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Home My WebLink AboutJ&G INDUSTRIES INC. (2) A-2022_065-01A MAYOR --_ CITY MANAGER Valerie Amezcua y -. Alvaro Nunez MAYOR PRO TEM r " CITY ATTORNEY Benjamin Vazquez ` �`+ Sonia R.Carvalho COUNCILMEMBERS f' I; CITY CLERK Phi[Bacerra , Jennifer L.Hall Johnathan Ryan Hernandez Jessie Lopez David Penaloza Thai Viet Phan CITY OF SANTA ANA PUBLIC WORKS AGENCY INSURANCt UN FILE 20 Civic Center Plaza•P.O.Box 1988 WORK MAY PROCEED Santa Ana,California 92702 UNTIL INIIJ A CE 111IR11 www.santa-ana.org CITY Il DATECLERII APR 2 2025 Match 17, 2025 J&G Industries, Inc, Attn: James K. Cain, President PKv �PZIU t4 18627 Brookliurst St., PMB 302 Fountain Valley, CA 92708 Re; Extension of Agreement A-2022-065-01 for On-Call Demolition Services Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by J&G Industries, Inc. ("Contractor")and the City of Santa Ana, dated May 3, 2022, the time period of the Agreement is hereby extended for an additional one(1)year period until April 14,2026. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other-terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, abil.Saba, PE Executive Director, Public Works Agency CITY F ANTA AN ATTEST - Alvaro Nunez ennifer Ial City Manager ..ty- APPROVED AS TO FORM CONTRACTOR -` K ellesen a es K. Cain Assistant City Attorney Pr sident SANTA ANA CITY COUNCIL Valerie Annezwa eeniannh Vazquez Thal Met Phan Jessie Lopez Phil Bacerra Jchnathan Ryan Hernandez David Penaloza Mayor Mayor Pro Tern,Ward 2 Ward 1 Ward 3 Ward 4 Ward 5 Ward 6 varngma lanla-ana.orq 6yazaoeztalsento-ana.ao tohanAsania-ana.om leeelalopezReanta-ene.orn obace"09antaaPworo iryanhemandaz®senta-ana,ora deora�gzafisanta-ana.ora A - I DATE IMMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F11/112024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policlas may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Phone: (707)996-2912 CONTACT Jerilee Carpenter Fax: (707)996-7912 NAME: Apollo General Insurance Agency,Inc,(1) PHONE A1C Nc E-MAIL jerileec@apgen.com apgen.com P.O,Box 1508 ADDRESS: Sonoma,California 95476 INSURER(S)AFFORDING COVERAGE NAIC9 INSURER A: Nautilus Insurance Company 17370 INSURED INSURERS: Key Risk Insurance Company 10895 J&G Industries,Inc. INSURERC: Slate Compensation Insurance Fund OfCa[sfornia 35076 18627 Brookliurst Street INSURER D: Tokio Marine America Insurance Co 10945. PMB 302 Fountain Valley,CA 92708 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:1493 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i POL LTR TYPE OF INSURANCE ADDLSUER POLICYNUMBER AM0IbYfYYYY MMlOECIYEXP LIMITS ✓ COMMERCIAL GENERAL LIABILITY ECP2038906-12 Il/I/2024 II/1/2025 EACHOCCURRENCE $ 1,000,000 A CLAIMS-MADE a OCCUR 100,000 PREMISES Eaaceurrenee $ ✓ Professional$1,000,000 y Y MEDEXP Anyoneperson) PERSONAL&ADV INJURY S 1,000,000 GI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 2]PRO Lf3C PRODUCTS•COMPIOPAGG $ 2,000,000 OTHER: Pollution $ 1,000,000 AUTOMCBILE LIABILITY BAP2041776-11 11/1/2024 11/1/2025 COMBINEDI SINGLE LIMIT $ 1,000,000 a 2cr ANY AUTO BODILY INJURY(Per person) $ AO OS ONLY WNED SCHEDULED BODILY INJURY(Per accident) $ HIRED j/ NON-OWNED PROPERTYDAMAGE S AUTOS ONLY AUTOS ONLY Par acddenl VMBRELLALIAB OCCUR FFX2038907-12 11/1/2624 11/1/2025 EACH OCCURRENCE $ 5,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000- OE D RETENTION S Y $ WORKERS COMPENSATION 9346758-24 10/1/2024 1011/2025 ERH C AND EMPLOYERS'LtABILITY ANYPROPRIETORIPARTNERIEXE:CUTIVfE YIN N E.L.EACH ACCIDENT S 1,000,000 OFROERIM EMBER EXCLUDED? O NIA Y I,000,000 (Mandatory In NH) E.L.DISEASE-FA EMPLOYEE $ If yes,describe under 1 000 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S , D Inland Marine(Commercial) ✓ Y CPP6412447-00 11/1/2024 11/1/2025 RcwcD`Laau&,Pet Item 750 Renlednaased:Perbccorr"ce 75 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES IACORD 101,Addlllonal Remarka Schedule,may be attached I!mare space is required)Continued on Attached Supplement. Re: "Demolition Services on an On-Call basis Agreement: A-2022-065-01". Operations of the Named Insured, City of Santa Ana, its officers, officials, employees, and volunteers are hereby named as Additional Insured, if required by written contract, per endorsement hereto. Waiver of Subrogation is provided, as required by written contract with the insured as respects coverage evidenced herein. Coverage evidenced herein is primary and non-contributory. Excess (schedule of controlling underlying insurance attached) is follow form to the underlying General Liability, Commercial Auto and Workers Compensation Coverage, A 30-day written notice shall be mailed to the certificate holder at the address provided herein, should a described policy(s) be cancelled before the expiration date thereof; 10-day CERTIFICATE HOLDER CANCELLATION APPROVED Holder's Nature of interest:Additional Insured Sy Cynthia Mora at 8:52 am,,tan 16,2t?25 SHOULD ANY OF THE:ASO City of Santa Ana THE (EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza M-30 Santa Ana,CA 92702 AUTHORIZED REPRESZ1. nVE �� 9 C119811-2015 ACORD CORPORATION, All rights reserved, ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD