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Home My WebLink AboutUNITED INSPECTION & TESTING 3B -2000City of Santa f -a $1 Clerk of the Coui—ji AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Clerk of the Council Office (M-30). Call 647-5237 if you have any questions. The agreement with 2TV AUG -4 All 9= 30 it . ., '.. t�i,i i_ i No. A-2000-064-05 was completed on 'Z—� . Z©p 1 and final payment has been made. Revised 07-23-07 Department: � \,i -K Phone/Ext.: Signature: Date: A-CJ.oOO-olv1- (7,). ., \NSURfl.NCE NOT ON~IL~ WORK MA.Y ~Ql PROGEED CLERK Of COUNC\L DAlE: lP ---" ,..OS e; f\~ ftp) lr{\,ol~ SECOND AMENDMENT TO CONSULTANT AGREEMENT THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT is entered into this 2nd day of June 2005, by and between United Inspection & Testing, Inc., a Delaware 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 Consultant Agreement A-2000-064 dated April 17, 2000, (hereinafter "said Agreement") by which Consultant has provided material testing and construction inspection services. B. In accordance with the terms and conditions of said Agreement, the parties wish to extend the term of said Agreement for an additional one-year term and to amend the Fee Schedule to comply with California prevailing wage requirements. 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 Second Amendment to Consultant Agreement, the parties agree as follows: 1. Section 2, COMPENSATION, shall be amended by replacing the current Appendix C, dated 7/1/03, with a new "Fee Schedule" dated 5/25/05, attached hereto as Appendix C, and incorporated by reference. 2. Section 3, TERM, shall be amended to extend the termination date from June 30, 2005 to June 30, 2006. II II II II II II r. . . '\ J . IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to Consultant Agreement on the date and year first written above. ATTEST: CITY OF SANTA ANA PATRICIA E. HEAL Clerk of the Council fL/l;(2.. DAVID N. REAM City Manager APPROVED AS TO FORM: . \ / \ ~L( ,/ L. z..<)f,~, /lj fi JOSEPH W. FLETCHER City Attorney APPROV AL: CONSULTANT UNITED INSPECTION & TESTING, INC. ~ I ( By:Y'"'-/ \jl-----./ ~ (1'fanje) nn') t2,'cJ'\CLV- 5 (Ti-tlf) 6;e-t"\cva I (Y1a-nCL3BY- ... .. DATE (MM/DOIYYYY) ACORD. CERTIFICA TE OF LIABILITY INSURANCE OP 10 2~ CONSO-2 08/15/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Butwin Znsurance GroUp ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Suite 414 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 60 cutter MiU. Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Great Neck NY 11021-3104 Phone: 516-466-4200 rax:516-466-4213 INSURERS AFFORDING COVERAGE NAIC .. IN8URED INSlRER A. JUG United Znspection & Testing INSrnER B: Houston Casua1ty CO. :IDC INSlFIER C 22620 <Jo1dencrest Drive A-.).{)OO txo1 suite 114 - INSlFIER D: Moreno va1ley CA 92553 /l-"",OOO-C4;>t/-Of INSlFIER E: //1/.. COVERAGES 03 1HE POliCIES OF INSURANCE LISTED BELOW Iil'lVE BEEN ISSUED TO 1HE INSURED NAMED ABOVE FOR 1HE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMErff WITH RESPECT TO WHIOi THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, 1l-E INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TI-E TERMS, EXCLUSIONS AND CONDrTlONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDlJCED BY PAID CLAIMS. L 1R INSRI TYPE OF Nlt.ftANCE POLICY NUMBER DATE (MMIODIVY) DATeI~J UMITS GENERAL LIABIUTV EACH OCCURRENCE $1,000,000 ~ A X X COMMERCiAl GENERAl LIABILITY 4022676 0'7/01/06 0'7/01/0'7 PREMISES (Ea occurence I $ 500 ,000 I CLAIMS Ml'DE ~ OCClFI MED EX? [Any one pen;on) $ 10,000 PERSONAl & I'DV I~RY $1,000,000 - GENERAl AGGREGATE $2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER PRODiXTS - COMPfOP AGG $2,000,000 I POliCY n ~ n LOG AUTOM08ILE LIABlUTY COMBINED SINGLE LIMIT $1,000,000 - A X ~ ANY AUTO 38539'74 0'7/01/06 0'7/01/0'7 (Ea acCident) AlL OWNED AUTOS BODILY INJURY - (Per pen;on) $ SCt-EDULED AUTOS ." . - 'rt0 PO' , HIRED AUTOS \fBt) :g..& BODILY INJURY - ~ $ NON-OWNED AUTOS --~~ ~ [Per accident) - ~'Z:r . - L--- PROPERTY DAMAGE $ '^"'" -_ C: :;;ORC,," [Per accident) GARAGE UABLITY ~ \..\~"" \-. , '1 p..ttOf\'"'' ) AUTO ONL Y - EA ACCIDErff $ ==1 ANY AUTO . nt C\ P.SS\sta.j,/ cD.f- 2- OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESSIUMSRELLA LIABILITY L EACH OCCURRENCE $4,000,000 A X ~ OCCUR D CLAIMS MADE BJJ:2963402 0'7/01/06 0'7/01/0'7 AGGREGATE $4,000,000 $ ~ DEDUCTIBLE $ X RETErfflON $10000 $ WORI<IRS COMPENSATION AND I TORY LIMITS I IUER A EMPLOYERS' LIABILITY WC'75'781'76 0'7/01/06 0'7/01/0'7 EL EACH ACCIDENT $ 1000000 ANY PROPRIETORfPARTNERfEXECUTIVE OFFICERlMErvtlER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 1000000 If yes, describe under EL DISEASE - POliCY LIMIT $ 1000000 SPECiAl PROVISIONS below OTJoER B PrOfessional Liab H'70516400 10/01/05 10/01/06 JJ:a OCcurr 1000000 Retro Date 9/1/85 ate 2000000 DESCRIPTION OF OPERATIONS I L0CA11ONS I YBtCLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROYlSlONS THB CZ'1'Y or ~A ANA, ZTS orr:I:CZl\S, :DdPLOYJJ:JJ:S, AGZN!.'S, VOLtJNTURS AND REPUSJ!:N'.rATJ:VZS ARE muam AS ADD:ITZONAL msUREDS WI:TH RESPJJ:CTS !OO THJJ: OPDATZONS PZRI'ORNJJ:D BY Oil ON BBHALI' or THB muam nmSRJJ:D, '!rIIZS msUItANCJJ: ZS PllDAllY AND NON CON'.rRl:BUTORY WI:'!rII ANY cnHBIl mstJRANCE CARRI:JJ:D BY OR rOll THJJ: BJJ:NBrZT or THJJ: ADD:ITZONAL msUBKDS, 10 nAY NON PADmN!l' CANcz:LI.ATZON APPLZJJ:S CERTIFICATE HOLDER CANCELLATION SAN'RAAN SHOULD AHY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1lE EXPlRAllON DATE THEREOF, THE ISSUING INSURER WILL MAIL 30 DAYS WRI1"1EN CZ'l'Y or SAN'J!A ANA - NOnCE m THE CERTIFICATE HOLDER NAMED TO THE LEFT PUBL:I:C WORKS AGJJ:NCY ROSS S'l'RJ!!:JJ:T ANNJJ:X-J!(-22 20 CZVZC e&N':rBll l'LAD SAN'J!A ANA CA 92'701 REPRESENTATlVE r-r. ACORD 25 (2001108) CI ACORD CORPORATION 1988 - .. Ru~ 14 06 03:14p 10.5 APDJTIONAL INSURED ENDORSEMENT 'FOR COMMERCIAL GENERAL UABIUTY POLICY Insurance Company _M'l~~NTERN~~.~ROUP (A/G} This endorsement modi fics such insurance as is afforded by the provisions of Policy # _~16.. ...__ relating to the following: 1. The City of Santa Ana. 20 Civic Center Plaza. Santa Ana, California 92701; its officers, employt:es, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to linbility and defense of suits arising from the operations and uses perfl"lI1ncd hy or on behalf of the named insured. 2. With respect to claims arising out of the OperatiOlUi and uses performed by or on hehalf of the named insured, su~h insurance as is aITordt.-d by this policy is primary and is not additional to or contributing with any other insurance camed by or for the benefit of the additional insureds. 3. Thi:i. insurance applies separalely to each insured against whom claim is made or suit is brought except v.rith 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 it claimant ifnnt so included. 4. With. respect to lhe additional insureds, this insurance shalloot 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 M-22. Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 7/1106 '~.m.__' this endorsement fonn as a part of Policy # ----4022.61!L-_ ___.. _ . __._ Issued to .........JlMIED INSPECTION & TE$TING INC. .. _ Named Insured ~.ltCTSjgllcd by __~ ~ }\S 'to '-'" Authorized Representative ~t.D . ~. "i?~0 ,.... ~:: 21'. .'; {,.. ..-;::::-;. '/--.. I-V ..---::::-;~.' .... S"'lO ',;_ \..\S~ (:.'. F>-\.\.UI'\ ",' C\\'j ) . toPC r? 0(- d- ~. "-.i" ). UNITED INSPECTION & TESTING INe. Revised 5/25/05 APPENDIX C FEE SCHEDULE TESTING AND INSPECTION SERVICES FOR THE CITY OF SANTA ANA CAPITAL IMPROVEMENT PROJECTS ITEM ESTIMATED UNIT HOURLY RATE/ ESTIMATED QUANTITY UNIT COST COST Soil Inspection 2250 Hours $60 $ 134,775.00 Concrete Inspection 1300 Hours $60 $ 77,870.00 Masonry Inspection 360 Hours $60 $ 21,564.00 Structural Steel 40 Hours $60 $ 2,396.00 Inspection Reinforcing Steel 900 Hours $60 $ 53,910.00 Inspection Asphalt Concrete Inspection 1300 Hours $60 $ 77,870.00 6" Concrete Cylinder (ASTM C-39) 1250 Units $17 $ 21,250.00 2X4 Mortar Sample (ASTM C-39) 170 Units $17 $ 2,890.00 3X3X6 Grout Samole (ASTM C-1019) 170 Units $17 $ 2,890.00 Masonry Prisms (ASTM E-447) 25 Units $17 $ 425.00 Geotechnical Engineering 200 Hours $125 $ 25,000.00 Services (ASTM 0-1556) Testing for Reinforcing Steel ASTM A-615 70 Units $30 $ 2,100.00 ASTM A-370 70 Units $30 $ 2,100.00 Testing for Structural Steel ASTM A-615 10 Units $35 $ 350.00 ASTM A-370 10 Units $35 $ 350.00 Post Tension Inspection 400 Hours $60 $ 23,960.00 Miscellaneous Quality Assurance/Quality Control 1 L.S. - $ 40,000.00 TOTAL $ 489,700.00 CERTIFICATE NUMBER SEA-000501470-07 PRODUCER MARSH RISK & INSURANCE SERVICES P. O. BOX 193880 SAN FRANCISCO, CA 94119-3880 CALIFORNIA LICENSE NO. 0437153 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL TER THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE MISC -UNITE-WIPRO- UIT CA INSURED UNITED INSPECTION & TESTING INC 22620 GOLDENCREST DRIVE, SUITE 114 MORENO VALLEY, CA 92553 COMPANY A NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA. COMPANY B N/A COMPANY C LEXINGTON INSURANCE COMPANY COMPANY D INSURANCE CO. OF THE STATE OF PA THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/DDIYY) DATE (MMIDDIYY) A GENERAL LIABILITY 706-1033 04/01105 04/01/06 GENERALAGGREGRATE $ 2,000,000 X cor,,~r...iERCiA~ GEhlERAL LiA8:LITY PRODUCTS-COMP/OP AGG ;) 2,000,00U CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY $ 1,000,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Anyone fire) $ 1,000,000 MED EXP (Anyone person) $ 5,000 A AUTOMOBILE LIABILITY 826-2024 (AOS) 04/01/05 04/01/06 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO ALL OWNED AUTOS BODIL Y INJURY SCHEDULED AUTOS (Per person) $ X HIRED AUTOS ,\l'PROVED AS TO FORM BODIL Y INJURY $ X NON-OWNED AUTOS (per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONL Y- EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE C EXCESS LIABILITY 1155287 04/01105 04/01/06 EACH OCCURRENCE UMBRELLA FORM CLAIMS MADE POLICY AGGREGATE X OTHER THAN UMBRELLA FORM A WORKERS COMPENSATION AND 7155121 (CA) 01/01/05 01101/06 D EMPLOYERS' LIABILITY 7155122 (AOS) 01/01/05 01/01/06 1,000,000 D THE PROPRIETOR! ~INCL 7155118 EXCLUD.CA,AOS,GA 01/01/05 01/01/06 EL DISEASE-POLICY LIMIT 1,000,000 PARTNERS/EXECUTIVE E OFFICERS ARE: EXCL 71551191GA) 01101/05 01101/0A FL DISEASE-EACH EMPlOYEE $ 1,000.000 OTHER C PROF_ LIABILITY (E&O) 1155287 04/01105 04/01/06 EACH CLAIM $1,000,000 CLAIMS MADE FORM AGGREGATE $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CITY OF SANTA ANA PUBLIC WORKS AGENCY CONSTRUCTION ENGINEERING P.O. BOX 1988/M-22 SANTA ANA, CA 92702 SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ~ MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN,~ ~~IOOI~J<MlI XX AAJ{I!II KSl<~19O()()()()( EJDIlI[.Kl(!I:lO:KXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX MARSH USA INC BY: Michlo Nekota ~tJL.,.L DATE (MM/DD/YY) 04101/05 PRODUCER MARSH RISK & INSURANCE SERVICES P. O. BOX 193880 SAN FRANCISCO, CA 94119-3880 CALIFORNIA LICENSE NO. 0437153 COMPANIES AFFORDING COVERAGE COMPANY E AMERICAN INTERNATIONAL SOUTH INSURANCE CO. MISC -UNITE-W/PRO- UIT CA COMPANY F INSURED UNITED INSPECTION & TESTING INC 22620 GOLDENCREST DRIVE, SUITE 114 MORENO VALLEY, CA 92553 COMPANY G COMPANY H Note: This is the usual form we use and it fulfills the legal requirement of Form CG2010 11 85. POLICY NUMBER: 706-1033 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Additional Insured Person(s) or Organization: Location(s) of Covered Operations WHERE REQUIRED BY INSURED CONTRACT AS DESCRIBED ON CERTIFICATE A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule. but only with respect to liability for "bodily injury", property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a pnncipal as a part of the same project. PRIMARY INSURANCE Such insurance as is afforded by this endorsement for the additional insureds shall apply as primary insurance. Any other insurance maintained by the additional insureds or its officers and employees shall be excess only and not contributing negligence on part of the additional insureds. GG 20 10 07 04 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONSTRUCTION ENGINEERING P.O. BOX 1988/M-22 SANTA ANA, CA 92702 MARSH USA INC. BY: Michlo Nekota ~UL PRODUCER MARSH RISK & INSURANCE SERVICES P. O. BOX 193880 SAN FRANCISCO, CA 94119-3880 CALIFORNIA LICENSE NO. 0437153 COMPANIES AFFORDING COVERAGE COMPANY E AMERICAN INTERNATIONAL SOUTH INSURANCE CO. MISC -UNITE-WIPRO- UIT CA COMPANY F INSURED UNITED INSPECTION & TESTING INC 22620 GOLDENCREST DRIVE, SUITE 114 MORENO VALLEY, CA 92553 COMPANY G COMPANY H Note: This is the usual form we use and it fulfills the legal requirement of Form CG2010 11 85. POLICY NUMBER: 706-1033 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Name of Additional Insured Person(s) or Organization(s): Location And Description of Completed Operations ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- WHERE REQUIRED BY INSURED CONTRACT AS DESCRIBED ON CERTIFICATE --------------------------------------------------------------------------------------....------------------------..------------_..---------------------------------~-------------------------- Section II - Who Is An Insured is amended to include as an additonal insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the 'products-completed operations hazard". PRIMARY INSURANCE Such insurance as is afforded by this endorsement for the additional insureds shall apply as primary insurance. Any other insurance maintained by the additional insureds or its officers and employees shall be excess only and not contributing negligence on part of the additional insureds. CG 20 37 07 04 \PPROV ED AS TO FORNI --~^-U'"t% J/~ . Laura Stitt She dy ,S:,lsta nt City ^ t torne\' CITY OF SANTA ANA PUBLIC WORKS AGENCY CONSTRUCTION ENGINEERING P.O. BOX 1988/M-22 SANTA ANA, CA 92702 MARSH USA INC. BY: Michio Nekota ~?..L.L ;<\~OR}y l'~~~:rl fIS,6.T~>9'Pl..IABILl,.y, ~,~u RA~iqEir;\j',,>;<..i.i....1 Do<' ~~;~;;~05 Producer Sandy Machlley THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Advanced Risk Solutions THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 12980 Metcalf, Suite 490 INSURERS AFFORDING COVERN~r Overland Park KS 66213 913.385.2455 INSURER Lumbermen's Underwriting Alliance www.advancedrisksolutions.com A INSURER Insured A-~m)-o/,T! B Employers Resource Management Co. A <>cOo 'UV1 -01,D2 INSURER For: United Inspection & Testing C 22620 Golden Crest Drive #114 INSURER Moreno Valley CA 92553 D COVERAGES. '. .',:.'>.. .Y> '. ...........:,,!...,.!' .' .... . .'.";,;\; " '. ., '.. 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, EXCLUS!ONS AND CON[)!T!ONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAiD CLMv1S. POLICY POLICY INSR EFFECTIVE EXP1RA liON TYPE OF INSURANCE POLICY NUMBER DATE MJ,~67vy LIMITS LTR "M/DDNY GENERAlllABILlTV EACH OCCURRENCE $ ~~MERCIAl GENERAL L1AB Not Applicable FIRE DAMAGE IAn" 1 fire) $ CLAIMS MADE DOCCUR MED EXP (An '0' erson) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGG LIMIT APPLIES PER PRODUCTS-COMPtOP AGG $ IPOllCY nPROJECTnLQC $ AUTOMOBILE LIABILITY Not Applicable COMBINED SINGLE LIMIT $ XXXXXX ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ XXX XXX HIRED AUTOS BODILY INJURY NON.OWNED AUTOS (Per accident) $ XXX XXX APPR PROPERTY DAMAGE OYED J\~ "n .n", (Per accident) $ XXX XXX ~~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO Not Applicable ~CC'i"'-..; if .' OTHER THAN EA ACC $ , ,.. - C, ,/ ,Ji ./ AUTO ONLY: AGG $ EXCESS LIABILITY Laura Stitt S EACH OCCURRENCE $ j~CCUR D CLAIMS MADE Not Applicable ccdy AGGREGATE $ !\ srSlant City tinrncv $ ~ ~EDUCTIBLE $ RETENTION S $ WORKERS' COMPENSATION & .II STATUTORY LIMIT I hTHER .0" ".' EMPLOYERS' LIABILITY El EACH ACCIDENT $ ITI1ITTII1 '" 273772 7/1/2005 7/1/2006 EL DISEASE. EA EMPLOYEE $ UUU. UU EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS THIS CERTIFICATE CONFERS NO ADDITIONAL INSURED RIGHTS UPON THE CERTIFICATE HOLDER. : Only the co-emgloyees of United Inspection & Testin8 22620 Golden Crest Drive #114 ;no .lltl /, Moreno Valley A 92553, but not subcontractors of: nited Inspection & Testing A/\i <;ERTI~ICA TE HOLDER . .... CANCELLp'~IQriJ.<.' . ..... ../ '.- ""q.,j"",'."-.._,.-.-'".""......."::;s-,,,., '. ,~/:"::,l":"","'" 241380 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SANTA ANA EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL PUBLIC WORKS AGENCY ~DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE CONSTRUCTION ENGINEERING LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE. P.O. BOX 1968/M-22 SENTATIVES. SANTA ANA CA 92702 AUTHORIZED REPRESENTATIVE .~~ ~(~~ Robert M Gaane i\C9@ 25-S (7197) created at www,eCeit:SONLlNE:com -"'",., l1!?A'CORD CORPORATION 1988 0..... :<"1 """,'; /. .-",.", ffo,-'-' Lilen \j~,c;;" ,f,.,,,, ;,-,,",,,,,&,,'-..,,, '.3roup F'axl0 516-4664213 T,o: Michel Girgis Dale lfm20U{ Ul b.:. ;-',\ii ;-''''9''' , CERTIFICATE OF LIABILITY INSURANCE OPID ,?&a/ DJ\lEjMMilJD'-'('fYVI ACORD. CONSO-2 07/09/07 . PRODUCER. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Butwin Insurance Group ONLY AND CONFERS NO RIGHTS UPON THE CeRTIFICATE Suite 414 HOLDER. THIS CERTIFICATE DOeS NOT AMEND. EXTEND OR 60 -Cutter l1J,ll Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Great t{ec:k NY 11021,-3104 I ~~~e:51~=466=~2~ Fax:S16-466-4213 INSURERS AFFORDING COVERAGE I NAIC # .-- -..--- --.-- i o,JSLFEPA A7G , United Ins;pection , Testing i\S1..REC3 hUonalUn1oni'lulu. c.. Ine 1-- . ---- 22620 Goldencrest Drive i',SlRE;;C _ !louston Casualty Co. - ,.-- --------- -- Suite 114 I 1~~.9.o~ Uoreno valley CA 92553 11\Si;~ti< ::: ----------- , ----------- COVERAGES n-rf pc): ICIFsor NlI,:PANCE LlS"'ED 8ELOW ,"",Vf. BEEt; ISSL'tC TO HE I',ISU<,[DN"M(C "B,\'f. fOR ~I-f POliCY PER1CO l\iJ1CATE::) NC-'V~TI-GfNIOI"C; ;..\ ;.~~~;....;dk::', ,t:'~:. '-';~ (.v[>l~ i,:YI:,1; Nj~ 'j)t-llllA::.i OHC H:.P m::rJl'/U,1 V,i::h kE'i"EC- -C WHICH lH,;; r~d~'iFiCAE M...V BE ISS..t.D<.:R '.'.','." ~C'~-,:';~' :: :.:c.!_::>:,'~~~ ..,~,,~;~~,~ '-'" H-'~ P0<.!CIESDESC~I8C:;; t-'fPFN I, ".1!R.:Fr:::T Tr !-'-l ,t-'F T,R''\3, EXCUS:O:-.lSN.o ~(;N~ITOll".rJF St.;r;-. KJI ~_!.' ",..;.,.,'tl>.l<,l LIMIi:;; So-jIJ\'I" MA'( :iA~:: tiel1\. fl'.oJLI;;UJ 8"'PAF..:, U-",1M';i LTIl. I'$RO TYPE OF INSURANCE POliCY tf..WBER LlMffS DATE (MIil/OD/VYJ DATE (MMIDDm'J I I 07/01/07 ! IAIX II I GENERAl liABILITY E""CJ--<or:cLP~rNC[ 1$1,000,000 07/01/08 PPEYIlso:~ IE~ ~CcLI~!1>1Cel IS500rOOO MEC EXPIMy O,lQ,m50.11 l!-lO , 000 ~ER${;N.'>'_~p[;v,'\.Iu,<)' ! ~.~., 000,000 1 :;:"NfAA..o\"GRFf,pJE .2,000,000 , '"'R-jC\jcrs CvM'l:.;PA.:>G !'2,OOO,O.0~ ..--..-.--- ';CM;JI"'E[)5j~j:)U:I.I:V:11 S 1/000/000 07/01/08 -:bttt(cl~~1 ,- -~ .~ .~ --. 30J!lY!l;,;l"n r :hrOO!ll:ill) ,-- ---- -- ---.-- 13(1::11' ;l,~LRY :Pl><llcClIonIJ I: :'""j "I'(()I'TI::1'Jl;,I,I,V\CT :F'l4I:l<;C(\I;JllI ,~\\ict?,~i.iIJ..('[:l~tl'i-<l.l"JjILI' I J ~,." i\Il,5- iVii~-,~ _ ^ . GCC~Fo' I 402267. L-- ",-?...~: -",' _"S ;-E~ "'-- 18 I j\'.rt';L;l.iB!U;:LW~)'_n'i m..., X '.~I "-1 ~ 1"",1_"-::- 3853974 07/01/07 ! ',~-'" '~!,''1!':',) ~ . '~;.< .--,,------------- I GAllAGiLlABLlTY . ,.. I ~#i-i f...t . ,<-",. ,- , : I:;N.,;;-,X.l:U<ri['lJCf: ..~ !. O_O~ r_O~~O._ _4 !. ~Oll., ~~O... : /l:W "'"..fI'~) ~~I~~~.?~~.~, -,~!\ ACCID12~T _ 'f~'-' :')1>1511 'lW, !:~.~(,~.(_:..j',_"d_ ,\IJI(j')Nty ,,_ [-~-~-'---- I ' IOl(CE:8S/l)lllijRa~A \.!ABILifY A ;, X i.~ I ~,.u,,. \,IAIMSW\~~, i , I I I BE4803422 07/01/07 07/01/08 '..J'.f.,.........,,;,L .x ~lO,OOO ~ :,- I" ,V,:;..".!{E;R$ ::;GMi>eJZHIOi'i /\"Jr:, I EMPlOYER!!' l",81U1Y 1 ~y' ~?~i>2E~-~,:!~_AR_::r:-::..~'::~t_Ull';:;; - .,... " L~ J TQ.F!;~IJ~~I~_L _LE~ ~. !:t.C~ .o,:;:C();:N'" , 1000000 , 1000000 $ 1000000 , i Wc7578176 I 07/01/07 07/01/08 iF l DISfASf [Af~/P _~'(:=E I :'l.~- <.iIl'?~,~aJ'J.e'. OTHEP: ~, D'SEASF.; .F'Qll;.:\' L;~iT i c I profes$ional :r.iab I H70616143 I 10/01/06 I 10/01/07 I i Retro Date 9/1/85 I ! I I oeSCRlPTION OF OPERATIONS :fLOCATIONS fVSHIClES I EXCUJSIONS AOOEO 81' ENOORSEMENT I SPECIAL PRO"VlSlOml THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND I REPRESEN'XATIVES ARE NAMED AS ADDITIONAL INSUREDS WI~ RESPEC'!rS TO THE OPERATIONS PERFClWED IlY Oil ON IlEHALF OF THE NAMED lNUSlWl, THIS INSURANCE IS l?Rn1A..ii.Y AND NON COl'lTlUBUTORY WITH ANY OTHER INSURANCE CARRIED BY OR FOR THE BENEFIT O!'THE. ADDITIONAL INSUREDS, 1.0 DAY NON PAYMENT CANCELLATION APPLIES 1,000,00-0 2rOOO,DOO Ea Claim Aggregate CERTIFICATE HOLDER CANCElLATION I I I SHOULD A~ OF THE ABCNE DESCRIBED POliCIES BE CANCELLED BEFORE THE EXPIRATION SANTAAN MAt.. 30 DAVS WRITTEN DATE lHfflEOf, THE ISSUING INSUflER WLL CITY OF SANTA ANA PUBLIC WO!lJ{S AGENCY ROSS S'l!RE!.T ANNEX-M-22 20 CIVIC ~ER PLAZA SJI-..NTA ANA c..~ 92701 NDTICE TO THE CERTifICATE HOLDER NA\1ED TO THELEFT AllT~~RE~SENTATI"'E OACORD CORPORATION 1988 ACORD 25 (2001/08) A - .JOOM) C:rI -01 -Ol -oJ - 0 'I ff ff f, " FfOfl1 Elien!:'.""g"" :::.r i..:,Ldw, , !f':5UfElrlC";' GrOup Fay.jD 516-486-4213 To. Michel Girgis uate II'dILUU( U-I.~L t'M t'age .: 01.: ADmT,OKAL J1\SlfREIl ENDORSEMENT r~OR COMMF.R('IAl,9,NERAL IJABlLlIY !'Olley lll,urancc Company _"'!>1FRJCAN INTERt-lATIOti!\,.~ROUP IAIG\ 11m: eLldorsement Ii .~~~916 mut.h fi:.:~ such insurance as js .~. relating to the- tollowing: alIorded by the provi,ions of Polity 1. rne \iIY o(Santu MR, 20 Civic Center Plaza, Santa Ana. California 921nJ; it, J.i1kr.:r:i., employees, ilgent!i. volunteers and representau....es are named as additiomd insureds l"aJJiliorml lnM.1Cdll"j with regard to Jinbilily and defense of suits arising from the operations i:S.llU uses perfonncd hy ()T un bchalfoflhe named insured. .!. \V ifh respel'l to daims arising out of the operatiOIlE and uses perfonnoo by or on hehalf of the namoo in3\lred. suclt insmance dO j. arroidcd by Ilti. policy i. primllI)' alld is not ,ddilic>nal to or conmbuting with any other insurance carried by or for llIe benefit of the additit1na[ in~uro.ls. 11lil'r. inSUl'tltlc,e applies ~p;rnttely to each insured against whom claim is made or ,;mi is l.",q,ghl t:n'~pt w'ith res:.-pect (0 the l'tJm:pan)"~ limitl:1 of liability. The inclusion of any pm~;(iI1 ot Qrg3tl1zation a~ <U) insured shall not affect any right which such person or organUliIbOll would have ::lS ~ c}alUliUlt Ifnot so included. 1- '''lith rcspl~e\ to the additi01'H11 insureds, this insurance shall not bt; (;,aIJGd~ or :1l111cndll, mlocoo In coVlnge or limns eXcel'! after thilly (30) duys writtJ::n notice Itas been given tn th~ City of Santa Aua. 20 Civic Cenll:r PJay" M.ll, Santa All., California '12701. {Comp!e1ioll ,If the foltlWtmg. including umnlcr..;gnamre, is reqnin:x1 to make this endun;emeut i,,:ffectivc I EfTective Z/110Z . litis endorsement fan" as a pan of Policy +1 ~onfj1L-. ___ 1<Slle4 to --'lliJIID INSPEg]Q!IjIO.STING INC . Named Insured CO'.lnlcT~jg}l(;d by _ e~ ~ _ ___ Authorized Representative "" ; "',d ~'.2/~ . '. - ...... . ' ~.._-