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HomeMy WebLinkAboutFRANK LA PLACA EXTERMINATING 1-2004 N-2004-144 6:eJ~ (t. ;.J~ INSURANCE NQI ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL DATE: I¡-IS-Co.¡ CONSULTANT AGREEMENT THIS AGREEMENT, made and entered into this / ~ay of t/Jr1~004 by and between Frank La Placa Exterminating, 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 rat and mouse abatement. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed $2,100.00 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. The term of this Agreement may be extended upon a writing executed by the Executive Director of Community Development 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 marmer 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 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. 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. 2 (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. 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. (iii) e. 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 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. 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 marmer with performance of services specified under this Agreement. 3 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 marmer provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 telefacsimile (714) 647-6956 With courtesy copies to: Executive Director of the Community Development Agency City of Santa Ana 20 Civic Center Plaza (M-25) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6736 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: La Placa Exterminating, Inc. 2206 South Lyon Street Santa Ana, California 92705 telefacsimile (714) 540-3939 A party may change its address by giving notice in writing to the other party. If sent by mail, any 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 4 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. 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 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 5 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 ofthis Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. PATRICIA E. HEALY Clerk ofthe Council CITYOF~ ~AM - City Manager ~T-IESL APPROVED AS TO FORM: R AT CIA C. HI AKER Executive Director of the Community Development Agency CONSULTANT ~d{cJ[Jð- President Tax ID# 9.'53 R8 J..f¿?> 6 '11/0~/2004 THU 15:57 FAX 714+565 4020 CITY OF SANTA ANA ~~~ CITY ATTORNEY ~~/V¡/~U~4 ~~;~4 rAA I4J 001/001 ~UU.l FRANK LA PLACA EXTERMINATING, INC. 2206 S.~YO" 811'CC1, lIanta Af'I., CA 92705 (7141580.0200 C8001525-2867 (714154003939 ~ ø.~: nanc you toe .."MUft9 u.,tAQ ~'IDIC. DlC. hi fl8'"'Æ.ca y.::iI" p88ucide wu.cn1Mi UIrlli.I:"U'lt... IL'I ìt.COOIrDn.D8 "s.'Ú\ ~ 1...' ud £89\I:!..aop.Oft tit pM A'r.'.'" at CA111Iacn4.. 1M nU). we 81'8 nlNiS'w 1.0 pJ'IIVa.... ro\1 wit" t.Þ. foU....1q .Lft.l'o-",,~~O" p.e.t.aE' ta app.u.eaUOft. .r P88"6'" "a ~\I" ,.,.,..rq. p).a... 'I.""" raw I!I_C5 -0 "... 8111 :a..~OM f..u.Ualf ~Ut. 'Jill! eDnUacl.. 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CXIÞIDI'I'tCftlS Nfl) C:CHGAIftl1 INSl 8 IT STATIONS roR RDŒN1'S KJ: Ii'AR~ IJ:fr ON BUSH ST. INSTAIL S ROCK BAIT STATIONS IN P ON Pt:QRTH ST. ,a CLmtn' IICKtICMoCDCZJ' ll.EamtlG A åDœOoL Dm)~ØtI 1INß1' Service ~''''t & A_sa ~. 1000 SANTA ANA BLVD SANTA ANA. CA 92701 ~ TRAIN CE M.! 1000 SANTA "'NABLVD .109 SANTA ANA. CA 92701 TJ....: Data: SltNice '''o.,e: 11'O1120!!- 11:22:41 AM 1110112004 (711) 5S5.2SeO Mop: B29-F1 Billing Pt\ane: (714) 585.2690 T.rgøt PINi Chemicals: B,: Sarvl.. Char~.: S - --.... - - . BY: ownar-Agent.Tenant AUthorized & ^~ptéd .-----.- S~tI Jiil:epresenl3t1ve EXH1RIT A . . EXHIBIT B ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # relating to the following: I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 9270 I; 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 ofthe 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 ofthe 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. ) , this endorsement form as a part of Effective Policy # Issued to Named Insured Countersigned by Authorized Representative 7 11/08/?004 Mo.N 11:18 FAX 714+565 4020 CITY OF SANTA ANA ~~~ CITY ATTORNEY I4J 002/003 ACORD. DAft (lllWDI'I"r) UIOS/ZOO4 1HS Clilll1FlCA'Æ 1$ ,nUB All ,. MATTliIl OF INFORMATIoN ON!. Y AND CONFERS NO RIG"Hi UPON J} i¡ CfllTlI'ICATE HOLDER. THIS C&llTlFICATE øo~ NOY AIIEND¡ EX7eND 011 . THO: AGO! A""OROI!D 8Y THe POI. CIIii$ BliLOW. COIIPANII!$ AR'oADI".. COVEMGE MClDUCCII Caldwdllll6. Aguu:y Ine 159J5 Wbütier U...d Whittier. CA 90603.2567 c_- A America.. S8fety &øk Iletemion ,...... Frank La PI... E"lorminlllÏh& ZZ06 S Lycm Stnet 5811111 AlIa, CA 92705 /J- d001-/14 t;gMÞ,AN'I' D COI4P.-.I'tV C '!"ÞoI1S IS TO c:umFY 'rHATTHE POLICIES Of!' INSuRANCE LISTED 8QOw WAvli ..... r$NED' TO n.e I'IISUfliO NAMIO ..ove 11'0111 THE P~ICY PeFQOO INDlCATEð. NOTWlT/otSTANOINS ANY AEOUlflEtJENT. TEPWI OR CONDITION OF IWY CQHTRACT OR OTIteR COI;""M.NT WI11i RESPECT yo IIIINI~ T~~ CSA'TI~CA'I'E "oftV' 8& ""Vim 0fII MAY PE"TAlN. THe INSURANCe ""'~"CEO Ðy ntE POuaES DESCA11110 H~R&JN JS SUBJeCT TO All n-IE ~s. EKCLUSIONS.\NO CONCIÏI NS OJ: SU~ POuceES, LIMITS ~ IMY a-¡,,-VE.UN AiEcUcec 8v PAlO ClAJM8. co ,no np& Df'IN8UIWrICE PDLlCTlClMIIiR -DUe" ~e:mti POL.!ÇY 1XJl1AA'JION 1:I""T.~gf'y1'J Q4n~ ..-, A -ÞOIU...l UA8ILrn' cow.RCiAL Gl:1'f~ l.IA&lll'rY CUIiI".s~e CiJ OCCIJA OWNER'S&~'.spi'qOT PC0041769mU OIIICI9I04 ODIOPlOS ~L """RA~__.. .~.. -_..,Zf.o.oOIOJlQ.~- PADOlJCTI. COMPfOP &GG ;I 0 f'ti1II~"&f1\IIN.IU i! ", 000 ..... coo"",,"""" . -.-b!!!!!I, 0 RAI¡I:IAM,I(iiE "'.flPI I 10000 Me ) fXD fAIl 0111 ~.n; I 5 000 .~.. ...uro81õ11118U! UAllLIT'I' ANY.lt.U'I"g QOM"N~D ettQ.8 LI...-r . """O~"U'1"05 Sl:"4mI.Jl.EC AlJ' 'O$ ~IRED AUTOS I"CpfoCMNm "11mI'; tIOOII.Y~N, uRY iP"'p8BI)I'I) . APPROVED ØOCIILY/NJuAV (P"'ICd"""I) ,~ PAOFIIRTY O"toI.-GE: r GdlACllELJ&tILITI' -...'" "I.froONI.'I'-6Jl.o\CClCl /'IT S O'ÞtEA 'TMAI\IIWTQ Qffl.V' EAC"4' ACCIOEI\IIT .:IIi ACCJIICc.aY£ ~ EACh OCCUAln!NCE. .. AOOAEG,,'r. f , '..,;,'.ï..'; ., " DC'ESs: \lMIUTY UY;A~¡:OJI'" an1Ef' """"N\A48AEu.AFOflM WCIIICIiRS COIIINNSATIQN.&NO u.L~.'I.IU8l.ftT u. UJM ELEAC:t-t~~T . Ii\. DIG~ - POUcy LIMIT S C'-PI'S~I'EAIIHIPt,aræ '" :i:!~~,j:~.FLH"\ /.~_;7.~.:~:"::: THE: ~8IJÞAI~ORI I'"NlTN1iRSlEliCUTlvl a "'"" ...... !NO<. Dl80A1M88111 e, ðHlut.1'I1iIN8IC.ð~TION!I/'oII!t80I.88I!ttI'MML rMInI P,opo,., D._g, Deductible $1000., Per Occuntnco Th. C-nitY ~optI\a)' Agency 01 lb. City olSiUlla Ana,lu Ofl\cors, A~.Dt!, iUld Employ- ar. to b. .......... 3S addlda...., IbsDred wlrh ."p.,<ls T.., C_ty Rcoðoyolop",...t A;e""1 or tho C;ty of s...... AAG I)-D.O... o..nlopmont Diy, 305 E. Fourth Sb'e8L, Suite 201 Santa Afta, CA 91701 SHOULD ANY œ TNIi: -OVIIi, DIiII:JII8IiD fIIOUCl1S liE ~NeÐ.lED IEliVAC TfC lØfØI"flOH Üfli ntlRMP. ~f I$SUINO COIIIP.lWI' WtLl NIL A.... M'r'!I WRITTEN r.lClflCS: 1'1iI 'rHIi ÇþlTllOCATE NOlbElt III.I"ID 111;1 T1f6 '-'n, 02~~::3,0~!..r'!'-~.:::;.~. FAX 714+565 4020 CITY OF SANTA ANA ~~~ CITY ATTORNEY . . I4J 002/002 OCI.I""... 01/28/Z005 08:51 F&I 3&" 29 05 09;34~ Tlt"Cl fill 001/001 ~. 1 ç\.L. ~". 9."""'..11... ;", . . THIS SHEET MUST BE COMPLeTED AND ACCOMPANY THE CER, """.LCATe OF INSU~NCE T'd ADDmONAL INSURED ENDORSEMENT InsuliIl1œc:ompany .AMERlCAN SAFETY RRS c/o THO/1CO This endo.-semenl moc!ifj~ suct'l insuranc:e as b illforded Þy the .:¡rOYlsions of POlicy NO.PC0041769t2!1l3 Rllatingla the following: . ,. Tno city "" SilO'Ita Ana, 20 Civic Center Plam, Santa Ana, California 82701. Its OlflCØlS, employees, agenl!l, and repJe58ntBllvli!s are nemli!d as additIonal insureds ("additional il1l5urøds") wi1h resaid 10 Jiabilit)l anCl dot.nero 01 sullS arising lrom the operations and usee performed by or on ~NI" of the mimed inllUm, Wi'" respect to claims artslng oul at - Dp8lil!lonS and uses pertormed by or an bend of the named Insured. such Insurance as Is afforded by this poliCY 1$ primary and i$ not additional to Dr conUlbuling with Bny other insurance canied by or tor the benefit of ,he ßClClIUonal insurecfS. 2. 3. 11\15 Insurance ~lie5 separlllely to eaGh in.....red against \'\/horn claim is made or suit is brought except with r85 )ðCII to the company's limits of lIaÞillty. Thll inclusion 01 sny person or arganlJ!8tlon M ar1 insul'Ðd shall not aliect any right whioll such person or organiZ3tion would have U a dalman! if not SO included. 4. W"h resp8Ctto 11'\8 aad"otig,..1 insureds. "I¡II Irmurance shall nat bil cancelled or . materlølly redl1ecd in cowr. or Mmhs exc:epl alter Ihirty (30) days written not~e . I'Ia& been given to the City of San1a Ana, 2Q Civic Center PIaU. Sa:n,- Ana. . CaliltJrnia 92701. .. (Compl"tion gf Ihe !ollowlng, including countersignature, is required to malw this D"dorsemertt IIffecd"...) eff9cù"" -... ~ANUARY 26. 2005 poncy No. PCOO41769~ 2~13 . this endorsemoO'lt torrn is a part of Issued 10 ~RANk II Plnr^.~~TF~M'NðTjUr- TNr NameCllnsured .~ w.:øa:n:;CMinO~.r"'''''''''lòe'''lIi~ ''I~11I APPROVED AS TO FORM )z:8?'f;/ / 2- .Y Laura Stitt Sheedy Assistant City Attornev R~O~~O ~O ttQ~~ # r ~ !HIE:DLÞB~9S SUI tt""PT":;¡ Client#: 50589 FRALAP1 AßORDm ' CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) 11/03/04 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. PRODUCER VanBeurden Ins Svc - Kingsburg 1600 Draper St Tel#559-897-2975 PO BOX 67 Kingsburg, CA 93631 INSURED Frank LaPlaca Exterminating, Inc. /J \ 2206 S. Lyon SI. 1\ \ -- 2.Q)-, - Lf4 Santa Ana, CA 92705 I v I INSURERS AFFORDING COVERAGE INSURERA. Clarendon Natllns (KRR) INSURER B: NAIC# INSURER c. INSURER D: 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. POLICY EFFECTIVE POLICY EXPIRATION DATE MMfDDIYY DATE MMfDDIYY TYPE OF INSURANCE POLICY NUMBER LIMITS L TR NSR GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLP.:MS MAD[ 0 OCCUR EACH OCCURRENCE DAMAGE TO RENTED P MI E E rr n e . . MED [XP íAny OIl€ p€;'Son} , PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ LOC ANY AUTO ALL OWNED AUTOS COMBINED SINGLE LIMIT . (Eaaccident) BODILY INJURY . {Per person) BODILY INJURY S {Peraccidenl) PROPERTY DAMAGE . (Peraccidenl) SCHEDULED AUTOS HIRED AUTOS NON..QWNED AUTOS GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ EA ACC $ AGG $ OTHER THAN AUTO ONLY EXCESS/UMBRELLA LIABILITY OCCUR 0 CLAIMS MADE EACH OCCURRENCE AGGREGATE . . . . . OTH- DEDUCTIBLE RETENTION . A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER 03KR0027118 10/01/04 10/01/05 X :"~'<)r - ,.~; \ft E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT .1,000,000 .1,000,000 .1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED"BYEND VISIONS CERTIFICATE HOLDER CANCELLATION City of Santa Ana P. O. Box 1988 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ---Í.O..- 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 ACORD 25 (2001/08) 1 of 2 #M95454 GJ ACORD CORPORATION 1988 . . 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 representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S (2001/08) 2 of2 #M95454