HomeMy WebLinkAboutCURBSIDE, INC. 1 - 2004
INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
,~.- ~ -0'1
CLERK OF COUNCIL
DATE: !"-{ 7-t)ì!
N-2004-092
CONTRACT TO PROVIDE SMALL BATTERY RECYCLING
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TIllS AGREEMENT, made and entered into this J3-th- day of ~d ,2004 by
and between Curbside Inc., a California Corporation (hereinafter "Contracto ), and the City of
Santa Ana, a charter city and municipal corporation organized and existing under the
Constitution and laws ofthe State of California (hereinafter "City").
RECITALS
A. The City desires to retain a Contractor having special skill and knowledge in the field of
battery removal and recycling services.
B. The City desires to retain Contractor to perform the services set forth in the Proposal.
C. Contractor represents that Contractor is able and willing to provide such services to the
City.
D. In undertaking the performance of this Agreement, Contractor represents that it is
knowledgeable in its field and that any services performed by Contractor 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
Contractor shall perform those services as set forth in Exhibit A "Scope of Services
Small Battery Recycling Program" to this Agreement.
2.
COMPENSATION
a. City agrees to pay, and Contractor 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 $7,500.00 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 June 30,
2005, unless terminated earlier in accordance with Section 12, below.
1
4.
INDEPENDENT CONTRACTOR
Contractor 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
Contractor performs the services which are the subject matter of this Agreement; however, the
services to be provided by Contractor shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Contractor 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, Contractor shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Contractor 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 Contractor's operations in the
performance ofthis 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 thereftom, and property damage, in the total
amount of $1,000,000 per occurrence. Contractor shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit D 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, Contractor, if Contractor 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, Contractor agrees to obtain and maintain any
employer's liability insurance with limits not less than $1,000,000 per accident.
d. If Contractor 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 Contractor
pursuant to this section:
(ii)
Contractor 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 Contractor 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 Contractor's right to be paid for its
time and materials expended prior to notification of termination. Contractor 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
Contractor agrees to and shall indemnify and hold harmless the City, its officers, agents,
employees, Contractors, 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 Contractor 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.
7.
CONFIDENTIALITY
If Contractor receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Contractor 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
3
of the Contractor disclosed in a publicly available source; (c) is in rightful possession of the
Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of
law; or (e) is independently developed by the Contractor without reference to information
disclosed by the City.
8.
CONFLICT OF INTEREST CLAUSE
Contractor 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-21)
P.O. Box 1988
Santa Ana, CA 92702-1988
telefacsimile (714) 647-6956
With courtesy copies to:
Executive Director of Public Works Agency
City of Santa Ana
20 Civic Center Plaza (M-43)
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
4
To Contractor:
Curbside Inc,
1605 N. Spurgeon Street
Santa Ana, CA 92701-2355
Attn: William Anderson, President
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
Contractor, 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 Contractor. 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 Contractor 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 Contractor,
Contractor 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 Contractors 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, Contractor shall be entitled to receive and the City shall pay Contractor
compensation for all services performed by Contractor 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 Contractor 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 Contractor 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
Contractor 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. Contractor 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
Contractor 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. Contractor 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
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.
~l~ OF SANTA ANry
, ) . "" /
/'-~~~¿ ')~
¡Í)AVIDN. REAM/
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By: I
Michael Vigliotta '
Deputy City Attorney
APPROýED AS TO ,Jo;;lNT:
-ßY--Y(~ !~~
James/G. Ross
Exeçutive Director, Public
W,dÍ-ks Agency
,,/
~J.-()b71ì'1Y
Employer ill # or Individual SS #
7
Scope of Services
Small Battery Recycling Program
The Small Battery Recycling Program is designed and managed by Curbside Inc.
1.
The initial price ofa single 5.5 gallon bucket is $150.00 and includes the following:
. Delivery of an empty bucket with applicable labeling.
. Collection, transportation and recycling of contents of the bucket.
. Documentation indicating that the batteries were collected for recycling.
2.
A deposit in the amount of $50 per bucket will be charged for each bucket. This deposit will be
credited toward the final invoice should the program be terminated.
3.
The price in effect at the time the bucket was dropped off will remain in effect for the term of this
agreement.
4.
The price is not based upon the contents of the bucket. Buckets will be collected at the request
of the City and the fee is fixed regardless of the quantity in the bucket.
5.
Only small household type batteries are permitted in this program and include: Alkaline, Ni Cad, Zinc
Carbonaire without mercury, silver zinc, lithium ion, mercury hearing aid batteries and similar types of
batteries. Cell phones are permitted.
6.
The following are unacceptable at the price quoted above: Commercial batteries, industrial batteries,
batteries from businesses (i.e., hearing aid stores or doctors offices), lead acid batteries, or large
quantities of mercury & lithium button batteries. This includes rechargeable batteries generated in large
quantities.
7.
The bucket remains the property of Curbside Inc.
8.
The client is responsible and agrees to hold Curbside Inc. harmless for any damage that
could be caused by the bucket or its contents while on City premises.
9.
Curbside Inc. employees will inspect each bucket prior to accepting it and will remove
any unacceptable items prior to accepting it.
10.
The deposit is subject to forfeit ifthe bucket is destroyed stolen or unavailable for final collection.
Exhibit A
I ,... y '" -L\~... "" 1..-1" ... .""'"', '- -, ~I""''''''.L...I I . . . . '-' ~ I ,'""'. . '" L- I 07/09!ZOO4
PRO~~R (949)622-5517 FAX (949)622-SS1& THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA 11:
GSM Insurance Services HOLDER. THI$ CERTIFICATE DOES NOT AMEND, EXTEND OR
lie. #0015612 Al TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
19200 Von Karman Ave. 1400
Irvine, CA 92612 INSURERS AFFORDING COVERAGE NAIC#
I~R~O Curbside, InC. INSURER A; American Int'l Specialty Lines 26&83
1605 N. Spurgeon St. IN3URER 5: Commerce & Industry Ins. Co. 19410
Santa Ana, CA 92701 INSURER C'
INSURER D:
INSURER E:
COVERAGES
THË POLICIES OF INSuRANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N01WITHST ANDING
ANY REOUIREMENT T!õRM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR...
MÅ Y PERT AfN, THE iNSURAN<:E AFFORDED BY THE POLICIES DESCRIBED HEREIN tS SUBJECT TO ALL THE rEIWS. EXCLUSIONS ANO CONOITIONS OF'Sf:5tH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAV!õ BEEN REDUCED BY PAID CLAIMS.
L m NSfI
TYPE OF INSURANCE
GENERAl. I.lA81UTY
X COMMe~lAl Ge;NI;RAI. 1.lAlJII.ITY
CLAIMS MADE 00 occuR
POUCY NUMBER
LIMITS
$
$
$
GENERAl. AGGREGATE
$
$
A
8
"RODUCTS . COM"IO" AGG S
LOC
CA 808 77 11 11/23/2003
08/21/2004
COMBIN!õO SINGLE LIMIT
(Eio..=dcnl)
5
ALL OWNEO AUTQoS
$CHEOVLE<D AIJTOS
HIReD AuTOS
BODILY INJURY
(P",pe¡oon>
5
NON.OWNE<O AlfTOS
80011. Y INJURY
(P", .ocl~enI)
5
PROPbRTY CAMAGI;;
(P", a<:cJ~onI)
s
GAAAGE LIABU.IT'(
fW'( AUTO
AUTO ONLY. EJ\ ACCIDëNT S
OTHER Tt1AN
/WTO ONLY,
E;A AGC $
AGG S
fÐ(CESSIUM8REUA LIABIUTY
OCCuR 0 C\.AtMS MACE<
EACH OCâJRRËNce
AGGREGATE<
$
S
oeOUCT'B..e
RETENTION
S
$
$
$
WORKeRS COMPeNSAnON AND
EMPLOYERS' LIABlUTY
ANYPROPR~TO~PARTNe~ECUTWE
OI'FICeRiMeM~ exCLUoeO'?
~~f~V':'S~~S ÞefooN
OTHER
on~ractor's Pollution
A liabili1:Y
$
e.L. OISEASe . EA EMPLOVe s
341 77 66 11/23/2003
08/23/2004
I;;.L [){SI;;ASI;; . POLICY UMIT S
$1,000,000 each loss
$1,000,000 total all losses
OESCRlP'T10N OF OPERA nONS I LOCA noNS I VEHICLES I EXCLU$IONS AODEO BY eNDORSEMENT I SP£CII\¡, P'IOVlS/ONS
he general liability policy includes the City of Santa Ana, its officers, employees,
olunteers and representatives as additional insured with regard to work performed by
he Named Insured where required by written COntract.
agents,
or on behalf of
Except 10 days for nonpayment of premium.
City of Santa Ana
Department of Public Works
20 Civic Center Plaza, M-21
Santa Ana, CA 92702
CANCEUATlON
SHOULO ANY OF THE ABOVE DESCRIBED POUCIE.S BE CANCELLED BEFORE THE
EXl'IMTJON DATI: TI1~OF. THE I3SUlNG INSURER WILL ~~~ t/IAI~
~ DAYS WRlTT'EM NOTICE TO THI' CI'R.TIFlCATE HOf.O£R HAIIIED TO TI1E LEFT.
CERTIFICATE HOLDER
~K)c~ )OO(X
(~~.JIU!OO(UI(X~JOOOO{XXXXXXXX
AUTH~ItEO ltep~eNTATIVE
ACORD 25 (2001/08)
@ACORDCORpORATION1988
Michael V igliotta
Deputy City Attorney
..
EXHlBrf D
ADDmONAL INSURED .
FOR COMMERCIAL GENERAL UAB1LlTYPOUCY
_C_y(j,.uÁ(;Ao- Jdl£ 4tL-eù~~ ~- t*ß,
Tbi$ ~ modifies suçh ÌIISuIUDOC as is afforded by the provisions of Policy
#I 31111f;,(, relatÚlgtothe 1òUowing:
J. The City ofSaIU ~ 20 Civic Ceou:r ~ SaDIa Ana. Califumia 92701; its
offi~ employees, ag~ vohmteers and n:presen1abves are oamed as additional insureds
("additional i:nsmedsn) with regard 10 Ii2biliI:y and. defi:use of suits arising û-om the operalÌOIIS
and uses perfomJed by Of 00 bebalfofthenamed insured.
,2. WJtJa.respect to c1aims 3risi.Dg out oftbe openboos and uses performed by or on
beba1f oftbe œmed insured. such insuraøce as is afforded by this po1icy is primary aDd is not
additiooal to or motribuling with any other iDsunmce caaied by or fOr the benefit of the
additional ÌDsUfeds.
3. This insunmœ applies sepan¡teIy to each insured against whom claim is made or
sun is brougbt except with respect to the com~s limits of6ability. The inclusioD of any
person or oq,mi~ as an ímured sball not affect any right wtUçb such person or organization
would have as a claimant if not so included.
4. W1th m;pect to the addiriooal insureds. tbìs iDærance sbaU oot be amcclI~ OJ"
lß8I:eriaIly reduœd mc;ovengc OF limits exœpt afta thirty (30) days written notice bas been
given to the City of Santa Ana. 20 Civic CeotcI- Plaza. Santa Ana. Calîfonña 92701.
(Completïoo oftbe foDowmg. inc.lllm,,! couotes:signatl is required to make this
ctfcctîve.)
Elfcotí,., (J 1-0 f(-/!)~
Policy iJ 3~
Issued to . t'.. I
this.
.
form æ a pan of
Named Insured
Countersigned by
~#
&
Michael Vigliotta
Deputy City Attorney
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE {MMI'DO{Yyyy¡
N 08/25/2004
PRODUCER (949)851-8800 FAX (949)851-8802 THIS CERTlFICA!~IS ISSI!.~P. ~~ A MÞ:! !.ER OF INFORMATION
GSM Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
license No: 0015612 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
30 Corporate Park #307 INSURERS AFFORDING COVERAGE HAIC.
Irvine, CA 92606
INSURED Curbsiae, Inc. tJ-~-Dq1- INSURER A: Steadfast Insurance Company
1605 N. Spurgeon St. INSURER B: Zurich American Insurance Co
Santa Ana, CA 92701 Pr"~-'"l~ INSURER c: State Compo Ins. Fund of CA 35076
INSURER Ð:
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 CERTlFICA TE MAY BE ISSUED DR
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.
~ ~ TYPE OF INSURANCE POUCYNUUBER DAT~ DA~ UM/TS
~ GENERAl LIABILITY GPl 543 5554-00 08/23/2004 08/23/2005 EACH OCCURRENCE . 1.000 OO~
X COMMERCIAL GENERAL LIABILITY ~Ea œ $ 100 OO~
I CLAIMS MADE 00 OCCUR MED EXP (Anyone person) $ 25.00~
A PERSONAL & ADV INJLRY . 1 000.000
r- GENERAl AGGREGATE . 1,000 OO~
t"GEN'l AGGREGATE LIMIT APPliES PER: PRODUCTS-COMPJOPAGG . 1,000 OO~
h POLICY n f~g n lOC
, AUTOMOBILE UABJllTY BAP 543 5553-00 08/23/2004 08/23/2005
COMBINED SINGLE LIMIT
X ANY AUTO (Ea accident) . I,OOO,O~
- All OWNED AUTOS $1, 000 DED COMP
BOOIl Y INJURY .
- SCHEDULED AUTOS $1.000 DED COll (Per person)
B r-
HIRED AUTOS BOOIlYINJURY
¡---- (Per accident) .
NON-OWNED AUTOS
¡----
¡---- PROPERTY DAMAGE .
(Per accident)
GARAGE UABIUTY AUTO ONLY. EA ACCIDENT .
~ ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AW .
EXCESSfUMBREllA LIASIUTY EACH OCCURRENCE .
P OCCUR 0 CLAIMS MADE AGGREGATE .
.
R ~DUCTIBlE .
RETENTION . .
WORKERS COMPENSATION AND 1750381-04 08/23/2004 08/23/2005 X I iÓRi,i"ITS I IV",,'
EMPlOYERS' LIABILITY I,OOO,OO!
C ANY PROPRIETORIPARTNERlEXECUTIVE E.L EACH ACCIDENT .
OFFICER/MEMBER EXCLUDED? E.l. DISEASE. EA EMPLOYEE $ 1,000,0001
g~~i~S18"NS below EL DISEASE - POLICY LIMIT $ I,OOO,OO!
OTHER GPl 543 5554-00 08/23/2004 08/23/2005 $1,000,000 Each incident
~õntractor I s Pollution
A liabil ity $1,000.000 Policy aggregate
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES' EXCLUSK>NS ADDED BY ENDORsEMENT I SPECIAL. PROVISIONS
The general liability policy includes the City of Santa Ana, its officers, employees, agents,
olunteers and representatives as additional insured with regard to work performed by or on behalf of
he Named Insured where required by written contract.
"Except 10 days for nonpayment of premium.
CERTIFICATE HOLDER
City of Santa Ana
Department of Public Works
20 Civic Center Plaza. ~r1P
Santa Ana, CA 92702
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCEllED BEFORE THE
EXPIRATJON DATE THEREOF, THE ISSUING INSURER WIlL ~ MAIL
3.0!- DAYS WRITTEN NOTICE TO THE CERßACATE HOLDER NAMED TO THE LEFT,
~~~eBSOOlIOOll(~x
IO~~JI~XXXXxxx
AUTHORIZ P.z:ATlVE
ACORD 25 (2001/08)
@ACORD CORPORATION 1988
I'
.-
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company Steadfast Insurance Companv
This modifies such insurance as is afforded by the provisions of Policy
# GPL 543 5544-00 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 opemtions and uses perfonned by or on behalf of the named insured.
2. With respect to claims arising out of the operations and uses perfonned 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 catried 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
effective. )
Effective 08/23/04
Policy # GPL 543 5544-00
Issued to Curbside. Inc.
, this fonn as a part of
Named Insured
Countersigned by
.L:
ntative
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