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HomeMy WebLinkAboutCSG CONSULTANT'S INC. (2) INSURANCE ON FILE r hcjr� Villgrlad ,NCIRK MAY PROCEEDJNTI A-2022-072-04A MAYOR ----- RIC hV� CITY MANAGER Valerie Amezcud ,� � Alvaro Nunez MAYOR PRO TE1N HI 13 2025 X .;.;00 CITY ATTORNEY Benjamin Vazquez Sonia R.Carvalho COUNCILMEMBERS L CITY CLERK Phil Bacerra ,A, Johnathan Ryan Hernandez Jennifer L. Hail Jessie Lopez David Penaloza Thai Viet Phan CITY OF SANTA ANA PLANNING AND BUILDING AGENCY 20 Civic Center Plaza.P.O.Box 1988 Santa Ana,California 92702 www.santa-ana.oro April 29, 2025 CSG Consultants, Inc. Attn: Eric Haghani 3707 W. Garden Grove Blvd., Ste. 100 Orange, CA 92868 Re: Extension of Agreement A-2022-072-04 for On-Call Building Safety Inspection Services Pursuant to Section 3 ("Term")of the above-referenced Agreement,entered into by CSG Consultants, Inc. ("Consultant")and the City of Santa Ana, dated May 17, 2022, the time period of the Agreement is hereby extended for an additional one-year period until May 16, 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, r Ali Pezeshkpour Acting Executive Director Planning and Building Agency CITY OF S TA ANA ATTEST varo Nunez Jennife ! Hall City Manager k APPROVED AS TO FORM CONSULTANT � �/-� 09R�"�- Melislat'M.-Crosthwaite Eric Haghani Senior Assistant City Attorney Vice President SANTA ANA CITY COUNCIL Valerie Amezwa Benjamin Vazquez Thai Viel Phan Jessie Lopez Phil Bacerra Johnathan Ryan Hamandez David Penaloza Mayor Mayor Pro Tern Ward 2 Ward 1 Ward 3 Ward A Ward 5 Ward 9 vamezcna(2lsanta-ana.om hvaz uez Santa-arts or t.hart Sams-anaorg lessialanezasanta-ana.oro bacerra santa-ana o jryanhemandez[lsanta-ana ore dgena1czP;santa-ana oro CSGCONS-01 JPERRY3 A��Rv CERTIFICATE OF LIABILITY INSURANCE DATOIYYYY) 1 21612rsrea24 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 end©rsement(s). PRODUCER License#OC36861 CONTACT Julia Perry Alliant Insurance Services,Inc. PHONE FAX 560 Mission St 6th FI (AIC,No,Ext):(925)280 4671 (A/C,plo): San Francisco,CA 94105 E-MAIL oRESS:Julia.Perry@alliant.com �talliant.Com o INSURER S AFFORDI_NG COVERAGE NAIL INSURER A:United States Fire Insurance Company INSURED INSURER B:Nationwide Affinity Insurance Company of America 26093 CSG Consultants,Inc. INSURERC:North River Insurance_Com an 21105 550 Pilgrim Drive INSURERo:United States Fire Insurance Company 21113 Foster City,CA 94404 INSURER E:PaCIfIC Insurance Company, Limited 10046 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILT LTRNSR TYPE OF INSURANCE ADDLINSD ISUBp POLICY NUMBER POLICY EFF POLICYMD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 CLAIMS-MADE �X OCCUR X 5432352732 12/412024 12/412025 DAEMISES?a occu D renre) $ 300,000 MED EXP(Any oneperson) 5 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑JJE T 1XI LOC PRODUCTS-COMPJOPAGG $ 2,000,000 OTHER B AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT 1,000,000 Ea accident $ X ANY AUTO X 72APBO10186 1214/2024 1214/2025 BODILY INJURY Perperson) $ OWNED SCHEDULED -- AUTOS ONLY AUTOS BODILY INJURY Per accident)$ _ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Pereccident $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE; 5821248132 12/412024 121412025 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ D WORKERS COMPENSATION X PER OTH- ANDEMPLOYERS'LIABILITY STAT TE ER 21412024 1214/2025 E.L.EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE N 4087479726 1 1,OO Q,UOO OFFICERIMEMBER EXCLUDED? [� N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L,DISEASE-POLICYLfMIT S 1,000,000 E Professional Liab 83 OH 0489503-24 1214/2024 121412025 Ea Claim/Agg 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Ramarks Schedule,may be attached if more space is required] 30-day Notice of Cancellation applies to the Auto Liability policy,form to follow. Re:Consultant Agreement for Municipal Plan Check Services City of Santa Ana,officers,agents,employees,and volunteers are named as additionally insured on this policy pursuant to written contract,agreement,or memorandum of understanding.Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be excess and noncontributory per general liability and automobile liability per attached endorsements. 30 Day Notice of Cancellation on Professional Liability per attached. APPROVED CERTIFICATE HOLDER CANCELLATION By Cynthia Mora at 8:50 am, Dec 13, 2024 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza,4th Floor Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE A` o,l ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy: 72APDO10186 M-5876(0512016) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE. READ IT CAREFULLY. BLANKET ADDITIONAL INSURED! ENDORSEMENT This endorsement modifies insurance provided under the following: B:U8INESS AUTO COVERAGE FORM GARAGE COVERAGE FORM TRUCKERS COVERAGE FORM In consideration of payment,of the additional prom,ium listed'below,LIABILITY COVERAGE is extended to any person or organization you are required.to add to this poicy as an additionali insured irr a written agreement between you and then additional insured that is executed prior to the"accident"provided that:. 1) such insurance applies only to the ownership, maintenance or use of a covered auto; and 2') such insurance applies only to.acts or omissions by you,,your agents or your"employees"while such covered auto is being used in.your business;and 3) such insurance does not apply to the acts or omissions of the:additional insured or any of the additional insured's agents or"employees"other than you; and 4) such insurance does not apply if the additional insured is subject to motor carrier insurance requirements and is not insured for hired"autos"un.deran"auto"liability insurance form that insures on a primary basis the owners of the"autos"and:their agents and"employees"while the.„autos"are being used exclusively in the additional insured's business and pursuant to operating rights granted to the additional insured by a public!authority; and 5) such inclusion of additional insured shall not increase our limit of Iiabil'ity under this policy. All other terms, conditions and agreements remain unchanged. Additional Premium: $ CompanyiVame Poky Number Endorsement.Effective Named li)sured Countersigned by tAuthorized Representative) Jh.a Attaching:Clause need be.completed ansy when this endorsement is issued subsoquent to preparation of the poacy.) M-5076(05'1201'6) Policy: 5432352732 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1. Expected Or Intended Injury 14. Newly Acquired Organizations 2. Amended Defense Coverage For Indemnitees 15. Additional Insureds By Written Contract 3. Nan-Owned Watercraft 16. Additional Insured —Lessors of Leased Equipment Additional Insured —State Or Governmental 4. Non-Owned Aircraft 17. Agency Or Subdivision Or Political Subdivision —Permits Or Authorizations 5 Property Damage Liability—Borrowed: 18. Additional Insured —Vendors Equipment 6. Property Damage Liability-•Elevators 1:9. Broad Knowledge 1 Notice Of Occurrence 7. Damage To Premises Rented To You 20 Waiver Of Transfer Of Rights of Recovery Against Others To Us 8 Contractual Liability For Personal And 21. Unintentional Failure To Disclose Hazards Advertising Injury 9. Medical Payments 22. Mental Anguish, Mental Injury Or Humiliation 10. Supplementary Payments 23. Mobile Equipment 11. Broad Form Named Insured 24. Waiver Of Sovereign Immunity 12. Fellow Employee Coverage 25. Liberalization Clause 13. Incidental Medical Malpractice Liability 26: Application Of This Endorsement FM 101.0.1206 01 11: Page 1 of 10 Includes copyrighted material of Insurance Service Office, Inc.with its permission. Policy: 5432352732 1. Expected Or Intended Injury Exclusion a.Expected Or Intended Injury under Section I -Coverage A- Bodily Injury And Property Damage Liability is hereby deleted and replaced by the following: "Bodily injury"or"property damage"expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury"or"property damage"resulting from the use of reasonable force to protect persons or property. 2. Amended Defense Coverage For Indernniteea Supplementary Payments --Coverages A and B is amended as follows: Paragraph 2.d.under Section I-Supplementary Payments - Coverages A and B is hereby deleted. Paragraph 2.e.under Section I-Supplementary Payments -Coverages Aand B is hereby deleted and replaced by the following: The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit". In the event we agree a conflict exists between the interests of the insured and the interests of the indemnitee,we will select and assign separate defense counsel for the indemnitee and pay reasonable attorney fees and necessary litigation expenses; and 3. Non-Owned Watercraft Paragraph (2)(a)of Exclusion g.Aircraft,Auto Or Watercraft under Section I-Coverage A- Bodily Injury And Property Damage Liability is hereby deleted and replaced by the following: (a)Less than 55 feet in overall length; and 4. Nan-Owned Aircraft Exclusion g.Aircraft,Auto Or Watercraft under Section I-Coverage A- Bodily Injury And Property Damage Liability does not apply to an aircraft, in which you have no ownership interest, provided: a. It is: (1) Loaned to; (2) Rented by; or (3) Hired or chartered by the insured with a paid and licensed crew; b. It is not being used to cant'persons or property for a charge; and FM 101.0.120601 11 Page 2of10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. Policy: 5432352732 c. The pilot in command holds a currently effective license, issued by the duly constituted authority of the United States of America or Canada,designating him or her as a commercial airline pilot for the particular aircraft being flown. 5. Property Damage Liability- Borrowed Equipment Paragraph (4)of Exclusion J. Damage To Property under Section I-Coverage A-- Bodily Injury And Property Damage Liability is amended to include the following: This exclusion does not apply to equipment which you borrow from a person or entity, other than an insured, unless the"property damage"occurs while such equipment is being used by an insured at a job site. Subject to all terms of Section III-Limits Of Insurance, the maximum limit in any one "occurrence"is$25,000 subject to an annual aggregate of$50,000 for all "occurrences". The insurance provided by this exception to Exclusion J.(4)as set forth in Paragraph 5.of this General Liability Enhancement Endorsement is excess over any other valid and collectible insurance available to the insured whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or any other basis, that would also apply to the loss covered under this provision. 6. Property Damage Liability-Elevators Exclusion j. Damage To Property under Section I -Coverage A-Bodily Injury And Property Damage Liability is amended to include the following: Paragraphs(3)and (4) of this exclusion do not apply to liability arising out of the use of elevators. The insurance provided by this exception to Exclusions j.(3) and j.(4) as set forth in Paragraph 6.of this General Liability Enhancement Endorsement is excess over any other valid and collectible insurance available to the insured whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or any other basis,that would also apply to the loss covered under this provision. 7. Damage To Promises Rented To You a. The last paragraph of 2.Exclusions under Section I-Coverage A- Bodily Injury And Property Damage Liability is hereby deleted and replaced by the following: (1) With respect to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner,.Exclusions c. through n., do not apply. (2) With respect to damage by other than fire to premises while rented to you or temporarily occupied by you with permission of the owner, Exclusions c. through n., except for Exclusion E, do not apply unless the damage arises out of"your work". A separate limit of insurance applies to the coverage set forth in (1) and (2) above as FM 101.0.1206 0111 Page 3 of 10 Includes copyrighted material of Insurance Service Office, Inc.with its permission. Policy; S432352732 described in Section III -Limits Of Insurance. b. Section III-Limits Of Insurance is amended by deleting Paragraph 6.and replacing it with the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of"property damage"to any one premises while rented to you or temporarily occupied by you with the permission of the owner. The Damage To Premises Rented To You Limit is the amount set forth in the Declarations or$300,000,whichever is greater. 8. Contractual U;albility For Personal And Advertising Injury Exclusion e.Contractual Liability under Section I-Coverage B-Personal And Advertising Injury Liability is amended to add the following after the last sentence: This exclusion also does not apply to that part of any contract or agreement pertaining to your business under which you assume the"tort liability"of another party to pay for "personal and advertising injury"to a third party or organization, provided the"personal and advertising injury"offense occurs subsequent to the execution of the contractor agreement. For the purposes of this provision, "tort liability"means a liability that would be imposed by law in the absence of any contract or agreement. 9. Medical Payments Section I -- Coverage C-Medical Payments is amended to include the following only if Coverage C -Medical Payments is not otherwise excluded from this coverage part: The Medical Payments Limit is changed to the greater of: a. $15,000; or b. The Medical Expense Limit shown in the Declarations of this coverage part. Paragraph 1.a.(3)(b) under Section I -Coverage C - Medical Payments is hereby deleted and replaced by the following: The expenses are incurred and reported to us within three years of the date of the accident; and 10. Supplementary Payments Supplementary Payments-Coverages A and B under Section I -Coverages is amended as follows: a. The bail bonds limit shown in Paragraph 1.b. is increased from $250 to $2,500. b. The actual loss of earnings limit shown in Paragraph U. is increased from $250 to $1,000. FM 101.0.1206 01 11 Page 4 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. Policy: 5432352732 11. Broad Form Named Insured Paragraph 1.d. under Section II—Who Is An Insured is amended to include the following: If you are an organization other than a partnership, limited liability company or joint venture, any of your subsidiary companies or any company over which you exercise control and actively manage will qualify as an insured only if other valid and collectible insurance does not apply. 12. Fellow Employee Coverage Paragraph 2.a.(1)(a) under Section II--Who Is An Insured is hereby deleted. 13. Incidental Medical Malpractice Liability Paragraph 2.a. (1)(d)under Section II—Who Is An Insured does not apply to "employees" who are employed as nurses or other"employees", excluding physicians and medical doctors,who provide incidental health care services within the scope of their employment by you. 14. Newly Acquired Organizations Paragraph 3.a.under Section II --Who Is An Insured is hereby deleted and replaced by the following: a. Coverage under this provision is afforded only until the end of the policy period. 15. Additional Insureds By Written Contract Section II —Who Is An Insured is amended to include as an additional insured, any person or organization whom you are required to add as an additional insured to this policy by written contract or written agreement that is: a. Currently in effect or becoming effective during the term of this policy; and b. Executed prior to the"bodily injury", "property damage"or"personal and advertising injury". 1.The insurance provided to the additional insured applies as follows: (a) That person or organization is only an additional insured with respect to liability for"bodily injury", "properly damage"or"personal and advertising injury"caused by your negligent acts or omissions at or from: (i) Premises you own, rent, lease or occupy; or (1) Your ongoing operations performed for the additional insured at the jobsite indicated by the written contractor written agreement. (b) The limits of insurance applicable to the additional insured are those specified in the FM 101.0.1206 0111 Page 5 of 10 Includes copyrighted material of Insurance Service Office, Inc.with its permission. Policy: 5432352732 written contract or written agreement or in the Declarations of this policy,whichever are less. These limits of insurance are inclusive of, and not in addition to,the limits of insurance shown in the Declarations of this policy. 2. If the additional insured is an architect, engineer or surveyor, the Insurance provided to the additional insured does not apply to "bodily injury", "property damage"or "personal and advertising injury"caused by: (a) The rendering of or failure to render any professional services including preparing, approving or failing to prepare or approve maps, drawings, opinions, reports,surveys, change orders, designs or specifications; or (b) Any supervisory, inspection or engineering services. 3. With respect to the insurance afforded these additional insured(s), the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage"or"personal and advertising Injury": (a) Occurring after all work (including materials, parts or equipment furnished in connection with such work)on the project(other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (b) Occurring after that portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. Paragraph a. Primary Insurance of Condition 4. Other Insurance under Section IV— Commercial General Liability Conditions is amended by the addition of the following: Regardless of whether other insurance is maintained by an additional insured on a primary basis, the coverage provided by Paragraph 15.of the General Liability Enhancement Endorsement will be primary to and noncontributing with other insurance maintained by the additional insured if the written contract between you and the additional insured specifically requires that this insurance be primary. 16. Addihlonal Insured—Lessors Of Leased Equipment Section II —Who Is An Insured is amended to include as an additional insured any person or organization from whom you lease equipment and with whom you have agreed to add as an additional insured to this policy by written contract or written agreement but only with respect to "bodily injury", "property damage"or"personal and advertising injury"caused, in whole or in part, by your maintenance,operation or use of the equipment leased to you by such person or organization. With respect to the insurance afforded to these additional insured(s), this insurance does not apply to any"occurrence"which takes place after the equipment lease expires or is FM 101.0.1206 01 11 Page 6 of 10 Includes copyrighted material of Insurance Service Office, Inc.with its permission. Policy: 5432352732 terminated. 17. Additional Insured—State Or Governmental Agency Or Subdivision Or Political Subdivision—Permits Or Authorizations Section II —Who is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision which has issued a permit or authorization to you. a. This applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. b. This insurance does not apply to: (1) "Bodily injury", "property damage"or"personal and advertising injury"arising out of operations performed for the state or governmental agency or subdivision or political subdivision; or (2) "Bodily injury"or"property damage"included within the"products-completed operations hazard". 18. Additional Insured—Vendors Section If —Who Is An Insured is amended to include as an additional insured any person or organization (referred to below as vendor)whom you have agreed to add as an additional insured to this policy by written contract or written agreement butonlywith respect in"bodily injury"or"property damage"arising out of"your products"which are distributed orsold in the regular course of the vendor's business, subject to the following additional exclusions: The insurance afforded the vendor does not apply to: a. "Bodily injury"or"property damage"for which the vendor is obligated to pay damages by reason of the assumption of liability in a contractor agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations FM 101.0.1206 0111 Page 7 of 10 Includes copyrighted material of Insurance Service Office, Inc.with its permission. Policy: 5432352732 performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily injury"or"property damage"arising out of the sole negligence of the vendor for its own acts or omissions or those of its "employees"or anyone else acting on its behalf. However,this exclusion does not apply to: (1) The exceptions contained in subparagraphs d.orf.; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. This insurance does not apply to any insured person or organization, from whom or which you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. The coverage afforded the additional insured under this provision will be excess over any valid and collectible insurance available to the additional insured as an additional insured under a policy issued to a manufacturer or distributor for products manufactured,sold, handled or distributed unless you require that this insurance be primary and non- contributory. 19. Broad Knowledge 1 Notice Of Occurrence Section 1V-- Commercial General Liability Conditions is amended to include the following: The requirement in Condition 2.a.,which states that you must see to it that we are notified of any"occurrence"or offense, applies only when the"occurrence"or offense is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. A member, if you are a joint venture; 4. An "executive officer",manager or supervisor if you are a corporation; or S. A member, if you are a limited liability company. The requirement in Condition 2.b.,which states that you must see to it that we recelve notice of a claim or"suit",will not be considered breached unless the breach occurs after such claim or"suit"is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. A member, if you are a joint venture; 4. An"executive officer", manager or supervisor if you are a corporation; or 5. A member, if you are a limited liability company. If you report an accident to your Workers Compensation insurance carrier which later develops into a claim or"suit"for a liability"occurrence"for coverage which is provided by FM 101.0.1206 01 11 Page 8 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. Policy: 5432352732 this policy, failure to report such "occurrence"to us at the time of the accident shall not be a violation of the notification of loss condition (Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV--Commercial General Liability Conditions) contained in this policy. It is agreed, however, that you shall give notification of such claim or"suit"to us as soon as you are made aware of the fact that the particular accident has developed into a claim or"suit". 20. Waiver Of Transfer Of Fights Of recovery Against Others To Us Condition 8. Transfer Of Rights Of Recovery Against Others To Us under Section IV— Commercial General Liability Conditions is amended to include the following: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included in the"products- completed operations hazard"when you have waived such right of recovery under a written contract with that person or organization. Such written contract must be: a. Currently in effect or becoming effective during the term of this policy; and Ib. Executed prior to the"bodily injury", "property damage"or"personal and advertising injury Alternatively, the written contract may be executed after the"bodily injury", "property damage"or"personal and advertising injury"but only if: (i) The terms and conditions of the written contract or written agreement had been agreed upon prior to the"bodily injury", "property damage"or"personal and advertising injury"; and (1)The insured can definitively establish that the terms and conditions of the written contract or written agreement ultimately executed are the same as those which had been agreed upon prior to the"bodily injury", "property damage"or"personal and advertising. injury". 21. Unintentional Failure To Disclose Hazards Section IV—Commercial General Liability Conditions is amended to include the following: 9. Unintentional Failure To Disclose Hazards Your unintentional failure to disclose all hazards or prior"occurrences"existing as of the inception date of this policy shall not prejudice the coverage afforded by this policy. 22. Mental Anguish, Mental Injury Or Hun-dilation The definition of"bodily injury"in Paragraph 3.under Section V— Definitions is hereby deleted and replaced by the following: "Bodily injury"means bodily injury,sickness or disease sustained by a person, including FM 101.0.1206 01 11 Page 9 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. Policy: 5432352732 mental anguish, mental injury, humiliation or death resulting from any of these at any time. 23, Mobile Equipment Paragraph 12.under Section V- Definitions is amended to include the following: Paragraph f.(1)does not apply to self-propelled vehicles of less than 1,000 pounds gross vehicle weight. 24. Waiver Of Sovereign Immunity The following provision applies if you are a"governmental entity"or we have added a "governmental entity"to your policy as an additional insured, and the"governmental entity" requires us to obtain permission prior to asserting a defense involving governmental immunity or the jurisdiction of the tribunal over the"governmental entity": We shall not raise any defense involving, in any way,the jurisdiction of the tribunal over the"governmental entity", the immunity of the"governmental entity"or its commissioners, officers, agents or employees, the governmental nature of such entity, or the provisions of any statutes respecting suits against the"governmental entity" without first obtaining express advance permission from the designated representative of the"governmental entity". Application of this provision shall not subject us to liability for any portion of a claim or judgment in excess of the applicable limit of insurance. For the purposes of this provision,"governmental entity"means a state, county, district, municipality, town,township, borough, parish, village, or other political subdivision or governmental agency or subdivision. 25. Liberalization Clause If we adopt a change in the coverage form, CG 00 01, which broadens coverage without an additional premium charge, the broader coverage will apply to this policy on the effective date of approval in the state shown in the Named Insured's address in the Declarations of this policy. 26. Application Of This Endorsement The coverage enhancements provided by this endorsement apply to the Commercial General Liability Coverage Part. If your policy includes other endorsements in addition to this General Liability Enhancement Endorsement,and there is a conflict between any of the terms of such endorsement(s) and this General Liability Enhancement Endorsement,the terms of the other endorsement(s)shall be given priority and control over the terms set forth in this General Liability Enhancement Endorsement,even if the terms of such other endorsement(s) have the effect of limiting,excluding or reducing the coverage provided under this General Liability Enhancement Endorsement. All other terms and conditions remain unchanged. FM 101.0.1206 01 11 Page 10 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIRD-PARTY NOTICE OF CANCELLATION OR NONRENEWAL Thlg e❑dLirse❑elt 11al❑16s ®surau�e pr❑ceded u❑derthe LHI❑❑®❑❑ COMM❑RC®L ❑❑❑❑R❑L Lnilll.Q❑CCl❑aR❑❑❑ P❑RT SCHEDULE First Named Insured: CS❑ C❑❑sultaEtsDM❑ Policy Number: ❑❑❑❑❑❑❑❑m Policy Period: ❑❑EE®❑❑—❑❑®®❑❑❑ Endorsement Effective Date: Number of Days' Notice- Nonpayment of Premium: 30 Number of Days' Notice-All Other Reasons: 10 Name And Mailing Address/Email Address of Third Party: Per attached schedule ®❑e ca❑cel Er ❑❑Hre❑e❑ thig P110❑❑❑e ❑dl ❑aMe❑a[>Do- ❑ther❑Cge del Der ❑Et[ae ❑❑ca❑cellat®❑EY ❑❑❑ena❑al t❑the Thf'7d Part❑sh❑❑❑®the Schedule am[a at the address sh❑❑❑❑❑clip❑❑[the thlrd[part❑❑11t[Mat®❑❑m als❑ ❑e ❑albd DrdelM-red t❑the ❑rat Palled ®sured❑ The ❑®®u❑ ❑u❑❑er ❑❑dais prur t❑the caLbellat®❑a ❑❑EIrella❑al that the ❑❑tDe ❑m ❑e ❑akd [Ir deln red 2 sh❑❑❑Ethe Schedule a❑❑[b❑ ❑II Ctherter❑s arid c❑❑d1t7F1s re❑a®u[xha❑❑ed❑ Ml 02 051 10 18 Page 1 of 1 I bludes c❑pErffEhted ❑ater®I ❑❑Bsura❑ce Ser❑Mes ❑[Me❑ EM 11[th bper❑C8s®❑❑ Policy: 4087479726 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY NOTICE OF CANCELLATION FOR CERTIFICATE HOLDERS This endorsement modifies insurance provided under this policy. SCHEDULE Name of Person(s) I Organization(s) Email Address Per attached schedule A. If we cancel this policy for any reason other than nonpayment of premium, we will endeavor to provide notice of such cancellation by electronic mail to any person or organization shown in the schedule above or set forth in a list provided to us by the First Named Insured, subject to the following conditions: 1. The schedule or list shall only contain the names and e-mail addresses of persons or organizations: (a) that have been sent a certificate of insurance; and (b) that you are required to notify in the event of a cancellation of the policy. 2. You must send us a written request to provide such notice as soon as possible after the First Named Insured shown in the Declarations receives notice from us of the cancellation of this policy; 3. We must receive such written request no later than 15 days after the date the notice of cancellation was sent by us to the First Named Insured; and 4. You must provide us with accurate e-mail addresses for all persons and organizations an the schedule and list. B. We will endeavor to maintain proof of e-mailing the electronic notification described in Paragraph A.of this endorsement, but we are not obligated to do so. C. Our delivery of notification of cancellation described in Paragraphs A. of this endorsement is intended as a courtesy only. We have no obligation to do so, nor do we have an obligation to provide such notification within the timeframe that you may have agreed upon with the certificate holder. Our failure to provide such notification will not: 1. Extend the Policy cancellation date; 2. Negate the cancellation as to any insured or any certificate holder; or 3. Provide any additional insurance that would not have been provided in the absence of this endorsement. D. We are not responsible for the accuracy, integrity, timeliness or validity of information contained in the schedule above or the list provided to us described in Paragraphs A. of this endorsement. All other terms and conditions of this policy remain unchanged. FM 303.0.22 04 11 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged In the work described in the Schedule. The additional premium for this endorsement shall be %of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization with whom or with which you have agreed See wording under Person or Organization in a written contract to waive your right of recovery against, provided such written contract; 1. is currently in effect or will be come effective during the term of this policy;and 2. was executed and became effective prior to the occurrence of the Injury covered by this policy. This form only applies in CA. This endorsement changes the policy to which It is attached and is effective on the date issued unless otherwise stated. Endorsement Effective Polley No,4087479726 Endorsement No. Insured Insurance Company Countersigned By CSGCONS-01NCHANNAPPA DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/24/2025 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). CONTACT License # 0C36861 Christine Spangler PRODUCER NAME: PHONEFAX Alliant Insurance Services, Inc. (628) 502-2841 (A/C, No, Ext):(A/C, No): 560 Mission St 6th Fl E-MAIL christine.spangler@alliant.com San Francisco, CA 94105 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Travelers Indemnity Company of Connecticut 25682 INSURER A : INSURED Travelers Property Casualty Company of America 25674 INSURER B : Pacific Insurance Company, Limited10046 INSURER C : CSG Consultants, Inc. 550 Pilgrim Drive INSURER D : Foster City, CA 94404 INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 300,000 CLAIMS-MADEOCCUR X 660-C130387912/10/202512/10/2026 $ PREMISES (Ea occurrence) X 5,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 X POLICYLOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO 810-C130658112/10/202512/10/2026 BODILY INJURY (Per person)$ X OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ 5,000,000 B XX UMBRELLA LIABOCCUR EACH OCCURRENCE$ CUP-C139057712/10/202512/10/2026 5,000,000 EXCESS LIABCLAIMS-MADE AGGREGATE$ 0 X DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION B X STATUTEER AND EMPLOYERS' LIABILITY Y / N UB-C138878A12/10/202512/10/2026 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ Professional Liabili83OH0489503-2512/10/202512/10/2026 Ea Claim/Agg5,000,000 C DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory per general liability and automobile liability per attached endorsements. 30 Day Notice of Cancellation applies. Ejhjubmmz!tjhofe!cz! Uv!Usbo! Uv!Usbo!Ohvzfo! Ebuf;!3137/12/16! 21;54;31!.19(11( Ohvzfo CzUvUsboOhvzfobu21;53bn-Kbo16-3137 CERTIFICATE HOLDERCANCELLATION 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. Planning and Building Agency 20 Civic Center Plaza, M-20 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD th\[L/— b a.9wʹ ЏЏЉΏ/ЊЌЉЌБАВ Policy Number: 660-C1303879 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION !Qpmjdz!Ovncfs;!771.D241498: Qpmjdz!Ovncfs!;!921.D2417692 Qpmjdz!Ovncfs!;!921.D2417692 ЊЋΉЊЉΉЋЉЋЎ