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HomeMy WebLinkAboutLE, CHOC 2HAGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effie.1 AUK, =s ' 9''2 Return form to the Deputy Clerk of the Council M-30 . Call 647-5237 if have uest_ P , ep Y ) Y 4� --------------------------------------------------------------------------- The agreement with No. 4 %)20 # /ge.2- 0.3 was completed on and final payment has been made. Department: /WCsA // y, _ i �j,� Signature: Date: 41, City of Santa Ana / Revised 08-28-06 Clerk of the Council 4�/ 16 INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES A-2004-122-03 is-/7-06 CLERK OF COUNCIL DATE: 9- 8-06 THIRD AMENDMENT TO AGREEMENT o: {hr-Ks W Ccar14?hompson}fHIS THIRD AMENDMENT TO CONSULTANT AGREEMENT is entered into on August 7, 2006, by and between Choc Le, a sole proprietor ("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-2004-122, dated June 21, 2004, (hereinafter "said Agreement") by which Consultant has provided martial arts instruction for participants registered through the City's Parks, Recreation and Community Services Agency. B. In accordance with the terms and conditions of said Agreement, the parties wish to amend the Scope of Services to reflect the parties' understanding regarding the City's ability to reschedule classes when necessary. 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 Third Amendment to Agreement, the parties agree as follows: 1. Section 1, SCOPE OF SERVICES, shall be amended by replacing Exhibit A with Exhibit A- 2, attached hereto and incorporated by this reference. 2. Except as herein amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Third Amendment to Consultant Agreement on the date and year first written above. aATTES PATRICIA E. HEALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W. LETC R City Attorney APPROVED AS TO� NTE t GERARDO MOUE , Executive Director PRCS CITY OF SANTA ANA (,J DA ID N. RAM City Manager CONSULTANT �, lul, I A C OC LE EXHIBIT A-2 SCOPE OF SERVICES 1. Consultant will prepare and instruct students in martial arts techniques, with an emphasis on Tae Kwon Do. 2. Consultant will confer with City to set the time and location of the classes, including days and hours of class and holidays to be observed. The City reserves the right to preempt any class as City deems necessary. Thirty (30) day notice of such change will be provided, if possible. Instructor may reschedule any class which has been preempted. 3. Consultant will provide and be responsible for equipment, records, personnel and clean up of the facilities and materials necessary to ensure the safety and effectiveness of said instruction. 4. If Consultant allows others to teach his classes, those teachers must be over 21, have obtained and maintain an instructor rating and be covered by Consultant's insurance. Consultant shall provide City with documentation to verify instructor and insurance requirements. Black -belt rated students may warm up beginning students, however, Consultant must be present at all times. CLASS SIZE — REGISTRATION 1. The minimum number or participants is 10 per class, the maximum is 130. 2. No registration will be accepted after the second week of classes. 3. In the event the minimum number of enrollees is not realized by the second week of classes, the class shall be cancelled, Consultant will be under no obligation to provide services and the City will have no obligation to pay Consultant compensation. FEES 1. Each participant shall pay a $20.00 class registration fee per monthly session. 2. No refunds will be made to participants after the commencement of a session unless the class is cancelled by the City. 3. City shall collect registration fees from each participant. Consultant shall refer interested students to City for registration. 4. Consultant shall receive seventy percent (70%) of the total fees collected each month. City and Consultant agree that City shall retain thirty percent (30%) of the fees collected as an administration fee. 5. Consultant agrees City is entitled to audit Consultant's records and classes to ensure compliance with this Agreement. 6. Consultant may not waive class participation/registration fees. 7. City shall prepare class rosters and provide a copy to Consultant. Only registered participants may participate in class. ACO D CERTIFICATE OF LIABILITY INSURANCEI DATE (MM DD YYYY) I=012005 PRODUCER Phww: (NO)395eG7S FiK (S58)St9.0022 RTNESS AND WELLNESS INSURANCE AGENCY 390 STEVENS AVENUE, SUITE 206 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT$ UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER LA=lmm� SOLANA BEACH CA 92075 Aaency Lic#:0028716 INSURERS AFFORDING COVERAGE NAIC 11 INSURED CHOC V. LE A -900 y— I A2-03 INSURER A: Zurich North America INSURER B: INSURER C: 4 FABRIANO IRVINE CA 92620-2676 INSURER D: INSURER E: 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. TYPE OF !INSURANCE POLICY NUMBER POLICY�9PPECTNE POLICY EXPIRATION LIMITS A GENERAL.LIABILITY X COMMERCIALGENERALLIABILITY C W MS MnDE FX1 OCCUR GENL AGGREGATE LIMIT APPLIES PER: X POLICY 7 JJC-CT LOC EOL9042327-01 12117106 12M7108 EACH OCCURRENCE S 1 �� DAHAOETORPrAmFMOD DAMAGE Ea Ea o EO S 100,000 MED. EXP (Any a w pwaon) S 2,800 PERSONAL B ADV INJURY i 1,()0,000 GENERAL AGGREGATE 3 3,6GG,000 PROOUCTS-COMPIOP AGG. S 3,000,000 AUTOMOBILE LAOAITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNEOAUTOS COMBINED SINGLE LIMIT (Ea acew") S BODILY INJURY (Pw parwn) S BODILY INJURY (Pera=iwnt) _ PROPERTY DAMAOE Per accxjom i GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACC40ENT S OTHER THAN EAACC AUTO ONLY: AGO S S EXCESS I UMBRELLA LIABBJTY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S A, eZk_ EACH OCCURRENCE II AGGREGATE S VWMAS COMPLNBATION AND EMPLOYHtS' UABILII Y AWPftOP lffT*WARTklRl 9CUWE OPPICIUMAKINIIER EXCLAMM? Mrir.Mu,lMt+nW, � PROVMK M aq,,, ....~ )..,2GY£`. r Lt .,i;1-:%y - . SLIM 6 oMER E.L. EACH ACCIDENT S E.L.EL. DISEAEA EMPLOYEE S E.L. DISEASE -POLICY LIMIT S OTHER: DESCRIPTION OF OPERATIONSA=ATIONSNEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER ADDED AS ADDITIONAL INSURED ONLY AS THEIR INTERESTS MAY APPEAR i.c.m I Irj%#^ i C n%mwr. ( City of Santa Ana Recreation am* W a..w A— O,.-d_ An SantO a CA 92702 Attention: PEGGY CALVERT ACORD 25 12001108) Certificate # 33091 GMIGtLLA 1 IQIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED DEFORETNE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 8O SHALL IMPOSE NO OBLIGATION OR LIASIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. 4i Id 0 Hit e O ACORD CORPORATION 1208 I. d 0Z80ZV0Z89-QN/8£:£I'1S/8£:£t 9067, UZ 03QC3ffl) 30NVdnSNI SS3NI13M QNV SS3N1iA W08J POLICY NUMBER: E0L9012327-01 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ THIS CAREFULLY ADDITIONAL INSURED PRIMARY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART This insurance is primary for the person or organization shown in the schedule, but only with respect to liability arising out of your work or that insured by or for you. Other insurance afforded to that insured will apply as excess and not contribute as primary to the insurance afforded by this endorsement. All other endorsement provisions, conditions and exclusions of this insurance shall remain unchanged and apply to the additional insured and described below. SCHEDULE ADDITIONAL INSURED NAMED INSURED CHOC V. LE 4 FABRIANO IRVINE CA 92620-2576 CONTRACT/PROJECT Cat Mtb # 33M Z d OZ80Zti0Z89 'DN/8E E L '1S%6E E l SOOZ OZ 030 (3n.L) 30NVdnSN 1 SS3Nl13M ONV SS3N.L I J WObd REQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: JUNE 19, 2006 TITLE: AGREEMENTS POR INSTRUCTORS CLERK OF COUNCIL USE ONLY: APPROVED LEISURE CLASS ❑ As Recommended ❑ As Amended ❑ Ordinance on 15' Reading ❑ Ordinance on 2n° Reading ❑ implementing Resolution ❑ Set Public Hearing For CONTINUED TO FILE NUMBER A -Roo-Y- IOW-63 RECOMMENDED ACTION 1.Direct the City Attorney to prepare and authorize the City Manager and Clerk of the Council to execute an amendment to the agreement with National Heritage Foundation FBO Academy of International Dance for dance instruction, increasing the agreement amount $7,000 and extending the term one year, for a total agreement amount not to exceed $22,000. 2. Direct the City Attorney to prepare and authorize the City Manager and Clerk of the Council to execute an amendment to the agreement with Martin Torres for Karate Do Kai instruction, increasing the agreement amount $7,000 and extending the term one-year, for a total agreement amount not to exceed $22,000. 3. Direct the City Attorney to prepare and authorize the City Manager and Clerk of the Council to execute an amendment to the agreement with Choc Le for Tae Kwon Do instruction, increasing the agreement amount $6,000 and extending the term one-year, for a total agreement amount not to exceed $30,000. DISCUSSION The Parks, Recreation and Community Services Agency Leisure Services Program offers low-cost courses and activities to Santa Ana residents in the areas of Music and Dance, Arts, Nature and Science, Equestrian and Aquatics, Sports, and other special interests. The new semi-annual Leisure Services Program brochure has been instrumental in increasing the number of students registering for many classes. Since last summer, the Parks, Recreation, and Community Services Agency has expanded the Leisure Services Program to include 87 new recreational and educational classes. 25B-1 Agreements for Leisure Class Instructors June 19, 2006 Page 2 The Leisure Services Program is a revenue -generating program that uses registration fees to pay for instructors and supplies. The recommended actions will allow the Parks, Recreation, and Community Services Agency to meet additional demand for leisure class instruction at six recreation centers and two senior centers. FISCAL IMPACT Funds are available in the Recreation, Other Contractual Services account (account no. 11-275-6291). Z",4 X"p, Gerardo Moue Executive Director Parks, Recreation, and Community Services Agency APPROVED AS TO FUNDS AND ACCOUNTS: Francisco Gutierrez .�,f Executive Director II__ Finance & Management Services Agency 25B-2 MINUTES OF THE REGULAR MEETING OF THE CITY COUNCIL OF THE CITY OF SANTA ANA SANTA ANA, CALIFORNIA JUNE 19, 2006 CALLED TO ORDER POLICE COMMUNITY ROOM 60 CIVIC CENTER PLAZA SANTAANA, CALIFORNIA 6:08 P.M. ATTENDANCE: Councilmembers present: MIGUEL PULIDO, Mayor LISA GIST, Mayor Pro Tern CLAUDIA ALVAREZ CARLOSBUSTAMANTE ALBERTA CHRISTY MIKE GARCIA JOSE SOLORIO STAFF Present: DAVID N. REAM, City Manager JOSEPH W. FLETCHER, City Attorney PATRICIA E. HEALY, Cierk of the Council PLEDGE OF ALLEGIANCE MAYOR PULIDO INVOCATION Gary Tucker, Police Chaplain CONSENT CALENDAR Mayor Pulido announced the following modifications to the Consent Calendar: • Item 25 O. pulled by Mayor Pro Tern Bist • Councilmember Alvarez recorded a No vote on item 25.H. • Closed Session Report — Item 19A Motion: Approve staff recommendations on the following Consent Calendar items. MOTION: Bist VOTE: AYES: NOES: SECOND: Alvarez Alvarez, Bist, Bustamante, Christy, Garcia, Pulido, Solorio (7) None (0) CITY COUNCIL MINUTES 190 JUNE 19, 2006 CONSENT CALENDAR ABSTAIN: None (0) ABSENT: None (0) Items removed for separate action or modified are highlighted. Separate actions show the actual vote. Items without votes are adopted as part of the consent motion. ADMINISTRATIVE MATTERS MINUTES Motion: Approve minutes. (Item 10.A.-10.C.) 10.A. ADJOURNED REGULAR MEETING OF JUNE 5, 2006 10.B. REGULAR MEETING OF JUNE 5, 2006 10.C. JOINT SPECIAL_ MEETING OF JUNE 9, 2006 ORDINANCES 11.A. FISCAL YEAR 2006-2007 - PROPOSED CITY BUDGET Placed on first reading at the June 5, 2006 Council Meeting and approved by a 7-0 vote Published in the Orange County Reporter on June 9, 2006 Motion: Place ordinance on second reading and adopt ORDINANCE NO. NS-2713 - An ordinance of the City Council of the City of Santa Ana appropriating monies to the several offices, agencies and departments of the City for the Fiscal Year Commencing July 1, 2006. BOARDSICOMMISSION SICOMMITTEES 13.A. VACANCY REPORT —JUNE 14, 2006 Motion: The Vacancy Report reflects only appointments made by the Council. CITY COUNCIL MINUTES 191 JUNE 19, 2006 CONSENT CALENDAR AGMT NO. 2006-145 - With Choc Le for Tae Kwon Do Instruction, increasing the amount by $6,000 for FY 2006-07 and extending it an additional one-year, for a total agreement amount of $30,000 25.C_ AGMT NO. 2006-146 - WIRELESS SERVICES AND EQUIPMENT - Execute an amendment to the agreement with AWS in an amount not to exceed $120,000 — Finance and Management Services Agency 25.D. AGMT NO. 2006-147 — ARCHITECTURE AND URBAN DESIGN SERVICES — Execute an amendment to the agreement with Urban Studio in an amount not to exceed $76,000 — Planning & Building Agency 25.E. AGMT NO. 2006-148 — NATIONAL POLLUTION DISCHARGE ELIMINATION SYSTEM INSPECTION SERVICES - Execute a second amendment to the agreement with Geomatrix Consultants, Inc. in the amount of $100,000 for a total contract amount of $600,000 and extending the agreement for one year — Public Works Agency 251. AGMT — UNREPRESENTED PART TIME EMPLOYEES Motion: 1. Direct the City Attorney to prepare and authorize the City Manager and Clerk of the Council to execute an agreement. AGMT NO. 2006-150 - REGARDING WAGES, HOURS AND OTHER TERMS AND CONDITIONS OF EMPLOYMENT FOR PART TIME EMPLOYEES - With the Service Employees International Union Local 347 (SEIU) 2. Adopt a resolution. RESOLUTION NO. 2006-033 - A resolution of the City Council of the City of Santa Ana to amend Resolution Nos. 82-110 and 85-27 to reflect changes regarding represented part-time titles and provide pay increases for all part-time titles for Fiscal Years 2006-2007 and 2007- 2008 25.G. AGMT NO. 2006-151 — GOVERNMENT LIAISON SERVICES — With Ferguson Group in an amount not to exceed $75,000 — City Manager's Office 25.H. AGMT NO. 2006-152 — GOVERNMENT LIAISON SERVICES — With Townsend Public Affairs in an amount not to exceed $25,000 — City Manager's Office Councilmember Alvarez voted No on Item 25.H. CITY COUNCIL MINUTES 197 JUNE 19, 2006 /- - za1)�2-/ ACORD CERTIFICATE OF LIABILITY INSURANCE DAT;ii20/20 ' TM. 06 PRODUCER Prx,.: (800)395-8075 Fax: (858)519,0822 THIS CERTIFICATE IS ISSUED AS A MATTER OF FITNESS AND WELLNESS INSURANCE AGENCY INFORMATION 380 STEVENS AVENUE, SUITE 206 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SOLANA BEACH CA 92075 INSURERS AFFORDING COVERAGE NAIC # AgencyLiOli OD28716 INSURED INSURER A: Zurich North America CHOC V. LE INSURER e: 4 FABRIANO IRVINE CA 92620.2576 INSURER C: NSURER D. NSURER E: 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. NSR TR ADDL NSRp TYPE OF INSURANCE POLICYNUMBER POLICY EFFEmrvE ppTE MMN vpucr EzrwprlDM DATE(MMNp LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILIT CLAIMS MADJX OCCUR ST63733.00 12/17/06 12117107 EACH OCCURRENCE $ 1,000,000 OA.AGE TO RENTED PRE. SES(E......—) $ tOO,000 MED. EXP(My one person) $ 2,500 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PEE X POLICY PRO- LOC PRODUCTS-COMPIOP AGG. S 3,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per Person) $ BODILY accide t) (Per accident) $ PROPERTY DAMAGE Per accitlent $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGG $ $ EXCESS I UMBRELLA LABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION$ EACH OCCURRENCE $ AGGREGATE $ 5 $ It WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROYRIETORIPARTNENExECUTNrE OEFICER)MEMMEN CSCLUDED? ay... x..N .. EcuL PRPRwIWlaoxe slow ToevTurrnnD E.L. EACH ACCIDENT 5 E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS SEE SUPPLEMENTAL CERTIFICATE INFORMATION CERTIFICATE HOLDER :CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 CommunityRedevelopment A PRent Agency Y 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 of the City of Santa Ana INSURER, ITS AGENTS OR REPRESENTATIVES. 20 Civic Center Plaza (M-25) Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Attention: Jeffrey E. Frick, CEO ACORD 25 (2001108) Certificate # 51125 © ACORD CORPORATION 1988 RECE; ^ 6 2006 DATE SUPPLEMENT TO CERTIFICATE OF LIABILITY INS #51125 DEC 2006 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS The City of Santa Ana, and the City of Santa Ana, located at 20 Civic Center Plaza, Santa Ana, California 92701; and their respective off! employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and of suits arising from the operations and uses performed by or on behalf of the named insured. Additional Insured Endorsement is Effective: 12101106 /3 Certificate # 51125 CG 20 10 11 85 DATE: DEC 20 06 POLICY NUMBER: 5763733-00 INSURED NAME: CHOC V. LE 4 FABRIANO IRVINE CA 92620.2576 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization Job/Project: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section 11) 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' for that insured by or for you. Primary Insurance it is agreed that such insurance as is afforded by this policy for the benefit of the additional insured shown shall be primary insurance, and any other insurance maintained by the additional insured(s) shall be excess and noncontributory, but only as respects any claim, loss or liability arising out of the operations of the named insured(s) or its subcontractors, and only if such claim, loss or liability is determined to be solely the negligence or responsibility of the named insured. Notice of Cancellation or Non -renewal it is agreed that the company will provide the additional insured shown below with 30 days notice of cancellation of this policy in the event of cancellation due to company election only. WAIVER OF SUBROGATION It is agreed that we waive any right of recovery we may have against the person or organization shown in the schedule because of payment we make for injury or damage arising out of "your work' done under a contract with that person or organization. The waiver applies only to the person or organization shown in the schedule. SCHEDULE NAME OF PERSON OR ORGANIZATION The City of Santa Ana, its Respective Officers, Employees, Agents, Volunteers and Representatives 20 Civic Center Plaza (M-25) Santa Ana CA 92701 Y — % 610& — DATE (MWDDNYYY) ACORD TMCERTIFICATE OF LIABILITY INSURANCE 1212012006 . PRODUCER Phone. (800)395-8075 Fax (8M)519-0822 THIS CERTIFICATE IS ISSUED AS A MATTER OF FITNESS AND WELLNESS INSURANCE AGENCY INFORMATION 380 STEVENS AVENUE, SUITE 206 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SOLANA BEACH CA 92075 INSURERS AFFORDING COVERAGE NAIC # %49 INSURER B: 2620.2576 4-Aovu-145 INSURERC: INSURERD:NCOA r-%j091-/21—613 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00 INDICATED, NOTWITHSTANDING OL ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOWHICH 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. POLICY EFFELLNE VOLICY E%FIMTWN LIMITS L TYPE OF INSURANCE POOCV NUMBER DALE NMN oerE Nwop o E GENERAL LIABILITY 5763733.00 12117106 12117107 onM cEEACH o NERRNTECENCE $ X COMMERCIAL GENERAL LIABILIT nREP. lE. eccmrol CLAIMSMAD� OCCUR MED.EXP(Any onepeccon) $ PERSONAL 8 ADV INJURY $ rA 1,000,000 100,000 2,500 1,000,000 GENERAL AGGREGATE $ 3,000,000 GENT AGGREGATE LIMIT APPLIES PE PRODUCTS-COMPIOP AGG. S 3,000,000 X POLICY PRO- LOC AUTOMOBILE UABILITY COMBINED SINGLE LIMB (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED AUTOS SCHEDU LED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE $ Par ac Idenl GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EACH OCCURRENCE $ E%CESS I UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ we sinm-OiNEP WORKERS COMPENSATION AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT E E.L. DISEASE -EA EMPLOYEE 1 $ AkY ROPRIETOMPARTNFR6%FELINE OFFICERMEUSAR E%CLUOELI T.., a..�ns...a.. BPECALP ROV.... -1— EL. DISEASE -POLICY LIMIT Is OTHER: DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS SEE SUPPLEMENTAL CERTIFICATE INFORMATION neural I ennN CERTIFICATE HOLDER' - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVORTO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT Community Redevelopment Agency FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE of the City of Santa Ana INSURER, ITS AGENTS OR REPRESENTATIVES, 20 Civic Center Plaza (M-25) CA 92701 AUTHORIZED REPRESENTATIVE J y Santa Ana Attention: Jeffrey E. Frick, CEO ©ACORD CORPORATION 1988 ACORD 25 (2001108) Certificate # 51125 R E C E :::.: 6 2006 f SUPPLEMENT TO CERTIFICATE OF LIABILITY INS #51125 DDATE EC 2006 I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS The City of Santa Ana, and the City of Santa Ana, located at 20 Civic Center Plaza, Santa Ana, California 92701; and their respective offh employees, agents, volunteers and representatives are named as additional insureds ("additional Insureds") with regard to liability and of suits arising from the operations and uses performed by or on behalf of the named insured. Additional Insured Endorsement is Effective: 12/01/06 Certificate 9 51125 CG 20 10 11 85 DATE: DEC 20 06 POLICY NUMBER: 5763733-00 INSURED NAME: CHOC V. LE 4 FABRIANO IRVINE CA 92620-2576 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Job/Project: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section 11) 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' for that insured by or for you. Primary Insurance it is agreed that such insurance as is afforded by this policy for the benefit of the additional insured shown shall be primary insurance, and any other insurance maintained by the additional insured(s) shall be excess and noncontributory, but only as respects any claim, loss or liability arising out of the operations of the named insured(s) or its subcontractors, and only if such claim, loss or liability is determined to be solely the negligence or responsibility of the named insured. Notice of Cancellation or Non -renewal it is agreed that the company will provide the additional insured shown below with 30 days notice of cancellation of this policy in the event of cancellation due to company election only. WAIVER OF SUBROGATION It is agreed that we waive any right of recovery we may have against the person or organization shown in the schedule because of payment we make for injury or damage arising out of "yourwork" done under a contract with that person or organization. The waiver applies only to the person or organization shown in the schedule. SCHEDULE NAME OF PERSON OR ORGANIZATION The City of Santa Ana, its Respective Officers, Employees, Agents, Volunteers and Representatives 20 Civic Center Plaza (M-25) Santa Ana CA 92701 4 — o2OO -V— 122 A - A,Dv'% - /o? ;� -0 3 X _ 200#-/ Z-20 - ACORD DATE ' CERTIFICATE OF LIABILITY INSURANCE 1 0115120 8 TM. PRODUCER Phone: (800) 395.8075 Faa: (853; 519,0822 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION FITNESS AND WELLNESS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 330 STEVENS AVENUE, SUITE 206 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR SOLANA BEACH CA 92075 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NA1C it - Actrcy.lic»_037ie45: INSURED ;_INSURER A: Philadelphia Indemnity Insurance Company j CHOC V. LE INSURER B: RVINE IANO CA 92620-2576 INSURER C: 'INSURER D:- i INSURER E: ' nnvco Ar_ee 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 AFFORCED 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. !NSF AOG'L PODGY EFFECTIVE LTR INSR,� TYPE OF INSURANCE POLICY NUMBER DwTE'NNroD I POLICY EXPIRATION DATE (NIMInOtM! LIMITS j GENERAL LIABILITY PHPK215316 12/17/07 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR 12/17/08 LEAqHCCCURRENCE _. _.. Ga.+acE TO RENTED .REMISES EE ocarence) MED. EXP ;Any one ptrsen) f g 1,000,000 100 000 2,500 A I 'PERSONAL S ADV INJURY rrf ! f 1,000,000 �5 3,000,000 LI 'GENERAL AGGREGATE - I GEN-L AGGREGATE LIMIT APPLIES PER:: - ; PRODUCTS-COMP/OP AGG. I: 3,000,000 -I PRO - I X i POLICY 1 I JECT IF-1 Loc i I AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) S ALLOWNEDAUTOS BODILY INJURY 1 SCHEDULED AUTOS (Per ptrsan)$--'- { I S HIRED AUTOS ( NON-O'JVNED AUTOS{Pwaccidont) j BODILY INJURY f PROPERTY DAMAGE j (P.accident` GARAGE LIABILITY :. ANYAUTOTHER THAN EA ACC AAUTO f ONLY: AGG EXCESS 1 UMBRELLA LIABILITY i I ' EACH OCCURRENCE S OCCUR—, CLAIMS MADE AGGREGATE (5 �i $ _ i DEDUCTIBLE j 'f RETENTION f ':f WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORJPARTNER(E%EClIME OFFICEWMEMBER E%cwoEDY I I wC STATL i OTHER emuI %RY LIMITS 1 E.L EACH ACCIDENT f `E.L. DISEASE -FA EMPLOYEE ! 3 �IfY—.d .db.—der aPPtiAl PftovNUONs "I..'', -� /1 -r-E. E.L. DISEASE -POLICY UMIT 3 OTHER: I DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS SEE SUPPLEMENTAL CERTIFICATE INFORMATION Community Redevelopment Agency of the City of Santa Ana 20 Civic Center Plaza (M-25) Santa Ana CA 92701 Attention: 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. AUTHORIZED REPRESENTATIVE Jeffrey E. Frick, CEO 4CORD 25 (2001108) Certificate # 67706 © ACORD CORPORATION 1988 F SUPPLEMENT TO CERTIFICATE OF LIABILITY INS #67706 'AN1508 I DESCRIPTION OF OPERATION S/LOCATIONSNEHICLES/SPECIAL ITEMS It is understood and agreed that the The City of Santa Ana, it's agents, officers, employees, volunteers and representatives are added as an additional insured but only as respects the operations of the named insured except that liability resulting from the additional insureds sole negligence. This Insurance is primary and non-contributory to any other insurance held by the insured. Additicnal Insured Endorsement Is Effective: 12/17107 Certificate # 67706 CG 20 10 11 85 DATE: JAN 15 08 POLICY NUMBER: PHPK215316 INSURED NAME: CHOC V. LIE 4 FABRIANO iRVINE CA 92620-25576 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Job/Project: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section 11) 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" for that insured by or for you. Primary Insurance it is agreed that such insurance as is afforded by this policy for the benefit of the additional insured shown shall be primary insurance, and any other insurance maintained by the additional insured(s) shall be excess and non-contributory, but only as respects any claim, loss or liability arising out of the operations of the named insured(s) or its subcontractors, and only if such claim, loss or liability is determined to be solely the negligence or responsibility of the named insured. Notice of Cancellation or Non -renewal it is agreed that the company will provide the additional insured shown below with 30 days notice of cancellation of this policy in the event of cancellation due to company election only. WAIVER OF SUBROGATION It is agreed that we waive any right of recovery we may have against the person or organization shown in the schedule because of payment we make for injury or damage arising out of "your work" done under a contract with that person or organization. The waiver applies only to the person or organization shown in the schedule. SCHEDULE NAME OF PERSON OR ORGANIZATION City of Santa Ana, it's Respective Officers, Employees, Agents, Volunteers and Representatives. 20 Civic Center Plaza (M-25) Santa Ana, CA 92701