HomeMy WebLinkAboutCOMMUNITY SERVICES PROGRAM INC.-2008INSURANCE ON FILE
WORK MAY PROCEED A-2008-097
UNTIL INSURANCE EXPIRES
CLERK OF COUNCIL
DATE: (o - y - O ~
~ ' ~~ (~ c ~ (Z> SUBGRANTEE AGREEMENT BETWEEN THE CITY OF
for ~ B.-o,.: ~~ SANTA ANA AND COMMUNITY SERVICE PROGRAMS
~6erry Str~m~~
FOR DOMESTIC VIOLENCE VICTIM
ADVOCACY PROGRAM FUNDS
THIS AGREEMENT is entered into this 2"d day of June, 2008, between the CITY OF
SANTA ANA, a charter city and municipal corporation of the State of California, hereinafter
referred to as "CITY", and COMMUNITY SERVICE PROGRAMS (CSP), anon-profit
California corporation, (hereinafter referred to as "SUBGRANTEE").
RECITALS:
1. City is an entitlement recipient of Domestic Violence Victim Advocacy Program funds from
the State of California, Office of Emergency Services.
2. The Domestic Violence Victim Advocacy Program hereinafter referred to as "DVVA"
mandates that a SUBGRANTEE agreement be executed prior to the disbursement of DVVA
funds.
WHEREFORE, in consideration of their mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
PURPOSE
The CITY shall allocate $62,946 in DVVA grant funds far disbursement to
SUBGRANTEE for training, field services, and victim/witness follow-up in the area of
domestic violence, in accordance with the Memorandum of Understanding between the
Santa Ana Police Department and Community Service Programs, Inc. which is
incorporated by reference into this AGREEMENT and attached hereto as Exhibit "A".
SCOPE OF SERVICES
A. SUBGRANTEE hereby agrees to provide services to victims of domestic violence and the
Santa Ana Police Department as described in Exhibit "A" attached.
B. In conjunction with the services to be provided by SUBGRANTEE, City shall provide:
1. Office space, furniture, telephone and a personal computer for the
SUBGRANTEE'S use in the services to be provided to victims of domestic
violence.
2. City shall refer all victims of violent crimes committed against women to
the SUBGRANTEE.
INDEPENDENT CONTRACTOR
It is understood and agreed that the SUBGRANTEE is, and shall be, acting at all times
during the term of this AGREEMENT as an independent contractor and not as an
employee of the C[TY. 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
SUBGRANTEE performs the services which are the subject matter of the
AGREEMENT, provided always, however, that the services to be provided by
SUBGRANTEE shall be provided in a manner consistent with all applicable standards
and regulations governing such services. SUBGRANTEE shall secure at its expense, and
be responsible for any and all payment of income tax, social security, state disability
insurance compensation, unemployment compensation and other payroll deductions for
SUBGRANTEE and its officers, agents and employees, and all business licenses, if any,
in connection with this AGREEMENT.
4. DISBURSEMENT OF FUNDS
Pursuant to the Office of Emergency Services of the State of California, Domestic
Violence Victim Advocacy Program Grant (DVVA), the CITY has allocated $62,946 for
disbursement to CSP, Family Violence Victim Services.
A. DVVA funds shall be expended within a time period not exceeding one (1) year
following the date of execution of this AGREEMENT. No disbursements shall be
made for services completed after June 30, 2009.
B. Disbursements shall be made to SUBGRANTEE following the submission of
invoices detailing how the disbursement was used. City will provide
SUBGRANTEE with a form to document expenses.
C. SUBGRANTEE agrees to submit requests for disbursement fifreen (15) days afer
the end of each calendar quarter during the term of the AGREEMENT. The dates
for the requests for disbursement are:
1. June 1, 2008 through September 30, 2008
2. October 1 through December 31, 2008
3. January 1, 2009 through March 31, 2009
4. April 1, 2009 through June 30, 2009
D. City shall disburse funds based upon the receipt of such invoices within thirty
(30) days after receipt thereof, provided CITY is satisfied that such expenses have
been incurred within the scope of this AGREEMENT and that SUBGRANTEE is
in compliance with the terms and conditions of this AGREEMENT.
E. SUBGRANTEE agrees to conduct all activities of the organization, whether
funded in whole or in part by DVVA funds from CITY, in accordance with the
provisions contained in 2 CFR Part 225, including those for contracts in excess of
Ten Thousand Dollars ($10,000.00) and including the provisions relating to audit
requirements and resolution of audit findings as provided in Circular A-133.
Additionally, if SUBGRANTEE receives $25,000 or more in grant funds,
SUBGRANTEE is required to submit an annual report including either a single
audit or program audit reports, which evidence an audit was completed in
accordance with specific program requirements.
F. SUBGRANTEE acknowledges that the CITY shall disburse funds to
SUBGRANTEE only upon execution of this AGREEMENT, and CITY is
empowered only to provide funds to SUBGRANTEE pursuant to the provisions
of this AGREEMENT.
G. SUBGRANTEE acknowledges that CITY shall have the right to recapture all or a
portion of DVVA funds disbursed to SUBGRANTEE should the SUBGRANTEE
fail to comply with all the terms and conditions of this AGREEMENT or refuse to
accept any conditions which may subsequently be imposed by the Office of
Emergency Services for the operation of the Domestic Violence Victim Advocacy
Program. If CITY is required to take legal action to recapture the full amount of
funds granted to SUBGRANTEE, SUBGRANTEE agrees to reimburse CITY for
attorney's fees and all associated legal fees.
H. SUBGRANTEE shall not dispose of any real or personal property acquired in full
or in part with DVVA funds through sale, use or relocation without the express
and prior written permission of the CITY
SUBGRANTEE agrees that any earned interest income on funds generated
through the use or investment of funds received from CITY shall be used in
conformance with program income requirements. The SUBGRANTEE shall
disclose to the CITY all program income received utilizing Office of Emergency
Services (OES) funds administered under this AGREEMENT.
5. RECORDS
SUBGRANTEE agrees to maintain program records for a minimum of three years after
the close-out of a sub-grant and to make such records available for onsite monitoring by
CITY not less than annually and to periodic inspections by the Office of Emergency
Services officials during this three year period.
6. CONFLICT OF INTEREST
SUBGRANTEE agrees that no officer, employee, agent, or assignee of CITY having
direct or indirect control of DVVA funds granted to the CITY shall serve as an officer of
SUBGRANTEE. Further, any conflict or potential conflict of interest of any officer of
SUBGRANTEE shall be fully disclosed to the CITY prior to the execution of this
AGREEMENT and shall be attached to and become a part hereof.
7. CERTIFICATION OF NONDISCRIMINATION
By signing this agreement, SUBGRANTEE certifies that it does not discriminate in
hiring or service on the basis of race, color, creed, religion, sex, sexual orientation, age,
marital status, national origin, ancestry, physical handicap or medical conditions.
8. NON-ASSIGNMENT OF AGREEMENT
A. Inasmuch as this AGREEMENT is intended to secure the specialized services of the
SUBGRANTEE, SUBGRANTEE may not assign, transfer, delegate, or sublet any interest
herein without the prior written consent of the CITY and any such assignment, transfer,
delegation or sublease without the C1TY's prior written consent shall be considered null
and void.
B. Nothing in this AGREEMENT shall be construed to limit the CITY's ability to have any
of the services which are the subject of this AGREEMENT performed by CITY personnel
or by other SUBGRANTEES retained by the CITY.
9. TERMINATION
Any of the parties may cancel this AGREEMENT by giving thirty (30) days written
notice of said cancellation to the other party. In the event of termination or cancellation
for any reason, CITY shall only be responsible to pay for services rendered up to such
termination.
10. INDEMNIFICATION
SUBGRANTEE hereby agrees to protect, defend, indemnify and hold harmless CITY, its
officers, and employees against any and all liability, claims, judgments, costs and
demands, however caused, including those resulting from death or injury to
SUBGRANTEE'S employees and damage to SUBGRANTEE'S property, arising
directly or indirectly out of the obligations or operations herein undertaken by
SUBGRANTEE, including those arising from the concurrent negligence of CITY, but
save and except those which arise out of the sole negligence, or the sole willful
misconduct of CITY. SUBGRANTEE will conduct all defense at its sole cast and
expense. CITY shall be reimbursed by SUBGRANTEE for all cost or attorney's fees
incurred by CITY in enforcing this obligation.
1 1. INSURANCE
Prior to undertaking performance of work under this Agreement, SUBGRANTEE
shall maintain and shall require its subcontractors, if any, to obtain and maintain
insurance as described below:
A. SUBGRANTEE shall obtain and furnish to CITY, policy of general public
liability insurance, including motor vehicle coverage covering services provided under
this AGREEMENT. Said policy shall indemnify SUBGRANTEE, its officers, agents and
employees, while acting within the scope of their duties, against any and all claims
arising out of or in connection with the services provided under this AGREEMENT, and
shall provide coverage in not less than the following amount, producUcompleted
operations liability and blanket contractual liability, of $1,000,000 per occurrence. If
coverage is provided under a form, which includes a general aggregate limit, the
aggregate limit must be no less than $1,000,000. Said policy shall name CITY, its
officers, and employees as Additional Insureds, and shall specifically provide that any
other insurance coverage which may be applicable to the services provided under this
AGREEMENT shall be deemed excess coverage and the SUBGRANTEE'S insurance
shall be primary.
Under no circumstances shall said above-mentioned insurance contain a
self-insured retention, or a "deductible" or any other similar form of limitation on
the required coverage.
B. Worker's Compensation Insurance. In accordance with the provisions of Section
3300 of the Labor Code, SUBGRANTEE if it 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, SUBGRANTEE
agrees to obtain and maintain any employer's liability insurance with limits not less than
$1,000,000 per accident. SUBGRANTEE shall require all subcontractors to provide
such workers' compensation insurance for all the subcontractor's employees.
SUBGRANTEE shall furnish to CITY a certificate of waiver of subrogation under the
terms of the workers' compensation insurance and SUBGRANTEE shall similarly
require all subcontractors to waive subrogation.
C. Prior to commencing performance of the work hereunder, SUBGRANTEE shall
furnish to CITY certificates of insurance subject to approval of the City Attorney
evidencing the forgoing insurance coverages as required by this AGREEMENT. Said
certificate shall:
1. Provide the name and policy number of each carrier and policy;
2. State that the policy is currently in force;
3. Promise to provide that such policies will not be cancelled or modified without
thirty (30) calendar days prior written notice of CITY;
4. State as follows: "The above detailed coverage is not subject to any deductible or
self-insured retention, or any other form of similar type limitation."
D. SUBGRANTEE shall maintain the foregoing insurance coverages in force until
the work under this AGREEMENT is fully completed and accepted by CITY.
E. The requirement for canying the foregoing insurance coverages shall not derogate
from the provisions for indemnification of CITY by SUBGRANTEE under the
AGREEMENT. CITY or its representatives shall at all times have the right to demand
the original or a copy of all said policies of insurance. SUBGRANTEE shall pay, in a
prompt and timely manner, the premiums on all insurance herein above required.
12. NOTICE
All notices pertaining to this AGREEMENT and all communications from the parties
may be made by delivery and said notices or communications in person or through the
U.S. Mail, first class, certified, return receipt requested and addressed as follows:
To SUBGRANTEE:
Community Services Programs, Inc.
Victim Assistance Programs
1821 E. Dyer Road, Ste. #200
Santa Ana, CA 92705
Attn: Ronnetta J. Johnson
To CITY:
Santa Ana Police Department
60 Civic Center Plaza M-97
P.O. Box 1981
Santa Ana, CA 92702
Attn: Chief Paul M. Walters
Written notice is effective five days afrer mailing to the most current address provided by
the parties. Failure by either party to notify the other of a change in mailing address shall
not invalidate service by mail to the most current address provided by that party.
Personal service of notice is effective upon delivery.
13. EXCLUSIVITY AND AMENDMENT OF AGREEMENT
This AGREEMENT supersedes any and all other agreements, either oral or in writing,
between parties hereto with respect to employment of SUBGRANTEE by CITY and
contains all covenants and agreements between parties with respect to such employment
in any manner whatsoever. 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, and that no other agreement or amendment hereto shall be effective unless
executed in writing and signed by both CITY and SUBGRANTEE. SUBGRANTEE
specifically acknowledges that in entering into and executing this AGREEMENT,
SUBGRANTEE relies solely upon the provisions contained in this AGREEMENT and
no others.
14. VALIDITY
If any term, covenant, condition or provision of this AGREEMENT is held by a court of
competent jurisdiction to be invalid, void or unenforceable, the remainder of the
provisions hereof shall remain in full force and effect and shall in no way be affected,
impaired or invalidated thereby.
I5. LAWS GOVERNING THIS AGREEMENT
This AGREEMENT has been executed and delivered in the State of California and the
validity, enforceability and interpretation of any of the clauses of this AGREEMENT
shall be determined and governed by the laws of the State of California. All duties and
obligation of the parties created hereunder are to be performed in Orange County, which
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.
16. SIGNA TURES/TlME OF EXECUTION
This AG REEMENT shall be void and its terms shall have no force or effect whatsoever
if not signed by authorized agents or officers of SUBGRANTEE within thirty (30) days
of receipt of this document. It shall be the responsibility of the City to transmit this
AGREEMENT and any other necessary documentation to SUBGRANTEE and to record
the date of receipt thereof.
IN WITNESS WHEREOF, the parties hereto have caused this AGREEMENT to be executed
by and through their authorized offices the day, month and year first above written.
,
CITY OF SANTA ANA, a municipal
co~ornj?J~;z~m;"
David N. Ream
City Manager
ATTEST:
Patricia E. Healy
Clerk of the Council
APPROVED AS TO FORM:
SUB GRANTEE
Joseph W. Fletcher
City Attorney
211') "
BY~. L\ LA ""'>{~-7
L ra Sheedy
Assistant City Attorney
Community Service Programs, Inc, a
Non-profit California Corporation
BY~Lla'~~?
Title: t'h1Vt}VTI fL. t.iYlsCYJ
By: ({vIv.J., -h,,-- \ sIt/Ie f
N S .,
ame: -tl,,)L 1-,1')
Title: ]) \ ,. -1r- "J-i M","'l-(,
EXHIBIT A
MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding shall stand as evidence that the CSP, Victim
Assistance Programs, Family Violence Victim Services and the City of Santa Ana,
through the Santa Ana Police Department intend to work together toward the mutual
goal of providing maximum available assistance for victims of domestic violence,
stalking and sexual assault in Orange County. Both agencies believe that implementation
of the Law Enforcement Specialized Unit as described herein, wiII further this goal. To
this end, each agency agrees to participate in the program, if selected for funding, by
coordinating/providing the following services:
The Santa Ana Police Department agrees to refer all victims of domestic violence,
stalking and sexual assault to CSP, Victim Assistance Programs, FamilyViolence
Victim Services.
The CSP, Victim Assistance Programs, Family Violence Victim Services agrees to
accept referrals from the Santa Ana Police Department and provide assistance to all
victims and their families. The Program will support services including but not limited
to: crisis intervention, orientation to the criminal justice system, resource and referral
counseling, emergency financial assistance, court support and accompaniment, assistance
with filing for temporary restraining orders and Victims of Crime Compensation Claims.
The CSP, Victim Assistance Programs, Family Violence Victim Services further
agrees to provide training to the staff of the Santa Ana Police Department relative to
victim issues and program services.
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID P9 CA.lE tMMIODfYYYVt
COMMIT - 6 12126/07
PRODUCER A-;looi' .;LIO THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO
Chapman ~ Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
License #0522024 A- u>o7- 05;;;>. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND o:rw
P. O. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO
pasadena CA 91117-0455
phone, 626-405-8031 Fex:626-405-0585 INSURERS AFFORDING COVERAGE NAIC#
INSURED - .____m -". -".. .. _H -.-------- --
INSURER A Ri.!_I!l~:!_.!?aura11c& c~~~
..'-'-.-"-' .- --
INSURER B: Everest National
_u.o___.__. -
communitb Service Programs~Inc INSURER C ,
-- --
1821 B. yer Road Ste. 200 INSURER D.
Santa Ana CA 92705 i
INsuRER E.
THE POLICIES OF INSURANCe LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY PERIOD INDICATED. NOiWlTHSTANDING
ANY REOUIREMENT, 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.
-...-- ~~!"MlDDJVY~': I'DATE MNI.nO
LTR .'R TYPE OF lNSURANCE POLleY NUMBER UNITS
~NERA1. UABIL.ITY I EACH OCCURRENCE .1000000
A }{. D~ERCIALGENERALLlA"UTY RICOO08559 10/01/07 I 10/01/08 PR!:MISES (Ea~) .100000
CLAIMS MAOE [jJ OCCUR 1 , MEO EXP (AnV one pencn] S 5000
, 10/01/07 I
.!. s~ual Abuse !RICOO08559 10/01/08 PERSONAL. & ADV INJURY $ 1000000
.!. PROFBSSIONAL . CONTRACTUAL L IABI L] mO/Ol/07 10/01/08 GENERAL AGGREGATE $3000000
GEN'L AGGREGATE LIMIT APPL.lES PER: PRODUCTS. CQMP/oP AGG S 1000000
- l, iPRo- r-'l, ' KInD Ben. 1000000
POLICY JECT LOC I
~TOMOBILE L1ABIUTY COMB&NED SINGLE LIMIT S 1000000
A }{. ANY AUTO RICOO08559 10/01/07 I 10/01/08 [Ea aoodent)
----- - --~ ---
ALL OWNED AUTOS
, - 8QDllYINJURY I
, SCHEDULED AUTOS (P.rpersonl
- -
}{. HIRED AUTOS I BODILY INJURY
.
~ NON.QWNED AUTOS I (Per acodeml
- ...-.. PROPERTY DAMAGE So'- -
fPerttcoKlenl)
=i~G' L1ABIUTY AUTO ONLY .EAACClCENT S
I ANY AUTO OTHER THAN EA ACe I
A.UTOQNlY: AGG S
5~SSlUM8REUA LIABILITY ~,?H OCCURREN~E S 1000000
A X OCCUR ~ CLAIMS MADE . RIlLOO08560 10/01/07 10/01/08 ~GATE - .1000000
- ------. --..- --
I S
H ~EDUCT1BLE $
RETENTION . S
I WORKERSCOMPENBATION AND X lroRnlMITsT ~
B EMPl.OYERS' L1ABIUTV 6600000007071 07/01/07 , 07/01/08 E.L. EACH ACCIOENT .1000000
ANY PROPRlETORIPARTNERlEXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EOMPlOYEE .1000000
~~~I~IW'R~VI~~S below E.L DISEASE. POLICY LIMIT $ 1000000
i OTHER
A \ Employee Dishonest I RICOOOS559 10/01/07 10/01/08 Limit 450,000
A ProDertv RICOO08559 10/01/07 10/01/08 Contents 249,000
DESCRIPTION OF OPERA nONS/lOCATIONS J VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENf J SPECIAL PROVISIONS
Re: Agreement #A-2007-210. The city of Santa Ana, Its Officers, Elnpl.oyee s ,
Agents, Volunteers and Representatives are named as additional insured with
regard to Liability and defense of suits arising from the operations of the
named insured per the attached endorsement. Such insurance is primary and
non-contributory. Workers cowpensation coverage excluded, (contd.. .)
CERTIFICATE HOLDER
CANCELLATION
SHOUL.D ANY OF THE ABOYE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATKl
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAU.
IMPose KO OBUGATION OR UABILlTY OF ANY KINO UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
okUT ED REPR
@ACORDCORPORATION 19S8
COVERAGES
SANTANA
city of Santa Ana
20 Civic Center Plaza
Santa Ana CA 92701
ACORD 25 (2001/08)
/.k), -' ?/
-.., 'Cr. /17
v
PRODUCER
Chapman , Associates
License '0522024
P. O. Box 5455
Pasadena CA 91117-0455
Phone:626-405-8031 Fax:626-405-0585
INSURED
THE POLlcrES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POWCY PERIOD INDICATED. NO'TWITHSTANDING
ANY REQUIREMENT. TERM OR CONDlnoN OF AMY CONTRACT OR OTHER DOCUMENTIMTH RESPECT TO WirCH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEIU:IN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHO\M.l MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~I~
ACORD.
CERTIFICATE OF LIABILITY INSURANCE
INSURERS AFFORDING COVERAGE
Communi ty Service ProgJ:Nl8,:mc
1821 E. Dy@r RO,c1 Ste. 200
Santa Ana CA 92 05
COVERAGES
INSURER A:
INSURER B;
INSURER C:
INSURER 0:
INSURER E;
LTA HIR TYPE OF INSURANCE
~NERAL IJABlUTY
X CONMERClAL GENERAl. l..WIIUTY
= ::J CLAIMS MADE ~ OCCUR
X Sexual. Abuse
X PROFESSIONAL
POUCYNUIIBI!R
A
10/01/08
EACH OCCURRENCE
PREMISES lEI occannce)
MED EXP (Any ani perain)
PERSClNAl.a ArN INJURY
GENERAL AGGREGATE
PRODUCTS - COMPIOP AGG
bp Ben.
R:IC0008559
10/01/07
RICOOOB559 10/01/07
CONTRAC'1't1AL LIABIL TnO/Ol/07
10/01/08
10/01/08
A
GEN'LAGGREGATE UUIT APPUES PER:
I POLICY h- 'JE.R@r n LOC
AlITOMClIllLE LWlILm'
-
X Nrf AUTO
I--
AU. OWNED AUTOS
I--
SCHEDUlED AUTOS
I--
~ HIRED AUTOS
~ NON-OWNEO AUTOS
BOOlL Y INJURY
(Per 8CCidenll
RIC0008559
10/01/0B
COMBINED SINGlE UMIT
(E811Cc1cl8nt)
10/01/07
BODILY INJURY
(Per ....-"
PROPERTY DAIMGE
(PlllllCCldellll
CIARAIIE L1ABLITV
~ PR( AUTO
EXCESIlUMBRELLA IJABlUTY
A ~ OCCUR 0 CLAIMS MADE
R DEDUCTIBLE
RETENTION S
WORICERI COMPENSATION AND
EMPLOYERS' UAIIUTY
B Af>rf PROPRIETORn'ARTNERlEXECUTlVE
OFRC~EMBEREXCLUOED?
~~~~~~NS&>.1oW
OTHER
AUTO ONLY - EA ACCIDENT
EAACC
AGG
OTHER THAN
AUTO ONLY;
RELOOOBS60
10/01/08
EACH OCCURRENCE
AOOREGATE
10/01/07
HAle #
IAUTI
. 1000000
s 100000
s 5000
s 1000000
s 3000000
S 1000000
1000000
S 1000000
S
S
.
S '
S
.
. 1000000
.1000000
.
$
$
07/01/08
X ITOIlY UMITS I IU~
E.L. EACH ACCIDENT $ 1000000
E.L. DISEASE-EA EMPLove S 1000000
. E.L. DISEASE - POUCY UMIT S 1000000
6600000007071
07/01/07
A Employee Dishonest RICOOOBS59 10/01/07 10/01/0B
A Property RICOOOBS59 10/01/07 10/01/08
DESCRlPnOH 01' OPl!RATlONSI LOtA llONa , V1i1lC1E8 , EXCLUlIDNI AIlDED IY ENDDR8EMI!NT, SPECIAL PROVIIIONS
'l'he Ci ty of Santa Ana, Its Of:ficers, EmpJ.oyees, Agents, V01untSHirs
and R8pJ:e.entat:.iVQ8 are named addit::i.ona1 insured. with respect: to the
operations of the named insured per the attachlilc1 CG 2026 end.orl!lem~.
Workers Compensation COVBJ:ag& excluded, evidence on1y. 10 days notice
o:f canClilllation for non payment of premium.
LiJai t
Contents
450,000
249 000
/ 'f' !ei
..1 l
~7/!'V
"',' ""--' 'y /'J..,,' ':' '. '
CERTIFICA TE HOLDER
CANCELLA nON
SANTANA SHOULD ANY OF 11IEABOVI! DESCRlBI!D PDUCIES BE CANCELLED BEFORE THE EXPlRAllO
o.\TE 11IEREOI', 11I1! ISSUING INSURER WI.L ENDI!AVOR TO IWL ~ DAYS WRITTEN
NOllCE TO 11IJ! CIRTlFlCATE HDLDER NAMED TO THE LEFT. BUT FAlWRE TO DO 10 SHALL
IMPOSE NO OIUGATION OR UABlUTY OF ANY KIND UPON THE INJURI!R, ITS AGENTa DR
REPRI!S!NTA1IVEI.
AU II
Ci ty of San,ta Ana
20 Civic Center Plaza
Santa Ana, CA 92701
ACORD 25 (2001/08)
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement
on this certifica.te does not confer rights to tne certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WANED, 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)
POLICY NUMBER: RICOD08559
COMMERCIAL GENERAL LIABILrTY
CG 20 26 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies Insurance provided underthe following:
COMMERCiAl GENERAL LIABILITY COVERAGE PART
SCHEDULE
.
. Name Of Additional Insured Pel&onlsl Or Oraanlzatlon'sl
erN OF SANTA ANA. 1TS OFFICERSJ EMPLOYEES.
AGENTS, VOLUNTEERS AND REPRESENTATIVES
20 CIVIC CENTER PLAZA
SANTA ANA, CA 92701
Information reauired to comolete this Schedule. If not shown above. will be shown in the Declerations.
Section II - Who II An In8ured Is amended to in-
clude as an addltlonallnsured the person(s) or organl-
zation(s} shewn In the Schedule. but only with respect
to liability for "bodily InJury", "property damagell or
"personal and advertising injury" caused. in whole or
in part, by your acts or omissions or the acts or omis-
sions of those acting on your behalf: .
A; In the performanpe of your ongoing operations: or
B. In connection with your premises owned by or
rented to you.
CG 20 26 07 04
~ ISO Properties. Inc., 2004
Page 1 of 1 [J
EXHIBIT B
ADDmONAL lNS1JRliD
FOR COMMERCIAL GENmuI. LIABILITY PCLtC'(
Riverport Insurance Company
Inswance Company
This endorsement modifies such insurance as is afforde(fby the provisions o( ~liC1
#RICOOOB559 relating to the following: .
. .f, . ,.'....
1. . The City of Santa Ana, 2() Civic: Center'Plaza, Santa AD:a. ~iCOPIia:~lOtdJa
oBicC3,'employees, apats, volunteers and iepresentativcs;8rCnamed .. ~;m~. .
("additional insureds") with ~Pld to liability and ~erense of suits arising 1iDn't*"~'
and uses performed by Or on behi1f of the'named in$un,d. . ..
2. With. resped. to claims arising out. of the opentions I!Dd uaes,enoim.ecH:i~ ";WJ
bebaJfofthe iuuned iDsun:d. such iDSUl'8l1Ce as is affonfed;by this polic)f ii.~~.;,;. .'
addiao.I to or contributing with any other iuslD'lII1~e carried by or- for the- b~ oftbe
additional iusureds.
3. This iDsurance applies s~ai'ately to- each inSUJ:ed ~ W~:~_.. ~'or'"
suit is brought e:"CeJ?f with respect-to thecompan1s limits otliabiJity; The .irte...joaot....
~on or organization as an insured shall not affect any right which such P~DO.I! Oig~On
would have as a cw,nant ifitot so included. ".
4. With respect to the ad(ijticmal iD$W"eds. this insurance lhal~.not,be~ClIled,;.
materially reduced in~e or limits exCept a~ertbirty (~O) days ~DbiJticc hasbeon
given to the City ofSluita Ana. 20 Civic center Plaza; Santa.A:na. Califothia 9270l~.
. I
(Completion.oftbe following, inCluding countersignature, is required to ~th~~~
- effeetiye.) .
Effective1 ~/09~08
Policy #. RIC0008559 . .'
Issued to Community Service Programs.
· this endo!:'Sement form~.. part'of
. .
Countemgned by
e