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HomeMy WebLinkAboutBAKER RESCUE SERVICES, INC. (4)INSURINCE ON KILL WORK MAY PROCEED UNTIL INSURANCE�,EXX TI's, MAYOR Valerie Amezcua bl"!__.. MAYOR PRO TEM CITY CLERK Benjamin Vazquez DATE, APR 2 3 2025 COUNCILMEMBERS Phil Bacerra b:I�Pp�t� Johnathan Ryan Hernandez 1 Jessie Lopez 6hllt- David Penaloza AThai Viet Phan Baker Rescue Services, Inc. Attn: David Baker 19744 Beach Blvd, #336 Huntington Beach, CA 92648 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 wWW.santa-ana.oro March 20, 2025 N-2024-195-01 Re: Extension of Agreement #N-2024-195 to Provide On -Call Confined Space Rescue Stand-by Services CITY MANAGER Alvaro Nuflez CITY ATTORNEY Sonia R. Carvalho CITY CLERK Jennifer L. Hall Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by Baker Rescue Services, Inc., and the City of Santa Ana, dated May 3, 2024, the time period of the Agreement is hereby extended for an additional one-year period from May 3, 2025 through May 2, 2026. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, Nabil Saba, P.E. Executive Director, Public Works Agency CITY OF SANTA ANA Minh Thai Assistant City Manager APPROVED AS TO FORM: SONIA R. CARVALHO BAKER RESCUE SERVICES, INC. City Attorney e Nellesen Dav1d Baker Assistant City Attorney President SANTA ANA CITY COUNCIL Vakne Amezcua Benjamin Vaaeuez Thal Viet Phan Jessie Lopez Phil Became Johnathan Ryan Hernandez David Penaloza Mayor Mayor Pm Tern, WaN 2 Wool Werd3 Ward Wood5 Wardfi vamez..0on bvazouez(Asanta-anaom 1nhanrAsantaanam 'essielwea&sanla-anaom pbawmsdsantaana am inhemandeensanfaana pm dM,,I,z,O,,nla-anapm ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDmYY) 1 L� 02/04/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. 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). PRODUCER CONTACT Shelby Cecena AFIS NAME: James G Parker Insurance Assoc PHONE (559) 584-3323 FAX (559 5849313 AlC No Eat : Na : License #0554959 E-MAIL shelbyc@jgparker.com ADDRESS: P O Box 1129 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Landmark American Ins Cc 33138 Hanford CA 93232 INSURED INSURER B: National Specialty Insurance Cc 22608 Baker Rescue Services Inc INSURER C: State Compensation Ins Fund 35076 19744 Beach Blvd #366 INSURER D: INSURER E: Huntington Beach CA 92648-2988 INSURER,: COVERAGES CERTIFICATE NUMBER: 24-25 Master GL/BAIWCI REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOL5UBR INSD MID POLICYNUMBER POLICYEFF MMIDD/YYYY POLICY EXP MMIDDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7x OCCUR EACH OCCURRENCE S 11000,000 PREMISES (E.occrmamad $ 50.000 MEDEXP(Any.r.,mon $ 5,000 PERSONAL a ADV INJURY $ 1,000,000 A Y Y LHC860014 08/03/2024 08/03/2025 GEN'L AGGREGATE LIMITAPPLIES PER: POLICY E PROJECT- ElLOC GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 CGL 8 Professional Liab s 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBiNEOSINGLE LIMIT Ea accitlent $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY X AUTO$ Y Y GM1060601 08/03/2024 08/03/2025 90DILY INJURY(Per acciaen0 $ HIREp NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per acdtlent $ Uninsured motorist s 1,000,000 UMBRELLALIAB OCCUR ��•••�•,"�� y"""" EACH OCCURRENCE $ 5.000,000 AGGREGATE $ 5,000,000 A EXCESS LIAR CLAIMS -MADE LHA602060 08/03/2024 08/03/2025 OED RETENTION 8 $ C WORKERS COMPENSATION AND EMPLOYERV LIABILITY YIN ANY PROPRIETORPARTNER1EXE11IVE OFFICEILMEMBER EXCLUDED? (Mandatory in NH) Rescribe yes, tlunder DESCRIPTION OF OPERATIONS below N/A Y 1851446-2024 09/01/2024 09/01/2025 SPER OTH- TAT UTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be ed cbed if more space Is required) City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are included as Additional Insured with respects to General Liability per attached form RSG95001 0903 and Automobile Liability per attached form CA2048 1013. Primary 8 Non-contributory is included with respects to General Liability per attached form RSG54155 0816. Wavier of Subrogation Applies with respects to General liability, Automobile liability and Workers Compensation per attached forms RSG54078 0310, CA04441013 810217 REV4-2018. APPROVED By To Tran Nguyen at 11:08 am, Feb 04, 2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: Water Resources AUTHORIZED REPRESENTATIVE 215 S. Center St Santa Ana CA 92703 j _ o � 1.1/ @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Tu Tran Digitally signed by Tu Tran Nguyen Nguyen DF0914�08'00'4 LANDMARK AMERICAN INSURANCE COMPANY This Endorsement Changes The Policy. Please Read It Carefully. ADDITIONAL INSURED (BLANKET - PRIMARY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART WHO IS AN INSURED (Section II) is amended to include as an insured: any person, organization, trustee, estate or Governmental entity to whom or to which you are obligated, by virtue of a written contract or by the issuance or existence of a permit, to provide insurance such as is afforded by this policy, but only with respect to operations performed by you or on your behalf or to facilities used by you and then only for the limits of liability specified in such contract, but in no event for limits of liability in excess of the applicable limits of liability of this policy; provided that such person, organization, trustee, estate or Governmental entity shall be an Insured only with respect to occurrences taking place after such written contract has been executed or such permit has been issued. If you are required by a written contract to provide primary insurance this policy shall be primary as respects your negligence and Section IV, Condition 4. Other Insurance does not apply, but only with respect to coverage provided by this policy. All other terms and conditions of this policy remain unchanged. This endorsement effective 8/3/2024 forms part of Policy Number LHC860014 issued to BAKER RESCUE SERVICES INC by Landmark American Insurance Company Endorsement No.: 01 RSG 95001 0903 LANDMARK AMERICAN INSURANCE COMPANY This Endorsement Changes The Policy. Please Read It Carefully. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION (SPECIFIC) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name of Additional Insured Any person or organization to whom or to which Named Insured is obligated by virtue of a written contract or by the issuance or existence of a written permit, to provide insurance such as is afforded by this policy. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the additional insured listed in the SCHEDULE above provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. This endorsement effective 8/3/2024 forms part of Policy Number LHC860014 issued to BAKER RESCUE SERVICES INC by Landmark American Insurance Company Endorsement No.: 20 RSG 54155 0816 Includes copyrighted material of Insurance Services Office, Inc. with its permission. LANDMARK AMERICAN INSURANCE COMPANY This Endorsement Changes The Policy. Please Read It Carefully. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any Person or Organization As Required By Written Contract The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US: We waive any right of recovery we may have against the person or organization shown in the SCHEDULE above because of payment we make for injury or damage arising out of your ongoing operations, "your product' or "your work" done under a written contract with that person or organization and included in the "product -completed operations hazard". This waiver applies only to the person or organization shown in the SCHEDULE above. This endorsement effective 8/3/2024 Forms part of Policy Number LHC860014 Issued to BAKER RESCUE SERVICES INC by Landmark American Insurance Company Endorsement No.: 23 RSG 54078 0310 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 2009 ENDORSEMENT AGREEMENT BROKER COPY WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SAN FRANCISCO EFFECTIVE SEPTEMBER 1, 2024 AT 12.01 A.M. ALLEFFECTIVE DATESARE AND EXPIRING SEPTEMBER 1, 2025 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME BAKER RESCUE SERVICES, INC 19744 BEACH BLVD # 366 HUNTINGTON BEACH, CA 92648 WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION REP D1 1851446-24 RENEWAL NE 7-42-16-60 PAGE 1 OF 1 NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAWN FFRRANCISCO: SEPTEMBER 4, 22024 2572 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO SCIF FORM 10217 (REV.7-2014) OLD DP 217 POLICY NUMBER: GMI-0606-01 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Baker Rescue Services Inc Endorsement Effective Date: 8/3/2024 SCHEDULE Name Of Person(s) Or Organization(s): Blanket where required by written agreement executed prior to loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1, of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: GMI-0606-01 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Baker Rescue Services Inc Endorsement Effective Date: 8/3/2024 SCHEDULE Name(s) Of Person(s) Or Organization(s): Blanket where required by written agreement executed prior to loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 44 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1