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Home My WebLink AboutMASK SYSTEMS, INC. 1B -2005 A-2005-002 INSURANCE UN filE WORK MAY PROCEED UNTIL INSURANCE EXPIRES ~ '2-'" \&' ~O5' CLERK OF COUNCIL DATE: I -;;l. '1-0'5 FIRST AMENDMENT TO CONSULTANT AGREEMENT c:f't> viScAl- THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into on January 3, 2005, by and between MASK Systems, Inc., a California corporation ("Consultant") and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). Recitals: A. The parties entered into Agreement #A-200 1-260, dated March I, 2002, (hereinafter "said Agreement") by which Consultant has provided emergency and preventive maintenance for the Santa Ana Jail security system. B. In accordance with the terms and conditions of said Agreement, the parties wish to extend said Agreement for an additional one-year period and increase compensation to pay for services during the extended term. Wherefore, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this First Amendment to Consultant Agreement, the parties agree as follows: I. Section 2, COMPENSATION, shall be amended to delete paragraph "b" in its entirety, to be replaced with the following: "b. Payment for part replacement and modifications shall not exceed $200,000.00 annually during the term of this Agreement. Payment by City shall be made upon completion of the project or as agreed upon by the parties, subject to City accounting procedures. All part replacement and modifications shall be pre-approved, in writing, by City. 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. 2. Section 2, COMPENSATION, shall be amended to add a paragraph "c", which shall read as follows: "c. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Consultant's Cost Summary Form, attached as Exhibit A-I to said Agreement. The total sum to be expended for security system maintenance costs shall not exceed $196,350.00 during the fourth year of said Agreement, commencing January I, 2005, payable in twelve (12) equal monthly installments, subject to City accounting procedures, subject to City accounting procedures." DEC-16-2004 15:29 Uuvl i .Jll.UiJ'tl ti:';'!,.' ~ U. ~.) MASK SYSTEMS INC. MIIUlt:.llII C( WlUI'c;',JIY 805 532 2332 P.02 rllA IIV, aU;) ~Ol UJDl r. UUD ACORD. CERTrFICA TE OF LIABILITY INSURANCE OP ID v~ "'''Ii CO''''''''^'''''1 ~-1 12/14/D4 PRaDUCiER THIS CERTIFIQA1l; ISI8SUEO AS A MATfER OF INFO~TIDN Andreini " Company-OxDarcl ONLY ANO CONFERS NO RlC3lfTS UPON THE CERTIFICATE Lio"Dse D20BB25 HOLDER. TIllS CERTIFICATE DOES NOT AMEND, EXTl!1ltl OR 30D tl>pl.......cIe, Snit.. lOD AI. TEfl THE COVERAGE AFFOIUlI'I> BY THI! POLICIES BELOW. Oxnard CA 93030 Phona'8oS~981-95eS Fax:eOS-981-0161 INSURERS AFFORDING COVERAGE NAIC' "'ilU_ fJr---if.::>93 -I ~ l.l lNBUIIlM~ f8~ral Ins~aac. COlllD....v INStJAl!R:1: Pr t)"\P \{-Dz..'1- IHMIiRQ, !t$~ s/\,.t_ Inc. - 9 9 1.cc"..~ Ct. J/IIiUReRD; ~orpark CA 9 21 INSURER. E~ coveRAGES THE POLICIES OF INs:UIWiICE 1J6TEO ea.owl'IAVe B&eH ISSUED TO THe INSURED NAMED AlCWE ~oR THE PDUl:YPEIUOD 'NPICATSD. N01'W.THSfAHOlNO A1f1 J(tQlJIqllllE!IIT, TElW DR CON>fTJON OF!MY COH'I'AAQr Oft C1J1oIER DOCLIMENTWI'T'H ~I"~TQ -,tQf tnIS' CfRTlFlCATE MAY 8E J$SUEC O't MAY PERTAiN. 'THe 'N8URIINCE~RDED 8YT1iE F'OL.Je1EB Dil!!CIIl8!O "PEIIII ~ S"JeJECTTO AlL 7HE TEIWS. E;XCUJtiO"'i Mf> OC>>lOrrJ0III8 OF BUCH POLICIES. AGt;REGATE &JtjIITS efoCl\llotl ",Y'HAVE. EElf ~[) IWPAIO CI...AIM6. 1'YJ/I' oa:: INstJAA"'CE PQl.1CY """'Ell u.rn; G&lEffAl. UAIlIUT"f EACH OCCURRfNCl' 11,000 000 A X co....~jAi.GI!htlIJtALLI,&IIL&'TY 3533-99-03 12/18/04 12/1B/05 ~J!l!l!It!A~ . 1 000 000 CLAIMS Ml'.De- [i] OCGtIR MEL)Ex/'fMyCll'ltPlll'llDrtI '10,000 I"IRSOP'W. INN INJURY .1 000,000 ~w.AGGREG4TE 1 2 000 000 GI!IIt, AtlGl\e<l4Te LI..,. ""PUS, P~, PROOIICT6.~IOP_ '2,000,000 f'OUCY ..0- '00 JECT .IWt1J~l;.llJlLe llABlUTY COMAINE;D $lNGU UlI1rr 11,000,000 A X ANY AUTO 7322-50-49 12/1B/04 12/18/05 (;a 0IISljdln) ALL OlI\'NeD ftUTOS BODl.YI~r 1 SCt-El)lJlfD..\L.ITQ$ """-, X lJUUOAtJTt)$ ImOllY INJURV X w......"'l 1 NQI<<)~PAl/f'OU P~QPC:RTV OAMAG. . fPt=roUDidetlt) ~lJAS:ll"'" NJTO 0,.." "l". ~ Aecl~NT . ANY AUTO OTHIIt~N EAACC S 4UTQ ONLY: AGO . EXCJ;SStUMEI~ UUlLnY EOCH OCCVIW!NCE . 5. 000,000 A X occu. o t'LAlNS NAOE 7972-98-79 12/18/04 12f1Bf05 ACGREcATE 15,000 000 1 DC:I)UCTJgIJ; 1 RE:n:NTlON . WOJltt<" CQMPil'l8A.TlQN All" /~ eupl,OYPS' UABll.rn" ANY ,.ItOJIRII!T'ORlPMTNE~c.uffVE OFFICERINEMBER EXClUtJEOO ~~-"'"" 8P IAl PROVISIONS below 0,.... OESCRIPTJON OF OP_T10tIG/l.oe.ATtONr;tVEHlCuIJ UCl.lIItONS MOIl) SY'ENDQRSENPT ISPECIAL PRaltSlONC C:art:iJ!j."..t:e hold.... iD ........d "9 ad<Uti"....l insursd Wldar t:ha gen"""l liability. CERTIFICA TE HOLOER CANCElLATION SANTA 5HDUlDAN'rOF THE ABOVE DESC'-I:!f1 ~~Iq. CAtlCJl.U!!O 'I!fIOU'fIo!1! l!XPI~tJOt.l DATE THEItEOf=. THE II8UING IH~ 'Niu, "P~VOt( TO NAIl. ~ DAYS WR'Tl'EN 1II0'rloa TO". Cet'nI'tQA.Te HOI.OER "'o\ME1;I to 'THE l.EFT. BUT F:A'LURE. TO DO SO ~L IMPOse NO OIUG.\l1ON OR llABlUTY OF AN'( KIND UPON TIE It.lSUREit ns AgENTS OR RE"'RESI!NTAnV@& AUJ1fC.uu:" I!$PR!SEHT""nVI ~~ C1 ty of Sant.. Ana 60 Civ;.c Center :u..".. SiUlta Ana ClI. 92703 ACORD 25(2001108) @ACORD CORPORATION '988 DEC-16-2004 15:29 l!l:iV! JUI ,"UJ't/ ILll,; lJ.Vf MASK SYSTEMS INC. "''-'1'''1111 C< \'Ulllpo\11Y flU I~Q, OU~~OI UIOJ 805 532 2332 P.03 r. UU I i I ADDITIONAL' INSURt:D ~NDORSEMENT I I I . I, Insurance Company F~ <E' ({ilL /J/ J'{f I'll ;Jc.e r d This 'endorsement modifies such insurance as is afforded by ~e Ptl , J: of Policy 1# 3 ~:J:? - fJ f d,2 rel.ating to the foilowing: ", . " 1. The City of Santa Ana. 20 Civic Centsr Pta~, Sa fa Ana. Oalifornia 92701; its ofrlC9rs. employees, ag..nlS. volunteers and 'representa~ive are named as , additiolJaI insureds ("additiOl,al insureds.) with reg,ard to liabilIty a~ eiense of suits ;lrising from the operation:;; and uses perlbrmed by or on behalf oftlr n, ad Insured. . 2. . With respe<;t to Claims ari~ out of tile ope~o~ llflQ usb performed by or on behalf of 1t1e named insured, sw:h inlOurance as is afford~ ~y this policy ill primary ;Ind is not additionaf to Of contributing lIIilJ1 any other insurance ,carried by Of for the benefit of th6 addllional insureds. ' ' . i 3: This insurance applies separately to each. insur'Qd a9 'i... whom claim is . made or suit is brought e;ec;ept with respect to the company'g limO liabirrty. The iT1Clusion of any person or organization as an in,sured shall oot , any right which su~ p:~n ::~::::n:o:d8h::;:::d~~::~~O:: i~:~ E:l shall "~ be, cancelleel, or materially reduced in coversge or limits except after thirty i30) days written notice has been given to the City csf . Santa Ana. 20 Civic Cente~ PI;;'~. Santa A.na, Catifornia 92701, (Completion of the following, including countersignsture. Is endo,.s;.ment effedive.) to rflslle this Effective I ~ II f' /d ~. Poficy# :J !:.?!J- P !N':;? . . this endorse nl rrm as a part of i l$sued to III IU.K. J'YJ'T67n.J' /)}(!,t Named Insured I j 2..u~ Authorized R resentatlve I I I I i I , i I I I I Countllrsigl\ed by ;Yfi!B 2/e' TOTAL P.03 JAN-07-200S 17:01 , O)l\~1/~IILv~-"'/r:\. ./.J': MASK SYSTEMS INC. nIK.\1~JlU p;; 'vVIUjJ't1r.tIY rftA ~u. ou~ JOt UlUI 805 532 2332 P.02 f. UU;/UUI ACORDh CERTIFJCA TE OF LIABILITY INSURANCE OP ID ~~ DA'tE_1lClIm'Yl ~-1 01/07/05 ,..,"",,,,,," TIllS CERTIFIC.O.TE IS ISSuSO I\IS A MAlTER Of INFORMATION I\ndreini , Ccmpany-o-,..,d . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATI'i Licanse 020a825 HOI.D~. THIS CE~llFICATE DOES NOT AIIIEND, EXTEND OR 300 Esplanade, 'Suit.. 100 ALTER THE COIIEAAGE AI'FORt>ED BY TIiE POLICIEl; BELOW, Oxnard CA 93030 Phone: 805-981-9585 Fax: 805-981-0161 INSURERS J\FFORllDIG COIlERAGE tlAlC , INSU'tED I~SuReA A:. AXG Xnsu:z:'aDce G.:l:'oup INSURER a Mask S~8t~, Inc. INSI.JlIlDtc: 11959 iseo~ C~. W'4SUR!l\D: Koo:parlc CA 93 21 MURBR E; COvERAGES THe PO:JCIES OF to:~NCfi USTeD 1ELOWH.we ElEEN I6GUEOTO 1lE tHSUmiQ NAlCD AGOVl FOR. TH!. POl..lCY ~~D IH~TeO, ~n,l\Ntllr<<i IIiN I'.!QVfV!td!HT. '11!ft14 Oft CONOmON OF AAY c~ ORQ"rnII" DCCUMEHTlMTH f4a:PECTTOWflCH nHS C:ERTIflCAlE ~y BE lUllED OR. w..y PERTAfK. THE INSLRA.NCE N'FORDED IJYnlE fIOllctES DESCRIeD lE~elN: IA Sl.~U~T TO AI.J. TUE; Tf;RM$. ~LI,I~,ylO eOHOfTJONS OF SUCI-4' POt.ICB. ~RffMTE'lMT1 SI-lQlMl NA.VHMfE B~ REDUCED BY"AID ctA...s. ~ 'n'PEOFIN$U"''''''' POUCV IllMlllat ~ "&iWtMli . U..'TS G~UAM./TV c.\CHOCCU~ S r- ~ Co..EPt:lI'L~l.WiILnY. PR;MJIa A. S ::J ClAIMS..... 0 oeeu~ MED EW' fA.".- 1*llI'~ . r-- ' PERSONAl. ,. KJV 1JCJtM( S ~A~1!. . GeN'lAGGReGAir: UWT N'I"J,.I$ f'eA: , PRODUCTS ~ COMPtcP AGG . -, POlICY n ~ n .00 AU'R)MOSllE lW!ILnY COMf!lIN~Stl(t;L.El.iJlT -- /..HV AUTO (Ea2l:6di11t'l1) S - ~l O\'JNEQ Aums r- ISCOILV'lNJUfty . ~\ll<60~NJYOS (!'er_ r-- HIRED PolJros 8OOIl.Y INJOOV r- l/'W_ s NON-QlJlINeD~ - , . . PROPERlY DNMBf . , lP"_ OAAAlJE LfAElllUT'r AUTO ONLY. EA ACCIDDO' . ~ANY MITe 0'1'It1!ll 'tfWC &A ACe s AUTO ONlr. AM . IiXCES$JUM~UA UAJIUTY !ACH OCClJPW!JC:I . ::=J O~UR Dc........."" AGGREGATE S ' . s R OEDUCr*LE s . RETENTION S S ~COM'EHJATlONANC ::r: lro.y~ i I I-Sl... A EMrl.OYER$" UABllJ'r( 9276304 12/18/04 12/18/05 E.L EACH ACCIOENl' .1000000 1ttfY P7WP~c"rQ""'N(t"I!l~M OJ;J:IC~EMBeR EXCLUDED? E.L DISEASE - EA EMPlOYE! S 1000000 "~--- ' lU. D~,.POL.J:YtMT . 1000000 S PROVIU)N$ beloW 0"'''' DESCRlPnON: OF OPERAllONS tl.OCAl1ON6 IVEHIC1.ES I ~lJ!iIONS A.DDm BY ENDOItSEIIENT I SPEQAl PROVI~ APPROVED AS TO CONTENT: Proof of in~n...rat'l.e.e . ~;~~y CSRTlFfCA TE HOLDER City of Santa Ana So. Civie c.n~r Plaza CANCELlATION C%'rYSAA oWfOULDf1oP>iYoP"TtJeAIOYE DDQ~ PQI.Il;iI91le ~~1.Z1) Dl:rOI\c 't'I'C: eAl'1~TlON DAlETHBtI!OF, 'tHe: IstUfNG INIU~ER WlU ENDEAVOR TO IIlIAll ~ DAYS WRm!;;N NO"fteETQ THS~nFICAn=.~~ NAMED TOTUt! ~, PItT FA.ll~TQ DO SO $HALL. IMPO$I;;tO OPUOAnQN OR U.\BI.,ITV OF MY lCIf'lD I,lPON T>>.I~Uf\GR, 1'1$ AG~ O~ W'Rf:5ENTA'IJYE5. AU'I'IiOM.c tteI'~TA11Ut!. IIlACOR[) CORPORATION 1SBll Santa An... CA 92703 "OOR!)'5 (2001/08) TOTAL P.02 ACORD. CERTIFICATE OF LIABILITY INSURANCE OP 10 VII DATE IM~/D~':""'I MASKS-1 ~I 01/07/05 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 AL rER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Andreini & Company-Oxnard License 0208825 300 Esplanade, Suite 100 Oxnard CA 93030 Phone: 805-981-9585 Fax: 805-981-0161 INSURED INSURERS AFFORDING COVERAGE INSURER A: AIG Insurance GrOUD INSURER B INSURER c: INSURER 0 INSURER E NAIC# Mask Systems, Inc. 11959 Discove~ Ct. Moorpark CA 93021 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 'NlTH 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. LT. NS. TYPE OF INSURANCE POLICY NUMBER I PD~'4E iMM/DDIY~"': P8k~~YI~~h~M-~N LIMITS ~NERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES '(E~~~~~nce) $ I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ PERSONAL & ADV INJURY , GENERAL AGGREGATE $ ~'~ AGGREnE ,LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ PRO- nl . , POLICY JEer LOC ~TOMOBILE L1ABIL.ITY COMBINED SINGLE LIMIT $ ANY AUTO (Eaaccident) I-- I-- ALL OWNED AUTOS BODILY INJURY (Per person) $ I-- SCHEDULED AUTOS I- HIRED AUTOS BODILY INJURY (Per accident) $ I-- NON-OWNED AUTOS I-- PROPERTY DAMAGE $ (Per accident) ~~RAGE L.IABILlTY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN EA Ace $ AUTO ONLY: AGG $ , ~ESS/UMBRELLA LIABILITY EACH OCCURRENCE $ U OCCUR 0 CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ , WORKERS COMPENSATION AND X I TORY LIMITS I IUER- A EMPLOYERS' LIABILITY 9276304 12/18/04 12/18/05 $ 1000000 ANY PROPRIETORfPARTNER/EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? E,L. DISEASE - EA EMPLOYEE $ 1000000 If yes, describe under $ 1000000 SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT OTHER , DESCRIPTION OF OPERATIONS { LOCATIONS { VEHICLES { EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Proof of insurance CERTIFICATE HOLDER CANCELLA rlON CITYSAA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 'b-~ City of Santa Ana So. Civic Center Plaza Santa Ana CA 92703 ACORD 25 (2001108) @ ACORD CORPORATION 1988 CERTHOLDER COpy STATE COMPENSATION INSURANCE FUND P.O. BOX 807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-18-2004 GROUP: POLICY NUMBER: 1771109-2004 CERTIFICATE 10: 3 CERTIFICATE EXPIRES: 12-18-2005 12-18-2004/12-18-2005 SL JOB: k' t7005-l~ k - o-oo~ - {)~ 1" CITY OF SANTA ANA 60 CIVIC CENTER PLAZA SANTA ANA CA 92]03 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the Califomia Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer. We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not_an insurance pot icy and does not amend. extend or alter the coverage afforded by the policies listed herein, Notwithstanding anyrequirem~nt, term, or condition of any contract or other document with r.espect to which this certificate of insurancerT41ybei~sued or -may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusiOns and conditions of such policies. ~ J~ t!. ~ AUTHORIZED REPRESENTATIVE PRESIDENT EMPLO'l'ER'SLIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000.000.00 PER OCCURRENCE. EMPLOYER LEGAL NAME MASK SYSTEMS INC 11959 DISCOVERY CT MOORPARK CA 93021 MASK SYSTEMS INC lREV.3'03J 11/17/2004 -. . . . ", . :' SL ACORD_ CERTIFICA TE OF LIABILITY INSURANCE OP 10 VII DATE (MM/DOIYYYY) MASKS-1 12/D9L05 PRODUCER (.} - .,;;t:O O--CO;> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Andreini & Company-Oxnard fl--c9cC> (Vco.3- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License 0208825 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 300 Esplanade, Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oxnard CA 93030 Phone: 805-981-9585 Fax:805-981-0161 INSURERS AFFORDING COVERAGE NAIC# ~SURED - INSURER A: Federal Insurance Company Mask Systems, Inc. INSURER B" Dorado Products, Inc. ~- Rosa Sasa INSURER C -- 11959 Discove~ Ct. INSURER 0" Moorpark CA 93 21 -- INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTV\llTHSTANDrNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WitCH 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 P L E ~r;. PDkTEY(MMib~Jl..'j'1't LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER .D~MMIDDIYY GENERAL LIABILITY EACH OCCURRENCE .1,000,000 A X TI COMMERCIAL GENERAL LIABILITY 3533-99-03 12/18/05 12/18/06 PREMISES (Ea occurence) .1,000,000 FP CLAIMS MADE ~ OCCUR MED EXP (Anyone person) '10,000 PERSONAL & ADV INJURY .1,000,000 ~..== GENERAL AGGREGATE .2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG .2,000,000 "I 'llPRO. n Emp1 Benf 1,000,000 POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT .1,000,000 A X ANY AUTO 7322-50-49 12/18/05 12/18/06 (Eaaccidenl) r- -- ALL O\tVNED AUTOS BODILY INJURY r- (Per person) . SCHEDULED AUTOS A ex HIRED AUTOS BODILY INJURY ex . A NON-OWNED AUTOS (Peraccidenl) r- ,- --- PROPERTY DAMAGE . (Per accident) GARAGE LIABILITY AUTO ONLY - EAACCIDENT . ~ ANY AUTO OTHER THAN EAACC . AUTO ONLY AGG . EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE . 5,000,000 A ~ OCCUR D CLAIMS MADE 7972-98-79 12/18/05 12/18/06 AGGREGATE .5,000,000 . ij;EOUCTIBLE . X RETENTION .0 . WORKERS COMPENSATION AND '$~ ITORY"lIMiiU IVER EMPLOYERS' LIABILITY ~~L3 I ANY PROP",ETGRlPARTi~[R:EXECUTIVE E.L. EACH ACCIDENT . ' OFFICER/MEMBER EXCLUDED? E L DISEASE _ EA EMPLOYEE $ If yes, describe under EL DISEASE - POLICY LIMIT SPECIAL PROVISIONS below . OTHER / { I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is additional insured under the general liabili ty per endorsement #80-02-2305 to be issued by the company CERTIFICATE HOLDER CANCELLATION City of Santa Ana 60 Civic Center Plaza Santa Ana CA 92703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ 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 REPRESENTATIVES. AUT 0 ZED RE"~ATlVE '..(,t.V.AQ.,~ ACORD 25 (2001/08) f. o @ACORDCORPORATION1988 ] . JAN-24-2006 16:11 . MASK SYSTEMS INC. 805 532 2332 P.02 ADDITIONAL INSURED ENDORSEMb"T Insurance Company Ft:;:7) ET {(ilL I ;/J'{j ieA )Ice Cd. This endorsement modifies wch insurance as is afforded by the PrOvilIionl of Policy # J S':;::J ~ nd..2 . J"il/aling to the renewing: - . 1. The City of Santa Ana. 20 Civic Cen1&r Plaza. Sa/lta Ana, Califomla 92701; its officers. emploYees. agents. volunteers andrepresantatlves al'9 named as additional insureds ("additional insuredsj with ~rd to liability arid lIefensB of suits arising from thB opsrations and uses perfurmed by or on benaff.of the named Insured. . 2., Wi!h respect to claims arising out of the operations and uses perlortnCld by or on behalf. of the named insured. Sl.Ich insurance as is affordl!la liv this poIlqt \a primary and is not additlonaf to Or CllfItrtbutirig with any other insurallca lCaIlied by or for the benefit of the additional insureds. ' . . .3.' Thls insurance appUes separately to each insured agliins: whom aaim is . made or sull is brought excaPt with respect to the company's limits of llabird:y. " The indusion of any person or organization as an insured shall not aft'ec!. any rig!'lt whic!'l Such person or organization would have as a daimant it not 50 ioclu~ . \ .' \'~' , '. 4. WIth respect, to tha additional insureds. this lnsutanll8, shaD not be. cancelled. or mstarfally ~uced in coVe~ or IImiIS except 3fterlhlrty 130) days written notice ,has been given 10 the City of .Santa Ana. 20 Civic Center Plaz:a, santa Ana. ear.fomis 92701.. (Completion of the following. Including courrtersignature. is endorsement I'Iffectivll-) EfFective - I:;" / I,. / () 5 Policy# :J!i':?:7- P 9 d 2 ' Issued to /lJ A l' )'. J'Y J'7 em.J' I )J (1. Namecllnsured recluin$:'! 10 l1Jaka this' . this er:m~nt ~ as a p8l'l0f C::OuntsrS;gned by [J . - . A~rized R _ ntatlve ::: '"-....w ... ~ ,~.-,. ... ~.- . .~5b TOTAL P.02 ACORD. CERTIFICA TE OF LIABILITY INSURANCE OP 10 VII DATE (MM/DDIYYYY) MASKS-1 12/09/05 !~f;DUCE~ . THIS CERTiFICATE is ISSUED AS A MATTER OF INFORMATION Andre1n1 & Company-Oxnard ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License 0208825 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 300 Esplanade, Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oxnard CA 93030 Phone: 805-981-9585 Fax:805-981-0161 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Granite State Ins. Co. ."... INSURER S' ~ Mask Systems, Inc. INSURER c: ,"", ~ Rosa Sasa ~.J1'. 11959 Discove~ Ct. INSURER 0: () Moorpark CA 93 21 INSURER E: .. ,. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING LJ:l ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT IfoJITH RESPECT TO VvrlICH THIS CERTIFICATE MAY BE ISSUED OR C:.:') MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH 0,:'-"," POLICIES, AGGREGATE LIMITS SHOVV'N MAY HAVE BEEN REDUCED BY PAID CLAIMS .L, ..H~ LTR NS'R TYPE OF INSURANCE POLICY NUMBER DA~E fMMfJerkf'\E; PiSkT'f (~~fh'b/''''(~lN LIMITS :;,,;.t GENERAL LIABILITY EACH OCCURRENCE $ c:~ I-- PREMISES '(E'~'(;~~~nce) COMMERCIAL GENERAL LIABILITY $ I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ PERSONAL & ADV INJURY $ I-- GENERAL AGGREGATE $ I-- -- GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ n nPRO n POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ,- (Eaaccident) $ ANY AUTO - ALL OWNED AUTOS BODILY INJURY - $ SCHEOULED AUTOS (Per person) -- HIRED AUTOS BODILY INJURY -- $ NON-OVVNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO VO.l d__ OTHER THAN EA ACe $ / ---)J'~, -- AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY , / EACH OCCURRENCE $ P OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X I TORY LIMITS I I~ER- A EMPLOYERS' LIABILITY 9516480 12/18/05 12/18/06 $ 1000000 ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT OFFICER/MEMBER EXCLUDED? EL. DISEASE + EA EMPLOYEE $ 1000000 If yes, describe under $ 1000000 SPECIAL PROVISIONS below EL. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS { LOCATIONS / VEHICLES / EXCL.USIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS Proof of Insurance CERTIFICATE HOLDER City of Santa Ana 60 Civic Center Plaza Santa Ana CA 92703 CANCELLATION SHOUL.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WIL.L. ENDEAVOR TO MAIL. ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOL.DER NAMED TO THE L.EFT, BUT FAILURE TO DO SO SHAL.L. IMPOSE NO OBL.IGATION OR L.IABILlTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUT 0 ZEDREW~ATIVE '..It-f./ .AQ.-tvf<.4-.> ACORD 25 (2001/08) @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 (2001/08)