HomeMy WebLinkAboutADVANCED AUTOMATED SYSTEMS 1-2004
N-2004-134
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iNSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
I ~l ~-D5 CONSULTANT AGREEMENT"
Ii t;~K OF COUNCJL I/) 1f t:'\ _r. ""/7
DP,; E: J/r--J'-()Lf THIS AGREEMENT, made and entered into this I~: day of reI v/5t:/v, 2004 by
and between Advanced Automated Systems, 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").
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
preventive maintenance of air conditioning system.
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 ofthe 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 (Proposal for
Preventative Maintenance) 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 $ 8,160.00 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 October
31, 2004 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 Finance
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$l,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.
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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 proofthat 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 ofthe 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
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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 ofthe Finance Department
City of Santa Ana
20 Civic Center Plaza (M-17)
P.O. Box 1988
Santa Ana, California 92702
and,
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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:
Advanced Automated Systems, Inc.
23691 Via Del Rio
Y orba Linda, CA 92887
Attn: Greg Perry
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
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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.
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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:
CITY OF SANTA ANA
PATRICIA E. HEALY
Clerk of the Council
~~
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney \ J
By: M L V
Michael Vigliotta
Deputy City Attorney
RECOMMENDED FOR APPROVAL:
CONSULTANT /lOV~A../ceJ~#~SYS?84r
/,(/C .
33-0571S3::S
Employer ill # or Individual SS #
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Advanc~,d Altornated Systems, Inc.
Septembel 1\ 2004
Mario G li :z
Building !\a ntenance Superintendent
City of ~a t<l Ana
Building r-la ntenance Division
20 Civic C ~rlterPlaza, M-II
Santa Alia C alifomia 9270 I
J
Dear Mai ).
Thank Y)l f( Ir giving Advanced Automated Systems, Inc. the opportunity to propose a full coverage annual service
contract .
!
Scope 0/ I ~rk:
One day :8 hours) per month preventive maintenance service which includes the following:
EnerflV t1 ~a2enrent Svstenr:
1) S('n 01 calibrations (Temperature, KWH, Flow, Etc.)
2) Co)r [(,1 loop tuning.
3) T':5 I idjustment of power supplies,
4) D ~\ c.: output calibration (voltage. miliamps).
5) Fiell panel cleaning (using pressurized nitrogen).
6) C)( lil.g valve maintenance (lubricate and adjust).
7) E\1 ; :;oftware backup.
8) N el vc rk diagnostics.
9) Siel lens and Johnson controls diagnostics.
10) Del Lil ~d service report noting any deficiencies and repairs made.
11) WE:; md or NCM3~0 component repair I replacement. (with owner supplied parts)
Other:
1) Val ahle speed drive maintenance.
1) E l! in ~ering PC support I Training
Also in.:!, !f 'd:
~ . 'n,ining on both mechanical and energy management.
~ I :olsulting
~ I :u ,to mer support
} I >perational programming enhancements as developed by AAS, Inc.
~irr~~6rr M
--
23691 \Ii; [el Rio.. Yorba Linda. CA 92887-2715
Phone(714) 939-1380
Fax(714) 939-1382 Lic# 685336
.-
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1:1 m Proposal
T', 93 2 of 3
Labor ratf E::
~ 1'- Jrmal business hours: $85
~ " fter hours service rate: $90
. ~ E nergency service rate: (for equipment covered under this agreement $0 for equipment not covered see
ab lV ~)
The hour>> quoted in this agreement are to be considered a minimum and does not include travel time,
parts picl up, paperwork or any other function not directly related to actual services perform~d. At the
discretior (If City of Santa Ana, any deficit of agreeable time spent (8 hours per month) will be (A)
accruecl ' lithin the contract year and can be used on other related services at no charge or (8) reduce
contract; lT,ount payable for that quarter by agreed hourly service rate.
/
Total Qt:a::e 'ly Cost: $ 2,040.00 ($ 8,160.00 Annually)
Terms A lei Conditions
I. .\1 s ~rvices provided under this agreement shall be provided during normal Advanced Automated Systems, Inc.
'....( rking hours (8:00am to 5:00pm Monday through Friday) except when equipment needs to be shutdow:l for
!;e vi;e, which will be at additional costs. (Holidays included)
2. Ei hf r party may terminate this agreement on the anniversary date or by giving thirty days notice to cancel.
3. A( v"need Automated Systems, Inc. will not be held liable for any loss or delay, injuries or damage caused by
cil ;umstances beyond its control.
4. AI v"nced Automated Systems, Inc. does not cover repairs due to misuse or abuse.
5. .\( Kneed Automated Systems, Inc. assumes no liability regarding the continuous non interrupted service of
an I device.
6. If :nlergency service is requested and is not covered by the terms of this agre~ment, the client will be charged
lh, r,:ferenced labor rate.
7. .\1 i"lVoices will be. billed quarterly and are due in full within 30 days from the date received.
City of Santa Ana - Service Contract Proposal
April 5, 2004
Page 2 of3
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.. Sep .l!: J4 11: 26a
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B IE. Proposal
!'c gH 3 of 3.
A2reemlln : Accepted:
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Advanced. tu 'omated Systems is authorized to proceed with the work as proposed.
Advanced ~:tomated S
By ~i~
;'
Title~;: ~'\Ii U
Date_~) -/ V-O~
/
SincerEll~ I
Advancl 'd Automated System, Inc.
Greg Pe ry
ServiCE! I ~clnager
City of Santa Ana
Purchaser
Title
,
Date
"
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:
1. 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
8
ACORDN CERTIFICATE OF LIABILITY INSURANCE OP ID J~ DATE (MM/DDIYYYY)
ADVAN-6 05/19/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Bolton & Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CA License #0008309 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
245 S. Los Robles Ave, Ste 105 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Pasadena CA 91101
Phone: 626-799-7000 Fax: 626-441-3233 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Westport Insurance Corporation
INSURER B: Fireman's Fund Insurance 21873
Advanced Automated Systems Inc INSURER C: Peerless Insurance Company
23691 Via Del Rio INSURER 0: State Compensation Ins. Fund 35076
Yorba Linda CA 92887
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.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER DATE (MMJDDNYl P8kre'IMMIDDNY N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
f.-
A X ~ COMMERCIAL GENERAL LIABILITY RP1017641 01/18/04 01/18/05 ~~~:S'Es rEa occurence) $ 100,000
e-- =:J CU\!MS MADE ~ OCCUR MED EXP (Anyone person) $10,000
~ $1,000 PD Ded PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
e--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
II ,[Xl PRO- n
POLICY X JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
f.-
C ~ ANY AUTO BA9769078 09/15/03 09/15/04 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS ~;~,~ (Per accident)
-
- C/-_ '/Ll~, /~ PROPERTY DAMAGE $
/)/ (Per accident)
GARAGE LIABILITY '-----' / /// AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO ,(/ OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $2,000,000
B ~ OCCUR D CLAIMS MADE XSMOO076293380 01/18/04 01/18/05 AGGREGATE $ 2,000,000
$
~ DEDUCTIBLE $
X RETENTION $0 $
WORKERS COMPENSATION AND X I TORY LIMITS I IOJr'
ER
D EMPLOYERS' LIABILITY 713886404 11/13/03 11/13/04 $ 1,000,000
ANY PROPRIETORlPARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,000
g~EMtS~W'~~s~6~s below E.L. DISEASE - POLICY LIMIT $1,000,000
OTHER
DESCRIPTION OF OPERATIONS J LOCATIONS J VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
The city of santa Ana and Siemens Building Technologies, Inc.,their
officers,employees,agents,volunteers and representatives are included as A/I
per form CG 2009 (7/96) attached. Primary wording per the attached.
Job: City of Santa Ana HVAC Building service agreement.
*10 Notice for non payment @
CERTIFICATE HOLDER
CANCELLATION
SANTAA1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER WIL' . MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEF I
City of Santa Ana
Attn:Clerk of the City Council
20 Civic Center Plaza (M-30)
P.O Box 1988
Santa Ana CA 92702
- -
ACORD 25 (2001/08)
@ ACORD CORPORATION 198
fllticr
SANTAAl
POLICY NUMBER:
NAMED INSURED:
Advanced Automated Systems, Inc.
RPIOl7641
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 09 10 93
ADDITIONAL INSURED - OWNERS, LESSEES or CONTRACTORS [Form A]
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization (Additional Insured):
The City of Santa Ana
Siemens Building Technologies, Inc.
Location of Covered Operations
City of Santa Ana HV AC Building service
agreement.
Premium Basis
Rates
Advance Premium
Bodily Injury and
Property Damage Liability
Cost
(Per $1,000 of Cost)
$ INCLUDED
Total Advance Premium
$ INCLUDED
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this
endorsement.)
1. WHO IS AN INSURED (Section II) is amended to
include as an insured the person or organization (called
"additional insured") shown in the Schedule, but only
with respect to liability arising out of:
A. Your ongoing operations performed for the
additional insured(s) at the location designated
above, or
B. Acts of omissions of the additional insured(s) in
connection with their general supervision
of such operations.
2. With respect to the insurance afforded these additional
insureds, the following additional provisions apply:
A. Exclusions b., c., g., h.(1), j., k., 1. and n. under
COVERAGE A - BODILY INJURY AND
PROPERTY DAMAGE LIABILITY (section I -
Coverages) do not apply.
B. Additional Exclusions. This insurance does not
apply to:
(1) "Bodily Injury" or "property damage"
for which the additional insured(s) are
obligated to pay damages by reason of
the assumption of liability in a contract or
agreement. This exclusion does not apply to
liability for damages that the additional
insured)s) would have in the absence of the
contract or agreement.
(2) "Bodily injury" or "property damage" occurring
after:
(a) All work, including materials, parts or
such work, on the project (other than
service, maintenance, or repairs) to be
performed by or on behalf of the additional
insured(s) at the site of the covered
operations has been completed; or
(b) That portion of "your work" out of which
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or
subcontractor engaged in performing
operations for a principal as a part of the
same project.
(3) "Bodily injury" or "property damage" arising
out of any act or omission of the additional
insured(s) or any of their employees other
than the general supervision by the additional
insureds(s) of your ongoing operations
performed for the additional insured(s).
(4) "Property damage" to:
(a) Property owned, used or occupied by or
rented to the additional insured(s);
(b) Property in the care, custody or control of
the additional insured(s) or over which the
additional insured(s) are for any purpose
exercising physical control; or
(c) Any work, including materials, parts or
equipment furnished in connection with
such work, which is performed for the
additional insured(s) by you.
CG 20 09 1093
Copyright, Insurance Service Office, Inc., 1992 Page I of I
.V~~.--("'~ ~,.2 /7
i~~'
SANTAAI
NAMED INSURED: Advanced Automated Systems, Inc.
POLICY NUMBER: RPI017641
PRIMARY INSURANCE CLAUSE
IT IS AGREED THAT SUCH INSURANCE IS AFFORDED BY THIS POLICY FOR
THE BENEFIT OF THE ADDITIONAL INSURED(S) SHOWN BELOW SHALL BE
PRIMARY INSURANCE, BUT ONLY AS RESPECTS ANY CLAIMS, LOSS OR
LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED(S),
HIS SUBCONTRACTORS, SUBCONTRACTORS OF HIS SUBCONTRACTORS OR
MATERIAL MEN, OR SUPPLIERS. ANY INSURANCE MAINTAINED BY THE
ADDITIONAL INSURED(S) SHALL BE NON-CONTRIBUTING.
ADDITIONAL INSURED:
The City of Santa Ana
Siemens Building Technologies, Inc.
NOTHING HEREIN CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, LIMITS, OR CONDITIONS OF THE POLICY
EXCEPT AS HEREIN SET FORTH.
.,-.~
r'~/S)
j' 7
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTO GOLD ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SECTION II . LIABILITY COVERAGE
A. COVERAGE
1. WHO IS AN INSURED
The following is added:
d. Any organization, other than a partnership or joint venture, over which you maintain ownership or a majority
interest on the effective date of this Coverage Form, if there is no similar insurance available to that
organization.
e. Any organization you newly acquire or form other than a partnership or joint venture, and over which you
maintain ownership of a majority interest. However. coverage under this provision does not apply:
(1) If there is similar insurance or a self-insured retention plan available to that organization; or
(2) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization.
f. Any volunteer or employee of yours while using a covered auto" you do not own, hire or borrow in your
business or your personal affairs. Insurance provided by this endorsement is excess over any other
insurance available to any volunteer or employee.
g. Any person, organization, trustee, estate or govemmental entity with respect to the operation, maintenance
or use of a covered "auto" by an insured. if:
(1) You are obligated to add that person, organization, trustee, estate or governmental entity as an
additional insured to this policy by:
(a) an expressed provision of an "Insured contract", or written agreement; or
(b) an expressed condition of a written permit issued to you by a govemmental or public
authority.
(2) The "bodily injury" or "property damage" is caused by an "accidenf' which takes place after:
(a) You executed the "insured contract" or written agreement; or
(b) the permit has been issued to you.
2. COVERAGE EXTENSIONS
a. Supplementary Payments.
~~) ;1/7
Subparagraphs (2) and (4) are amended as follows:
(2) Up to $2500 for cost of bail bonds (Including bonds for related traffic law violations) required because of
an "accidenf' we cover. We do not have to furnish these bonds.
Includes copyrighted material of Insurance Services Offices. Inc. with its pennission
Page 1 of 4
GECA 701 (01/01)
0911512003 CA 9769078
NEUSXCLE 1709
AGENT COPY
PGDMll60D J03315
AGENTG 00000477 Page 25
(4) All reasonable expenses incurred by the "Insured" at our request, including actual loss of earning up to
$500 a day because of time off from work.
SECTION III . PHYSICAL DAMAGE COVERAGE
A. COVERAGE
The following is added:
5. Hired Auto Physical Damage
a. Any "auto" you lease. hire, rent or borrow from someone other than your employees or partners or members
of their household is a covered "auto" for each of your physical damage coverages.
b. The most we will pay for "loss" in anyone "accident" is the smallest of:
(1) $50.000.
(2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or
(3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and
quality.
If you are liable for the "accident", we will also pay up to $500 per "accident" for the actual loss of use to the
owner of the covered "auto."
c. Our obligation to pay for, repair, retum or replace damaged or stolen property will be reduced by an amount
that is equal to the amount of the largest deductible shown for any owned "auto" for that coverage. However,
any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire
or lightning.
d. For this coverage, the Insurance provided is primary for any covered "auto" you hire without a driver and
excess over any other collectible insurance for any covered "auto" that you hire with a driver.
6. Rental Reimbursement Coverage
We will pay up to $75 per day for up to 30 days. for rental reimbursement expenses incurred by you for the rental of
an "auto" because of "loss" to a covered "auto." We will also pay up to $500 for reasonable and necessary expenses
incurred by you to remove and replace your materials and equipment from the covered "auto."
If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage
only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage
Extension.
7. Customized Furnishings Coverage
We will pay with respect to a covered "auto" for "loss" to custom furnishings including, but not limited to:
a. Special carpeting and insulation;
b. Height-extending roofs;
c. Custom murals, paintings, or other decals or graphics.
-/,.S?<'
:2>-,r5
/ v
" /'7
J'
Our limit of liability for loss to custom furnishings shall be the least of:
a. Actual cash value of the stolen or damaged property as of the time of the loss; or
Includes copyrighted malerial of Insurance Services Offices, Inc. wilh ils pennission
GECA 701 (01/01)
Page 2 of 4
0911512003 CA 97e9078
NEUSXCLE1709
AGENT COpy
PGDMD60D J03315
AGENTG 00000478 Page 26
b. The amount necessary to repair or replace the property; or
c. $500.
This coverage does not apply to electronic equipment.
8. lease Gap Coverage
If a long-term leased "auto" is a covered "auto" and the lessor is named as an Additional Insured - Lessor, In the
event of a total loss, we will pay your additional legal obligation to the lessor for any difference between the actual
cash value of the "auto" at the time of the loss and the "outstanding balance" of the lease.
"Outstanding balance" means the amount you owe on the lease at the time of loss less any amounts representing
taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage
charges; excess wear and tear charges; and lease termination fees.
B. Exclusions
The following is added to Paragraph 3
The exclusion for "loss" caused by or resulting from mechanical or electrical breakdown does not apply to the accidental
discharge of an airbag.
Paragraph 4 is replaced with the following:
4. We will not pay for "loss" to any of the following:
a. Tapes, records, disks or other similar audio, visual or data electronic devices designed for use with audio, visual
or data electronic equipment.
b. Equipment designed or used for the detection or location of radar.
c. Any electronic equipment that receives or transmits audio, visual or data signals.
Exclusion 4.c does not apply to:
(1) Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely
for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of
the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's"
electrical system, in or upon the covered "auto"; or
(2) Any other electronic equipment that is:
(a) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's"
operating system; or
(b) An integral part of the same unit housing any sound reproducing equipment described in (1) above and
permanently installed in the opening of the dash or console of the covered "auto" normally used by the
manufacturer for installation of a radio.
D. DEDUCTIBLE
The following is added: No deductible applies to glass damage if the glass is repaired rather than replaced.
SECTION IV. BUSINESS AUTO CONDITIONS
A. lOSS CONDITIONS
J~'()
r"~
Li/7
Item 2.a. and b. are replaced with:
Includes copyrighted material of Insurance Services OffICeS, Inc. with its pennission
Page 3 of4
GECA 701 (01/01)
0911512003 CA 9769078
NEUSXCLE1709
AGENT COPY
PGDM060D J03315
AGENTG 00000479 Page 27
. .
. .
2. Duties In The Event of Accident, Claim, Suit, or loss
a. You must promptly notify us. Your duty to promptly notify us is effective when any of your executive officers,
partners, members, or legal representatives is aware of the accident, claim, "suit", or loss. Knowledge of an
accident, claim, "suit", or loss, by other employee(s) does not imply you also have such knowledge.
b. To the extent possible, notice to us should include:
(1) How, when and where the accident or loss took place;
(2) The names and addresses of any injured persons and witnesses; and
(3) The nature and location of any injury or damage arising out of the accident or loss.
The following is added to 5.
We waive any right of recovery we may have against any additional insured under Coverage A. 1. Who Is An
Insured g., but only as respects loss arising out of the operation, maintenance or use of a covered "auto"
pursuant to the provisions of the "insured contract", written agreement, or permit.
B. GENERAL CONDITIONS
7. e. is added:
e. All parts of the world for an "auto" you hire for less than 30 consecutive days, if the insured's responsibility to
pay damages is determined in a "suit" on the merits in the territory described in 7. a - 7. d.
9. is added:
9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Your unintentional failure to disclose any hazards existing at the effective date of your pOlicy will not prejudice the
coverage afforded. However, we have the right to collect additional premium for any such hazard.
COMMON POLICY CONDITIONS
2.b. is replaced by the following:
b. 60 days before the effective date of cancellation if we cancel for any other reason.
~/17
Includes copyrighted material of Insurance Services OffICes, Inc. with its permission
Page 4 of 4
GECA 701 (01/01)
09115/2003 CA 9769078
NEUSXCLE17Q9
AGENT COPY
PGDM0600 J03315
AGENTG ()()()()()48() Page 28
-r
ACORD. CERTIFICA TE OF LIABILITY INSURANCE OP 10 J~ DATE (MMIODIYYYY)
ADVAN-6 11/11/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Bolton , Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CA License #0008309 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
245 S. Los Robles Ave, Ste 105 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Pasadena CA 91101
Phone: 626-799-7000 Fax:626-441-3233 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Westport Insurance Corporation
INSURER 8: Fireman's Fund Insurance 21873
Advanced Automated Systems Inc INSURER c: Peerless Insurance Comoany
23691 Via Del Rio INSURER 0: State Compensation Ins. Fund 35076
Yorba Linda CA 92887
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.
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE fMMfDDIYYI- DATE MMfDD1YYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
f.-
A X X COMMERCIAL GENERAL LIABILITY RPI017641 01/18/04 01/18/05 PREMISES YE~~~~~nce\ $100,000
I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $10,000
~ $1,000 PD Ded PERSONAl & ADV INJURY $1,000,000
'- GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APf!YIPER: PRODUCTS - COMP/OP AGG $2,000,000
'I ( Iil PRO-
POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
C 1C. ANY AUTO BA9891367 11/13/04 11/13/05 (Eaaccidenl)
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS {Per person)
-
- HIRED AUTOS BODILY INJURY
$
NON..QWNED AUTOS (Peraccidenl)
I--
r- PROPERTY DAMAGE $
(Peraccidenl)
GARAGE LIABILITY ~ l.t'..e{7 AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACe $
AUTO ONLY: AGO $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000
B ~ OCCUR 0 CLAIMS MADE XSMOO076293380 01/18/04 01/18/05 AGGREGATE $2,000,000
$
;=1 DEDUCTIBLE $
X RETENTION $0 $
WORKERS COMPENSATION AND X JIORY Ll~WS I !UER-
D eMPLOYERS' LIABILITY 713886405 11/13/04 11/13/05 $1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1 000,000
~P~~I~tS~~V~~?~~S below E.L. DISEASE - POLICY LIMIT $1,000,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The city of santa Ana and Siemens Building Technologies, Inc. , their
officers,employees,agents,volunteers and representatives are included as A/I
per form CG 2009 (7/96) attached. Primary wording per the attached.
Job: City of Santa Ana HVAC Building service agreement.
*10 Notice for non payment @
CERTIFICATE HOLDER
CANCELLATION
City of Santa Ana
Attn:Clerk of the City Council
20 Civic Center Plaza (M-30)
P.O Box 1988
Santa Ana CA 92702
SANTAAl
~.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER WIL' . MAIL 30. DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEF I
ACORD 25 (2001/08)
@ACORD CORPORATION 198
From: Je!:;'S;c.-1 Chavez-Roy At: Bolton & Co. FaxlD: Bolton and Company To: CITY OF SANTA ANA
,
.-
Date: 2,.1712005 03:24 PM Page: 1 of 3
.
, ACORD. CERTIFICATE OF LIABILITY INSURANCE DA'J'! (MMIDOIVYVY)
OP 10 J~ 02/17/05
ADVAN-6
PRODUCIOR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Bolton & Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CA License '0008309 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
245 S. Los Robles Ave, Ste 105 ALlER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
Pasadena CA91101
~hone:626-799-7000 Fax: 626-441-3233 INSURERS AFFOROING COVERAGE NAIC#
INSUREIJ INSURER A: "_t;porl; In.uranl:!i Co:r;po~tion
INSURER B: Fireman's Fund Insurance 21873
Advanced Automated Systems Ine INSURI;R C: Fearless Insurance Company
23691 Via Del Ri~ INSURER D: stII.t. CalIpGnoation InD. Fund 35076
Yorba Linda CA 9 887
. INSURER 1;:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 1HE POUCY PERIOD lfoDICATED. NOTWITHSTANDING
ANY REQUlkEMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUt.tENTWJTH RESPECT TO WHICH THIS CERTIFICATE MAY 910 ISSUED OR
MAY PERTAIN, 'rHE INSURANCE AFFORDED BVTHE 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.
LT' N5R TYPE OF INSURANCE POUCY NUMBER I D~TE'iAfr:1nf5tW\c 1r-~.t~1'(~ffir,yy;N LIMITS
~NERAL LIABILITY ! EACH OCCURRENCl: $1,000 000
A X ~ ==r~ERCIAL GENERAL UABILITY WCP117003565200 01/18/051 01/18/06 PREMISES Ell occurence\ , 100,000
f-- CLAlMS MADE [!] OCCUR MED EXP (Anyone plll'GDn) $10,000
~. $1,000 l'D Ded I F'ERSONAL &ADV INJURY $1,000_,000
GENERAL AGGREGATE $2,000,000
GIOH'LAGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $2 000,000
h POLICY 5Cl ff8r n LOC I
~TOUOBlLE UABILITY 11/13/04 I COMBINED SINGLE liMIT $1,000,000
C ~ Am AUTO BA9891367 11/13/05 (Esaccldent)
- ALL OWNED AUTOS APPROVED AS r BODILY INJURY
, (Perll"lIlSon) $
- SCHEDULED AUTOS FORM
HIRED AUTOS BODILY INJURY
- $
NON.oWNEO AUTOS ~L.P d, ~/_~ (Peracc:ldent)
-
- PROPERTY DAMAGE ,
' Lura Stitt('Sh Ip~ (Per Bcclden!)
GARAGE UABIUTY t-\-SSI 'tant City At orne\' AUTO Otl...Y. EAACCIDENT $
=l ANY AUTO OTHER THAN EAACC $
AUTO ONl.. Y: AG. $
~SSJUMBRELLA UABILITY EACH OCCURRENCE $2 000,000
B X OCCUR D ClAIMS MADE XSMll6680410 01/18/05 01/18/06 AGGReGATE $2 000,000
$
~ ,DEDUCTIBLE .I $
X RETENTION $0 $
WORKERS COMPENSATION AND I X IToR'v"'lI'MJTS IUS\'
D EMPLOYERS' UABIUTY 713886405 11/13/04 11/13/05 E.L. EACH ACCIDENT $1,000,000
IANYPROP~ETO~ARTNE~ECUTIVE
oFFICERlMEMBER EXCLUDED? E.L: DISEASE M EA EMPLOYEE $1 000,000
, ~~~~~~'OV;~NSbelow I E.L DISEASE. POLICY LlMrr $ 1 000 000
lomE. ,
I
DESCRIPTION OF OPERATIONS' LOCATJONS I VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
GL Additional insured per CG2009 10/93. Primary Wording per the attached.
JOb:Operations of the Named Insured
*10 day notice for non payment.@
CERTIFICATE HOLDER
Ci ty of Santa Ana
Office of the City Attorney
20 Civic Center Plaza
F.O Box 1988
Santa Ana CA 92702
SANTAA3
,-
CANCELLATION
SHDULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATlO
DATETHEREOF,THEI5SUINGINSURERWlLL - MAIL. 30* DAVSWRITTEN
NOTICE 70 nt!; CERTlFICATri HOLDER NAMED TO THE LeFT,
ACORD 25 (2001108)
@ACORDCORPORATION198
-~_._----._--------_..._------._----~----------_._----~------
From: Je:<sica Chavez-Roy At: Bolton & Co. FaxlD: Bolton and Company To: CITY OF SANTA ANA
'.
Date: 2/1712005 03:24 PM Page: 2 of 3
IMPORTANT
If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be
endorsed. A. statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance On the reverse side of this form does not cOnstitute a
contract between the issuing Insurer(s), authorized representatve or producer, and
the certificate holder, nor does it affirmatively or negatively amend, extend or alter the
coverage afforded by the policies listed thereon.
"':;';>'.:;i;l';',t~.-;
A.PPROVED AS TO Po
--~ c/,
Laura Stitt Sh -" .
A . eedy
,SSlstant City A
ttor'i,
" :I.:f't>:;....,r'i..~;!. . ,~.).-d,;_~,$
-;~, k'r.~.2::.}~~..,; '.~ /,~'-~,:;:'-:, ''i..,'~, '._"'''':<;_"~;,.,'. ;.,\;~l'iJ. '; :..::n;s~: ^';tJ',t,t,-~~.",,'
-t . 1/' ':~-:' ,:"~r' :';.'
. :~,', <,".
, '-c_.'
ACORD 25 (2001/08)
From: Je""sica Chavez-Roy At: Bolton & Co. Fax!D: Bolton and Company To: CITY OF SANTA ANA
"
Date: 2/1712005 03:24 PM Page: 3 of 3
.
SANT A1\3
POLICY NUMBER
NAMED INSUREr)
Advanced Automated Systems, Inc
WCP 117003505200
COMMERCIAL GENERAL LIABILITY
TIDS ENDORSEMENT CHANGES THE POLICY. PJ,EASE READ IT CAREFULLY.
CG 20091093
ADDITIONAL INSllRED - OWNERS, LESSEES or CONTRACTORS [Form AJ
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Orgaruzation (Additional Insured):
The City ot" Santa Ana, its officers, employees, agents, volunteers !lnd representatives.
Location of Covered Operations
Operations of the Named Insured
Premium Basis
Rates
Advance Premium
Bodily InJmy and
Property Damage Liability
Cost
(Per $1,000 of Cost)
$ INCLUDED
Total Advance Premium
$ INCLUDED
or no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this
endorsement.)
1. WHO IS At'J INSURED (Section ll) IS amended to
include as an insrned the person or organization (called
"additional Insured") shown in the Schedule, but only
Wlth respect to liability arising out of:
A Your ongoing operations performed for the
additional insured(s) at the location designated
above, or
B. Acts of omissions of the additional insrned(s) in
connection with their general supervislon
of such operations.
2. With respect to the insurance affordeu these additional
insureds, the following additional provisions apply:
A ExclUSIons b., c" g" h,(I), j" k" Land n. under
COVERAGE A - BODILY INJURY AND
PROPERTY DAMAGE LIABILITY (section [ _
Coverages) do not apply,
B. Additional Exclusions. This insurance does not
apply to:
(I) "Bodily Injury" or "property damage"
for which the additional insrned(s) are
obligated to pay damages by reason of
the assumption of liability in a contract or
agreement This exclusion does not apply to
liability for damages that the additional
insured)s) would have in the absence of the
contract or agreement.
(2) IP Bodily injury" or "property damage" occurring
after'
(a) All, work, including materials, parts or
""",..........."....t +"......;~h",,1 ;.., ""......,"'~t,,,.... n,;th
such work, on the project (other than
service, maintenance, or repairs) to be
performed by or on behalf of the addItIonal
insrned(s) at the site of the covered
operations has been completed; or
(b) That portion of "your work" out of which
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or
subcontractor engaged In performing
operations [or a principal as a part of the
same project.
(3) "Bodily injury" or "property damage" arising
out of any act or omission of the additional
insurcd(s) or any of their employees other
than the general supervision by the additional
insureds(s) of your ongoing operations
performed for the additional insured(s).
(4) "Property damage" to
(a) Property owned, used or occupied by or
rented to the additional msured(s);
(b) Property in the care, custody or control of
the additional insured(s) or over which the
additional insurcd(s) are for any purpose
exercising physical control; or
(c) Any work, including materials, parts or
equipm ent furnished in connectlOn with
such work, which is performed for the
additional insrned(s) by you.
CG20091093
Copyright., Insrnance Service Office, Inc., 1992
;\]>Pi<.' '\c' 10 FORM
~;>Z~Ofl
" , ,Sheedy
.li Attorney
Feb'11 05 09:58a
p.4
.
CERTHOLDER COPY
STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142~807
COM~EN5ATION
INSURANCI!
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 01-12-2005
GROUP: 000713
POLICY NUMBER: B86~ -200~
CERTIFICATE ID: 354.
CERTIFICATE EXPIRES: 11-13-2005
11-13-2004/11-13-2005
TEB IRVINE COKPANr OFFICE PROPERTIBS
630 NEWPORT CENTER DR. STE.#100
NEWPORT BEACH CA 92660
JOB. ALL OPERATIClIlS
This is to certify that we have Issued a valid Worker's Compensation insuranoe policy in a form approved by the Ca:ifomia
Insurance Commissioner to the employer named below for Ihe porlCY period Indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the empioyer.
/ We will also give you 30 days advance notice should this polley be cancelled prior to Its normal expiration.
This certificate of insurance is not an insurance poley and does not amend, extend or alter !he coverage afforded by the
policy listed herein. Notwithslanding any requirement, term or condition of any contract oc otI1er document with
respect 10 which this certificate of insurance may be issued or to which It may pertain, the Insurance afforded by the policy
described herein Is subject to all the terms, exclusions. end conditions, of such poliey.
~
,&~ c. eL
AUTIiORlZED REPRESENTATIVE
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #1600 - lIIAUREEN V JO!roY, PRBSIDSNT TRE - EXCLUDED.
EllDORSEMENT #1600 - ItEITH S VOYSBY, SECRETARY - EXCLUDED.
ENDORSEtIENT #1500 - MIRE CURREY, SEC - BXCLUDED.
ENDORSEMENT 111600 - CHRIS TAYLOR, TRES - EXCLUDED.
ENDORSEMENT #1600 - CHRIS FLANDERS, VP - EXCLUDBD.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 11-13-2003 IS
ATTACBED TO AND FORKS A PART OF THIS POLICY.
ENDORSEMENT 112570 EllTITLED WAIVER OF SUBROGATION EFFECTIVE 01-12-2005 IS
ATTACBED TO AND FORKS A PART OF THIS POLICY. THIRD PARTY Nl\KE:
THE IRVINE COMPANY OFFICE PROPBRTIE9
APPROVED AS'
r, TO PORM
-
E~OYER
ADVANCED AtlTOMATED SYSTEMS mc AND/OR AND/OR
· AC'()BD!
PRODUCER
Arthur J. Gallagher & Co.
Ins Brokers of CA Inc. 072629
15 Enterprise, Suite 200
A1iso Viejo CA 92656
Phone: 949-349-9800 Fax:949-349-9900
OP 10 DATE (MMlDDIYYYY)
ADVANOB 03 29 06
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.
CERTIFICATE OF LIABILITY INSURANCE
INSURERS AFFORDING COVERAGE
INSURED
N-;lo01-13't
INSURER A:
INSURER B:
INSURER c:
INSURER 0:
INSURER E:
Great A1qriean Assurance Co
Clarendon Natio...l tnsur. Co.
Advanced Automated Systems,Inc
& Electrical Systems, Inc. ./ . ,I 'I
23691 Via Del Rio .1 -'ro.,.-13"'-C
Yorba Linda CA 92887 1"-eX
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.
LTR
POLICY NUMBER
I ~9..~E MMIDDiW'lc PgkTE MMJDDNY
A
EACH OCCURRENCE
I PRa1:Si:.s (Ea occurence)
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS. COMPIOP AGG
GLP9251462
02/21/06
02/21/07
RE {ISE
,
,
I
U
COMBINED SINGLE LIMIT
(Eaaccidenl)
,;.{
,
L.,j
-_..~-' 1.; I i CAJf
;,:iJ':::S ALL PF iOFl
IS"UED
PROPERTY DAMAGE
(PeraccJdenl)
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
A
~RAGE LIABILITY
I ANY AUTO
~ESSIUMBRELLA LIABILITY
~ OCCUR D CLAIMS MADE
02/21/07
EACH OCCURRENCE
AGGREGATE
AUTO ONLY. EA ACCIDENT
OTHER THAN
AUTO ONLY:
EA Ace
AGG
EXC9251463
02/21/06
B
I DEDUCTIBLE
I RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMe.ER EXCLU~ED'!
~~~~I~iS~~bOVIS16NS below
OTHER
11/13/05
x ITO''\"/''MITS 1 IOJ~'
11/13/06 E.L. EACH ACCIDENT
-~, .
E.L. DISEASE. EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
01KR0031627
NAIC#
LIMITS
.1,000,000
.50,000
. EXCLUDED
.1,000,000
.2,000,000
.2,000,000
.
.
.
.
.
.
.
.2,000,000
.2,000,000
.
.
.
.1,000,000
.1,000,000
.1,000,000
. ,
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS I. /.pYX! i' 1/
RE: City of Santa Ana HVAC Building service agreement. (T";::'l":J_Jic/__lj <:
Ci ty of Santa Ana and Siemens Building Technologies, Inc., their officers; ..- - l~~ - ~ -l.__
employees,agents,volunteers and representatives are n~ed as additional
insured per the attached endorsement. Primary wording applies to GL.*10 day
notice of cancellation for nonpayment of premium.
CERTIFICATE HOLDER
CANCELLATION
City of Santa Ana
Attn:Clerk of the City Council
20 Civic Center Plaza (M-30)
P.O Box 1988
Santa Ana CA 92702
SANTAAl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO 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.
AUTHr~~TATlVE
ACORD 25 (2001/08)
C ' .
@ ACORD CORPORATION 1988
, .
POLICY NUMBER:
GLP9251462
Advanced Automated Systems, Inc.
Electrical Systems, Inc.
COMMERCIAL GENERAL LIABILITY
CG 20 10 10 93
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:
As required by written contract or agreement.
(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.
It is agreed that the Limits of Insurance afforded by this policy to any Additional Insured included herein shall not
exceed the Limits of Insurance required by the terms and provisions of the project(s), specifications, written con-
tract(s) or agreement(s) between the Additional Insured and the Named Insured.
The inclusion herein of any Additional Insured shall not operate to increase the Company's Limits of Insurance.
7-/> (U
CG 20 10 10 93
Copyright, Insurance Services Office, Inc" 1992
Page 1 of 1
o
,.-
, .
JlGREAT AMERICAN INSURANCE CQMf :S
Subsidlllries of American Financial Co...<lrlltlan
ssa WALNUT STREET, CINCINNATI, OHIO 45202
GLP9251462
Advanced Automated Systems. Inc.
Electrical Systems, Inc.
CG 88 02 lEd. 11 851
BUSINESSPRO GENERAL ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
PRIMARY INSURANCE ENDORSEMENT
It is hereby noted and agreed that effective upon inception. this policy shail be considered primary to any similar insurance
held by third parties in respect to work performed by you under written contractual agreement(s) with said third parties.
The third party to whom this endorsement applies is:
AS REQUIRED BY WRITTEN CONTRACT
'-?2~<.'? "'
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