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Home My WebLink AboutTSCM CORPORATION 6B.q1ty, of Santa Ana Clerk of the Goest;eit AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and all amendments (if any) are no longer in effect. Return formto the Clerk of the Council Office (M-30).. Call 647-6520 if you have any questions. COTC Office Use Only 2G11 .'N� 26 FIN 3= 53 't s Li INL 14�a t 00iHC1L The agreement with ,L--t' f� bb�—Odd �/((bA)tote �4ry� �moo a—� / No. #/i vZ(�lt� L�UcaB)was completed on Ip and final payment has been made. (List all amendments. Use space below if needed.) /> Deportment: �GL� Phone/Ext.: Signature: Date: Revised 9$23-10 INSURANCE ON FILE A-2007-005-02 WORK MAY PROCEED UNTIL INSURANCE EXPIRES CLERK OF COUNCIL DATE: 1 a - S - O'e SECOND RENEWAL OF AGREEMENT THIS SECOND RENEWAL OF AGREEMENT is entered into on October 30, 200& by and between TSCM CORPORATION, a California corporation ("Contractor") 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 ("City"). RECITALS: A. The parties entered into that certain Agreement A-2007-005, dated January 17, 2007, (hereinafter "said Agreement') by which Contractor has provided street sweeping services for the Santa Ana Regional Transportation Center. B. In accordance with the terms and conditions of said Agreement, the parties wish to renew the Agreement for an additional one-year period and increase compensation to pay for services during the renewal term. WHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this First Amendment to Agreement, the parties agree as follows: Section 2, COMPENSATION, shall be amended to increase compensation by S 10,000.00, to pay for services during the renewal term from January 17, 2009 through January 16, 2010. 2. Section 3, TERM, shall be amended to renew the terms and conditions of said Agreement for an additional one-year period, through January 16, 2010. 3. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Agreement on the date and year first written above. ATTEST: PATRICIA E. HEAL Clerk of the Council APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney Bv: Laura Sheedy Assistant City Attorney RECOMMENDED FOR APPROVAL: CY THIA J. N SON Assistant City Manager for Development Services CITY OF SANTA ANA DAVID N. REAM City Manager ^w-Lalye %. r_m i irill I c Ur LIAMLI I Y MUKANCE un,�ITM/V W,Ti II - -- • • I --- 1 . +. 1 l GeH I UAGATE IS ISSUED AS A MATTER OF INFORMATION Spectrum Risk Mgmt. & Insurance Services ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE CA LiC. 9007748S AND OR -Z.005—at's, ALTER THE COVERAGE AFFO DEDBHOLDER. THIS CERTIFICATE DOES OYTHEPOLICEST AMEND, EBE OW. 74 Discovery A•aoo(o-ozL3 Irvine, CA 92618 A -aoo6 -3a5 INSURERS AFFORDING COVERAGE NAIC i1 isuREO TSCM Corp. INSURERA: Navigators Ins. CO. 42307 Hunts Gothgton Beach, St.ch, CAe 264 N_�9gq-211 INSURERS General Ins. Co. of America Huntington Beach, CA 92648 INSURERC. St.Paul Fire &Marine Ins. Co. A aoo3_ 3 g INSURER D Cypress Insurance C A-,00y -0.;o Company 10855 NSURER E. 11� MEDABOVE FOR THE ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENTAWITH RESPECT TO WHICOH LICY THIS OD CERTIFICATE MAY BE ISSUED OR NOTWDING 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. rR Re SR 00' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE "INIMMMLIMITS POLICY EXPIRATION DATE iml GENERAL X i LABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR 06CGL000491-02 01/01/2008 01/01/2009 EACH OCCURRENCE $ 11000 00 DAMAGE TO RENTED S SO, OOO $ 5 QO MED EXP (ADy one paean) PERSONAL S AOV INJURY S 1,000100( GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGA-E LIMIT APPLIES PER. POLICY jEO LOC PRODUCTS - COMR/OP AGG S 1,000,00 1 AUTOMOBILE LIABILITY ANY AUTC ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NONOWNED AUTOS 24-CC-153067-2 01701/ 0008 61101 22009 COMBINED SINGLE LIMIT (Eaaeadenq $ 1,000,000 X ILY INJl BODILY INJURY $ X BODILY INJURY(Per accident) S X PROPERTY DAMAGE IPer acadent) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGG $ $ EXCESSIUMBRELLALIABILITY X OCCUR CLAIMS MADE OEDUCTIB LE X RETENTION $ lO, OO QK04SO0369 01/01/2008 01/01/2009 EACH OCCURRENCE If 4.000,000 AGGREGATE $ 4,000.000 S S XERS COMPENSATION ANO LOYERS' LIABILITY PROPRIETOR(PARTNEAIEXECUTIVE fOFFICERIMEMBEREXCLUDED? deSnlNe untlar SPECIAL PROVISIONS below 3310010909-071 07/Ol/2007 07/01/2008 X WC STAru- orH- E.L. EACH ACCIDENT S 1,000,000 E L. DISEASE - EA EMPLOl 5 1,000,00 S 1 000,00 E.L DISEASE -POLICY LIMIT OTHER 'SCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS : Parking lot sweeping services. e City its officers, agents, employees are named additional insureds with resepect to the CL and auto ability per the attached forms. Notice below: 10 days notice for non-payment of premium and/or non -reporting of payroll. The City of Santa Ana Attn: Carolyn Fullerton 20 Civic Center Plaza M-25 Community Development Agency Santa Ana, CA 92701 ;ORD 25 (2001108) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL BMINBIRN WO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, CACORD CORPORATION 1988 L Named Insured: TSCM Corporation Policy # 06CGL00048102 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT (EXCLUDING RESIDENTIAL) This endorsement modifies insurance provided underthe following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) CG201011 85 SCHEDULE Name of Person or Organization: Any person or organization that the named insured is obligated by virtue of a written contract or agreement to provide insurance such as is afforded by this policy. WHO IS AN INSURED (Section ll) is amended to include as an insured the person or organization shown in the Schedule, but only with respectto liability arising out of "your work" for that insured by or for you. The following additional provisions apply to any entity that is an insured by the terms of this endorsement: 1. Primary Wording If required by written contract or agreement: Such insurance as is afforded by this policy shall be primary insurance, and any insurance or self-insurance maintained by the above additional insured(s) shall be excess of the insurance afforded to the named insured and shall not contribute to it. 2. Waiver of Su brogation If required by written contractor agreement: We waive any right of recovery we may have against an entity that is an additional Insured per the terms of this endorsement because of payments we make for injury or damage arising out of "your work" done under a contract with that person or organization. 3. Neither the coverages provided by this in endorsement shall apply to any claim arising insured or any of their agents? employees. ;urance policy nor the provisions of this out of the sole negligence of any additional 4. This endorsement does not apply 10 any work Involving or related to properties intended for permanent residential or habRational occupancy (other than apartments). The words "you" and "your" refer to the Named Insured shown in the Declarations. "Your work" means work or operations performed by you or on your behalf; and materials, parts or equipment furnished in connection with such work or operations. ANF-ES 160 (5/ 2006) P-d—, Logy COTC PROCESSING FORM AGREEMENTS AND AMENDMENTS TO: CLERK OF THE COUNCIL OFFICE FROM: DEPT.: !/1. ql PM 3: 26 MAIL STOP: PROJECT MANAGER: s4V ru, &,h N EXT.: E FOLLON(J,aITEMS_NEED�1',_ RQYD. ptT�R 7IN / AGREEMENT NUMBER (if amendment A1 N .e / n co—l-- ( I AMENDMENT NUMBER (if applicablle))�:� ❑ 1" 4�2ND ❑ 3ft0 ❑ NAME OF CONSULTANT: G4ae�o- AMOUNT: ❑ OVER $255,000- (A) Ly UNDER $25,000* (N) COUNCIL APPROVAL DATE: 'c ri ITEM #: TERM OF AGREEMENT- EFF CTIVE DATE: TERMINATION DATE: SIGNATURES REQUIRED: VENDOR AGENCY CITY ATTORNEY OTHER (INSURANCE APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) INSURANCE REQUIRED: RYES ❑ NO (Provide City Attorney Office approval) COMMENTS FOR ADDITIONAL REMARKS: * Charter amendment ❑ AUTO XCGL (Commercial General Liability) ❑ PROFESSIONAL LIABILITY ZWORKERS COMPENSATION ❑ PROCESS ❑ DO NOT PROCESS ❑ MISSING CONTACT/PROJECT MANAGER INFORMATION ❑ MISSING SIGNATURES ❑ NEEDS COUNCIL APPROVAL ❑ OTHER , 2006 for City Manager contract authority increase. A CERTIFICATE OF LIABILITY INSURANCE PRODUCER Spectrum Risk Management I THIS CERTIFICATE IS ISSUED AS A MATTEI 74 Discovery ONLY AND CONFERS NO RIGHTS UPON Irvine, CA 92618 HOLDER. THIS CERTIFICATE DOES NOT A ALTER THE COVERAGE AFFORDED BY THE )49-756-5730 OC77485 DATE (MWDDn11'YYJ ^' INSURERS AFFORDING COVERAGE NAIL # INsuRED TSCM Cor 17791 Jamestown Lane NsURERAL.f$NgalQm Insurance Cc Huntington Beach CA 92647 INSURER B: medcan �canomv In, C INSURER C: St. Paul Fire & Marine Ins CB INSURER o: Everest National Insurance Co. INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY ANY PERIOD INDICATED. NOTWITHSTANDING REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, MAY BE ISSUED OR POLICIES. AGGREGATE. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, EXCLUSIONS AND CONDITIONS OF SUCH NSR 0&1 ILTR Not TYPE OF INSURANCE POLICY BFFECTNE POLICYEXPIRATION POLICY NUMBERDATEIM A OENERALLIABILITY O6CGL00048t•03 1/1/2009 1/1/2010 LIMITS EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY 1 FRAE ES Ea occurrence S 1,000.0QI1 CLAIMS MADE 0OCCUft MEG EXP(My one Perron $ 51000 -- — - PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE 5 2,000,000 GENLAGGREGATF LIMITAPPLIES PF.R PRQ 1-1 il M PRODUCTS-CAMP/OPAGG S 1400.000 POLICY Lac B AUTOMOBILE WSILITY 02CE20555210 1/11'2009/q .1d.512010 ANY AUTO TO Q la acddeatSINGLE LIMIT 5 RS iM1 1000.O ALLOWNEDAUTOS PNl SCHEOVLEO AlR05 - BODILY INJURY (Per pv'6 ) $ HIRED AUTOS BODILY INJURY S NONOWNEDAUTOS 1.I ORC S� Pttor City eY pssts ant PROPERTY DAMAGE 5 (PerealdenU T,/ GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANYAIITO OTHER THAN EAACC S S AUTO ONLY: AGO C EXCESS I UMBRELLA LIABILITY QK04500515 1/1)2009 1/1/2010 EACHOMURRENCE $ 4000,000 V/1 OCCUR nCLA&LB MADE AGGREGATE $ 4000,000 $ DE DUCTIBLE 5 RETENTION $10,000 D WORKERS COMPENSATION ANDEMPLOYERS'LIASILITY CA10000979091 7JV2009 7I1/2010 we sT M1Tu- OTH- $ YINER ANYCEFUMEETOR'PARTNERrEffECUTNEa OFFICERRdEA1BER EXCLUDED'/ E.L. EACH ACCIDENT $ 100000 (Mandatory WNH) It PRO antler F.L. DISEASE - EA EMPLOYE $ 1000E0,000 SPECIAL SPECW. PROVISIONS W. E.L. DISEASE -POLICY LIMIT 5 11000000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Re: The Depot at Santa Ana -1000 E. Santa Ana BW. Santa Ana CA Olnc, its officers, agents and employees and the City, Its officers, agents and employees are additional Insureds with respect to the general liability per the attached blanket carder form. Primary and non-contributory wording applies. Re: The Depot at Santa Ana -1000 E. Santa Ana Blvd, Santa Ana CA City of Santa Ana Attn: Downtown Development Division 305 East Fourth Street #201 Santa Ana CA 92701 SHOULD ANYOF THE ABOVE DESCRIS60 POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL XX;OOVM MAIL 30` DAYS WRITTEN NOACETO THE CERTIFICATE HOLDER NAMED TO THE LEFT, kkX%KNAlb71 KQBOJUP71Kk1R(U7XOBEFINX9CaX ' 10 Days for Non -Payment of Premium. AUTHORIZED REPRESENTATIVE Jim Waterhouse -- --- — •---- --I w IUUO-ZUUU AUUKU CORPORATION. All rights reserved. CERT NO., 6410670 CLIENT ( PE, Olnnie 01pMt CUI[ 12/9/2009 10:40:91 AN Ptge 1 of IMPORTANT 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 certiricate does not confer rights to the certificate holder in Ileu of such endorsement(s). DISCLAIMER This Certificate of Insurance 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. 25 f2009/011 CEW 50., 6410670 CLIM COOS, Ginnie Ginnie Clarke 12/9/2009 10340,41 Tit Page 2 of 3 06CGL000481.03 TSCM Corp THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT (EXCLUDING RESIDENTIAL) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) CG 20 10 1186 SCHEDULE Name of Person or Organization: Any person or organization that the named Insured is obligated by virtue of a written contract or agreement to provide insurance such as is afforded by this policy, 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. 12/9/2009 The following additional provisions apply to any entity that is an insured by the terms of this endorsement: 1. Primary Wording If required by written contract or agreement: Such insurance as is afforded by this policy shall be primary Insurance, and any Insurance or self-insurance maintained by the above additional insured(s) shall be excess of the Insurance afforded to the named insured and shall not contribute to It. 2. WahmrofSubrogalion If required by written contract or agreement: We waive any right of recovery we may have against an entity that Is an additional Insured per the terms of this endorsement because of payments we make for injury or damage arising out of 'your work' done under a contract with that person or organization. 3. Neither the coverages provided by this Insurance policy nor the provisions of this endorsement shall apply to any claim arising out of the sole negligence of any additional Insured or any of their agents/ employees. 4. This endorsement does not apply to any work Involving or related to properties intended for permanent residential or habitational occupancy (other than apartments). The words "you" and "your" referto the Named Insured shown in the Declarations. "Your work" means work or operations performed by you or on your behalf; and materials, parts or equipment furnished in connection with such work or operations. ANF-ES 160 (6(200fi)p�a.VD ,AS �� -`� STORCK 1 tSA city Attorney Assistan C-R NO.; G610690 CLIEW CVD., Ginnie Ginnie C1.tke 12/9/2009 30:90:91 AM P,g 1 of 3 v'