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HomeMy WebLinkAboutORANGE COUNTY CONSERVATION CORPS 1a - 2010 City of Santa Ana "r Clerk of the Council AGREEMENT TERMINATION FORM COTC Office Use Only Please complete this form when the attached agreement and all amendments (if any) are no longer in effect. Return form to the Clerk of the Council Office (M-30). Call 647-6520 if you have any questions. The agreement with 0 •C,. C C .) v 4 Cori) No. Aot 0— O� /� v, 0 f pleted on _LO*1 and final payment has been made. (List all amendments. Use space below if needed.) Department: CA)04 Phone/Ext.: Signature: Date: Revised 08-23-10 WORK A-2010-019-001 CLERK C- EXTENSION OF AGREEMENT UNDER o ? a 3 v? DATE FEB 0 8 2011 THE WORKFORCE INVESTMENT ACT THIS EXTENSION, made and entered into this 11`x' day of January, 2011, by and between Orange County Conservation Corps ("Contractor") and the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City and Contractor entered into that certain Agreement Under the Workforce Investment Act dated March 1, 2010 (Agreement #A-2010-019), hereinafter referred to as "said Agreement". B. The parties hereto now desire to amend Section III, to extend the term of said Agreement. Relevant exhibits, if any, affected by this change will also be updated. WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter contained and made, and subject to all of the terms and conditions of said Agreement as hereby amended, the parties hereto do hereby agree as follows: 1. Section III, "Time Period of Agreement" is hereby extended through June 30, 2011. The budget will not be effected; the amount of City's Obligation remains as stated in said Agreement. However, due to the extension, allocation of staff time will be modified as represented on Exhibit A, attached hereto and incorporated herein. 2. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Extension of said Agreement the date and year first above written. ATTEST: Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: City Attorney BY:?? Yd%z Lisa E. Storck Assistant City Attorney CITY OF SANTA ANA, a municipal corporation of the State of California "CITY" f By: L ?4-G David N. Ream City Manager "CONTRACT( Orange County BY: Name: Max Title: Exec servation Corps Director ORANGE COUNTY CONSERVATION CORPS 144, Earn... Learn... Serve... Tools to Green the Future! .anuarv 11, 2011 Julie, Castro-Cardenas Workforce Specialist, II Community Development Agency I,dministrative Services 00 E Santa Ana Blvd, Suite 200 Santa Ana; CA 92,701 toll free: (888) 641-CORP (2677) 1853 north . :0 www.hireyouth.org JAN 78 201, FEE: Modification, for Orange County ?Conservation Corps W A, Contract, A-2010-019 Mrs. Castro Cardenas The Orange County Conservation Corps (OCCC) would like to request a modification on WIA contract A-2010-019. Due to scheduling problems, not all ten participants have attended the solar panel installation training; yet, and ti7erefore have not, completed•the three months of; paid work experience. As we discussed the:000C is proposing thefollowing: 1. OCCC would like to extend the WIA contract until June 30, 2011. Extending the contract would allow the participants to complete the 3 months of ()aid work experience at the OCCC after completing the solar panel installation training at Taller San Jose. 2. The OCCC budget will not be affected, but allocation of staff time will be adjusted if the modification is approved. mG44ly, Maggie. Lopel . )) Director 6f Pvbgrar Workforce Investment Board/Youth Council January 11, 2011 Grant Proposal - Budget Modification Orange County Conservation Corps and Taller San Jose LINE ITEM BUDGET for 3/1/10 through 2/28/11 (extend through 6/30/11) Taller San Jose - 12 Months Taller Tech TSJ - Paid by OCCC- Paid by Construction & OCCC - 3 month Total Contract other Revenue other Revenue Total Program solar training Paid Externship Costs Sources Sources Cost Program expenses Taller San Jose Intern training stipends (10 for 17 weeks) 17,000 17,000 17,000 000C Interns (10 for one week) 11000 1,000 1,000 Paid Internship (20 for three months) 1 70,522 70,522 70,522 Solar panel class fees (20) 13,400 13,400 13,400 Classroom tuition and supplies (20) 7,0001 7,000 9,000 7,875 23,875 Supportive Services - general (bus passes, payroll fee) (20) 3,000 3,000 3,000 Supportive Services - Uniform (jackets, pants, boots) (20) 2,720 2,720 2,720 CM Incentives/Bonus (20) 2,225 2,225 2,225 Project Transportation Related (20) 6,000 6,000 2,500 8,500 Staff Training 300 300 600 700 1,300 Occupancy Related 9,0001 5,000 14,000 5,000 3,000 22,000 Subtotal 47,700' 89,767 137,467 14,7001 13,375 165,542 Payroll - Program Manager, Raul Guzman 25% I 18,600. 18,600 18,600 40% Instructor, z 21,600 21,600 - -- - 1,600 Solar Panel Instructor Q TED - 20% - 7,800 i 7,800 7,800, - --- - 15,600 -- Instructor, Kevin Rhoades-40% - 28,800 28,800 Case Manager - TED - 25% 13,500 , 13,500 Intake Coordinator, Abigail Castillo - 33% 9,974 9,974 -- 9,974 Alumni Services Coordinator-40% 5,100 5,100 5,100 10,200 Director of Workforce Development, Juana Perez - 20% 7,800 7,800 7,800 15,600 Executive Director, Shawna Smith - 10% - 13,440 13,440 Director of Finance, Nancy Loughrey - 10% 8,767 8,767 8,767 Executive Director, Max Carter - 7% 7,018 7,018 3,509 10,527 Program Director, Maggie Lopez - 7% 4,184 4,184 2,092 6,277 Finance Director, Tony Huynh - 7% 5,558 5,558 2,779 8,337 Payroll Support, Phiyen Pham - 7% 3,532 3,532 1,766 5,298 Project Manager, George Patina - 7% 3,936 3,936 1,968 5,904 CMs Recruiter/Trainer, Javier Cabrera - 20% 7,322 7,322 3,661 10,982 WIA Program Specialist, TBD - 45% - 1 17,131 17,131 8,566 25,697 Crew Supervisor, Simeon Jasso - 100% 23,195 5 23,195 I 11,597 34,792 Payroll Subtotal 79,641 71,876 151,517 76,440, 35,938 263,896 Total Charged to Contract 127,341 161,643 288,984 91,140 49,313 429,438 ORANGE COUNTY CONSERVATION CORPS - LINE ITEM BUDGET OCCC - Paid 16 Months OCCC by other Total OCCC - Paid Proposed Revenue Program Externshi Contract Sources Cost Program expenses Paid Internship (17 participants for three months) 70,522 70,522 70,522 17 participants @32 hours week for 13 weeks $8.00/hour + 25% taxes & workers compensation 20 x 32 x 13 x $8.00 + $1.97 Supportive Services - (17) 3,000 3,000 3,000 Bus passes, payroll processing fees, equipments, hand tools, supplies. Classroom Tuition and Supplies (17) - - 7,875 Supportive Services - Uniform (17) 2,720 2,720 2,720 All participant will be issued uniforms which include back pack, boots, ear plugs, gloves, hard hat, jacket, rain poncho, safety glasses, 2 pairs of pants, 2 shirts, sweatshirt and belt. 20 participants x $160.00 CM Incentives/Bonus (17) 2,225 2,225 2,225 Various incentives to encourage participants to succeed which include: $60 orientation, $50 perfect attendance for the month, $40 referral, $50 certification, $50 driver license, $100 CAHSEE, $200 diploma, $30 life skills, $20 commendation, $40 probation-parole discharge, $100 program completion. 20 participants x $175 (estimate per participant) Project Transportation Related (17) 6,000 6,000 2,500 8,500 Transportation to/from various jobsites, fuels, servicing of vehicles, insurance, lease. Staff Training 300 300 300 Staff training that will enhance our expertise and effective in this field. Occupancy Related 5,000 5,000 3,000 8,000 Proportionate lease of building, utilities, office equipments, insurance, maintenance and repairs. Subtotal 89,767 89,767 13,375 95,267 Payroll Executive Director, Max Carter - 7% 7,018 7,018 2,072 9,090 Provides leadership, supervision and coordination of the various program components and is responsible for the overall direction, development and success of the project. Program Director, Maggie Lopez - 7% 4,184 4,184 1,179 5,363 Responsible for the overall direction, coordination, and evaluation of the project support service units. Ensure contract deliverables are met and contract compliance. Page 1 of 2 ORANGE COUNTY CONSERVATION CORPS - LINE ITEM BUDGET OCCC - Paid 16 Months OCCC' by other Total OCCC - Paid Proposed Revenue Program Externshi Contract Sources Cost Finance Director, Tony Huynh - 7% 5,558 5,558 1,723 7,281 Responsible for all financial and accounting functions, including preparation and completion financial reports, payroll, grant billings, and contract compliance. Payroll Support, Phiyen Pham - 7% 3,532 3,532 1,095 4,627 Process payroll and all pay related garnishment and levy. Process trade payable and provide support to the Director of Finance. Project Manager, George Patino - 7% 3,936 3,936 1,109 5,045 Responsible for project coordinations, ensuring all projects needs are met including staffing and training. CMs Recruiter/Trainer, Javier Cabrera - 20% 7,322 7,322 2,097 9,419 Responsible for recruiting, interviewing, pre-screening, hiring and facilitating orientation for new participants. Also responsible for participants development throughout their tenure. WIA Program Specialist, TBD - 45% 17,131 17,131 4,906 22,037 Responsible for screening grant applicants, determining eligibility, and enrollment. Also, responsible for all caseload associated with grant including ongoing support and follow-up to ensure all goals and performance measures are met. Crew Supervisor, Simeon Jasso -100% 23,195 23,195 11,407 34,602 Responsible for the daily direct supervision, training, safety and performance of all participants. Payroll Subtotal 71,876 71,876 25,588 97,464 Total Proposed Contract for OCCC 161,643 161,643 38,963 192,731 Page 2 of 2 Ac6ii ® CERTIFICATE OF LIABILITY INSURANCE DATE (M),VDDIYYYY) 1212912010 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 endorsement(s). PRODUCER CONTACT NAME MARSH RISK& INSURANCE SERVICES PHONE SAN FRANCISCO, CA 94014 E - AIC o CALIFORNIA LICENSE NO. 0437153 and ' ' E-MAIL ADDRESS: NonProfils United Workers Comp Group RODUCER P Suite 200 4311 Street Sacramento Ca 95814 10 4: , , 398879-WCASWC-11-12 INSURERS AFFORDING COVERAGE NAIC 0 INSURED INSURER A : NonProtits' United Workers' Compensation Group Orange County Conservation Corps (1560) 1853 N Ra ond A ACE American Insurance Company INSURER 8: 22667 . ym ye. Anaheim, CA 92801 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-001916406-01 REVISION NUMBER: 1 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. INSA LTA TYPE OF INSURANCE ADD jam S BR wa POLICY NUMBER POLICY EFF MWODIYYYY POLICY EXP MWODNYYY LllAliS GENERAL LIABILITY _ EACHOCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence _ $ CLAIMS-MADE r_1 OCCUR MED EXP (AnV one person) $ PERSONAL &ADV INJURY $ Q ??( W GENERALAGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER., 'r? EjJ/ ' ?y r PRODUCTS -COMPIOPAGG $ P RO- POLICY PRO LOC P ? $ AUT OMOBILE LIABILITY CK COMBINED SINGLE LIMIT $ R ST O (Ea accident) _ ANY AUTO L?SA qty Attorn y BODILY INJURY (Per person) $ ALL OWNED AUTOS nt ASSista BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ NON-OWNED AUTOS $ S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE S RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY NPU-WCG 001-2011 01/0112011 01101/2012 WC STAT'U X oTH- 0, LIM,: ANY PROPRIEfOR/PARTNER(EXECUTiVE a N /A E-L. EACH ACCIDENT 500 600,000 $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 500,000 t YSs describe under DESCRIPTION OF OPERATIONS below F L DIS SE - POLICY LIMIT 5w,000 $ B Excess Workers' Compensation WCLC45714496 01/0112011 01/0112012 t 000,x $500,000 WC 000'000 $500,000 EL DESCRIP17oN OF OPERATIONS/ LOCATIONS /VEHICLES (AttachACORD 101, Additional Remarks Schedule, If more space isrequhed) Santa Ana Workforce Investment Board Fran Julzi 1000 East Santa Ana Boulevard Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Lea Warburton ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD AC40 CERTIFICATE OF LIABILITY INSURANCE OP ID PC rTE(MM/DD/111Y) `,..•? ORANG-9 08/23/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chapman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena CA 91117-0455 Phone: 626-405-8031 Fax:626-405-0585 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Great American Insurance Co 16691 INSURER B: Carolina Casualty Ins Co 10510 Orange County Conservation Cor Tai Tony Huynh INSURER C: 1853 N. Raymond Ave. INSURER D: Anaheim CA 92801 INSURER E: COVERAGES 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. LTR INSR TYPE OF INSURANCE POLICY NUMBER DATECMM/DD/YYYY) DATE (MM/DD/YYYOYN LIMITS GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 A X X COMMERCIAL GENERAL LIABILITY PAC5154680 07/20/10 07/20/11 DAVAGE TO RENTED PREMISES (Ea occurence) $100,000 CLAIMS MADE a OCCUR MED EXP (Any one person) _ $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG s3,000,000 POLICY PRO LOG JECT Em Benef 1400,000 AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT E $ ANY AUTO VTO a accident) ( q? I ALL OWNED AUTOS +. ? N BODILY INJURY SCHEDULED AUTOS /? ?+?19' / / 1 (Per person) $ ? HIRED AUTOS RY D NON-OWNED AUTOS mto 'ne (Pe ccident) $ C k t PROPERTY DAMAGE g $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION UIH- AND EMPLOYERS' LIABILITY Y I N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVq OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ (Mandatory in NH) If describe under es E.L. DISEASE - EA EMPLOYEE $ y , SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER A Property coverage PAC5154680 07/20/10 07/20/11 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Santa Ana, its officers, agents, employees and volunteers are named additional insured with respect to the operations of the named insured per the attached CG 2026 endorsement. 10 days notice of cancellation for non-payment of premium. XX CERTIFICATE HOLDER CANCELLATION COMMDEI Community Development Agency M-25 City of Santa Ana P.O. Box 1988 Santa Ana, CA 92702-1988 ACORD 25 (2009/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL-MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ATIVE ©1988-2009 ACORD CORPORATION. All richts reserved The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to 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 endorsement(s). DISCLAIMER 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. ,&PPROVED AS TO FORM `V LISA E. STORCK 4 Assistant City Attorney NOTEPAD: ORANG-9 PAGE 3 INSURED'S NAME Orange County Conservation Cor OP ID PC DATE 08/23/10 Co. B. Directors & Officers Liability/EPL Policy #3862508 12/28/09 to 12/28/10 $2,000,000 limit of liability (claims made form) TrQ FO'RM 777 CK z;; Attorney Assistant City Y, Administrative Offices 0694804 GREAT AMERICAN ALLIANCE INS CO 580 Walnut Street CG 20 26 (E d . 07 / 04 ) GRF.ATA1v1F,[uCAN Cincinnati, OH 45202 INSURANCE GROUP 513.369.5000 ph Policy: PAC 5 1 5- 4 6` 8 0 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED--DESIGNATED OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ame of Person or Organization: ITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ITY OF SANTA ANA OMVIUNITY DEVELOPMENT AGENCY .0. SOX 1988 ANTA ANA, CA 92702-1988 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. SECTION 11 - WHO IS AN INSURED is amended to include as an Additional Insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations; or B. in connection with your premises owned by or rented to you. APPROVED AS TO FORM LISA E. STORCK Assistant City Attorney x/Y Copyright, Insurance Services Office, Inc., 1984 CG 20 26 07104 (Page 1 of 1) F.8972C (9101) iARILITY INSURANCE 185 n ?Aj92801 7WITHST Ana eim - - t'yES E BEEN ISSUED TOTHE INS U ED NAMED ABOVE AESPECT FO" H CUCY PERIOD ItiDICATEO. NO,,,S ED R i rHj, MENTWITH TOWN1RCHS EXCLU covERA SIONSANDCONDITONSOFSUCH -- THE POLICIES OF INSURANCE LISTED BEL011 HAV - LIMITS ANY REOUTAEMENT,TTRMORCONOTIIONOBY EBCR DUCEDCWhIS.-- ALC Y?FECi -LI N4 DA o?lfOH S Y PERUIRE THE 1NSURAHCE AfFORDED BY THE PCLICI£$ O BYTSCRIBEOPAIO HEREIN iS SUBdECT1 A MITHE OCCURRENCE EACH f6REqTEU MA GE 5 POUCIES. AGGREAI SHOWN MAX POLICY 17UM8ER 11A - QAEMtSES (Ea e?utence)__ RPS TYPE OF INSURANCE - pn one Payson) $ hlED EXP l Y?_.-- S GENERALLIABILRY ENERAL _ PERSONALBADVINJURY _ S G COMMERCIAL -OCCUR -109 DE C1 -? AGGREGATE GENN AL GG S -. C1A1MSMp - PRODUCTS - GOMPJOP A • APPLIES ` Y - ?- ~-' EN9 AGGREGATE GOMBlNTO SING, ELIMR S 1 [ 000 [ 000 _ ?_?? - IEastcident) CC pRO G POLICY JECT 01/01/10 07 /01 / 11 ? ?- AU70110BILELIABILITY 1560 - per pelsort) A }( ANY AUTO ALLO\V17EDAUTOS - {percddent)Y $ ?- SCHEDULED AUTOS PROPERTY `--- DAMAGE $ HIRED AUTOS O-n V, (Pe[acadenl) NON.OWNEOAUTO9 ? ?r- TO ONLY. EAACCIDEN7_ $ AU ?v-- ---- EAACC S -- OTHERTHAN AUTO ONLY: AGG S GARAGE LIABILRY O 2y EACH OCCURRENCE -- ANY AUT ? ?' r I0I = AGGREGATE - $ EXCESSIUMBRELIALIABILITY 0 OLAIMS MADE r 5 f $ OCCUR = J ER TORYLIhUTS _- DEDUCTIBLE $ _ -- EL. EACH ACCIDENT RETEN7lOH S W ORKERS COMPENSA71OT7 YIN y S' E.L. DISEASE E7APLOYEE $ DISEASE . POLICY LkMIT S 8P-E: ECUTi _l AND EMPLOYER T L. below notice of cancellation for non-payment of TlON Of OP£RAT70NS 1 LOCATXIHS 1?0 ENICL£S I days EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PRO 1 of coverage Evid vidence premium. 34 DAYS RE THE £XPIRATIO CANCEL t A7i0t1 WRITTEN SHOULD AHy OF THE ABOVE DESCRIBED POLICIES BE O MAIL CANCELLED BEFO SHALL CERTIFICATE HOLDER DATE THEREOF, THE ISSUVNO INSURER WILL ENDEAVOR T NOTICE TO THE CERTIFiCA7 LIHABniTR tjF AMED ANY TO KIND THE LEFT, UPON THE BUT ENSURER,FAILUREITS TO DO SO AGENTS OR IMPOSE HO 06416A710N OR REPRESENTATN£S- of f ice AU RQED R PRESENTATIVE Santa Ana YiIA Admin . 100 Basna SanA 92na Blvd $200 01988.2009 ACORD CORPORA -ION. All rights reserve . Santa A are registered marks o1 ACORD ACORD 26 (2009(01) The ACORD name and togo IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsene policies may -' If SUBROGATION IS WAIVED, subject to thecert terms n dconditions fer righpocy, ts to the c aerticate require an endorsement. A statement on this not con holder in lieu of such endorsement(s). DISCLAIMER Certificate of Insurance does not constitute a contract nor does it affirmatively or negatively amended This representative or producer, anafforded by the policies fisted thereon. extend or alter the coverage ACOORD 25 (2009101) dehicte Schedule for Orange County Conservation Corps 1560 00312010 V# Year Matte Model Vlid Back Liability Vehicle Vehicle Phys Dam Rental up Limit Type Use Coverage Limit 5 2000 Ford F650 3FDNW6522YMA3430 X • $1 Million Truck Maintenance Full Coverage $50 3 6 2008 Chevy Truck 4KBB4B1U68J01696 $1 Million Truck Cargo Full coverage $50 8 2008 GMC Canyon 11GTCS1398$8171132 $1 Million Pickup Maintenance Full Coverage $50 10 2001 Ford Faso 3F0WW35871h1A1344 $1 mullon Truck Maintenance Full Coverage $50 5 117 2003 GRbC Van 1GJHG39U231104311 $1 Ml11on Maxlvan Maintenance Full coverage $50 18 2003 GMC Van 1GJHG3911331103894 $1 Willon MWvan Maintenance Full Coverage $50 19 2009 CIAO Grew 1GTHC23U83F129058 $t Million Pickup Maintenance Full Coverage $50 20 2003 oMC Van J6004J14837006207 $1 Mllllon MaxNan Maintenance Full Coverage $50 22 2004 GMC 2600 1GDHK29U34E189617 $1 Million Truck Maintenance Full Coverage $50 23 2004 GMC Van 1GJHG39U241166731 $1 "Ilion Maxhran Maintenarx;e Full coverage $50 24 2003 GMG BoxTrk JBD"14X37009033 $1 Millon Trucc Maintenance Full Coverage $50 28 2005 Chevy Colorado 1GCOT138758292839 $1 Million Plokup Maintenance Full Coverage $50 27 2006 GMG Canyon 1GTDT136X68224062 $1 Million Pickup Maintenance Full Coverage $50 28 2007 GMG Truck JBD04J16277003833 $1 fAlllon Truck Maintenance FuH Coverage $50 29 2009 Ford F150 1FTRX1=9K842628 $1 Million Pickup Cargo Full Coverage $50 3n 2009 Chevy Express 1GAHG39K691141368 $1 Million Maxim Maintenance Full Coverage $50 /s?e? PRODUCER Chapman License #0522024 P. O. Box 5455 Pasadena CA 91117-0455 Santa Ana W IA Admin. Office 100 East Santa Ana Blvd #200 Santa Ana, CA 92701 ACORD 25 (2009/01) g to 01010 p ?o ney ??SP Oki