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HomeMy WebLinkAboutLATINO HEALTH ACCESS (3) - 2008INSURANCE NOT ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL DATE: `~-.~~-v~ G~ : CDA (2~ V i ~i ~~el~l'~ RIGHT OF ENTRY AND LICENSE AGREEMENT N-2008-128 THIS RIGHT OF~NTRY AND LICENSE AGREEMENT ("Agreement") is made and entered into as of~ ay of September, 2008 by and between THE CITY OF SANTA ANA, a charter city duly organized under the Constitution and laws of the State of California (hereinafter referred to as the "City"), and LATINO CENTER FOR PREVENTION AND ACTION IN HEALTH, INC., dba LATINO HEALTH ACCESS, a California nonprofit public benefit corporation (herein referred to as "Latino Health Access"), with respect to the following: RECITALS A. The City is the owner of that certain real property known as Centennial Park in the City of Santa Ana, California, a portion of which is described as follows: SEE SITE PLAN AT EXHIBIT A, ATTACHED HERETO AND BY THIS REFERENCE MADE A PART HEREOF (Commonly known as the area to the rear of the Fire Department Training Facility at Centennial Park, 3006 Centennial Way, Santa Ana, California and referred to hereinafter as the "Properly") B. Latino Health Access is a California nonprofit, public benefit corporation which describes itself as a center created to assist with the multiple health needs of Latinos in Orange Count. C. Latino Health Access desires to enter onto the Property owned by the City in order to utilize the Property as storage for two 12' x 56' trailers with a 12' deck between, which are shown on Exhibit B to this Agreement. D. The City wishes to accommodate Latino Health Access's desire to utilize the Property on anon-exclusive basis by granting a right of entry and license to Latino Health Access upon certain terms and conditions. NOW, THEREFORE, for good and valuable consideration, Latino Health Access and City do hereby agree as follows: 1. Right of Entry and License. Provided that all of the terms and conditions of this Agreement are fully satisfied, the City hereby grants to Latino Health Access and its employees, agents and invitees the nonexclusive, nonassignable, personal right and license to enter upon the Property to store said two (2) trailers and the associated deck, and for no other purpose. This Agreement shall be from "month to month" and shall automatically terminate and expire thirty (30) days after written notice of expiration is provided by City Manager, which shall be given at the City Manager's sole and absolute discretion. It is expressly understood that this Agreement does not in any way whatsoever grant or convey any rights of possession, easement, equitable servitude or other cognizable property interest in the Property. 2. Access. Latino Health Access shall have the right to access said trailers as reasonable on Mondays through Fridays between the hours of 8:00 a.m. and 5:00 p.m., excepting federal, state or city holidays. 3. Agreement. By execution of this Agreement, Latino Health Access agrees for itself and on the behalf of its employees, agents, consultants and contractors as follows: (a) That Latino Health Access will not permit any dangerous condition or waste to be created on the Property. (b) All acts and things done by Latino Health Access on the Property will be done in a careful and reasonable manner, in accordance with all federal, state, county and local laws and regulations. (c) Latino Health Access shall enter the Property entirely at its own cost, risk and expense. (d) Latino Health Access shall not undertake any temporary special event on the Property, not permitted by this Agreement, unless such event is first approved in writing by the City Manager or designee. Latino Health Access understands that the approval of a request to undertake a temporary special event may include additional conditions imposed by the City. (e) Prior to undertaking performance of work under this Agreement, Latino Health Access shall obtain and maintain insurance as described below: i. Commercial General Liability Insurance. Latino Health Access shall maintain commercial general liability insurance naming the City of Santa Ana and its officers, employees, agents, volunteers and representatives as additional insureds) and shall include, but not be limited to, protection against claims azising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Latino Health Access'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 $1,000,000.00 per occurrence. Latino Health Access shall supply City with a fully executed additional insured endorsement in substantially the form attached hereto as Exhibit C upon execution of this Agreement, which shall be approved in form by the City Attorney. ii. The following requirements apply to the insurance to be provided by Latino Health Access pursuant to this section: Latino Health Access shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. Certificates of insurance shall be famished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. 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. iii. If Latino Health Access fails or refuses to produce or maintain the insurance required by this section or fails or refuses to famish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at its election, to forthwith terminate this Agreement. (f) Latino Health Access shall maintain the Property in a neat and clean condition. (g) Latino Health Access shall not permit any mechanics', materialmen's or other liens of any kind or nature ("Liens") to be filed or enforced against the Property in connection with this Agreement. Latino Health Access shall indemnify, defend and hold harmless City from all liability for any and all liens, claims and demands, together with costs of defense and reasonable attorneys' fees, arising from any Liens. City reserves the right, at its sole cost and expense, at any time and from time to time, to post and maintain on the Property, or any portion thereof, or on the improvements on the Property, any notices ofnon-responsibility or other notice as may be desirable to protect City against liability. In addition to, and not as a limitation of City's other rights and remedies under this Agreement, should Latino Health Access fail, within ten (10) days of written request from City, either to discharge any Lien or to bond fox any Lien, or to defend, indemnify, and hold harmless City from and against any loss, damage, injury, liability or claim arising out of a Lien, then City, at its option, may elect to pay such Lien, or settle or discharge such Lien and any action or judgment related thereto and all costs, expenses and attorneys' fees incurred in doing so shall be paid to City, as applicable, by Latino Health Access upon written demand. (h) Latino Health Access shall not have any interest in the Property or be entitled to any reimbursement or repayment for any work performed upon the Property pursuant to this Agreement. (i) Latino Health Access shall take all necessary precautions to prevent the import and/or release into the environment of any hazardous materials which are imported to, in, on or under the Property during this right of entry. If hazardous materials are imported onto the Property, Latino Health Access shall be solely responsible for removing such imported hazardous materials in conformance with all governmental requirements. Latino Health Access shall report to the City, as soon as possible after each incident, any unusual or potentially important incidents with respect to the environmental condition of the Property. (j) At the request of the City Manager or designee, Latino Health Access shall meet and confer with the City to review issues or matters related to its use of the Property; provided, however, that the City shall have no obligation to request or hold a meeting prior to exercising the rights retained by the City under this License. 4. Indemnity. Latino Health Access hereby agrees to defend, indemnify and hold the City and its officers, officials, members, employees, agents and representatives, harmless from and against any and all loss, damage, injury, liability, claim, cost or expense (including, without limitation, reasonable attorneys' fees, expert witness fees, court costs, and expenses) arising from or attributable to the activities of Latino Health Access or any of its employees, agents, consultants or contractors upon the Property pursuant to this Agreement. All use of and entry upon the Property shall be at the sole cost, risk and expense of Latino Health Access. Latino Health Access recognizes and understands that should this Agreement be deemed by the County of Orange to create a possessory interest subject to property taxation, that Latino Health Access shall be subject to the payment of property taxes levied on such interest, and that it shall defend, indemnify and hold the City of Santa Ana and its officers, officials, members, employees, agents and representatives, harmless from and against any and all such claims. 5. License Payment. Latino Health Access shall pay to City a license fee of $1.00 per month, receipt of which is hereby acknowledged. 6. Miscellaneous. (a) Choice of Law. This Agreement is to be governed by, and construed in accordance with, the laws of the State of California. (b) Remedies. Either party shall, in addition to all other rights provided herein or as may be provided by law, be entitled to the remedies of specific performance and injunction to enforce its rights hereunder, except to the extent expressly provided to the contrary in this Agreement. All rights and remedies under this Agreement are cumulative and no one of them shall be exclusive of any other, and each party shall have the right to pursue any one or all of such rights and remedies or any other remedy which may be provided by law, whether or not stated in this Agreement, except to the extent expressly provided to the contrary in this Agreement. (c) Counterparts. This Agreement may be executed in two (2) or more counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument. (d) Non-Liability of Public Officials. No officer, employee, member, agent or representative of the City shall be personally liable to Latino Health Access, or any successor in interest, in the event of any default or breach by the City, or for any amount which may become due to Latino Health Access or its successor, or for any breach of any obligation of the terms of this Agreement. (e) Effective Date. This Agreement shall become effective on the date first set forth above. IN W1TNE5S WHEREOF, the parties hereto have entered into this Agreement as of the date first set forth above. LATINO CENTER FOR PREVENTION AND ACTION IN HEALTH, INC., dba LATINO HEALTH ACCESS, a California Nonprofit Public Benefit Corporation By: America Chief Executive Officer CITY OF SANTA ANA, a Charter City By: ~~ David N. Ream, City Manager ATTEST: Patricia E. Healy, Clerk of the Council APPROVED AS TO FORM: Joseph W. Fletcher, City Attorney By: Attorney EXHIBIT A PLOT PLAN (next page) y~0~, Santa Ana Fire FIRE Training Facility Centennial Regional Park 22 FWY _ _ .. ~ ~ ^ ,~~ yP ~~__~_ ~ `~ r ~,~~ Edinger ~ ~ Thomas Bros.Guide Page 829 A-6 3006 Centennial Way (Map is notto scale) Warner ,~~ '~ ~ ~ _ ~ hh ~ ~ ~~ . 405 EXHIBIT B Trailers EXHIBIT C ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy 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 insureds, 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 : ] ICI' I .iii 1 (III I I ,. I[ ill', ..il ~~.. I „i. -~'I" ~ i.~' li I I I: it II I I~ I I I ~'i 1 I : I,'. "I ~ ~~iii:, l ~;~.~~. :I'. II , ,.... ^,III ,• I ., tll ~ I ~:: ~I" 'i , ~..., ~. ,, ..:: I ..[ ,:li .n.• :. 'i~ ' I ill !' I. I I: I .~i ." 1 ills ,li ~- .., il.l I I ~ 'i ' I ,~ a I I II I.. ~ .II II ._i: I. I I ~I I li :' I .III I':..II~ I .~I~~ I . '.I I II:~I• ~., :.' .~~ ~ll', ~ _III ..~! ~~'I '~. I.I .I I. I ,, I. ry/A~~ :1111 ~~; III ;~ ,III,, illy' ,::Ih II,. .. !,~ !I:~II il,.il, s . I ~ :I' I il- I.,I,.. I l ill. ........ .. I .I. II ,I~ .:I ,~:_31. I I I III: ::I I ~ ATE ~MMIDDIYY~ 'II ;'~~~ ~', 7~ ~ ~~~ I - ~~~~"~ ~ ~ ~I I'i':~ ~ l~:,q~l: I ~~'~~~il: a ~':~-~ I '~:'~~ I' .. .: I I i.. i~4 II III "!- ~4 I ~' I ~~L .I . li,l ..II _III I III r,i I I ~? I ~ II ": II II ,: I I,.. .... ~ .~ 'I , .'~~, .. .,: I Il,.i, ~~. .. ', I;: I !. ~. •:~ .;:, .. I. :; ~',. ..I .,.I'; .. .~'~. II II .., ~~II I, .•.~ y ,III.-!. 'I .I~~~: I I...I. ~ i .I ..... I 1..., ..6 PRODUCER Serial # 100198 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 13LAKEMDRE & ASSOCIATES ONLY AN^ CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR • P.O. BOX X731 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, SAN DIEGG, CA 929fi1 ~ CDMPANfES AFFORDING COVERAGE fi~9-222-4458 -- - - --- GoMPANY PHILADELPHIA INDEMNITY INSURANCE CO. A INSURED ~~ _ COMPANY LATINO HEALTH ACCESS g . 17D1 N. MAIN 5T. ---- - ---- -- I SANTA RNA, CA 9270fi COMPANY I C COMPANY I D - ~~ .:.. I ', ". :: .. ~: .... ', I. :I, I. W~~ .. ,; I.. II, I ill ~~ I ..::, r.. I.: I'I .I~ ,.,. ;,, .I:'I:;, l : p;.. I G,:,Il., . .'. ~ ,,, ,,.°.„ i ~ .. .. ~ .I .I ~... :::,~ ..:~:, ,.' :~~' I ,: ..'il. '. ..... .,~ :.I , "I I.. I.. ..:,..:,,~ I,'. :~~~. i. .. ~.~~~ .~:I II.. ~. II. :III,.. .. .. :'~.':. ~...~ .. i. 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I:n.:.. ..,~;. ,., ~i." ~~~~:.I: ,i ~I 3 : I I,~~, I ~ i I I I:I I I I IIC.,~: I .. ::; I I I `ii~~ I I ~ I' .j.: ~!.: .'I-.x 1. mi : .. ~.. ...nn r I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO • •EN ISSUED T ,~~ .~ ~ .ED NAMED AB W HAVE BE O THE INSUR II ~ OVE (FOR THE POLICY PERIOD fNDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCWENT WITH RESPECT TD WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E?CCLUS!c~NS AND CONDITI~JNS OF SUCH POLICIES, LIMITS SHOII~JN MAY HAVE REE[~! REDUCI=D BY PAID CLAIMS, , I I ~ CO I POLICY EFFECTIVE POLICY EXPfRAT[ON LTR TYPE OF INSURANCE II POLICY NUM$ER DATE ~MMlDDIYY) DATE {MMlDDIYY) GENERAL LIABILITY IIPHPK31~291 05/20/08 05/20/09 A ~ 'COMMERCIAL GENERAL LIABILITY I I ~ CLAIMS MADE ~ QCCUR , I C------ ~I dWNER'S & CONTRACTOR'S PROT • I ~ I i AUTOIt~DBILE LIABILITY ~PHPK314291 0512010$ ~ 05/20/09 ,~ X ANY AUTO . -_ 'ALL OWNED AUTOS _..._~ I j SCHEDULED AUTOS I ~ X ~ HIRED AUTOS I I I ~x NON-DINNED AUTOS III. I I I 11 ~ I I ~ ~~..._ .__-__ __.. G~'RAGE LIABILITY ' L~ I I ANY AUTO II __~'I __.._._.._ _._ I II ~ EXCESS LIABILITY UMBRELLA FORM -----~ j (.OTHER THAN UMBRELLA FORM _....III WORI~(ER'S COMPENSATION AND I EIyIPLOYERS' LIABILITY THE; Ni,Gr'RIET'ORI ~ INCL PARTNERSlExECUTIVE I OFFICERS ARE: E?LCL OTHER }.• _. .. r . -.. ,• n - ~ .._ i ~ R•' I LIMITS GENERAL AGGREGATE $ 1 aaQaaa PRODUCTS - COMPIOP AGG $ 1 aaaoaa PERSONAL & ADV INJURY $ _ 1 aQaaaa EACH OCCURRENCE I $ 1 aaaaaa FIRE DAMAGE (Any one fire) $ 1 aaaaa MED EXP (Any one person) $ 5aaa COMBINED SINGLE LIMIT ~ 1 aoaa0-Q BODILY INJURY ~ $ (Per person) BODILY INJURY ~ (Per accident) PROPERTY DAMAGE g AUTO ONLY _ EA ACCIDENT I I - -- $ ~ I I OTHER THAN AUT6 ONLY: _..... __ EACH ACCIDENT $ ' AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ + I VtiIO STATU- 0TH- +' II TORY LIMITS ER EL EACH ACCIDENT $ EL DISEASE -POLICY LIMIT $ EL DISEASE - EA EMPLOYEE $ I DESCRIPTION OF OPERATIONSlLOCATIONSIVEHICLESISPECIAL ITEMS 1 CITY OF SANTA ANA ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS IS NAMED ADDITIONAL INSURED PER ATTACHED EXHIBIT B ,. .. ; .. :~: t : I :. , .,„~ i ,ail I I I~, I 1l~''~. I I , I I .. EIRTIFIC , .. I I: . AT.E. H~LDE.I~: I II .. I ..I ., 16- I II I~ NIC'ELI,.A,TIQN ~ :.I l .I , I I III I I", V.o a I , I , ~~ ... '. . I:Ir' .~~ , ~::.. ~ ° I I II ~ ~ I .. ,.. I II,, II,:a I -:': I :I ~ I .i I I ' II . ,~: r,..'.: SHOULD -. .. ~ ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BE[=pRE THE i CITY OF SANTA ANA EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL EN~Q3 MAIL + 2Q CIVIC•CENTER PLAZA, M-21 ~0 DAYS WRITTEN NOTICE TD THE CERTIFICATE HOLDER NAMED TD THE LEFT, SANTA ANA, GA 9271 ~~~~~~~ 'i ~~ ~ AUTHORIZED REP /N IVE BLAf4EMORE•~ ASS CIATES I ~ ' ~ _ , ~~ '° ~,~: ,::~~: is '~~ I [ : II - . , ~. I 'd t I '. I III I :~I ., l ,, I ~, ;I I .. le~yy . .. :. , , ~M~ ~~~!: '. ,I 3 it I I~ G ', I ui; I II..I': I ~ i i ~ ~ I I II~ I I,:, I I I':Ij 1.1:;.. AQ RQG .:....~ . ~ .. ...~: I ~:.... I .II I I .I .~^ .~...~. , '-: ....,, ., I.~ . ~t ~. IJ .i,~~ ,:..., ,. I. il... I I.. .ICI ~;': I .. i.l.~ .I I_. - I .' . ., ... .I . L I; I , . I , ...~, I I i .l III II AIC ~~ P~ T~~O ,11958 :, I .:.:III I L.. ;: I ,'. I . ~ . ~~. IO~,D II .,R.. ,~ , ~I a I .u. I. ; u I C:IFMPROIGERTPROS LATINOHEALTHACCESS.FPS ADDITIONAL INSURED ENDORSEMENT Insurance Company Philadelphia Indemnity Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy #PHPK314291 relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents and volunteers 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 ofthe operations and uses performed b Y or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additian~l to or contributing with any other insurance carried by orfor the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made ar 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 b~ canceled, or materially reduced in coverage or limits except after thirty X30}days written notice has been given to the City of Santa Ana, 24 Civic Center Plaza, Santa Ana, . California 92701. y (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective ~~~~/a2o~8 ,this endorsement form as a part of Policy # PHPK314291 Issued to Latino Health Access Named Insured Countersi ned b G%~z''~ ~ ~~ ~ Y .~!~.~ Authorized Representative , ~~~~ DATE (M _' Y) - tk sS~~kk ~ ~~ t H~tr4T . __.- ..r_.,..~ 3.. ~~ ~ -..d- ~...,__~. r. _~ ~ ~ ~ R L s R1. . _o---~ ...-. ._:. 05/232008 PRODCCER Senal# 100198 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BLAKEMORE & ASSOCIATES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX 7737 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I SAN DIEGO, CA 92167 N , ZCTb b J , ~~ _ __ COMPANIES AFFORDING COVERAGE 619-222-4458 coM=ANY PHILADELPHIA INDEMNITY INSURANCE CO A INSURED OCMPANY LATINO HEALTH ACCESS B t701 N. MAIN ST. - - --- - SANTA ANA, CA 92706 ~ CCMPANr C COMPANY D py' , ! si'- a 7 T Y L 3' T -o-a t:+1a .!~%~E?RA~SY ~;.': ... 4.:x.1 Pf-r41M: ir+- 44-~P w% rfy}~M. Y3 }R~' a I F-., ~~ Eyf # ,..:Y ..~ "~- M.. ...y:.91-43- SP1 (; ~,~r9~a~#'~~i Yi~YS~f{ ~ ..e r't- I THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HA VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDE D B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAV - E SEEN REDUCED BY PAID CLATAS CO T POLICY EFFECTIVE POLICY EX%RATION I LTR TYPE OF INBURANCE POLICY NUMBER '. DATE (MMf00M/t DATE (MMfODMy) LIMITS ' GENERAL Uaewrv '''PHPK314291 0520/08 05!20/09 GEnERAL AGGREGATE s 7000000 A X vOMMERLIALGENERAL LIABILRY ~ PRODUCTS-COMPIOP AGG 5 7DDODOD CLAIMSldADE ~ OCOJR PERSOFAL6AJVINJURY 5 7D000OO .OWNER'S&CCNTRALTORS PROT ~ EACH OCCURRENCE $ 7DOODOO '. ~ -~ FiRE DAMAGE (Any ane fire) E 1GODOO ~ ~ AUTOM08ILE LIABILITY ~pHPK314291 /{ rX ANY AUTO 05l20lD8 MEO EXP (Any ane pexon) 0520!09 GOMB'NED SINGLE LIMIT - E SDDO S 1000000 ALL OW NED AUTOS ~ I - '. BODILY INJURY I8 ' _ SCHEDI.LED AUTOS ~ fPer pexonl I X I HIRED AUTOS ~ ggOLILr INJURY Iver ac ia E I X '. NON-OWNED AUTOS '~. c enry '-, --'-'--- PROPERtt DAMAGE '',g GARAGE LIABILITY ' AJTO ONLY EA ACCIDENT ''S ,ANY AUTO OTHER THAV AUTOOnLV _-- ~, ~ i _ - I EACH ACCIDENT 5 j AGGREGATE E I EXCESS LNleIL1TV EACH OCCURRENCE 5 ' UMBRELLA FORM __ _ _ AGGREGATE 5 OTHER THAN UMBRE-LA FORK . '-r aq ";f y`yyy 5 WORKER'SCOMPENSATION ANO ~ i ~ ' I~ ' NC SrRTLL oiw TORY LIMITS ER 'EMPLCYERS'LIABILITY __ ~' ! cAJIACCIDENT EL- $ ~ THE PncPalE rov INCL ~~~ P4RiNERYc%EC~NF - ~`~yT,L~ ~ ~ EL DISEASE-.. --_ 'LIGY LIMIT _. _. _._.______. $ oEFICERS ARE EXLL - '~ EL DISEASE-EA EMPLOYEE 8 ~' OTHER i ,,,,_ I DESCRIPTION OF OPERATIONSILOCATIONSNEHIOLESISPECIAL ITEMS I CITY OF SANTA ANA ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS IS NAMED ADDITIONAL INSURED PER ATTACHED EXHIBIT B - CER7IFICYITE310L'DER` - , ~~ :'-~ ' 3 ~ rd*~ ~=11T$~[ -` ~ ':.. 1 ~ :IZ ~x b e+. - '.: E " y :, ._ .. ,. -. , ~ x - .- .... :. r, .+ ~'~^ri __ e i Prr _. v--Ra ...f_.,:rA -a,9a5~:# 3as.-~I'-'L vfii 4 F n SHOULD ANV OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE CITY CF SANTA ANA EXPIRATION GATE THEREOF. THE ISSUING COMPANY WILL ENB§461tofb MAIL 20 CIVIC CENTER PLAZA, M-2t 3D DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, SANTA ANA, CA 92707 I ' AUTHORIZED REPl~~I/V~EJBQUIK~~/AC~CIATES ~ ~ GI f~ _... ...... _ .i. _ r r.. ~.; d... Y~_ .~. 8 a ..~ k dF Y.3 :.a'. Iw'ki e, __ _ _ __ _ _ ~Q~i , C'IFMPROICERTPROS LAT:NOHEALTHACCESS FPS' ADDITIONAL INSURED ENDORSEMENT Insurance Company _Philadelphia Indemnity Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # PHPK314291 relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents and volunteers 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 canceled, 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 O`~~ojoog ,this endorsement form as a part of Policy # PHPK314291 Issued to Latino Health Access Named Insured Countersigned by ~~~ z~ ~~ Authorized Representative