HomeMy WebLinkAboutQuiroz, Leticia 1City of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION
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Please complete this form when the attached agreement is no longer in effec .~I` f
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AGREEMENT Department: ---~-y ~, ,
NAME NUMQER SUFFIX
Phone/Ext.: ~ ' i,~-- ~ ~J
QUIROZ, LETICIA N-2004-133-01 1A ~ 'y S
QUIROZ, LETICIA N-2004-133-02 1 B
QUIROZ, LETICIA N-2004-133-03 1C ~--~~~~
Signature: ~
QUIROZ, LETICIA N-2004-133-04 1D ~`-'~ ''~
Date: /j ~ J //~ ~~~
Revised 05.04-0$ ~ ~-~ ('' 4J
N-2004-133
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\NS~nANGE IiQI ON FILE
WORK MAY tilll PROCEED
CLERK OF COUNClL
DATE: (I r&-04'
THIS AGREEMENT made and entered into this ~ day of Mvem).:JeJte., 2004 by
and between Leticia Quiroz, an individual (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").
CONSULTANT AGREEMENT
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
teacher assistance for jail inmate instruction in GED and computer classes.
B. Consultant represents that Consultant is able and willing to provide such services to the
City.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably be
expected from a professional consulting firm in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
Consultant shall assist the instructors in jail inmate GED and computer education classes,
including, but not limited to:
. Provide tutorial assistance to inmates.
. Administer and score tests or work samples.
. Perform clerical duties, including recording attendance; preparing and distributing
teaching aids and instructional materials; filing; assist in setting up, organizing
and maintaining equipment and supplies; explain proper operation of equipment.
. Assist in translation.
Consultant shall provide teaching assistance a maximum of 12 hours per week.
2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services, an
hourly fee of$15.00. The total sum to be expended under this Agreement shall not exceed
$10,000.00 during the term of this Agreement.
b. Payment by City shall be made within thirty (30) days following receipt of proper
invoice evidencing work performed, 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 August
31,2005, unless terminated earlier in accordance with Section 12, below. The term of this
Agreement may be extended upon a writing executed by the Chief of Police and the City
Attorney.
4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor
shall it be construed to create an employer-employee relationship, a joint venture relationship, or
to allow the City to exercise discretion or control over the professional manner in which
Consultant performs the services which are the subject matter of this Agreement; however, the
services to be provided by Consultant shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Consultant shall pay all salaries and
wages, employer's social security taxes, unemployment insurance and similar taxes relating to
employees and shall be responsible for all applicable withholding taxes.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the City, its officers, employees, agents, volunteers and
representatives as additional insured(s) and shall include, but not be limited to protection against
claims arising from bodily and personal injury, including death resulting therefrom and damage
to property, resulting from any act or occurrence arising out of Consultant's operations in the
performance of this Agreement, including, without limitation, acts involving vehicles. The
amounts of insurance shall be not less than the following: single limit coverage applying to
bodily and personal injury, including death resulting therefrom, and property damage, in the total
amount of $1 ,000,000 per occurrence. Consultant shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit A upon
execution of this Agreement and shall be approved in form by the City Attorney.
b. 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.
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(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.
c. 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 for personal injury,
damages, just compensation, restitution, judicial or equitable relief arising out of claims for
personal injury, including health, and claims for property damage, which may arise from the
direct or indirect operations of the Consultant or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates to the services described in
section I of this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay
all costs for the defense of the City, including fees and costs for special counsel to be selected by
the City, regarding any action by a third party challenging the validity of this Agreement, or
asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief
due to personal or property rights arises by reason of the terms of, or effects arising from this
Agreement. City may make all reasonable decisions with respect to its representation in any
legal proceeding.
7. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
that it shall not use or disclose such information except in the performance of this Agreement,
and further agrees to exercise the same degree of care it uses to protect its own information of
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
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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:
Chief of Police
City of Santa Ana
60 Civic Center Plaza (M-97)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 245-8007
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:
Leticia Quiroz
711 W. First St. Apt E103
Santa Ana, California 92701
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
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to the new address. If sent by mail, any notice, tender, demand, delivery, or other
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or
other communication shall be effective or deemed to have been given twenty-four (24) hours
after the time set forth on the transmission report issued by the transmitting facsimile machine,
addressed as set forth above. For purposes of calculating these time frames, weekends, federal,
state, County or City holidays shall be excluded.
10. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, and supersedes any and all other agreements, oral or written, between the parties. In
the event of a conflict between the terms of this Agreement and any attachments hereto, the
terms of this Agreement shall prevail. This Agreement may not be modified except by written
instrument signed by the City and by an authorized representative of Consultant. The parties
agree that any terms or conditions of any purchase order or other instrument that are inconsistent
with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without
the City's prior written consent shall be considered null and void. Nothing in this Agreement
shall be construed to limit the City's ability to have any of the services which are the subject to
this Agreement performed by City personnel or by other consultants retained by City.
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. 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
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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 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 its 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.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
PATRICIA E. HEALY
Clerk of the Council
. CITY OF SA~
~M
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
BY:~~#~
Laufa Sheedy
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
CONSULTANT
~. IvJ ~,l~('~-
PAUL M. W ALTERS
Chief of Police
~
)?E'rIClA ~;OZ"_..
Tax ID#
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EXHIBIT A
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 ifnot 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
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.:
CERTIFICATE OF INSURANCE .
EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS.
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER: PUBLIC ENTITY (ADDmONAL INSURED)
Driver Allia!1t Insurance Services CUy 06 san:ta. Ana
P. O. Box 28323 20 Civic. CenteJt P.f.aza, M-28
Santa Ana, CA 92799-8323 San:ta. Ana, CA 92701
(949) 660-8163 ,
License No: OC 36861
NAMED INSURED (EVENT HOIDER): I EVENTINFO~TIBli . nat e1.6
,..; - lXoo1-/.33 TYPE: n.6 mo -S ImplWvement
DATE(S): I/Ub/U~ IZ/"IU~
Leticia QUVl.OZ LOCATION: S.A. JaM:
.
This is to certify that the policies of insuIaDcelisted below have been issued to tbe insured named above for tbe policy period
indicated. NotwitbstaDding any req.w.~ull., tenns or conditions of IDY coDlracl or other ~t with respect to which this
certificate, may be issued or may pertain. tbe insuIaDce afforded by tbe policies descnbed herein is subject to all tbe tenns,
exclusions and c:onditioos of such policies. Limits shown may have been Ieduced by paid claims. .
INSURANCE CARRIER: Evanston Inswance Company
MASTER POLICY NUMBER: OsSEPlOOOOO1
MASTER POLICY DATES: EFFECTIVE: JANUAR~ 1, 2005 EXPIRATION: JANUARY 1,2006
COMMERCIAL GENERAL LlABIUTY OCCURRENCE FOIlM DEDUCTmLE: NONE
GeueraI AaJqalc Limit S 2.000.000
Produc1s &. c:on.>IeIed Opontioos 1.000.000
PaaonoI &. AAhatisi..lnjUIY 1.000.000
Each Occurnmcc Umit 1.000.000
FiR JJomose (Any One Fire) 50.000
Medical Payments (Any One Persoo) 5.000
The limits ofin......... apply .-ntely lo oach ....t inIured by thi. poIic:y as if. -'" policy of insurance.... been illUed fw1hat....L
"Who i. _" is amended to include,.. an _.the person ... orpnlzadan shown in tlris schedule, but only with respect to liability arisins oulofthe
ownership. maintcoanc.... ... of the premises UJOd by the named insured (event hold...~ This insunnce daes 1101 apply to: Any "occurrence" which...... place
_ the....t holder _ robe . tenant in 1hat pmni-.
OTHER ADDmONAL INSUREDS
,
CA~' I A noN: Should Ihc 8bove descrjbed policy to ClllCdlcd before the expiration date thereof. the issuing company will mail 30 days wriuen notice to the
certificate holder and addftional insureds listed.
AUlHORlZED REPRESENTATIVE:
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DATE ISSUED:
Janu.aJty 6, 2005
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02/15/2005 17:14
7142458148
SANTA ANA JAIL BKNGK
PAGE 05
EVANSTON INSURANCE COMPANY
CERTlFlCATE NO.:
CERTJFlCATI: OF INSURANCE ,
EXCI.UDES COVERAGE:roll NOMINEE EVENTS. SEE SEPARATE Al'J'LICA.TIONS FOR NOMINEE EVENTS.
SPECIAL EVENT UABIl.ITY PROGRAM
, PRODUCER: PUBUC l!NTrtY (ADnmONAL INSURED)
Driver Alliant IDsutance Scrvic:cs CUI/ C f, San..t4 AIta
P.O.llox 28323 20 Civic Ce/l.tVt Puza., /0/-28
Suta AlIa, CA 92799-8323 StULta. AlId, CA 92101
(949) 660-8163
LicellIe No: OC 36861
NAMED INSURED (EVENT HOlDER): , BVlNT INFOnrn~ nal elf,
rV- 9-.00'-1-/33 TYPE' 114 0 ' ' - S I mplLOvenrent
DATE(S): IllIblll) - IZ/~IIII>
Let.i.Wt QuiIto z LOCATION: S.I\. Ja.,u
Thio is 10 catify dJat 1bc policieo of iIIIlnaceJiJted below have ~ isIaed II) tile iDsuNd IINIIed abcr<e fer 1bc poljcy period
iIIdicaIiod. NllIWill-. .1:.-& JDJ' '.---01>0, .... cw <:oIIcIiIiGaI of JDJ' _ or otbot do-. -'Ill 'll'itb Il:IIpllCt 10 TIIlich tbiI
corti1ieote, may be iasuecI <Ie .,........ ... iuutucc afrozded by'" )IOIicieI described hcRiD is IlIbjcct to aU 1bc termo,
exclusions IJId coadllioaa of such poIicia. Lituilo Ibowa may Jave beCII nU:ed by paid c--.
INSURANCE CARRIER: B_m.u.-:e ~y
MAS'I'ER POUCY NUMBER: OSSEl'IOOOOOI
MASTER POUCY DATES: IJI'FECTJVE: JANUARY t. 2005 J:XPIRATlON: JANUARY t, 2006
COMNI!RClAL GEIlERALlJABtUlY llCCI.WIENl:1I FORM llEllOCTIllLlS: NONl!
GoIoonI... i.m.ic $2.OlIO,lJIlO
Proolucls A " ..lh.J()plaIiaaI IAOOAOO .
'--lAAd... . . _19"'7 I,llOOAOO
_t' ._ UmiI I,llOOAOO
I'Ve 0.... (Ally O,din) 5O,/lOO
NeclieoIPa".". (AnY One_) SAOO
1hclinillol___r. ---........,.... policy. iI"_poIicyor_..._ inuooI for..........
"WIlo" -- Is_ loillcltJdr, ".irDuroII,..._ or ~~ . 11.11....... .....-.lIutanJjrwillJ _ Ioliollili\y """OUlor..
-....__or'*'or...................,..._ ........(__~ 11110 ---110I",,1)'10: ~.... .--" -tIId"',-
-"''''''hoI<Ior_Jtibea_in_--.
OTHER ADDmONAL lNSUUDS
,
t:A"""I ........"'. _lire - -- JlOIie1Io CIIIllOl1alI>eltn tlrt.............. """"'t tile iJsQu., """"""'" will moilJOd'I)S _ DOlico lolll<
_hoI<Iorllnd____
AUTJfORlZED REPRESENTAllVB:
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OATBJsSUED:
]MU/Vt!/ 6. 2005
'I/I"!.(A/
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:ANTA ANA RISK ~MT. . Fax:714-647-S311
Mar 82006 11:22
P.Ol
BV ANSTON INSURANCE COMPANY
CERmICATE NO.:
Post-it' Fax Note
To
7671 Date.:1
"om
CERTIFICAl
EXCLUDES COVERAGE FOR NOMINEE EVENTS. S
SPECIAL EVENT
-
Co.
Phone #
Fax.
PRODUCER: PUBLIC ENTITY (ADDmONAL INSURED)
City of Santa Ana
Driver Alliant Insurance Services in CoJ\jullction with 20 Civic C....t.r Plaza, M-28
Apex InsU(llnce Services Santa Ana, CA 92701
P. O. Box 28323
Santa Ana, CA 92799-8323
(949) 660-8163
Li=e No: OC 36861
NAMED INSURED (EVENT HOLDER): EVENT INFORMATION:
Leticia Quiroz )J - ~~'-I- /33' TYPE: Instruct1onallSelf-Imnrovement
N - -;).004 -( 33 -01 DATE(S): January 1 - December 31. 2006
LOCATION: Santa Ana Jail
This is to certify that the policies of illsurance listed below have been issued to the insured named above for the policy period
indicated. Notwithstanding any requirement>, terms or conditions of any contract or othsr 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. Limits shown may have been reduced by paid claims.
INSURANCE CARRIER: Evanston Insurance Company
MASTERPOUCY NUMBER: 04SEPlOOOOOl
MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2006 EXPIRATION: JANUARY 1, 2007
COMMERCIAL GENERAL LIABILITY OCCIJRll.ENCE FORM DEDUCTIBLE: NONE
General Aggregate Limit $ ;1,000,000
Products & Completed Operations 1,000,000
Personal & Advertising Injury 1,000,000
Bach Occurrence Limit 1;000.000
Fire Damag< (Any One Fire) 50,000
Medical Payments (Any One Person) 5,000
The limits of insurance :apply $ep.ilr~Y to eu:h event insl..lfl!!d by this pOlicy as jf.a separate policy of insurance has been iss.ued for that event.
<<Who is insured" is amendoo to include, .as a.n insured, the person or organization ahQwn in thiQ ~hedule, but only with respect to liability arising out of the
ownership, maintenance Of use of the premises used by the named insured (evetltholder). this insurance d~ not apply to: Any "occurrence" whicb takes place
after the ~cnt holder ceases to be a tenant in that premises.
011{J!:R ADDITIONAL INSUREDS
r.ANrFT T A TION: Should the above de:;lcril::Jed poli.cy to canccl1cd before the expiration date thereof, t1u: issuing company will mail 30 days written notice to tbe
certificate holder and addjtional imiurec:1!;; listed. .
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AUTHORlZED REPRESENTATIVE:
DATE ISSUED: Januarv 20. 2006
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EVANSTON INSURANCE COMPANY
CEIHIFICATE :'iO.: 2007-08
CJi:RTlFICATE OF INSURANCE
EXCLlJD~:S COVERAGE FOR NOMINEE F:VENTS. SEE SEPARATE APPLICATIONS F'OR NOMINEE Ji:VENTS.
SPECIAL EVENT LIABILITY PROGRAM
!f I'RODlJCcR PUULIC ENTITY (ADDITIONAL INSURED)
I, City of Santa Alia
II
if ,\illant Insurance SerVH.:e:.:, 1m.:, in conjunction with 20 Civic Center Plaza, M-28
,I }\po Insuram:e Service:; Santa Ana, CA 92701
'I II O. Box 6450
r ~.:wport Beach, CA 92658
I (<J49) 660-8163
i LlCt"llSt,;' No: OC 36861
I !\AMED INSURED (EVENT HOLDER): EVENT INFORMATION:
I) Leticia Quiroz N-2.0cY-133 TYPE: Self-Improvement
ii 71 I W. First Street. E-103 N-2DCY-J 3.3-0\ DATE(S): 01101107 - 12131107
II SOlllta Ana. CA 92701 LOCATION: Santa Alia Jail
~._- **L1quor LLabllity after 2am 0
:: 'llll~ i~ to certify that the policies of lllsurance listed below have been issued tu lhe insured named above for the policy period
1: llldic<.lted. Notwithstanding any reqUIrements, tenus or conditions of any contract or other document with respect to which this
Ii ..:~rtilicatl' may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms,
~ "::\:Clll.~lons and conditIons of s.uch policIes. LLUlits shown may have been reduced by paid claims.
I ''''~'m '~m. ","~ '"'..- ,"-,
: 'lASTER POLICY NUMBER: 04SEPIOOOOOl
I EXPIRATION: JANUARY 1,2008
' 'lASTER POLICY DATES: EHECTIVE: JANUARY 1,2007
,I :: (l\Hvll-I-/:('I\1 \irNLRAI UAI3IIITY OCCURRENCE FORM DEDUCTIBLE: NONE
:1 ',cllcl-~1 _'\ggreg:.Jl~ Llmil $ 2,000,000
j hldm;t-; & Completed Operatlom j ,OOO,OUO
~ I'cl~i<lllUI & :\ullnllslI1g Injury 1,000,000
I J.:h ()':cllrr~ll(l: l.llll11 I ,000,000
i I in: Dalllage (AllY One Firc) 50,000
.I ro..lcoi..:al Pavmems lAnyOnel'erSl1nj :',000
~ .
I ~ Ill' IllTlits ofinslIran<.:c apply separately \() each event insuretl by this policy as if a separate policy of insurance has been IssUed tor that C'o'cnt.
I
,
! \'dll' i, insured" i.;; amended w include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out ofthc
l' '\Hr,llIp, lIlaiTlk'n;Jlil;e or u~e of the premises used by the named insllred (event holder). 'l11is insurance does not apply to: Any .'occuITcncen which takes place
!L ..ih;:' th..: ~\'~nl h"ldn Lca~l~-, tll Iw a ttml!ll i" lhal prt:mises
W._' ..___ _._ OTHER ADDITIONAL INSUREDS
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II ..A~lliJ..A TI( IN SlillUld till: <Jbuve de,eribnl policy lU cancelled before the' expiration date thereof, the issuing company will mail 30 days written notice to the
! .l:r:iliLJte hnldtl,mdaddilillnal insureds listed
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\lJTHORIZED REPRESENTATIVE:
DATE ISSUED: _---kHlli!IY__Ol'--2_QO~
r~'I'JII!rored In' Risk MUJHIKement Division by:
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Page 1 of2
Mitre-Ramirez, Norma
From: Sheedy, Laura
Sent: Wednesday, February 06, 2008 10: 16 AM
To: Morales, Briza
Cc: Mitre-Ramirez, Norma
Subject: RE: Instructor's at Jail
IN-2004-133
!N-2004-133-01 <
IN-2004-133-02
IN
! -2004-133-03
I have forwarded this string of emails to let Norma know that commercial general insurance is not required for these
instructors:
Leticia Quiroz
Daniel Achatz
Felice Stinson
Luis Martinez
Norma, please let me know if you need something more.
Thank you
Laura
From: Morales, Briza
Sent: Wednesday, February 06,2008 10:14 AM
To: Sheedy, Laura
Subject: RE: Instructor's at Jail
Does the Clerk's office need anything from you in order to note this on their database?
Briza Morales
Personnel Secretary
Risk Management Division
(714) 647-5475
Please note new email address: bmorales5@santa~ana.org
From: Sheedy, Laura
Sent: Wednesday, February 06, 2008 10:05 AM
To: Morales, Briza
Subject: RE: Instructor's at Jail
They do not need insurance to provide counseling services. They will require Workers' compensation if they have
any employees.
Thanks
Laura
From: Morales, Briza
Sent: Wednesday, February 06, 2008 9:57 AM
To: Sheedy, Laura
Subject: Instructor's at Jail
Laura:
These are the names of the instructors at the jail:
2/6/2008
Page 20f2
Leticia Quiroz
Daniel Achatz
Felice Stinson
Luis Martinez
Thanks for looking into this
Briza Morales
Personnel Secretary
City of Santa Ana
Risk Management Division
20 Civic Center Plaza, M-28
Santa Ana, CA 92701
Ph: (714) 647-5475
Fx: (714) 647-5311
bmorales5@sa!l!~~J!!H!",Q!1J
2/612008