HomeMy WebLinkAboutMONUMENT ROW (8) !NSURI3f,,E'F ON =iLE
WORK f!irlf PROCEED A-2021-223^01113
UNTO !NSUR,( tlCE E,KIN(
MAYOR CITY MANAGER
Valerie Amezcua -.IT, LLRK � s Alvaro Nunez
MAYOR PRO TEM n , ,' CITY ATTORNEY
Benjamin Vazquez OCT 2 Q 2025 --j_ Sonia R.Carvalho
COUNCILMEMBERS CITY CLERK
Phil Bacerra Jennifer L. Hall
Johnathan Ryan Hernandez
Jessie Lopez
David Penaloza
Thai Viet Phan CITY OF SANTA ANA
P W 6 (z) PUBLIC WORKS AGENCY
'�7G1 V id �0 hit I Q2-(PZ) 20 Civic Center Plaza+P.O.Box 1988
Santa Ana,California 92702
WWW.santa-ana.org
September 24,2025
Monument ROW
Attention: Amber Costello,President
200 Spectrum Center, Suite 300
Irvine, CA 92618
Re: Second and Final Extension of A reement A-2021-223-01 to Provide On-Call
Acquisition and Relocation Services
Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by Monument ROW
("Consultant"), and the City of Santa Ana,dated November 16,2021,the time period of the Agreement is
hereby further extended for an additional one-year period through November 15, 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.
Sincerel�
olfo Rasas,P.E.
Acting Executive Director,
Public Works Agency
AF
SANT NA ATTEST
ut3ez e '
City Manager City Cl r
APPROVED AS TO FORM MONUMENT ROW
Kyt Nellesen A4&Co hello
Assistant City Attorney President
SANTA ANA CITY COUNCIL
Valerie Amezcua 9eniamin Vazquez Thai Viet Phan Jessie Lopez Phil Sacerra Johnathan Ryan Hernandez David Penaloza
Mayor Mayor Pro Tem.Ward 2 Ward i Ward 3 Ward 4 Ward 5 Ward 6
vamezcua(fsanta-ana,oro dvamuez S31'Ila-ana.orq Iphan sanla-ana.org lessielopezAsanta-ana orn pbacerra(tsanta-ana.om jnLanhemandezasantaana.om dpenaloza(ibsanla-ana or4
ACo CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDIYYYY)
�--� 5/612025
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).
PRODUCER CONTACT
Venbrook Insurance Services PHONE carols Kin
16815 Von Karman Avenue E 818-598-8965 A D No):
Suite 184 ADDRESS: ckin venbrook.com
Irvine, CA 92606 INSURERS AFFORDING COVERAGE NAIC#
www.venbrook.com CA Lic No.OD80832 INSURER A: Hartford Underwriters Insurance Company 30104
INSURED INSURER B: Travelers Property Casualty Cc of Amer 25674
Monument ROW INSURER c: Underwriters at Lloyds of London 15642
8 Cobblestone Court
Laguna Nigel CA 92677 INSURER : Scottsdale Insurance Company 41297
INSURER E: Travelers Excess and Surplus Lines Co 29696
INSURER F: Travelers Casualty and Surety Co of Amer 31194
COVERAGES CERTIFICATE NUMBER: 85170368 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.
INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
LTR POLICYNUMBER MMIDDfYYYY MMIDDIYYYY LIMITS
A �/ COMMERCIAL GENERAL LIABILITY �/ `/ 72SBABRBLJ2 4123/2025 4/23/2026 EACH OCCURRENCE $1000000
DAMAGE TC RENTED
CLAIMS-MADE OCCUR PREMISES Eaoccurrence $1 DDD DDD
MED EXP(Any one person) $10 000
✓ Deductible;none PERSONAL&ADV INJURY 51,000,00()
GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000
✓ POLfCY PED ❑LOC PRODUCTS-COMPIOPAGG $2,000 000
OTHER: $
A AUTOMOBILE LIABILITY 72SBASR6LJ2 4/23/2025 4/23/2026 COMHENEDSINGLELIMIT $
Ea accident 1,000 DDD
ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE✓ $AUTOS ONLY ✓ AUTOS ONLY Per accident
A ✓ UMBRELLA LIAR H OCCUR 72SBABR6LJ2 4/23/2025 4/23/2026 EACH OCCURRENCE $5 000 OOO
EXCESS LIAR CLAIMS-MADE AGGRFGATE $5 000 000
DE❑ ✓ RETENTION$10.000 $
B WORKERS COMPENSATION UB2Y3528922442G 4/23/2025 4/2312026 ,/ STATUTE ERH-
AND EMPLOYERS'LIABILITY Y 1 N
ANYPROPRIETORfPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000 DDD
OFFICERIMEMBEREXCLUDED7 N 1 A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S1,000,00
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s 1 OOO 000
C Professional Liability(Claims Made) MPL444730524 4/23/2025 4123/2026 $3,000,000 Each Claim/Aggregate Limit
D Professional Liability(Excess) FKS3571558 4/23/2025 412412026 $3,000,000 Aggregate Limit
E Cyber Liability CY610809647300 7/2412025 7124/2026 $2,000,0001 Per Occurrence
F lCrime 108082890 7/1/2025 711/2026 $25 0001$2 500 ded
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 1 D1,Additional Remarks Schedule,may be attached if more space is required) Tu Tran yglta y signe
b Tu Tran
The City,its officers,officials,employees,and volunteers are included as an Additional Insureds with respects Nguyen
to General Liability.Primary/Non-Contributory and Waiver of Subrogation apply in favor of the Additional Insured when required Nguyen Date;2025.o6.23
by written and signed contract. Subject to policy terms,conditions,and exclusions. 16:55:34-0/'00'
APPROVED
By Tu Tran Nguyen at 4:55 pm,Jun 23,2025
CERTIFICATE77—
HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Attention: Public Works Agency, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Santa Ana, CIP/Design Engineering ACCORDANCE WITH THE POLICY PROVISIONS.
20 Civic Center Plaza
Santa Ana CA 92702, M-36
AUTHORIZED REPRESENTATIVE
Jeffrey Lang
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
95170398 l 2025 GL, HNG, U1413, WC, PL I Carcla icing 15/6/2025 4:4a:20 PM (PDT) I Page 1 of 5
This certificate cancels and supersedes ALL previously issued certificates.