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Home My WebLink AboutVALLEY OAK SYSTEMS (AON) - 2002 f' . ... .J. ,;>; ! 8 8 A-2002-035 '7 -2 '.{-D¿ -'-'-- "~'-'-''''''-''',- -.' .~ -FIRST AMENDMENT TO VALLEY OAK SYSTEMS AGREEMENT .. ' {'- ("" :, ~.\ \it WL..,..,~,'¿. ,.Art: THIS FIRST AMENDMENT, made and entered this 5th day of April, 2002, by and between the Valley Oak Systems, Inc. (VQS) and the City of Santa Ana (City), collectively referred to herein as "the Parties." RECITALS A. The Parties entered into an agreement entitled "Valley Oak Systems Software License, Service, and Maintenance Agreement" dated March 16, 1999, hereinafter referred to as "said Agreement," for the provision of services to provide the Risk Management Division with a Risk Management Information System for both Liability and Workers Compensation. B. The Parties now desire to amend said Agreement for the first time to add the implementation of the Public Risk Database Project module which is in an amount not to exceed Two Thousand Five Hundred Dollars ($2,500.00) to said Agreement. WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter contained and made, and subject to all of the terms and conditions of said Agreement as hereby amended, the Parties hereby agree as follows: 1. VOS shall implement the Public Risk Database Project module for an amount not to exceed Two Thousand Five Hundred Dollars ($2,500.00), which shall be added to said Agreement. 2. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA: / -) xl/? / ----" '. ~ '-JcJ~¿ -~ Ô PATRICIA E. HEALY Clerk of the Council Q4 ü¿[/J2.- DAVID N. REAM City Manager c ... 8 8 (Signatures continued from previous page) APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney VALLEY OAK SYSTEMS, Inc. ~ER President Tax ID# 68-0331363 2 ACORD 1M CERTIFICA OF LIABILITY IN SURA DATE (MM/DDIYY) 07/30/2002 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE PRODUCER Kurl & Jordan Ins. Agcy. 1818 Catalina Ct. Livermore, CA. 94550 mt~~~J_~Q 6-7 713 INSURED Valley Oak Systems, Inc. INSURER A United States Liability B Safeco INSURER'{;,,' Mt. Vernon Fire SURER D 3189 Danville Blvd. Alamo, CA 94507 INSURER E, COVERAGES N THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSU (> TO TH£I~SL1RI!DNAMED ABÖVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTI4€RDOCUMENT 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSlr" ------------- P LJ Y EFFE IVE L TR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY GENERAL LIABILITY X COMMERCIAL GENERAL liABiliTY CLAIMS MADE W OCCUR ,..,..,..' LIMITS A PPP1000316-C 07/28/02 EACH OCCURRENCE $ 1.LQO 0 , OQQ- FIRE DAMAGE (Anyone fire) $25,000 MED EXP (Anyone person) $1,000 07/28/03 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $1,000,000 PRODUCTS - COMP/OP AGG $1,000,000 COMBINED SINGLE liMIT $1,000,000 (Ea accident) BODILY INJURY (Per person) 09/10/02 BODILY INJURY 09/10/03 (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONL Y . EA ACCIDENT ~--,-._-- OTHER THAN EA ACC $ AUTO ONLY AGG $ EACH OCCURRENCE $2,000,000 AGGREGATE $4,000,000 07/28/03 $ GEN'L AGGREGATE liMIT APPliES PER. ~ POliCY ~ j~~T I I AUTOMOBILE LIABILITY IJ :~~:::,~~:,: B :-_X l HIRED AUTOS I X I NON.OWNED AUTOS ---l .~ n__~_. LOC 02-CC-870022-4 02-CC-870022-5 09/10/01 09/10/02 GARAGE LIABILITY ANY AUTO EXCESS LIABILITY X OCCUR i CLAIMS MADE DEDUCTIBLE XL131673-C (over Gen. 07/28/02 C Liab. ) RETENTION WORKERS COMPENSATION AND : EMPLOYERS' liABILITY I E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE. POliCY liMIT OTHER A! Prof. I Liability PPP1000316 07/28/02 07/28/03 DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is named as an additional insured~ ..._1.0_~.:_~_.~ j :1" , ~..; , c.' t)L ~y' (.ít\ .\ll(',n:I..:Y CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION City of Santa Ana Jeff Stevens - Risk Mgr. 20 Civic Center Plaza Santa Ana, CA. 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TD THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRE "ACORD CORPORATION 1988 ACORD 25.S (7/97) .. 8 8 POLICY NUMBER: PPPI000316-C COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS (FORM B) THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE NAME OF PERSON OR ORGANIZATION: The City of Santa Ana, its officers, agents, employees and volunteers 20 Civic Center Plaza Santa Ana, CA. 92701 (If no entry appears above, information required to complete this endorsement will be shown in the declarations as applicable to this endorsement.) Who is an insured (Section II) is amended to include as an insured the person(s) or organization(s) shown in the schedule, but only with respect to liability arising out of your ongoing operations for that insured by or for you. " :"I';:¿ (')',! ¡-' ¡') /\S TO FORM />~j.-.. -.k'l.,..~ JL~--, .._~, . . -------..-...-..--.--'-.'---". "".'" .:: :!'--,'.' >- " ,,,.:.. ( ,t"\ ioriì<òY "'-,\"..'-' '.' -- .. , CG2010 10 93 Copyright, Insurance Services Office, Inc, 1996 Page 1 of 1 ACORQM CERTIFiCAtE OF LIABILITY INS*NCE I DATE (MM/DDIYY) 09/27/2002 PRODUCER (650) 341-4484 FAX (650)341-4465 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Business Professional Ins. Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1519 South B Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Mateo, CA 94402 INSURERS AFFORDING COVERAGE INSURED Va I I ey Oak Systems Inc. INSURER A AIG American International Co. 3189 Danville Blvd. #100 INSURER R Alamo, CA 94507 INSURER c: INSURER D. I INSURER E, COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, I~T~ TYPE OF INSURANCE POLICY NUMBER PDk+~Y ~~~5gME GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR LIMITS EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ LOC COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) OTHER THAN AUTO ONLY, AUTO ONLY - EA ACCIDENT $ EA ACC $ AGG $ $ $ $ GARAGE LIABILITY ANY AUTO EXCESS LIABILITY OCCUR D CLAIMS MADE """--'-- EACH OCCURRENCE AGGREGATE DEDUCTIBLE RETENTION $ 58 96 55 88 57 16 CALIFORNIA - MICHIGAN - PENN / FL 10/16/2002 10/16/2003 $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ 1,000,00 1,000,00 1,000,00 A OTHER DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS roof of Insurance !¡;!:::j~ Deputy City AtlUfï1';V -~"--..... CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION City of Santa Ana Attn: Jeff Stevens Risk 20 Civic Center Plaza Santa Ana, CA 92901 Manager SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL -.1!L.. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~~- @ACORD CORPORATION 1988 Debbie Upland22/SANDEE ACORD 25-S (7/97) FAX: (714)647-5311 tAœBQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYVY¡ 08/25/2004 PRODUCER (650)341-4484 FAX (650)341-4465 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Business Professional Ins. Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1519 South B Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Mateo, CA 94402 INSURERS AFFORDING COVERAGE NAIC# INSURED Valley OaK Systems Inc. Iv I ffl-oo 3 INSURER A. Federal Insurance/Chubb Ins. 5000 Executive Pkwy., Suite 340 A- ¡¡>.oQ;I.- 0.35 INSURER B" Granite State Ins. Co San Ramon, CA 94583 "t- ~ 00.3 -0(,9 INSURER c: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DO' TYPE OF INSURANCE POLICY NUMBER PRHi~ EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 3582-10-16 PLE 07/28/2004 07/28/2005 EACH OCCURRENCE $ 1,000,00C X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,00C I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 10 ,OOC A PERSONAL & ADV INJURY $ 1,000,OOC - 2,000,00C GENERAL AGGREGATE $ - GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMPfOP AGG $ 2,000,00C I ,nPRO. n POLICY JECT LaC AUTOMOBILE LIABILITY 7499-64-69 07/28/2004 07/28/2005 COMBINED SINGLE LIMIT - (Eaaccident) $ 1,000,00C ANY AUTO X ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) A X HIRED AUTOS BODILY INJURY X $ NON-OWNED AUTOS Of} "¿r. (Per accident) -"- '~ /h- PROPERTY DAMAGE - ~c ~\V1 I (Per accident) $ ~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ :==JESS/UMBRELLA LIABILITY 7983-41-70 07/28/2004 07/28/2005 EACH OCCURRENCE $ 3,000,00C OCCUR 0 CLAIMS MADE AGGREGATE $ 3,000,00C A EXCLUDES PROFESSIONAL $ ~ DEDUCTIBLE LIABILITY $ X RETENTION $ 10,00C $ WORKERS COMPENSATION AND CA WC 311-14-75 10/16/2003 10/16/2004 X I WC STATU., I IOJ~' EMPLOYERS' LIABIUTY PA/FL WC 311-12-24 l,OOO,OOC B ANY PROPRIETORfPARTNERfEXECUTIVE EL. EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? MI/MD we 311-12-23 E.L. DISEASE - EA EMPLOYEE $ 1,000,00C g~Ëêil~Lsp~'õvïš?åNS below EL. DISEASE - POLICY LIMIT $ l,OOO,OOC OTH'f.. Liability 3582-10-16 07/28/2004 07/28/2005 $3,000,000 ro esslonal A (EXCLUDED FROM EXCESS $50,000 Deductible LIABILITY POLICY) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS he City of Santa Ana, its officers, agents, employees, and volunteers are named as Additional Insureds .n respects to insureds business operations. dditional Insured applies to General Liability policy only 10 day notice of cancellation for non payment of premium shall apply. City of Santa Ana Jeff Stevens- Risk Mgr. 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 1I'rUX~ MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ~~(I(IIIIIJ0iIt(¡1liXi1lXIIIII¥«J(XX IOOOOOOOOIJIj(~IiI(ItJ{XIlOOt{II(IIØXIOOOOUOO(XXXXXXXX AUTHORIZED REPRESENTATIVE QQ,.~ - Debbie Uland SANDEE ACORD 25 (2001/08) @ACORDCORPORATION 1988 ¡.M} , . . COMMERCIAL GENERAL LIABILITY Valley Oak Systems Inc, Policy Number 3582-10-16-PlE Federal Insurance/Chubb ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: The City of Santa Ana, its Officers, Agents, Employees, and Volunteers. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. SUCH INSURANCE AS IS AFFORDED BY THE GENERAL LIABILITY POLICY IS PRIMARY INSURANCE AND NO OTHER INSURANCE OF THE ADDITIONAL INSURED Will BE CAllED UPON TO CONTRIBUTE TO A LOSS, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CG 2010 1093 ~Ql J-t£c 2/2- /' O(l-t ( / ACOBa. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) 11/03/2005 PRODUCER (6$0)341-4484 FAX (650)341-4465 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Business Professional Ins. Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1519 South B Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Mateo, CA 94402 INSURERS AFFORDING COVERAGE NAIC# INSURED Valley Oak Systems Inc. ~- \ClClI\ -00'3 INSURER A: Federal Insurance/Chubb Ins. 5000 Executive Pkwy., Suite 340 A''2.00~ ~oas INSURER B: Granite State Ins. Co San Ramon, CA 94583 A . 2003 -OlD'l INSURER c: INSURER 0: l\ - zeos - 012- INSURER E: COVERA"'ES THE POLICIES OF INSURANCE L1STEO BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DQCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DO' TYPE OF INSURANCE POLlCY NUMBER POLICY EFFECl1VE P~~.fJ' EXP1RA nON LIMITS GENERAL. LIABILITY 3582-10-16 PLE 07/28/2005 07/28/2006 EACH OCCURRENCE $ 1,000,000 Xl COMMERClAL GENERAL L1A81L1TY DAMAGE I9~~ENTED $ 1,000,000 I CLAIMS MADE m OCCUR MED EXP (Anyone person) $ 10,000 A I-- PERSONAL & ADV INJURY $ 1,000,000 I-- GENERAL AGGREGATE $ 2,000,000 h'L AGGREGATE LIMIT AP~t PER: PRODUCTS. COMP/OP AGO $ 1,000,000 (nPRO- POliCY JEer lOC ~TOMOBILE LIABILITY 7499-64-69 07/28/2005 07/28/2006 COMBINED SINGLE LIMIT (Eaaccident) $ - ANY AUTO 1,000,000 ~ All OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Perpersonj A - ~ HIRED AUTOS BODILY INJURY $ ~ NON-OWNED AUTOS (Peraccidentj PROPERTY DAMAGE $ (Per accident} ~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ :=JESS/UMBRELLA LIABILITY 7983-41-70 07/28/2005 07/28/2006 EACH OCCURRENCE I 3,000,000 OCCUR 0 CLA1MS MADE AGGREGATE $ 3,000,Ooe A EXCLUDES PROFESSIONAL $ ~ DEDUCTIBLE LIABILITY . X RETENT10N $ 10 , 00( $ WORKERS COMPENSA TlON AND CA we 184-37-90 10/16/2005 10/16/2006 X I T"X~ STtI,~~ I IOJ~- EJ,lfl'U}Vi;;:Q<;' I lABILITY ~1I WC 184-40-07 1,000,00e B ANY PROPRIETOR/PARTNERIEXECUTIVE El. EACH ~.CCIDENT $ OFFICER/MEMBER EXCLUDED? ALL OTHER STATES - E,L DISEASE ~ EA EMPLOYE $ 1,000,000 If yes, describe under WC 184-34-39 1,000,000 SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $ p~THr. 3582-10-16 07/28/2005 07/28/2006 $3,000,000 A ro ess;onal Liability (EXCLUDED FROM EXCESS $50,000 Deductible LIABILITY POLICY) h-'iESCRIPTlON OF OPERATIONS I LOCA TlONS f VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS are named as Additional Insureds he City of Santa Ana, its officers, agents, employees, and volunteers n respects to insureds business operations. r'ldditional Insured applies to General Liability policy only '10 day notice of cancellation for non payment of premium shall apply. CERTIFICATE HOLD C City of Santa Ana , Jeff Stevens- Risk Mgr. 20 Civic Center Plaza Santa Ana, CA 92701 'ROVED AS 1'0 ,t. ~kaft/. . Ira Stitt SLc dy 11 City Allor" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL JL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE C>:I ~ '--'''1'1 .::::,- @ACORDCORPORATION 1988 ACORD 25 (2001/08) COMMERCIAL GENERAL LIABILITY Valley Oak Systems Inc. Policy Number 3582-10-16-PLE Federallnsurance/Chubb ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the foi/owing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: The City of Santa Ana, its Officers, Agents, Employees, and Volunteers. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured, SUCH INSURANCE AS IS AFFORDED BY THE GENERAL LIABILITY POLICY IS PRIMARY INSURANCE AND NO OTHER INSURANCE OF THE ADDITIONAL INSURED WILL BE CALLED UPON TO CONTRIBUTE TO A LOSS. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CG 2010 1093 \Pi,)Ruv LV AS TO F01~M V -c:;; * --,~,. Laura Slllt Sl;ccdy \','>lSlailt City AtLOr:ley