HomeMy WebLinkAboutCOMMUNITY VETERINARY HOSP 2r AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Deputy Clerk of the Council (M-30). Call 647-5238 if you have any questions.
-__ --------------------
The agreement with /~'.'h;~j~- c . y ~ ~'-~;~c'-~1.~.~ tit A z ~ - ~ _~~
~~~- ~- was completed on l ~j 3 ~ ~ ~~ 1
ana final payment has been made.
AGREMNT Department: ~ n
NUMBER SUFFIX ~ ~ ~` ; , ~- ~
--~- -- ~_.3~..! Signature: ~ ~
'N-2005-068 2 ~J i ~ <:? s ;~ ~. ~
. __ __
A-2006-095 ,2a Date: c ~. ~ 3i :~ ~a
N-2005-068-01 '2b ~~ '~ ~~ ~- (41., Lw~
N-2005-068-02'2c City of Santa Ana
Clerk of the Council
Revised 05-22-05
It~S'LJRANCE filiI Olll i:ILE
WORK MI\'{ NQT PROCEED
CLERK OF COUN~'1:
D/l.1[; ::;'dlc'L-'
N-2005-068
CONSULTANT AGREEMENT
t', Pi)
l RSCIIlj
THIS AGREEMENT, made and entered into this c2L(fi" day of n1 NLf ,2005 by
and between Community Veterinary Hospital, Inc., a California corporation (hereinafter
"Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and
existing under the Constitution and laws of the State of California (hereinafter "City").
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
veterinary medicine to provide veterinary services for Police Service Animals.
B. Consultant represents that Consultant is able and willing to provide such services to the
City.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably be
expected from a professional consulting firm in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
Consultant shall perform those services as set forth in Exhibit A attached hereto.
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 $10,000.00 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 the date first set forth above and terminate on June
30, 2006, unless terminated earlier in accordance with Section 12, below. The term of this
Agreement may be extended upon a writing executed by the Chief of Police 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. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the City, its officers, agents, volunteers, and employees 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. If Consultant is or employs a licensed professional such as an architect or engineer:
Professional liability (errors and omissions) insurance, with a combined single limit of not less
than $1,000,000 per claim.
2
e. 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 or changed in any other material aspect without
thirty (30) days prior written notice to the City.
f. 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, (1) 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
3
like importance, but in no event less than reasonable care. "Confidential Information" shall
include all nonpublic information. Confidential information includes not only written
information, but also information transferred orally, visually, electronically, or by other means.
Confidential information disclosed to either party by any subsidiary and/or agent of the other
party is covered by this Agreement. 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 oflaw; 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 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:
Chief of Police
City of Santa Ana
60 Civic Center Plaza (M-97)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 245-8007
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
4
To Consultant:
Community Veterinary Hospital, Inc.
13200 Euclid
Garden Grove, California 92843
Telefacsimile (714) 537-1971
Attn: Dr. William A. Grant II
A party may change its address by giving notice in writing to the other party. If sent by
mail, 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, 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, that terms and conditions hereof, shall not bind or obligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without
the City's prior written consent shall be considered null and void. Nothing in this Agreement
shall be construed to limit the City's ability to have any of the services which are the subject to
this Agreement performed by City personnel or by other consultants retained by City.
12. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of termination,
subject to the following conditions:
5
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 of this 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.
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 her 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 iffully set
forth in the body of this Agreement.
6
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST:
CITY OF SANTA ANA
1 (C)~/.
(~f€~ -cc'F=
PATRICIA E. HEALY
Clerk of the Council
~M~
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
"
\.../ \/
By:\Cicv(P'- LLk.cL, /
1/ ' - /
Laura Sheedy
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
CONSULTANT
~L~( ',l l \5
PAUL M. WALTERS
Chief of Police
~~d~W
WILLIAM A. GRANT, II '7 ~
Chief of St~ g:[
Tax lD# ~2(;~ ~
7
EXHIBIT A
Scope of Duties (Police Canines)
· Provide initial canine physical and evaluation for police service dogs, including but not
limited to blood work, x-rays and medical examination.
· Veterinary treatment as required for sick and/or injured canines
· Annual physical examination and recommended vaccinations
· Surgeries as required
· Consultation regarding all canine related medical care and treatment
COMPENSATION
Said services shall be compensated at the rates and charges set forth in Consultant's Fee
Schedule dated 5-1-05, attached hereto as Exhibit A-I.
8
Hpr lCJ U;J UO:::JUP
communl~~ VeCerlnar~ nosp (l~ ~~(l~{l
,.,.cc
FEE SCHEDULE EtTcctiyc 5/1105
EHF $2.75
Office Call & Exam $27.00
Recheck Exam $20.75
Injections (dose/drug dependent) $25.50-$30.50
Radiographs (large, two yjews) $70.00
Radiographs additional views $15.00 sm / $30.00 Ig
Complete blood profile (CBC/Chemrrhyroids) $77.75
Heartworm blood test $20.75
Urinalysis $26.75
Urine Collection Fee $5.00--$15.00
Heartguard 272mg $35.00
Sentinel 51-100 lbs $65.00
IV Catheter $30.00
Hospitalization/day
Based on wcight
Canine
$25.00 1-251bs
$30.00 26-50 lbs
$35.00 51-751bs
$40.00 76-1001bs
$45.00 >1001bs
EXHIBiT A 1
EXHIBIT B
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 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 if not so included.
4. With respect to the additional insureds, this insurance shall not be cancelled, or
materially reduced in coverage or limits except after thirty (30) days written notice has been
given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701.
(Completion of the following, including countersignature, is required to make this endorsement
effective.)
Effective
Policy #
Issued to
, this endorsement form as a part of
Named Insured
Countersigned by
Authorized Representative
9
~, ,
ACORD," CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDfYYVY)
08/12/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Association Unit ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ABD Insurance & Financial Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
2480 Natomas Park Dr. Suite 200
Sacramento, CA 95833 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Fireman's Fund Insurance
Community Veterinary Hospital, Inc. INSURER B:
13200 Euclid Street INSURER c.
Garden Grove, CA 92843 ;J -d./J05 -{)U--''( INSURER D:
INSURER E:
Client#. 18321
COMMUVETE
COVERAGES
THE POLICIES OF INSURANCE USTED 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.
LTR NSR TYPE OF INSURANCE POL.ICY NUMBER PJ>}~~Y Jf1J8~~t Pg~~J f~1ftb~.gN LIMITS
A X ~NERAL LIABILITY AZC80767283 10/01/04 10/01/05 EACH OCCURRENCE '1 000 000
X COMMERCIAL. GENERAL. LIABILITY ~~~~~~~9ERENTED n ~, '100000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) '10000
PERSONAL & ADV INJURY '1 000 000
- ,2 000 000
- GENERAL AGGREGATE
~'LAGGREGATE LIMIT APnS PER; PRODUCTS. COMPtOP AGG $2 000 000
.nPRO-
POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGlE LIMIT ,
ANY AUTO (Eaaccident)
-
C- ALL OWNED AUTOS BODILY INJURY
{Per person) ,
- SCHEDULED AUTOS
- HIRED AUTOS BODILY INJURY
(Per accident) $
- NON-OWNED AUTOS
- PROPERTY DAMAGE ,
(Per accident)
~~GE LIABILITY AUTO ONLY - EA ACCIDENT ,
ANY AUTO OTHER THAN EA ACC ,
AUTO ONLY: AGG ,
p~SSIUMBRELLA LIABILITY EACH OCCURRENCE ,
OCCUR D CLAIMS MADE AGGREGATE ,
,
R ~EDUCTIBLE ,
RETENTION , $
WORKERS COMPENSATION AND I T'[;~g,1.WS , IOJ~'
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT ,
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYE ,
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT ,
OTHER
,\ "r> bil\i:,' ),,\ [I) ! U!<r~ij
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
** Supplemental Name ** ',)'/ ,','
Doing Business As: Community Veterinary Hospital, Inc. . .--.- 1i?~;\~::,~:~--~\t:."2 ~(j:'~~--
(dba) Animal Friends Pet Hotel
(dba) Animal Discount Clinic ,-
(See Attached Descriptions)
CERTIFICATE HOLDER
CANCELLATION
City of Santa Ana
20 Civic Center Plaza, M-30
Santa Ana, CA 92702
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL E~~L -30.... DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 8lJ1X')1)t.)(RDOIXIJllX~XIJt4CXXX
ACORD 25 (2001 (08) 1 of 3
ntl~tl
__DftG)OJ)(B:X
S;:::::?T~ ~p
XBlXJt8l;~XK\lB(XXX
.
#710020
COMMUVETE
NJC
@ 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 iieu 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
affirmativeiy or negatively amend, extend or ailer the coverage afforded by the pOlicies listed thereon.
\1 ;)R()\'Ef) /\S i';) l")i~jv~
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',', I :-,!:;:~: { :: \',\ r I" :i'-).: \
ACORD 25-5 (2001/08)
2 of 3
#710020
DESCRIPTIONS (Continued from Page 1)
William A Grant & Virginia L Grant, Trustees of the Grant
Family Trust, agreement dated 3/26/80 as respects improved
real property
Certificate Holder is named Add'l Insured as respects to Veterinary
Services performed by the named insured.
Loc# 1 - 13200 Euclid SI.; Garden Grove, CA
Loc# 2 - 13252 Euclid SI.; Garden Grove, CA
Loc# 3 - 13220 Euclid St.; Garden Grove, CA
,
"
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AMS 25.3 (2001/08)
3 of 3
#710020
Additional Insured - Owners, Lessees or Contractors - AB 90 67 12 93
Policy Amendment Section II
Insured
Community Veterinary Hospital Inc.
Policy Number
AZC80767283
Producer
ABD Insurance & Financial Services
Effective Date
10101/04
Schedule
Name of Person(s) or Organization(s)
City of Santa Ana
20 Civic Center Plaza, M-30
Santa Ana CA 92702
(If no entry appears above, information required to complete this Endorsement will be shown in the Declarations
as applicable to this Endorsement.)
The following is added to Part I. - WHO IS AN IN-
SURED in the Business Liability Section of the policy:
5. The person or organization shown in the Schedule
is also an insured, but only with respect to liability
arising out of your work for that insured by or
for you.
All other terms and conditions of the policy apply.
This Form must be attached to Change Endorsement when issued after the policy is written.
One of the Fireman's Fund Insurance Companies as named in the policy
Secretary
President
'1 U Li) i\:" fO l'O~~ :',;
~::,:~:, ~~::'igh"d M,t,,,,] 0"",""",, Smi", om". I",. 1984c*-~;~7_ ..
(\\Ad.Sac-fsIL;serarea\Njc\My Document:;\Asoociallon Cen FormslAI AS 9067 Doc)
uq./ I ,}/ t:uuu u r :;::b t'flA
~002/005
, Client#: 18321
r-.A~ORD~ CERTIFICATE OF LIABILITY IN
COMMUVETE
THIS CERT
ONLY AND
HOLOER. TH
ALTER THE
SURANCE I OAT! (fo1M1DDIY"fYY)
04/13106
IFICA TE IS ISSUED AS A MATTER OF INFORMA nON
CONFERS NO RIGHTS UPON THE CERnFICATE
IS CERTIFICATE DOES NOT AMEND, EXTEND OR
- COVERAGE AFFORDED BY THE POLICIES BELOW.
-----
FFORDING COVERAGE NAIC #
em an's Fund Insurance
~--- ~
Pf\ODUCEFo:
Assoclallon Unil
ABO Insurance & Flnanciel Sorvlca.
2480 Nolomas Park Dr. Sulto 200
I ~::::Dmonlo~::m~~i:: VOI.rin-:;~~sPllal, Inc.
i 13200 Euclid Streel
I
L Garden Grove, CA 92843
COVERAGES
INSURERS A
INSURER A: Fir
INSURER B
INSURER C
INSURER D'
INSURE~ E:
THE POLICIES OF INSURANCE LISTED BELOW HA\/E BEEN ISSUED TO THE INSURED NAA1EO ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUiREMENT, TERM OR CONDITION OF At>("( CONTRACT OR OTHER DOCUMEt-iT 'NITH RESPECT TO WHICH TlllS CERTIFICATE MO..Y BE ISSUED OR
MAY PI:RTAlN. THE INSlJRANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONOlilONS OF SUCK
POLICiES. AGGR!:GATc LIMITS $"10WN MA'r' HAVE BEEN REDUCED BYF'AID CLAIMS
TYPE OF In.sURA~CE POUCY IIIUMB!!'" !PJlAl,f~EFF T1V P~~Ji:,~~~~~N I LIMITS
L TR N,SR --
A[X ~ERA.L liABIUTY AlC80790199 110/01/05 10101/08 ] EACH OCCUR.RENCE .1 000 000
. I =r=rERCOA' GENERAL '''"ILIN ! OAMAGE TO RENTED .100 000
J Cl),1f.'S MADE [X] OCCUR i I PRFMISES rEa Ot'~IJtl'fll!lCl!l .10,000
I ~~o EXP [ArlY one p"lli1lon)
__I PERSONAl. & ArN INJUflY .1 000 000
~. GeNERALAGGRE~TE .2 000 000
.2E!"LAGGREGAT': LIMIT APP'..IE$ PER: i PRODUCTS.COM~OPAGG .2 000 000
I POLICY ~I ~:8~
~OMOBllE ...:ABlLlTY I COMBINED SINGLE; LIMiT .
~ A~Y AuTO I (EllIaeeiaerll)
I --l ALL QWrlECl AUTOS BOOIl. Y INJURY .
SCHEDULED ....UTOS {Per person)
1--1 !~)R(;.DAUTOS --
a.ODIL Y INJURY .
e- NON..OW1"ED AlJTOS (P~r,ecidol1')
~---- PROPERTY DAMAGit .
(Peracti!Jenl)
~ f-- --
~. UABlUrf I AUTO CNL Y . EA ACCIDENT .
ANY AUTO OTHER THAN EAACC I
I i AUTO ONLY.
I- ---./.- I --- ~GG . -----
~e$SrUMeREll.A LIABILITY EACH OCCURRENC'..E .
I U OCCIJR D CLAJMSMAOE 1
! AGGRE:~ TE .
H DEOUCTlBLE . "-
':r~ , I
) I RETENTION . ,WZP80931-.m-~---- '07101/05 x};~I IOJl;l- . --
A I}NORKER3 COMPENSATION AND 07/01106
t\ EMPL.OVERS' UAB1UTY I
/ AN" PRQPRlETOq;PARTNERlEXECUTIVE 1 e.L. EACH ACCIDENT .1 000 000
.~ OFFtCERlMEMBER EXClUDE~? E.L. DISEASE. fA EMPLOYE .1,000 000
~~~tl~r~~$~8NS below I =,L. DISEASE .POUCY LJM,T .1 000,000
OTt-ER
I
--L ] --
DESCRIPTION OF QPERAnON-$ , L.OCATlONS' VEHICLES J EXCLUSIONS ADDED BY eNDORSEMeNT I SPECIAL PROVISIONS
- Supplemental Name ..
Doing Bualnl.1 As: Community Voterinary Hospital, Inc.
(dba) Animal Friends Pet Hotel
(dba) Animal Olscounl Clinic
(Soe Attached Descriptions)
CERTIFICATE HOLOER
CANCELLA ntN
j'"
i <)
SHOULD ANY OFTHI!!ABOVE DEBCAlB5D POUCIES IS CANCELLED BEFORE THE! EX:PlRAT1ON
CAn: THI!RI!OF, THE I8aU;NQ INSURU WILL ENDEAVOR TO MAL ~ DAYS WRITTEN
NOTICE TO rHE CERTIFICATe HOlO!R NA.I\III!:D TOTH!! ll!lFT. BUT 'All.URE TO D080 SHAL.L
IMPOSI NO OBUGATlON OFt UABIUTV OF ANY KIND UPON THE I~SURER. ITS AGENTS OR
e TATlVES. ~_.
. 0 REPRE71ATlVE J,..
J~...v' .-.e- I
COMMUVETE NJC
-
CIty of Sanla Ana
20 Civic Centor Plaza, 11I-30
Sanla Ana, CA 92702
i)P'.)
Gl ACORD CORPORATION 1988
ACORD 25 (2001/08) 1 of 3 #8
"', j:~ [;; .1 ~ \.; i
',J-", 1.J( <;.1JUU l}!.':'O rr...\
lfZJ UI1:$/ ()U~)
IMPORTANT
If the certificate holder is an ADDITICNAL INSURED, the policy(ies) must be endorsed. A statement
on this certlficate dt')es not confer rights to the certificate holder in lieu of such endorsement(s}.
If SUBROGATION IS WAIVED, sub;ect to the terms and conditions of the policy, cGrtain policies may
require an endorsement. A statement on tliis certificate dOBS not confer rights to the certificate
holdGr 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 is.suing insurer(s), authorized reprElsentative or producer, and the certlticate holder, nor dOBS it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
.\
~2/r
ACORO 25-5 (2001/08)
2 of 3
#819530
U~/ ,.)( ~lllit) lJ r : Zi') 1"'.-1..\
41 004,'005
DESCRIPTIONS (Continued from Page 1)
William A Grant & Virginia L Grant, Trust....s of the Grant
Family Trust, agreement dated 3/26/80 as respects Improved
real prop.rty
Certificate Holder I. nemed Add'llnsured as respects to Veterinary
Service. performed by the named Insured.
Loc# 1 .13200 Euclid St.; Garden Grove, CA
Loc# 2 . 13252 Euclid 51.; Garden Grove, CA
Loc# 3 . 13220 Euclid St.; Garden Grove, CA
,/~ ,. ; ~ '1',
L<~ . ''''.'
~3(r-
/.
.L,:l ~ '-, l '-,
AMS 25.3 (2001108)
3 of 3
#819530
UQI/J/2UUD Ur:ZH ~AA
14JOO~/OO!j
Additional Insured - Owners, Lessees or Contractors - AD 90 67 12 93
Policy Amendment Section II
Insured
Community \'eterlnary Hospital, Inc.
Policy Number
AZC80790199
Producer
ABO Insurance & Financial Services
Effective Date
10101105
Schedule
Name ot' Person(s) or Organization(s}
City at Sa"'" Ana
20 CivIc Center Plaza, M.30
Santa Ana CA 92702
(If no entry appears abQv~, infonnation required to complete this :Endorsement will be shown in the Declarations
as applicable to this Endorsement.)
The following is added 10 Part I. - WHO IS AN IN-
SCRED in the Business LJability Sectinn of the policy:
arising out of your work tor that insured by or
for you.
,
The person or orgalJ ~zation shown in the Schedule
IS also an insured. hut only with respect to liability
All other tenns and conditions of the policy apply
This Fi)rIl'i must be attached to Change Endorsement when issued afh.."! the policy is ",rit1eI1.
Om:: of the Hreman'~ Fund InsunlDce Compaule~ as nar;led in the policy
Secretary
President
AB:J06"'12-'H
Conta;nscop)Tighted Mat.eri[jJ of ln$lcl'<lll<::e Services Ofllee. ,"'c,> 1984
("^c1-Sac..rs"Ulel'Wdo'<NjclMy D<.>~~mcnl\\ '""'-""....iOll Com F<'>IlIl>\i\/ AD ~7.Docl
. / rJ/C
-~-~7
ACORDN CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
01/23/2007
PRODUCER , THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
,
A.ssuciation Unit A - ~OO4>-Oq-5 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ABD Insurance & Financial Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
~80 Natomas Park Dr. Suite 200 ~
Sacramento, CA 95833 -N - ~C65 -D(,,~ INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Fireman's Fund Insurance
Community Veterinary Hospital, Inc. INSURER B:
13200 Euclid Street INSURER c:
Garden Grove, CA 92843 INSURER D:
INSURER E:
Client#: 18321
COMMUVETE
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,
LTR NSR TYPE OF INSURANCE POUCY NUMBER PD~~~~:~6g~IE Pg~fl,~~b~,AAN LIMITS
A X GENERAL L1ABIUTY AZC80806771 10/01/06 10/01/07 EACH OCCURRENCE $1 000 000
ex COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100000
I CLAIMS MADE [i] OCCUR MED EXP (Anyone person) $10000
PERSONAL & ADV INJURY $1 000 000
- $2 000 000
GENERAL AGGREGATE
- $2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMPIOP AGG
I POLICY n ~~8T GLOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Eaaccident) $
ANY AUTO
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
r--
HIRED AUTOS BODILY INJURY
r-- U (Peracc/denl) $
NON-oWNED AUTOS ".' :0 rU\1
r-- ~,
r-- PROPERTY DAMAGE $
J ..L.L (Peraccidenl)
GARAGE UABILlTY - '0" -Of. / Y AUTO ONLY - EA ACCIDENT $
~ ANY AUTO l' [1'/'1- OTHER THAN EA ACC $
h' r'T "'" AUTO ONLY:
/ AGG $
EXCESSlUMBRELLA LIABILITY v EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
R ~EDueTIBLE $
RETENTION $ $
A WORKERS COMPENSATION AND WZP80942490 07/01106 07/01/07 X I we STATU.J. iOJ~'
EMPLOYERS' UABIUTY E.L. EACH ACCIDENT $1 000000
ANY PROPRIETORlPARTNERfEXECUTlVE
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $1,000,000
If yes, describe under E.L. DISEASE. POLICY LIMIT $1,000,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDeD BY ENDORSEMENT I SPECIAL PROVISIONS
** Supplemental Name ** 01/31/0706=32 RCiJn
Doing Business As: Community Veterinary Hospital, Inc.
(dba) Animal Friends Pet Hotel .
(dba) Animal Discount Clinic
(See Attached Descriptions)
CERTIFICATE HOLDER
CANCELLATION
ACORD 25 (2001/08) 1 of 3
#944085
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ......30..- 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.
~~~
COMMUVETE A5A
@ ACORD CORPORATION 1988
City of Santa Ana
20 Civic Center Plaza, M-30
Santa Ana, CA 92702
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.
....~ J)~____
ACORD 25-5 (2001/08)
2 of 3
#944085
DESCRIPTIONS (Continued from Page 1)
'ViiI/am A Grant & Virginia L Grant, Trustees of the Grant
Famfly Trust, agreement dated 3/26/80 as respects improved
real property
Certificate Holder is named Add'l Insured as respects to Veterinary
Services performed by the named insured.
Loc# 1 - 13200 Euclid 51.; Garden Grove, CA
Loc# 2 - 13252 Eucl/d 51.; Garden Grove, CA
Loc# 3 - 13220 Euclid 51.; Garden Grove, CA
t%:53Jj
AMS 25.3 (2001/08)
3 of3
#944085
,
f>OLICY NUMBER: AZC80806771
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON or
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of Santa Ana
20 Civic Center Plaza, M-30
Santa Ana, CA 92702
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable fo this endorsement.)
WHO is AN iNSURED (Section II) is amended to inciude as an insured the person or organization shown in
the Schedule, but only with respect to liability arising out of your operations or premises owned by or
rented to you.
Certificate Holder is named Add'l Insured as respects to Veterinary
Services performed by the named insured.
/56 i/Y
CG 20 26 11 85
OCT~ 24-cQG_18 a°: 10 FROM:CVMA 9266469183 T0: 714 2458550 P.1'3
,~coRV CERTIFICATE OF LIABILITY INSURANCE aPID roc DATE(MWDDIVYYY)
PRODUCER COI+NE-1 lO 24 0$
THIS CERTIFICATE IS ISSUED A3 A MATTER OF INFORMATION
Veterinory xas . 3®rviCes Co
.
CA License #OS64180 ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE
1900 River park D~'ive
#180
OT
RD
~
E
E
,
AL
ER THE COVERAGE AFFO
ED B
THE
POLIC ES
BELOW_
3acr~n~ CA 85815
phone:888~762-3163 Fax: 916-921-2266
INSURERS AFFORDING COVERAGE
INSURED _ • NAIC i{
INSURER A; Fireman's l~W1a7 ineacanoa Co.
C~nit veterinary Ho itel WSVRER B - ~ '- ~~
ltilllam ~ Grant jI
, DVl~ INSURER C'
Garde
A
o
e
-
INSURER O.
n
Gr
v
CA 9 843
-
INSURER E~ '-
COVERAGES
'THE POltC1E5 Ot INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THC INSURED NAMED ABOVE FOR'iHE POLICY PERIOD INDICATED. NOTWITNSTANUING
ANY REDUIRGMENT, TERM OR CONDITION OF ANY CONTRA
T
C
OR OTHER DOCUMENT WITH RCSPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DES(:RI~O HEREIN IS SUBJECT TO ALL THE TEAMS
PO
C
U
I
E
. EXCLUSIONS ANO CONDITIONS OF SUCH
S. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIM6
LL~~
'
LTR N Rtl TYPE OF INSURANCE POLICY NUMBER ~ ~ ~ ~ATt?CTIVE POQLWEYPf11A~jpN - -
DATE NRIUDDm
UMfTB
GENERAL LIABILITY
A R R COMMERCIAL GE NERpI LUIBILITY EACH OCCURR ENCC S 1, OOO r OOO
BH`ASC60832674 10/01/09 10/01/09
PREMIStS(E.9oocurxlce) s 100,000 _
CLAIMS MADE ~ I OCCUR
MED EXP (Any anp Qeraon) S 1O , OOO
~~
- PERSONAL 8 ADV INJURY 1
~-
GENERALAGGREGAfE S 2,000,000
OEN'L AGGREGATE LIMIT APPLIES PER; _
_
x POLICY JPERCT LOC PRODUCTS • COMPIDP AGG S 1 , OOO , OOO _
~ AuTnlawLE uABILrn Hen • 1 000 000
~ ANy AUTO s~~csos3z474 lO/Oi/O8 lO/O1/O9 COM9INED; INGLE LIMIT f 1 , OOO
(Efi 80Citlenl r OOO
ALl OWNED AUTOS _
Sf.NF,OVLED AUTOS BODILY INJURY
f
(Perperaon)
R HIRED AUTOS _
NON-OWNED gUTpg BODILY INJURY
f
~
(
sr ecTJCenI)
t
I. .. .. ..
OARACE LIABILITY
ANY AUTO
BkCEBS/UMBRELLA LIA81LfTY
I
A OCCUR ~IcLAiMSMADE 8Ei4AZC80832471 10/01/08
DEDUCTIBLE
x RETENTION 1
MIORKAgB COMPlNSATNk/ AND
A OINPLOYERB' LIA&LRY
ANY PRDPRIETDRlPARTNERfEXECUTIVE 18K6ilTLp80965134 07/01/08
O~tICER/MEMBER FXCLUDED9
Ilyes, pBBpIDB UIWvr
~w~rur ~n~w Vr OPERATIONS / 40CATION3! V EHlCLES / El(CLUSIONB ADDED BV ENDORSEMENT / SPiCIAL
Tho certificate holder is named as additional ].nsurad.
10-day notice of cancellation for nos-payment.
PROPCRTY DAMAOE I f
(Par a¢iegnt}
I AUTO ONLY • EA ACCIDENT $
OTHER THAN EA ACC 5
AU'fU ONLY. ACC i
EACH OCCURRENCE ~S,OOO,000 _
10/01/09 AGGREGATE s 5 000, OOO
-_ - _.
_.. ... I 1 .. ..
07/01/08 C.LEACHACClDENr 1],,000,000
E L DISEASE - EA EMPLOYEE 1 ], , OOO , OOO
E,L. DISFA$ • POLICY IIMI, 1 O
t_ .,, w.,_ ; .. ... ,
I
~/
INS ..... ...._ _,._..__..._..-.._
Laura Sig; `;:~~:n
Assistant L: iiy f, tE orney
**Certifi.cate holder continu®s: its officers, employees, agents, volunteers
and reproaantativea.
CANCELLATION
CYTYSA3 SHOULD ANY OP TM4 ABOVE DEBCRNiED POLIGEB BE CANCELLED BEiIOR6 T-IE E1tPNGTIO
DATE TNERiOP, THE IbSVlNO INSURER Will EMAIL 3O DAYS WRITTEIy
Clty Of $aata Ana, ** NOTICE TO THE CERTIFICATE HOLDER NAMED TO TNi ~~.g~sNALL
Sgt • Marty Shirey/Canine Tait IMPOSE NO OBLIGATION OR uAB11JTY OP ANY KIND UPON 7ME 1NSUR
20 Civic CeAt®r Plaza I"I-3O REPRESENTATIVE . 8R. 1T8 AOENTS OR
Santa And CA 92702 nirru.,.~s e~ _--_-- - _
ACORD
N-aoor-o6~-c~/
i~CT-24-2008 09:10 FROM:CVMA
9166469183 T0: 714 2458550 P.3~3
Additional Insured -Owners, Lessees or Contractors - AB 90 6712 93
Policy Amendment Section ll
Insured Community Veterinary Hospital Policy Ntunber SH4AZC80832474
William A. Gtartt 11, DVM
Producer Veterutary Ins Services Cn )affective .Date 1 0/0 1 12008
5ched ulc
Numc of 1Peraoa(s) or Organization(s)
City of Santa Ana, its officers, employees, agents, volunteers and representatives
I'rimaryln,surunce: !t is agreed that such insurance as afforded by tlai.c policy for the benefit of the
cldditional insured shall be primary inrura»~cy ~ respects any e~aim• lass or liability crrisi~g directly or
indi,'eetly fro-n the insarred ;c operations and any vlher insurance maintained by the additional insured
.durll be non-~unbibutorv with the insuaance provided hereunder.
(If no entry appears above, information required tt- complete this Endorsement will be shown in the Declarations
ns applicable tp this Lndorsement)
Th(; tbllowing is Added co Part I -WHO [S AN tN-
SURF..D in the Business Liability Section of this policy
5. The person or organization shown in the Schedule
is also an insured, but only with respeeta to liability
arising out ol'your work for that insured by or for
you.
All other terms and conditions ofthe policy apply.
This form ntusc be attnchccl to Chtutgc Endorsement when issued aRer the policy is written.
One of'tho Fireman's Fund insurance Companies ~ ntimcd in t}ic policy.
tie0rctary -
Presidcnt -
Atlvp67 I?~93
C:onffiin~ c;npyR~~ -~atenol of tn.uraacc Scrvicr~ Utiiccs, Inc: , 19t{q
r~Cj-24-2008 09:10 FROM:CUMA 9166469183 T0: 714 2458550 P.2~3
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(sj.
bISCLAIMER
The Certifcate 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.