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Home My WebLink AboutCLINICAL LABORATORY OF SAN BERNARDINO - 2007INSUhANCE ON FILE WORK MAY PROCEED UNTILI~RAN;EEXPI~R~S ` G CLERKOFCOUNCIL ~ ~.r~. 12 - l 1 ~~ THIRD AMENDMENT TO AGREEMENT THIS THIRD AMENDMENT TO AGREEMENT is entered into on November ~ 23, 2009, by and between Clinical Laboratory of San Bernardino, a Califomia corporation ("Consultant') and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). ,~~ RECITALS: f n 0, A. The parties entered into that certain Consultant Agreement #A-2003-239, dated ~ V December 31, 2003, (hereinafter "said Agreement") by which Consultant has - ~ provided domestic water quality testing. / B. Said Agreement has twice been amended to extend the term and add compensation to pay for services during the extended term. C. In accordance with the terms and conditions of said Agreement, the parties wish to extend the term for an additional six-month period. 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 Third Amendment to Agreement, the parties agree as follows: 1. Consultant shall continue to provide domestic water quality testing as set forth in Exhibit A to said Agreement, at the rates and charges set forth in Exhibit B to said Agreement. 2. Section 3, TERM, shall be amended tc> extend the term for an additional six-month period, through June 30, 2010. 3. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect. // // // // // A-2007-246-01 1N WITNESS WHEREOF, the parties hereto have executed this Third Amendment to Consultant Agreement on the date and year first written above. ATTEST: CITY OF SANTA ANA ~--- MARIA R. HUIZAT~~ RAUL GODI Clerk of the Council Executive Dig Public Works APPROVED AS TO FORM: JOSEPH W.FLETCHER City ~A/ttJorney (j~ / BV'il'li iAw rti_~1~ a ~ lG/i . 4;aitta Sheedy Assistant City Attorney. CLINICAL LABABORATORY OF SAN BERNARDBVO Yv~2~t~ ~,-tt/VYt¢C _~scs0_ (NAME) (Title) MAR-16-2009 MON 08 55 AM FAX N0. N. U1 MAR-16-2009 MON 08:56 AM his rlu, t', utiut "t®'Y-~ bui; BUSINESS AUTOMOBILE INSURANCE COMPANY: American Casualty Company of Reading, PA POLICY TERM: February 1, 2009 to February 1, 2010 Limits of Insurance Combined Single Limit Bodily Injury and Property ~ $ 1,000,000 Damage Per Accident- Owned ~ Non-Owned and Hired Autos Only Medical Payments $ 5,000 Uninsured /Underinsured Motorists Liabilily $ 1,000,000 Employers Non-Owned and Hired Automobile Liability $ 1,000,000 Mired Automobile Physical Damage $ 25,000 E]eductibles Comprehensive $ 1,000 Collision -Waived $ 1,000 Rental Reimbursement $ 50 per Day 3D Days Coverage Extensions • 30 Notlce of Cancellation, except 10 days for Non-Payment • SR75 Flling Included • Employees as Insureds • Fellow Employee Exclusion Deleted CONDITIONS • 3 or more moving violation • D.U.I. conviction within the last 3 years Exclusions All policies contain conditions and exclusion, all which cannot be listed in a proposal. Please read your policy carefully for all policy terms, condltians and exclusions. • ~YPRUVEll. AS TO FORM :.aura Stitt n ,,,,, a n~t~ • MAR-16-2D09 MON 08:57 AM FAK N0, P, O1/Ot ~G'Vi PR~FESSI~NAL LIABILITY INSURANGE COMPANY: Continental Casualty Company POLICY TERM: February 1, 2009 to February 1, 2010 Deductible (lnc7uded Defense and Expenses Costs) 100,000 Claim Extension Period • From Cancellation or Expiration if the company cancels ornon-renews: 12 Months Q100% Annual Premium Included Retroactive Dates Full Prior Acts • Clinical Laboratory Full Prior Acts • GEO Monitor Rating Basis • $2,300,000 Gross Safes Terms & conditions: • Full Prior Acts Goverage • Coverage for APA/FhiA~OSHA claims • Free Pre-Claims Assistance . Circumstance Reporting Coverage • Limited Contractual Liability Coverage • slanket Joint Venture ~ Mediation Deductible Credits pefense Reimbursement Provisions • Personnel Leased by You • Innocent Principals Coverage • Retired Consultant Personnel ^ °^A ^"'" _!' ~~':) FORM - ~..,, Speedy -- ~~iry Attorney ANDREINI ~ COMPANY Limits of Insurance $ 3,000,000 Each Claim $ 3,000,000 Aggregate MAR- 16-2009 MON 08 58 AM FAH N0, --~ ~~,, ^ f G, Y/ ~ / r ~`~ COMMERCIAL GENERAL LIABILITY INSURANCE COMPANY: American Casualty Company of Reading, PA POLICY TERM: February 1, 2009 to February 1, 2010 COMMERCIAL GENI+RAL LIABILITY Limits of Insurance Each Occurrence $ 1,000,000 General Aggregate $ 2,000,000 ProductslCompleted Operations $ 2,000,000 Personal and Advertising Injury $ 1,000,000 Fire Damage Liability $ 1 D0,000 Premises Medical Payments $ 10,000 Employee Benefits Liability Aggregate $ 1,000,000 Per Occurrence $ 1,D00,000 Deductible - EBL Only $ 1,000 Rekroactive ^ate 2101104 Coverage Extensions In addition to the policy terms and conditions, coverage extensions Include, but are not limited to: • Liability Assumed under an Insured Contract • Broad Named insured Clause • Notice of Loss Modification + Unintentional Errors & Omissions in Application Clause • Hostile Fire Exception to a Pollution Exclusion • Aggregate Limits by Location • Blanket Additional Insured Endorsement • Provides "property damage liability" coverage for elevators and sidetrack agreements • Provides "Non-Owned" Aircraft Liability coverage if other coverage is not otherwise available • fi0 Day Notice of Cancellation except 10 days for Non-Payment F~tclusions All policies contain conditions and exGusion, all which cannot be listed in a proposal. Please read your policy carefully for all policy terms, conditions and exclusions. P. OI/O1 APPROVBV ,v5 'fU r~:... :~-~ ,, , Assistant {yFgnttAnv POLICYHOLDER COPY STATE P.o. eox 42oso7, SAN FRANCISCO,CA 94142-0807 COMPENSATION IrNSURANCE r U N ~ CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 02-01-2009 GROUP: POLICY NUMBER: 1896779-2009 CERTIFICATE ID: 4 CERTIFICATE EXPIRES: 02-Ot-2010 02-07-2009/02-01-2010 CITY OF SANTA ANA ~ SG DEPARTMENT OF PUBLIC WORKS 220 SDAISY AVE SANTA ANA CA 92703-4334 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 ~ancellation'by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does nbt 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 perUin, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. HORIZED REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE APPROVED AS TO FORM C--Z - -~ Laura Stitt Shee Assistant City A orney EMPLOYER CLINICAL LABORATORIES OF SAN BERN AND/OR GEO MONITOR INC PO BOX 328 SAN BERNARDINO CA 82402 SG - M0409 1REV.2-o5) PRIMED 01-18-2009 STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 GOM PEN SATION I N S U R A N C 8 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE FEBRUARY 1, 2009 PoucvNUMBER:1886779 - 09 CERTIFICATE EXPIRES: 2-1-10 CITY OF SANTA ANA DEPARTMENT OF PUBLIC NORKS 220 S DAISY AVE SANTA ANA, CA 92703-4334 JOB: ALL CALIFDRNIA OPERATIONS L 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 ten days' advance written notice to the employer. We will also give you TEN 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. A HORIZED REPR~ SENTATIVE 7 """~"~ PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: 41,000,000 PER OCCURRENCE. vau ~,s ~I'o p~KM APpR~ EMPLOYER CLINICAL LABORATORIES GEO MONITOR INC. P. O. BOX 329 OF SAN BERNARDINO AND/OR SAN BERNARDINO, CA 92402 ~'r ~. e~ p(4 ~auta Butt Jntloc Assistant City r\ L ,,,, SCIF 10262 (REV. 02-08) / _ r ~i - ,~ CCU ~ .~' y~ ~~~ From: Dolores Muir FaxID:650-378-4361 Date:4/6!2010 01:24 PM Page: 2 of 5 .!#COR'D~ CERTIFICATE t}F L (ABlLlTY INSURANCE ~LiH~~ DA / 0 . 04I06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER.OF INFORMATION Andreini & Company-South Coast ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License 0208825 HOLDER.THI5 CERTIFICATE DOES NOTAMEND, EXTEND OR One MacArthur Place, Suits 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOYI(. South Coast Metro CA 92707 Phone: 714-327-1400 Fax:714-327-1499 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA Anarimn Cenueity Cmnpany ar 2D427 INSURER B: contiaantal Casualty canpany 20443 Clinical Labozatories of Znc San Bernardino tNSURERc , , P . 0. Box 329 ; INSURER D: San Bernardino CA 92402 INSURER E: f:r~V FRdf; FS THE POLICIES OE INSURANCE LISTED BELDW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERM INDICATED. NOT W RHSTANOING ANY REQUIREMENT, TERM OR GONDfITON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PE47AIN, THE INSURANCE AFFORDED BY THE POLX:IES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONOYTIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. '' ~ LTR ~~,[ NSR ~_ -- TYPE DF INSURANCE ~ .............~ POLICY NUMBER TE MNVDOtYYVY DATE MMtOD T10N ' LtE1R9 ...__ GENERAL UA8iU7Y EACH OCCURRENCE S1 OOO,ODO ' A X COMMERCIAL GENERALLIA81l.1TY 2068975201 02/Ol/10 02/O1/11 PREMISE~EdOCCUrerlce 5100 OOD _ CLAPIiSMADE ~ OCCUR MEOEXP(Artyana,xrsanj S 10,000 PERSONALEAOV INJURY 31, OOO,DOO GENERAL AGGREGATE S 2 OOD r OOO GEN'L AGGREGATE LIMITAP PLIES PER: ' PRODUCTS-COMPlOP AGG sExcluded POLICY ~ JECT LOC E Bei3 . 1 OOO , OOO AU TOMOBILE LIA8IUTY CQMSINED SINGLE UMR s1 000 004 A X ANYAUTO 2068975084 02/01/10 ~ 02/01/11 (~Eaaccldentl , , ALL 04VNED AUTOS 8001LY INJURY S SCI#OULED AUTOS : (Per person} X HIRED AUTOS j +)i\`~ V ~ A C' T!l tiJ 1 r J C/\i91, L'l/i\ :, BODILY INJURY I; $ X NON-0WNEO AUTOS . . j (Per accldsM) ' !~'- ~ PROPERTY DAMAGE _...... ~ ~I ~,j ~> >. _. (Per accldenl) s GARAGE UAOILtT'Y LaUI St:Ct Sh'eed AUTO ONLY-EA ACCIDENT S ANY AUTO ~~ssist<i t City At(vr , OTHER THAN ~ ACC S ~ - AUTO ONLY• AGG i EXCESSJUMBRELLA LW67Lf'rl ~: EACH OCCURRENCE S__Jr ~ GOO, O00 A X occuR Q cLAIMSMADE 20689753444 02/O1/10 O2/O1/11 ~ AGGREGATE s ~ s DEDUCTIBLE j _ S ~'~ X I RETEMION i O _ _._ S I WORKERS COMPENSATION AND EMPLOYERS' LIABILRY W TATU- TM-I TORY LIMITS ER ' Y ! N ANY PROPRIETORlPARTNEFtIEXECU ' ~'~: E.L, EACH ACCIDENT _ S OFFiCER MEMBER EXCLUDED? {MandAtofy in NHj EL. DISEASE - EA EMPLOYE!" $ rt yes, desa~e under SPECIALPRQVISIONSMaw E.L.OfSEASE-POLICYtIMR' f OTHER B Professional EEA276170923 02/01/10 02/O1/11 Claim/Agg 3,000,000 Liabilit {E60} Deduct. 100 000 DESCRIPTION OF OPERATIONS ! LOCATIONS J VEHlCLE91 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECAAI. PROVISIONS Certificate Holder is additional insured as respects to General Liab111ty per attached G-17957-G99. *Supercedes and Replaces certificate issued 2-1-10*** *The CANCELLATION notice herein is amended to read 20 Days as respects any cancellation due to non-payment of premium. CERTIFICATE HOLDER CANCELLATION ~,) City o£ Santa Ana Dept of 7..ri c T~7ark~ 220 S. s rP,4~e `~ ~'~' "`" Santa Ana CA 92703 ACOR^ 25 l20A9lD11 All riahtc reserver! SHOULD ANY OF THE A80VE DESCRi8E0 POLICIES 0E CANCELLED BEFORE THE EXPIRATION .SANSANE DATE THEREOF, THE IBS UfNG INSURER WILL ENDEAVOR TO MAIL 3O ...-__ DAYS WRITTEN NOTICE TO THE CERTIPICATE HOLDER NAMED 70 THE LEFT, OUT FAILURE TO 00 SO SHALL IMPOSE NO OBL)GATION OR I,IA8ILITY OF ANY KIND UPON THE INSURER RS AGENTS OR REPRESENTATNES. TbeACORD name and logo are registered marks oiACORD FXOm:Dolares Muir FaxTD:650-378-4361 Date:4/6I20i0 01:24 PM Page:. 3 of 5 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies} must be endorsed. A statement on trhis certifcate does not confer rights tv 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 certificate does not confer rights to the certificate holder in lieu of such endorsements}. DiSCtAtMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AGpRO 25 (~UU$(01) From:Dolores Muzr FaxID:650-378-4361 Dat:e:4/6/2010 01:24 PM Page: 4 of 5 CNA G-17957-G99 (Ed. 10/01) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDtTtONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C.1. OF THIS ENDORSEMENT FOR THESE DUTIES, ALSO, THIS ENDORSEMENT CHANGES THE CONTRACTUAL LIABILITY COVERAGE WITH RESPECTS TO THE "BODILY INJURY" OR "PROPERTY DAMAGE" AR1StNG OUT OF THE "PRODUCTS-COMPLETED OPERATIONS HAZARD." SEE PARAGRAPH B.3. OF THIS ENDORSEMENT FOR THIS COVERAGE CHANGE. THIS ENDORSEMENT CHANGES `SHE POLICY. PLEASE READ 1T CAREFULLY. CONTRACTOR'S SCHEDULED AND BLANKET ADDITIONAL INSURED ENDORSEMENT WITH LIMITED PRODUCTS -- GQIIIIPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABlL1TY COVERAGE PART SCHEDULE Name of Person or grganization: Designated Project: (Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above,] A. WHO IS AN tNSURED (Section 11) is amended to written contract or written agreement or in the include as an insured any person or organization, Declarations of this policy, whichever is less. including any person or organization shown in the These Limits of insurance are inclusive of, and schedule above, (called additional insured) whom not in addition to, the Limits of Insurance shown you are required to add as an additional insured on in the Declarations. this policy under a written contract ar written 3, The coverage provided to the additional insured agreement; but the written contract or written by this endorsement and paragraph f, of the agreement must be: definition of "insured contract" under 1. Currently in effect or becoming effective during t?EFINITIONS (Section V) do not apply to the term of this policy; and "bodily injury" or "property damage" arising out of the "products-completed operations hazard" 2. Executed prior to the "bodily injury," "property unless required by the written contract or written damage," or"personal and advertising injury." agreement. When coverage does apply to B. The insurance provided to the additional insured is "bodily injury" or "property damage" arising out limited as follows: of the "products-completed operations hazard" such coverage wilt not apply beyond: 1. That person or organization is an additional insured solely for liability due to your negligence a. The period of time required by the written and specifically resulting from "your work" for contract or written agreement; or the additional insured which is the subject of the b. 5 years from the completion of "your work" written contract or written agreement. No on the project which is the subject of the coverage applies to liability resulting from the written contract or written agreement, sole negligence of the additional insured. whichever is less. 2. The Limits of tnsurance applicable to the additional insured are those specified in the 4. The insurance provided to the additional insured does not apply to "bodily injury," "property G-17957-G99 ~ Page 1 of 2 (Ed. 10/01) From: Dolores Muir FaxID:650-378-4361 Date:4/6/2010 01:24 PM Page: 5 of 5 G-17957-G99 {Ed. 10101} damage,` or "personal and advertising injury" 4. Other Insurance arising out of an architect's, engineer's, or b. Excess Insurance surveyor's rendering of or failure to render any professional services including: This insurance is excess over any other a. The preparing, approving, or failing to insurance naming the additional insured prepare or approve maps, shop drawings, as an insured whether primary, excess, opinions, reports, surveys, fseld orders, contingent or on any other basis unless a written contract or written agreement change orders or drawings and specifically requires that this insurance specifications; and be eifher primary or primary and b. Supervisory, or inspection activities noncontributing to the additional performed as part of any related insured's own coverage. This insurance architectural or engineering activities. is excess over any other insurance to C. As respects the coverage provided under this which the additional insured has been added as an additional insured by endorsement, SECTION IV -- GOMMERGIAL endorsement GENERAL LIABILITY CONDITIONS are amended . as follows: When this insurance is excess, we will 1. -the following is added to the Duties !n The have no duty under Coverages A or B Event of Occurrence, Offense, Claim or Suit to defend the additional insured against any "suit" if any other insurer has a duty Condition: to defend the additional insured against e. An additional insured under this that "suit." If no other insurer defends, endorsemen# wilt as soon as practicable: we will undertake to do so, but we will be entitled #a the additional insured's {1) Give written notice of an occurrence or rights against all those other insurers. an offense to us which may result in a claim or "suit" under this insurance; When this insurance is excess over other insurance, we will pay only our (2} lender the defense and indemnity of " " share of the amount of the loss, if any, suit any claim or to us for a loss we that exceeds the sum of: cover under this Coverage Part; {3) Tender the defense and indemnity of " " (1) The total amount that all such ofher insurance would pay for the loss in any claim or suit to any other insurer the absence of this insurance; and which also has insurance for a loss we cover under this Coverage Part; and (2) The to#al of all deductible and self- {4) Agree to make available any ofher insured amounts under all that other insurance. insurance which the additional insured has far a loss we cover under this We will share the remaining foss, if any, Coverage Part. with any other insurance that is not described in this Excess Insurance f. We have no duty to defend or indemnify an provision and was not bought additional insured under this endorsement specifically to apply in excess of the until we receive written notice of a claim or Limits of Insurance shown in the "suit" from the additional insured. Declarations of this Coverage Part. 2. Paragraph 4.b. of the Other Insurance Condition is deleted and replaced with the following: G-17957-G99 Page 2 of 2 {Ed. 10101)