HomeMy WebLinkAboutWilliam Hezmalhalch Architect 1City of Santa Ana ~'.o`2-~OS
_r, Clerk of the Council
- AGREEMENT TERMINATION FORM
COTC Office Use Only
Please complete this form when the attached agreement and all amendments (if any)
are no longer in effect.
Return form to the Clerk of the Council Office (M-30).
The agreement with ~pC(i ~'TAyyl -~'f~?~l_g ~{~ g ~ A~1 ~-/-C~.1 ~~ ~jl~
No. ~(-~(TOlt - aST.Z was completed on ~ and final payment has been made.
(List all amendments. Use space below if needed.)
Department: [app
Phone/Ext.: ~d-F~~
Signature: ~,(_~/~ p ~('~
Date: 03 ~11~2of0
Revised 07-22-09
N-2004-152
INSURANCE ON FILE
WOR K M~ Y PROCEED
UNTIL INSURANCE EXPIRES
q -/-05 CONSULTANT AGREEMENT
CLERK OF COUNCIL
DATE: ).flO/oS THIS AGREEMENT, made and entered into this its> t day of Pnt~U <;t 2004 by
, Gl::04 and between William Hezmalhalch Architects, Inc., a California corporation (Ii remafter
c....~~ "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and
l./). existing under the Constitution and laws of the State of California (hereinafter "City").
RECITALS
~e-!!>~DoI>'I-'-
A. The City desires to retain a consultant having Sfl88ial skill and knowledge in the field of
architecture.
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 prepare digital graphics images of vendor carts in Santa Ana, as set forth '/>:.-""'
in Exhibit A to this Agreement, WHI~1i ,~ I"-lLDept>il..ATE'!:> Hi::RE""'- ,"-' F/JL.L. ?
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 $5,000.00 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. PIi')'lRBIH Re8E1 Rat
be mads far .;;srk .,t~.:..h f~~L Lv u.ll>_",l HlG Jtltlldm~b 5f~Glfo~HH.UJ.,",'-' .,,,,,,L furll! ~11lin;; Rli;\..lldb
\.,hich UJ.uy .l,-,liJenaely 66 eJ(fJeeteEl B) Cit).
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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 parties agree that
architectural services provided by Consultant since August 9, 2004 shall be included within the
Scope of Services of this Agreement. The term of this Agreement may be extended upon a
"
writing executed by the Executive Director of the Community Development 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. 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.
b. Professional liability (errors and omissions) insurance, with a combined single
limit of not less than $1,000,000 per claim.
c. 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 at efl.aflgea ia Elfl.) ether matsrial as}38et without
thirty (30) days prior written notice to the City.
~ -reu ~l>) b'lfb IN"ntE fNetrl>F ~.i"'"f'MeJr l:"pl~t..I'Il,
d. 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
.
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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, ~,Ili~h .M.) =;O~ [>VB. tl.e TO "Tltt:.'" 61
direct or indirec operations of the Consultant or its contractors, subcontractors, agents, errerr'~
employees, or other ns acting on their behalf which relates to the services described in
section I of this Agreement. Nt:::f,.Ut.-t=-..n- Jt H P
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 ofthis Agreement, C>~";"'eeI> 8,/
and further agrees to exercise the same degree of care it uses to protect its own information of u-.:: m,
like importance, but in no event less than reasonable care. "Confidential Information" shall I ~w
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 andlor agent ofthe 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 ofthe City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
3
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:
William Hezmalhalch Architects, Inc.
2850 Redhill Avenue, Suite 200
Santa Ana, California 92705-5543
telefacsimile (714) 250-1529
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, the terms and conditions hereof, shall not bind or obligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
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promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without
the City's prior written consent shall be considered null and void. Nothing in this Agreement
shall be construed to limit the City's ability to have any of the services which are the subject to
this Agreement performed by City personnel or by other consultants retained by City.
12. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of termination,
subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to deliver
to the City all work product completed as of such date, and in such case such work product shall be
the property of the City unless prohibited by law, and Consultant consents to the City's use thereof
for such purposes as the City deems appropriate.
b. Payment need not be made for work which fails to meet the standard of performance
specified in the Recitals ofthis 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 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.
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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.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST: (/"
~~- ~~ ef
PATRICIA E. HEALY
Clerk of the Council
CITY OF SANTA ANA
~:rd-
City Manager
APPROVED AS TO FORM:
~.4~PH tY~~~'ER
City Attorney
ATRICIAC. WHITAKER
Executive Director
Community Development Agency
WILLIAM HEZMALHALCH
President
Tax ID# 30 - DI7~q~4-
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EXHIBIT A
WILLIAM HEZMALHALCH
ARCHITECTS INC,
August 9, 2004
WORK AUTHORIZATION AGREEMENT
AACHITECTU/ilE
PLANNING
Mr. MatthewT. Lamb, P.E.
Downtown Development Manager
CITY OF SANTA ANA
Community Development Agency
Downtown Development Division
305 East Fourth St. Suite 201
Santa Ana. CA 92701
COMMtlNIT'f DESIGN
SUBJECT:
WORK AUTHORIZATION AGREEMENT FOR ARCHITECTURAL SERVICES Project #2004368.00
Two (2) Perspective ViewslDigital Graphic Images
Vendor Cart Graphics
Santa Ana, California
The firm of WILLIAM HEZMALHALCH ARCHITECTS, INC., Architects/Planners (Architect), a California
corporation agrees to provide services as outlined below for fees indicated to CITY OF SANTA ANA (Client).
I. SCOPE OF SERVICES:
A. Provide 2 perspective views of vendor carts to illustrate the following:
. Technical view of cart layout and scale
. View of vendor cart in urban setting
A black and white sketch block out will be provided for proposed view angle for client approval
and meeting use on Tuesday 8-10-04. Final digital artworK will be provided in as an electronic
PDF at 8.5xll for City of Santa Ana print use and large format prints at approximately 24x30
for council meetings. Final renderings are due by end of day on August 16m, 2004.
(Reimbursable costs are estimated at $250.00 for ink jet prints without mounting.)
B. Provide one (1) client meeting and coordination.
2850 Aadh;1I Avenue Suile 200 Santa Ana" CA 92705-5543
Tel 949 250 0607 Fa> 949 250 1529
www.wtlarChitects.com
3875 Hopyard Road Surte 325 Pleasanton CA 94588-8527
Tel 9254631700 Fax 9254631725
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Vendor CaIt Graphics
Project #2004368.00
Page 2
11. OUTLINE OF ARCHITECT'S COMPENSATION:
A. Fee: The work described above shall be the following:
1.
2.
Presentation Graphics Services:
lime and Materials with an estimated budget figure of:
Reimbursables:
Estimated Total
$2,690.00
$250.00
$2,940.00
The work will be commenced upon receipt of a fully executed telefax. This telefaxed document will
serve as the official hard copy.
Senior Principal
Principal(s)
Senior Associate
Associate
Senior Professional
Color Designer
Intermediate Professional
Tee hnical Staff
Jr. Technical Staff
Administrative/O perations
$200.00
$175.00
$150.00
$120.00
$110.00
$100.00
$85.00
$75.00
$65.00
$50.00
B. Reimbursables: The Architect is to be reimbursed at 1.15 times the cost for all materials,
graphic supplies, blueprinting, CADD disks, CADD plotting, mylar reproducibles, photo
work/reductions for record sets, governmental fees, messenger charges, automobile mileage,
transportation and living expenses in connection with out-of-town travel authorized by the
Client. Automobile mileage will be billed at the standard IRS rate. Payment for reimbursable
expenses will be due in full on a monthly basis.
C. Payment Schedule: The Client will pay the Architect within 30 days of the date of Architect's
invoices for services hereunder. Interest will also be due and payable, at the rate of 1 1/2%
per month, but not to exceed the maximum rate allowable by law, on any invoices not paid
within said 30 days.
D. Retainer: A retainer of $500.00 shall be advanced prior to the start of work by the Architect
and shall be applied against the last payment (see attached invoice). If the services
performed are less than the retainer, the balance shall be returned to the Client upon
completion and/or termination of the project.
EXHIBIT "
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Vendor Cart Graphics
Project #2004368.00
Page 3
III. GENERAL PROVISIONS:
It is understood and agreed that the services being provided under this letter form agreemen1/worl<
authorization (agreement) are preliminary in nature. These services are part of the conceptualization
development of the project. As such. if the project does not proceed to actual development by the
Client, the Client agrees to indemnify, hold harmless and defend Architect, to the fullest extent allowed
by law, from any claims, liability, or costs, including attomeys fees, that may arise out of or in
connection with the project, even actual or alleged 'design defects" and/or 'active negligence". If the
project proceeds to actual development by the Client. then the Client will negotiate a new agreement
with tile Architect to perform the professional services required to be performed by an arChitect, or the
Client will retain another appropriately licensed architect to perform such services. If the Client retains
another architect the Client agrees to indemnify, hold harmless and defend Architect, to the fullest
extent allowed by law, from any claims, liability or costs, including attorneys fees, that may arise out of
or in connection with the project, even actual or alleged 'design defects' and/or "active negligence".
The Client will provide the Architect with all information within Client's possession which is relevant to
the services provided hereunder. The Architect is entitled to rely on the accuracy and completeness of
such information without independent review or checking unless such additional review is specifically
part of the Architect's scope of services hereunder. Wrth respect to the resutting lot yield of plans
provided, it is specifically understood that the lot yield is necessarily based on preliminary and/or
partial information provided by the Client or others, and the Archrtect shall in no event be liable for
assuring that the estimated lot yield can be obtained. The Client agrees to indemnify, hold harmless
and protect the Architect, to the fullest extent allowed by law, from any claims, liability or costs,
including attomeys fee, that may arise out of or in connection with the use of such infol111ation provided
by or through the Client and/or any yield calculations provided hereunder, even actual or alleged
"design defects' and/or "active negligence".
The services under this agreement may result in conceptual or preliminary plans or reports
("Deliverables"), which are instruments of service, the ownership of which will be retained by the
Architect. However, the Client may use such Deliverables, but only for thiS project and only for use by
this Client If the Archttect is no longer the archttect of record for this project the indemnification and
hold harmless provisions of the first paragraph under these General Provisions shall apply to any such
use.
Architect's services and the rights and obligations of the Client hereunder may not be assigned by the
Client without specific written agreement of the Architect.
In consideration of the Architect's undertaking of the obligations imposed by this Agreement, The Client
agrees to waive any claim against the Architect and to defend indemnify and hold the Architect and
Architects principals and employees harmless to the fullest extent allowed by law from any claim or
liability for Injury or loss allegedly arising from the use of the Architect's plans.
The protections, indemnifications and limits of liability afforded to the Architect under this agreement
are also afforded to the Architect's subconsultants and both of their principals, subconsullants and
employees.
EXHIBIT A 1
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Vendar Cart Graphics
project #2004368.00
Page 4
In the event of any dispute arising from or related to the services provided under this Agreement, the
prevailing party will be entitled to recovery of all reasonable costs incurred, including staff time, court
costs, attomeys' fees and other related expenses.
Either party may terminate this agreement, for any reason, with at least 2 calendar days' prior notice.
The indemnification obligations set forth herein shall survive any such termination and the Client will
compensate the Architect for all services rendered up to the effective date of the termination.
The Client will pay the Architect within 30 days of the date of Architect's invoices for services
hereunder. Interest will also be due an payable, at the rate of 11/2% per month, but not to exceed the
maximum rate allowable by law, on any invoices not paid within said 30 days.
This Agreement may be executed in one or more counterparts, each of which shall be deemed an
anginal, but all of which together shall constitute one and the same agreement.
The foregoing is mutually agreed to by the individuals executing this agreement each represent that they have
read and understood its provisions, and that they are authorized to bind the parties for which they sign.
We request that you please execute, date and retum this Agreement to the office of WILLIAM HEZMALHALCH
ARCHITECTS, INC.
The foregoing is mutually agreed to by:
Client
Architect
CITY OF SANTA ANA
By:
WILLIAM HEZMALHALCH ARCHITECTS, INC.
By:
Its;
Its:
President
Date:
1:'corncto.CnY 01 SDiI An~OO4368.00
\W.1.WJ1 C. HElMAJ.HAl.Ct1 ARc:tfl'ECTS. INC. 2004 ~
Date:
August 9, 2004
EXHIBIT A
len :
ACORD~ CERTIFICA~
- OF LIABILITY INSUR
DATE (MM/DDfYYYY)
10/27/2004
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.
NCE
PRODUCER
Dealey, Renton & Associates
P. O. Box 10550
Santa Ana, CA 92711-0550
714427-6810
William Hezmalhalch Architects
2850 Redhill, Suite 200
Santa Ana, CA 92705-5543
INSURERS AFFORDING COVERAGE
INSURER A: United States Fidelity & Guaranty
INSURER B: St. Paul Fire & Marine Ins. Co.
INSURER C:
INSURER 0:
INSURER E:
NAIC#
INSURED
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 NUMBER POUCY EFFECTIVE Pg~IfJI~~~~N
LTR NSR TYPE OF INSURANCE DATE MMlDD/YY LIMITS
A ~NERAL L1ABIUTY BK01461996 09101/04 09/01/05 EACH OCCURRENCE .1 000 000
X COMMERCIAL GENERAL LIABILITY General Liab. ~~~~~i,~9E~En~~~~nce' '1 000000
I CLAIMS MADE [XJ OCCUR excludes claims MED EXP (Anyone person) .10000
arising out of PERSONAL & ADV INJURY .1 000 000
the performance GENERAL AGGREGATE .2 000 000
~'~ AGGREAE ~lIMIT APAsIPER: of professional D RECE VED BY PRODUCTS - COMPIOP AGG .2 000 000
POLICY ~~g. lOC services WNTOWN DEVI " ^.
A ~OMOBILE L1ABIUTY BK01461996 09/01/04 09101/05 COMBINED SINGLE LIMIT
ANY AUTO OCT l 2004 {Eaaccidenl} '1,000,000
-
- ALL OWNED AUTOS BODILY INJURY
{Per person) .
- SCHEDULED AUTOS CITY OF S ANTA ANA
~ HIRED AUTOS BODILY INJURY
(Peraccidenl) .
~ NON-QWNED AUTOS
PROPERTY DAMAGE .
(Per accident)
~~GE UABILITY AUTO ONLY - EA ACCIDENT .
ANY AUTO OTHER THAN EA ACC .
AUTO ONLY: AGG .
3~SSfUMBRELLA LIABILITY EACH OCCURRENCE .
OCCUR 0 CLAIMS MADE AGGREGATE .
.
~ ~EDUCTIBlE .
RETENTION . $
B WORKERS COMPENSATION AND WVA7726881 09/01/04 09/01/05 X I we STATU-, I 10J~'
EMPLOYERS'L1ABILlTY .1,000,000
ANY PROPRIETORlPARTNER!EXECUTIVE E.l. EACH ACCIDENT
OFFICERlMEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYE .1,000,000
If yes, describe under .1,000,000
SPECIAL PROVISIONS below E.l. DISEASE - POLICY LIMIT
B OTHER Professional QP03801862 09/20/04 09/20/05 $1,000,000 per claim
Liability $1,000,000 annl aggr.
DESCRIPTION OF OPERATIONS { lOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS , - ,be-' ( C TC >:-< n;1rv1
'. , . -' '~,-.'
-Except 10 days notice of cancellation for non-payment of premium.
The City of Santa Ana, its officers, agents, volunteers and employees are _~(i~
additional Insured on General Liability coverage but only as respects to ..,. --
work being performed by the insured. J.-->; ~. It C::".
.j_~~_j _ _'.., Jh~'-"-"j
Coverage afforded the additional insured is primary and non-contributory. A.S.:;.:,L..H --':dy , .
CERTIFICATE HOLDER
CANCELLATION
City of Santa Ana
Alln: Danell Mercado
Downtown Development Division
305 E. Fourth Street, S#201
Santa Ana, CA 92701
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL E~K~l ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BIJf)f)I.)tWOllXDlQ:klXl".tlt9(Xxx
lJIllXlil:lllXQClX )OS(lJlm~)()l3(OiIIJCXXX
lIl8P.(!XmM)lJJ)(D!:KX
AUT ORIZEO REPREiN~
ACORD 25 (2001108) 1 of 1
#M113249
THC
@ ACORD CORPORATION 1988
Policy Number: BK01461996
Owners}...Lessees or Contractors (Form B)
ADDITluNAL INSURED
Change(s) Effective: 10/27/2004
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY. This endorsement modifies insurance policy under the following:
LIABILITY COVERAGE PART:
Schedule
Name of Person or Organization:
City of Santa Ana
Attn: Danell Mercado
Downtown Development Division
305 E. Fourth Street, S#201
Santa Ana, CA 92701
SECTION II - WHO IS AN INSURED 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 work" for that insured by or for you.
The City of Santa Ana, its officers, agents, volunteers and employees
are additional insured
PRIMARY INSURANCE:
IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY
AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED
SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS
INSURANCE.
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