HomeMy WebLinkAboutGENERAL LEARNING CLIMATES 1 - 2003
PÓ
f~
iNöÚRilNCE ON filE
WORK MAY PROCEED
U, '", I' INSURAI~CE EXPIRES
:1' ì-o't
CLERK OF COUNCIL, 3 CONSULTANT AGREEMENT
DATE: I;;" - .3 , - 0
M
THIS AGREEMENT, made and entered into this /5 day of þ.¿tCf11h£R, 2003 by
and between General Learning Climates, Inc" a California corporation (hereinafter
"Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and
existing under the Constitution and laws of the State of California (hereinafter "City").
A-2003-243
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
policy implementation required for the City to provide continuous quality service to the
public.
B. Consultant represents that Consultant is able and willing to provide such services to the
City.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably be
expected from a professional consulting firm in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
1.
SCOPE OF SERVICES
Consultant shall perform those services as set forth in Exhibit A to this Agreement.
2.
COMPENSATION
a, City agrees to pay, and Consultant agrees to accept as total payment for its services, an
hourly fee of one hundred, seventy-five dollars ($175.00), The total sum to be expended under
this Agreement, shall not exceed $30,000.00 during the term of this Agreement.
b. Payment by City shall be made within thirty (30) days following receipt of proper
invoice evidencing work performed, subj ect to City accounting procedures. Payment need not
be made for work which fails to meet the standards of performance set forth in the Recitals
which may reasonably be expected by City.
3.
TERM
This Agreement shall commence on the date first written above and terminate on
December 3 I, 2004, unless terminated earlier in accordance with Section 12, below. The term of
this Agreement may be extended upon a writing executed by the Chief of Police and the City
Attorney.
4.
INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor
shall it be construed to create an employer-employee relationship, a joint venture relationship, or
to allow the City to exercise discretion or control over the professional manner in which
Consultant performs the services which are the subject matter of this Agreement; however, the
services to be provided by Consultant shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Consultant shall pay all salaries and
wages, employer's social security taxes, unemployment insurance and similar taxes relating to
employees and shall be responsible for all applicable withholding taxes.
5.
INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the City, its officers, employees, agents, volunteers and
representatives as additional insured(s) and shall include, but not be limited to protection against
claims arising from bodily and personal injury, including death resulting therefrom and damage
to property, resulting from any act or occurrence arising out of Consultant's operations in the
performance of this Agreement, including, without limitation, acts involving vehicles. The
amounts of insurance shall be not less than the following: single limit coverage applying to
bodily and personal injury, including death resulting therefrom, and property damage, in the total
amount of$I,OOO,OOO per occurrence. Consultant shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit B upon
execution of this Agreement and shall be approved in form by the City Attorney.
b. Business automobile liability insurance, or equivalent form, with a combined single
limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for
owned, hired and non-owned automobiles.
c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300
of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against
liability for worker's compensation or to undertake self-insurance. Prior to commencing the
performance of the work under this Agreement, Consultant agrees to obtain and maintain any
employer's liability insurance with limits not less than $1,000,000 per accident.
d. If Consultant is or employs a licensed professional such as an architect or engineer:
Professional liability (errors and omissions) insurance, with a combined single limit of not less
than $1,000,000 per claim.
2
e. The following requirements apply to the insurance to be provided by Consultant
pursuant to this section:
(ii)
Consultant shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement.
Certificates of insurance shall be furnished to the City upon execution of
this Agreement and shall be approved in form by the City Attorney.
Certificates and policies shall state that the policies shall not be canceled
or reduced in coverage or changed in any other material aspect without
thirty (30) days prior written notice to the City.
(i)
(iii)
f. If Consultant fails or refuses to produce or maintain the insurance required by this
section or fails or refuses to furnish the City with required proof that insurance has been procured
and is in force and paid for, the City shall have the right, at the City's election, to forthwith
terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its
time and materials expended prior to notification of termination. Consultant waives the right to
receive compensation and agrees to indemnify the City for any work performed prior to approval
of insurance by the City.
6.
INDEMNIFICATION
Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents,
employees, consultants, special counsel, and representatives from liability: (I) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims
for personal injury, including health, and claims for property damage, which may arise from the
direct or indirect operations of the Consultant or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates to the services described in
section I of this Agreement; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects
arising from this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to
have been suffered, by reason of the events referred to in this Section or by reason of the terms
of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold
harmless, and pay all costs for the defense of the City, including fees and costs for special
counsel to be selected by the City, regarding any action by a third party challenging the validity
of this Agreement, or asserting that personal injury, damages, just compensation, restitution,
judicial or equitable relief due to personal or property rights arises by reason of the terms of, or
effects arising from this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding.
7.
CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
that it shall not use or disclose such information except in the performance of this Agreement,
and further agrees to exercise the same degree of care it uses to protect its own information of
3
like importance, but in no event less than reasonable care. "Confidential Information" shall
include all nonpublic information. Confidential information includes not only written
information, but also information transferred orally, visually, electronically, or by other means.
Confidential information disclosed to either party by any subsidiary and/or agent of the other
party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure
shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is,
through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful
possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Consultant without
reference to information disclosed by the City.
8.
CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interests and shall not have interests, direct
or indirect, which would conflict in any manner with performance of services specified under
this Agreement.
9.
NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this
Agreement shall be in writing and shall be deemed to be properly given if delivered in person or
mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other
telegraphic communication in the manner provided in this Section, to the following persons:
To City:
Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
telefacsimile (714) 647-6956
With courtesy copies to:
Captain of Administrative Services
Santa Ana Police Department
60 Civic Center Plaza (M-97)
P.O. Box 1981
Santa Ana, California 92702
telefacsimile (714) 245-8007
and,
4
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-6515
To Consultant:
Dr. David Hartl
General Learning Climates, Inc.
180 East Main Street, Suite 240
Tustin, California 92780
A party may change its address by giving notice in writing to the other party. Thereafter,
any notice, tender, demand, delivery, or other communication shall be addressed and transmitted
to the new address. If sent by mail, any notice, tender, demand, delivery, or other
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or
other communication shall be effective or deemed to have been given twenty-four (24) hours
after the time set forth on the transmission report issued by the transmitting facsimile machine,
addressed as set forth above. For purposes of calculating these time frames, weekends, federal,
state, County or City holidays shall be excluded.
10.
EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, and supersedes any and all other agreements, oral or written, between the parties. In
the event of a conflict between the terms of this Agreement and any attachments hereto, the
terms of this Agreement shall prevail. This Agreement may not be modified except by written
instrument signed by the City and by an authorized representative of Consultant. The parties
agree that any terms or conditions of any purchase order or other instrument that are inconsistent
with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without
the City's prior written consent shall be considered null and void. Nothing in this Agreement
shall be construed to limit the City's ability to have any of the services which are the subject to
this Agreement performed by City personnel or by other consultants retained by City.
5
12.
TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of termination,
subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to deliver
to the City all work product completed as of such date, and in such case such work product shall be
the property of the City unless prohibited by law, and Consultant consents to the City's use thereof
for such purposes as the City deems appropriate.
b. Payment need not be made for work which fails to meet the standard of performance
specified in the Recitals of this Agreement.
13.
DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital
status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited
by applicable law, in the recruitment, selection, training, utilization, promotion, termination or
other employment related activities. Consultant affirms that it is an equal opportunity employer
and shall comply with all applicable federal, state and local laws and regulations.
14.
JURISDICTION - VENUE
This Agreement and all questions relating to its validity, interpretation, performance, and
enforcement shall be governed and construed in accordance with the laws of the State of
California. This Agreement has been executed and delivered in the State of California and the
validity, interpretation, performance, and enforcement of any of the clauses of this Agreement
shall be determined and governed by the laws of the State of California. Both parties further
agree that Orange County, California, shall be the venue for any action or proceeding that may
be brought or arise out of, in connection with or by reason of this Agreement.
15.
PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United States, the State of California,
the City of Santa Ana and all other governmental agencies. Consultant shall notify the City
immediately and in writing of her inability to obtain or maintain such permits, licenses,
approvals, waivers, and exemptions. Said inability shall be cause for termination of this
Agreement.
6
16.
MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
indemnity City fully, including reasonable costs and attorney's fees, for any injuries or damages to
City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set
forth in the body of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST:
~l .
./ ~Z~
TRICIA E. HEALY
Clerk of the Council
CITY OF SANTHNA 1
~/)~
AVID. REAM
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
r
'-o'
By: Pi}: /1 'I (
Lau a Sheedy
Assistant City Attorney
y.G " ( /
/
CONSULTANT
GENERAL LEARNING CLIMATES! T~c..
~
DR. DAVID HARTL
President
Tax ID# 33-0067744
7
EXHIBIT A
SCOPE OF SERVICES
Consultant shall provide consultation and training in the following areas:
I.
POLICY ANALYSIS
Assessing the impact of implementation of policies designed to improve the quality of
services provided by the Agencies and Departments comprising the City of Santa Ana.
2.
CONSULTATION SUPPORT
Providing assistance with managing the changes required as the organization undergoes
ongoing transformation to continuous quality management and services. Providing
assistance with insuring that the organizational climate supports the values of integrity,
community safety and security, community participation, courteous and efficient service
and organizational growth.
3.
TRAINING SUPPORT
Providing in-house training and team development experiences for organizational
executives, managers, supervisors and employees to support the transformation of
services to a quality basis.
8
EXHIBIT B
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its
officers, employees, agents, volunteers and representatives are named as additional insureds
("additional insureds") with regard to liability and defense of suits arising from the operations
and uses performed by or on behalf of the named insured.
2. With respect to claims arising out of the operations and uses performed by or on
behalf of the named insured, such insurance as is afforded by this policy is primary and is not
additional to or contributing with any other insurance carried by or for the benefit of the
additional insureds.
3. This insurance applies separately to each insured against whom claim is made or
suit is brought except with respect to the company's limits of liability. The inclusion of any
person or organization as an insured shall not affect any right which such person or organization
would have as a claimant if not so included.
4. With respect to the additional insureds, this insurance shall not be cancelled, or
materially reduced in coverage or limits except after thirty (30) days written notice has been
given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701.
(Completion of the following, including countersignature, is required to make this endorsement
effective. )
Effective
Policy #
Issued to
, this endorsement form as a part of
Named Insured
Countersigned by
Authorized Representative
9
APR-28-2004
10:03
SANTA ANA POLICE DEPT
714 245 8094
P.01
"';~'"~'''
MdlBP. CERTIFICATE OF LIABILITY INSURANCE .1~ ØAft~
~~1 0'/22/0.
- THIS CamFlCATE IS ISSUED ~S A MATTEIt )f IfFO~TION
ONLY AND CONFERS NO RIGHTS uPON 'nil; C!RTIPICf.TE
LPL :1n.~an~ A98nC¡ :Ene IIOLDØI. T>4fS.CI!"TlFItA1E DOES NOT AlIENO. ~OR
4&11 Eureka Avenue ¥ ALTI;R THIS C_Q¡; ""FORDED 8'1' THE POLIClEllIlELDW.
Torba LiDda ÇA 92886
Phon.:714-572-9700 ra.:714-572.9880 IIISURERS AfFOI\OING COYIRAGe 1We'
IN....., /I¡ -.J. 003- .243 _A '~~I"'þll:PWt:I
UdI..lRUI. ~QI) CASInU.'tY INS CO UU4
~'n.1. ~lNG CLIHAI!£S IN$UREA. C.
Db§"¥Jn-1IM'n.
PO' 2 "'''''''0
0 CA 92859-0788
, -e.
COVERAGEs
11£POU:ES OF "SUIWG: ll$1G IELO'4V HAW 8EE!II1$$IJID TO TIE ItISI¡IREQ NMED ABOVe FOtI TI'4 POUÇY ÞVbOO ~1iD. IIIQ'JWrT1q:rIoNC)l!lG
Ñl'fReaLItIŒIiIEHT."ÆRN °" tOND'TtOH Of I¥W ~ICTRAÇT gill OTHeR DOtUtliEtllT\'VfTH RI$pE;r;T fOWtUtH THIS C¡RTlA:A'J1: ~y.e: IlIlÆD:O"
~YPeIllTAIN.1'1G! ~ oti.FFOADEClIY'01I: POl,f!::1I:3CeSCUEðI1EfU:.INISSUlJEC1TQ AU. ftlr. Tt.~. £kCLU8Q13AHQc:GfoIQlTtOfq Of' WCH
11'0&.1,,", ~nl.MTS ~~Y HA'4 lIEN NClIJtm IY"AID W"ø.
-, ;ou;,. NUÌtHJI. M'. .~~T m _.. -,. "uuaTï - ~ . '- ..
lTII TV'" OF ...,....CI
,!!'efW.1JQIUTY , I <AC"OCCUOUO.- .1000000
B ..~ ~RCt.I.L~ERAlllAQmo 72SJSaJm9228 0./Ol/0~ 04/01/05 I p.....uUIh-"-1 . 300000
CtJUllSlIIADE CiJOCCtnI: "'Q liD' t"'- -..-.J 110000
X B1.t.a... OVøeJ!:e ~&AfIII1rItNRY .1000000
GENeIW. AGGMGI'.'J8 .2000000
~~ñtUITanñ,Pl~ [ I'RQDUI;T8 . CCIMÞIOÞ atGG .2000000
POUC;1' ~ I.OÇ
.. ,- T -.
~1Jt01ØO..e uaP.m ~""'EI.IMIT .
- -.uno ...-
- ALL OWMED..uTO$ ecoILY8iI.,JURY
.
- tC~DUU!DAlnOS (II...,.,.....
~ ......- 8OtlI,'ItU1.MY
.
_Al/TOI '(pe'''-''"
I-
""""E'nT- .
1""-1
.........~ ..aø1'&ONt'r - f.,8, ÞCCI:IfNT .
~-AM'!'AUTo. OTKR-.. ..""'.
/ ~ 'j / AOTa~"'~ """.
r"...-'-' . . UA8IJft /)0/UJi:;' . -:...., 1{)d/ ! '/,5 ......~ ,
0-... 0 tINOoS "-'DE 1/' _1i- .
',,-/ . .
h~""",. . . :
.
11111',,"001 . .
~_Gøtr"CJlt~TQN AtlD ~IIW~
A ElØ'LQY&a!I' LULln 1443563 0./Ó1/0~ 0./01/05 .1000000
am P",gÞAC'I'0IIDaA1\IS.M:ÆCUT1VE. !.L.~"AeCIDEJIO'
~~AIiXQ,WIO'1 i.L ð8£ME - EA U8\C'J'rØ; '1000000
:m~"Z'LbIIow !.L~.PCM.fCt\JII8T 01000000
""'""
I ~'f'IcÞN0F OP£M~11.OCA11QIC~~~~DCUISIQIØ~'" IIIDOMEIIfNT' IfJGW. ~vdmNS
ALL 0_TtON9 01' '1'112 INSVIŒÐ JUI COVEIŒD In: 'I1ŒSE POL1C1BS. IU: CONsm.'rIHC:
S!i:RVUZS. TII.E: ÇITY W !UUftA -. ITS DIi'FI(;I!Jg. ~!J-. I!MP1.Dnzs 1IIID
,",L1JNTUP.S ME N»IED JI!ID¡:'rIO!IAI. INSUUU PER JI.'M.'Jl.CIŒt) CG2010 10"3. 'rEM DAY
lIO'l'IC:Z O¥ CAIICEUJI'lION APPLIES FOR, --PA'IMEN'J: OF pJll:Mt1M.
CERTIflC~TE HOLDER
tl'1'YOFS
CANelllLATJON
SHOÞLD"" D5 nt£A8CW&DU~ ~..~~ .-8ØOM,'þf!""'"
. DATE nIfJtEðF- ntEJS5UDIGlNIC,IIQRN..L 1 1, M. 3& ~~
. MC~TOftili[;riii,c.tt" . --mTO'~LEPT.M.I.r' . .., J:lHUt
1Ií~V'..3I':Y ""'""""""..,-,........ ..-ul8iVM
~:J[.V:Y-1iX
..--
(!J:ft Olr SJIIt1'rA lINA
ATTIC: Ln. LNM C-,ry t:?1.EA1(
20 CIVIC CEN'l'2R ~
StIII'!'A aNA ~ .2'101
ow- S
. CI'CU
AÇQAÐ '''/2GO'f1ll81
0
RO CORPOItATlON,1I88
¡MJ r-
i
. ...
APR-28-2004 10:03
MAK n iOP' IbJPM
¡¡¡f ,.,. ,... '":'"
SANTA ANA POLICE DEPT
STME Em
!,to\(~. ~ 11~-G33--1¡sa
714 245 8094
~,:51 p.!
I'Iar, ¡¡ ~4 Bló'\lPl'l P\
P,02
llØ1J",ll CEImI'ICA'fI or 1N.IiIll\.NC&
Gf6œ1.+-V . ....0
Ap.' 1S49
Al'O 418
'n..iIr"'~N ',' ,
Slam fill;" MuI~,aI ^\llsn.."U~ h,"tn.n6¥ c.a~ft.V . - " " . ~BI89Ji'I~n.
IIIhll10 Iou -It.. ra"" ..1116"'. i0oi- ,..th"",~,~ i!<A'..,,- 1f6,.-rop.. oh""'IHI'~-wI!I""'lD
dsIY8 'M'iü"ft ".- 1"61
ÇiIY or IUtA ~A
AtÇ\\' City Cletk
20 C1Y1$ C.4ttr JJLI&
Santa UA C& niO!
. ~;
"
. :,"
", " I"'"
'. ". . .;'1"
',~or1¡>1!...'otV",loi.:, 1m.
't,W . , . ,~ ':',.r,'I,"¡jì,."'jJGU
"'.' .... ~,., r.-:
UAJIIUl'J(, ,CO,'I'I{RMII/\ "
I.",I~' .n'¡',b~~,
. ,
, ' !)o'¡oy tP¡UIJ' , ' \"I6~J\~ 0."...". !\o(;ly !,g.'CI '''';'JIOOII )¡¡I>'P
...h-,.-- I """"- "I' .......iII<Jt f !lmglel.iwlh
5 , 11k_0 3"',i.;n~'", ' "I,'.:'IÖ~ðO:. $ '.010._"
. , .
. ~I ~,. . :. ¡ I "
~ 11,. ,C,,~ .nlll\lfNlOl ~ MI ""''W''!he! ':'I)"""SO P"" Îdtd 1'1' 111. ;loittiHð 1'0\11\',
ï I!.""" ~...'" IIAII.TL. ÞA VIJ) n . G!!rW1. LFJ.I\1IIO CI.IK.\f&i
! ' rOn.,.IY.\lnbt<' Vf<j III3-AI$-7tK
t ~I\\ool¡;'. Þ"", J'AB I), .oo~
I 11.111 A-M. s-bh11'hw
<
K
"
.'. ;', .. ;':
6Q7'..I1
, ~~~,))..
CbItl't!Rv ~Pw am.-
t¥->
,~
-. ,
)l
,.'
'-.-
~II" bno.1d "'" trol16Jnil1a! memo 11171
~ ~¡
C¡t'/¡J'SI4
. ;¡'i.f5-80'fJi
Ca.
3
~+c....
;:.-:::---. /..
r;Y?7tfi"(y-;ß 3
~'
(/
RPR-28-2004 1O:O4
SRNTA ANA POLICE DEPT
714 245 8094
P,03
. ,...
"
.
c
THIS ENDORSEMeNT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
CG 20 10 1093
ADDmONAL INSURED.;QWNERS, LESSEES OR CONTRACTORS (FORM' B)
nlis endorsement modifies insurarlœ pl'Q1/klQd under !he following:
C()~CIAL GENERAL LIABILI1Y COVERAGE PART
This endorsem8l1t change.S the policy elhlctive on the inception date of lIIe policy unlfi~ ¡mother dale is indicsled below.
Eador5emenl,efftd;..e PoIiey No- ,
4I112Ø84- . _."n.. --. '1'7'1'\, 6.11"- '"' ""'" T.!SBr\K9226 - - -_._-- .- ,.. '- ...-
Named-Insured Counlelsigneá by'
GENERAL LEARNING ClJMA 1ES
...-,.-.
(_i¡çdJlc~"')
SCHEDULE
Name of Persœ or Organizlltion:
THE CITY Of SANTA ANA, ITS OffiCEKS,AOfNTS. [MPl.QYE.ES 1\1'10 YOLUNTI!I!I!.S.
(If no entJy apþeara abOVe, Informallon requirelllo complete this endorsement wiD be shown In !he Dec:lanJIions as
applicate to this endor&ernenl}
WHO IS AN INSURED (Section II) is amenllld \0 Inciude ¡IS ¡In ¡n.¡urad thlt perwrI QI' Organízil!ion shown in Ihl! Schild-
ule. but only with respect to liability aritling 01.11 of your ongoing operallOns performed for tl\;lt in$I)~,
¡l!5/Uf'ðI3/S
..p -- ..- --.
'--"'.--..-
---.""""-"__-On.."'"
Copyr;gM, InsLlianc:e. $entices OffICC lac... 1.~
TOTRL P,IZI3
---
. r~J STATE FARM INSURANCE COMPANIES@
900 Old River Road
Bakersfield CA 93311
DATE OF NOTICE: APR 08 2004
39A
A
A - ,;>,þO 3 - ,;)J-I3
CITY OF SANTA ANA CT
ATTN; CITY CLERK
20 CIVIC CENTER PLAZA
SANTA ANA CA 92701-4058
11,1,",1,11,"111'111"11,1"111111,1,1,1"1",1,111111"1,11
¡ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company
NAMED INSURED: POLICY NO: V541083.A15-75M
S HARTL, DAVID E YR/MAKE/MODEL: 1993 LEXUS 4DR
::: 3808 E LARKSTONE DR VIN/CAMPER: JT8UF11 E7P0151 684
:!: ORANGE CA 92869-5355 AGENT NAME: TANYA PEARSON
~ AGENT PHONE: (714)289-1226
a: ENDORSEMENT NO: 6028AU
0-
N POLICY MESSAGES: This policy shown above supersedes policyl V541 083-75L.
i The policy includes a los8 payable clause protecting the additional insured's interest in the de~oríbed car to the extent of the insurance
-- provided and $ubject to all policy provisions. The additional ¡n,urad will be given 20 days notice if the policy is terminated, Until 8u~h notice
; is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 daya of
('II any change of interest or ownerahip coming to their attention. Failure to do so will render this policy nul! and void.
"I
0
~
COVERAGE:
Bl AND PD LIABILITY
$1 MILI$1 M\L/$1 MIL
$100 OED. COMPo
$250 DED COLL,
POLICY EFFECTIVE
MAR 23 2004 UNTIL TERMINATED
~//L
{1Æß~
6037F.11 CERTIFICATE OF INSURANCE
35996-4-2 ~
Agent 8549
AFO 418
This is to certify that:
State Fann Mutual Automobile Insurance Companv , of Bloomington,
Illinois has coverage in force as shown below for the named insured. If the coverage is changed or tenninated we will give 10
days written notice to:
CITY OF SANTA ANA CT
ATTN: CITY CLERK
20 CIVIC CENTER PLAZA
SANTA ANA CA 92701-4058
Description ofVehic1e:
1993
LEXUS
JT8UFl1E7POl51684
LIABILITY - COVERAGE A
Limits of Liability
Bodily Injury
each person I each accident
1000000 $ 1000000
Property Damage
each accident
Bodily Injury and Property Damage
Single Limit
$
$
1000000
$
each accident
"
~
~
m
0
rn
This Certificate ofInsurance does not change the coverage provided by the described policy.
s
Named Insured
HARTL, DAVID E
M
0
0
N
N
0
~
Policy Number
V541083.Al5-75M
~~~~-\Ç>/.
Chief Executive Officer
Effective Date
MAR 23 2004
12:01 A.M, Standard Time
Countersigned
(Year)
¡;;
0
~
0-
M
6037F.ll
By
Authorized Representative
~¿/~