HomeMy WebLinkAboutSCANTRON, INC. 1 - 2003
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IN~trnANCE Uij FILE
-WORK MAY PROCEED
UNTIL IN.~U~ANCE EXPIRES
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CLERK OF/COVNCIL
DATE: 0//2/03
STANDARD CONSULTANT AGREEMENT
N-2003-023'" .
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THIS AGREEMENT, made and entered into this lJfh day of ~(u1tr ,2003 by
and between Scantron, Inc., a California corporation (hereinafter "Consultant"), d 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
maintenance record forms.
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 to this Agreement.
2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services,
the rates and charges identified in Exhibit A. The total sum to be expended under this
Agreement, shall not exceed $ 10,000.00 during the term ofthis 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 written above and terminate on January
22,2004, unless terminated earlier in accordance with Section 12, below. The term of this
Agreement may be extended upon a writing executed by the Executive Director of the Public
Works Agency and the City Attorney.
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4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term ofthis 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, employees, agents, volunteers and
representatives as additional insured(s) and shall include, but not be limited to protection against
claims arising from bodily and personal injury, including death resulting therefrom and damage
to property, resulting from any act or occurrence arising out of Consultant's operations in the
performance of this Agreement, including, without limitation, acts involving vehicles. The
amounts of insurance shall be not less than the following: single limit coverage applying to
bodily and personal injury, including death resulting therefrom, and property damage, in the total
amount of $1 ,000,000 per occurrence. Consultant shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit B upon
execution of this Agreement and shall be approved in form by the City Attorney.
b. Business automobile liability insurance, or equivalent form, with a combined single
limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for
owned, hired and non-owned automobiles.
c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300
of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against
liability for worker's compensation or to undertake self-insurance. Prior to commencing the
performance of the work under this Agreement, Consultant agrees to obtain and maintain any
employer's liability insurance with limits not less than $1,000,000 per accident.
d. 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.
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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: (I) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims
for personal injury, including health, and claims for property damage, which may arise from the
direct or indirect operations of the Consultant or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates to the services described in
section I of this Agreement; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects
arising from this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to
have been suffered, by reason of the events referred to in this Section or by reason of the terms
of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold
harmless, and pay all costs for the defense of the City, including fees and costs for special
counsel to be selected by the City, regarding any action by a third party challenging the validity
of this Agreement, or asserting that personal injury, damages, just compensation, restitution,
judicial or equitable relief due to personal or property rights arises by reason of the terms of, or
effects arising from this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding.
7. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
that it shall not use or disclose such information except in the performance of this Agreement,
and further agrees to exercise the same degree of care it uses to protect its own information of
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, California 92702-1988
telefacsimile (714) 647-6956
With courtesy copies to:
Executive Director
Public Works Agency
City of Santa Ana
220 S. Daisy Avenue
Santa Ana, CA 92703
telefacsimi1e (714) 647-5622
4
, .
and,
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-6515
To Consultant:
Michael Groot
District Sales Manager
Scantron
/3'=>1 oj ALLtv q",- Ave.
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~06- 1~'t.. - <P81t,
telefacsimile ll-'t - z.'/l-ctl/ 'b
I\Jlfl.tir AOIlE>) rJ
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A party may change its address by giving notice in writing to the other party. Thereafter,
any notice, tender, demand, delivery, or other communication shall be addressed and transmitted
to the new address. If sent by mail, any notice, tender, demand, delivery, or other
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or
other communication shall be effective or deemed to have been given twenty-four (24) hours
after the time set forth on the transmission report issued by the transmitting facsimile machine,
addressed as set forth above. For purposes of calculating these time frames, weekends, federal,
state, County or City holidays shall be excluded.
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, the terms and conditions hereof, shall not bind or obligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
5
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:
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 ofthe 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 and all questions relating to its validity, interpretation, performance, and
enforcement shall be government and construed in accordance with the laws of the State of
California. This Agreement has been executed and delivered in the State of California and the
validity, interpretation, performance, and enforcement of any of the clauses ofthis 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
6
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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 ofthe 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 if fully set
forth in the body of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
PATRICIAE. HEALY
Clerk of the Council
CITY OF SANTA ANA: .
~~
/DA VID N. REAM
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City
By
Crist! . haw
Assistant City Attorney
C~L~
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Micheal Groot
District Sales Manager
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7
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5 CAN T "~"",Q"M,N
Professional Services Pricing
City of Santa Ana, Water Resources Division
1/2/2003
Description Qty Unit Cost Extended
Cost
Services
Form Design, Programming, & Optimization with Image Directory Scripting 1 1,250 1,250
Water (Main) Valve Location Fonn
Fonn Design, Programming, & Optimization with Image Directory Scripting 1 1,250 1,250
Service Record Fonn
Form Design, Programming, & Optimization with Image Directory Scripting I 1,835 1,835
Hydrant Maintenance Form
Form Design, Progrannning, & Optimization with Image Directory Scripting 1 1,835 1,835
Hydrant Location Form
FULL DAY On-site Production Support (to import forms, establish database 1 1,700 1,700
connectivity and conduct comprehensive system tests) Up to 8 hours
HALF DAY On-site Production Support (to impon fonus, establish database 1 800 800
connectivity and conduct comprehensive system tests) Up to 4 hours for
follow-up production support. (NOTE: 12 hours are recommended for
oroduction SUDoort on four fonns.
I"OT\I. 8,670
S;jln [ax :'\llt .'VpljCilMc
Shipllin~ "ot .-\PI)lkalih'
Unlefts otherwise stated above:
. Tenns are Net 30 once the work has been completed and a Scantron invoice has been generated.
. A purchase Order or Letter of Written Authorization is required to initiate programming.
. Prieing is valid for 60 days unless extended in writing by Scantron
. If the scope of the project changes Scantron resetves the right, with customer approval, to make price, hardware
and/or software changes.
. It is understood and agreed that each party shall have no liabilily for any indirect. incidental, special or
consequential damages (including loss of business, revenue, profits, use, data or other economic advantage)
suffered by the other party or any third party, even ifthat party has been previously advised of the possibility of
such damages. Liability for damages for any claim whatsoever shall be limited to the amount paid by Customer to
Scantron for the Services. which are the subject matter of the claim in the one-year period prior to the event-giving
rise to such damages.
EXHIBIT A
,
02/06/2003 17:33
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4047605680
114L4(t](I.Lt:5
MARSH USA
~~ANIKUN ~~U~AllUN
Pi~GE 23
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EXHIBIT B
ADDmONAL INS:QEED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company PeBEHAL INSeRAi'iElE CeM!' ANY
This endorsement modifies such insurance as is affOrded by the provj~:iQns of Policy
# ~~ ~A1 pb relating to the following:
1. The City ofSatrta Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its
officeal, employees, agents, vollll1teers and representatives are Damed as additional U:stlreds
("additional wu.reds") with regard to liability and defeDse of suits aril;ing from the operations
and uses performed by Of on behalf of the name~ msured.
2. With respect to claims arising out of the operations and uses :JCrforroed by or OIl
behalf of the named insured, such insurance as is afforded by this policy is trimaIy al1d is not
additional to or contributing with any other insw'ance cmied by or foJ' tb.e b<mefit of the
additional insureds.
3. This insurance applies separately to each insured agaiDst whcm claim is made or
Mt is brought ex.eept with respect to the company's limits of liability. The inclusion of any
person or orgllIlization 18 an insured shall not affect any right which s~ch person or organization
would have as a claimant ifnot so included.
4. With respect to the additional insuzeds, this insUl1UJ.ce llhall mt be cancelled, or
materially reduced in coverage Of limits except after thirty (30) days written notice h:lii been
slven to the Clerk of the Council, City of Santa Ana, 20 Civic Center Plaza, Santa NJa,
California 92701.
(Completio.n of the following. including counter$isnature, is required to mllkll this er.dorsement
effective. )
Effective Ol-Ol-0~ to 01-01-0M
Policy # 353R1 pu
bNed to SCAN"'1)f"\lIT t"'nrlPQRJlTI9W
, this lmdorsement form lIS a pari of
Named Insured
COunt=isned by
~ L~ j,.t-:.
Authorized Rep1\~sentB::;;ve
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"Marsh USA Inc.
2/11/03
10:01
PAGE
2/2
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CERTIFICATE t1UMe~ 1:
A 1l-OOC791153-11
THIS CERTFICATE 18 ISSUED AS A MATTER OF INfORMATION OH Y AND CCNFERS .
NO RIGHTS UPON THE CERTIfICATE Ho..DER OTHn: TH~ THOSE PROVIDED iii THE '
POLICY. TH&! CERTFICATE DOES NOT AMEND, EX reND O~ AL TE~ THE COVERAGE
N-FORDED BY THE POLICES DESCRIBED HEREIN_
PRO,UCER
Mareh
3475 PiedmD" Road N.E., St. 1200
Atianta, GA 3.)305
4C4-S!&3000
Attn: Brenda Voung.E.pps
75142-CAS-
IilSURED
Scantron COfpOfStion
34 Parker
Irvine, CA 92618
COMPANIES AFFORDING COVER ~GE
(404)995-3074
CCHi=lHojY
A FEDERALlNSURANCE CO
,
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COI'1PiNY
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THIS IS TO C:RTIFY THAT PO--IOES OF INSJRMlCE OEs:::RIBED HERSN HAVE BEEN I.fBJED TO ~E INSJRED N~EJ HEREIN FOR. .. HE PO ICY pr:RIOD INQIo:ATE'D
",arV"ITHsrANOING A~IY REWIREMENT, TERM OR CONOITlCJ>j OF ANY CONTRACT CR OTHER OOCUMENT\o\1lH RESPECTTO\M-'IQ-! THE CER.'I~ICAT~ W I>Y EE IS-O:U=J OR 11,1."
PERn"JN, T.-lE INSJRN.CE AF~OROEO BY THE POuaES OE:s:::RIBED HER8N IS SUBJECT TO JrtL THE TERMS. co~omQ\ls AND EXO.USQ\S CF W()' POJO;:;S AGGF:EG/ITE
LIMITS 9-iOlM MAY HI-VE BEEN REDUCED BYPJiI~ Q..A1MS
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ca.1PHoY
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POLICY NUMBER
POLICY EFFECTIVE ~OLICY EXPIRATICH
DATE (MMIDDfYY) DATE (MMrooNY)
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d'~'; Q..AlMS MJ[IE ~ OCQ.lR
QM>.ER'S & CGtrRACTOR'S PROT
,frIJrOMCElLE LIABIUTY
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s:HEOULED AUTOS
HIR;D AUTOS
NQo.I..Q\M.jED Au-rQS
35381324
35381324
01/ll1/03
01/01/ll3
03101/04
03101/04
$
PROCUCTS .IX:J.i\PfQP I-.GG $
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$ 101}JCCK.l,
$ 1'~~~~1
DESI:;RIP--ION OF OPERATICINS/LOCATlONS!VEHICLES/SPECIAL ITEMS
The City of Santa Ana, its officers, employees, agents, and representative are induded as additional insured as their interesl may cppeaJ per 'J/Titton l;or:tr;;irt.
A
A
A
A
A
B
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EX CESS LIABILITY
GENERAL I-GIREGAT=
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EA~ QCOJR ~ENCE
FIR:: Q"\lAGE (AnyOl ~".~
Mea EX::' (An~ rnepe'OO'IJ _
73260213 (ADS)
73260209 (lX)
73260210 (VA)
73501034 (MA)
73260212 (PR)
01/01/ll3
01101/03
01101103
01101103
01/01/03
03101/04
03101104
03101104
03101104
03101/04
BOI11LY IN~UR ~
(Pe' accident)
x I LI~3'<,EL_A =CRi'w
aTHER THAN UM8RELLAFORM
A WO~KERS CO!ilPEftS,
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PAF:TNERSEXEaJTlV;
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PROPERTY D,MAGE
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$
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01/01103
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APPROVED AS 10 fO
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9iOU.CI....tl'{ OF TI-E POlIOES nESOU!lEDI-EREIN erE: CANCl" _LEO I!IEF(IIl.E TI", EXF'I::..TiOll: D....r; 1-1E':I'CF
IN9.JIER AFFORDING COVER,o,a: \'~lL E~,,*~ 'oWL --3.Q rM'I'll WRlmN NO- Cl" 1(' -""',
City of Santa I~na
20 Civic Center Plaza
P.O. Box 198f1
Santa Ana, CA 92702
CERTiFICATE HeLDE'1 M'.II.ED HERE'N, Bur F"LURE ~o M/lIL ! JCH ~IOTC:: .5H~ L III,P:>>:l'" r-M:' OB~IQ'1l('" ':11 i
I5SUeROI'"THSa:Fl1lFICATE
W,o,BIUTYOI' ,o,tl'{1(11'l) LPONTH: IN!'Ul.i:i\ IJ'FORDIN<; CCWERJ GE, ITS Aa;NTS (,Fl R=~'~"'SENTAT \..~; 0'1 IH1' i
.--..)
Laura Sheedy
L. ,. <;ly City Attorney
ARat USA"C_
y: Michael Dennis
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02/07/2003 08:57
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7142470018
SCANTRON CffiPORATION
PAGE 03/03
PAGE eJ
fJOlA W".t!/ :',:l
02/06/2003 17:33 40476e5688
V&la*'&OO~ .Q:O~ f1~~4'Og~O
MARSl-I USA
~11H.'l.J'l~IU..IN
, .
E.XH1Brr B
,o\DDfIlONAL "-"ITl1nm ENDORSEMENT
[OR COMMERCIAL Ot:NBRAL UABILJ1'Y POLICY
msurance Company PlllllHI.~L lllaaRAlI1!!e eeMI'klH --
nua enclor.ic:mellt modifies IIICh iJIIInnee as is lIfI'ordDd by fie provi~iODS of Policy
/I .",A, .?A Idatingto1llafollowillll:
1. The City ofSauta Au, ZO Civic CadIlr PJua, Sanla Ana. CBliftJmla 92701; its
offiCIIS, empIoy-. agents, vo~ IIld ~ves arc nBJned as additional ir.s~
("idditi=a1 inmecIs") with resard to Iiabilir.y IIId defense of suits arising from the opt(mQll$
and uses perlbrmcd by or on bdIaIf oIthe namecI ~
2. With respect to claima Il'iaina out of the opanltiollS ancl uses l~rroed by or 011
bebaltofthe uamed insuxed, suc:h illJQftDC8 III is aftiJn\8d by (bla poUey is pimarY and ill nut
additional to or contn'btIIDg -M1b. any oIiIIIr insur.InCC *1iccl by or filr the Mnent of the
additiwal illSUffldl.
~. This ioS1ll'U!le applies separately to eIIllh lnswed. apiMt whc,m c1l1i1n is made or
:Nit is bIoqII:t sxeept wilh I'll$p8Gl to die ..01. .pm}"s limlts of !lability. TM inclusiOl1 of any
per.on 01{ OI'Imir.atlClllaa an insuled wn not ~ ~ rigllt which $'lld\ petIOlI or Otg<l,,;nd:iOTl
'I\'llU1d bPI IIl.cIaimaIll ifllOllO included.
4. With respect to the additional insurecls. Ibis iDsumlce shall not be Q1Dccltocl, or
materially Rduced UI CllM:nIe OJ' limits exa:ept after thh1y (30) days writl:ell "ot:Iee Ms beell
slval to the C1cIC of the Couoc:iI, City of SIDta Ana, 20 Civic Center p~ Santa Aila.
Califomla 9270 1.
(Completion of tbc following, incl.v<filig COIlDtela~ is reqtrired to IDIII.~ this endoJ:Sem,ellt
cfti:ctive.)
Effilctive Ol-{) 1 -O~ to 01-01-nil
....,,""~
,n.JU_J J5iA1 i~.11
Issued m ~&bJ"'Dnw l"nll'DnDATION
. tbls md~t fotm. as a pat of
Named m~d
COUDtcqlgned by
~J J<.-~
~
Au1horizled. R.epr........tet.lve
APPRO\E:) A.S TO FORM
-/ .~,.33~
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s
pepUlY ,.)
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