HomeMy WebLinkAboutDEKRA-LITE (3A)C ,~ CC~,fi D~/'
City of Santa Ana
-~ - ~~; Clerk of the Council
.~
AGREEMENT TERMINATION FORM
COTC Office Use Only
Please complete this form when the attached agreement and all amendments (if~anY1~~P ~ ~ ~,fi~ ~~ ~3
are no longer in effect.
1~'`~
Return form to the Clerk of the Council Office (M-30). ~~f ~ ~ ?~` ±`
Call 647-2520 if you have any questions. `~`
The agreement with ~rA~ ~I-~
pp
No. ~ s aQ~~~ ~,~ ~ ~ %j was completed on P ~jlJ 9 Ij ~ and final payment has been made.
(List all amendments. Use space below if needed.)
~/ Department: V~~"
~; ~
Signature: -i ~ i~A~-~ `.Q~_ i,~ ~~ l~ ~,i ~,
Date: ~-~ ~ ~ ~~
Revised 07-22-09
.-
INSURANCE ON FilE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
"I~ 8 .Or?
CLERK OF COUNCIL
1'IA:1E: NOV 8 W~1
0'. COA Ci)
Gap\:AJL.
N-2007 -113-01
FIRST AMENDMENT TO
CONSULTANT AGREEMENT
THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into
on October 17,2007, by and between DEKRA-LITE, a California 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 Agreement # N2007-113,i, dated September 21,2007,
(hereinafter "said Agreement") by which Consultant has installed holiday lighting and
banners on City property
B. In accordance with the terms and conditions of said Agreement, the parties wish to
amend the Scope of Services and increase compensation to pay for the additional
servIces.
WHEREFORE, in consideration ofthe covenants contained in said Agreement, and
subject to all the terms and conditions of said Agreement, except those amended in this
First Amendment to Consultant Agreement, the parties agree as follows:
1. Section 1, SCOPE OF SERVICES, shall be deleted in its entirety and replaced with
the following:
"Consultant shall install, remove and store City owned decorations as set forth in
Exhibit A to said Agreement. Consultant shall provide additional installation, renovation
and removal services as requested, in writing, by the Assistant City Manager for
Development Services. Such additional services shall be based on specific proposals
submitted by Consultant and approved by the City. The City hereby approves the
services set forth in Exhibits A-I and A-2, attached hereto."
2. Section 2, COMPENSATION, shall be amended to increase compensation by
$10,000, for a total not to exceed amount of $20,000 during the term of said
Agreement.
3. Except as hereinabove amended, all terms and conditions of said Agreement shall
remain in full force and effect.
W'
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to
Consultant Agreement on the date and year first written above.
CITY OF SANTA ANA
ATTEST:
'D~ :i ~J pPjw
1\'" ~IAE.fI ALY
Clerk of the Council
~
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By: /')ti \.',","-. c,. ))l"Lj (e t /-
I ; , r
Laum Sheedy
Assistant City Attorney
DEKRA-LITE
~,
f j
MIKE STERLING
General Manager
~
VDEKRA-LITE
~~0a/_~?^
3102 W. ALTON A.VE.
SA.NTA ANA. CA 92704
PHONE: 714.436.0706 FAX: 7t4.436.0612
PROPOSAL
PRP014253
DATE
PAGE:
9/7/2007
1
BILL TO:
SANTA ANA DOWNTOWN DEVELOP.
305 E 4TII STREET STE. 201
SANTA ANA CA 92701-4639
SHIP TO:
SANTA ANA DOWNTOWN DEVELOP.
1000 E SANTA ANA BLVD
SANTA ANA CA 92701
CAROLYN FULLERTON
PHONE (714) 565-4003 Ex!. 0000
FAX (714) 647-6549 Ex!. 0000
INSTALL DATE
REMOVAL DATE
DEe 2007
PO Number
Salesperson ID Shipping Method
SJ INSTALL
Payment Terms
50/50
Req Ship Date
0/0/0000
Master No.
16,403
Customer ID
SAN028
Quantity Item Number
Description UOM
4 TREELTGMISC
Palm Trees lit with low voltage clear clip lights Each
includes all materials, manpower and machinery for
installation.
Unit Price Extended Price
$1,335.75 $5,343.00
Please sign and fax to 714-436-0612
Subtotal
Tax
Freight
Total
$5,343.00
$306.88
$0.00
$5,649.88
$2,978.38
$2,671.50
WI! PfCP<lGC' nllrl:lW to i\.mish product ;nl,Io; IIlbolo ~ 10 acccroan;:e~h ilIbaWl SllCtiftcatia'ls, fer the ~ of
50% DEPOSrT oue UPON ACO:PTAi'lCe OF PROPOSAl
BALANCE AMCUNT CUE LI'ON INSTALLATION OR DEUVERY
ceneraI "R!tm!i: ihe Partle5 agree to me Folk:lwIng a:kttl:InaI terms of ttlis Contra<:!:
A <ie::osit of ~00t Is clJe upcn 8ll!3CUtiGn of tm tont<<lct ',/d1 the balarq due <:n the ~ ~ or dell>.lerydatv ri!7.; specifiecJiII:Jt:Mf. ~I~ changes Iv the ~tiEd wor1t wi be ~
ro *ICllllcn.ll ~ C;r!~;li'113 ~~;r. SlJbject ro a 30* ~g fft. Am ~ not pad \\tMn OYlt,.lI MJlCtto a Ilttell/tgl of 'l~per mOl'Ml18$ per ;l,.,um~ ~ G raporlSible
for I7tYldlnQar.cl ~~elet!IfCllIOlJlIetS~r>t to the PfOJ:IOlIl!<l/lxlltlw fotllt ~tkirl$iftd bJiIOI'lg~ ~e"f!Ot~for" fIW ~~cd flfloll;Mto~lIlI.
\Iltnrne YmU1lIlt cono~klm.<< iIct$ arC<<! ~r>;j ~ m;b4ff01't$ tonlllllat SIlCtl ~ toran~dlafge. AlICl1tK ~ n SUlljl(;t to ~aroe 4M 10 l'ltlllntW ~Oekr.l-IJr.t'MIlttl)laO& any
malfilrcti01ing ptCdud tul ebBs not ~ that 4lacn iMiviltJallalnp wi light dUIin!llhl ttlti"& inst;Ill(ll*iOd. T1lI!;~ is IWo'llmlld b\I CiI~ _ am is tI19 entinl calCr.I(;t blllMlln IN
p;;r1Ias,
sul)lne(fngal Prb' ~ W Yrii1g$ ~l:!1e IJrtles tlll'ltl fYCt1t ofa IIilIQIJte ilI'isi119 OIJt of tills cmttact..ttlc partieul'IaI dtratein<lr'qjll CDuntytefote a Sl'lglt l'tttral>::uelllCtlld~
.lA.M.s.te/!lllSPlJTE. Ant ~ up::n tl'll io'MlarCf IllI\lGeI'1d tlVtre~ _ bunteredInal't\'court t\Jvlo\I~ittIOnthercol'. The ~wt\lIrl-lJrb~#la/ltleentitledCiOlt$t'morntble
a~fe!l5<l""'OJSb. __"'......,._
Stacey Jordan~:;.:::=~:...
10 o.a.:2007.09.0109:4O:0100TOO'
Ifoot a:~ept&j Wltt1ln aays, ttis p-qxJS;II rmy be Wlthclrarm. Dek~
~of F'roIlOJIt The irt::fviclllIIltiQrlinQ ttliJContr.lct lIOC<<lt$ll'le ~I'roc:ola anlter'tiflC$ to ~Ulllt that he orVit i$~ to~ it1b;l Ihi$Ccn~ 00 bel1#cfOwrllll'.
Property Owner.
.l\uthorizro Ager.t:
D.....,
By;
EX'" 12
J"IJ _ ji
/.
v
VOEKRA-LITE
~ c;ff~w fJ/0U# ~
3102 W. ALTON AVE.
SANTA ANA, CA 92704
PHONE: 714.436.0706 FAX: 714.436.0612
PROPOSAL
PRP013436
DATE
PAGE:
6/25/2007
1
BILL TO:
SANTA ANA DOWNTOWN DEVELOP,
305 E 4TH STREET STE, 201
SANTA ANA CA 92701-4639
SHIP TO:
SANTA ANA DOWNTOWN DEVELOP,
305 E 4TH STREET STE. 201
SANTA ANA CA 92701-4639
GABY LOMELI
PHONE (714) 647-5479 Ex!. 0000
FAX (714) 657-6549 Ex!. 9000
INSTALL DATE
REMOVAL DATE
PO Number Customer ID Salesperson ID Shipping Method Payment Terms Req Ship Date Master No.
SAN028 SJ INSTALL Net 30 0/0/0000 15,508
Quantity Item Number Description UOM Unit Price Extended Price
10 REFURBISH DECOR Refurbish Customer owned Overhead Decor Each $0.00 $0.00
remove existing bows and replace with 18"
structural bows. (6) per Overhead Element.
60 BOWBI18RED23T AIL 18" Red Structural Bow with 23" Tails Each $45.00 $2,700.00
I SALESDISCOUNT Sales Discount Each ($175.00) ($175.00)
Please sign and fax to 714-436-0612
we propose hereby to furrish product arxll or 1alJor. completely in accordance WIth allow specifications. for the sum of
Subtotal
Tax
Freight
Total
$2,525.00
$195.68
$0.00
$2 720 68
$2.720.68
$0.00
SO% DEPOSIT DUE UPON ACCEPTANCE OF PROPOSAL
BALANCE AMOUNT DUE UPON INSTALLATION OR DEUVERY
General nmns: The Il<lIties agree to the fOlloWing adcWonaJ tl!n'ns of tl1ls Contract
A deIlOSlt of 5011. is due ~ execution of thiS Contract with the balance due on the installation date a- delivery date unless S!ltlCified alxM!. All reQuested changes to the aIJove.<lescribed
'Mlrlc wi be subject
to acIditionaI charges, Cancellations and r1KIuctions are subject to a 30% restocking fee. Arrv amount not paJd when due, ;s subject to a late Charge of 1.5% per month (18% per annuli).
Owner is R!$IlOI1Sible
fOr J)rO\Iidi'lg and maintalning adeQUate electrical outlets adjacent to the proposed lOCations fOr lit decorations and bullclinO lightS. OetC3-llte is not I'l!SllClmlble fOr arrv IlCOdUCtS
damaged or lOSt ooe to vandalism.
extreme weather conditions, Of acts of Cod and wilt mal<e efforts to replace such product fOr an adcIitional charge. All dates specified are subject to change due to i'ldement weather.1Jl!Imt.l.ilr
WI replace any
mallU1ctiol'ling product bUt does not gua-antee that each indlvIduallamp y,jilllg/lt during the entre inStaled IlOOOd. ThIs Contract is pemed by CaIifomla law and is tile entlre CDlltract
between tile parties,
5UIll!f'5l!CIng all prlor conversations and writk1gs between the partie$. In tile event of a disllute arlsiog out Of thiS Contract. the parties wi arbitrate in CI'ar1ge County befQre
a slngJe arbitrator selected thrOUGh
J.A.MSjENDISPUTE. Arrv jJdgement lJPOI1 the award rendered by the artlitTator may be entered in any court hiIvinIl jurisdiction thereof. The prevaDlg partY in arbitration shall be entitled
to its reasonable
attomeys'fees and costs. __..s__
Stacey Jordan ~"'-::.=:"~am
Dele: 2007..06.25 12:38:01 -GTOO'
If not accepted withln
3 0 days. this proposal may be withdrawn
Deknl-\.Ita:
AceeptanCe of PrOposal: The indMcluaJ sionJng this Contract acCl!Dts tile aboYe ProIlosaI and certifies to Delcra-Ute that he or she is authorized to enter into this Contract on behalf
Of OWner:
Date:
::::::;"1'\&1.'1'\ 0- tk.m do
ev U P:Ul' A',..
I..../'.II,!..:"<I
ACORQ" CERTIFICATE OF LIABILITY INSURANCE I DATE IMMIOOIYYYY)
06104/2007
PRODUCER Stone Witter Insurance Services, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
POBox 8035 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
CA Ins Lie OF15720 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Long Beach, CA 90808-8035
Ph: 562-420-3422 FAX: 562-420-1022 INSURERS AFFORDING COVERAGE NAIC"
INSURED DEKRA-L1TE INDUSTRIES, INC. INSURER A St Paull Traveler's Companies 41521
The Jeffrey Lopez Rev.Trust dtd 03104197 INSURER B;
3102 W. Alton Ave. INSURER C;
Santa Ana, CA 92704-6817 INSURER 0;
I INSURER E;
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOiWlTHSTANDING
A/oN 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.
~ ~~~ 'TV.........,. I POUCY NUMBER PJli?~~~~~~R~~ POUCY EXPIRATION UMITS
OAT
IZI GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
~ ~~EMtSE" ,~. occurencel
,i.. OMERCIAI. GENERAL LlABILllY 6600420LS52 04/08/2007 04108/2008 S
CLAIMS MADE [Z] OCCUR MED EXP (Any one penon) S 5.000
- S 1,000,000
- PERSONAl. & ADV INJURY
- GENERAL AGGREGATE S 2,000,000
GEN"L AGG~nE LIMIT APPLIES PER; PRODUCTS. COMP/OP AGG S 2,000,000
f7l POLICY p'~f!.r n LOC
[Z] ~TOMOBILE LIABILITY COMBINEO SINGLE LIMIT S 1,000,000
~ ANY AUTO BA1863L705 04/08/2007 0410812008 (Ea accident)
,i;. ALL OWNED AUTOS BODILY INJURY S 1,000,000
~ SCHEDULED AUTOS (Per person)
,i;. HIRED AUTOS BODII. Y INJURY S 1,000,000
~ NON-OWNED AUTOS (Per accident)
--
~ PROPERlY DAMAGE S 1,000,000
(Per accident)
ID GARAGE L1ABIUTY AUTO ONLY - EA ACCIDENT S
R ANY AUTO OTHER THAN EA ACC S
AUTO ONL Y; AGG S
IZI 0'ESSIUMBRELLA LIABILITY EACH OCCURRENCE S 2 000 000
,f OCCUR 0 CtAJMS MADE CUP6374Y17A 04/0812007 04/08/2008 AGGREGATE S
S
B DEDUCTIBLE i S
RETENTION S , S
WORKERS COMPENSATION AND PX~Jr~T.'t~ I lOr.:-
EMPLOYERS' LIABILITY
my PROPRIETORIPARTNERJEXECUTIVE E.L. EACH ACCIDENT S
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE S
~~I~l~'Ovrs~~~s below E.L. DISEASE - POLICY LIMIT S
OTHER
DESCRIPTlOH OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDEO BY ENDORSEMeHT I SPECIAL PROVISIONS
Downtown Christmas Decorations. City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as additional
insured as respects to the Insureds operations and ONLY if required by written contract per the attached endorsement 30 days NOC Bxcept for 10
days for non payment of premium.
CERTIFICATE HOLDER
CANCELLATION
City of Santa Ana SHOUI.D AK'f OF THE ABOVE DESCRIBED POLICIES BE CANCELLED IIEFOAI! THE EXPIRATION
altn: DaneU Mercado DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
20 Civic Center Plaza M-25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO so SHALL
Santa Ana, CA 92701 IMPOSE NO OBLIGATION OR L1AIlILlTY OF ANY KIND UPON THE 'NSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHO~EOREPRESENTAT~ ~tl .a M- 4-;"
I
ACORD 25 (2001/08)
Produced using Form.~QI.~t~~~:.,~.F~~~C~; ~~.~.IY" '{'bUshing &00-208.1577
- - ,j ..........' . "Vii
----. ~.'~~.<; ',~ . ~ -~..{Y1.:/L~~
(~7", ---
@ACORDCORPORATION 1988
To: 15624201022 Page: 2/11 Date 611f2007 8:46:06 AM
CHANGE EFFECTIVE DATE: 05-24-07
CHANGEENDORSEMENTNUMBER:~
e TRA VE LE R 5 One Tower Square, Hanford. Connecticut 06183
CHANGE ENDORSEMENT
Named Insured:
DEKRA-LITE INDUSTRIS, INC. THE
JEFFREY LOPEZ REVOCABLE TRUST
Policy' Number: I-560-0420L552-TIL_07
Policy Effect~ve Date: 04/08/07
Issue Date: 05/30/07
Additional Premium $ 109
INSURING COMPANY:
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
Effective from OS/24/07 at the time of day the policy becomes effective.
THIS INSURANCE IS AMENDED AS FOLLOWS:
ADDITIONAL INSURED (CONTRACTORS), CG 02 47, 08-0S,
IS AMENDED AS FOLLOWS:
THE FOLLOWING HAS BEEN ADDED AS AN ADDITIONAL INSURED TO FORM
CG D2 47:
CITY OF SANTA ANA
20 CIVIC CENTER PLAZA M-25
POBOX 1988
SANTA ANA CA 92701
Stone Witter Insurance Services, Inc.
POBox 8035
Long Beach, CA 90808-8035
Ph: 562/420-3422
CA Ins Uc OF15720
NAME AND ADDRESS OF AGENT OR BROKER:
DATE:
,-.: ~~.J i'-'~>..) '1 ',:~)FL);~~!\'1
....... ~-..?/I_
~;~~]...(Cl/
},..,L<.;!L ''--'':;lyAtt{)r;~,3V
10: 15624201022
Page: 3/11 Date: 611120078:4606 AM
CHANGE EFFECTIVE DATE: 05-24-07
CHANGE E.NDORSEMENT NUMBER: 0004
,. TRAVELERS
POLlSY NUMBER: 1-660-0420L552-TIL_07
EFFECTIVE DATE: 04-08-07
ISSUE DATE: 05-30-07
LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORS&MENTS
BY LINE OF BUSINESS.
It TO 07 09 87
It T8 01 10 93
CHANGE ENDORSEMENT
FORNS, ENDORSEMENTS AND SCHBDULE NUMBERS
COMMERCIAL GENERAL LIABILITY
CG D2 47 08 05
ADDITIONAL INSURED ( CONTRACTORS)
AIPROVEU /\S TO FOlZM
-~3Lf=-.
LaL:r:l ~~t.;l
,A.~~)lsr.ant \~i(,/ AI1\..':-'-.,,;;v
IL TB 01 10 93
PAGE:
1 OF
1
10: 1 :Jti:l4:lUl UZ~
POLICY NUMBER: 1-660-0420L552-TIL_07
Page: 8/11
Date: 6/1120078:46:08 AM
COMMERCIAL GENERAL LIABILITY
ISSUE DATE: OS-]0-07
THIS ENDORSEMENT CHANGES THE rOLlCY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
(CONTRACTORS)
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSON(S) OR ORGANIZA TION{S):
CITY OF SANTA ANA
20 CIVIC CENTER PLAZA M-25
POBOX 1988
SANTA ANA CA 32701
PROJECT/LOCATION OF COVERED OPERATIONS:
INSTALL 71 WREATH POLE MOUNTS
AND 10 OVERHEAD STREAMER
1. WHO IS AN INSURED - (Section II) is amended
to include the person or organization shown in the
Schedule above, but:
a) Only with respect to liability for "bodily inJury",
"property damage" or "personal injury"; and
b) If, and only to the extent that, the Injury or
damage is caused by acts or omissions of
you or your subcontractor in the performance
of "your work" on or for the project, or at the
location, shown in the Schedule, The person
or organization does not qualify as an addi-
tional insured with respect to the independent
acts or omissions of such person or organiza-
tion,
2. The insurance provided to the additional insured
by this endorsement is limited as follows:
a) In the event that the limits of Insurance of
this Coverage Part shown in the Declarations
exceed the limits of liability required by a
"written contract requiring insurance" for that
additional insured. the insurance provided to
the additional insured shall be limited to the
limits of liability required by that "written con-
tract requiring insurance", This endorsement
shall not increase the limits of insurance de-
scribed in Section III - limits Of Insurance.
CG 024708 05
b) The insurance provided to the additional in-
sured does not apply to "bodily injury", "prop-
erty damage" or "personal injury" arising out
of the rendering of, or failure to render, any
professional architectural, engineering or sur-
veying services, including:
i, The preparing, approving, or failing to
prepare or approve, maps, shop draw-
ings, opinions, reports, sUNeys, field or-
ders or change orders, or the preparing,
approving, or failing to prepare or ap-
prove, drawings and specifications; and
ii. Supervisory, inspection, architectural or
engineering activities,
c) The insurance provided to the additional in-
sured does not apply to "bodily injury" or
~property damage" caused by "your work"
and included in the "products-completed op-
erations hazard" unless a "written contract
requiring insurance" specifically requires you
to provide such coverage for that additional
insured, and then the insurance provided to
the additional insured applies only to such
"bodily injury" or "property damage" that oc-
curs before the end of the period of time for
which the "written contract requiring insur-
ance" requires you to provide such coverage
A: ,-'f;l")'\/;;~J' ~,('
. -........ 'A....,(i J-1L.,)
! ,~> ,,-j/l
<> 2005 The SI. Paul T",vele", Co",,:,~e:'.'.~f~
"-. " j ~; ,;. ~
Page 1 of 2
.-;tJ./
',.:." I,; (l L '.~.:;~. ..; j- Ci':.
r
10: 1:>ol4lUl022
Date: 6/1/2007 8:46:08 AM
COMMERCIAL GENERAL L1ABIUTY
or the end of the policy period, whichever is
earlier.
3. The insurance provided to the additional insured
by this endorsement is excess over any valid and
collectible "other insurance", whether primary.
excess. contingent or on any other basis, that -is
available to the additional insured for a loss we
cover under this endorsement. However, if a
"written contract requiring insurance" for that ad-
ditional insured specifically requires that this in-
surance apply on a primary basis or a primary
and non-contributory basis, this insurance is pri-
mary to "other insurance" available to the addi-
tional insured which Covers that person or organi-
zation as a named Insured for such loss, and we
will not share with that "other insurance". But the
insurance provided to the additional insured by
this endorsement still is excess over any valid
and collectible "other insurance", whether pri-
mary, excess, contingent or on any other basis,
that is available to the additional insured when
that person or organization is an additional in-
sured under such "other insurance".
4. As a condition of coverage provided to the
additional insured by this endorsement:
a) The additional insured must give us written
notice as soon as practicable of an "occur-
rence" or an offense which may result in a
claim. To the extent possible, such notice
should include:
i. How, when and where the "occurrence"
or offense took place;
ii. The names and addresses of any injured
persons and witnesses; and
iii. The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b) If a claim is made or "suit" is brought against
the additional insured, the additional insured
must:
Page 2 of 2
Page: 9/11
i. Immediately record the specifics of the
claim or "suit" and the date received; and
ii. Notify us as soon as practicable.
The additional insured must see to it that we
receive written notice of the claim or "suit" as
soon as practicable.
c) The additional insured must immediately
send us copies of all legal papers received in
connection with the claim or "suit", cooperate
with us in the investigation or settlement of
the claim or defense against the "suit", and
otherwise comply with all policy conditions.
d) The additional insured must tender the de-
fense and indemnity of any claim or "suit" to
any provider of "other insurance" which would
cover the additional insured for a loss we
cover under this endorsement. However, this
condition does not affect whether the insur-
ance provided to the additional insured by
this endorsement is primary to "other insur-
ance" available to the additional insured
which covers that person or organization as a
named insured as described in paragraph 3.
above
5. The following definition is added to SECTION V.
- DEFINITIONS:
"Written contract requiring insurance" means
that part of any written contract or agreement
under which you are required to include a
person or organization as an additional in-
sured on this Coverage Part, provided that
the "bodily injury" and "property damage" oc-
curs and the "personal injury" is caused by an
offense committed:
a. After the signing and execution of the
contract or agreement by you;
b. While that part of the contract or
agreement is in effect; and
c. Before the end of the policy period.
/. ~,
1-'..,) TO FOR.M
~-:57s-
.t. i, "'1,,', \, -~;---
,. .'1Upr1"'
-' "ey
@ 2005 The St. Paul Travelers Companies, Inc.
CG 02 47 OB 05