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HomeMy WebLinkAboutJOHNSON-FRANK AND ASSOCIATES-2009City of Santa Ana "r=<' Clerk of the Council AGREEMENT TERMINATION P09 JUL 19 Pit 3: n 9 Please complete this form when the attached agreement is no longer in elefTY OF SAN TA ANA Return form to the Clerk of the Council Office (M-30). CLERK OF COUNCIL Call 647-6520 if you have any questions. NOTE: PLEASE INCLUDE �7A-LL, AMENDMENS IF ANY. THANK YOU. The agreement with �/ n M ge n 1jefh e OL AFSe c No. ',�nQ f!(ag was completed on l and final payment has been made. Department: Phone/Ext.: x cJ 6 Signature: jZ �„ r Date: aavis 1a7.07 INSURANCE NOT REQUIRED WORK MAY PROCEED CLERK OF COUNCIL j1?TF NOV 2 4 2009 n_N V7?? E N 2 -- 3 v ?- FIRST AMENDMENT TO AGREEMENT A-2009-168 THIS FIRST AMENDMENT TO AGREEMENT is entered into on October 5, 2009, by and between Johnson-Frank and Associates, Inc., a California corporation ("Consultant') and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). RECITALS A. The parties entered into Consultant Agreement A-2008-086, dated May 5, 2008, (hereinafter "said Agreement") by which Consultant has provided aerial mapping and digital surveying services. B. In accordance with the terms and conditions of said Agreement, the parties wish to increase compensation to pay for additional mapping and surveying services. 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: 1. Section 3, COMPENSATION, shall be amended to increase compensation by $200,000 for a total not to exceed amount of $500,000.00. 2. Except as herein 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: MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SEPH W.FLETCHER City Attorney CITY OF NTA A DAVID N. RE M City Manager JOHNSON FRANK AND ASSOCIATES, INC. ALAN D. FRANK, PLS Vice President CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) PRODUCER IOA Insurance Services 11/30/2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 130 Vantis, Suite 165 13 0 Su ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Aliso Viejo, 92656 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 949-680-1790 OE67768 www.ioausa.com INSURERS AFFORDING COVERAGE NAIC # INSURED Johnson-Frank & Associates, Inc. INSURER A: Travelers Property Casualty Ins Co of America 25674 5150 E. Hunter Avenue An h i CA 92807 INSURERB: a e m INSURER C: INSURER D: INSURER E: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR OD' t TYPE OF INSURANCE POLICY NUMBER POLICY EF FEECTIVE POT CY EXPIRATION D LIMBS A GENERAL LIABILITY 68068251-007 12/1/2009 121112010 EACH OCCURRENCE $ 1,000,000 v1 COMMERCIAL GENERAL LIABILITY Scheduled AI Endt DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 CLAIMS MADE O OCCUR #CGD3820907 MED EXP (Any one person) $ 10,000 ? Pflmary/NOnCOntrib PERSONAL &ADV INJU Y _ R $ 1,000,000 Waiver Subro GENERAL AG GREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRO PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY y `/ LOC A AU TOMOBILE LIABILITY BA68191_639 12/1/2009 T91/2010 ANY AUTO Designated Insured COMBINED SINGLE LIMIT (Ea accident) $ 1 000,000 ALL OWNED AUTOS Endt #CA20480299 SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN $ AUTO ONLY: AGG $ A EXCESS / UMBRELLA LIABILITY / CUP7915Y817 12/1/2009 1211/2010 EACH OCCURRENCE $ 4,000,000 r OCCUR CLAIMS MADE AGGREGATE $ 4,000,000 / r DEDUCTIBLE ice` $ RETENTION so ? $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A ^ L'> WC STATU- OTH- ?1 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? lcy E.L. EACH ACCIDENT $ (Mandatory in NH) If yes, describe under , ?TS E.L. DISEASE - EA EMPLOYE $ SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate Holder is Additional Insured as respects General Liability but only if required by written agreement with the Named Insured prior to an Occurrence per coverage form #CGD3820907. General Liability includes Severability, of Interest & Contract Liability per limitations in Liab coverage form #CG00011001. Auto Liability Designated Insured included perform #CA20480299. Coverage subject to all policy terms , conditions, limitations and exclusions. rtFIaTIeIf'ATC unl nom City of Santa Ana, Its Officers, Employees, and Representatives Attn: Sherry Barkley PO Box 1988 Santa Ana CA 92702 Acr%Dn 9S i-3nnnm4% SHOULDANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL (}V("Q MAIL 30 - DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 7?lec?>KrsK7axrwcoec Jr}1(Xl?COIIAQ1ftFx>4lW(?}QX9CIIOBIC )ID(PIM+( - 10 Days for Non-Payment of Premium. AUTHORIZED REPRESENTATIVE (AVC) Alicia K. Igram /'?%" ?iGJ?//?G? -- W 1988-2009 ACORD CORPORATION. All rights reserved. CERT NO.: 6330899 (AVC) Betty Tran 11/30/2009 9:39:11 AM Page 1 of 4 Johnson-Frank & Associates, Inc. 6806825L007 COMMERICAL GENERAL LIABILITY POLICY NUMBER: ISSUE DATE: - - 11/30/2009 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): City of Santa Ana, Its Officers, Employees, and Representatives PROJECT/LOCATION OF COVERED OPERATIONS: PROVISIONS A. The following is added to WHO IS AN INSURED (Section 11): The person or organization shown in the Sched- ule above is an additional insured on this Cover- age Part, but only with respect to liability for "bod- ily injury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products-completed operations hazard". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply to the render- ing of or failure to render any "professional services". e. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III) for this Coverage Part. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that, for the addi- tional insured shown in the Schedule, the insur- ance provided to that additional insured under this CG D3 82 09 07 © 2007 The Travelers Companies, Inc. Page 1 Of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission CERT NO.: 6330899 (AVC) Betty Tran 11/30/2009 9:39:11 AM Page 2 of 4 COMMERICAL GENERAL LIABILITY Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance" for such addi- tional insured. But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional in- sured when the additional insured is also an addi- tional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against the additional insured shown in the Schedule above because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" on or for the pro- ject, or at the location, shown in the Schedule above, performed by you, or on your behalf, un- der a "contract or agreement requiring insurance" with that additional insured. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with that additional insured entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal in- jury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include the person or organization shown in the Schedule as an ad- ditional insured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs, and the "personal injury" is caused by an of- fense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. tE S Page 2 of 2 © 2007 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office, Inc., with its permission CG D3 82 09 07 CERT NO.: 6330899 (AVC) Betty Tran 11/30/2009 9:39:11 AM Page 3 Of 4 POLICY NUMBER: BA68191_639 Johnson-Frank & Associates, Inc. COMMERCIAL AUTO ISSUE DATE: 11/30/2009 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): City of Santa Ana, Its Officers, Employees, and Representatives (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the end orsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. APPRO\'..._, ;,o', V o FOR1Ni t,aura Stitt Sheedy As,staot City Attorney CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 CERT NO.: 6330899 (AVC) Betty Tran 11/30/2009 9:39:11 AM Page 4 of 4 CERTHOLDER COPY STATE P_O_ BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION I N S V R A N C E FU N ? CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 07-26-2070 GROUP: 000092 POLICY NUMBER: 000067 8-2009 CERTIFICATE ID: 245 CERTIFICATE EXPIRES: 07-07-2017 01-01-2010/07-07-2077 CITY OF SANTA ANA SG BUILDING 8 SAFETY DEPT PO BOX 7988 SANTA ANA CA 92702-1985 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form ap Proved by the California Insurance Commissioner to the employer Hamad below for the policy periotl indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy b® cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein issubject to all the terms, exclusions, and conditions, of such policy. THORIZED REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: 57,000,000 PER OCCURRENCE. ENDORSEMENT N7600 - RDGER FRANK PRES - EXCLUDED. ENDORSEMENT 1/7600 - ALAN FRANK S.T - EXCLUDED. ENDORSEMENT 82065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-2008 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT 1!2570 ENTITLED MAIVER OF SUBROGATION EFFECTIVE 2010-01-26 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF SANTA ANA EMPLOYER JOHNSON-FRANK & ASSOCIATES (A CORP) SG 5150 E HUNTER AVE ANAHEIM CA 92807 SG [B1Q,SG] IREV.2-05) PRINTED 07-28-2010 T a ,acoRO CERTIFICATE OF LIABILITY INSURANCE DATE (MM)DDIYYYY) ?...?' 11/30/2009 PRODUCER IOA Insurance Services THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 130 Vantis Suite 165 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE , II HOLDrEly. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ) Aliso Viejo, CA 92656 COVERAGE AFFORDED BY THE POLICIES BELOW. A 949-680-1790 ww.io OE67768 www.ioausasa.c .c om NSUNSfi;. AFFORDING COVERAGE AIC # INSURED Johnson-Frank & Associates, Inc. CL INSURE Ike Eeazle Insurance Company. Inc, 5150 E. Hunter Avenue INSURER B: Anaheim CA 92807 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYYYM DATE (MMIDO/YYYYl LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES a o=rrence $ CLAIMS MADE ? OCCUR MED EXP An one person $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GEN1 AGGREGATE LIMIT APPLIES PER PRODUCTS • COMPIOP AGG $ POLICY PRC'T- LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea acctlant) ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Perperscn) $ HIREDAUTCS AS OVI A? R ?y TO FORM BODILY INJURY $ NON•OWNEDAUTOS APP (Per accident) / A PROPERTY DAMAGE (Per acddenl) $ GARAGELIABILITY aura Stitt heed AUTO ONLY-EA ACCIDENT $ ANY AUTO tant City i Attorney OTHER THAN EA ACC $ s Ass AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATII OTH- AND EMPLOYERS' LIABILITY ER YIN - ANY PROPRIErORIPARTAERIEXECUTIVE ? E.L. EACH ACCIDENT $ OFFICE ]MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe trader SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER A Professional V15PR3090201 92/1/2009 121112010 $1,000,000 per Claim Liability $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS] VEHICLES ) EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 30 Day Notice EndL BICAE00411105 included City of Santa Ana, Its Officers, Employees, and Representatives Attn: Sherry Barkley PO Box 1988 Santa Ana CA 92702 SHOULD ANY OFTIE ABOVE DESCRIBED POLICIES BE CANCELLE DB EFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 L DAYS WRtrTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. '10 Days for Non-Payment of Premium AUTHORIZED REPRESENTATIVE (AVC) Alicia K. Igram ACORD 25 (2009/01) CERT NC.- 6330999 (AVC) Betty Trap 11/30/2009 9:43:24 AM Page 1 of 3 ®1988-2009 ACORD CORPORATION. All rights reserved. Effective date of this Endorsement: 11/30/2009 This Endorsement Is attached to and forms a part of Policy Number: V15PR3090201 Insurer: Beazley Insurance Company, Inc. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER This endorsement modifies Insurance provided under the following: AFB A&E MEDIA TECH' POLICY In consideration of the premium charged for the Polley, it is hereby understood and agreed that in addition to the provisions of Clause XVII CANCELLATION AND NONRENEWAL B., if this policy is cancelled by the Insurer, other than for non-payment of premium, the Insurer will provide 30 days written notice to the following party(ies): City of Santa Ana, Its Officers, Employees, and Representatives All other terms and conditions of this Palley remain unchanged. Autho zed Representative BICAE00411105 Page 1 of 1 CHAT NO.. 5230999 (AVC) Betty Tran 11/30/2009 9,43:24 AM Page 2 of 3 POLICYHOLDER COPY P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-04-2011 CITY OF SANTA ANA SG BUILDING & SAFETY DEPT PO BOX 1988 SANTA ANA CA 92702-1988 GROUP: 000092 POLICY NUMBER: 0000678-2010 CERTIFICATE ID: 340 CERTIFICATE EXPIRES: 01-01-2012 01-01-2011/01-01-2012 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - ROGER FRANK PRIES - EXCLUDED. ENDORSEMENT #1600 - ALAN FRANK S,T - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2008 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2011-01-04 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF SANTA ANA EMPLOYER JOHNSON-FRANK & ASSOCIATES (A CORP) SG 5150 E HUNTER AVE ANAHEIM CA 92807 (PMF,CSj SG (REV.8-2010) PRINTED : 01-04-2011 A? " CERTIFICATE OF LIABILITY INSURANCE DATE (MWODNYYY) 11 /30/2011 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 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 endorsements). PRODUCER Insurance Office of America CONTACT NAME: 130 Vantis, Suite 250 PHONE • 94 -297-5962 (ac. No): 949-297-5960 Aliso Viejo, CA 92656 www.ioausa.com CA-License #,OE67768 INWRERA: RLIlnsurange Company,_ INSURED INSURERe: Beazle Insurance Company Johnson-Frank 81 Associates, Inc. 5150 E. Hunter Avenue INSURER C: Anaheim CA 92807 INSURER D: INSURER E : NAIC # CAVFRnrFSt CCDTICIr`ATC L11 IRAMOM. 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. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MMIDDY WDD YY POLICY FXP LIMITS A GENERAL LIABILITY V ? PSB0001301 12/1/2011 12/1/2012 EACH OCCURRENCE $ 1,000,000 ? COMMERCIAL GENERAL LIABILITY Scheduled Al Endt #PPB3130610 PREMISES EatN I IzD ce s 1,000,000 CLAIMS-MADE F7/ OCCUR Professional Services MED EXP (Any one person) S 10,000 ?_ Priman?On-COntflbUtOr?_ I performed by the insured PERSONAL BADVINJURY $ 1,000,000 ? Waiver of Subrogation are Excluded GENERAL AGGREGATE 000 $ 2 000 , , GEN'L AGGREGATE LIMIT APPLIES PER: P RO PRODUCTS-COMP/OPAGG $ 2,000,000 ? LOC POLICY ? JECT S A AUT OMOBILE LIABILITY ? ? PSA0001078 12/1/2011 12/1/2012 %=SINGLE LIMIT Desi nat d I d $ 1,000,000 V1 ANY AUTO g e nsure BODILY INJURY P ALL OWNED SCHED Endt #CA20480299 ( er person) $ AUTOS E ULED AUTOS NON O WNED Primary/Non-Contributory BODILY INJURY (Per accident) $ V/ HIREDAUTOS '/ - AAUUTOS and Blanket Waiver of PROP ?R DAMAGE Subro atio i l d i d ^ $ ? Primary/Non-Contributory g n nc u n e Coverage Form #PPA3000311 $ ? Waiver of Subr ation $ A UMBRELLA LIAB EXCESS `/ OCCUR PSE0001230 12/1/2011 12/1/2012 EACH OCCURRENCE $4,000,000 LIAB CLAIMS-MADE Excludes Professional AGGREGATE Li bilit $ 4,000,000 DED RETENTION $ a y $ $ i s WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N WC STATU- pTH TORY LIMITS ER ANY PROPRIETOPJPARTNERJEXECUnVE OFFICERAAEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ (Mandatory In NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS helow E.L. DISEASE - POLICY LIMIT $ B Professional Liability Claims-Made V15PR3110401 12/1/2011 12/1/2012 $1,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space is required) Certificate Holder is an Additional Insured with respect to General Liability and Automobile Liability but only when required by written contract with the Insured prior to an occurrence as per Endorsement(s) noted above General Liability includes Se ar ti f I d . p a on o nsure s and Contractual Liability per limitations in the BusinessOwners Coverage form. Coverage is subject to all policy terms, conditions, limitations and exclusions 30 Day Notice . of Cancellation/10 Day Notice for Non-Payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CIty of Santa Ana, Its Officers and Employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P. O. Box 1988 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE AV A ( C) licia K. I ram v love-cvly /4%.UKU VUKI'UKA 1IUN. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD CERT NO.: 11750526 Teresa Frank 11/30/2011 4:28:07 PM Page 1 of 4 Policy Number: PSB0001301 RLI Insurance Company Named Insured: Johnson-Frank & Associates, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack® FOR DESIGN PROFESSIONALS SCHEDULED ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM - SECTION II - LIABILITY Schedule Name of Person(s) or Organization (s): City of Santa Ana, Its Officers and Employees SECTION II C. Who Is An Insured is amended to include as an additional insured the person or organization shown in the schedule above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product-completed operations hazard". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply to the rendering of or failure to render any "professional services". b. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. 3. The following is added to SECTION III H.2. Other Insurance - COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II - LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION III K.2 Transfer of Rights of Recovery Against Others to Us - COMMON POLICY CONDITIONS (BUT APPLICABLE TO SECTION I- PROPERTY AND SECTION II - LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. PPB 313 06 10 Page 1 of 1 CERT NO.: 11750526 Teresa Frank 11/30/2011 4:28:07 PM Page 2 of 4 POLICY NUMBER: PSA0001078 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indi- cated below. Endorsement Effective: 11/30/2011 Countersign. Named Insured: Johnson Frank & Associates, Inc. Authorized Re resentative SCHEDULE Name of Person(s) or Organization(s): City of Santa Ana, Its Officers and Employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section 11 of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 ? C6RT NO.: 11750526 Teresa Frank 11/30/2011 4:20:07 PM Page 3 Of 4 This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Broad Form Named Insured The following is added to the SECTION II - LIABILITY Coverage, Paragraph A.I. Who Is An Insured Provision: Any business entity newly acquired or formed by you during the policy period, provided you own fifty percent (50%) or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of one hundred eighty (180) days following the acquisition or formation of the business entity. This provision does not apply to any person or organization for which coverage is excluded by endorsement. B. Employees As Insureds The following is added to the SECTION II - LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured Provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Blanket Additional Insured The following is added to the SECTION II - LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: We waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any "accident" or "loss", provided that the "accident' or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. E. Employee Hired Autos The following is added to the SECTION II - LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions: Paragraph S.b. of the Other Insurance Condition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and Any person or organization that you are required to include as an additional insured on this coverage form in a contract or agreement that is executed by you before the "bodily injury" or "property damage" occurs is an "insured" for liability coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II - LIABILITY COVERAGE. The insurance provided to the additional insured will be on a primary and non-contributory basis to the additional insured's own business auto coverage if you are required to do so in a contract or agreement that is executed by you before the "bodily injury" or .,property damage" occurs. D. Blanket Waiver Of Subrogation The following is added to the SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, S. Transfer Of Rights Of Recovery Against Others To Us: PPA 300 03 11 (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". F. Fellow Employee Coverage SECTION II - LIABILITY COVERAGE, Exclusion B.S. does not apply if you have workers compensation insurance in-force covering all of your employees. G. Auto Loan Lease Gap Coverage SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance, is amended by the addition of the following: In the event of a total "loss" to a covered "auto" shown in the Schedule of Declarations, we will pay any unpaid amount due on the lease or loan for a covered "auto", less: Page 2 of 5 CERT NO.: 11750526 Teresa Frank 11/30/2011 4:28:07 PM Page 4 of 4 CERTHOLDER COPY SG P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-09-2012 GROUP: 000092 POLICY NUMBER: 0000678-2011 CERTIFICATE ID: 422 CERTIFICATE EXPIRES: 01-01-2013 01-01-2012/01-01-2013 CITY OF SANTA ANA SG BUILDING & SAFETY DEPT PO BOX 1988 SANTA ANA CA 92702-1988 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. 4'?"6 Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - ROGER FRANK PRIES - EXCLUDED. ENDORSEMENT #1600 - ALAN FRANK S,T - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2008 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2012-01-09 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF SANTA ANA EMPLOYER JOHNSON-FRANK & ASSOCIATES (A CORP) SG 5150 E HUNTER AVE ANAHEIM CA 92807 [B1Q,SG] (REV.s-2010) PRINTED : 01-09-2012