HomeMy WebLinkAboutVideo Engineering Services 1City of Santa Ana
Clerk of the Council COTc office use o
AGREEMENT TERMINATION FORM
15 M 2'
Please complete this form when the attached agreement and all rI T
amendments (if any) are no longer in effect.
i
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with Video Engineering Services
No. A-2003-269 was completed on 2/l/05 and final payment has been made.
(List aft amendments. Use space below if needed.)
Department:
PRCSA
Phone/Ext.:
5254
Signature:
.0
Date:
7/21/15
Revised 1031-12
INSURANCE ON FILE
WORK MAY PROCEED A-2003-269
,UNTIL INSURANCE EXPIRES
CLERK DF COUNCILCONSULTANT AGREEMENT
DATE .2 - /,2--0#
THIS AGREEMENT, made and entered into this / Vf day of E(Zhrt(Ae-q 2004 by
FRCS Video Engineering Services (hereinafter "Consultant'), and the City of Santa Ana, a harter city
GalYa and municipal corporation organized and existing under the Constitution and laws of the State of
California (hereinafter "City").
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field
video equipment maintenance and use.
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:
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,
the rates and charges identified in Exhibit A. The total sum to be expended under this
Agreement, shall not exceed $ 45, 760.00 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, subject 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
February 1, 2005 with 4 one year options to extend unless terminated earlier in accordance with
Section 12, below. The term of this Agreement may be extended upon a writing executed by the
Executive Director of the Parks Recreations and Community Services Agency 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, agents, volunteers, and employees 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 $1,000,000 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.
e. The following requirements apply to the insurance to be provided by Consultant
pursuant to this section:
(i) Consultant shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement.
(ii) Certificates of insurance shall be furnished to the City upon execution of
this Agreement and shall be approved in form by the City Attorney.
(iii) 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.
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: (1) 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 1 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.
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
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:
Executive Director of Parks, Recreation and Community Services
City of Santa Ana
20 Civic Center Plaza (M-23)
P.O. Box 1988
Santa Ana, California 92702
and,
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:
Tom Bystry
3058 Westhaven
Orange, CA 92665
(714)998-3371
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, that 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.
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 government 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.
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
indemnify 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:
PATRICIA E. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W.FLETCHER
City Attorney
By:
Michael Vigliotta
Deputy City Attorney
RECOMMENDED FOR APPROVAL:
Jon` p" Ribble
Executive Director of the
Parks Recreation and Community
Services Agency
CITY OF SANTA ANA
DAVID N. REAM
City Manager
CONSULTANT
V;Ae-v Fn), n EPJ' I "y
S c-,.- �✓ , c cis
(NAME)/nrts G B✓sry
TITLE) 0W n
a�L9-5A - I�/I
Employer ID # or Individual SS #
R
EXHIBIT A
Services to be Provided
1, Consult and confer with the Executive Director of Parks,
Recreation and Community Services to evaluate needs and
supervise maintenance activity of all City owned audio/video
facilities.
2. Review and make recommendation for the repair and/or
replacement of said facilities.
3: Qeesign laybut'.of electrical•, circuitry -for existing and/or
acquired audio/video, equipment.
4. Ensure compliance with local, state, and federal safety
codes and regulations.
5. Establish and maintain detailed equipment maintenance log
sheets and data bases to refer to in tracking long term
equipment performance and maintenance.
6. Help establish and enforce Agency wide policies for
equipment use.
7. Conduct regular security checks on the City's production
equipment.
8. Prepare preventive maintenance schedules and execute said
maintenance on a routine basis.
9. Supervise annual asset inventories and tagging, as needed,
of new assets.
10. Coordinate equipment repair with outside agencies.
11. Coordinate acquisition of new production equipment.
12. Facilitate and supervise use of facilities by outside
agencies, other City employees, or Comcast staff.
13. Facilitate completion of production services requested by
City staff (including making tape dubs, setting up
equipment, delivering equipment, and setting up studio and
operating facilities, as needed).
a..
14. Provide weekly status report to Executive Director updating
progress of equipment maintenance projects and projecting
anticipated completion dates.
15. Assist City Clerk and other users of the Council Chambers
and set up audio recordings, lighting, or other technical
needs.
Compensation
CITY will pay CONTRACTOR $55.00 (Fifty-five dollars) per hour, for a maximum of
sixteen hours per week. The first and third Monday of each month shall be two regularly
assigned workdays for CONTRACTOR.
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
Feb-02-04 02:30pm From -DRIVER ALLIANT INS, C
9497562713 T-617 P 02/02 F-853
DRIVER -ALLIANT
License Number: OC36861
Pbooe (949)1564271 / Fax (949) 756-2713
Certificate Number:047 Dam 2/2104
VENDOR / CONTRACTOR LIABILITY PROGRAM
Named Insured:
TomBystry / DBA: Video Engineering Services
Address:
3058 Westbaven
City/State/zip;
Orange, CA 92865
Additional Insured;
City Of Santa Ana
Contact Teem: From-
02/01/04 TO 02/01/05
Description of Contract: Vidto Tape City Council Meetings
Contract Amow;t $45,000.00
COMM&RCIAL GENERAL LIABILITY —NEW OCCURRENCE FORM
Gemral Aggregate.
S3,000,000,
Produem/Complated Operations Limit:
$1,000,000.
Personal Advertising;
S1,000,000.
Each Occurrence:
S1,000,000.
Fire Damage:
$ 50,000.
Medical Payments;
S 5.000
IMPORTANT!
Coverages are Limited to described coon'acr.
DEDUCTIBLE: $1,000. Each Claim, Including Legal and A4jUSUWnt EVemas
ANNUAL PREMIUM.
S625.00 Fully Earned at Inception
SURPLUS LINES TAX:
S 20.31 Fully Earned at Inception
POLICY FEE:
$ 50_00 Fully Earned at Inception
TOTAL
S69531
COMPANY: COLONYINSURANCECOMPANY
THIS COMPANY BINDS THE XIND(S) OF INSURANCE STIPULATED HEREON. THIS
INSURANCE IS SUBJECT TO THE TERMS, CONDITIONS, AND LM TTATIONS OF THE POLICY
OF MASTER POLICY #CP3073434 ISSUED TO VENDORS/CONTRACTORS LIABLITY GROUP. A
COPY OF THIS POLICY IS AVAILABLE ON REQUEST.
THIS CERTIFICATE MAY BE CANCELLED BY THE INSURED BY SURRENDER OF THIS
BINDER OR BY WRITTEN NOTICE TO TILE COMPANY STATING WHEN CANCELLATION WILL
BE EFFECTIVE_ TIUS CERTIFICATE MAY BE CANCELLED BY THE COMPANY BY NOTICE TO
THE INSURED IN ACCORDANCE WITH TIM POLICY CONDITIONS.
`,,,,`�
AUTHORIZED SIGNATURFJCO RSIGNATURE
RE. CHAIX & ASSOCIATES INSURANCE OROKERS ,04C.
Licaw Numbm 0726213
1501 WcttcliRDri-% Suim 290,Ncwpan BmCh, CA 92660
PHONE (949)722-4171 / PAX; (949)722.4172
( -1-i G
htQ�—
DRIVER - ALLIANT
License Number: SC36861
Phone (949) 7M4271 / Fax (949) 756-2713
Certificate Numbee043 Date: 1/24/05
VENDOR / CONTRACTOR LIABILITY PROGRAM
Named Insured:
TOM BYSTRY
Address:
3058 WESTHAVEN STREET
City/State/Zip:
ORANGE, CA 92865
Additional Insured;
CITY OF SANTA ANA
Contract Term: From:
02/01/05 TO 02/01/06
Description of Contract: VIDEO TAPING CITY COUNCIL MEETINGS
Contract Amount $45,760.00
COMMERCIAL GENERAL LIABILITY — NEW OCCURRENCE FORM
General Aggregate:
$1,000,000.
products/Completed Operations Limit:
$1,000,000.
Personal Advertising:
$1,000,000.
Each Occurrence:
$1,000,000.
Fire Damage:
S 50,000.
Medical Payments:
$ 5,000
IMPORTANT!
Coverages are Limited to described contract.
DEDUCTIBLE: $1,000. Each Claim, Including Legal and Adjustment Expenses
ANNUAL PREMIUM: $686.00 Fully Earned at Inception
SURPLUS LINES TAX: $ 22.12 Fully Earned at Inception
POLICY FEE: S fQ.QQ Fully Earned at Inceptiou
TOTAL $758.12
COMPANY: COLONY INSURANCE COMPANY
THIS COMPANY BINDS THE li'.IND(S) OF INSURANCE STIPULATED HEREON. THIS
INSURANCE IS SUBJECT TO THE TERMSUED , CONDITIONS, AND LO&TATIONS OF THIS POLICY
OF MASTER POLICY #G13215216 ISSTO VENDORS/CONTRACTORS LIABLITY GROUP. A
COPY OF THIS POLICY IS AVAILABLE ON REQUEST.
THIS CERTIFICATE MAY BE CANCELLED BY THE INSURED BY SURRENDER OF THIS
BINDER OR BY WRr TEN NOTICE TO THE COMPANY STATING WHEN CANCELLATION WILL
BE EFFECTIVE. THIS CERTIFICATE MAY BE CANCELLED BY THE COMPANY BY NOTICE TO
THE INSMg R�N, W TJ pOLTCY CONDTTIONS.
AUTHO '''(RIZZEEDvD SIGNATURE/COUNTERSIGNATURE
/COOUNTERSFSI�IGGNIATURE
R.fi CHAIX k ASSOCIAM INSURANCE BROKERS ,INC.
ri=w Number. 0726213
41 C rpomw Park, Suite 310, Irvine, CA 92606
PHONE (949)7224177 1 FAX: (949)722 4172
Aei'ROVED AS TO FORM
�r� dy
Aabistant City Attorney
DRIVER-ALLIANT
Lleense Number: OC36961
Phone (949) 7M4271 / Fax (949) 756-2113
CatiSuteNumber.043 Date: 1/24/05
VENDOR/ CONTRACTOR LIABILITY PROGRAM
Named Insured: TOM BYSTRY
Address: 3059 WESTHAVEN STREET
City/5mte2ip: ORANGE, CA 92963
Additional Insured: CITY OF SANTA ANA
ContractTetr. From: 02/01/05TO02/01/06
Description of Contract: VIDEOTAPING CITY COUNCIL MEETINGS
Contract Amount: S45,760.00
COMMERCIAL GENERAL LIABILITY— NEW OCCURRENCE FORM
Oencrai Aggregate: S1,000.000.
p /Completed Operations Limit: 51,000 (100.
Personal Advea¢siag: $I,000,000•
S1,000.000.
Each Occmrma: S 50,0DO.
Fire Damage: S 5,000
Medial Payments:
rMPORTANTI
Coverages are Limited to dea< rbed contract.
DEDUCIBLE: $1,000. Each Claim. Including Legal and Adlnatment Expenses
ANNUAL VREMMM: $686.00 Fully Earned at Inception
SURPLUS LINES TAX: 22.12 Fully Earned At locePtion
Fully earned a �ePun
POLICY FEE: $ s75&�12
TOTAL
COMPANY: COLONY INSURANCE COMPANY TED HEREON, TiiIS
THIS COMPANY BINDS THE KIND(S) OF INSURANCE S UKJJ-A
INSURANCE IS SUBIECTTO THETffitMS, CONDITIONS,VENDANDCON�CTOARS LIABLITY GROUP. A
OF MASTER POLICY #W215216 ISSUED TO VENDOl�
COPY OF THIS POLICY IS AVAILABLE ON REQUEST.
OFTHIS
THIS CERTIFICATE MAY B,IMCEIo �CONRANy THGSWHEN CANERCELLATIONWILL
BINDER OR BY 1" TTEIQ TO
BE EFFF.CTIVR• THIS CERTIFICATE MAY HE CANCELLED BY THE COMPANY BY NOTICE
THE INSUR;"; AC 7 POLICY CONDITIONS.
AUTHORIZED SIGNAT[1AE/COUNTE�IGNATURE
RE CHALY a, ASSOCIATES INSURANCE HROKEas -INC-
kv?ROVEL) AS TO FORM
Beare Number: 0726213 .+
41 C.Mm u' Pert, Sulm 310. WFINCA 92606 /
PRONE (94917224177 / FAX (949)722-4172
'�.adta Stitt S edy
AaaistaaL City Attorney
FEB-16-2006 14:57 FROM:
TO:714 647 5311 P.313
_.
DRIVER -ALLIANT
License Number: 006861
Phone (949) 756-0271 / Fag (949) 7S&2713
CcrtifcaleNumber.035
Date: 219/06
VENDOR/CONTRACTOR LIABILITY PROGRAM
Named insured
VIDIiOCNGINEF,RTNGSERVICES— THOMASE.BYSTRY
Address:
3058 NORTH W ESTHAV EN ST.
City/State/Zip:
ORANGE, CA M65
Additional Insured!
CITY OF SANTA ANA
Contract Term: From:
02/01/06 TO 02/01/07
Description of Contract:
VIDEO PRODUCER
Contract Amount'
S63,600
COMMBRCIAtCENERAL-LIARM]I 'Y—NEW-OCCURRENCE-FORM
General Aggregate: SI,000,000.
Products/Completed Operations Limit: S1,000,000.
Personal Advertising: S1,000,000.
Each Occurrence: S1,000,01)0.
Fire D.uwge: S 50,000.
Medical Payments: S 5,000
IMPORTANT!
Coverages are Limited to described couIIxt.
DEDUCTIBLE: $1,000. Each Claim, Including Legal and Adjustment Expenses
ANNUAL PREMIUM: S1,902,00 Fully Earned at Inception
SURPLUS LINES TAX: S 60.39Fully Famed at Inception
POLICY FEE: S aN Fully Famed at Inceplim
TOTAL $2,012.39
COMPANY: COLONY INSURANCE COMPANY
THIS COMPANY BINDS THL KIND(S) OF INSURANCE STIPULATED HEREON. THIS
INSURANCE IS SUBJECT TO THE TERMS, CONDITIONS, AND LIMITATIONS OF THE POLICY
`OFMASYE-R-POLIC't"L33092131SSUE0'7-0-VBNDCRWE)NTRACTf)RS-L1ABL•tT-YGROUP—. ^ --
COPY OF THIS POLICY IS AVAILABLE ON REQUEST.
THIS CERTIFICA rE MAY BL CANCELLED BY THE INSURED BY SURRENDER OF THIS
BINDER OR BY WRIT17EN NOTICE TO THE COMPANY STATING WHEN CANCELLATION WILL
BE EFFECTIVE. THIS CERTIFICATE MAYBE CANCELLED BY THE c omPANY BY NOTICE TO
THE INSURED IN ACCORDANCE WITH THE POLICY CONDITIONS.
AUTHORIZED SIGNATURE/COUN7ERSIGNATUPE
R.E.C14AIX&ASSOCIATES INSURANCE BROKERS,INC.
I immc Numb". 0726211 41 CorP"ae Park. Suite 310, Irvine, CA 92606
M"E(9e9)72241771 FAX (949)722A172