HomeMy WebLinkAboutFAMILIES TOGETHER 2 -2004
A-2004-202
INSURANCE NQT UN FILE
WORK MAY NQI PROCEED
CLERK OF COUNCIL
DATL~/1510't
CONSULTANT AGREEMENT
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THIS AGREEMENT, made and entered into this 1A day of tkjoh-€Y, 2004 by
and between Families Together of Orange County (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, as a grantee of the United States Department of Justice Weed and Seed Grant
A ward, pursuant to Title I of the Omnibus Crime Control and Safe Streets Act of 1968,
42 u,s,c. 3701, et. seq, (hereinafter "the Act"), desires to enter this Agreement with
Consultant for the expenditure of Weed and Seed Grant funds to provide instruction in
computer technology,
B. Consultant represents that it is able and willing to provide such services to the City,
C, The City and Consultant have duly executed this Agreement for expenditure of said
funds,
NOW THEREFORE, it is agreed by and between the parties that the foregoing Recitals are a
substantive part of this Agreement and the following terms and conditions are approved and,
together with all exhibits and attachments hereto, shall constitute the entire Agreement between
the City and Consultant:
1. SCOPE OF SERVICES
Consultant shall provide instruction in computer technology for residents living in the
Empowerment Zone II, 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 $16,000,00 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 October 1,2004 and terminate on September 30,
2005, unless terminated earlier in accordance with Section 14, below, The term of this
Agreement may be extended upon a writing executed by the Executive Director of the
Community Services 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 ofthe 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 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:
2
(i) Consultant shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement,
(ii) Certificates of insurance shall be furnished to the City upon execution of
this Agreement and shall be approved in form by the City Attorney,
(iii) Certificates and policies shall state that the policies shall not be canceled
or reduced in coverage or changed in any other material aspect without
thirty (30) days prior written notice to the City,
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: (I) 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; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects
arising from this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to
have been suffered, by reason of the events referred to in this Section or by reason of the terms
of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold
harmless, and pay all costs for the defense of the City, including fees and costs for special
counsel to be selected by the City, regarding any action by a third party challenging the validity
of this Agreement, or asserting that personal injury, damages, just compensation, restitution,
judicial or equitable relief due to personal or property rights arises by reason 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
3
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. SOURCE OF FUNDS
Consultant acknowledges that the funds being provided by City for Consultant's services
are received by City as a grant from the United States Department of Justice, and warrants that
expenditures of these funds shall comply with the laws, regulations and policies governing use of
said funds as set forth in Title I of the Omnibus Crime Control and Safe Streets Act of 1968, 42
U.s,c. 3701, et. seq,
10. CONSULTANT CERTIFICATIONS
Consultant agrees to be bound by all the terms and conditions of City's Grant Agreement with the
United States Department of Justice, including but not limited to:
a, Audit Report Requirements. Consultant agrees that if Consultant receives Three
Hundred Thousand Dollars ($300,000,00) or more in federal funds, Consultant shall
have an annual audit conducted by a certified public accountant in accordance with the
standards as set forth and published by the United States Office of Management and
Budget - OMB Circular A-133, Consultant shall provide City with a copy of said Audit
by October I.
b, Record KeepinglReporting, Consultant shall keep and maintain complete and adequate
records to assist City in meeting and maintaining its record keeping responsibilities
under the Act. City and the United States Government and/or their representatives shall
have access for purposes of monitoring, auditing and examining Consultant's activities
and performance, to books, documents and papers, and the right to examine records of
Consultant's subcontractors, bookkeepers and accountants, employees and participants
in regard to said program, Nothing herein shall be construed to require access to any
privileged or confidential information as set forth in federal or state law,
c, Use of Funds, Consultant certifies and agrees that it will not use funds provided through
this Agreement to pay for entertainment, meals or gifts,
4
d, Lobbying, Consultant certifies that it will comply with federal law and regulations
found at 24 CFR Part 87, which provide that no appropriated funds may be expended by
the recipient of a federal contract, grant, loan or cooperative agreement'to pay any
person for influencing or attempting to influence an officer or employee of any agency,
Member of Congress, or an officer or employee of a Member of Congress in connection
with awarding of any federal contract, the making of any federal grant or loan, entering
into any cooperative agreement and the extension, renewal, amendment or modification
of any federal contract, grant, loan or cooperative agreement.
e, Drug Free Workplace, Consultant certifies that it has established the following drug-
free workplace policy:
I, The unlawful manufacture, distribution, dispensing, possession or use of a
controlled substance is prohibited in the workplace for any employee involved in a
federally funded program,
2, As an employee working in conjunction with a federally funded program, the
employees of Consultant will be required to:
. Abide by the terms above in statement I,
· Notify appropriate officials of Consultant and City officials of any criminal drug
statute conviction for a violation occurring in the workplace not later than five
days after such conviction,
. The United State Department of Housing and Urban Development will be notified
within ten days after receiving notice of any such violation.
. Within 30 days of receiving such notice, appropriate personnel action will be
taken against such employee, up to and including termination,
· Each such employee shall be required to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a federal, state
or local health, law enforcement, or other appropriate agency,
f. Consultant assures and certifies that it will not use any funds appropriated under this
Agreement for religious activity or anti-religious activity, or to promote or oppose any
political candidate, party or belief.
g. Consultant assures and certifies that where applicable, classroom instructors are properly
credentialed, and training curriculums comply with State Education Codes,
h, Consultant assures and certifies that it is in good standing with the California Secretary
of State, Franchise Tax Board and Internal Revenue Service,
11. 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
5
mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other
telegraphic communication in the manner provided in this Section, to the following persons:
To City:
Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O, Box 1988
Santa Ana, CA 92702-1988
telefacsimile (714) 647-6956
With courtesy copies to:
Executive Director of Community Development
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:
Families Together of Orange County
801 S, Lyon Street
Santa Ana, California 92705
telefacsimile (714) 836-4478
Attn: Maria Halverson
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,
6
12. 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,
13. 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,
14. 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.
15. 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,
16. 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
7
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.
17. PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United States, the State of California,
the City of Santa Ana and all other governmental agencies, Consultant shall notify the City
immediately and in writing of her inability to obtain or maintain such permits, licenses,
approvals, waivers, and exemptions, Said inability shall be cause for termination of this
Agreement.
18. 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
indenmify 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~EST; ~
/ 4:&-:.'-<-. =. _ _
(- -
~~ i _./
PATRICIAE, HEALY .
Clerk of the Council
CITY OF SANTA ANA
/
( 't2. /]/)
fY~v ,/O~1.-
DAVIDN, REAM
City Manager
--
APPROVED AS TO FORM:
~1~O~7
JOSEPH W, FLETCHER
City Attorney
CONSULTANT
Tax ID# ;;!D - Q~\ b{gS'1
8
EXHIBIT A
SCOPE OF SERVICES
Consultant shall develop, coordinate and implement a "Weed and Seed Safe Haven" site
program at its Lyon Street Parent Center to provide computer classes for youth and their families
as part of the Special Emphasis Initiative, The program will provide instruction on beginning
Microsoft Work, Excel, PowerPoint, Access and Internet Navigation, Sessions will be taught in
English and Spanish, Participants will also have access to all other Center services including
parent education classes, youth development programs, after school services and health care
referrals,
Consultant will comply with all reporting requirements of the Executive Office for Weed and
Seed, Such requirements include providing monthly report to the City Community Development
Agency, describing the number of clients served and the type and level of services provided.
Consultant shall include the following documentation regarding the program:
Registration forms
Attendance sheets or sign-in sheets
Copies of flyers/marketing materials used to promote the program
Pictures of special events
Pre and post tests to determine program effectiveness
Safe Haven survey
COMPENSATION
Consultant shall be compensated as follows:
Computer Instructor
$14,00 per hour x 20 hours per week x 48 weeks
$13,440.00
Supplies - Ink cartridges, paper, computer maintenance, etc,
$ 2,560,00
Total
$16,000,00
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EXHIBIT B
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its
officers, employees, agents, volunteers and representatives are named as additional insureds
("additional insureds") with regard to liability and defense of suits arising from the operations
and uses performed by or on behalf of the named insured,
2, With respect to claims arising out 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 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
10
~
..- ........
Feb-24-05 02:07P Mar1a Halverson
P.02
l!;!'iut-UA It I"-tMiOOlYV)
2/14105
PROCUCi.R
Driver. Alliant tn5uranco Sorvicos, Inc.
p ,0. Sox 25684
Santa Ana, CA 92799
(800) 821.9283 ElCt 190. Fox (949) 755-2713
ucense No OC36861
IN5UPtED -!;ptclAi."Llo\ii[ifYiiSu~ lP)r.a.t.lIUr.H"
FAMIUES TOGETHER OF ORANCE COUNTY
801 S. LYON ST.
SANr A ANA, CA !l27OS
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONl,V AND'"
CCNFIIlS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ClIlrIplCAYE-'
DOts NOT AMEND, EXTEND OR ALTER THE COYeRAOl! AFFORD!!D BY THE
POLICIES BELOW,
COMPANIES AFFORDING COveRAGE
I~~Y' "j,.--ILLlNOIS UNION INSURANCE COMPANY
COMPANY
LETTeIt B
"COMPANY
LOTUM c
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THIS IS TO CERTIFY mAT THI: P(lLICIU 0' IN&UItAHCI: Ll$,e ULOW HAW' .UN ISSUED TO TtI! llSUIIIED NAIlED MOvI FOIIt THil ~., """P INDICATED.
NOTWITHSTANDING ANY .!Ot.....NT. TERMOR COHtIf11ONOF AHYCONTRACt 0.. OTttri" DOCUMEKT WITH Rr.~T TOWIICHTHIICEATfRCAft_"..ISSUEU
OR aMY ,.RTNN. THE INIUfWfCI!. Af'fOfIID!D BY' THE. POUCIU DEICRIBIlO HEA~1lI1$ SU&.lECr TO AU. TKE nUll. 9CLUSION AIilO CONDITIONI OF SUCH P(lt.JI)Ifj;,
_..~~M~.~.~,'!~~1!8VJ~~~'-~!::!!!!:...____. __'_~y'_'""'_' ___".__'..__._____
~~R f'tItl Of" IIl4$URAJltCE POI.JCV NUMHR POLICY EFFlCTNE IXPlRATIQIrf
0llTE: tIIM/DDM'l DATE MMIDDI't'V
10/27/04 09/29/05
LIIITS
A
GENERAl UUIIIUTY
G2207845ll
GENEIlbU.AOGAIGATI.
rAODUCTS-coNPIOP
G
rE:RlONAL & Ar::N. INJURY
-au IIELOW .
COMMEftCW" Gl!NERAL
UMU\.m-
~ 13] OCCUR
OVIINER'S I CONlRA.CTOR'S
tl'FtO'f
GLDEOoSl,OOIl
EACH OCCURPENCE
FIREi DAM^G& !Any,",,,)
~) t!.WJII::NSE (Any OM
$1.llOO,OOO
---
$1.000,000 .
$1.000.000;
$l.ooo;~,_
N/A
$1.000.000
Al1TOMOtIIl..! LIAILJTY
ANY AUTO
All OW"~Aln('lS
SCHfOll,F.DAl/IOS
HIReD AUTOS
NON-OWNEO "lJTo..<;
GARAGE:: llABII.lTV
AUTO Deoo .1,000
G22078458
09/29/05
A
APPROVE
'ROhllViNJlJ
{Perpr.:Mnl
800lL Y INJURY
(F'W eccfClenl)
PfIDPEIUY tWMGe:
uwancLLA rORM
OTHER 'THAN \It.mRFI LA FORW
Laura lie
ssistant Cit$" Alforne\
'NOAKIE,.., COMPlNSATtON
AND
IMPLOYBt'B UAaJ'1'"f
A I NON,PROFITOIRECTORS
AND OFFICERS
G22078458
10/27104
09/29/05
$1.000,000
PI!R OCCURRENCe AND
ANNUAL A~E~TE
Of. R IT.
o It.''lTE .........tllillllill!y......... ...1IlI\II....M,......I..iIltJ .. ...~~)~n..,...Itr-.OoM..tI'Qllimil
AS RESPECTS TO THE COMMUNITY DEvelOPMENT BLOCK GRANT THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS IIND EMPLOYEES S>iALL BE
NAMED AS ADDITIONAL INSURED, ADDITIONAL INSURED ENDORSeMENT ATTACHED, SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSjONa
.
. l!:;.llf."u., _~ .." ..,:~,:,-=" .,J<Git. ..:I;.;::rjs, iT' ~'''''''_'''-_-_::''''~'''';''''''''.-':~''-''".,."
1!1f!~i:i,..,.""i!l'~",f.~~i"~,..~;",~,~.-~..u'
C'TY OF SANTA AN"
10 C Me (".ENTER PLAZA. M-25
SANTA ANA,CA 92702
I SHOULD ANY DF THE ABOVE DESCRiBED POLICIES BE CANCELLED BEFORE TH&
!XPtRAnON 0.. l'E THEIltEOf, THE ISSUING COMPANY WILL "~IO[ .u~A W MM..
~ DAYS WRITTEN HOl1CHO THECeRl1FICATE HOeDER NAMED TO THE LEFT. '
aUT FAILURE TO "'AlL SUCH NOTIC'! SMALL IMPOSE NO OBuGATION ORLIABlUTY
QtO ANY KINO UPON THE CDMPANY, ITS AGENTS OR REPRESENTAllVES
"excEPT 10 OAYS FOR NDN-PAYMENT
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....~~..~.."... ""~~ .ca' D~lIrA
...:~Jo::!(;: :':.~~. ~.!I!!;
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-"'-"-
-Feb~24-05 02:07P Maria Halverson
P.03
Endorsem!;!nt. No.3
ADDITIONAL INSU,lU:n - DI':SIGNA.:!]:n PERSON OR OR(iANI7.A1'ION
iT IS AGREED THAT THE FOLLOWING ARE ADDED AS ADDITIONAL INSURED (S) HEREUNDER
BUT ONLY AS RESPECTS LTABILrty ARISING OUT OF THE OPERATIONS OF THE NAMED
INSURED, AND I'URTHER PROVIDED THAT THE INCLUSION OF SUCH ADDITIONAL INSURED ,.
SHALL NOT SERVE TO lNCREASE THE COMPANY'S LIMIT OF LIABiLITY AS SPECIFIED TN THIZ
DECLARATIONS OF THE POLICY.
SCHEQUItt:
NAMED JNSUBEP;
FAMIUES TOGETHER OF ORANGE COUNTY
801 S, LYONST,
SANTA ANA, C:A 9270~
NAME OF PERSON OR
ORGANIZA TlQN/CERTlFICA.TE HOLDER:
CITy OF SANTA ANA
20 CIVIC CIlN1'I!R PLAZA, M.2S
SANTA ANA,CA 92702
PER CERllHCA TlS OF INSURANCE APPROVED!lY TH1i COMPANY, AND ON FILE Wn'l1 THE COMPANY
EFFECTIVE DA.TE OF THIS ENDORSEMENT: 10/27/04
ATTACHED TO AND FORMING A PART OF POLICY NO.: 022078458
All other terms and condilions remain unchanged. .. 1'1<0 V 1::0 AS TO FORM
Insurer: II.LlNOIS UNION INSURANCE COMPANY 7--'3"7 '?-/2-
Special Liability Insurance Program (SLlP) ---."-~"ra Stilt Sheedy
Effeclive September 29.2004 to September 29,2005 .,,,,tant City Attorney
DAlE ISSUED: 2/14105
PRODuCER
Driver + Allianllnsurance Services, InG.
PO, Sox 25884
Santa Ana. CA 92799
(800) 821-9283 Ex!. 190. Fax (949) 766.2713
Lieen&8 No. 0C368tl1
'"SUMO SPECIAl LWtl.Jtv 1N$I"lRA.NCE PROGAAI.4 ($LIPJ W;;t4ER~ .
FAMII.IES TOGETHER OF ORANGE COUNlY ;4-.:;/o,yl-;;W I
801 S, I.YON ST.
SANTA ANA, CA e270~ ~ ~ - ..2o~
A- ;;wu'f-;)..rJ( - 01
Ao-a-004-a.t);l.- 01
/l-0Ec3' -07,1'-0/-1-
T-470
III
P,02/03 F-547
......~~~-.'...\"".~.........." 'J
10/6/05
GOMPANY
I.E1TER
COMPANV
LETTER
MY
lETTfiR
IlOlrAHY
LETYllft
CONPAI/V
LO'l'nR
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOIlMATION ONLY AND
CONFERS NO RIGHTS UF'ON THE CERTlFlCATE MOLDER THIS CERTlFlCATE
DOES NOT AMEND, EXTEND OR At rER THE COVI!RAGE AFFORDED BY THE
POLICIES BELOW,
COMPANIES AFFORDING COVERAGE
A EVANSTON INSURANCE COMPANY
B
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E
1lft9 IS TO CEJrrI THAT THE POUCJI$ OF INSUlUNca Llano .aow HA~ ~ ~ 'r0 THI!! JNSUR~~ ~ Move ~~ THII"OLICY PfiRlOD INOICATED.
HO'rWrrHSTANOU\IG AMY AlCIlIREMENT, f1iRM Oft CONDrTION.OF AN'f COf(rMCT OR O'TH&R OOCUMEN.T W1THIf:e$1!:CT TO WHICH Ttttl CEJlTWltcATfi M4V S&ISSUj;D
OR WloY' PERT~. THIi "~&l.JR.t.NC1 NFOR[)EP BY 1111 POUCtES DEaC,... klJuilN Ie SUBJECT TO ALL THe TI!:~~ JiX-cLUStON AND COhtPlTlONS 01' SUCH POLICIES.
LMTS Ii Y HAW IIftN "I!~D BY PAID
CO
LTR
TYPII!: OF JNSUAANcE
PDUCV NUMBefll
GE~EAAL I.IA8.IL.ITY
COMM~ GENERAL
lIABILITY
Cl.A1MS fXl OCCUR
MAIlE ~
OWNER.S" CONYAACTOR-S
PROT.
Gl. OED,S1 ,000
SllP300CHl5
POLICY I!fFECTrvE I'OUCY
DATE (-llO/I'Y) DPlItA"nON LIMlYa
DATE MIWDIVY
09129/05 09/29106 GENERAl.. AGGRlGAn NJA
PROOUOTs..cOMPIOP $1.000.000
AG
PER$ONAL $. ADV. INJLRY $1,000,000
EACH OCCURAl!HCE $1,000.000
FIRE DAMAGE (Ai;y on.",.) 51.000.000
MED, N5e WI, Me NlA
09/29106 51.000.000
A
A
AUTOIlO8lt.E I.lA*UTY
Sl'PJOOo.05
ANY AUTO
AU. OWNED AUTOS
SCHEOlJl.EO ALJTOS
X H~O "vrOa
X NOk-OWNECl AUTOS
G.4.RAGE LJAAlI..ITY
AUTOOEO: $1,000
UMBRElLA FORM
eTHER TJ.w.l UMBAEUA FORM
~D1L Y tNJURY
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Y ....lJRY
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PROPERTY OAMAOE
APPROVED AS 0 FORM
EACH OCCuARENCE
AGGREGATE
WORKER's COMPEHSATtON
""D
~PLOYlEfrli UABlLlTY
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EAC:H ACCIDENT
CIS &POlICY llMfT
OISEASE.v.cH ."'Pc YEf
A
NON-PROFIT DIRECTORS
AND OFFICERS
SllPJOoo.o5
09/29105
09129106
$1.000,000
PeR OCCURRENCE AND
ANNUAlAGGRfGAn;
llM IONOFDn"ATlQHII TIOJrtlSNEhlClE.IISl1KlALrt1:MS
AS RESPECTS TO THE COMMUNITY DEvELOPMENT 81.OCK GRANT, THE CITY OF SANTA ANA, rrs OFFICERS. AGENTS, EMPLOYEES AND
VOI.UNTEERS SHAl.l BE NAMED AS ADDITIONAL INSURED. THIS INSURANCE IS PRIMARY AND ANY INSUAANCE OR SELF INSURANCe MAINTAINeO BY
SUCH ADDITIONAL INSUREDS SHAll NOT CONTRIBUTE TO IT, ADDfTlONAl.INSUReD ENDORSEMENT ATTACHED. SUBJECT TO F'OI.ICYTERMS,
CONDfTlONS AND ExCLUSIONS,
I ':.::T~!'jj'f, " ,:".'.-:.1'.....' .,lr'Li'.';;.," ',:';.' ':,t,;I:'!'~:I.,';.iI"".1;','. '.',',:Il",".",:l,l~:\.",::"", :'.',~r ',<',.' '~,"'.',,\.': :-1,'.':,."':',,' ,:,':.,,'.', ',:11," '- >: ,"; ..T\...."t"::....:.~,'1r,: '(I~:"\'I ';',;~,'I,r~~.\:;;w, ,'M' _.Il"~ ,,~', .,~;';r,(~:;r'....i')..,..; :_,' :,,; :". '..',:,":..f ...... :.'.~.~. .
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SHQUU) 4NY OF rHE ABOVE DESClIIBED POLICIES BE CANCELLED BEH>I<E rHE
EXPIRATION OAr. THEREOF. Y'HE ISSUING COMPANY WII..L. ~)''''''''' ,...lOt TI:} MAlL
~ PAYS WRITTEN NOTlCf TO rHE CERTIFICATE HOLDER NAMED TO THE LEFT.
BUT FAILURe TO MAIL. SUCH NonCE S,fiAl.L IMPOSE NO OSI.IGATlON OR LlAall-l'J'Y
Of ANY KIND UPON "'H~ COMPANY. ITS AGE"'TS OR REPRl:S~NTATfVES
.E>:CEPT 1c:l ClAY$ FOR NON-PAYME:;NT
AU HORIZEO AIIV
CITY OF SANTA ANA
COMMUN'TV DEVELOPMENT AGENCY M.~S
20 CIVIC CENTER DRive
PO BOx 19l11l
SANTA AW.,QA 92702
.
Oct-06-05 02:22pm From-DRIVER ALLIANT INS, C
9497562713
T-470 P,03!03 F-547
~ ..
Endorsement. No.3
ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION
lTlS AGREED THAT THE FOLLOWING ARE ADDED AS ADDITIONAL INSURED (S) HEREUNDER
BUT ONLY AS RESPECTS LIABIUTY ARISING OUT OF THE OPERATIONS OF THE NAMED
INSURED, AND FURTHER PROVIDED THAT THE INCLUSION OF SUCH ADDITIONAL INSURED
SHALL NOr SERVE TO INCREASE THE COMPANY'S LIMIT OF LIABILITY AS SPECIFIED IN THE
DECLARATIONS OF THE POLICY.
SCHEDULE
NAMED INSURED:
FAMllJES TOGETHER OF ORANGE COUNl'Y '
801 S, LYON ST,
SANTA ANA, CA 92705
NAME OF PERSON OR
ORGANIZATION/CERTIFICATE HOLDER:
CITY OF SANTA ANA
COMMUNITY DEVELOPMENT AGENCY M-25
20 CIVIC CENTl>R DRIVE
POBOX 1988
SANTA ANA,CA 92702
THIS INSURANCE IS PRIMARY AND ANY INSURANCE OR SELF INSURANCE
MAINTAINED BY SUCH ADDITIONAL INSUREDS SHALL NOT CONTRIBUTE
TO IT,
PER CERTIFICATES OF INSURANCE APPROVED BY TIlE COMPANY, AND ON FILE WITH THE COMPANY
EFFECTIVE DATE OF THIS ENDORSEMENT: 09/29/05
ATrACHED TO AND FORMING A PART OF POLICY NO.: SLIP3000-05
AI! other terms and conditions remain unchanged,
Insurer:
EVANSTON INSURANCE COMPANY
Special Liability Insurance Program (SLIP)
Effective September 29, 2005 to September 29, 2006
DATE ISSUED: 10/6/05
~ ~a:.~ _..._.._
APPROVED AS TO FORM
1'>3 2/z-'
Laura .';1 [(t Sheedv
AS~lstallt Cj!y Auor;-it;y