., Inc., and the City of Santa Ana, dated July 20, 2021, the time period of the Agreement is hereby extended for an additional two-year period, from July 20, 2024 through July 19, 2026. 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, AFr &,-kA Nabil Saba, P.E. Executive Director, Public Works Agency CITY OF SANTA ANA Alvaro Nuiiez Acting City Manager APPROVED AS TO FORM K Nellesen Assistant City Attorney ATTEST SANTA ANA CITY COUNCIL Valerie Pm .z Thai Wel Phan Benjamin Vazquez Jessie Lopez Phl eaceva Jobnalhan Ryan Hemimdez De M Penaloza Meym Mayar Pm Tam, Ws 1 WaN2 W.W3 Wartl4 Wad yam usfalsanle-ena.om �oMnrdsanle-ana ar bvazouez9san a-ana om WaN6 e.W..e5or obaertaAsanlaena ticenalwalal=ana- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 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: Venbrook Insurance Services Venbrook Insurance Services PHONE 811i 9B B FAL No: BIB-59B-891O Woodland Hills, CA 6320 Canoga Avenue 12th Floor r� _ E-MAI �67_ � � � _ ADDR sfi: Pni x� INSURED INSUA FT:/rt{sBf�laMVF'yuflkpQpq�, y �UI Mladen Buntich Construction Co., Nsr .ER c Starr "Ie nily &Liability Co_ V 1500 W. 9th Street Upland CA91786 —1 INrIRERD:I neeil�Ie3i'llencEfO%u� 06 A A I A !Y 1' FIIR�(W� L n r s COVERAGES / -1 f \ e /1 / . JtpdnmduluJRAiI if A r THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEI JVN' HAVE BEEN ISS E 0 T INS NAME VE HE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR COND. rION 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 SUBR Am POLICYNUMBER POLICY EFF MWUD POLICY UP MWDD LIMITS A r/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �✓ OCCUR BFPO/XCU/OCP ✓ 54303218 Deductible: $10,000 9/26/2023 9/26/2024 EACH OCCURRENCE $1000000 WAMAGE TO -RENTED PREMISES (Ea occurrence) $100000 ✓ MEO UP (Any one person) $S OOO ✓ Contractual PERSONAL &ADV INJURY $1000000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY 0 JECT 7 LOG GENERALAGGREGATE $2,000,000 PRODUCTS -COMPIOPAGG $2000000 $ OTHER: B AUTOMOBILE LIABILITY 54303217 9/26/2023 9/26/2024 INGLE LIMIT EeEOccuren�/Ag!gmgat $1 Q00 O00 ANY AUTO OWNED SCHFOULED AUTOS ONLY AUTOS HIRED NON'WNED AUTOS ONLY ✓ AUTOS ONLY Physical Damage for Hired &Non -Owned $50,000/$5,000 Ded BOINJURY person) $ BORY (Par accident) $ ✓ PRDAMAGE P $ $ Core 5 000 ✓ Coll: 5 000 C �/ UMBRELLALIAB OCCUR 1000586574231 9/26/2023 9/26/2024 EARRENCE $5000000 ✓ AGE $$QQQ QQQ D EXCESS LIAR CIAIMS-MADE (underlying GL, AL, EL) CXP-022252-00 (overStarr) 9/26/2023 9/26/2024 DEO RETENTION $ Eance/ AggrTH- g5000000 B WORKERS COMPENSATION ANDEMPLOYERS' LU\BILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDEDV � NIA 54303219 9/26/2023 9/26/2024 PER OTH- ✓ I STATUTE ER F.L. EACH ACCIDENT $1 000000 E.L. DISEASE - EA EMPLOYEE $1 000,000 (Mandatary In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS below E Inland Marine/Equipment SML93044881 9/26/2023 9/26/2024 $13,387,094 / $1,000 Deductible E Leased/Rented SML93044881 9/26/2023 9/26/2024 $1,000,000 / $5,000 Deductible E Installation Floater SML93044881 9/26/2023 9/26/2024 $3,500,000 / $1,000 Deductible F Contractors Pollution Liability iabilit G71182393 006 9/26/2023 9/26/2024 $5,000,000 / $5 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: Extension Agreement (A-2021-132-02) for Sewer System Repair Services Certificate holder is named as Additional Insured's under the General Liability policy if required by written contract with the Named Insured but only for coverages and limits provided by the policy and the additional insured endorsement. *10 Days Notice of Cancellation for Non -Payment of Premium, 30 Days All Others. City of Santa Ana Public Works Agency P.O. Box 1988 20 Civic Center Plaza Santa Ana CA 92702 AUTHORIZEDREPRESENTATIVE it 01988-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 60545334 1 23-24 cL AL EX WC Cro Per, I Adrienne Padilla 1 6/19/2024 10:52:49 AN (PUT) I Page 1 of 2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF- NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC RA M®MgemelltDIP[slmt olmlri-u-4 REVIEWED&APPROVED BY: A+.f.a Aurwcd Risk Management Specialist Mladen Buntich Construction Co., Inc. POLICY NUMBER:54303218 COMMERCIAL GENERAL LIABILITY CG 20 12 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: 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 include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. 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 contract or 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 for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury' arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". B. 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 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. ., RideM¢negementDisdafan BEIAEW D^^&APPRAO� �B//Y: n'� 1�M Risk Management SpedAlst 01 CG 20 12 12 19 C Insurance Services Office, Inc., 2018 B0545334 123-24 GL AL EX WC CPP CPL I Adiiamea Padilla 16/19/2024 30:52:49 AM (PDT) I Page 2 aE 2 Page 1 of 1