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HomeMy WebLinkAboutPLANNING CENTER, THE 2B -1998 ~ - ~~_ D i Consultant Services by The Planning Center ~- 2 c~ ~~ to prepare EIR/EIS for Fairview Widening /~t~/~ Project # 1579 ~" /°V" ' WO # 49427 & 46600 Project Manager Shahir Gobran $ 253,755.00 ,_._. ~ :~.._ -~ p~-, o~ -.~ AMENDMENT TO AGREEMENT THIS AMENDMENT TO AGREEMENT, made and entered into this day of 1998, by and between THE PLANNING CENTER, hereinafter refereed to as "CONS LTANT" and the City of Santa Ana, a municipal corporation, of the State of California, Post Office Box 1988, Santa Ana, California 92702, hereinafter referred to as "CITY". WITNESSETH A. The City and Consultant entered into that certain Agreement, dated August 8, 1995 by which consultant agreed to provide environmental and engineering services (the "Agreement") B. The parties do now desire to amend the Agreement to provide additional environmental and engineering services. Wherefore, in consideration of their mutual and respective promises, and subject to the terms and conditions of the Agreement has hereby amended, the parties hereto do hereby agree as follows: 1. The Recital, Section A, of the agreement is amended to read as follows: r • CITY desires to retain a professional firm with special skills and knowledge in the fields of environmental protection and engineering for the following purposes: to prepare an EIR/E/S and engineering studies for Fairview Street widening from the intersection with Fifth Street to Garden Grove Boulevard. 2. The Recitals, Section B, of the Agreement is amended to read as follows: CITY has prepared and distributed a REQUEST FOR PROPOSAL (RFP) dated May 1, 1995, to solicit proposals from qualified firms for the required professional services. In response to the RFP, CONSULTANT submitted a proposal dated May 24, 1995, to perform such services. A separate Fee Proposal, dated May 24, 1995, was submitted. A Revised Fee Proposal and Scope of Work dated August 14, 1995, was subsequently submitted. A Fee proposal for additional environmental and engineering services dated October 15, 1997 and dated January 20, 1997, was submitted. The Proposal, the Revised Fee Proposal and Scope of Work and the Fee proposals for the additional services are hereinafter collectively referred to as the "PROPOSAL". The RFP and the PROPOSAL are public records on file in the offices of the Executive Director of the CITY's Public Works Agency and are incorporated in their entirety as though set forth in full. 3. Section 1 of the Agreement is amended to read as follows: CONSULTANT agrees to provide environmental and engineering services for the widening of Fairview Street from the intersection with Fifth Street to Garden Grove Boulevard. CONSULTANT agrees to pen`orm all services, produce all documents, and 2 • fulfill all requirements at its own cost and expense except for the compensation specified in the RFP and the PROPOSAL, subject to such modifications as may be set forth in the text of this AGREEMENT. In the event of any inconsistency between the RFP and the PROPOSAL, the PROPOSAL and the revised fee proposals shall control, unless otherwise stated in the text of this AGREEMENT. In undertaking the performance of this AGREEMENT, CONSULTANT represents that it is knowledgeable in the fields specified in Recital A of this AGREEMENT, and that any services performed by CONSULTANT under this AGREEMENT will be performed in compliance with such standards as may be expected from a professional consulting firm in that field. 4. Section 2 of the Agreement is amended to read as follows: Consultanf's performance of this Agreement shall be completed by January 20, 1998, subject to extension with the approval of the CITY Project Manager, which shall not be unreasonably withheld. CONSULTANT shall commence work no later than five (5) working days following receipt of a Notice to Proceed from CITY. 5. Section 3 of the Agreement is amended to read as follows: CITY agrees to pay, and CONSULTANT agrees to accept for said services, an hourly rate and direct cost as specified in the PROPOSAL. The total compensation for the entire scope of service as specified in the PROPOSAL shall not exceed Two Hundred Fifty Three Thousand Seven Hundred and Fifty-Five Dollars ($253, 755) without written approval of the CITY. 3 ,. 6 Section 4 of the Agreement is amended to read as follows: If CONSULTANT performs additional services for CITY which are clearly above and beyond the scope of the RFP and the PROPOSAL, and as paid for under Section 3 above, and are authorized in advance in writing by the City of Santa Ana, CONSULTANT shall be compensated at an hourly rate and direct cost in accordance with the hourly rate schedule included in the PROPOSAL, however, that such additional services shall not exceed $25,375. IN WITNESS WHEREOF, the parties hereto have executed this Amendment to Agreement the date and year first above written. ATTEST: anice C. Guy Clerk of the Council ' APPROVED AS TO FORM: ,~ ~~--tom .Joseph W. Fletch r City Attorney RECOI~IIMENDED FOR~P'F~ROVAL: CITY OF SANTA By: i~uel A. Pulido ayor APPROVED AS TO CONTENT: ~~ ~. Dave N. Ream City Manager THE PLANNING CENTER By: mes G. Ross Dwa~ Executive Director Princ Public Works Agency agree:SG:fairview amendment rev/nhs 4 REQUEST COUNCIL FOR ~ ACTION CITY COUNCIL MEETING DATE: FEBRUARY 2, 1998 TITLE: eapcacion l8r SECOND AMENDMENT TO AGREEMENT FOR FAIRVIEW STREET WIDENING PROJECT BETWEEN SANTA ANA RIVER AND ROUTE (PROJEC NO. 1 79) ~~ CLERK OF COUNCIL USE ONLY: APPROVED ^ As Recommended ^ As Amended ^ Ordinance on 15t Reading ^ Ordinance on 2"d Reading ^ Implementing Resolution ^ Set Public Hearing For CONTINUED TO FILE NUMBER ~, ~ ~ ~~ ~ ~ RECOMMENDED ACTION Direct the City Attorney to prepare and authorize the Mayor and Clerk of the Council to execute a second amendment to the agreement with The Planning Center to prepare an environmental document and preliminary engineering plans in the amount of $34,855 for a total contract amount not to exceed $279,132. DISCUSSION In August 1995, the Council authorized approval of an agreement with The Planning Center to prepare environmental documents and preliminary engineering plans for the Fairview Street widening project. The approved project limits are from the Santa Ana River in the City of Santa Ana to State Route 22 in the City of Garden Grove {Exhibit 1) The City of Santa Ana is acting as the lead agency. The project consists of improving Fairview Street to major arterial standards which include three general purpose lanes in each direction, a raised 14-foot median and widening the Fairview Street Bridge at the Santa Ana River. Additionally, due to the potential number of residential takings and business displacements, an Environmental Impact Report (EIR)/ Environmental Impact Statement (EIS) will be prepared. The EIR/EIS is required so the option of seeking federal funding for future phases of the project would be available. The project is now 75o complete. On July 22, 1997, staff met with California Department of Transportation (CALTRANS) and Federal Highway Administration (FHWA) representatives. .They requested revisions to the original scope of work. As a result, on November 3, 1997, Council authorized an amendment to the agreement with 059 - • • Second Amendment To Agreement For Fairview Street Widening February 2,1998 Page 2 The Planning Center for $20,515 resulting in a total contract amount not to exceed $244,277. Most recently, FHWA requested that the project's southern terminus at the Santa Ana River be extended to Fifth Street, a distance of approximately 2000 feet. They indicated the extension will provide Fairview with a continuous six lane facility from the San Diego Freeway to the Garden Grove Freeway. Since CALTRANS and FHWA are both City desires the opportunity to funding, staff is recommending the the additional work requested by additional items is $34,855. participants in this project and the apply for future State and Federal project scope be revised to include CALTRANS and FHWA. The cost of the FISCAL IMPACT Funds for this project are budgeted and in the Fairview Street Widening Project (project no. 1579, account no. 59-551-6631, account no. 32-551- 6631 and account no. 35-631-6631). APPROVED AS TO FUNDS AND ACCOUNTS: ~a s ~.-xo s ~ l E cutive i ector lic Wo Agency 3-2 RFCA-Fairview widening(sg/nh) ~. Rod R. Coloma Executive Director Finance & Management Services 0 ~ o • • i ACORD CERTIFIC OF OP ID T DATE(MMlDD/YY) LIABILITY INSU NCB , ANN-1 09/10/01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE John Burnham Insurance Service HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 2415 Campus Dr. , Suite 200 , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Irvine CA 92612 . Phone:949-833-2462 Fax:949-833-0127 INSURERS AFFORDING COVERAGE INSURED INSURER A: Assurance COm an of America INSURER B: CNA Insurance Co . The Planning Center Inc INSURER C: 1580 Metro Drive Costa Mesa CA 92626 INSURER D: ~'I/S INSURER E: VVYCRFiV GJ 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. LTR TYPE OF INSURANCE POLICY NUMBER LI FE IV DATE MM/DD/YY P LI EXPI TI N DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1, 0 0 0, 0 0 0 A X COMMERCIAL GENERAL LIABILITY PPS035165530 07/01/01 07/01/02 FIRE DAMAGE (Anyone fire) $ 50, 000 CLAIMS MADE ~ OCCUR MEO EXP (Any one person) $ 5 ~ Q Q Q PERSONAL & ADV INJURY $ ] Q D Q Q Q 0 , ~ ~ GENERAL AGGREGATE $ 2 Q Q Q Q Q Q GEN'L AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS -COMP/OP AGG ~ ~ $ 2 , O O O , O O O POLICY LOC JECT AU TOMOBILE LIABILITY A X ANY AUTO PPS035165530 07/01/01 07/01/02 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ALL OWNED AUTOS .~~( Rl`11 SCHEDULED AUTOS L+ ~ ~O _ BODILY INJURY (Per person) $ X HIRED AUTOS t~ 7 ~ Y~ ' O X NON-OWNED AUTOS ~ ~~ ~ BODILY INJURY (Per accident) - - $ ,L S~ O ~CJp` ~~ t r•a1~y tDAMAGE P O d $ `, er a c en ( GARAGE LIABILITY ,w~q~$a ~IM'_ L 1 AUTO ONLY-EA ACCIDENT $ ANY AUTO ~ OTHER THAN ~ ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ 4~ 0 0 0~ 0 0 0 A OCCUR ~ CLAIMSMADE PPS035165530 07/01/01 07/01/02 AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ OTHER B Professional MCE114003308 07/01/01 07/01/02 Per Claim 1,000,000 Liabilit 3 YR TAIL AVAILABLE Ann A re 1,000,000 DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS See Additional Insured Form No. CG2010 (10/93) r~oT~rrn wTr u~. r.rr. I __ SANTAAN City of Santa Ana Planning Division Attn: Tonia Zerba 20 Civic Center Plaza, Santa Ana CA 92701 ACORD 25-S (7/97) M-20 ~..' _ .. a:.... ; ~i ~ rt .; .; ! ~~';!y'~ .._...1 V'.. SHOULD ANY OF 7HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP DATE THEREOF, THE ISSUING INSURER WILL87I1~9SOInQ}~D MAIL ~~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT I~+#~~I~Fi6ifl~X~iL~~~iK7~F~kiik4lSA~i~€Io~~Ak~+1~ii~# ~iFE~~Fi~~ AUTHORIZED REPRESENTATIVE i ©ACORD CORPORATION 1988 GENERAL ENDORSEMENT In consideration of an additional premium of N/A it is hereby understood and agreed that the following applies: [ X ] ADDITIONAL INSURED City of Santa Ana and its officers, agents employees and volunteers as additional insureds [ X] PRIMARY COVERAGE With respect to claims arising out of the operation of the Named Insured, such insurance as afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the above Additional Insured/s. [ ] CROSS LIABILITY CLAUSE The naming of more than cne person, firm or corporation as insureds under this policy shall not, for that reason alone, extinguish any rights of one insured against another, but this endorsement, and the naming of multiple insureds, shall not increase the total liability of-the company under this policy. [ ] WAIVER OF SUBROGATION It is understood and agreed that the Company waives the right of subrogation against the above Additional Insured/s for project described in certificate attached hereto. [ X ] NOTICE OF CANCELLATION It is understood and agreed that in the event of cancellation of the Policy for any reason other than non- payment of premium, 30 days written notice will be sent to the following by mail. City of Santa Planning Division, Attn: Tonic Zerba 20 Civic Center Plaza, M-20, Santa Ana, CA 92701 In the event the policy is canceled for non-payment of premium, 10 days written notice will be sent to the above. Policy No.:PPS035165530 Insurance Company: Assurance Co of America Issued to: The Planning Center, Inc ut orized Representative APPROVED AS TO FORM ISA E. STORCK -Assistant City Attorney ~~~J Effective Date: 07-01-01 Issue Date: 09-10-01 ACORD CERTIFIC OF OP ID T DATE(MM/DD/YY) LIABILITY INSU NCB , ANN-1 09/10/01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE John Burnham Insurance Service HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 2415 Campus Dr. , Suite 200 , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Irvine CA 92612 . Phone:949-833-2462 Fax:949-833-0127 INSURERS AFFORDING COVERAGE INSURED INSURER A: PreferrgCj ~j 10 erS Ins. CO. INSURER B: Plannin Center InC ~ INSURER C: 1580 Me ro Drive Costa Mesa CA 92626 INSURER D: INSURER E: V V Y CrIMV CJ 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. IN R LTR ' TYPE OF INSURANCE POLICY NUMBER SATE MMlDD/YY DATE MM DDNY N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ CLAIIdS MADE ~ OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO PRODUCTS -COMP/OP AGG $ POLICY LOC JECT AU TOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS ~~ (PerDperson)URY $ HIRED AUTOS }~ ~~ NON-OWNED AUTOS {fie t~ ~~~~ BODILY INJURY (Per accident) $ - GK S r p, ~,. R Hey PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ~51StaI1 ~~ AUTO ONLY - EA ACCIDENT $ ANY AUTO ~ ~ OTHER THAN ~ ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X TORY LIMITS ER A WKN106696-1 07/01/01 07/01/02 E.L. EACH ACCIDENT $ 10QQQQQ E.L. DISEASE - EA EMPLOYEE $ l O O O O O O E.L. DISEASE -POLICY LIMIT $ l O O O O O O OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTlSPECIAL PROVISIONS In the event the policy is canceled for non-payment of premium, 10 days written notice will be sent. Project !`C GTI CI/'~ATC IJAI 11tH -- _. City of Santa Ana Planning Division Attn: Tonia Zerba 20 Civic Center Plaza, M-20 Santa Ana CA 92701 ACORD 25-S SANTAAN ~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE DATE THEREOF, THE ISSUING INSURER WILL Eb~fdCbZ7~p MAIL ~- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, L ~13~i7blf&BP~~GR4BOb[24iK~Ld~]4'XF3a~4SIY7iRt6:17~25iC74~~Jd,7s'rXXdI<~~# ~iF~~17GpfQRQ~XXX CORPORATION 1988 A~~? GERT[FICA~ OF LIABILITY INSUR CC PID TF DATE (MM/°o,~- ER PLA13N-1 07/12/00 PRODUC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Botnnan Company Ins . Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lic. # 0584679 HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR P. O . Box 689 , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Tustin CA 92781-0689 . COMPANIES AFFORDING COVERAGE James D . Honell COMPANY Phone No. 714-838-0622 Fax No.714-730-9071 A Assurance Company of America INSURED ~!'~ ~ COMPANY B CNA Insurance Co. i,i,iiii The Planning Center Inc ~! V L ~ ~ ~u~il COMPANY C 1580 Metro Drive Costa Mesa CA 92626 ti v? ' ~ i COMPANY D . l;'; 7 COVERAGES 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 MAYBE 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. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE (MM/DD/YY) DATE (MM/DDlYY) GE NERAL LIABILITY GENERAL AGGREGATE $ 2 000 QQQ A X COMMERCIAL GENERAL LIABILITY PPS035165530 O7/O1/OO O7/O1/O1 PRODUCTS-COMPlOPAGG ~ ~ $2 000 QQQ CLAIMS MADE ~ OCCUR ~ ~ PERSONAL & ADV INJURY $ 1 r 0 0 0 r Q Q Q OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1 QQQ QQQ ~ ~ FIRE DAMAGE (Any one fire) $jQ 000 ~ MED EXP (Any one person) $ 5 ~ Q Q Q AUT OMOBILE LIABILITY A X ANY AUTO PPS035165530 07/01/OQ 07/01/01 COMBINED SINGLE LIMIT $ 1~000~QQQ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) }~ HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ .Q ~ Q Q Q ~ Q Q Q A X UMBRELLA FORM PPS035165530 07/01/00 07/01/01 AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS CGMPENSATION ANU WC STATU- 0TH- EMPLOYERS' LIABILITY TORY LIMITS ER T EL EACH ACCIDENT $ HE PROPRIE70R/ INCL PARTNERSlEXECUTIVE EL DISEASE -POLICY LIMIT $ OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE $ OTHER B Professional MCE114003308 07/01/00 07/01/01 Per Claim 1,000,000 Liability Ann Aggre 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS See Additional Insured form attached. (4) Workshops and (3) Study sessions CERTIFICATE HOLDER '.CANCELLATION EVIS SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Santa Ana EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL Planning Division 3O Attn: Maya de Rosa DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 206 W Fourth St, 4th floor ~~~ Santa Ana CA 92705 ~~'*+~~X~`fi~~i~s~l~€a'€I~. AUTHORIZED REPRESENTATIVE / J L ~~~!~'j2R~~-~1~4 ACORD 25-S (1/95) ACORD CORPORATION 1988 ~. t GENERAL ENDORSEMENT In consideration of an addi#ionai premium of N/A , it is hereby understood and agreed that the following applies: [ X ] ADDITIONAL INSURED City of Santa Ana, and its officers, agents„ employees and volunteers as additional insureds is/are additional insured/s as respects to work done by Named Insured. [ X] PRIMARY COVERAGE With respect to claims arising out of the operation of the Named Insured, such insurance as afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the above Additional Insured/s. [ ]WAIVER OF SUBROGATION It is understood and agreed that the Company waives the right of subrogation against the above Additional Insured/s for project described in certificate attached hereto. [ X ] NOTICE OF CANCELLATION It is understood and agreed that in the event of cancellation of the Policy for any reason other than non-payment of premium, 30 days written notice will be sent to the following by mail. 1n the event the policy is canceled for non-payment of premium, 10 days written notice will be sent to the above. Policy No.: PPS35165530 Insurance Company: Assurance Co of America Issued to: The Planning Center Inc Aut ized Representative Effective Date: 07-1-00 Issue Date: 07-01-00 Form No. CG2010 (11/85) a.tr, eotrtor, s Asaoolaltar: 6toarrrao II100ldT3~ ?aorta. ~Cwtn iSl(ts dlio cA asTOT 5:aa:..n •a.':t;syKs`'.~,Ra'V`.^'~'~:<i".,:esi';:~:':~'~,$~~}•sa>`.~z~ZS~~i::a~> `2'f•;;•'~3~.'~%,'~n,`...~s'~•"~' OTIOT THI$ C8R'TIFICATB IS ISSUED AS A PATTER OF INFpRMA710N ONLY AND DOES N07 AME p EX'~ND R ALTER Ti1E COV~pE AFfORDE~D~BYAT~HE . POLICIES BELOW, .............................. CC1MPAtVlES AFFpADINQ QOVERAQE ................................. ........................................ COMPANY ......................................._.............................., LETTER A it. Aaaot t7re d MaarJw ... INSURm ...................... COMPANY _ ............................................... . . LETTER Q Wat n Profeaatowl Jana ;.. 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F.:.. .'f:y.'<~Si?\ii.;i.: :Y.::::YiS:,. rf}}}:;< %E%k~ THIS 15 TO CERTIFY THAT THE ..... :.:.:>......:,::>;:.};;:,>}:.}:<:::,~>.:•::•::;:;.:.f;:'>Ei~:.:.:>:>'.::.<.;:::::;,;.:~:><>i..;;:.~:•i:•:;};:.~a.a>~:~':~;•kr.:};:<f::ff;>:-:';:::,: ,:.,r:::,,:.: POUCIE9 OF INSURANCE ~~::~::kz~:'i<Y~kaz'%"?fi:% LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE~POLICY~P INDICATED, NOTIMTHSTANDW(3 ANY REQUIREMENT TERM , ERIOD OR CONDITION OF ANY CONTRACT DR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN THE INSURANCE AFF , ORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT 7O ALL THE TERMS, CLUSIONS AND COND... .. _ .. . . ITiON9 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS • TYPE of wsLanANC,r L1R POLICY NLMr9ER ~ . ..... ...................................... ..POLICY EFPECAVE..:,POLICY EXPRIATION (.. ....... . ' ~~ DATE (MMaDDN1~ DATE A L~'~ RPO6a550920 .. .. ,. ... . 07/01/98 07/01/99 QENERAL A~REOATE ... .... . X caMMEwcw. aaENERn. Lwelutt ! . t 5, DQ0,000 .. , cLalMS MADE X DccuR. PROOUCTSCOMPioP Aoaa. ;= 5 000 000 owNERS a coNtgACTOas PROT. PEIZ9ONAL a aDV, INJURr ~ i 5, 000, 000 . EACH OCCURRENCE ;s 5,000,Q00 `. :FIRE DAMAGE (Any,,,e ~) a IN,CLU,OEO ............._.... .........,............ ~' ' AuTOaagelL~ LIABLfTY ............................ . .... MED ExPEHSE iAny o„s peson) s .......... ..... ... 5 000 ... .• . CA06611109 X ;ANY AUTO , .. • 07!01/98 07/01/49 ..f ............. .......... COMBINED SINGLE i LiMfT iS 1,DDD,DDD ALL ONNEO AUTOS :_ ...................•. . SCHEDULED AUTO$ 60DILY MJURY ..; iPer person) ;S X ;HIRED AUTOS > ........................................... '„ . X ~ NON•9MM60 AUTO6 . . . : ~ ; 130pL,Y INJURY _.._..., ' ~ (Per ecciden» '9 QAFiAldE LIABILITY ' ........................................ i, .............................. I ; OPERTY DAMAQE s ~E UMBAELLLA FORM ........, f ......................... ....... EACH OCCtJFiHENCE i .. OTHER THAN UMBRELLA FORM AOORECiATE _ M'OIiI~FiS COMPENSATgN _ : StATUTORY LIMffS i APID ........................ ...:... `EACH ACCIDENT . 's EawwYl~+s LUIBt.TTY oLSEASE -POLICY LIMir _ O'D.~R DISEASE - EAGH EMPLOYEE t A arrrshsafaoal Llabfitty PL0103530901 07/01/98 07/01/99 PER CLAIM :ANNUAL AGGREGATE 1,000,D00 1,000,000 DEBCRIPTgN OF oPEaATgNSA.ocATID~NSn~HICLes18PECNl r1EMS _ _ i Certificarte holder named as Additional Insured as respects General Liability*FOR PROFESSIONAL LIABILITY COVERAGE THE AGGREGATE LIMIT IS THE TOTAL INSURAN~E AVAILABLE FOR ALL COVERED CLAIMS PRESENTED YITNIN THE POLICY *EXCEPT 10 DAY NOTICE Of CANCELLATION FOR NONPAYMENT OF PREMIUM. PERIOD. THE LIMIT YIIL BE REDUCED BY PAYMENTS FOR ,~M ::. ...:...: . .:..:. :::::; ;: ' :::,r:..:. :a?~~»*i;~~:,k:~:<>:,>;~;>:. •.;:xaz>.:::.o;:f::a::.;:.;:•::,:•o>: ; :.:..:.,....,,.. INDEMNITY AND EXPENSES. n: ... .. n+.~.:.. :.: r, vv.: :. Y.y'..v.v$,.:...v.}.;;~ili:vh;~A:}:b:r.i•.,....: ,y::.::':Y:.S•}S;.+y:..}::r.~ic .~,.::t...}:i4:f.ism.vK..::}:h+.v''f,.:~iS:.:.::{:yi?}>:::::::}::q:,:•h :. ...: ~ .v •n.J::fif,.v.:<4:"f•}.',:. :.; :...v: .: ir:... .....}.v.. ~}::T...+.i... /.:v:~,.: :...:;..{.: •%f.... } • fi:ti}, .,,: Y:. .... k.y.`i•.$~i ti:~'{%ri i.'.n,, ?'a" SHOULD ANY ...,Y.n.~,.~.,:.•..,. .c•:~..'.....x...:..,.....:`~`?"..'::.}>}.`~a''.r~.:ti[I~;:y'.••n.~''.,'t~'~;,`a,3~t[urisysi%"::?i.°'''y,r{~.:'.E:.. ;; OF THE ABOVE DESCRIBED POLICIE3 BE CANCELLED BEFORE THE•~ EXPIRATION DATE THEREOF, 7HE ISSUINfi COMPANY WILL "~ 30 ~ xtarnarxxaxxxxx CITY OF SANTI ANA ~%.> MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED Tb THE RO. eOX !>P38s ygf '>.'s'~ LEFT, SANTA ANA CA 9Y70i `3~>t.FV~co'r~3r,...,, ,......._.. _..._._ XlACreredaaaracrerer~.,....,...,.. d a>*ItCtr ~oi~o raj N~nos d~a c~aj ~~ : £o a~M 86-80-7I1C ~' ~ GENERAL ENDORS M ~T !n consideration of an additional premium of _ NIA , it is hereby understood and agreed that the following applies: [ X ] ADDiTlONAL INStlRED City of Santa Ana, its officers, employees 8 volunteers is/are Additional Insured/s as respects to work done by Named Insured. [ X ] 1~lOTICE OF CANC~gt~~( It is understood and agreed that in the event of cancellation of the Policy for any reason other than non- payment of premium, 30 days written notice will be sent to the following by mail City of Santa Ana P.CJ. Box 1988,M-21 Santa Ana, CA 92742 In the event the policy is canceled for non-payment of premium, 10 days written natice will be sent to the above. Policy No.; RP06b50920 Insurance Company: St. Paul. Fire & Mariae Issued to: THE PLANNf..N~G. C/~ENTER ~2~~'C Authorized Representative M. Wheeler ~0/£0 'd Effective Date:?/01/98 Issue Date;7/07/9a H,~I]OS ~~Q lid ~~ . £0 adM 86-80-7(]T ,,_~- -~ ..#,;~ xw~h .'s ~ ..:.. 'tea .: ~:. .. t.:..:,rcY?~w;!{,_txx: .;<:~~.'Y•~~"'w\~-•....,G %icAz??`$`~Yk~'''3k t'~ `.>•z:}":;z>_.^x-:~,;.-~+xf;~:'7;:%;v~t~v:.:;~esC.2••:chtS.G„r.^fc~;x.:siio.?~C;:~:x2x.::: ^ ;..,. .- ~.`Y ,. ..: ... '•':,:,~,.:•;c;.iG... ... 6n'~'# ISSUE DATE .... x`b.::_ '.:@1's; '*- ? `r• ;fix ,s,. _ ~ .°ai4ti: ~ ;;c; ';;:;»x,.>:f•;::~t>::;.Y < AMID • ::::. . ~ h:. - ,: ••:i ' n ~ {~ •' ~ ~.. .. \.. ..-., ~. .~?•.i:h•.:K~ ,1.Jo:~...Ci<i%~.'?::.i~T:ji}~,Ch'.r~ L`Ei}~-:N v ~~i{~:w'iA6~~ .•~\~i + ~': ~4^.Yi:vtiiC:- `-i:•:,4.i :~G::•a•: CSi,G: PRODUCER A IS AS A O ON i BARATTO, SULLIVAN & CO . CONFERS NO RIGHTS UPON THE CERTIFlCATE HOLDER. THIS C>:RTlFiCATE 1765 GOODYEAR AVE . , SUITE 207 ~~ NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VENTURA, CA 93003 STEVE PETRILLO, AGENT COMPANIES AFFORDING COVERAGE 805 650 6690 FAR ................................................................................................................................................................. rALEr e~ A ALPINE '805 650 9690 ....................................................................................................................................................................... ................._....._.............-•-•---........................................ ...... COMPANY B IN>su~D ..................................... LETTER ACE FENCE COMPANY -------------------------------------------------------------------------------------------- -------------------------- ----------------------------------------------- AFRICA TANG, INC . LE~TrEA'"Y C GOLDEN MEADOWS. CONSTRUCTION ....................................................................................................................................................... 15135 SALT LAKE AVENUE ~~ 0 CITY OF INDUSTRY, CA 91746 ....................................................................................................................................................................... E . .. .,:.: u::...::; ..x:-.v:.>'-::ix..:':ii::•.::.:;aG::x•~-.;.:•:::.::'•:':_::.s:iiG:.,:iGS:"i•::'•:x::.;:: ..G.:.,::.::~.x"::i:. ~(], - a,~:?> ~Rc' 2~, g. G:xM'!'k~ s. y•F.2G: ":f.G.'. f-~i} • +.•{'!•:v. #••}~2G~••''~~ :ni•.vt .-::}n'^i+.~:r'~^:i::+f.:i::i.3;; .m'apt'~D.'e:+~~-~::~isYuF~a~~',a~:..:..:~:i~.~ca<•:~.°3'.~<;~..'~~.a~ke•~: ~..«N'~~'~a~'~~:?'M`f,,......•,'~!#3S:::fi~;:~sr.;.:o~?c'3tY,:~:'~o.9Ss:`:.;.^.:::5% THIS 13 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 CERTIRCATE 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. UMRS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~' ~ ~ TYPE OF INSURANCE POLICY NUMBER :POLICY EFFECTIVE :POLICY EXPIRATON LTR: :DATE (MMfDDlYY) DATE (MMIDD/YY) UMTfS AQENERALUA6IUTY AL 1348 :06/18/95:06/30/96cENEAALAGGREGATE 5 100000 .................... >.. g-.t~IMERCL4L GENERAL LU181UTY ; PRODUCTS~OMP~l7P AGG..... ,._ ....... CLAIMS MADE g iOCCUA. ; E PERSONAL $ ADV. INJURY ... 5... ...,' 00000--- :....... - ... 100000 _-.-g•`OWNER86CONiAACTOR'SPROT. EACH OCCURRENCE -.:.5-•--.....•100000-- :RAE DAMAGE (My one frs) ...:. S ....... .. ...............................................:..........................500-- : MED. EXPENSE (My one Parson? 5 AuroMOelue uaewrY i.•..••••.~~0 C~ INEDSINGLE 'S ....--- •ALL OWNED AUTOS tNJUR ........:SC>•I~UU~ AUTOS 18POaDIL~~ Y S ........ HIRED AUTOS :.-......-:NON•OWNED AUTOS - PODILY~INJ~URY I l U S ...........GARAGE UA&UTY . '.•••....: i PROPERTY DAMAGE ' S :EXCESS UA8IUTY = EACH OCCURRENCE 3 .............................. ........ BREilA FORM GREGATE S :OTHER THAN UMBpELU FORM WORKER'S COMPENSATION STATUTORY UMTf8 ,., - ANO :EACH ACCIDENT ...S ..:.:.: . ................................ DISFJISE-POLICY UMfT S EMPLOYER'S UA8IUTY DISEWE -EACH EMPLOYEc S OTHER DESCRIPTION OF gPEAATIONS/LACATONSNEJi1CUS/SPECIAL ITEMS pTHIS NOTICE WILL BE SENT IN THE EVENT OF COMPANY ELECTION ONLY ALL JOBS yy~, ... v......•::: k .. R'nlfMI.~SF7,::. ` i;?:~:': }.>' :t.. .:.y. Fyv: / 1:i ...... . ,- ~h :G:'v'f.. .i::tivii i•:iG:G:.. .. .:.t. {..•.:.. y..xv .: x• .: ...ah:: .f:: :x •.: i:C'•ii;:.,... :. .., ., iy.v..:: ..;. :.vv -ay:'•i•:.;:.:;.'{L:i:: i::'v::i:::Gii YYlfLil• f~: Q .•.... .. :..a.. !. n: rte... ..v..f{w..::: .5.....:. (~'• GG::I.}•~C•lf}: •, .::': ::y• .... v.JOL+:yXU: ti•:i'i?.. rv.:: v'.t~:?Cri::.}•.-.:v •.: wnx ..G: i.::: .: h::.v iK,liiSi:i::::%iv:.:i.T:.:bri?XL1ni: }?K2:'v::!~G:h itl0.Y~rS4. r ~ .. .•~.~•~.1.::.tv. ...:. n:~..:: .:::::n~~,p.•. v- n •k.: Yr.G ha...~{?ti::•..v;:3' :...>.. .}.. •S.G\.:n • : CG.Gii::ti : . .,,.x:G.,.::-xurv `.,.:ss../.,,..::...k•...r...,n.,:.s.,,,a:.:::...»:•; ••:: •: •::G;:•sxGa..,~.:..:.:::,..S:,:ai:::.•:"a•:,r .::...,.t; ,..:: ,:.,..s?f.:,:txw,... 3~:axlk:. y,;, ..; wG,•si: aiau.`~,~.~e`: CITY OF SANTA ANA, ITS OFFICERS, ::::: .:,,.,.,.. ,~„ ...,.u,<.;<:::;.~:;~;.,:~<„G~,,,,,~.a,,,,,.:::..,.,~:.;w:~.::~aw~::::;:.;kw...:. ... ~. AGENTS AND EMPLOYEES -~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE PUBLIC WORKS DEPARTMENT `` EXPIRATION DATE THEREOF, THE ISSUING COMPANY well MAIL~30 DAYS WRITTEN NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE (ADDITIONAL INSURED) ~~ 217 N MAIN STREET SANTA ANA, CA 92701 ATTN B.ALBRIGHT<' :%::: AUTHORI~D REPRESENTATIVE ,«.: .::: .~ ~, r ::: :,i <.>: -~--=~. ,:;: ,, \ , .,~ STEVE G / PETRILLO - ~; ...z.......... ~ 4 ' ~ .:. ..~ .... ~ r f ~i~ . f ii::iii:}ii..:. "i . ::4. ..`{ :::::: ni•:::....{}$•. ~::,r ~:.:::... ~v~,~•.i}{:xv::: r.;.::::.r,.:}.{•: %F{:h~: Y. •: :,w::: :{:::•:::::::tiw::::::: n. ......:v: '•: :}.: :•:::::nv:::::::: ... ...ti.::.:vn ................. :::vw: ::::: ~ g;:.::u%•. .::...: ....; :: :.:.:• .:.~:.: ....;;.'• :. :..::;: <:.:' .. ': ;: :.. ':%~ :::: '•::::~'.. ''~: ...:'~:i:%%;::::~~ ~ .:::::::i::{.i;:i;:<::r::::;:::::::::;':;;::.::-:. ISSUE DATE •xr ~2.n:r.: £.w.{{R2i:ir a~u{~~> Erb:::'.<: ••: nv}7f.v`_~~.h{>}i}{iiaY:Y ~~:: nh...UC n .. h{:.. ":tiv. ':i:{:::?. ai11EN~0~%GLX{{,'A':A~'~'1 nti~aiJPOt•VC.::X.?:nQJ::.~:i:..........}..'.v:t:........:i~{4{:h\... ::+i{:?::v:v{iii:::: iv -.v, .. .. .. PROOUC~ IS ICA IS ISSUED AS MA R OF IN ORMA ION ON AND BARATTO, SULLIVAN & CO. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 1765 GOODYEAR AVE . , SUITE 2 07 DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE VENTLTRA, CA 93003 POLICIES BELOW. STEVE PETRILLO, AGENT COMPANIES AFFORDING COVERAGE 805 650 6690 FAIL .................................................................................................................................................................... ~PRNY A MERCURY CASUALTY 805 650 9690 :.......................................... ...........................................................................:................................................ 111i1J~ .................................................................................. ....... COMPANY B .......................... LET1'EA ACE FENCE COMPANY ................................................................................ ........................ .......~--.........---....................................... AMBRICA TANG, INC. ~i-r~ C GOLDEN MEADOWS CONSTRUCTIONINC ....................................................................................................... ............................................. ................ 15135 SALT LAKE AVENUE ~~ D CITY OF INDUSTRY, CA 91746 .............................................. .................................................................................. .................................... COMPANY E UTTER ...:.. nr. ''~:#.. .. n.:n n. .. .... :. \{:4i ... .Yn.......v......,n ...................v.:v v.: .... .:.nv: v:::::.v: v:.v:: v. .... 8 •: 'Gi : . { :.::.. •: wnv;:- v{ .... ::::::•.: {...:: ::::: v:. ..... v:.v:::: ;••:::::w:: w; ........:•...:n ............. v:........... i8 ~.. ::rv:.:}:hvf.:}n{{{{.%n~i f.: i:Si:{:~:%1:{.:,,?{' ,v.{.; .:.. :.{,v:;;:i •: m,0.:; }.,?. v.: ::}•O:{•i w Gv:•v.:n•: .v s.. .nn:.}.:. ..........:.....:...........v{.....:....\:viii}'J;:.; .:.vx'~ .. j::{{'~,{'~.:••:v vrn:4.'.JF.nv.h<h.v:::%v.,:n.:.v:{{viv..v~'~',....:Nlr4.{S{t:i:'r{]in•:{•:'f.{:v....n.%-ii'•Y\~ii':'r~3::•%•:{•i:•:is~%ni:\•:{i,{{G%::rrivx:::x?x::?':::ni'v}}:v>hvvt:J.•i:!tWryi}}hi:?X:ii3: ii::~ '::'r'.i{:iii 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 CONDRION OF ANY CONTRACTOR 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. TYPE OF INSURANCE POLICY NUMBEA :POLICY EFFECTIVE POLICY EXPIRATION: OMITS s- :GATE (MM/DD/YY) DATE (MMIDD/YY) GENERAL LIABILITY : GENEAAL AGGREGATE $ :COMMERCUIL GENERAL LL181UTY PRODUCTS•COMP/OP AGG. S .......... ................ • ::..... :CLAIMS MADE .OCCUR ~ RSONAL & ADV. INJURY j ............................ .........; ER'S d~ CONTRACTOR'S PROT. :EACH OCCURRENCE : j E DAMAGE (Any one fire) j MED. EXPENSE (My one Pe~nf j A.A..~OMO81~L'"~'~TM AC 11004874 :06/18/95 06/18/96 coM EDSUVaLE JWYAUTO :UNIT N ~ j 100000 ;.......{ALL OWNED AUTOS .. ........: ~ ' IlY Y :BOO INJUR g :SCHEDULED AUTOS ; (per Pe~nl E e--• --- . g :HIRED AUTOS ; .- ... ....... :""°••' ~ ~ 8001LY INJURY i...g.:NON-0WNED AUTOS : (Per aocidern) j = tiARAGE LIABILITY :................................................:......................... ;........: :PROPERTY DAMAGE ~ j :.EXCESS LUU3ILITY :EACH OCCURRENCE j ..., ...:...... ... .........~IiMBRELI.A FORM :AGGREGATE ........................ ............................... j :OTHER THAN UMBREUA FORM WORI~RS COMPENSATION STATUTORY LIMITS AND ~ EACH ACgOENT : j ...........................:....... - ................................ :DISEASE-POLICY UMR j EMPLOYERS LIABILITY DISEASE -EACH EMPLOYEE j :OTHER DESCRIPTION OF OPERATIONSAACATIONS/VEHICLES/SPECIAL ITEMS 10 DAY NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM. ALL JOBS AS COVERED BY THIS POLICY ,...... ...:..:: .....:.:::..::n.:::.~:....,..:::.~:.:::::::.: ...... !n .. .f•......... ... : }..v {3: •:.G^. •:.:v::: iC .,•h%~S:x{{.::xh x-.. -.... v: {.v:: v .v {:.i\L'jiiv:. : .:.. .... :.:::::::::...............: v: nv:::::::.v::::::::::::::: nvx: :~ .. .' '/ 3.: ... ..: ... v.v,{..:f. .. ....R... .{~v:: t.,•.,...:h .. :. .; .. ..rw{{.%>i'•::{•:i.{•:}:•.b: v:x.:: n,..v :.:v,vvxv:.... S. [~~}y . ''•$.2n 1 n.+i :h}}.. ::.{. .v?Y : Y .: •::\{~ ::}::.J::N:i }ij'i{}' •v S:.:iY:{:i-v.::iiiit:{:?:: ~ ;:AYb.[.}xi:3.{: :?=•d}V.+~~.?i...T: -~-+~s~, f f,:.v .v+v.~.~•~~~7. {%{:y ::.{.::.i•:.:': h .r?~. F{:ti ri%i''<.:i:•i.C..n... ~h~,x.a':r.asoc~wxtfn'>.•.:o:•.~,~,'~:+:{a~as: i.;.,.~cS%R,:,x{. „3n'^o:w:{..r•.»+:e :~:er.-at:;ea:•`.{{n.:;.:::..::t•.'.-o.{•:.:: •- a:{: o:>•niw:r;:: ~: •> ., t~ a CITY OF SANTA ANA, ITS OFFICERS - - ~x• ~ . {.a,.w ~ ,~,,,x:.~,.,,~:.,.~...,.:::~:<<>:?<.:~~,~.<>}.{.a.?~:s~~::-~~;k~':~~~~;~: AGENTS AND EMPLOYEES ~ ~~` SHOULD ANY OF THEABpVE~DESCRIBED POLICIES BE CANCELLED BEFORE THE PUBLIC WORKS DEPARTMENT ~~' EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ~Q (ADDITIONAL INSURED) ~~~ MAIL'~o DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 217 N MAIN STREET --•`' ~~' SANTA ANA, CA 92701 ATTN B.ALBRIGHT~<' ;:.<.:: AUTHORIZED REPRESENTATIVE / ,... ~~ ~'- STE VE P ETRILLO .: ... :- . {:.::{< ::.::.:.:::::.::.;.>.:.>,,:.~::.,.:{.;:::<:.;,.;::.::.;;:;,::;:.;::{:,.:{{.::;>.;:.,{::.;:.;•.:~:.;:..:::-:{.><iii ::<;:;:,>::>,i:-i:{:.:{.i::;:.:;:.;i:{.:{.%.;:,:-:.;:.:.;:.;:::;.;;>:.;.... .....: ...:.:::'.~.... , r .:.:::.::::::..:.,i: :::.:::............................:::::::::.~::........................:::::::: ... :... .. ::: ':: .. .......... h...... .. .... ....n..... n..n .........................:.. ~::::::.~::::::::::::: :.: ::.::: :.::.:1Y.Oi?ii:•i:.i:ip fh;: {:::::::{•iiii:::J}::i;{.iiivviiii:::':iiiii?iii:::Y.{{::Isis::ii::{i;3;;{i0;ryi:•iii;4}i}}; ..'./ . .+ ~.: - -- i .. _._.., .' ~ '-~ ,' P.O. BOX 420807,, SAN FRANCISCO, CA 94142-0807 ' STATE ~-.. COMPENSATION IN-8URANCE f.~:.<:. - .:.: , . V N ~ CERTIFICATE OF WORKERS' COMPENSATIONfNSUR~-NCE ,_ ~ , .JUNE 15', L 9 ~,~ - k ~ POUC~rtvuM~ER: 1 Q x,14 7 5 - 9 5 . , CERTIFICATE EXPIRES:. S'-1-9 6 tt-. -----~^-, ~ ~ ~•~~~ X1'^5 Y / ~ ~., a v ..,,, Z -: eITY •OF S1Cial"~~l .ANA ,- Q.Y . .. _ - ~~ . .: 5 %S _ .. •; _ y :. t~. ~?E~.T:_OF _.9iITf~"ltls hND`.SAFSgY` .,.. - -~~ZUb~- li~tES'T. 'FO~B'~`S.'F~REE7'' _ ~ Z~^ c~ "SANTht` .ANAL Cl-G . .9~?T02 .i0$'. 2 £MPL41rESS ~-C L" , _ 3 -. - ...~ _ _ This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California _ Insurance Commissionerto the employer named below for the poli~~eriod indicated. _ Tt~jg policy is not subject to .cancellation by the Fund except upon t~ifsrdays' advance written notice to the employer. 3fl We will also give you T~19 days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding -any requirement, term,. or condition of any contract or other document with ' respect to which -this certificate of insurance may be issued or may pertain, the insurance affacded by the policies ' .described herein>is ubject to all the terms, exclusions and conditions: of such policies_ - ._ . PRESIDENT • __£MPLOYER'S LIAi3ILITY LIMIT INCLUDING DEFENSE ~CSTS: ~i,COr),©QJ P£R OCCURRE:iCE ENDORSEMENT #OOI5 ENTITLED XDDiTIQN.~1. INSURED EMPLOYER ~:EFECTIVE 06/1593 IS AT'T-ACHED TO ANII FORMS A PART OF THIS POLICY. } NAME OF 'ADDITIONAL INSURED.: CITY OF SANTA ANA r .~ .. \ ENDORSEMENT #206.5 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVs^, .Qfrf15/95 IS ATTACHED TO AND FORMS-A PART OF THIS POLICY. _ _ ,.~ ~- SPE'CIHEf ENDORSEMENTS #OOIS ~i~D #20b5'ATfilCCHED: -'- - - - - .,_1. _ - - _- ,.. _ ::.:v..^. ~ -. - - - .. '~L - - - -a .. ,_ - ... ., ~ .: -Y..v. '.. _~ dti - ~: ~ {,_ - ' ;: f ... ~ EMPLOYER ~ <; >• • ~ <- ' - .; +~,>>` -_ _, ~ - ~: r ... r - - ~: .... <, _ *GOLDEN l7£AIt(YWS, CONSTRUCTI'U!y'`, _ _ ~ Y .:.. ~; .,. _ >.. - ACE' FENCE ~O:", _. ,~ ., .. _ .- - -- <" ~_; jar:. ~~ 51-35::;:.SALT ~K' ~AVE .. . ,IcA ~:~ IND~OSTRY C1i+~ 9`I746 _ - _ - tlJ:..- ~,~