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HomeMy WebLinkAboutRUFFIN, DON A. AND ARLENE B. 1C coq AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Deputy Clerk of the Council (M-30). Call 647-5238 if you have anj- 't' .qq,E� ions,' The agreement with No. and final payment has been made. - aw) � -WI-C) i � -,aD C) S- -0 Q3 -03 N -SLOC) Revised 05-22-08 �WAIWI N U WV was completed on Department: F aj�Js A Signature: sS� JW \jCA � A )()—A1G0 Date: to 11,°z 1) 4- City of Santa Ana Clerk of the Council INSURANCE ON FILE WORK MAY PROCEED UNTIL. INSURANCE EXPIRES - 31—C) CLERK OF COUNCIL DATE: & `� O5 N- 2008 -063 (C- ( z) CONSULTANT AGREEMENT Car (ec- 14it —p k i "S THIS AGREEMENT made and entered into this 8v' day of May, 2008, by and between Don A. Ruffin and Arlene B. Ruffin, jointly (hereinafter "Consultant "), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). RECITALS A. The City desires to retain a consultant having special skill and knowledge in tennis instruction to provide classes in the City's leisure class program. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terns and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed $25,000.00 during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the June 1, 2008 and terminate on June 30, 2009, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of Parks, Recreation and Community Services and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer - employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Consultant shall supply City with a fully executed additional insured endorsement in substantially the form attached hereto as Exhibit B upon execution of this Agreement and shall be approved in form by the City Attorney. b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self - insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. c. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. d. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terns of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. 8. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M -30) P.O. Box 1988 Santa Ana, CA 92702 -1988 telefacsimile (714) 647 -6956 With courtesy copy to: Executive Director of Parks, Recreation and Community Services City of Santa Ana 20 Civic Center Plaza (M -23) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 571 -4235 To Consultant: Don A. Ruffin and Arlene B. Ruffin 35 Field Street Irvine, California 92620 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, communication shall be effective or deemed to have been given twenty -four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: PATRICIA E. 13EALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney gy. � 4 L 2 Sheedy Assistant City Attorne RECOMMENDED FOR APPROVAL GERARDO MOUE Executive Director of Parks, Recreation and Community Services CITY OF SANTA ANA ot DAVID N. REAM City Manager CONSULTANT A -� 14. (I►. • •� Tax ID# 302 S- 5,2 -3005 EXHIBIT A Consultant will provide tennis instruction at the Neal Machander /Santa Ana High School Tennis Center as part of the City's Leisure Class program. A variety of skill levels and ages will be offered as well has lessons, camps and competitive play opportunities. The classes will be scheduled on dates and times to be agreed between Consultant and City. 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 the instruction. If Consultant allows others to teach a class, 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. Each class will have a minimum of 4 paid students and a maximum of 32, depending on the structure of the class /camp. If the minimum number is not met by the commencement of a given class, that class will be cancelled. CLASS FEE Each participant shall pay the registration fee agreed between Consultant and City, and on file at the Parks, Recreation and Community Services Agency administrative offices. The City will collect the registration fee from each participant. Consultant shall not collect fee, but shall refer interested persons to the Santa Ana Parks, Recreation and Community Services Agency. City will provide a list of registered participants, who will be allowed to participate in the class. Consultant will receive 70% of the registration fees collected by City. City will retain 30% of registration fees. Consultant may not waive class registration fees for any participants. City may audit Consultant's records and classes to ensure compliance with the terms of this Agreement. City shall prepare class rosters and provide a copy to Consultant for each class. Only registered participants may participate in class. EXHIBIT B ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy M relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ( "additional insureds ") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is 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 additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy # Issued to this endorsement form as a part of Named Insured Countersigned by Authorized Representative United States Professional Tennis Association, Inc. Determining the way the world learns to play tennis May 12, 2008 Don Ruffin 35 Field Irvine, CA 92620 -3345 Dear Don: u� This letter will confirm that, as a Developmental Coach of the United States Professional Tennis Association ( USPTA), you have liability insurance as outlined below. This USPTA Iiability policy covers applicants, and certified and certain honorary members in the United States, its territories or Canada, and nonmembers who are insured through a certified member's policy. THE USPTA LIABILITY POLICY INCLUDES $9 million liability insurance, while on court, for bodily injury to others, and for damage to property not in the tennis professional's care, custody or control. It does not cover injury to the tennis professional, or damage to his/her property. The accident must have taken place on court, and arisen from the tennis professional's playing, practicing, teaching or officiating in tennis. Policy number: Effective period: For questions or to report an accident, contact: PHPK279449 12/31/07- 12/31/08 USPTA World Headquarters 3535 Briarpark Drive, Suite One Houston, TX 77042 Telephone(713)978 -7782 If we may be of further assistance, please do not hesitate to contact us. Sincerely, UNITED STATES PROFESSIONAL TENNIS ASSOCIATION, INC. Loach (~' Insurance Department This coverage is null and void if the member is not a citizen of or does not legally reside, and work in the Upited Sjates, its territories of Canada. 3535 Briarpark Drive, Suite One • Houston, TX 77042 800.USPTA -4U • 713.97.USPTA - 713.978.7780 fax • uspta@uspta.org • wwwuspta.org United States Professional Tennis Association, Inc. Determining the way the world learns to play tennis May 12, 2008 Arlene Ruffin 35 Field Irvine, CA 92620 -3345 Dear Arlene: usp This letter will confirm that, as a Developmental Coach of the United States Professional Tennis Association ( USPTA), you have liability insurance as outlined below. This USPTA liability policy covers applicants, and certified and certain honorary members in the United States, its territories or Canada, and nonmembers who are insured through a certified member's policy. THE USPTA LIABILITY POLICY INCLUDES $9 million Iiability insurance, while on court, for bodily injury to others, and for damage to property not in the tennis professional's care, custody or control. It does not cover injury to the tennis professional, or damage to his /her property. The accident must have taken place on court, and arisen front the Tennis professional's playing, practicing, teaching or officiating in tennis. Policy number: Effective period: For questions or to report an accident, contact: PHPK279449 12/31/07- 12/31/08 USPTA World Headquarters 3535 Briarpark Drive, Suite One Houston, TX 77042 Telephone (713) 978 -7782 If we may be of further assistance, please do not hesitate to contact us. Sincerely, UNITED STAPES PESSIONAL TENNIS ASSOCIATION, INC. MelonT oao(hn17�� Insurance Department This coverage is null and void if the member is not a citizen of ordoes not legally reside and work in the United Si }tes, its ter;ifofies or C4pada. 3535 Briarpark Drive, Suite One • Houston, TX 77042 800.USPTA -4U • 713.97- USPTA • 713.978.7780 fax • usptaCuspta.org • wwwuspta.org ACORD. CERTIFICATE OF LIABILITY INSURANCE page I of 3 06/02DATE /2008 PRODUCER 877- 945 -7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willie North America, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED United States Profess. onal Tennis Association, Incj.INSURERA: Philadelphia Indemnity Insurance COmp_a_ny 18058 -001 B TX 3535 Houston, TX 77042 ark Drive INSURERS: Fireman's Fund Insurance Co. - 21873 -091 3535 -- - - - - -- - -- - �INSURERC___ —_ -- INSURER D. INSURER 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. INSR DO' POLICYEFFECTIVE POLICYEXPIRATIONI LTR NSR TYPE OF INSURANCE POLICYNUMBER DATE MMIDD DATE MNUDDAM LIMITS A x GENERAL LIABILITY PHPK279449 12/31/2007 12/31/2008 EACHOCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL PREMISES TO RENTED $ 100, 000 r, JCLAIMS MADE XIOCCUR The City of Santa Ana V `1ZS4 J•1 RED EXP(My cne parson) $ 520 W. Walnut St. Santa Ana, CA 92701 PERSONAL S ADV I NJURY $ 1,000,.000 GENERAL AGGREGATE I$ 2,000.000__ G_EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS= COMPIOPAGG._ $ 11000c 000— X 1 POLICY JECOT LOC i� AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ ANYAUTO (Eaaclenp _ A,L OWNED AUTOS I SI,HEDULED AUTOS (Per parson) r_ Ir HIRED AUTOS 80DILY INJURY $ NON- OWNEDALTOS (Peramd.M) 1 III PROPERTY DAMAGE $ (Paracddent) GARAGEUABIUTY AUTO ONLY - EA ACCIDENT $ r ANVAUTO OTHER THAN EAACC $ j_ AUTO ONLY AGG $ A PHUB100994 12/31/2007 12/31/2008 EACH OCCURRENCE $ 3,000,000 _E%CESSNMBRELLA_LIABILITY �X OCCUR ] CLAIMSMAOE Ii AGGREGATE $ 3 000 000 1 DEDUCTIBLE $ DIN $ $ _ _L WORKERS COMPENSATION AND WOSTAN- OTH- TORY LIMITS ER EMPLOYERS'LIABILITY r E.L. EACH ACCIDENT ANY PROPRIETORIPARTNERJEXECUTIVE $ OFFICERIMEMBER EXCLUDED? E.L. DISEASE -EA EMPLOYEE $ Xyes,IAL PRe ISIO SPECIAL OVer below E L DISEASE- POLICY LIMIT IS B OTHER MX00080002660 '12/31/2007 127 31 2008 Bxceee Liability $5,000,000 Lisit DESCRIPTION OF OPERATIONSlLOCATIONSIVEHICLESlE %LLUSIONS ADDED BY ENDORSEMENTIBPECIALP8OVISIONS THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 5/29/2008 WITH ID: 10768554 Arlene Ruffin 54144 USPTA Members are insureds for General Liability for playing, teaching or officiating in tennis or operating a tennis ball machine for practicing or teaching. CFGTICICATF Ml11 TIPP CAMCFI I ATIAN ACORD 25(2001/08) Coll:2372098 Tpl:780116 Cert:IW82886 ©ACORD CORPORATION I9BU 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 The City of Santa Ana V `1ZS4 J•1 VPRESENTATIVES. 520 W. Walnut St. Santa Ana, CA 92701 ACORD 25(2001/08) Coll:2372098 Tpl:780116 Cert:IW82886 ©ACORD CORPORATION I9BU W111IS CERTIFICATE OF LIABILITY INSURANCE page 2 of 3 06102DATE /2008 PRODUCER 877 - 945 -7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willie north America, Inc. 26 Century Blvd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1 P. O. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED United States Professional Tennis Association, Inc.INSURERA: Philadelphia Indemnity Insurance Company 18058 -001 3535 Briarpark Drive Houston, TX 77092 INSURERS: Fireman's Fund Insurance Co. 21673 -091 INSURER C: INSURER D: INSURER E. The City of Santa Ana, its officers, employees, agents, representatives and volunteers are included as an Additional Insured as respects General Liability but only as respects to claims arising out of the negligence of the Named Insured. Coll:2372098 Tpl:780116 Cert:10782886 Page 3 of 3 ETIUSI A — If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) Co11:2372098 Tp1:780116 Cert:10782886 ACORD,a CERTIFICATE OF LIABILITY INSURANCE page 1 of 3 06/02DATE /2008 PRODUCER 877- 945 -7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis North America, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED United states Professional Tennis Association, Inc.INSURERA Philadelphia Indemnity Insurance Company 18058 -001 3535 Briarpark Drive Houston, TX 77042 INSURERS Fireman's Fund Insurance Co. 21873 -091 INSURER INSURERO COVFRAGFR 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 SHO WN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL INSR ADO' r POLICYEFFECTNE POLICYEXPIRATION LTR INSR TYPE OFINSURANCE POLICYNUMBER DATE (MMIDDIYY DATE IMMIDDMI LIMITS The City of Santa Ana A X GENERAL LIABILITY '', PHPK279449 12/31/2007 12/31/2008 EACHOCCURRENCE—is Santa Ana, CA 92701 1,.000,.000. X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREM ISES(Eaoccu ante) IS 100 000 CLAIMS MADE OCCUR �X ',, '_MED EXP Anyone Person) $ $ 1 000,000 ',. PERSONAL B ADV INJURY $ 2 000 000 GENERAL AGGREGATE _ GEN'L AGGREGATE LIMIT APPLIES PER '_PRODUCTS- COMPIOP AGG $ 1, 000., OOO PRO- POLICY JECT LOG POLICY - A TO LIABILITY -_I COMBINEDSINGLE LIMIT S ANVAOTO �(Ea accident) ALLOWNEDAUTOS BODILY INJURY S SI.HEDULFD AUTOS (Per Person) L .I. HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per act den0 PROPERTYDAMAGE L $ (Per.Jrr ) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT -' $ EAACC OTHERTHAN — - $ - -- - -- - - - - -- ANYAUTO - -� II ' AUTOONLY: AGG'$ A j EXCESSIDMBRELLA LL161LITY ' PHUB100994 12 31 2007 / / 12/31/2008 EACHOCCURRENCE___$__ 3_,000 000 �X OCCUR ! CLAIMS MADE I AGGREGATE _. -_$_ 3 000-000 DEDUCTIBLE, RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH - TORY LIMITS ER . EMPLOYERS 'LIABILITY - - - -- — '- r - - ----- - -__ -- ANY PROPRIETORIPARTNEREXECUTIVE E L EACH ACCIDENT_ _$ _ E.L. DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? If yes, describe under 'SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ B ',OTHER SHX00080002660 12/31/2007 12731/2008 IExcess Liability $5,000,000 Limit DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIE %CLUSIONS ADDED BY ENOOftSEMENTISPECIAL PROVISIONS THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 5/29/2008 WITH ID: 10768554 Arlene Ruffin 54144 USPTA Members are insureds for General Liability for playing, teaching or officiating in tennis or operating a tennis ball machine for practicing or teaching. .. CFRTIFICATF HOt DFR CANCELLATION ACORD 25 (2001108) Coll:2372098 Tp1:780116 Cert:16182886 ©ACORD CORPORATION 1988 ), 'ro I ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 1 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR The City of Santa Ana Ir%FT� If� i - PRE$ENTATIME$. AU RI2 RE T 520 W. Walnut St. '' Santa Ana, CA 92701 ACORD 25 (2001108) Coll:2372098 Tp1:780116 Cert:16182886 ©ACORD CORPORATION 1988 POLICY NUMBER: PHPK279449 COMMERCIAL GENERAL LIABILITY NAMED INSURED: United States Professional Tennis Association, In 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. Name of Persons or Organization: The City of Santa Ana its officers, employees, agents, representatives and volunteers (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 II) 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. CG 2010 11 85 Includes Copyrighted Material of Insurance Services Office, Inc. with it's permission. Copyright, Insurance Service Office, Inc. 1984 Named Insured: United States Professic United States Professional Tennis Association, Inc. Determining the way the world learns to play tennis May l2, 2008 Don Ruffin 35 Field Irvine, CA 92620 -3345 Dear Don: This letter will confirm that, as a Developmental Coach of the United States Professional Tennis Association ( USPTA), you have liability insurance as outlined below. This USPTA liability policy covers applicants, and certified and certain honorary members in the United States, its territories or Canada, and nonmembers who are insured through a certified member's policy. THE USPTA LIABILITY POLICY INCLUDES $9 million liability insurance, while on court, for bodily injury to others, and for damage to property not in the tennis professional's care, custody or control. It does not cover injury to the tennis professional, or damage to his/her property. The accident must have taken place on court, and arisen from the tennis professional's playing, practicing, teaching or officiating in tennis. Policy number: Effective period: For questions or to report an accident, contact: PHPK279449 12/31/07- 12/31/08 USPTA World Headquarters 3535 BriaMark Drive, Suite One Houston, TX 77042 Telephone(713)978 -7782 If we may be of further assistance, please do not hesitate to contact us. Sincerely, UNITED STATES PRC FESSIONAL TENNIS ASSOCIATION, INC. JC40 111ony Loach Insurance Department 3535 Biiarpark Drive, Suite One • Houston, TX 77042, 800.USPTA -4U • 713.97.USPTA • 713.978.7780 fax • uspta @uspta.org • wwwuspta.org United States Professional Tennis Association, Inc. Determining the way the world learns to play tennis May 12, 2008 Arlene Ruffin 35 Field Irvine, CA 92620 -3345 Dear Arlene: This letter will confirm that, as a Developmental Coach of the United States Professional Tennis Association (USPTA), you have liability insurance as outlined below. This USPTA liability policy covers applicants, and certified and certain honorary members in the United States, its territories or Canada, and nonmembers who are insured through a certified member's policy. THE USPTA LIABILITY POLICY INCLUDES $9 million liability insurance, while on court, for bodily injury to others, and for damage to property not in the tennis professional's care, custody or control. It does not cover injury to the tennis professional, or damage to his/her property. The accident must have taken place on court, and arisen from the tennis professional's playing, practicing, teaching or officiating in tennis. Policy number: Effective period: For questions or to report an accident, contact: PHPK279449 12/31/07- 12/31/08 USPTA World Headquarters 3535 Briarpark Drive, Suite One Houston, TX 77042 Telephone (713) 978 -7782 If we may be of further assistance, please do not hesitate to contact us. Sincerely, UNITED STATES ^PRR FAAE,SSIlIONAL TENNIS ASSOCIATION, INC. ,-A /� C MelonT oach — hrsurance Department This coverage is nuH %and void-if the member is not a citizen of or does vot.Iegally reside and work m the Urtiteci Stites its tegito;ies orCa ada. 3535 Briarpark Drive, Suite One • Houston, TX 77042 800.USPTA -4U • 713.97.USPTA • 713.978.7780 fax • usptaCuspta.org • wwwuspta.org IT- X00,6- OG 3 ACORD,N CERTIFICATE OF LIABILITY INSURANCE INBR page 1 of 3 12/31/2008 PROWLER 877 - 945 -7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PQLICYNUM ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willie axe HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 305191 COMMERCIALGENERALUABILITY CLAIMSMADE ®OCCUR Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED United States Professional Tennis Association, 3535 Briarpark Drive In .INSURERA, Philadelphia Indemnity nsurance C an - ---- 18058 -001 21873 -091 Houston, TX 77042 PERSONALSADVINAURY INSURERS: Fireman's Fund Insurance Ca. INSURERC: INSURERD: NSUREft E: $ 2,000,000 rnveonr_oe 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, INBR R X TYPE OFINSURANCE PQLICYNUM T DETC—EYME FFpCTRE 12/31/2008 POLAICYEXPR T N 12/31/2009 LIMITS A GENERALLIASILDY X COMMERCIALGENERALUABILITY CLAIMSMADE ®OCCUR PHPK370771 EACHOCCORRENCE $ 000 000 DANIA E OaEONTE0 ros MED E�XSP one person) $ 00 00 $ PERSONALSADVINAURY S 1 000 GENEAALAGGREGATE $ 2,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER POLICY PRO L0C PRODUCTS- COMP/OPAGG $ 1,000,000 AUTOMOBILE LIABILITY ANYAUTO ALLOWNEO AVTOS A PPR PPROV A A FORM COMBINED SINGLE LIMIT (Eaxgtlenl) $ SCHEOULEDAUTOS 9arperw) $ HIREDAUTOS _ NON-0WNEDAUT09 Uf, Sl I )IB0 EDGILY INJURY (Pere denO $ PROPERTYDAMAGE (Per .wenO $ ASSISI$ IL y AItO BY GARAGELNBIUTY AUTO ONLY -FA ACCIDENT § NJ AUTO OTHER EA AGE AUTO ONLY. AGE $ b A EXCESS/UMBRELLA WISILITY X OCCUR CLAIMS MADE PHUB258269 12/31/2008 12/31/2009 EACHOCCURRENCE $ 31000,000 AGGREGATE $ 3,000,000 $ DEDUCTIBLE a RETENTION 4 $ _ EUPLOYER3'LIABI �TIONANO YT T s OI- E.LEACHACCIDENT § ANYPROPRIETORIPARTNEWEXECUTIVE OFFICERMIEMBEREXCLUDED7 E.L. DISEASE• EA EMPLOYEE $ 8 If SPE61K PROVISIONS below OTHER 58X00081693970 12 31 08 12 3 200 E.L. DISEASE - POLICYLIMIT $ Hxceas Liability $5,000,000 Limit DESCRIPTIONOFOPERATION$ OCATIONSNEHICLE3MXCLUVONSADDEDBYENDORSEMENTIWECMLPMMMIONS Arlene Ruffin 54144 USPTA Members are insureds for General Liability for playing, teaching or officiating in tennis or operating a tennis ball machine for practicing or teaching. City of Santa Ana ( Neal Machander Tennis Center Santa Ana High School) is an Additional Insured as respects General Liability but only as resongto--jo_a"ims arising out of the negligence of the City of Santa Ana ( Neal Machander Tennis Center Santa Ana High School) 520 W. Walnut St. Santa Ana, CA 92701 (2001108) 2574361 Tpl:87 SHOULD ANY OFTHE 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 FAIWRE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILRY OF ANY NMD UPON THE INSURER, ITS AGENTS OR 9194 1988 DATE W111IS CERTIFICATE OF LIABILITY INSURANCE page 2 of 3 12/31/2008 PRODUCER 877- 945 -7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF Willie HRH 2d century 05191 P. O. Hox 305191 Nashville, IN 372305191 INSURED INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# United States Professional Tennis AseoClation, In 3535 Hriargark Drive Seuston, T% 77042 . WSURERA: Philadel his ]:ndnm�; Insurance Co an INSURERS: Fireman's Fund Insurance Co. SB058 -001 21873 -091 INSURERC: INSURER 0: INSURER E: DEBCRIPTON OG OPERAnnuan ncennuemem,., ee�.,... ...... -.__� _. � Page 3 of 3 IMPORTANT Fthiscerfificate ate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed- A statement cate does not confer rights to the certificate holder i n lieu of such endorsement(s). TION IS WAIVED, subject to the terms and conditions of the policy, certain policies may ndorsement. A statement on this certificate does not confer rights to the certificate of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) call: 574361 Tp1:876675 Cert:119B9194 POLICY NUMBER: PHPK370771 COMMERCIAL GENERAL LIABILITY NAMED INSURED: United States Professional Tennis Association. In 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. Name of Persons or Organization: City of Santa Ana ( Neal Machander Tennis Center Santa Ana High School) (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 II) 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. CG 2010 11 85 Includes Copyrighted Material of Insurance Services Office, Inc, with We permission. Copyright, Insurance Service Office, Inc. 1984 United States Professional Tennis Association, Inc. Setting the standard for teaching professionals —That's Who We Are March 5, 2009 Arlene Ruffin 35 Field Irvine, CA 92620 -3345 Dear Arlene: This letter confirms that, as a Recreational Coach of the United States Professional Tennis Association, You have purchased liability insurance as outlined below. This USPTA liability policy covers applicants, and certified and certain honorary members in the United States, its territories or Canada, and nonmembers who are insured through a certified member's policy. It also covers Recreational Coaches who elect to purchase the insurance. THE USPTA LIABILITY POLICY INCLUDES $9 million liability insurance, while on court, for bodily injury to others, and for damage to property not in the tennis teacher's care, custody or control. It does not cover injury to the tennis coach, or damage to his /her property. The accident must have taken place on court, and arisen from the tennis teacher's playing, practicing, teaching or officiating in tennis. Policy number: Effective period: For questions or to report an accident, contact: PHPK370771 12/31/08- 12/31/09 USPTA World Headquarters 3535 Briarpark Drive, Suite One Houston, TX 77042 Telephone 713- 978 -7782 If we may be of further assistance, please do not hesitate to contact us. Sincerely, UNITED STATES PR ESSIONAL TENNIS ASSOCIATION, INC. Melony Leach Insurance Department 3535 Briarpark Drive, Suite One a Houston, TX 77042 800- 877 -8248 e 713- 978 - 7782.713- 978 -7780 fax. uspta@uspta.orge uspta.com United States Professional Tennis Association, Inc. Determining the way the world learns to play tennis January 2, 2009 Mr. Don A. Ruffin 35 Field Irvine, CA 92620 -3345 Dear Don: This letter confirms that, as a Recreational Coach of the United States Professional Tennis Association, you have purchased liability insurance as outlined below. This USPTA liability policy covers applicants, and certified and certain honorary members in the United States, its territories or Canada, and nonmembers who are insured through a certified member's policy. It also covers Recreational Coaches who elect to purchase the insurance. THE USPTA LIABILITY POLICY INCLUDES $9 million liability insurance, while on court, for bodily injury to others, and for damage to property not in the tennis teacher's care, custody or control. It does not cover injury to the tennis teacher, or damage to his /her property. The accident must have taken place on court, and arisen from the tennis teacher's playing, practicing, teaching or officiating in tennis. Policy number: Effective period: For questions or to report an accident, contact: PHPK370771 12/31/2008 - 12/31/2009 USPTA World Headquarters 3535 Briarpark Drive, Suite One Houston, TX 77042 Telephone (713) 978 -7782 ,kPPROVED AS TO FORM If we may be of further assistance, please do not hesitate to contact us. Sincerely, uaiiiu ti ;tt Saecdy Asmxattt City Attorney, UNITED STATES P 7MIONAL TENNIS ASSOCIATION, INC. M�y De ch ent Insurance D arms 3535 Briarpark Drive, Suite One • Houston, TX 77042 800 - USPTA -4U • 713- 97 -USPTA • 713 -978 -7780 Fax • uspta@uspta.org • www.uspta.com /V' — 20 0 �S — 06 3 - 0 2 �� CERTIFICATE OF LIABILITY INSURANCE page 1 ot: 3 �o1 %oe /�ao 0 PROOUeER 677- 945 -7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS LPON THE CERTIFICATE willies Znauraae• Barvicss o! Georgia, Znc_ ss century Hloa. HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TYPE OPIMSURANGE D. O. Hos 305191 Nashville, TN 3723 0 -5191 INSURERS AFFORDINf3 COVERAGE NAICRI WSVRED Dnited StaCaa proiYaional TeTmia Aaaeeiation, Zn .INSURERA�RhLladel his IaauranOe C See 1S0S8 -900 INSV Bs•.BLre>.an• a D'uafl Znauraane CO. 2 18 7 3 -091 3s3s Hrierpar)c Dsivs Neuaeon, TX 770a2 INSURER C: S _� QOO, 000 COMMER ... GENERAL LIABILITY COVE : , =a.i::::,..� -. -.. THE POLICIES OF INSURANCE USTED 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 ISSUEO OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSION8 AND CONDITIONS OF SUCH POLICIES. AG�3REGATE LIMITS SHOWN MAY HAVE SEEN REDUCED OY PAID CLAIMS. R TYPE OPIMSURANGE PODGY NUMBER �� SY/31/2009 I 12/31/2 D10 LIMrt3 A X oENERAUMBP.In PHp)C510031 EACNOCCURRENCE ___ S _� QOO, 000 COMMER ... GENERAL LIABILITY Q• NTEO , S 100 O CLAIMS MADE ®OCCUR MEO EXP M aM _ S PERSONAL BADV INJURY f OFiVERAL A00RE0ATE S GEN'L AOGREOAiE LIMIT APPLIES PER= PROOUCTB- COMP /OP AGO f O POLICY LOC AVTOYOHILE LIABILITY ANYAVTO Item ha be COMBINE091NOLE LIMIT (Ee eorJeerLL) s ALL OWNEOAUTOS SCNEOULeDAVTOS Reviewed- BODILY INJIXiY � °`P°"°"I —_ S HODRy1NJVRy (P.I aaTJAant) i _ NIREDAUTOS NON -0WNED AUTOS Approved- 2� / __ PROPHRTY DAMAGE (PEr gctlelt) -- 1 DSte: ---------- OARATiE LfABILITV AVTOONLY -EA ACCIDEM_ S OTHER THAN EA ACC AUTOONLY� AGG i ANY AUTO i A EXGE881YMBRELLA LUBILnY pIiUH293364 12/31/2009 I2 /31/2010 EACH CCURRENCe S 00 OCCUR � CWM9 MADE AOORHOATE S O S s DeoucnaLE s ReTeNrwN s WORI[PJi8 ANDENPLOYER9•LV161Lm1 / WYPROPRIETCR�F WFICE�M�MBER �(NN�MaI�Wr(( ODMPEMSATION "LN 'P.RTN�JRIEXECLIT ^.F'` EXCLVDE09 L_J NNNRII j { f E.L. EACH M:CfI:ENT � ___ _ _ E_L OIHEA3E- FA EMPLOYEE _i _ _ S_ E.1_ DISEASE - POLICY LIMfr -- _ -____ S 1( MNab VIWN Y 8 OTHER eHX 1 12 2 010 BxeePa Liability 53,000,000 Limit DHSCRE'TION OF OPERATIONS I LOGTgNH /VEHICLES / EXCLVeV]NS ADDED BY HNDORSBNENT / 9PHCUILPROVISKINS Arlene RuElin 54144 UBPTA NemberB era SnBnredB Cor General Liability Cor playiag� teaching or oCEiciating in tennis oz operating a tonnie ball alaehine Cor practicing or teaching. City of Santa Ana (Neal Machander Tenaie Center Santa Ana High School) is an Additional Insured as r SHOULD ANY OP THE ABOVE OESCRNIHO POLICE'S BE CANCELLED BEFORE THL GIPIMTNNI GATE TNBREOP, THE ISSUWO WSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE GCRTIFN:ATe MOLDER NAMED TO THE LEFT, BUT PAILVRe TO DO SO SHALL oR08H If0 OBUOATNJN OR LUBILITY OF ANT HIND UPpI THE INSURER, n3 AGENTS OR Ci Cy oL Santa Ana (Heal Naehsnflor Tonaia Center Banta Ana Nigh School) REPREeENTATVEB. Sao w. walaue St. AVTNORI>CZD REPRESENTATVE Santa Ana, CA 92701 ACORD 25 (2006!01) Co 11:2903568 Tp1: 1040196 Cart:13. 765 ®1 BB -2006 ACORD CORPORATION. All rights reserved. The ACORO name and logo are registered marks of ACORD � Page 3 of 3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statemerit On this certificate does not confer rights t0 the certificate holder In flea of such endorsamant(s). If SUBROGATION IS WAIVED, aubJect to the terms arld conditions of the policy, eertaln polices may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of insurance does not constitute a contract between the issulhg Irtsurer(s), authorized representative or producer, and the certificate holder, nor does It affirmatively or negatively amend, extend or alter the coverage afforded by the policies hated thereon. Tp1:1o90198 Carta 137267 THIS ENDORSEtitllEhlT GRANGES THE POLICY PLEASE R —�l,D IT CAREPULi.Y ADDITIONAL INSURED: OWNERS AND J OR LESSORS OF PREMISES, LESSORS OF LEASED- EQUIPMENT, SPQINSOR$ OR CO- PRQMOTERS This endorsement tmodittes Insurance provided under the following: COMMERCIAL [iENERAL LU►AILITY COVERAGE PART This policy is amender! t0 includa� as an additional Insured. any person or orgarrizetkxt of the types designated below, but only wtlh neapect to liability .arising aut of your operations- 1. owners end / or !.assort;• of the premises leased. r+entad, or loaned to you. subJect to the toHOwlrtg adtiltlortai exotutrions; a. TMs Instirerlce applies only to an 'occurrence' which (ekes place whtle you are e. tenant In the pnemises; - b_ This insurarvosdoas tw4apptyto'boditylryury or'prtapergr damage` resulting from structural aiteratior►s, flew t:ortatre�eSon or demoRtlon oparattona performed by or on behalf of fha owner end / or Ieasor of Otis j�oeritlssa;. c. TMs Inauartce does. not apply fo ut+trlsty of the orvrters and / or lessors for -bodily lryury or 'property damage` arledr�_ cut of arty design defect or atrudutal maintenance of the premieres ex loss osused by a premises deiect. With respect tD any addltloiial.Bisui!e)d Irrch.ided utrder tflfs pocky, fhia Insurance does no! apply io the sole negligence of audr txttlitlonellnetusd. 2. Lessor of Leased Equi�mertt, but only with raspee;t to tlabfNgr for `bodily injury, 'propergr damage' or "personal and advmritseng injury' caused, M whob or: in part, byyour malrtterlanca, apasatlon or use of equipmerrl teased to you by tiuCtr perann(S) Or organlzatkm(s) si,bject to the followin8 addWonal exdusiona: a. This intraxanoe does not apply to any `occurrence' whictr takes plane esker the equipment tease expires. 3. Sponerors a. co- Prornoiera City of Santa Ana /City Attorney Item has Reviewed: APPrn�ed: Date: Page � oT t United States Professional Tennis Association, Inc. Setting the standard for teaching professionals - That's Who We Are March 21, 2012 Ms. Arlene B. Ruffin 28 Grant Irvine, CA 92620 -3353 -,� Dd 8" - �C�3-023 2 usP-r�.. Dear Arlene, This letter confirms that, as a Recreational Coach of the United States Professional Tennis Association, you have purchased liability insurance as outlined beioty_ This USPTA liability policy covers applicants, and certified -and certain honorary members in 'the United States, its territories or Canada, and nonmembers who are insured through a certified member's policy. 7t also covers Recreational Coaches who elect to purchase the insurance: THE USPTA LIABILITY POLICY INCLUDES $9 million liability insurance, while on court, for bodily injury to others, and for damage to property not in the tennis teacher's care, custody or control. It does nor cover injury to the tennis teacher, or damage to his/her property. The accident must have taken place on court, and arisen from the tennis teacher's playing, practicing, ,teaching -" or ofFiciating in tennis. Yollcy Number: EtfeMlve Period: For questions or to report an accident, contact: If we may be of further assistance, please PHPK801956 12/31/2011 - 12/31/2012 USPTA World Headquarters 3535 Briarpazk Drive, Suite One Houston, TX 77042 Telephone 713 - 978 -7782 do not hesitate to contact us_ Sincerely, t`U` " /N�IjT'(n /ED STATES PROFESSIO AL TENNIS ASSOCIATION, 1NC. Melony DeLo h ����g� - - Insurance De artment E41R- 2DBD- XNF -g2XB 3535 Briarpark Drive, Suite One - Houston, TX 77042 800- 877 -8248 • 713- 978 -7782 - 713 - 978 -7780 Fax • usp[a riluspta.org - uspta.com