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HomeMy WebLinkAboutPAYPHONE COMPANY, THE 2 -2008 INSURANCE ON FILL N-2008-161 WORK MAY PROCEED UNTIL INSURANCE EXPIRES 5 3 1- l `c{ CLERK DF CDUNCIL NON-EXCLUSIVE LICENSE DATE I a/ - I ~ -c~~ WITH THE PAYPHONE COMPANY J - C s~A 111 nr.f~~-;) Cs~'o~Yn ~1ler-1'~n This License Agreement is entered into on November 1, 2008, by and between the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the state of California, (hereinafter referred to as "Licensor") and Z Venture Capital Frontiers, Inc., dba The Payphone Company, (hereinafter referred to as "Licensee"). I. ACKNOWLEDGEMENTS a. Licensor is the owner of that property known as The Depot in Santa Ana ("the Property"), located at 1000 E. Santa Ana Boulevard, Santa Ana, California. b. Licensor hereby grants to Licensee a non exclusive license to install, operate and maintain 9 payphones and associated equipment, including any pedestal, enclosure, signage, wiring and conduit (hereinafter "payphone") on the Property, subject to the following terms and conditions: 1. Licensee certifies that it is the owner of the payphones and that said payphones shall remain the sole property of Licensee. 2. Licensee shall provide nine (9) Payphones and one (1) Credit Card swipe enabled payphone, and 2 PayEmail Internet Payphones on the Property in accordance with its Proposal dated September 18, 2008, a copy of which is attached hereto and incorporated herein as Exhibit A. One of the payphones shall be a TDD phone. Licensor reserves the right to relocate said payphones within the Property at anytime, so long as Licensee is notified of such a move. 3. All Licensee records pertaining to the revenue generated at The Depot shall be made available at all times for audit by Licensor upon request. All audits shall be paid by for by Licensee. 4. Licensee agrees to provide the installation, service and maintenance required for the operation of said payphones at no obligation or cost to Licensor. Licensor shall notify Licensee in the event a payphone needs repair, is vandalized or stolen. Licensee shall respond within four (4) working hours to calls regarding problems with said payphone, and repair said payphone (when inoperable) within twenty-four (24) hours. 5. This License shall be effective for one year commencing on November 1, 2008 and terminating October 31, 2009. Thereafter, the License maybe extended for three one- year extensions upon a writing signed by the each of the parties. 6. Either party may terminate this License by giving the other party thirty (30) days written notice of revocation of said License. Within ten (10) days of termination of this t License, Licensee shall remove said payphones, and return the Property to its original status. 7. This License is personal to Licensee and shall not be assigned. Any attempt to assign this License shall automatically terminate the License. No legal title or leasehold interest in the Property is created or vested in Licensee by the grant of this License. 8. Licensee is solely responsible for any damage to, or theft of, said payphones; Licensor shall have no responsibility or liability with regard to such payphones. A copy of the insurance policy for said payphones is attached hereto as Exhibit B, and incorporated herein by reference. Licensee is also responsible to Licensor for any damage to Licensor's property caused by or arising out of the leasehold interest granted herein. 9. Licensee shall defend, indemnify and hold harmless the City of Santa Ana, its officers, agents, employees and volunteers, from claims of any kind or nature, including workers' compensation claims, for damages to physical property, theft, and/or physical injury or death to persons resulting from or arising out of acts, errors or omissions of Licensee, its agents, employees, or subcontractors, pursuant to the terms and conditions of this License. 10. Notice and written communication sent by one party to the other shall be personally delivered or sent by U.S. mail, postage prepaid, to the following addresses: If to Licensor: The Depot at Santa Ana 1000 E. Santa Ana Boulevard Santa Ana, CA 92701 Phone: (714) 565-2690 If to Licensee: The Payphone Company 1968 W. Adams Blvd., Suite 311 Los Angeles, California 90018 Phone: (323) 730-1617 Attn: Karim Zaman 11. This License has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this License 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 License. 2 IN WITNESS WHEREOF, the parties hereto have executed this Non-Exclusive License the date and year first above written. ATTEST: CITY OF SANTA ANA ~ i L<Gt~ J PATRICIA E. HEAL DAVID N. AM Clerk of the C~ancil City Manager APPROVED AS TO FORM: JOSEPH W. FLETCHER, City Attorney ~ By: Lisa E. Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: LICENSE; . Cynthia J. Nelson Karim Zaman Deputy City Manager for Dev. Services President Community Development Agency Tax m # ~~67~0 3 ~'eSe~i~~~'lO~l ~O ~le ~e~O~ ~~.n~~ ~,n~ Z Venture Capital Frontiers, Inc. (ZVCF) DBA a phone Com e~' Y ~ Y i ~ ~ s . ~ . ~ • ~r i THE PAYPHONE COMPANY 1968 WEST ADAMS BLVD. SUITE 311 LOS ANGELES, CA 90018 ®323.730.1617 ®323.730.0509 a W W W.T H EZAM AN GROUP.COM/PAYPHON ES September 18, 2008 Ms. Carolyn Fullerton City of Santa Ana The Depot at Santa Ana 1000 East Santa Ana Blvd. Suite 108 Santa Ana, CA 92701 Dear Carolyn: Z Venture Capital Frontiers, Inc dba/The Payphone Company (TPC) appreciates the opportunity to propose on the RFP Payphones and Payphone Service for The Depot at Santa Ana. It has been our pleasure to provide you with your Payphone Service for since 2002. Since taking over from the contract from AT&T we have had several notable accomplishments: 1) TPC has significantly increased revenues to The Depot at Santa Ana while maintaining affordable calls for travelers. 2) TPC has made capital investment by purchasing new payphones and Spanish Language Signage. 3) TPC has provided a direct dial coin international platform for customers making international calls. Under the new contract, TPC will make the following capital investments and upgrades: 1) TPC will offer nine (9) Protel payphones and (1) Credit Card swipe enabled payphones with In-Language Operators based on the users credit card country of origin. hones. 2) TPC will offer 2 state of the art PayEmail Internet Payphones. The newest technology in payp 3) TPC will have scrolling Signage on the LCD Screen and a link to the City of Santa Ana website on the PayEmail Internet Payphones. 4) TPC will provide a Prepaid Calling Card Machine where the cards can place calls by PIN and also e utilized in the credit card swipe. 5) TPC will perform two scheduled visits a month to service and collect its payphones at The Depot at onto Ana. Repairs will be serviced within 24 hours of notice. The Payphone Company agrees to all the requirements and specifications of RFP Payphones and Payphone Service for The Depot at Santa Ana. W e are a full service payphone hone Come ante has beenrin the pubaecoromunications Headquarters is located in Los Angeles California. The Payp P Y industry for over 1 I years. The Payphone Company is a certified MBE/DBE and State of California Small Business Enterprise. The Payphone Company has vast experience in the payphone industry. Our contract include: the City of Los Angeles Sheriffs Department Inmate and Juvenile Facilities, Patton State Hospital, and Cuyahoga County Jail. We contracts atmmajor airportsinclduding Los Angeles World Airportdit~i'ol i~aukeevGene al Mitchel Airport and San and Diego Airport. Finally, we are able to provide you with the very best service, unique calling programs, the latest technology, and value by: reactingtos sues more q ucklyncustomize solutions tai orledrto The Depot d Santta Ana[s Beds ande and operate on lower margins than companies of a much larger scale. If you have any questions or would like to schedule an interview, please do not hesitate to contact me at (323) 730- 1617. Smce~ely, \ ~ti Karim Zaman President We are honored to have the opponity to ro ose onr payphone sex~vxces to p p The Depot at Santa Ana... i r~ x ~ ~ _ ~ frT`f-z h L - ~ M, A k,' ~ xfl~ ~ M _ ~ r . - y~ s ~ r - x `..i' 1, y a, A~Sa.. ~ , `a x yh ~4'y ~,t „f~+,4 a ,4 ~ s id s'. ~i a x T ~ ~ w A O~ AC.COUNTS ~ C~IENT~ fip~1Vi ~ ..................5., ~IV~ental Health f<:~. OF A~9 1 1 o~ ago ~ ' ~ 1_ui :1 rt.>;ilt'< <l"rrtltl :1irf!t,r!> R • _ PFrrow 1sOiPIT? - ~ 15:~ „ ' ~ re . 7 rs° • • • e.. v d Cuyahoga Hawthorne cd e: SAN DIEGO r INTERNATIONAL 1 AIRPORT i General Mitchell International Airport ~X~"'Ritt ~r ~ h f ~ _ 3;1$ ~ yr: ~ g w..~w,_4.. .n _ , . cp a ,5'~ L ~3 xp F~ a+ H } . . ~35'u+.a.,w.... . a The Pa hone Com an will provide_nhones) (2) Payphones, (1) c~realt Card Swi e Payp . ' ternet Phones and ~1) Prepaid Calling Card PayEmail In Machine at various sites f or The Depot at Santa Ana. ~'i ~ 3 t p cnr. ¢ar cart cn.C _ w w p~ r /~Q m If The Depot at Santa Ana elects not toWa d when The Payphone Compa y does notoob~ectp. aid Caging Card Machine ix~ the contract a The aforementioned products/services in the contract commissions can stand a one bundled. ~.1~II~~~~r ~T~ ~r~a~.c~ Product -Prepaid Domestic/International calling ~ a_.~s°... card Phone • BBG Patented Swipe and Call Pre Pay Calling Cards.work from ~ayphones just like credit cards. Your customers will not be required to enter the 1800 number or any PIN. • Pother denominations are available)$10 and $20 • Program Objective: - To provide better PPC telephone value for TPC "Saj Customers. m--.e - To provide a better financial offer to TPC. - To guarantee growth - - To always provide a means for a customer to make a call EVEN when he or she is out of credit and without a credit card (via Collect Call) • Choice of blue, red, yellow or black cabinet • Cabinet dimensions (WxDxH): in=14 x 10.5 x 22 • Machine weight - 551bs • Heavy gauge steel cabinets and durable steel locks • Can hold a capacity of up to 660 cards jj *..Estimated monthly revenue is $500/machine ~®~1 PayEmail Functionality: • It needs a T-1, cable modem, or DSL line to supply a broadband high speed "always on' connection. Pay Email is designed to fit in a space vacated by a pay a • phone but can hang on a wall, sit on a desk or counter. • A bill acceptor is optional to boost sales r _ ~ A printer can be added and can charge a per page fee. " r--- - The unit can provide a WiFi antenna and the necessa t-.., software to otter this service. Pa Email Features: • Handset for VOIP calling 15" flat screen monitor _ ~ Painted steel housing w/ Rugged vandal and fluid resistant keyboard d ~ Industrial strength trackball and mouse • Swipe credit card reader Wall or desk mount • Fluorescent backlit sign • Made in the USA -durable and reliable 18" W x 22" H x 11" D ~ 471bs. • Internal operating computer i Accepts cash, credit or debit. cards * Estimated monthly revenue is $400/machine .a ~~O ~ O~ ~~.C~S f ~ • TPC shall provide all transportation, supervision, trained personnel, equipment and materials to successfully manage all aspects of the contract. • TPC shall submit a detailed sched aced atThe Depotlat Santa Ana. maintenance to all instruments to • TPC shall have all commission chrijksandlhow commissnons areh detailed audit sheet showing reve applied. • TPC shall have the ability to answer all repair calls and make any corrections within 24 hours. • If the contractor fails to provide serviocritractor at a rate of $500.00~~ shall have the right to bill back the per incident. * n« a.. _ : ~ > _ _ t._...~...,..__.__ '~o S~xr~.xx~~~ You can expect an INCREASE in revenue rom the Pa Email Payphones and Pre- f y Paid Calling Card Machines. Pa hone Company caters to the fast The yp rket. growing telecommunications ma Win-Win Deal! 3, ~5.«-_ . a ~ 4 S ~ ~ • PROPOSER'S STATEMENT . COMMISSION PROPOSA • INSURANCE • CERTIFICATIONS AND QUALIFICATIONS • CONTRACTOR'S QUALIFICATION QUESTIONNAIRE • OFFEROR'S REFERENCES Y ~ f a ~ a, f~ ~r ,g~~3~ r t ~ rJ.~ls ~~h #9~~ Ex y~`~~~ W.... ....e E~<F ~s.~_ y. ~ ~ o~~~ ~ . 4 ~ .~aY n'•~ c~. X y Y ~ L:.~:i...:.,.... THIS SHEET MUST ACCOMPANY BIDDERS RESPONSE PROPOSER'S STATEMENT I have read, understand, and agree to the terms and conditions of all pages of this Request for Proposal. Upon request, I will transfer and deliver services to the City of Santa Ana in accordance with said terms and conditions. Authorized officer (Print):Ka ' aman Title: Presides-Signature: Firm Name: Z Venture Ca ital Frontiers Inc. dba The Pa hone Com an Address: 1968 W. Adams Blvd., Suite 311 Ci Los Angeles , CA Zip Code 90018 Telephone Number: 323-7~ 1617 Fax Number 323-709 r_.. s- ~ i;„;~ F- x~~.~~~~o~ cod®~ ~ _ ~R t - r "8f `r Kp ~„s r xr~xn~ssion Pr~o~os~l Co OSED COMMISSION, to be paid PROP to The City of Santa Ana shall be: - 40% of Payphone Revenue - 25% of PayEmail Internet Payphone Revenue - estimatedrevenue is $400/machine ated - 35% of Prepaid Calling Card Revenue - estim revenue is $500/machine - Commissions will be paid each and every month f or the lif a of the agreement. /,U t1G i month period. Effective date will be on or about October 1, 2008. e * TERM OF THIS AGREEMENT is to be for a successful offeror, for up to three (3) addtt oval twelve ( 2)tmonth period beyond the primary contract period.ement from the City an s e' > , , per. .a_..... ~?r. ~ ~ i ` $ t 9 Y r. ~ ~ ~S~d i ~ DATE IMwoomrY) ACORD CERTIFICATE OF LIABILITY INSURANCE 7/a zoos (760) 241-7900 FAX: (7 6 01 241-14 67 TONLYCgNpIFICONFERS SNOE RIGHTS UPON RTHE ICERRTIF~ICATE :ooucER ISII Iasurance Services - ARMAC Agency p~TERTHE CIOVERAGEIAFFORDED BY ~HE POL CIES BELOW,OR 17177 Yuma Street Victozville CA 92395 INSURERS AFFORDING COVERAGE NAIC# INSURERA TranB ortatioa Iasurance 20494C INSURED Z Vesture Capital FLOatier8 IaC INSURER B: D:Ont].nEntal Casualt 20443C DBA: The Payphoae Company, The Zamora Group INSURER C'. 1968 W AClamB Blvd Ste 311 INSURER O: LOS ANGELES CA 90016 INSURER E. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A9GVE FOR THE POLICY PERI00 INDICATED. NO7NflTHS7AN01NG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TFIE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. A ATE IT H V N POLICY EFFECTIVE PODCY E%PIRATON LH11T3 INSR ADD'L rypE OFINSURANCE POLICY NUMBER DATE MMlDDIYY DATE MMlODM' EA H R ! $ 1. 000. DUO GENERAL LIABILITY DAMAGE TO RENTED 30Or DOO p e o rra S X COMMERDIAL GENERAL LIABILITY lOrOOO A X OIAIMS MADE OCCUR 3013149644 5/31/2009 5/31/2009 MED E%P An me arson S P R N s v V s 1r 000. 000 GEN RPL AGGREGATE S 2, OOOr 000 T Ip s 2r 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S lr OOOr 000 (Ea acti0an0 X ANY AUTO `~I~ $ AIL OWNED AUTOS 3013137849 .aTI K/2006 5/31/2009 BODILY INJURY S L``'" (Per Person) SCHEDULED AUTOS O X HIRED AUTOS ~s ~ (p Damitl BURY S X NON-OWNED AUTOS 9 (J PROPERTY DAMAGE S 4~~f ~ O``~ ~8~ (PeraccWenl) GARAGE LIABILITY A rNN11 AUTO ONLY-EA ACCIDENT S ANY AUTO ~\CJf (`t'GVl) OTHER THAN E A C S $Y5~ AUTO ONLY: qGG S g 4,000,000 E%CESSIUMBRELLA LIABILITY ¢ r OOO r 000 X OCCUR CLAIMS MADE AGGREGATE S B X DEDUCTIBLE 3013151958 5/31/2009 5/31/2009 s s X RETENTION 10,000 WC STATU- OTH- $ WORKERS COMPENSATON AND 1r 000. 000 EMPLOYERS' LIABILITY E.L EACH ACCIDENT S ANY PROPRIETORIPARTNER/EXECUTIVE 5/31/2009 5/31/2009 E.L. DISEASE-EA EMPLOYEES lr OODr OOO OFFlCERlMEMBER E%CLUDED9 3013149699 EL DISEARE-POLI Y IMR S 1.000.000 H yes, tlescMe order SPECIAL PROVISIONS below OTHER OESCRIPTON OF OPERATIONSILOCATIONBNENICLESIE%CLUBIONSRDDED BY ENDOR9EMENTISPECIAL PROVISIONS Certificate holder is hereby named as additional insured. *SO Day notice of cancellation for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE The City OJ: Santa Asa E%PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Carolyn FnllertOII 3 D DAYS WRITTEN NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE LEFT. BUT The Depot Of Santa Ana FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 1000 East Santa Asa $lvfl #lOa INSURER ITS ADENTS OR REPRESENTATNES. $aata Ana. CA 927D1 pUTNOR6ED REPRESENTATNE ~ K McEachron/XRYMCE © ACORD CORPORATION 1988 ACORD 25 (2001/OB) Pa9a m2 IN50251o1oe).Dea IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(iesl 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 certifcate 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. ACORO 2512001/Oa) page 2 of 2 INS025loioel oea Y. y. ~~~~0~~ =4 f~ ~~~~~~.0~~ ~~N C:_ s= r', A y 3 g'. _ s ~ c'e L. t. CERTIFICATION & QUALIFICATION 100% MINORITY OWNED 8r OPERATED State of California Small Business Statt~sounty of Los Angeles bidding preference) MBEIDBE State of Colorado - D Southern CA Minority Bus. Development Council Pennsylvania -DBE r>°~=. Supplier Clearinghouse MBE Chicago -DBE , ~ _ s r. '~~~3 Texas r . -„c ~e~. DBE City of Phoenix ~ MBEI SBEI DBE n Los Angeles Unified School District Florida -DBE ffi SBE Status x Washington DC 41 ~ CA Unified DBE MBE n Program DBE K. Columbus Regional Airport Authority t. ` f The City of Kansas, Missouri Ohio -DBE DBE City of Los Angeles _y Milwaukee County, WI -DBE MBEIDBE City of LA Metropolitan Water District of Southern CA Small Local Business SBE New York New York & New Jersey ~ SBA-in progress DBE MBE I ~ a.,, k ' r- k= f - LS i` ...Q. ,r+_r.. / ~ 7 ' } e. ~.ia.e.:FLx-EUau.. S.~..m......._m~..>. .,„„v..'k.s.,.,«.. w..ww...o. ..aizw.w~n y ,1 y '1'r~,p .v p ~4~.~:n.~ia`.f ..v._.... .r.:iut '.4.' W.~..w..++...., ae 'vL 1 1t f P. S w. ® ?Y `'4 F ~ 'ryv .S, .f • Y'T" .a r.:e`..M~~fe+ai~`m:sic....V.. a.. >_a THIS DOCUMENT MUST ACCOMPANY BIDDERS RESPONSE OFFEROR'SREFERENCES THIS SHEET MUST BE COMPLETED 1N FULL AND RETURNED WITH OFFEROR'S PROPOSAL suppl es, equ pbment!lor services included with the ope of the proposal specafi a~ionsaAttach additionalppagesefhe required. The City reserves the right to contact each of the references listed for additional information regarding your firm's qualifications. Reference No. 1 Customer Name: Los An eles World Aimorts Contact Individual: Renee Fone Phone Number: 310-21 ~-7685 Address: 7301 Worl~ av West Los Angeles CA 90045 Facsimile Number: 310-417-3094 Year: 2000 -oresent Contract Amount: 404~00~0 Description of supplies, equipment, or services provided: Pa hones Pre aid Callin Cards and Machines Internet Kiosks. Electronic Vendin Service Maintenance and Collections. Reference No. 2 Contact Individual: Kim Broean Customer Name: Milwauk___?e ?`!~Ort Phone Number: 972-718-5882 Address: 5300 S. Howell Avenue Milwaukey Facsimile Number: 972-718-763? Year: 2005 -oresent Contract Amount: S50 00_ 0 Annually Description of supplies, equipment, or services provided: Pav hones and Pre aid Calling Cards and Machines Reference No. 3 Contact Individual: Sabine Resoress Customer Name: County of Cuyahoga Phone Number.~~16t443-8154 Address: 1255 Euclid Ave. - 4th Flr Clevelany Facsimile Number: (2161 6` ~ Year: 2007 - rp e- sent Contract Amount: $75 00_ Oy Annually Description of supplies, equipment or services provided: Pa hones and Jail Phones Dare IMwDDKYW) 7 8 2008 A oR CERTIFICATE OF LIABILITY lTISURANCESS~ED As A MATTER GF mfGRbIATION :DDUDeR (760)241-7900 FAX: (780)241-1467 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ISO Insurance Services - AR.MAC Agency A~~~'HE COVERAGEIAfFORDED BY THE POENCIES BELOW,OR 17177 Yuma Street NA1CB CR 92395 INSURERS AFFORDING COVERAGE Victorville INSURERA Trans ortatioa Insurance 20443C INSURED INSURER B:Contineatal Casualt Z Vesture Capital Frontiers Inc INSURER C: DHA: The Payphone Company, The yaman Group w uaE D: 1968 W Adams H1Vd Ste 311 INSURER E: CA 90018 LOS AI6GELES THE POLVCIES OF MSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE fOR THE POLICY PERIOD INDICATED. NOTWITHSTANOIN TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT NATN RESPECT TO WHICH THIB CERTIFICATE MAY BE ISSUED OR MAY P-eRTAIN, THE INSURANCE AFFORDED SY THE POLICIES DESCRISEO HEREIN IS SU&i PGLK^T! V~TN¢ yq~jDgMFSj,'D R~anONSI0N5 ANO CONDITIO~Sri F SUCH POLICIE . REQUIREMENT, DATE MWDDIYV DAre mM , 1, 000,000 INSR DVL POl1CY NUNBl11 TYPE OF INSURANCE 300 , 000 OAMAGETO RENTED S GENERAL LWBIMTV 10,000 X COMMERLULGENERAL lU1BILR'Y 3013169666 5/31/2008 5/31/2009 P N°" s 1,000,000 A X CLAIMS MADE ~OCGUR S 2,000,000 RA RE 6 2,000,000 i~- GEN'LAGGREWTEP OT APPLIES PER: X P ILy, L L COMBINED SINGLE LIMIT S ]„000,000 IEa a~oEnO AUTONOSIIP UABILRY X ANY AV:O 5/31/2008 5/31/2009 BODILY INJURY S H 3 0 13137 86 8 (PS germn; ALL ONNEO AUTOS SCHEO'JLED AUTOS ~ BODILY INJURY S X H10.ED AUTOS O 1?a eccitlenq X NON.OVMED AUTOS A~ ~ PROPERTYOAMAGE S -fCr. + (Px aaliantl ~ Y .e AUTOONLV-EA AGLmENf s GARAGE LIABILITY ~ S' \ORyv Hey OTHERTNAN A S ANY AUTO AUTO ONLY. p g ~ , 6,aoo,DDo ~~s E 4, GoD, DDo E%Cfi55lUMBRELLA LIABII.RY A R S OCCUR ~ LUNIB MADE S 5/31/2008 5/31/2009 B 3013151958 S H X DEOVCTIBLE yJC BTATU. OTN- 7( TEnTtO l0.OD0 S 1, 000.000 H WORKERS COMPENSATON ANO E. IOENT EMPLOYERS'MA&LITV EMP Y E 1, 000000 ANY PROPRIETORIPA0.TNERIEXECUTIVE 5/3I/2008 5/31/2009 E' 013 PO v 1, 000, 000 OFFIGERMEMBER EXC'-UDED4 3D13168689 5 6 YM. descflDS Dndel Sp IAL P40VI ION below oTNER Cienal ineuxed• •10 Day notice OE cancellation fox non-payment of premium. OESCRIPnON OP OPERATIONSILOOATION8.NEIDOLEGIEXCLUSION3 ADDED BY INDORSBAfiNTfLPiCIAL MONSIONS Hamad as addl Certifieata holder ie hoxeby CANCELLATION CERTIFICATE HOLDER axoulD ANV oP Txe ABOVE DescweeD Pouaes RE CANCELLED BEFORE THE E%PIRAnON DATE THBRfiOF, THE ISSUING INSURER WILL ExOEAVOR TO MAIL The City o£ Santa Ana 3O DAYS vneIT1EH NOTICE TO THE CERIlFlGAre HOLDER NAMED TO THE LEFT, BUT Ot Of S aorta An8 PAILURE 70 DO SO SHALL IM105E NO OBLIDAnON OR LIABILITY OF ANY KIND UPON Carolyn Pullertoa The Dep plgyq ITB AGENT80R RBPRESENTATNES 1000 East Santa Ana Slvd #108 AInxDRmED RePRBSSgrpnvE ,~,~,c(~~ C7 Santa Ana, CA 92701 K McEachronJKRYMCE `L-D ^ m ACORD CORPORATION 1965 Psp' oI2 ACORD 2 IN50261moB>oea I pox ~a~o~ . , A~ F~A~c~sa, ~A s~i o~o~ ~M~ENSATf~?N INURANC~ ~ ~ ~~~r~~N~~r~ of ~o~~t~~,. o~~~~u?~~r~~r~ ~ ~u~~~v~~ Ju~l~ ~i, ~4~4 P ~ ,1~~8643 ~ ICY NuI~B~~..:,.;..:..:: CERTIFICATE EMPIRE: ~ 1 ~ THE c r T~ a~ SANTA ANA THE BEi~4T OF SAfi~TA ANA 1040 EA"T SANTA ANA BL~~ SANTA ANA CA ~~741 C* This is to cer#ify that we have isseed a valid ylCaricers' compensation insurance policy in ~ farm approved by the ~alifarnia tns~rance Hamm€ssioner to the employer named below fvr the pal€cy period ir~dicated~ ~4 y~.4 This policy is not sub e # to car~cella#ior~ by tine ~ur~d except upon days' advance wrilter~ notice to the em la er. 1 p Y vie w€li also give yore ~~N days' advance notice shat~ld this olio bs cancel€ed rior t~ its ~ r p ~ p o mal explra#~on, This certificate of ir~s€~rance is na# are insurance policy aid does not amend, extend or alter the cavern a afforded b the ofic ~ listed herein, Natwithstandlr~g any requirement, term, or Condit€an o~ an contactor ~ Y P Y y other document with respect to which this certificate of insurar~ee may be issued or to which it may perta€n, the ir~s~rrance afforded by the pal€cy dascr€bed herein is subject #o afl the terms, exclusions and conditions of such poi€cy, A H~R~~ED REP~E~ENTATIVE PRESIDENT Ei~P~.~YER' S ~.I ABI~, ATV I T ~N~LUD ~ N(3 DEFEh~SE CDSTS s 1, 400 ~ 444 PER pCE~lRREN~E. F1~D~R5~hlENT f~~4b5 ENTITLED ~FRT~FCATE HO~.DERS'N~T1CE EFF~ECT~V~ 45~~~~14 1S ATTA~IFD TD AND FDRi~€S A PAPT 5l= T~1~5 PpLIEY. ll.4F r~' i.,It~~.#. ~.1~~~ ~r~~: ~S~~~Ic~~~k 4..,€~ ~~~i~r~e~ EMPt.DYER ~ VFNT~JHE CAPITAL FRQNT~FRS ANC DDA~ THE PAYPHgNE CU~PANYITHE ~AI~AN GHgHP u~~~T ~~~aN ASE ~n~ A~~~~.E~ EA ~4D~~ {