HomeMy WebLinkAboutMAYNE, VIRGINIA G. (2) - 2010
INSURANCE ON FILE N-2010-107
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
/ - / -
CLERK OF. COUNCIL CONSULTANT AGREEMENT
DATE. NOV - 5 ?()to 0A / wort t~ ~~er C2~
z~.~e z
f Svl `tHIS AGREEMENT, made and entered into this 1" day of October, 2010, by and
between Virginia G. Mayne (hereinafter "Consultant"), and the City of Santa Ana, a charter
city and municipal corporation organized and existing under the Constitution and laws of the
State of California (hereinafter "City").
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field
of job preparedness instruction and employability skills instruction for clients at the
Santa Ana WORK Center.
B. Consultant represents that Consultant is able and willing to provide such services to
the City.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably be
expected from a professional consulting firm in the field.
NOW THEREFORE, in consideration ofthe mutual and respective promises, and subject to
the terms and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
Consultant shall provide Work Readiness Workshops at the Santa Ana WORK Center as
set forth in Exhibit A to this Agreement. Workshops and hours must be pre-approved by the
Santa Ana WORK Center staff.
2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services,
$50.00 per hour, as identified in Exhibit A. The total sum to be expended under this
Agreement shall not exceed $10,000"00 during the term of this Agreement.
b" Payment by City shall be made within thirty (30) days following receipt of proper
invoice evidencing work performed, subject to City accounting procedures. Payment need not
be made for work which fails to meet the standards of performance set forth in the Recitals
which may reasonably be expected by City"
3. TERM
This Agreement shall commence on the date first written above and terminate on June 30,
1
2011, unless terminated earlier in accordance with Section 12, below. The term of this
Agreement may be extended upon a writing executed by the Deputy City Manager for
Development Services and the City Attorney.
4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an independent
contractor and not an employee of the City. This Agreement is not intended nor shall it be
construed to create an employer-employee relationship, a joint venture relationship, or to
allow the City to exercise discretion or control over the professional manner in which
Consultant performs the services which are the subject matter of this Agreement; however,
the services to be provided by Consultant shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Consultant shall pay all salaries
and wages, employer's social security taxes, unemployment insurance and similar taxes
relating to employees and shall be responsible for all applicable withholding taxes.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall maintain
and shall require its subcontractors, if any, to obtain and maintain insurance as described
below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the City, its officers, employees, agents, volunteers
and representatives as additional insured(s) and shall include, but not be limited to
protection against claims arising from bodily and personal injury, including death
resulting therefrom and damage to property, resulting from any act or occurrence
arising out of Consultant's operations in the performance of this Agreement,
including, without limitation, acts involving vehicles. The amounts of insurance shall
be not less than the following: single limit coverage applying to bodily and personal
injury, including death resulting therefrom, and property damage, in the total amount
of $1,000,000 per occurrence. Consultant shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit B
upon execution of this Agreement and shall be approved in form by the City Attorney.
b. (reserved)
c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300
of the Labor Code, Consultant, if Consultant has any employees, is required to be
insured against liability for worker's compensation or to undertake self- insurance.
Prior to commencing the performance of the work under this Agreement, Consultant
agrees to obtain and maintain any employer's liability insurance with limits not less
than $1,000,000 per accident.
d. The following requirements apply to the insurance to be provided by Consultant
pursuant to this section:
2
(i) Consultant shall maintain all insurance required above in full force and effect
for the entire period covered by this Agreement.
(ii) Certificates of insurance shall be furnished to the City upon execution of this
Agreement and shall be approved in form by the City Attorney.
(iii) Certificates and policies shall state that the policies shall not be canceled or
reduced in coverage or changed in any other material aspect without thirty (30)
days prior written notice to the City.
d. If Consultant fails or refuses to produce or maintain the insurance required by this
section or fails or refuses to furnish the City with required proof that insurance has
been procured and is in force and paid for, the City shall have the right, at the City's
election, to forthwith terminate this Agreement. Such termination shall not effect
Consultant's right to be paid for its time and materials expended prior to notification
of termination. Consultant waives the right to receive compensation and agrees to
indemnify the City for any work performed prior to approval of insurance by the City.
6. INDEMNIFICATION
Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents,
employees, consultants, special counsel, and representatives from liability: (1) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of
claims for personal injury, including health, and claims for property damage, which may arise
from the direct or indirect operations of the Consultant or its contractors, subcontractors,
agents, employees, or other persons acting on their behalf which relates to the services
described in section 1 of this Agreement; and (2) from any claim that personal injury,
damages, just compensation, restitution, judicial or equitable relief is due by reason of the
terms of or effects arising from this Agreement. This indemnity and hold harmless agreement
applies to all claims for damages, just compensation, restitution, judicial or equitable relief
suffered, or alleged to have been suffered, by reason of the events referred to in this Section or
by reason of the terms of, or effects, arising from this Agreement. The Consultant further
agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including
fees and costs for special counsel to be selected by the City, regarding any action by a third
party challenging the validity of this Agreement, or asserting that personal injury, damages,
just compensation, restitution, judicial or equitable relief due to personal or property rights
arises by reason of the terms of, or effects arising from this Agreement. City may make all
reasonable decisions with respect to its representation in any legal proceeding.
7. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such information
is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall
not use or disclose such information except in the performance of this Agreement, and further
agrees to exercise the same degree of care it uses to protect its own information of like
importance, but in no event less than reasonable care. "Confidential Information" shall
include all nonpublic information. Confidential information includes not only written
3
information, but also information transferred orally, visually, electronically, or by other
means. Confidential information disclosed to either party by any subsidiary and/or agent of
the other party is covered by this Agreement. The foregoing obligations of non-use and
nondisclosure shall not apply to any information that (a) has been disclosed in publicly
available sources; (b) is, through no fault of the Consultant disclosed in a publicly available
source; (c) is in rightful possession of the Consultant without an obligation of confidentiality;
( d) is required to be disclosed by operation of law; or (e) is independently developed by the
Consultant without reference to information disclosed by the City.
8. CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interests and shall not have interests, direct or
indirect, which would conflict in any manner with performance of services specified under
this Agreement.
9. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this Agreement
shall be in writing and shall be deemed to be properly given if delivered in person or mailed
by first class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic
communication in the manner provided in this Section, to the following persons:
To City:
Clerk of the City Council City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
telefacsimile (714) 647-6956
With courtesy copies to:
Deputy City Manager for Development Services
City of Santa Ana
20 Civic Center Plaza (1\4-25)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-6549
and,
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647-6515
4
and,
Santa Ana WORK Center
1000 E. Santa Ana Blvd., #200
Santa Ana, CA 92701
Telefacsimile (714) 565-2602
To Consultant:
Virginia G. Mayne
1601 East Avalon Avenue
Santa Ana, CA 92705-7 1 1 8
(714) 953-3081
A party may change its address by giving notice in writing to the other party. Thereafter, any
notice, tender, demand, delivery, or other communication shall be addressed and transmitted
to the new address. If sent by mail, any notice, tender, demand, delivery, or other
communication shall be effective or deemed to have been given three (3) days after it has
been deposited in the United States mail, duly registered or certified, with postage prepaid,
and addressed as set forth above. If sent by telefacsimile, any notice, tender, demand,
delivery, or other communication shall be effective or deemed to have been given twenty-four
(24) hours after the time set forth on the transmission report issued by the transmitting
facsimile machine, addressed as set forth above. For purposes of calculating these time
frames, weekends, federal, state, County or City holidays shall be excluded.
10. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, and supersedes any and all other agreements, oral or written, between the parties.
In the event of a conflict between the terms of this Agreement and any attachments hereto, the
terms of this Agreement shall prevail. This Agreement may not be modified except by written
instrument signed by the City and by an authorized representative of Consultant. The parties
agree that any terms or conditions of any purchase order or other instrument that are
inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate
Consultant nor the City. Each party to this Agreement acknowledges that no representations,
inducements, promises or agreements, orally or otherwise, have been made by any party, or
anyone acting on behalf of any party, which are not embodied herein.
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the
prior written consent of the City and any such assignment, transfer, delegation or subcontract
without the City's prior written consent shall be considered null and void. Nothing in this
Agreement shall be construed to limit the City's ability to have any of the services which are
the subject to this Agreement performed by City personnel or by other consultants retained by
5
City.
12. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay
Consultant compensation for all services performed by Consultant prior to receipt of such
notice of termination, subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to
deliver to the City all work product completed as of such date, and in such case such
work product shall be the property of the City unless prohibited by law, and
Consultant consents to the City's use thereof for such purposes as the City deems
appropriate.
b. Payment need not be made for work which fails to meet the standard of performance
specified in the Recitals of this Agreement.
13. DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by
applicable law, in the recruitment, selection, training, utilization, promotion, termination or
other employment related activities. Consultant affirms that it is an equal opportunity
employer and shall comply with all applicable federal, state and local laws and regulations.
14. JURISDICTION -VENUE
This Agreement and all questions relating to its validity, interpretation, performance, and
enforcement shall be government and construed in accordance with the laws of the State of
California. This Agreement has been executed and delivered in the State of California and the
validity, interpretation, performance, and enforcement of any of the clauses of this Agreement
shall be determined and governed by the laws of the State of California. Both parties further
agree that Orange County, California, shall be the venue for any action or proceeding that
may be brought or arise out of, in connection with or by reason of this Agreement.
15. PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United States, the State of
California, the City of Santa Ana and all other governmental agencies. Consultant shall notify
the City immediately and in writing of her inability to obtain or maintain such permits,
licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of
this Agreement.
6
16. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow has
the power, authority and right to bind their respective parties to each of the
terms of this Agreement, and shall indemnify City fully, including reasonable
costs and attorney's fees, for any injuries or damages to City in the event that
such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if
fully set forth in the body of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST: CITY OF SANTA ANA
Maria D. HPizar David N. Ream, City Manager
Clerk of the Council
APPROVED AS TO FORM: CONSULTANT
Joseph W. Fletcher, City Attorney
Lisa Storck, Assistant City Attorney Virginia 6--Mayne
RECOMMENDED FOR APPROVAL:
Cynthia J. Nelso , Deputy City Manager
For Development Services
7
VIRGINIA G. MAYNE
1601 East Avalon Avenue • Santa Ana, CA 92705-7118
Home (714) 953-3081 • Cell (949) 246-5074 a e-mail: maynes8CcDjuno.com
August 23, 2010
Carlos de la Riva
Economic Development Specialist
Santa Ana W/O/R/K Center
1000 East Santa Ana Blvd., Ste. 200
Santa Ana, CA 92701
RE: Employability Skills Workshops Applicant Information
Dear Carlos:
This is in response to your Request for Qualifications for presenters of Employability Skills
Workshops at the Santa Ana W/O/R/K Center. My proposal is enclosed for your review.
1 have a Bachelor of Arts degree in English, Teaching Emphasis,'with a minor in Education j
from the University of California, Davis. Originally, I had planned to become a secondary
English teacher. However, life intervened as it always does, which set me on the path of
human resources development. Throughout my career I have held several customer service
and clerical positions, eventually taking a clerical human resources position with Orange
County Teachers Federal Credit Union (now Schools First Federal Credit Union). This
institution taught me how to provide "World Class Service," which I try to practice every day. In
this position, I also gained knowledge and skill in a variety of areas including recruitment,
benefits processing, basic employment law, employee relations, confidentiality and others.
After leaving the credit union, i began to work part-time for the Santa Ana College School of
Continuing Education as an Office Skills instructor. Almost 100% of the time, my students
were English-as-a-Second-Language speakers who held entry-level and manual labor jobs,
and who were trying to gain skills and improve their family situations. I was tremendously
impressed by how hard they worked and how willing they were to learn something-anything-
new that would help them progress in life. 1 knew then that adult education was my true
calling. I also enjoyed improving and sharpening my Spanish-language skills, which I now use
almost daily.
I taught the Office Skills course for approximately a year and a half and then took a short
break. When I returned to work in the fall of 2000, my new assignment was to teach
Employability Skills at the Santa Ana W/O/R/K Center. I was very excited to be a part of the
process of helping people find work. In the beginning I gave the orientation to W/O/R/K Center
services in addition to teaching Skills Analysis and R6sum6 Writing, and I was always amazed
at what services were available to our community.
Virginia G. Mayne Applicant Information. Page Two
Soon after I began I was asked to review and edit the workshop materials that were available,
which 1 did, and which have evolved into the Workforce Preparation Workbook we still use at
the W/O/R/K Center today. In 2009 1 was awarded Santa Ana College's Curriculum
Development Award for the workbook. In addition, my R6sum6 Labs and Interviewing Skills
Workshops have become featured services at the W/O/R/K Center. I have also taught the
popular Job Search Stress Management and Job Retention workshops, and have provided lab
assistance and individual r6sum6 assistance when time has permitted.
Through this experience I have gained in-depth knowledge of the W/O/R/K Center's
operations, personnel and clientele. I am very comfortable presenting workshops to larger
audiences as well as giving instruction to individuals, and 1 have been praised for my ability to
communicate with and encourage others at all levels of understanding and from all walks of
life. I have developed a keen sensitivity to and appreciation for the special needs of our
community, and I am personally motivated to give my clients valuable resources they can use
throughout their professional lives. Along with my experience and my desire to serve the
community, I can contribute the following qualifications:
• Polished presentation style with an emphasis on personal empowerment and positivity
• Presentation of outplacement workshops to local companies under the WIA Rapid
Response program
• Instruction of life skills and employment skills to "at-risk" and mainstream youth through
community organizations and the W/O/R/K Center's summer youth programs
• Guest speaking assignments on several employment skills topics at many community
organization meetings
• Volunteer experience as an employment counselor and religion instructor
I believe 1 am uniquely qualified for this appointment for many reasons. As I mentioned, I have
been performing exactly these services at the W/O/R/K Center for the last 10 years under my
assignment with the Santa Ana College School of Continuing Education. In addition, I have
consulted for the City for several years to provide these services when the College has had a
semester break or "non-instructional" day in order to maintain the availability of services for
clients. I propose to continue any or all of these services as a consultant for such contingencies.
I welcome the opportunity to discuss with you further how my qualifications may meet your
needs. Thank you for your consideration.
Sincerely,
Virginia G. Mayne
I
VIRGINIA G. MAYNE
1601 East Avalon Avenue - Santa Ana, CA 92 705-71 1 6
Home (714) 953-3081 - Cell (949) 246-5074 . e-mail: maynesS@)Juno.com
PROFESSIONAL PROFILE
Seeking a position to apply strong skills and extensive experience in human resources, adult education
and public speaking. Outstanding qualifications include:
Communication and Customer Service
. Strong experience in training and public speaking to small and large groups including specialized
audiences
. Superior written and verbal communication skills; adept at communicating sophisticated information
to all levels of understanding; recognized for effective and dynamic presentation style and curriculum
development
. Excellent customer service provider; comfortable in situations requiring tact, discretion and
encouragement; able to resolve concerns with confidentiality, sensitivity and urgency and with value-
added service
. Experience in a multi-agency environment including government and community services
. Additional communication skills in conversational Spanish
Human Resources Development
. Extensive experience screening candidates and analyzing qualifications; intuitive ability to provide
career counseling and direct qualified candidates to available positions
. Experience with human resources functions including recruitment, compensation analysis, benefits
processing, HRIS data management, basic employment law/employee relations
. Able to draw upon large network of community and educational contacts to facilitate recruitment
outreach
. In-depth knowledge of multiple employability topics including Skills Analysis, R6sum6 Writing, Job
Searching, Interviewing, Job Retention and Stress Management
Administrative Skills
• Proficient with MS Word and Excel, Internet, e-mail, data management and typing 50 - 60 wpm to
communicate and produce correspondence, spreadsheets, ad-hoc reports and presentation materials
. Excellent project manager from project conception through implementation and follow up
. Skilled in office administration including reception, records management, all routine and special projects
. Highly organized, thorough multi-tasker; adept at problem-solving and process improvement
EMPLOYMENT HISTORY
Instructor, Santa Ana College School of Continuing Education 1999 - Present
Rancho Santiago Community College District (Santa Ana, CA)
Instructor, Employability Skills, Santa Ana W/O/R/K Center, 2000 - Present
. Partner with WIA "One-Stop' Job development center to facilitate employment counseling
. Present workshops to the public regarding various job search methods and employment skills;
consistently recognized and preferred by clients due to technical knowledge, professionalism and
positive attitude
. Edit and create workshop materials; authored materials in "Job Retention," "Overcoming Job Search
Obstacles" and "Managing Your Money"
. Received the 2009 Santa Ana College Profiles in Excellence Curriculum Development Award for The
Santa Ana W/O/R/K Center Workforce Preparation Workbook
Instructor, Vocational Education, Office Sirius, 1999 - 2000
. Instructed clerical skills, business correspondence, customer service, job search techniques and language
skills to majority ESL student base
. Developed streamlined curriculum to matriculate students in a timely manner (e.g., within an
abbreviated summer semester)
VIRGINIA G. MAYNE, R6sum6 Page Two (714) 953-3081 (H) 1 (949) 246-5074 (C)
Administrative Secretary, Human Resources 1995 - 1998
SchoolsFirst Federal Credit Union/formerly OCTFCU (Santa Ana, CA)
. Screened r6sumds and applications; scheduled Interviews; extended employment offers
. Assembled new hire packets and administered orientation for all new hires including regulatory
documentation
. Administered employee programs including vision benefit, tuition reimbursement, etc.; facilitated
conversion of vision benefit from bi-yearly to yearly payouts
. Implemented employee flu vaccination clinics with all associated research, legal and administrative
requirements, which program remains in force at the credit union
. Assisted company-wide performance evaluation process from planning through follow up; achieved
100% capture of completed evaluation forms In a timely manner
. Created and maintained budget tracking system; assisted yearly department budget preparation
. Produced ad-hoc reports using word processing, spreadsheet and HRIS database programs (e.g.,
Advanceware, Wycomp, Lawson)
. Performed all routine and special administrative duties while maintaining strict confidentiality
. Cross-trained on several other human resources functions including benefits administration, Workers'
Compensation. job fair presentation, etc.
. Managed office single-handedly while HR staff attended extended training for HR1S conversion
. Received monthly Service Excellence Award,• nominated for annual Dream Team Award 1997
ADDITIONAL EXPERIENCE
Business Owner, Red Letter R6sum6s (Santa Ana, CA) 2007 - Present
• Provide r6sum6 writing services and general job search assistance to private clientele
. Conduct recruitment, compensation analysis and outplacement services for corporate clientele
. Perform all associated business management tasks
Member, Rancho Santiago Community College District Speakers Bureau 2006 - Present
. Present employment and life skills topics to various community and service organizations
. Coordinate with district and organization personnel to facilitate instruction to specialized groups
. Formulate targeted presentations based on special needs, e.g., "at-risk" youth, parolees, etc.
Independent Contractor/Instructor, City of Santa Ana Community Dev. Agency 2002 - Present
. Instruct employment and life skills to "at-risk" and mainstream youth and adults under various WIA
programs
. Present outplacement workshops at local companies under WIA Rapid Response program
Employment Specialist, Pastoral Congregation (Orange, CA) . 2002 -2006
• Provided volunteer job search assistance to congregation members; attended monthly meetings;
participated in periodic church-sponsored job fairs; presented job search skills workshops
Sunday School/Ladies' Auxiliary Teacher, Pastoral Congregation (Orange, CA) 1997 - Present
• Instruct religious principles to adult congregation members based on established curriculum; elicit
participation and discussion; establish and maintain reverent atmosphere
EDUCATION AND PROFESSIONAL DEVELOPMENT
B. A., English (Education Minor) University of California, Davis 1993
. Dean's Honors List, Spring 1993
R6sum6 Training National R6sum& Writers Association
Yearly Professional Development Courses SAC School of Continuing Education
Personal and professional references furnished upon request
t, PROGRAM SUMMARY COVER SHEET
PROPOSER INFORMATION:
AGENCY NAME: VIRGINIA G. MAYNE
AGENCY ADDRESS: 1601 EAST AVALON AVENUE
SANTA ANA, CA 92705
PROGRAM NAME: EMPLOYABILITY SKILLS
SITE ADDRESS: SANTA ANA W/O/R/K CENTER
1000 EAST SANTA ANA BLVD. STE_ 200
SANTA ANA, CA 92701
PROGRAM CONTACT PERSON: VIRGINIA G. MAYNE
TELEPHONE 714-953-3081 (In) Fax: n/a
714-246-5074 (c) E-mail: maynes8 Munc.com
CONTRACT SIGNATORY: VIRGINIA G. MAYNE
TELEPHONE same FAX same E-mail: same
FEDERAL I.D. 552-29-1945
AGENCY STATUS:
Public Non-Profit Corporation Private Non-Profit Other XX
Private For Profit Government
Years in Operation 10
PROGRAM DESCRIPTION: Briefly summarize the proposed program.
Instruction and consultation services will be provided to the Santa Ana W/O/R/K Center staff
and clients in various subjects including R6sum6 Writing, Interviewing Skills, Job Search
Stress Management, Job Retention, Summer Youth Program Training, WIA Rapid Response
Outplacement Presentation and any other workshops the W/O/R/K Center deems necessary
for the benefit of its clientele. Services will be provided principally at the Santa Ana W/O/R/K
Center facilities and any offske locations as necessary. These services also include any
preparation time, editing and production of materials, and any other related services that take
place off site such as r6sumd review after scheduled hours.
IF APPLICABLE: FEE FOR SERVICE: $501hour OFF-THE-SHELF PRICE:
In compliance with the request for qualifications format, and subject to the conditions
thereof, the undersigned offers to furnish the services requested and certifies he has
read, understands, and agrees to all terms, conditions, and requirements of this request
for qualificatlons and is authorized to contract on behalf of the firm named above
should the need arlse_ V
Signature of/AuthorizedLRep" reesentative:
Title: C~,S u (1 Date: &I I I U
" See Proposed Cost Sheet
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: 2010-002
CERTIFICATE OF INSURANCE
EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS.
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED)
Alliant Insurance Services, Inc. in conjunction with City of Santa Ana
Apex Insurance Services 20 Civic Center Plaza
P. O. Box 6450 Santa Ana, CA 92701
Newport Beach, CA 92658
License No: OC 36861
NAMED INSURED (EVENT HOLDER): EVENT INFORMATION:
Virgina Mayne TYPE: Self Imurovement
1601 E. Avalon Ave. DATE(S): 1/7110 -12/18/10
Santa Ana, CA 92705 LOCATION: Santa Ana WORK Center
*Liquor Liability Yes ED No
**Li uor Liability after 12 am ends be-fore 2 am
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 requirements, terms or conditions 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.
INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER: 1 OSEP 1000001 I
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2010 EXPIRATION: JANUARY 1, 20l 1
COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE
General Aggregate Limit 3 2,000,000
Products & Completed Operations 1,000,000
Personal & Advertising Injury 1,000,000
Each Occurrence Limit 1,000,000
Fire Damage (Any One Fire) 50,000
Medical Payments (Any One Person) 5,000
Liquor Liability (If purchased) 1,000,000
The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event.
"Who is insured" is amended to include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out of the
ownership, maintenance or use of the premises used by the named insured (event holder). This insurance does not apply to: Any -occurrence" which takes place
after the event holder ceases to be a tenant in that premises-
OTHER ADDITIONAL INSUREDS D j;S
E. VTORCK
city Attorney
Assistant
CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the
certificate holder and additional insureds listed.
AUTHORIZED REPRESENTATIVE: c%
DATE ISSUED: January7 2010 by Briza MoraleseQV?~