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Home My WebLink AboutUNITED INSPECTION & TESTING 3A City of Santa F -a 4�' Clerk of the Coui...iI Itit AGREEMENT TERMINATION F� t AUG Ail 9- 30 �y{ :,,t3 Please complete this form when the attached agreement is no longer in effect. Return form to the Clerk of the Council Office (M-30). z Call 647-5237 if you have any questions. f.� r The agreement with V t--o'' \\ No. A-2000-064-05 was completed on - 2_7) 1 and final payment has been made. Department: 4—\% Phone/Ext.: C Signature: Date: 1� /06 Revised 07-23-07 .~ . . . A - LOQc).- 0 C:.~-C FIRST AMENDMENT TO CONSULTANT AGREEMENT THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into this 25th day of June 2004, 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 renewed said Agreement for an additional one-year period by letter dated May 15, 2003 (hereinafter "Extension"). C. The parties wish to again extend the term of said Agreement for an additional one- year term. Wherefore, in consideration ofthe covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement and Extension, except those amended in this First Amendment to Consultant Agreement, the parties agree as follows: I. Section 3, TERM, shall be amended to extend the termination date from June 30, 2004 to June 30, 2005. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Consultant Agreement on the date and year first written above. APPROVED AS TO FORM: /~' r' V ~ 1;X'CUA.-f.l:A. '~i1' ~OSEPH W. FLETCHE City Attorney CITY OjSANT A A2 /~AIfl1;jL . JAMrrS d. ROSS E)"ecutive Director , /f'ublic Works Agency L---. ~ ,.. ..', " DATE (MMIDDIYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE OPID~ 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 Nil.]. Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Great Neck NY 11021-3104 ~hone:516-466-4200 rax:516-466-4213 INSURERS AFFORDING COVERAGE NAIC t# INSURED INSlJlER A AZG United Znspection & Testing INSrnER B: Houston Casual.ty Co. Znc I NSlJlER C 22~20 CIol.dencrest Drive A-,,).{JOO txtJ1 SU1te 114 - INSlJlER D: Moreno VaHey CA 92553 /kAOOO-C/Pi/-()( INSlJlER E: 0;1. COVERAGES o~ THE POLICIES OF INSUF/JINCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED .ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING I>N( REQUIREMENT, TERM OR CONDITION OF /'NY GaIITRACT OR OTHER DOCUMEI'IT WITH RESPECT TO WHIQ-I THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. TIE INSURANCE AFFORDED BY THE POliCIES DESCRIBED HEREIN IS SUBJECT TO,AlL TIE TERMS, EXQUSIONS AND CONDITIONS OF SUa-I POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ~~ lYPE OF INSURANCE POLICY NUMeER DATE (MMIOO/YY) .~'tETc UMITS ~NERAL LIABILlrY EACH OCCURRENCE $1,000,000 A X X COMMERCI,Al GENERAL LIABILITY 4022676 07/01/06 07/01/07 PREMISES lEa occurence 1 $ 500,000 I a.AIMS MllDE ~ OCClJl !'.ED EXP (AfllI one person) $10,000 PERSON,Al & NJV INJURY $1,000,000 I-- GENERAL AGGREGATE $ 2 ,000,000 I-- GEN'L AGGREGATE LIMIT APPliES PER PRODOCTS - COMPIOP AGG $ 2 ,000,000 h POLICY n '1& n LOC AUTOM06ILE LIABILITY COMBINED SINGlE LIMIT I-- $1,000,000 A X ~ I>N( AUTO 3853974 07/01/06 07/01/07 (Ea aecldentl ALL O\MIIED AUTOS BODILY INJURY - " " (Per person) $ - SCHEDULED AUTOS '.to fEr - - HIRED AUTOS \,t\J"6 8\.'0 BOOIL Y INJURY ~ ~ (Per accident) $ NQN..OWNED AUTOS h=?t\~ ( - PROPERTY DAMAGE - ~- (Per accident) $ ,.<--'f -_ C GARAGE UABLITY ~ \..\~I-\ 1,..' , 'J 1\ttoP ) AUTO ONLY - EA ACCIOEI'IT $ =J ANY AUTO t C\ P-SS\st3r-/ cD.f' 7- OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESSlUMBRELLA UABILlTY ~, EACH OCCURRENCE $4,000,000 A X ~ OCCUR D a.AIMS MADE BI:2963402 07/01/06 07/01/01 AGGREGATE $4,000,000 $ ~ DEDOCTIBLE $ X RETEI'ITION $10000 $ WORKERS COIiPENSATlON AN) I TORY LIMITS I IUEFt' A EIotPLOYERS' LIABILITY 'H'C7578176 07/01/06 07/01/01 $ 1000000 I>N( PROPRIETORJPARTNERIEXECUTIVE E L EACH ACCIDEm OfFICERlll.EWER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 1000000 If yes, describe under EL DISEASE - POLICY LIMIT $ 1000000 SPECIAL PROVISIONS below OTHER B Professional. Liab H70516400 10/01/05 10/01/06 I:a Occurr 1000000 Retro Date 9/1/85 ate 2000000 DESCRIPTION OF OPERATIONS I LOCATIONS I YEHCLES I EXCLUSIONS ADDEO BY E~ENT I SPECW. PROVISIONS THll CZ'1'Y or SAN'l'A ANA, ITS orrzCERS, B:MPLOYB:B:S, AGB:N!:'S, VOLUNTEI:RS AND BBPRBSl!:N'.l'.M!IVES ARJ!: NAHII:D AS ADDZTZOlQL msUREDS w:Ift BBSP~S TO '1'HJ: OPERATZONS PBRI"ORMI:D BY OR ON BBHALI" or '.rIIJr. 1Q,MI:D INUS1U!:D, ftZS INSUBANCB: ZS ~I\DGU\Y AND NON CONTI\J:BUTORY w:Ift .AHY OTHBI\ msURANCE CAJUUB:D BY OR rOR TJU: B:ENBI'ZT 01' '.rIIJr. ADDZTZONAL msURBDS, 10 DAY NON PA~ CANCI:LLA!I!ZON APPLZI:S CERTIFICATE HOLDER CANCELLATION SANTAAN IHClULD AN'( OF TIlE ABO\IE DESCRIBED POLICIES BE CANCELLED BEFORE lIE EXPIRATION DATE llEREOF, THE ISSUING INSURER WILL MAIL 30 DAYS~ CZTY 01' SAN'1'A ANA - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT PUBLZC MOlUtS AGENCY ROSS STBBI:T ANNEX-M-22 20 CJ:VJ:C CJl:N'.rBR PLAZA SAN'l'A ANA CA 92701 REPRESENTATl\IE ~~ ACORD 25 (2001108) Cl ACORD CORPORATION 1988 - . ~~ 14 06 03:14p !D.S APDJTIONAL INSURED ENDORSEMENT F'OR C:OMMERC~. GENERAL LlABILlTY POLICY Insurance Company _~J:F~.!9MiJNTERN~~.~ROUP (AIG) This endorsement modifies such insurance as is afforded by the provisions of Poticy # .--.402221.6 .... relating to the following: 1. The City of Sanla Ana. 20 Civic Center Plaza. Santa Ana, California 92701 ~ its officers. employees. agents. volunteers and representatives are named as additional insureds ("additional insmeds") with regard to linbility and defense of suits arising from the operations and uses perfol1ncd hy or on behalf of the named insured. 2. With respOOl to claims arising out of the operations and uses perfonned by or on behalf of the named insnred, su~h insurance as i:5 afforded by this policy is primary and is not additional to or c.ontributing with any other insurance camed by or for the benefit of the additional insureds. 3. Thi:o. insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the l:'ompany'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 ifn01 so included. 4. With. respect to the additional insureds, this insurance shall nol be cancelled. or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the Oty 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 _J!1106 . "_._._._.' this endorsement form as a part of Policy # -.AOZ267ii__ . _._.. _ . ___ Issued to .........JJ.MIED INSPECTION & TESTING INC. .. _ Named insured ~tltCTSjgllcd by __~ ~ 1\.'2> 'to 'V Authorized Representative . ~;;~~O\Jr:.D /./ 1.. .-.... . .'~ ..-'- J;'" vA' j <~.< .~O '...., r; \S~ '(:., S ~\\.o,\\-' \.. "\\'j . \.3\1\ v ) (! Of"d- CERTIFICATE NUMBER SEA-000501470-06 PRODUCEr~ r-n.ARSH RI\3K & 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN. '- COMPANIES AFFORDING COVERAGE MISC .UNITE-W/PRO- un CA J .I- INSURED Me. ~ 4'7- UNITED INSPECTION & TESTING INC (I \; U-.. -' 22620 GOLDENCREST DRIVE, SUITE 1 4 MORENO VALLEY. CA 92553 A _ 1"0[,(; . 0 CJJ L( - D I A-dO(j() -Noll COMPANY A NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA. COMPANY 8 AMERICAN HOME ASSURANCE CO COMPANY C AMERICAN INTERNATIONAL SPECIALTY LINES INS. CO. COMPANY o INSURANCE CO. OFTHE 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 DOCUMEtH WITH RESPECT TO WHICH THE CERTIFICATE MAYBE ISSUEDOA MAY PERTAIN, THE INSURANCE AFFORDED BYTHE 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 (MMfDDIYY) DATE (MMfDDIYY) A GENERAL LIABILITY GL933-3116 04101104 04/01/05 GEf~ERAL AGGREGRATE 5 2,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COM PlOP AGG $ 2,000,000 CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY $ 1,000,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Anyone fire) 5 1,000,000 MED EXP (Any OM person) S 5,000 A AUTOMOBILE LIABILITY 826-1679 AOS 04/01104 04/01/05 B X COMBINED SINGLE LIMIT $ 1,000,000 ANY AVTO 826-1680 MA 04/01104 04/01/05 A ALL OWNED AVTOS 826-1681 TX 04/01104 04/01 /05 BODIL Y INJURY SCHEDULED AUTOS (Per person) 5 X HIRED AVTOS BODIL Y INJURY $ X NON-OWNED AUTOS (peraccidanl) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONL Y- EA ACCIDENT S ANY AVTO OTHER THAN AVTO ONL V: EACH ACCIDENT $ AGGREGATE 5 C EXCESS LIABILITY 819-4168 04101104 04101/05 EACH OCCURRENCE $ $1,000,000 X UMBRELLA FORM AGGREGATE $ $1,000,000 OTHER THAN UMBRELLA FORM $ A WORKERS COMPENSATION AND 7155121 (CA) 01101105 01101106 X OTH- EMPLOYERS' LIABILITY ER 0 7155122 (AOS) 01101/05 01/01106 5 1,000,000 0 THE PROPRiETORI X INCL 7155118 EXGLUD.CA,AOS,GA 01/01/05 01/01/06 EL DISEASE. POLICY LIMIT $ 1,000,000 PARTNERS/EXECVTIVE E OFFICERS ARE: EXCL 7155119 (GA) 01101/05 01/01/06 EL DISEASE-EACH EMPLOYEE $ 1 000,000 OTHER C PROF. LIABILITY (E&O) 819-4168 04101104 04/01/05 EACH CLA:~vl ...~ ,...,...,... "........ '1> 1 ,""",vv.... CLAIMS MADE FORM AGGREGATE $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS , Q1' <- Laura Stitt Sheet- Assistant City A~ ..,;\ CITY OF SANTA ANA PUBLIC WORKS AGENCY CONSTRUCTION ENGINEERING P.O. BOX 1988/M-22 SANTA ANA, CA 92702 f -, ~ l 'G/.I~ '7 \B. L-__ -- - -- OO:J SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL KN~ MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN,)e01XUI(XI16e(ROOM:~lloeUON ~NteOOO<MD<<!II8~XMJI~~)QE)(~XXXX AA~)l!()Itm~K),()OO(I;:~~~m~X>9(]IJflG<XXXXX E~>em:JO:RXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX , -~ -~._-- , -1 MARSH USA INC BY: Michlo Nekota ;;MMH3i'@ 1LuLJUL v~L.i'Q'~:rqF: -: T2Y?8!_Q4 j J . DATE (MM/DDIYY) 12/28/04 PRODUCER MARSH RISK & INSURANCE SERVICES P O. BOX 193880 S~N FRANCISCO. CA 94119-3880 CALIFORNIA LICENSE NO. 0437153 COMPANY E AMERICAN INTERNATIONAL SOUTH INSURANCE CO. MISC .UNITE-W/PRO- U1T 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: GL 933-3116 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 Person or Organization: WHERE REQUIRED BY INSURED CONTRACT --.-----------.----------------------------------------------------.------------------------------------.-..---------..--------..---.------.----.--------.------------.-..----------------. ----------....----------------.--.-----------.--------------.--..------------..-----------..----.-..----------------.--------.....-------.-.----------------------..--.-.---------...._---- (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II. Who Is An Insured is amended to (1) All work, including materials, parts or include as an insured the person or organization equipment furnished in connection with shown in the Schedule, but only with respect to such work, on the project (other than liability arising out of your ongOing operations service, maintenance or repairs) to be performed for that insured. performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or B. With respect to the insurance afforded to these additional insureds, the follOWing exclusion is added: 2. Exclusion This insurance does not apply to "bodily in- jury" or "property damage' occurring after: (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 principal 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. CG20101001 APPROVED AS TO FORM 'I~ Z/2 Laura Stitt Sheet) Assistant C:: CITY OF SANTA ANA PUBLIC WORKS AGENCY CONSTRUCTION ENGINEERING P.O. BOX 1988/M-22 SANTA ANA, CA 92702 MARSH USA INC. BY: Mlchio Nekota 'b.dL-JULL PRODUCER MARSH RISK & INSURANCE SERVICES P. O. BOXJ93880 S'l\N FRANCISCO, CA 94119-3880 CALIFORNIA L1c:;ENSE NO. 0437153 DATE (MMIDDIYY) 12/28/04 NIES AFFORDING COVERAGE COMPM1Y E AMERICAN INTERNATIONAL SOUTH INSURANCE CO. Mise -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: GL 933-3116 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 Person or Organization: WHERE REQUIRED BY WRITTEN CONTRACT -n-n~n-nnn__~~_n_nn_n~~nnn__n_nn_nn___hnnnn____~_nn_nnn_hn-nn---uhn-n-_n_..n_nn__n_hnnn_nuhn_nn_nnunn_nnuhnnnn_n_hn_n__ -----------~------------~------------~------------------------~----------~~-----------~~------------~----------~-~--------------------_____________________________n______________________ Location And Description of Completed Operations: Additional Premium: o -______n_____________________n_________h_______________---------~------_____~____________u__________h__________________________________.._____________________________________________ -u~nn-n_n_nnnn____hnnnnnhnn_n___..nn____n_hn_n__n..n_nn__n_nnn-__n_hn_n__n_hn_n___nhn_n___n_hnnn_n_Un_n_n_______n_nn___h_nnn. (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work' at the location designated and described in the schedule of this endorsement performed for that 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. CG20371001 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONSTRUCTION ENGINEERING P.O. BOX 1988/M-22 SANTA ANA, CA 92702 .. MARSH USA INC. BY: Michlo Nekola ;':I./w~~~':" ~(dLL 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/~ . '. - ...... . ' ~.._-