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HomeMy WebLinkAboutPUBLIC AGENCY RETIREMENT SERVICES (PARS) - 2011V 09,:; -Qq - 20t -Z INSURANCE ON FILE A- 2011 -114 WORK MAY PROCEED UNTIL INSURANCE EXPIRES QS — 09 - 2-0 t Z CLERK OF COUNCIL DATE: JUL 2 6 2011 AGREEMENT FOR ADMINISTRATIVE SERVICES CJ This agreement ( "Agreement ") is made this .3 day of 2011, between Phase II Systems, a corporation organized and existing under the laws of the State of yj California, doing business as Public Agency Retirement Services (hereinafter "PARS ") and the City of Santa Ana ( "Agency "). WHEREAS, Agency is desirous of retaining PARS, as Trust Administrator to the PARS Trust, to provide administrative and consulting services with respect to the qualified City of Santa Ana PARS Supplementary Retirement Plan (the "Plan "). NOW THEREFORE, the parties agree: 1. Services. PARS will provide the services pertaining to the Plan as described in the exhibit attached hereto as "Exhibit IA" ( "Services ") in a timely manner, subject to the 4 further provisions of this Agreement. 2. Fees for Services. PARS will be compensated for performance of the Services as U described in the exhibit attached hereto as "Exhibit 1B ". 3. Payment Terms. Payment for the Services will be remitted directly from Plan assets unless otherwise stated in Exhibit 1B. In the event that the Agency chooses to make payment directly to PARS, it shall be the responsibility of the Agency to remit payment directly to PARS based upon an invoice prepared by PARS and delivered to the Agency. If payment is not received by PARS within thirty (30) days of the invoice delivery date, the balance due shall bear interest at the rate of 1.5% per month. If payment is not received from the Agency within sixty (60) days of the invoice delivery date, payment plus accrued interest will be remitted directly from Plan assets, unless PARS has previously received written communication disputing the subject invoice that is signed by a duly authorized representative of the Agency. 4. Fees for Services Beyond Scope. Fees for services beyond those specified in this Agreement will be billed to the Agency at the rates indicated in the PARS standard fee schedule in effect at the time the services are provided and shall be payable as described in Section 3 of this Agreement. Before any such services are performed, PARS will provide the Agency with written notice of the subject services, terms, and an estimate of the fees therefore. 5. Information Furnished to PARS. PARS will provide the Services contingent upon the Agency's providing PARS the information specified in the exhibit attached hereto as "Exhibit 1 C "( °Data "). h shall be the responsibility of the Agency to certify the accuracy, content and completeness of the Data so that PARS may rely on such information without further audit. It shall further be the responsibility of the Agency to deliver the Data to PARS in such a manner that allows for a reasonable amount of time for the Services to be performed. Unless specified in Exhibit IA, PARS shall be under no duty to question Data received from the Agency, to compute contributions made to the Plan, to determine or inquire whether contributions are adequate to meet and discharge liabilities under the Plan, or to determine or inquire whether contributions made to the Plan are in compliance Page 1 with the Plan or applicable law. In addition, PARS shall not be liable for non- performance of Services if such non - performance is caused by or results from erroneous and/or late delivery of Data from the Agency. In the event that the Agency fails to provide Data in a complete, accurate and timely manner and pursuant to the specifications in Exhibit 1C, PARS reserves the right, notwithstanding the further provisions of this Agreement, to terminate this Agreement upon no less than ninety (90) days written notice to the Agency. 6. Suspension of Contributions. In the event contributions are suspended, either temporarily or permanently, prior to the complete discharge of PARS' obligations under this Agreement, PARS reserves the right to bill the Agency for Services under this Agreement at the rates indicated in PARS' standard fee schedule in effect at the time the services are provided, subject to the terms established in Section 3 of this Agreement. Before any such services are performed, PARS will provide the Agency with written notice of the subject services, terms, and an estimate of the fees therefore. 7. Records. During the term of this Agreement, and for a period of five (5) years after termination of this Agreement, PARS shall provide duly authorized representatives of the Agency access to all records and material relating to calculation of PARS' fees under this Agreement. Such access shall include the right to inspect, audit and reproduce such records and material and to verify reports fumished in compliance with the provisions of this Agreement. All information so obtained shall be accorded confidential treatment as provided under applicable law. 8. Confidentiality. Without the Agency's consent, PARS shall not disclose any information relating to the Plan except to duly authorized officials of the Agency and to parties retained by PARS to perform specific services within this Agreement. The Agency shall not disclose any information relating to the Plan to individuals not employed by the Agency without the prior written consent of PARS, except as such disclosures may be required by applicable law. 9. Independent Contractor. PARS is and at all times hereunder shall be an independent contractor. As such, neither the Agency nor any of its officers, employees or agents shall have the power to control the conduct of PARS, its officers, employees or agents, except as specifically set forth and provided for herein. PARS shall pay all wages, salaries and other amounts due its employees in connection with this Agreement and shall be responsible for all reports and obligations respecting them, such as social security, income tax withholding, unemployment compensation, workers' compensation and similar matters. 10. Indemnification. PARS and Agency hereby indemnify each other and hold the other harmless, including their respective officers, directors, employees, agents and attorneys, from any claim, loss, demand, liability, or expense, including reasonable attorneys' fees and costs, incurred by the other as a consequence of PARS' or Agency's, as the case may be, acts, errors, or omissions with respect to the performance of their respective duties hereunder. Page 2 11. Compliance with Applicable Law. The Agency shall observe and comply with federal, state and local laws in effect when this Agreement is executed, or which may come into effect during the term of this Agreement, regarding the administration of the Plan. PARS shall observe and comply with federal, state and local laws in effect when this Agreement is executed, or which may come into effect during the term of this Agreement, regarding Plan administrative services provided under this Agreement. 12. Applicable Law. This Agreement shall be governed by and construed in accordance with the laws of the State of California. In the event any party institutes legal proceedings to enforce or interpret this Agreement, venue and jurisdiction shall be in any state court of competent jurisdiction. 13. Force Majeure. When satisfactory evidence of a cause beyond a party's control is presented to the other party, and nonperformance was unforeseeable, beyond the control and not due to the fault of the party not performing, a party shall be excused from performing its obligations under this Agreement during the time and to the extent that it is prevented from performing by such cause, including but not limited to: any incidence of fire, flood, acts of God, acts of terrorism or war, commandeering of material, products, plants or facilities by the federal, state or local government, or a material act or omission by the other party. 14. Ownership of Reports and Documents. The originals of all letters, documents, reports, and data produced for the purposes of this Agreement shall be delivered to, and become the property of the Agency. Copies may be made for PARS but shall not be furnished to others without written authorization from Agency. 15. Designees. The Plan Administrator of the Agency, or their designee, shall have the authority to act for and exercise any of the rights of the Agency as set forth in this Agreement, subsequent to and in accordance with the written authority granted by the Governing Body of the Agency, a copy of which writing shall be delivered to PARS. Any officer of PARS, or his or her designees, shall have the authority to act for and exercise any of the rights of PARS as set forth in this Agreement. 16. Notices. All notices hereunder and communications regarding the interpretation of the terms of this Agreement, or changes thereto, shall be effected by delivery of the notices in person or by depositing the notices in the U.S. mail, registered or certified mail, return receipt requested, postage prepaid and addressed as follows: (A) To PARS: PARS; 4350 Von Karman Avenue, Suite 100, Newport Beach, CA 92660; Attention: President (B) To Agency: City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701; Attention: Executive Director of Personnel Services Notices shall be deemed given on the date received by the addressee. 17. Term of Agreement. This Agreement shall remain in effect for the period beginning April 18, 2011 and ending April 17, 2016 ( "Term "). This Agreement will continue unchanged for successive twelve -month periods following the Term unless either party Page 3 gives written notice to the other party of the intent to terminate prior to ninety (90) days before the end of the Term. 18. Amendment. This Agreement may not be amended orally, but only by a written instrument executed by the parties hereto. 19. Entire Agreement. This Agreement, including exhibits, contains the entire understanding of the parties with respect to the subject matter set forth in this Agreement. In the event a conflict arises between the parties with respect to any term, condition or provision of this Agreement, the remaining terms, conditions and provisions shall remain in full force and legal effect. No waiver of any term or condition of this Agreement by any party shall be construed by the other as a continuing waiver of such term or condition. 20. Attorney's Fees. In the event any action is taken by a party hereto to enforce the terms of this Agreement, the prevailing party therein shall be entitled to receive its reasonable attorney's fees. 21. Counterparts. This Agreement may be executed in any number of counterparts, and in that event, each counterpart shall be deemed a complete original and be enforceable without reference to any other counterpart. 22. Headings. Headings in this Agreement are for convenience only and shall not be used to interpret or construe its provisions. 23. Effective Date. This Agreement shall be effective on the date first above written, and also shall be the date the Agreement is executed. AGENCY: BY: TITLE: Executive Director of Personnel Services DATE: PARS: BY:Ci%tE �L TITLE: C� DATE: _ Z41 Z_C a Jeseph Straka Assistant City Attorney Page 4 ATTEST. MARIA D. HUIZAR CLERK OF THE COUNCIL Paul M. Walters Interim City Manager EXHIBIT IA SERVICES PARS will provide the following services for the City of Santa Ana: 1. Plan Consultation Services: (A) Meeting with Agency personnel to discuss the impact to the Agency of implementing a Plan; (B) If appropriate, completing a fiscal analysis, based on data and assumptions provided by Agency, to determine the fiscal feasibility of a Plan; (C) Meeting with Agency personnel to discuss the fiscal analysis and receive feedback on the analysis, data, and assumptions made; (D) Making appropriate revisions to the fiscal analysis as directed by Agency. 2. Plan Installation Services: (A) Meeting with appropriate Agency personnel to discuss plan provisions, implementation timelines, benefit communication strategies, data reporting and contribution submission requirements; (B) Providing the necessary analysis and advisory services to finalize these elements of the Plan; (C) Providing the documentation needed to establish the Plan for review by Agency legal counsel. 3. Plan Administration Services: (A) Monitoring the receipt of Plan contributions made by the Agency to the trustee of the PARS Trust Program ( "Trustee "), based upon information received from the Agency and the Trustee; (B) Performing periodic accounting of Plan assets, including the allocation of employer contributions, distributions, investment activity and expenses (if applicable), based upon information received from the Agency and /or Trustee; (C) Acting as ongoing liaison between the Participant and the Agency in regard to distribution payments, which shall include use by the Participants of toll -free telephone communication to PARS; (D) Producing benefit illustrations and processing enrollments; (E) Coordinating the processing of Participant distribution payments pursuant to authorized written Agency certification of distribution eligibility, authorized direction by the Agency, and the provisions of the Plan, and, to the extent possible, based upon Agency - provided Data; (F) Directing Trustee to liquidate Plan assets (if necessary) and make Participant distribution payments, and producing required tax filings regarding said distribution payments; Page 5 (G) Notifying the Trustee of the amount of Plan assets available for further investment and management, or, the amount of Plan assets necessary to be liquidated in order to fund Participant distribution payments; (H) Coordinating actions with the Trustee as directed by the Plan Administrator within the scope this Agreement; (I) Preparing and submitting a report of Plan activity to the Agency, unless directed by the Agency otherwise; (J) Coordinating and selecting of a licensed actuary to perform actuarial valuation, if required, on a periodic basis to comply with state and federal laws (the actuarial certification fee for which shall be paid by the Agency); (K) Preparing and submitting the Annual Report of Financial Transactions to the California State Controller, as required by law, for the PARS Trust Program, including the required certified audit of the PARS Trust. 4. Plan Compliance Services: Coordinating and preparing changes to the Trust, Plan and other associated legal documents required by federal and state agencies to maintain the Plan in compliance, for review by Agency legal counsel. 5. PARS is not licensed to provide and does not offer tax, accounting, legal, investment or actuarial advice. In providing the services specified above, PARS will retain qualified professional service providers at its cost as it deems necessary if the service lies outside its area of expertise. 6. Any analysis provided by PARS is subject to the receipt of accurate information and assumptions as may be provided by Agency. The Agency is responsible for integrating the PARS analysis into any Agency budgetary analysis or decision - making processes. The fiscal projections in the PARS analysis are dependent upon future experience conforming to the assumptions used and the results will be altered to the extent that future experience deviates from these assumptions. It is certain that actual experience will not conform exactly to the assumptions used in the analysis. Page 6 EXHIBIT 1B FEES FOR SERVICES PARS will be compensated for performance of Services, as described in Exhibit IA based upon the following schedule: Upon implementation of the Plan associated with this Agreement, the Agency agrees to pay: (A) An ongoing administration fee equal to five and one -half percent (5.50 %) of all contributions made by the Agency on behalf of participants in the subject Plan. Fees will be billed to the Trustee as contributions are made by the Agency, and it will be the responsibility of the Trustee to pay those fees from the assets of the Plan. These fees are exclusive of Trustee and investment management fees, which are based on the standard fees charged by the Trustee. (B) A fee equal to actuarial expenses, if any, charged to PARS by an outside contractor for an actuarial valuation of the Agency's Plan ( "Actuarial Valuation Fee "). (C) A fee equal to the stated IRS application fees and legal fees related to any ongoing federal and /or state required Plan compliance changes. Such fees will not be charged to the Agency without prior authorization by the Plan Administrator. Page 7 EXHIBIT 1C DATA REQUIREMENTS PARS will provide the Services under this Agreement contingent upon receiving the following information: 1. Participant Data (provided by Agency): (A) Participant's Legal Name (B) Participant's Position (C) Participant's Address (D) Participant's Birth Date (E) Participant's Hire Date (F) Participant's Contract Salary (G) Years of Agency Service (H) Retirement Date 2. Executed Legal Documents (provided by Agency): (A) Certified Resolution (B) Adoption Agreement (C) Plan Document (D) Trustee Investment Forms 3. Completed Funding Documents (provided by Agency): (A) Authorization to Pay Benefits Form (B) Funding of PARS Supplementary Retirement Plan Form 4. Completed Enrollment Forms (timely submitted by Participant): (A) Correction Form (B) Enrollment Form (C) Beneficiary Designation Form (D) Tax Withholding Request Form (E) Letter of Resignation 5. Other information pertinent to the Services as reasonably requested by PARS. Page 8 ♦ T /ITTTAIT • EXHIBIT "A" ADOPTION AGREEMENT TO THE PARS TRUST AGREEMENT Member Agency: City of Santa Ana Plan Name: City of Santa Ana PARS Supplementary Retirement Plan Plan Effective: April 18, 2011 Plan Administrator: Kathie Gonzalez Title: Executive Director of Personnel Services Address: 20 Civic Center Plaza, Santa Ana, CA 92701 The above referenced California public agency ( "Member Agency ") adopts the PARS Trust Agreement, as amended and restated effective 7/1/99, as the trust portion ( "Agency Trust ") of the above referenced qualified plan ( "Plan"), effective as of the date set out above. Pursuant to resolution number 2011 -024, dated April 18'h, 2011, which authorizes the adoption of the PARS Trust Agreement and names the above referenced individual by position of employment to act on behalf of the Member Agency in all matters relating to the Member Agency's participation in the PARS Trust Program and Agency Trust ( "Plan Administrator "), the Plan Administrator certifies the following entities within the Agency Trust: TRUSTEE: Union Bank, N.A. TRUST ADMINISTRATOR: Phase II Systems dba Public Agency Retirement Services INVESTMENT FIDUCIARY: Union Bank, N.A., acting through its subsidiary HighMark '' II Capital Management, a registered investment advisor. By: _l� �u Title: Executive Director, Personnel Services Date: Gill,, ACCEPTED: Trust Administrator: P ase II Systems dba Public Agency Retirement Services By: Title: 31 S a it Date: 1 Truste aq nd Iquestment Fiduciary: Union Bank, N.A. /� By: Title: L"I Date: Trustee and Inve ent Fi ciary: Union Bank, N.A. By: k& Title: Date: H�K V CERTIFICATE OF LIABILITY INSURANCE �'n7 ^111YYT) OP ID: Q8 CERTIFICATE OF LIABILITY DATE 1 07120 07120/111 1 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 BF,, EN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. "` 1 ,', �( �. C: IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGA 10 k 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 714 - 997 -8100 (OC)Heffernan Prof. Practices 714- 460 -9935 '11856 W. Katella Ave, #266 NAME: PHONE ac No _ ADDRESS: Orange, CA 82687 ER .PHASE -3 INSURERS AFFORDING COVERAGE HAIG0 EACH OCCURRENCE INSURED Phase II Systems INSURERA:Hartford Casualty Insurance Co 29424 dba: PARS INSURER a:LLO d's of London PERSONAL S AOV INJURY 4350 Von Karmen Ave., Ste 100 Newport Beach„ CA 92660 INSURER C: INSURER D - INSURER E: PRODUCTS - COMP /OP AGG S 4,000,00 INSURER F : $ - -- A COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER: 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF SANTA ANA POLICY NUMBER CY EFF MD POLICY EXP MMIODIYYYY UMITS A GENERAL LIABILITY X COMMERCIALGENERALLIABILITY CLAIMS -MADE OCCUR SANTA ANA, CA 82701 72SBAAC2429 O F pVED 05108/11 05/09/12 EACH OCCURRENCE $ 2,000,00 PREMISES (Ee ocwrnmcet $ 1,0_00,00 MED EXP(Any one person) $ 10,00 PERSONAL S AOV INJURY $ 2,OOD,00 GENERAL AGGREGATE S 4,000,00 GEN L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS - COMP /OP AGG S 4,000,00 $ - -- A AUTOMOBILE LUUHLIW ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS (72SBAAC2429 Pt' Stra a Jose At" A$$IStSRt City ey 06108/11 06108/12 COMBINED SINGLE LIMIT S 2,000,00 BODILY BODILY INJURY(Per Parton) -- $ BODILY INJURY (Per accident) 3 PROPERTY DAMAGE lPeracddanl) $ X X $ S UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE N/A EACH OCCURRENCE S AGGREGATE S DEDUCTIBLE . RETENTION S $ $ WORKERS COMPENSATION ANDEMPLOYERS'UABILITY YIN ANY PROPRIETOFUPARTNERIEXECUTNE OFFICER/MEMBER EXCLUDECT (Mandatary In NH) 11 es, descrto,mc it DESCRIPTION OF OPERATIONS tmI NIA NIA 0 STATU. OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE S E.L. DISEASE - POLICY LIMB S 6 PROFESSIONAL LIABILITY I I �WROD0013L 071301T"011 PER CLAIM 2,000,00 AGGREGATE 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS l VEHICLES Attach ACORD 101, Additional Remarks Schedule, If mon, pace Is required) PROJECTS AS ON FILE WITH THE INSURE INCLUDING BUT NOT LIMITED TO THOSE USUAL TO THE INSURED'S OPERATIONS /PARS SUPPLEMENTARY RETIREMENT PLAN. THE CITY OF SANTA ANA ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS ON GENERALLIABILITY POLICY -SEE ATTACHED ENDORSEMENT. CERTIFICATE HOLDER CANCELLATION ®1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: EXECUTIVE DIRECTOR OF AUTHORIZED REPRESENTATIVE PERSONNEL SERVICES 20 CIVIC CENTER PLAZA SANTA ANA, CA 82701 ®1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Policy No. 72SBAAC2429 Phase II Systems, dba: PARS_ THIS HNDORSEMENT CHANGES UH pgUCY, PLEAS19 READ )TCAREFULL ADDITIONAL INSURM - DESIGNATED PERSON OR ORGANIZATION 7111 ondonemunt inudmoo Insuronoo proyidod under Iho folloWlnp; MINNS LIABILITY OOVURAGO FORM 0, W10 Is on Insurad In Iho 11M1NIM LIABILITY OOVBRAN FORM Is gorended to Inofu d9 o on Insurod lllo person or orouni4ollon ehwm In 010 VocleroBone out only 941111 raspact to IleUlllly odrino out oflhs operations 01 (ho named hreurod, ..— Person or Organization: 1`00 941194 Covered under the BftNN80 LIABILITY 00MA04 of Utls poUoy Ihis Ineuranee Is prlmery to Aar valid and colloolllito ln4uranw pdeh is avallnhlo to Iho person or ardretlon ollown In Ulu oaclerallone assn Addlilone insured, The City of Santa Ana, its officials, employees and volunteers Fom108 04 40 00 00 pdntoftV.O,A (N0) Copydohh Horlford Piro Insurnnco Oompeny, 1005 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER- TH15 ACC)Rtf CERTIFICATE OF LIABILITY INSURANCE 11a � � DATE 7/20//2011 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 endorsement(s). PRODUCER CONTACT Mary' Ann Stexart Warner Pacific Insurance PxoNE „ (818)225 -0101 FAX (91a)575 -2340 32110 Agoura Rd ADORE INSURERS AFFORDING COVERAGE NAICN EACH OCCURRENCE INSURER A2BDI to era Cautpeneation Ins. Co 11512 Westlake Village CA 91361 INSURED INSURER B PERSONAL B ADV INJURY INSURER C: PHASE II SYSTEMS, INC, DRA: PARS 4350 VON AARMAN AVE INSURER D: GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- LOC INSURER E: $ SUITE 100 1 INSURER P: NEWPORT BEACH CA 92660 COVERAGES CERTIFICATE NUMBER:CLI172000940 REVISION NUMIRER• 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. LTR TYE OF NSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN U R NUMBER POLICY EFF POLICY UP DON LIMITS 20 Civic Center Plaza GENERALLIAMLITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-I OCCUR .1 `Tye^ $.Q Or LY �O EACH OCCURRENCE S PREMISES IIEao=rrfnu) $ MFA EXP (Any One n) $ PERSONAL B ADV INJURY g GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- LOC PRODUCTS - COMPIOP AGO $ $ OMOBILE LABIMTr ANY AUTO ALL G.WNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOS S tl,p ,QSep(' `-'�� (� KD(jtey COMBINED SINGLE LIMIT Ee aG enl BODILY DLURY(PK paraen) $ P BODILYNJURY(Praccidern) $ Per $ UMBRELLA UAB EYCESSLIAB OCCUR CLAMS4IADF EACHOCCURRENCE $ AGGREGATE f. DED RETENTION $ A WORKERS COMPENSATION ANDEYPLOYER5lUMLITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERRAEMBER EXCLUDED] ❑ (MaradMOry in NMI If DESCRIPTION OOPERATIONS bebw MIA 0021106D9 /112011 /1/2012 WC TATU- OTH- X Y TS E EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOY $ 1 000 000 E.L. DISEASE - POLICY LIMIT $ 1.000.000 DESCRP ONOFOPERATIONS ILOCATION$IVEHICLES (ANaoh ACORD 101, Additional Remadra SehedWe, if mom opacr Ie mwlM ) CERTIFICATE HOLDER CANCELLATION AOIOKID 25 (2070ms) INS026 (2af om) of ®- 1886.2010 ACORD CORPORATION. AN rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE MATH THE POLICY PROVISIONS. Attn:Rxeoutive Director of Personnel Eve AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza Santa Ana, CA 92701 AOIOKID 25 (2070ms) INS026 (2af om) of ®- 1886.2010 ACORD CORPORATION. AN rights reserved. The ACORD name and logo are registered marks of ACORD A+�QRL7" PHASIIS -01 HBCT06 CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DD'YYYY) 6/5/2012 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. INIPUft IAN 1: It 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 License # 0564249 (OC) Heffernan Insurance Brokers 88 Hutton Centre Drive, Suite 500 Santa Ana, CA 92707 714 1 ac, No Ext ; ( ) 361-7700 (A/c, No); 1 (714) 361 -7701 INSURER(S) AFFORDING C( 1. INSURER A: Sentinel Insurance Corn INSURED INSURER B: Phase II Systems dba PARS JNSURIER C 4350 Von Karman Ave, Ste. 100 INSURER D Newport Beach, CA 92660 INSURER E of London Limited INSURER F: COVERAGES CERTIFICATE NUMBER: 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. _ - — - - -�ADDL -SUBRr - - -T— - -- ILT R TYPE OF INSURANCE 1 POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER -- - - -- - - -- IMM /DD/YYYY MMIDD/YYYYI LIMITS ' GENERAL LIABILITY - - -- -- -- -- - -� A X COMMERCIAL GENERAL LIABILITY X 72SBAAC2429 5/8/2012 5/8/2013 �_ CLAIMS -MADE [ X OCCUR '. GEN'L AGGREGATE LIMIT APPLIES PER: EACH OCCURRENCE _ $ 2,000,000 _ DAMAGE TO RENTED 1,000 OOO PREMISES Ea occurrence) I $ _ _ --� MED EXP (Any one person) $ 10,0001 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000. PRODUCTS - COMP /OP AGG $ 4,000,0001 _POLICY Fj PRO- LOC 1 AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT -� (Ea accident) $ 2,000,00 A ANY AUTO 72SBAAC2429 5/8/2012 5/8/2013 BODILY INJURY (Per person) $ ., ALL OWNED SCHEDULED f 1 AUTOS AUTOS NON -OWNED 1� AUTOS X BODILY INJURY (Peraccident) PE DAMAGE-—- TY - j $ -= ,HIRED AUTOS '—y UMBRELLA LIAB - - -� ' Per aca ent I'L - ^�. _ 1$ I.. - ~. OCCUR S 1 EACH OCCURRENCE $ EXCESS LIAB �_ CLAIMS -MADE DED RETENTION $ j}' l�{Iy, AGGREGATE $ I'- �} - -T . WORKERS COMPENSATION T AND EMPLOYERS' LIABILITY V U$ehh Oti' ANY PROPRIETORIPARTNER/EXECUTIVE Y / N C U j'a jfa WC STATU- 0TH- TORY_LIMITS� $ F_ - OFFICER/MEMBEREXCLUDED? N /A' /� A`4slS r�,af Ci E.L. EACH ACCIDENT $ 11 (Mandatory in NH) If Dyes, describe under DESCRIPTION OF OPERATIONS below l., AttO E.L. DISEASE - EA EMPLOYEE $ m%71-30/2012 —_ _ E.L. DISEASE - POLICY LIMIT $ B PROFESSIONAL �I WR000013M 7/30/2011 /PER _ CLAIM 2,000,000 B LIABILITY WR000013M 7/30/2011 7/30/2012 AGGREGATE 2,000,000 DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) !PROJECTS AS ON FILE WITH THE INSURED INCLUDING BUT NOT LIMITED TO THOSE USUAL TO THE INSURED'S OPERATIONS /PARS SUPPLEMENTARY RETIREMENT PLAN. THE CITY OF SANTA ANA, ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS ON GENERAL LIABILITY POLICY -SEE ATTACHED ENDORSEMENT. CERTIFICATE HOLDER CANCELLATION T SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA ATTN: EXECUTIVE DIRECTOR OF THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PERSONNEL SERVICES ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA r _ SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE 1 , ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Policy No. 72SBAAC2429 Phase iI Systems, dba: PARS, THI$ PNDORSP.MENT GHANbV8 THM 0OL10Y, PLHA8V READ 1r CAREWULLY, ADDITIONAL INSURIMtd - DESIGNATED PERSON OR ORGANIZATION 711ta ondoreenlonl rliodl 00In -MOn0a plovldodtatdorilio (ollov(Inp: t3 IN888 LIAUILITY OOVURAdTI Nnli(il a, W10 Is on 111surod In tho buslN00 IdMt11lITY 00VGRAOtr FORM to IpOilded to Inaudo na on WOW 1110 poison or 1irounizatlon 9110! /d In tho Uoola(otlono Out 0111y %111) rospool to fla011lly Q11#1110 out of 1110 operatloor of tho nar»oo I1104(40, ,.N Person or Organization: l'orloovv3 covarsd vader (ho MIN460 LIABILITY 100etliQf Wild (vild a0IfW1bl0 l ln8Urfancol Jiftlto to avntlohlo I0 tho porgvn oror anlzatton 01romm in Q19 0400rollone as 811 r ddlttono injured, Blanket where required by contract Form 88 04 A0 00 00 prtntod fn tj.t k (f48) Copyiloht, Hoilrvrd Piro Insurance Oompeny,1003 PHASIIS -01 HBCT15 `{�_°,ROP CERTIFICATE OF LIABILITY INSURANCE DATE DYYYY) 5/3/2013 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 INSURERS), 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 License # 0564249 (OC) Heffernan Insurance Brokers 6 Hutton Centre Drive, Suite 500 Santa Ana, CA 92707 CONTACT NAME: PHONE 1 (714) 361 -7700 FAX ) A/C No Ext : A /C, No): 1 714 361 -7701 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Sentinel Insurance Company Limited 11000 TORY LIMITS ER INSURED INSURER B: Lloyd's of London $ INSURER C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Phase II Systems dba PARS INSURER D 4350 Von Karman Ave, Ste. 100 Newport Beach, CA 92660 INSURER E: E.L. DISEASE - EA EMPLOYE 1 INSURER F: (Mandatory in NH) If yes, describe under UUVtKAUhb CERTIFICATE NUMBER: 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. INSRR TYPE OF INSURANCE I IN SR WVD POLICY NUMBER MM /DDfYYYY ) (MOMIDDIYYYYI LIMITS GENERAL LIABILITY =T=D CE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY X 72SBAAC2429 5/8/2013 5/8/2014 PREMISES Ea occurrence $ 1,000,000 CLAIMS -MADE � OCCUR MED EXP (Any one person) $ 40,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PE I LOC AUTOMOBILE LIABILITY A ANY AUTO ALL OWNED SCHEDULED AUTOS L AUT OS X HIRED AUTOS I X AUTO - SWNED UMBRELLA LIAB IH OCCUR EXCESS LIAB CLAIMS -MADE PERSONAL & ADV INJURY $ 2,000, GENERAL AGGREGATE $ 4,000, PRODUCTS - COMP/OP AGG $ 4,000, 5/8/2013 5/8/2014 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ PER ACCIDENT O $ EACH OCCURRENCE $ L � _ AGGREGATE $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) PROJECTS AS ON FILE WITH THE INSURED INCLUDING BUT NOT LIMITED TO THOSE USUAL TO THE INSURED'S OPERATIONS /PARS SUPPLEMENTARY RETIREMENT PLAN. THE CITY OF SANTA ANA, ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS ON GENERAL LIABILITY POLICY -SEE ATTACHED ENDORSEMENT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SERVICES ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION WC STATU- 0TH - AND EMPLOYERS' LIABILITY YIN �aK,a el TORY LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A A� or E.L. DISEASE - EA EMPLOYE 1 $ (Mandatory in NH) If yes, describe under A 77/30/2012 I E.L. DISEASE - POLICY LIMIT $ �13 DESCRIPTION OF OPERATIONS below PROFESSIONAL LDUSA1204508 7/30/2013 PER CLAIM 2,000,000 B (LIABILITY iLDUSA1204508 7/30/2012 7130/2013 AGGREGATE 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) PROJECTS AS ON FILE WITH THE INSURED INCLUDING BUT NOT LIMITED TO THOSE USUAL TO THE INSURED'S OPERATIONS /PARS SUPPLEMENTARY RETIREMENT PLAN. THE CITY OF SANTA ANA, ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS ON GENERAL LIABILITY POLICY -SEE ATTACHED ENDORSEMENT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SERVICES ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Policy No. 72SBAAC2429 Phase II Systems, dba: PARS. x THI9 I'NpOROMMENT 0HAN4tr$ THE 0OL10Y, PLEAsE RUAD 1Y CAtiEFULLY. ADDITIONAL INSURED M DESIGNATED PERSON OR ORGANIZATION Wo ondoroontont modlfioo Insuronoo provtdodunderthe follovtinp: 13UUIN989 LIAUILDY 00VMRA6q IfoAfA 0, W10 la an Insurod In II10 ttU81N6$J LIAVILITY Forfoasos covered under Iho BV61NIT80 LIADILITY COVCRAOC- F0RM to nrpsrtded to Includo as en COVt:RA011 vI Us policy Ittlo Insursrtae Is Fprtrnary Insurov Itto porson of orgsnliatlotl ettvyIn In the to atlror valid and ooltedlblo Inaufanca vritlni is o t of 11U op but only 1(h n illod to f1a oo' pilling avallable to tho porson orof�anlrallon ol►oten In Ate eu! of the ofzerntlons oFtho nontod hseurotl, 0411erallons as an Addlllonst Injured, Person or Organization: Blanket where required by contract Form 08 04 40 04 00 pdnfad In V.8,A. (149) CopyBOhl, Hartford Piro hlauronw Oompany,1003 HZFFERNAN INSURANCE BROKERS 6 HUTTON CENTRE DR. SUITE 500 SANTA ANA, CA 92707 CITY OF SANTA ANA ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SERVICES 20 CIVIC CENTER PLZ SANTA ANA CA 92701 -4058 A-20 , CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDYYYY) .c ' ,,,i�" 051OS i20 i 3 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 MARSH USA INC. SUITE 400 1255 23RD STREET, N.W. WASHINGTON, DC 20037 CONTACT NAME- PHONE FAX IAIC. No. Extl: A/C No): E -MAIL ADDRESS: _ INSURERS} AFFORDING COVERAGE NAIC # 040356-- EO+FI -13 -14 INSURER A : St. Paul Protective Insurance Company 19224 INSURED ICMA RETIREMENT CORP INSURER B: Federal Insurance Company 20281 INSURER C: St. Paul Fire & Marine Ins Co 24767 ATTN: UJUANA THOMAS 777 NORTH CAPITOL ST., N.E. WASHINGTON, DC 20002 INSURER D : Standard Fire Insurance Company 19070 INSURER E: Great American Insurance Co. 16691 INSURER F: 1:000,000 _ MED EXP (Any one person) THIS 1S 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 RESFECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY i-HE 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 INSK SUBR WVo POLICY NUMBER MM /DDYYYY I (MM/DD/YYYY1 - -- - -- LIMITS A GENERAL LIABILITY ZLPlOS82630 08/01/2012 08/01/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Cxl OCCUR X CONTRACTUAL COV INCL. - YT'LO CO� T AI DAMAGE T_ RENTED PREMISES Ea occurrence 1:000,000 _ MED EXP (Any one person) _$ $ 10,000 PERSONAL & ADV INJURY GENERAL AGGREGATE $ 1,000,000 $ 2.000,000 – GENT AGGREGATE LIMIT APPLIES PER: X POLICY LOC PRODUCTS - COMP /OP AGG _ _ $ 2,000,000 $ — AUTOMOBILE -- LIABILITY S �� COMBINED SINGLE LIMIT irJent1 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS C' of POSY lam" BODILY BODILY INJURY (Per person; $ BODILY INJURY (Per accident) – — $ NON -OWNED HIRED AUTOS AUTOS PROPERTYDAMAGE Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ __ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRErORIPARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? N/A UB- 6508M89 -4-12 08/01/2012 08/01/2013 X 1 wCSTATU- I I1T1- E.L. EACH ACCIDENT $ 1000,000 ,— E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in and If yes, describe under E.L. DISEASE - POLICY LIMIT _ _ $ 1,000,000 DESCRIPTION OF OPERATIONS below B BANKERS PROF. LIAB. 8211 -6261 04/19/2013 06/30/2014 LIMIT 12,500,000 C BANKERS PROF. LIAB. ZPL- 14R20360 -13-N2 04/19/2013 06 /30 /2014 SIR 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF SANTA ANA ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SVS 20 CIVIC CENTER PLAZA M-34 SANTA ANA, CA 92702 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. ManashiMukherjee W 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 040356 (LOC #: Washington ADDITIONAL REMARKS SCHEDULE Paae 2 of 2 AGENCY NAMED INSURED MARSH USA INC. ICMA RETIREMENT CORP. ATTN: UJUANA THOMAS 777 NORTH CAPITOL ST., N.E. POLICY NUMBER WASHINGTON, DC 20002 CARRIER NAIC CODE EFFECTIVE DATE: A nnITInhIA I OCK& A nw� V ZUUS AGURD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Acord CERTIFICATE OF LIABILITY INSURANCE Date10MMiDDO 8 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THEVPOLICIES 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 require an endorsement. A statement on this'.. certificate does not confer rights to the certificate holder in lieu of Risk Strategies Company 2040 Main Street, Suite 580 Irvine, CA 92614 Lic. #OF06675 Phase II Systems Dba: PARS 4350 Von Kerman Ave., Ste 100 Newport Beach, CA 92660 Sherry Young tnic c r1, 949.242.9240 I =...— 949.596.0866 I aooiiPRS. syoung @risk- strategies.com I THIS IS TO CERTIFY THAT 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 ADD SUER POLICY NUMBER POLICY EFF POLICYEXP LTR INSR WVD MANDD MM/DDM'YY LIMITS GENERAL L LIABILITY EACH OCCURRENCE $2,000,000 A X COMMERCIAL GENERAL LIABILITY x 72SBAAC2429 05/08/13 05/08/14 DAMAGET RENTurD $1.000,000 MED EXP(Any one camon) $10.000 CLAIMS -MADE r OCCUR PERSONAL &ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L. AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $4,000,000 POLICY X PROJECT LOC $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ANY AUTO 72SBAAC2429 05/08/13 05/08/14 ALL OWNED AUTOS SCHEDULED NOW ® ±� BODILY INJURY (Per accident) $ X HIREDAUTOS X OWNED AUTOS VV'' (Peo accident) PRPERTY DAMAGE $ da'6p VV $ UMBRELLALIAB OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESB LIAR MADE a SVC OY ey OED RETENTION $ �Og Atti �e.gl "d $ WORKERS COMPENSATION p ORVTATU- OTW AND EMPLOYERS' LIABILITY YIN �{JjS !'� ER ANY PROPRIETOP/PARTNER/EXECUTIVE/ LIMITS E.L. EACH ACCIDENT § OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in N.H.) E.L. DISEASE - EA It yea, describe under DESCRIPTION OF EMPLOYEE $ OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Professional Liability - LDUSA1304508 07/30/13 07/30/14 PerClalm $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks schedule, It more space is required) PROJECTS AS ON FILE WITH THE INSURED INCLUDING BUT NOT LIMITED TO THOSE USUAL TO THE INSURED'S OPERATIONS /PARS SUPPLEMENTARY RETIREMENT PLAN. THE CITY OF SANTA ANA, ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSUREDS ON GENERAL LIABILITY POLICY -SEE ATTACHED ENDORSEMENT. CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH ATTN: EXECUTIVE DIRECTOR OF THE POLICY PROVISIONS, PERSONNEL SERVICES AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 u 1�tLuns °° 1 ° °' °' ° °/ C91- 6 -ZU1U AGORD CORPORATION. All rights reserved. Policy No. 72SBAAC2429 BUSINESS LIABILITY COVERAGE FORM 2. Applicable To Medical Expenses Coverage We will not pay expenses for "bodily injury": a. Any Insured To any insured, except "volunteer woriksm ". b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any Insured. c. Injury On Normally Occupied Premises To a person Injured on that pan of premises you own or rent that the person normally occupies. d. Workers' Compensation And Similar Laws To a person, whether or not an "employee" of any insured, if benefits for the %odily Injury" are payable or must be provided under a workers, compensation ar disabiiity benefits law or a similar law. e. Athletics Activities To a person injured while practicing, instructing or participating in any physical exercises or games, sports or athletic contests. f. Products-Completed Operations Hazard Included with the "producffi- completed operations hazard". g. Business Liability Exclusions Excluded under Business Liability Coverage. C. WHO IS AN INSURED 1. if you are designated In the Dsolarefions es: a. An individual, you and your spouse are Insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you arc an Insured, Your members, your partners, and their spouses are also Insureds, but only wilt respect to the conduct of your business. e. A limited Nobility company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured, Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your sthokholders are also insureds, but only with respectto their liability as stoddholders. Page 10 of 24 e. A trust, you are an Insured, Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Employees And Voluntser Workers Your "volunteer workers" only while performing duties related to the conduct of your business, or your •employees ", other Man either your " executve officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing dukes related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for, (1) "Bodily injury" or "personal and advertising Injur: (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), or to a co- "employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co- ..employee or that *volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described In Paragraphs (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services, If you are not In the business of providing professional health care services, Paragraph (d) does not any to any nurse, emergency medical technician or paramedic employed by you to provide such services. (2) "Property damage" to property: (a) owned, occupied or used by, Form $S 00 08 04 06 BUSINESS LIABILITY COVERAGE FORM (b) Rented to, In the care, custody or b. Coverage under this provision does not control of, at over which physical apply to: control is being exercised for any (t) "godly injury" or "property damage" Purpose by you, any of your that occurred; or "employees ", "volunteer workers ", any partner or member (If you are (2) "personal and advertising Injury" a partnership or joint venture), or arising out of an offense committed any member (If you are a limited before you acquired or formed the liability company). organization, b. Real Estate Manager 4. Operator Of Mobile Equipment Any parson (other than your " ®mployee" or I Wdh respect to "mobile aquipment' registered in "volunteer works'), or any organization your name under any motor vehicle registration white acting as your real estate manager, law, any person Is an insured while driving such c. Temporary Custodians Of Your equipment along as public highway with your Property �yy l Any person or organization having proper responsible for the conduct of such parson is temporary custody of your property if you also an Insured, but only with respect to [lability arising out of the operation of ft equipmeK and die, but only: only if no other Insurance of any kind is available (1) With respect to ilattillry adslhg out of the to that person or argan zation for this liability. maintenance or use Df that property; and However, no person or organisation is an insure! (2) Until your legal representative has with respect ttc been appointed, a. "Bodily injury" to a co "employea" of the d. Legal Representative If You Die person driving the equipment; or Your legal representative If you die, but I b. "Property damage" to properly owned by, only with respect to du0es as such, That rented to, In the charge of or occupied by representative will have all your rights and you or the employer of any parson who Is dutias underthis insurance, an Insured under this provision. a. Unnamed Subsidiary '. Operator of Nonowned Watercraft Any subsidiary and subsidiary thereof, of With respell to watercraft you do not own that yours which is a legally incorporated entity i is less than 51 feet long and Is not being used of which you own a financial interest of to cony persons for a charge, any person Is an more than 50% of the voting stock on the li insured while operating such watercraft with effective date of this Coverage Part. your permission. Any other parson or The insurance afforded herein for any organization responsible for the conduct of subsidiary not shown in the Declarations such person Is also an Insured, but only with as a named Insured does not apply to respect to liability arising out of the operation injury or damage with respect to which an of the watercraft, and only if no other insured under this insurance is also an insurance of any kind is available to that Insured under another policy or would be person or organization for this liability. an insured under such policy but for Its However, no person or organization is an termination or upon the exhaustion of its Insured with respect to: limits of Insurance. a, "Bodily injury" to a co- "employs®" of the 3. Newly Acquired Or Formed Organization person operating the watercraft; or Any organization you newly acquire or form, b. "Property damage" to property owned by, other than a partnership, joint venture or rented to, in the charge of or occupied by limited liability company, and over which you you or the employer of any person who is maintain financial Interest of more then 50% of an insured under this provision, the voting stock, will qualify as a Named 5. Additional Insureds When Required By Insured It there Is no other similar Insurance Written Contract, Written Agreement Or available to that organization. However. Permit a. Coverage under this provision is afforded The person(t) or oganization(s) identified in only until the 160 day after you acquire Paragraphs a. through f. below are additional or form the organization or the and of the Insureds when you have agreed, In a written I policy period, whichever is earlier,, and Form SS 00 00 04 05 Pago 11 of 24 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional Insured on your policy, provided the Injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional Insured under this provision only for that Period of time required by the contract, agreement or permit. However, no such person or organization is an additional Insured under this provision if such person or organization is included as an additional Insured by an endorsement issued by us and made a part of this Coverage Part, Including all persons or organizations added as additional insureds under the specific additional Insured coverage grants in Section F. — Optional Additional Insured Coverages. a. Vendors Any person(s) or orgaruzation(e) (referred to Wow as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or add in the regular course of the vendor's business and only If this Coverage Part provides coverage for "bodily irqury' or "property damage" Included within the "products- completed operations hazard". (1) The insurance afforded to the vendor Is subject to the following additional exclusions: This insurance does not apply to: (a) "Bodily injury' or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement This exclusion does not apply to liability for damages that the vendor would have In the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor, (d) Repackaging, except when unpacked solely for the purpose of Inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container, b. (a) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual tours of business, in connection With the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage° arising out of the sole negligence of the vendor for its own acts or omissions or those of Its employees or anyone else acting on Its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs (d) or (f); or (It) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or nomaiiy undertakes to make in the usual course of business, In connection with the doinbutlon or sale of the products. (2) This insurance does not apply to any Insured person or organization from whom you have acquired such products, or any Ingredient, part or container, entering Into, accompanying or containing such products. Lessors of Equipment (1) Any person or organization from whom you lease equipment; but onty with respect to their liability for "bodily injury", "property damage" or "personal and advertising injury" caused, In whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. Page 12 of 24 Form 66 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the Insurance afforded a. Permits Issued By state or Political to these additional insureds, this Subdivisions insurance does not apply to any "occurrence" (1) Any "a or political subdivision, but which takes place after only with respect to operations You cease to lease that equipment performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has Issued a permit. whom you lease land or premises, but (2) With respect to the Insurance aifforded only with rasped to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises leased to you. (a) "Bodily injury', •property damage" "personal or and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or Insurance does not apply to: municipality, or (a) Any "occurrence" which takes (b) " Bodly Injury" or "property damage place after you cease to lease that included within the "products. land or be a tenant In that completed operations hazard". premises; or f, Any Other Party (b) Structural alterations, new (1) An other person or y P organization who construction or demolition de is not an Insured under Paragraphs a, operations pertoor or on through e, above, but only with behalf of such person or Orgahizatian respect to liability for bodily irgury", "propel damage' or "personal and d, Architects Engineers Or Surveyors g y advertising Injury" caused, in whole or (1) Any architect, engineer, or surveyor, but In part, by your ads or omissions or only with respect to lisbilty for "bodily the acts or omissions of those acting injury", "property damage• or "peracnal on your behalf. and advertising injury" caused, in whole (a) In the performance of your or in part, by your ads or omissions or ongoing operations; the ads or omissions of those acting an (b) In connection with your premises your behalf. owned by or rented to you; or (a) In connection with your premises; (e) In connection with "your work" and or included within the eproducia- (b) In the performance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (I) The written contract or written (2) With respect to the Insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (It) This Coverage Part provides "bodily Injury", "property damage" or coverage for "bodily injury" or "personal and advertising injury" "property damage" included arising out of the rendering of or the within the "products- failure to render any professional completed operations hazard", services by or for you, including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional Insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, i "Bodily injury", "property damage" or reports, surveys, laid orders, "personal and advertising Injury" change orders, designs or arising out of the rendering of, or the drawings and specifications; or failure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, Including: activities. Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, Inspection, architectural or engineering activities. The limits of Insurance that apply to additional Insureds are described in Section D. — Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured Is described In the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. No person or organization Is an Insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 1. The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits ". 2, Aggregate Limits The most we will pay for: a. Damages because of "bodily injury" and "property damage" included In the "products- completed operations hazard" is the Producta- Camplated Operations Aggregate Limit shown In the Declarations. b. Damages because of all other "bodily injury", 'property damage" or "personal and advertising injury`, including medical expenses, is the General Aggregate Limit shown in the Declarations. This General Aggregate Limh applies separately to each of your "locations" owned by or rented to you. "Locators" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway or right -of -way of a railroad. This General Aggregate limit does not apply to "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of fire, lightning or explosion. �. Each Occurrence Limit Subject to 2.a. or 21 above, whichever applies, the most we will pay for the sum of all damages because of all "bodily injury", "Property damage" and medical expenses arising out of any one 'occumenca' is the Liability and Medical Expenses Limit shown in the Decarations. The most we will pay for all medical expenses because of "bodily Injury" sustained by any one person is the Medical Expenses Limit shown in the Declarations. 4. Personal And Advertising Injury Limit Subject to 2.b. above, the most we will pay for the sum of all damages because of all "Personal and advertising injury" sustained by any one person or organization is the Personal and Advertising Injury Limit shown in the Declarations. 5, Damage To Premises Rented To You Limit The Damage To Premises Rented To YoL Limit is the most we will pay under Business Liability Coverage for damages because of "property damage" to any one premises, while rented to you, or In the case of damage by fire, lightning nr explosion, while rented to you or temporarily occupied by you with permission of the owner. In the case of damage by fire, lightning or explosion, the Damage to Promises Rented To You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of these, B. How Limits Apply To Additional Insureds The most we will pay on behalf of a person or organization who is an additional Insured under this Coverage Part is the lesser of: a. The limits of insurance specified in a written contract, written agreement or permit issued by a state or political subdivision; or b. The Limits of insurance shown In the Declarations. Such amount shall be a part of and not in addition to the Limits of Insurance shown In the Declarations and described in this Section. Page 14 of 24 Form 86 00 08 04 05 If more than one Ilm@ of Insurance under this Policy and any endorsements attached thereto applies to any claim or "suit ", the most we will pay under this policy and the endorsements is the single highest limit of liability of all coverages applicable to such claim or "suit ". However, this paragraph does not apply to the Medical Expenses limit set forth in Paragraph 3, above. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, untess the policy period is extended after issuance for an additional period of less than 12 months. In that onA the additional period wil be deemed part of the last preceding period for purposes of determining the LIrefB of Insurance. E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS. 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured °s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. Notice Of Occurrence Or Offense You or any additional Insured must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should Include: (1) How, when and where the "omurronce°' or offense took place; (2) The names and addresses of any Injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. Notice Of Clain If a claim is made or "suit" is brought against any insured, you or any additional Insured must; (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You or any additional insured must see to It that we receive a written notice of the claim or "cult°' as soon as practicable. c. Assistance And Cooperation Of The Insured You and any other Involved Insured must: BUSINESS LIABILITY COVERAGE FORM 41) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us In the investigation, settlement of the claim or defense against the "suit "; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization that may be liable to the Insured because of Injury or damage to which this insurance may also apply. d. Obligations At The Insured's Own Cost No Insured will, except at that Insured's own cost, voluntarily make a payment, assume any obligation, or Inca- any expense, other than for Arai aid, without our consent e, Additional Insured's Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other Insurance available to an additional insured, such additional Insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written oontract written agreement or Permit that this insurance is primary and non- contributory with the additional insured's own insurance. f. Knowledge Of An Occurrence, offense, Claim Or Suit Paragraphs a. and b, apply to you or to any additional insured only when such "occurrence", offense, claim or "suit" is known to: (1) You or any additional insured that Is an Individual; (2) Any partner, if you or an additional Insured is a partnership; (3) Any manager, If you or an additional Insured Is a limited liability company; 44) Any "executive officer` or Insurance manager, if you or an additional Insured is a corporation; (5) Any trustee, I you or an additional Insured Is a trust; or (8) Any elected or appointed official, if you or an additional Insured is a political subdivision or public entity. Form 86 00 08 04 05 Page 16 of 24 BUSINESS LIABILITY COVERAGE FORM This Paragraph f, applies separately to (3) We have issued this policy in reliance you and any additional insured, upon your representations. 3, Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy Is cerlified as proof of Hazards financial responsibility for the future under If unintentionally you should fall to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the Insurance business at the inception date of this Provided by the policy for 'bodily Injury, "property Coverage Part, we shall not deny any liability and damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of q. Otherinsurance Insurance required by that law. b. With respect to "mobile equipment" to if other valid and collectible Insurance Is which this Insurance applies, we will available for a loss we cover under this provide any liability, uninsured motorists, Coverage Part, our obligations are limited as underinsured motorists, ncAault or other i follows: coverage required by any motor vehicle a. Primary insurance law. We will provide the required limits for This Insurance Is primary except when b. ritose coverages, below applies. If other insurance is also 4. Legal Action Against Us primary, we will share with all that other No person or organization has a right under Insurance by the method described in c. this Coverage Form: below. a. To join us as a party or otherwise bring us b. Excess Insurance into a "suit" asking for damages from an This Insurance Is excess over any of the insured; or other insurance, whether primary, excess, b. To sue us on this Coverage Form unless contingent oron any other basis: all of its terms have been fully complied (f) Your Work with. That is Fire, Extended Coverage, A person or organization may sue us to recover Builders Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for "your work "; against an Insured; but we will not be gable for (2) Promises Rented To You damages that are not payable under the terms of this insurance or that are In excess of the That is fire, lightning or explosion applicable limit of insurance. An agreed insurance for remises rented 4o u proms Yo settlement means a settlement and release of in temporarily pied h you with y y liability signed by us, the insured and the permission of the owner, claimant or the dalmants legal representative. (3) Tenant Liability S. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned In this policy in the first Named Insured, this Insurance applies: a. As if each Named insured were the only Named Insured; and b. Separately to each insured against whom a claim Is made or "suit" Is brought. S. Representations a. When You Accept This Policy By accepting this policy, you agree: (1) The statements in the Declarations are accurate and complete; (2) Those statements are based upon representations you made to us; and That is Insurance purchased by you to cover your liability as a tenant for "Property damago" to promises rented to you or temporarily occupled by you with permission of the owner; (4) Aircraft, Auto Or Watercraft If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section A. — Coverages. (5) Property Damage To Borrowed Equipment Or Use Of Elevators If the loss arises out of "properly damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion k. of Section A. — Coverages, Page 16 of 24 Form SS 00 03 04 05 (6) When You Are Added As An Additional Insured To other Insurance That is other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional Insured by that Insurance; or (7) When You Add Others As An Additional Insured To This Insurance That is other insurance available to an additional Insured. However, the following provisions apply to other insurance available to any person or organization who Is an additional insured under this Coverage Part (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed In a written contract, written agreement or permit that this insurance be primary. K other insurance Is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non - Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non- contributory with the additional insured's own insurance, this Insurance Is primary and we will not seek contribution from that other Insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional Insured has been added as an additional insured. When this Insurance Is excess, we wig have no duty under this Coverage Part to defend the Insured against any "sult" if any other insurer has a duty to defend the insured against that "sulr" If no other insurer defends, we will undertake to do so, but we will be entitled to the Insured's rights against all those other Insurers. BUSINESS LIABILITY COVERAGE FORM When this Insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of (1) The total amount that all such other insurance would pay for the loss in the absence of this Insurance; and (2) The total of all deductible and self - Insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown In the Declarations of this Coverage Part. c. Method Of Sharing If all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid Its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each Insurers share Is based on the ratio of Its applicable Omit of insurance to the total applicable limits of Insurance of all Insurers. 1. Transfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us. The Insured must do nothing after loss to impair them. At our request, the insured will bring "sult" or transfer those rights to us and help us enforce them. 'rhis condition does not apply to Medical Expenses Coverage. b. Waiver Of Rights Of Recovery (Waller Of Subrogation) If the insured has waived any rights of recovery against any person or organization for ag or part of any payment, Including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the Insured waived their rights of recovery against such person or organization In a contract, agreement or permit that was executed prior to the Injury or damage. Form SS 00 08 04 05 Page 17 of 24 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED COVERAGES If listed or shown as applicable in the Declarations, one or more of the following Optional Additional Insured Coverages also apply. When any of these Optional Additional Insured Coverages apply, Paragraph & (Additional Insureds When Required by Written Contract, Written Agreement or Permit) Of Section C., Who Is An Insured, does not apply to the person or organization shown in the Declarations. These coverages are subject to the terms and conditions applicable to Business Liability Coverage in this policy, except as provided below: 1, Additional Insured - Designated Person or Organization WHO IS AN INSURED under Section C. is amended to include as an additional Insured the person(s) or organizations) shown In the Declarations, 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 promises owned by or rented to you. 2. Additional Insured " Managers Or Lessors Of Premises e. WHO IS AN INSURED under Section C. Is amended to Include as an additional Insured the person(s) or organizadon(s) shown in the Declarations as an Additional Insured - Designated Person Or organization; but only with reaped to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Declarations. b, With respect to the insurance afforded to these additional Insureds, the following additional exclusions apply: This insurance does not apply to; (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such Perron or organization. 3. Additional Insured -Grantor Of Franch Ise WHO IS AN INSURED under Section C. is amended to include as an additional Insured the person(s) or organization(s) shown in the Declarations as an Additonal Insured - Grantor Of Franchise, but only with respect to their liability as grantor of franchise to you. 4. Additional Insured " Lessor Of Leased Equipment a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured — Lessor of Leased (Equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or In part, by your maintenance, operation or use of equipment leased to you by such person(a) or organization(s). b. With respect to the insurance afforded to these additional insureds, this Insurance does not apply to any "occurrence" which takes place after you cease to lease that equipment. Additional Insured - Owners Or Other Interests From Whom Land Has Been Leased a. WHO IS AN INSURED under Section C. Is amended to include as an additional Insured the person($) or organizatlon(s) shown In the Declarations as on Additional Insured — Owners Or Other Interests From Whom Land Has Been Leased, but only with respect to liability arising out of the ownership, maintenance or use of that pan of the land leased to you and shown in the Declarations. b. With respect to the insurance afforded to these additional Insureds, the following additional exclusions apply; This Insurance does not apply to: (1) Any "occurrence" that takes place after you cease to lease that land; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. ¢. Additional Insured - Stats or Political Subdivision — Permits a. WHO IS AN INSURED under Section C. Is amended to Include as an additional insured the state or political subdivision shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Insured -- State or Political Subdivision - (e) Arty failure to make such Permits, but only With respect to inspections, adjustments, tarts or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional Insureds, the following distrifwtionor sale of the products; additional exclusions apply: (f) Demonstration, installation, This Insurance does not apply to: servicing or repair operations, (1) "Bodily Injury", "property damage" or except such operations perfumed "personal and advertising injury" at the vendo"s premises In arising out of operations performed for connection with the sale of the the state or municipality; I' or product (2) " Bodly Injury" or "property damage" (g) Products which, after distribution Included In the "product - completed or sale by you, have been labeled operations" hazard. or relabeled or used as a container, part or ingredient of any 7. Additional Insured — Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C. is the vendor; or amended to Include as an additional (h) "Bodily Injury" or "property Insured the person(s) or organizations) damage arising out of the sole (referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with rasped to "bodily its employees or anyone else Injury" or "property damage" arising out of acting on its behalf. However, this "your products" which are distributed or exclusion does not apply to; sold In the regular course of the vendor's (i) The exceptions contained in business and only if this Coverage Part "bodily i Subparagraphs (d) or (f); or provides coverage for Injury" or "property damage" included within the (11) Such inspections, "products- oompistsd operations hazard ". adjustments, tests or servicing b, The Insurance aBonied to the Vendor is as the vendor has agreed to subject to the following additional exclusions; make or normally undertakes to make In the usual course of (1) This insurance does not apply to: business, in connection with (a) "Bodily injury' or "property the distribution or sale of the damage" for which the vendor Is products• obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of Insured person or organization from liability in a contract or agreement, whom you have acquired such This exclusion does not apply to products, or any Ingredient, part or liability for damages that the container, entering into, vendor would have In the absence accompanying or containing such of the contract or agreement; products, (b) Any express warranty $. Additional Insured — Controlling Interest unauthorized by you; WHO IS AN INSURED under Section C. Is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or orgahizatfon(s) shown In the by the vendor; Declarations as an Additional Insured — (d) Repackaging, unless unpacked Controlling Interest, but only with respect to sdsly for the purpose of inspection, their liability arising out of: demonstration, tasting, or the a. Thelrfinencial control of you; or substitution of parta under b. Premises they own, maintain or control Instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container, Form 86 00 08 04 05 Page 10 of 24 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. S. Additional Insured — Owners, Lessees Or Contractors — Scheduled Person Or Orprilzation e. WHO IS AN INSURED under Section C. is amended to include as an additional Insured the person(s) or organization(s) shown in the Declarations as an Additional Insured — Owner, Lessees or Contractors, 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 sots or omissions of those acting on your behalf: (1) In the performance of your ongoing operations for the additional insured(s); or (2) In connection with 'your work" performed for that additional insured and included within the "products - completed operations hazard ", but only if this Coverage Part provides coverage for "bodily injury" or "property damage" Included within the "products - completed operations hazard ". b. WM respect to the Insurance afforded to these additional insureds, this insurance does not apply to "bodily injury", "property damage" or "personal an advertising Injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. 10. Additional Insured — Co -Owner Of Insured Premises WHO IS AN INSURED under Section C. Is amended to include as an additional insured the person(s) or Organizations) shown in the Declarations as an Additional Insured — Co- Owner Of Insured Premises, but only with respect to their liability as co -owner of the premises shown in the Declarations. The limits of Insuranca that apply to additional Insureds are described in Section D. — Limb Of Insurance. How this insurance applies when other insurance Is available to an additionel Insured is described In the Other Insurance Condition in Section E. — Llability And Medical Expenses General Conditions. G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 1. "AdvartisamenY means the widespread public dissemination of Information or images that has the purpose of Inducing the sale of goods, products or services through: a. (1) Radio; (2) Television; (3) Billboard; (4) Magazine; (5) Newspaper; b. The Internet, but only that part of a web site that Is about goads, products or services for the purposes of Inducing the sale of goods, products or services; or e. Any other publication that is given widespread public dietributlon. However, "adverteemenl" does not include: a. The design, printed material, information or images contained in, on or upon the packaging or labeling of any goods or products; or b. An interactive conversation between or among persons through a computer network, 2. "Advertising Idea" means any idea for an "advertisement". 3. "Asbestos hazard" means on exposure or threat of exposure to the actual or alleged properties of asbestos and includes the more presence of asbastas in any form. 4. "Auto" means a land motor vehicle, trailer or semi- trailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment". 5. "Bodily injury" means physical: a. Injury; b. Sickness; or c. Disease sustained by a person and, if arising out of the above, mental anguish or death at anytime. e. "Coverage terdtory" means: Page 20 of 24 Form SS 00 08 04 05 CO CA DI01 License No. OFO6675 INSURED Phase H S Serns dba PAR� 4350 Von Karman Ave., Ste 100 Newport Beach CA 92660 rim ........ . . COVERAGES CERTIFICATE NUMBER' 20976202 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF lNSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY FE—FOOD INDICATED. NOTMTHISTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VOTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR IMAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POL01ES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CL)MMS. IN . SR LTIR TYPE Or- INSURANCE IN POLICY NUMSER POUCYIEFF K I � I " j I Yyy LIMITS A COMMERCIAL GENERAL LIABILITY 72SBAAC2429 51812,014 5/812015 EACH OCCURRENCE $ $2,000,000 ICLOMMS-MADE 17, OCCUR $1 X0,000 ME2 lalL{An)� one pe aorq S $10,000 V URY 0000 PERSONAL & All INJ S $2,�010 r;E.N1 AOGREGATE UMIT APPLES PER: qENERAL AGGREGATE $ $4,000,000 PRO. POLICY EIDECT E LOC 54,000,000 PRODUCTS - COMP OP AGG $ - OTHER $ A AUTOMOBILE UAWLaY 72SBAAC2429 518/2014 515,+`2015 nr4l'AED g"NGLE LIMIT $2000,000 , ANY AUT O 800LYiNJURY(Perperqon) $ BOWLY INJURY (Pew accident) $ ALL OWNED SCHEDULED --I,, - AUTO's AUTOS NON-OWNED HiRED AUTOS AUTOS P $ UMBRELLA UAS OCIDUR EACH OCCURRENCE $ EXCESS LIAS CLiMMS-MADE AGGREGATE �D E D�RET F NTJO N $ $ WORKERS COMPENSATION p5p, ofl+ ASFA'l "T AND EMPLOYFRTUABILITY YIN ANY PR0PRNETOPJPAPTNEPJEXECUTWE E,L, IEACH AMPENT $ 0FRCERM,tEMBER EXCLUDE El (Mandatory In NH) MIA E.L. DISEASE - EA EMPLOYEE $ 0 g, desctibe uncler 0 S wRIPTION OF OPERA=NS below E.L. DISEASE - POUCY LIMIT $ B , Prolessk,)nal I uabIflty LDUSAI 04508 7/3012014 7/30(2015 P(-,V Cl inn $2,0010,000 Aggregate: $2,000,0010, 'N - 0,ESCRIPT9ON; 07; ERA;;NS LOCATIONS I VEHICLES lACORD 101, AddiVonal Remarks Schedule, may be attached if more space Is requIred) Projects as on r1le With the Insured including but not limited to those usuall to the insured's operations/PARS Supplementary Refi here nt Plan, The City of Santa Ana, its offidals, employees and volunteers are named as additional insureds on the general fiaNfit%ag I' R§ee attached I P ,( )RM endorsement. A,P 1119YED x 'U Wyd 7 CERTIFICATIE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, N07110E WILL BE DELIVERED IN Attn. Executive Director of Personne� Services Attn. ACCORDANCE WrrH THE POLICY PROVISION& 20 Center Raze Santa Ana CA 92701 AUTHORIZED REPRESENTATiVE it Mike Christian @ 19188-2014 AC10RD CORPORATION, All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of AC RID �!ERT IT'D.: '0570,0,7 ;tp%'N alb_ , :b?_: _i' 7j21 /..mN 1.a,'„r „IR.) AM va r 4, 1 Jf i.,-, 72SBAAC2429 BUSINESS LIABILITY COVERAGE FORM 17-71111111IF2010-TIMM398 =— I ON= 1. If YOU are designated in the Declarations as: a. An individual,, you and your spouse a insureds,, but only with respect to t conduct of a business of which you are sole owner. b. A partnership or joint venture, you are insured. Your members, your parMtners, a their spouses are also eds, but only wi respect to the .mm . of your business. c A limited liability company, you are insured, Your members are also insured but onily with respect to the conduct of yo business. 'Your managers are insureds, b only with respect to their duties as yo managers. d. An organization other than a partnershi joint venture or limited liability company, y areaninsured. 'Your "executive offflfl cars" a di�rectors are insureds, but only with resp to their duties as your officers; or directo Your stockholders are also Insureds, but on wi h respect to their liability as stockholders Page 10 of 24 J 1, 7 F 0 Z Sharry y,7,m,4 /�Z3)":,%4 10:$,, ' ( ➢V Page 2 of i, (a) To yoiu, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), or to a co-"employee" while in the course of his or her emiployment or performing duties related to the conduct of your business, or to your other $0 volunteer workers"' while performing duties, related to the conduct of your businiess; (b) To the spouse, child, parent, brother or sister of that co- "employee" or that °.volunteer worker' as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services, If you are not in the business of providing professional health care services, Paragraph; (d) does not apply to any nurse,, emergency medical technician oir paramedic employed by you to provide such services. (2) "Property damage" to property: (a) Owned, occupied or used by, Forml SS 00 08 04 05 300�yy J' I � Any subsidiary and! subsidiary tthiereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Part. The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not apply to injury or damage with respect to which an insured under this insurance is also an insured under another poilicy or would e an insured ' under such policy but for its termination or upon the exhaustion of its Hmits of insurance. 1 Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company:, and o ou maintain financial interest of more than 50% of the! voting stock, will qualify as a Named Insured if there is no other simiilar insurance available to that organization, However: a. Coverage under this prWsioni is afforded only until the 180th day after you; acquire or form the organization or the end of the policy period, whichever is earlier; and Form SS 00 08 04 05 T P I C 2 0 {17 G " F12 I 1, �W%P' j 5�11a'Zz�y x"O 11'.9 AZI nFJRUF*d*J W,- .1 i 111111 .... " "I'll 1#1110M Page I I of 24 MIMI-IN't I'll I'll I I UTMNU 91IJ! Zi contract, written agreement or because of a (e) Any failure to make such permit issued by a state or potitical inspectlons, adjustments, tests or !subdivision, that such person or organization seirvidng as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement, or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that Demonstration, installation, period of time required by the contract, servicing or repair operations, agireement or permit. except Such operations performed at the vendor' s premises in However, no such person or organization is an connection with the sale of the additional insured under this provision, if such, product; person or organization is included as an additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F. — Optional Additional Insured Coverages, the vendor; or a,. Vendors (h) "Bodily injury" or "property damage"' arising out of the sole Any person(s) or organization(s) (referred to negligence of the vendor for ft ow as vendor), but only with respect to bell own acts or omissions or those of "bodily injury" or "property damage" arising its employees or anyone else out of "'your products" which are distributed acting on, its behalf, However, this or sold in the regular course of the vendor's exclusion does not apply to., business and only if this Coverage Part provides coverage for "bodily injury" or (1) The exceptons contained in .property damage" included Within the Subparagraphs (d) or (f); or .products-completed operations hazard"'. (N) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual course of business, in This insurance does not apply to: connection with the distribution (a) "Bodily injury" or "'property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization frorn reason of the assumption of whom you have acquired such prod!ucts, liability in a contract or agreement. or any ingredient, part or container, This exclusion, does not apply to ente'dng into, accompanying or liability for damages that the containing such products. vendor would have in the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only "bodily with respect to their liability for (c) Any physical or chemical change injury", "property damage" or in the product made intentionally "personal and advertising injury" by the venidor-, caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container', Page 12 of 24 Form 00 08 O 05 %C,. 'IRVITI% Bh� r ,ao,-9 AD rnr"(1 Page 4 ME MIS (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subtlivislons insurance does not apply to any (1) Any state or political subdivision, but 1. occurrence" which 'takes place after only with respect to operations you cease to lease that equipment. performed by you or on your behalf for c. Lessors Of Land Or Prernises which the state or political subdivision (1), Any person or organization from has issued a permit, whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this, of the ownership, maintenance or use insurance does not apply to., of that part of the land or premises (a), "'Bodily injury", "property damage" leased to you. or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or insurance does not apply to: municipality; or (a) Any "occurrence" which takes (b) "Bodily injury" or "property damage"" place after you cease to lease that included within the "products- land or be a tenant in that completed operations hazard". p'remises; or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an insured under Paragraphs am operations performed by or on through e. above, but only with behalf of such person or respect to liability for "bodily injury", organization. "property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, in whole, or (1) Any architect, engineer,, or surveyor, but in part, by your acts or omissions or only mfith respect to liability for "bodily the acts or omissions of those acting injury", "property damage" or "personal on your behalf: and advertising injury" caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) in connection with your premises your behalf: owned by or rented to you; or (a) In connection with your premises; (c) In connection with "your work" and or included within the "products- (b) In the performance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (1) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (H) This Coverage Part provides "bodily injury", "'property damage"' or coverage for " "bodily injury" or "personal and advertising injury" "property damage" included arising out of the rendering of or the within the 1. products- failure to render any professional completed operations hazard", !services by or for you, including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "'Bodily injury", "property damage" or reports, !surveys, field orders, personal and advertising injury" change orders, designs or an . smg out of the rendering of, or the drawings and specifications; or failure to render, any professional (b) SUpervisory, inspection, architectural, engineering or surveying architectural or engineering services, including: actMfies. Form SS 00 08 04 05 Page 13 of 24 CFY 1,7 NO D 1 , (-, :, 0 2 CH rrvrl YDe: ; 7%i'J IC,; 19. viz AN k V 5 'C' 12 e M111_11NLF?tX#11__1M 11 1� The Most WeWill Pay The Urnits of Insurance shown in Th L s 0 f n we will pay regardless of the number of. a. Insureds,- b. Clai�ms made or "suits" brought; or c. Persons, or organizations making claims b ri It ringing "suits". 2. Aggregiate Limits The most we will pay f] a. Damages because of "bodfly injury" All 11property damage" included in t ..products-completed operations hazard" the Products-Completed OpieratJo Aggregate Limit shown in Declarations. b. Damages because of all other "bodi injury", "property damage"' or "person and advertising injury including medic expeni,ses, is the General Aggregate Ll ate Ll shown in the Declarations. This General Aggregate Limit appli separately to each of your "loication owned by or rented to you. "Location" means premises �nvolving same or connecting lots, or premis whose connection is interrupted only by street, roadway or flght-of-way of ragroad. Page 14 of 2�4 C'ER7 ,,.Ia -,I 'ZO2 MWN' Sh"i-,gy yo7l qr in,.Ba%on fiv "?.'aim 6 vf 1,2 This General Aggregate limit does not apply to '"property damage" to premises while rented to you or temporarily occupied by you with per on of the owner, arising out of fire, lightning or explosion. 3. Eaoh Occurrence Limit The most we will pay on behalf of a person or organization who is an, additional insured under this Coverage Part is the lesser of., a The limits, of insurance specified in a wdtten contract, written agreement or permit issued by a state or political subdivision: or b. The Limits of Insurance shown in the Declarations. SUch amount shall be a part of and not in addition to the Limits of Insurance shown in the Declarations and described in this Section. 4, Form SS 00 08 04 05 If moire than one limit of insurance under this (1) immedlately send us copies of any policy and any endorsements attachied thereto demands, notices, summonses or applies to any claim or "suit", the most we Wil pay legal papers received in connection under this, policy and the, endorsements is thie with the claim or "suit"; single highest limit of liability of all coverages (2) Authorize US to obtain records and applicable to such claim or "sult". However, this other information; paragraph does riot apply to the Medical Expenses (3) Cooperate with us in the investigation, limit set forth in Paragraph 3. above. settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the "suit"; and separately to each consecutive annual period and to (4) Assist us, upon our request, in the any remaining period of less than 12 months, starting enforcement of any right against any with the begmningi of the policy period shown in the person or organization that may be Declarations, unless the policy i is extended liable to the insured because of injury after issuance for an additional period of less than 12 or damage to which this insurance months. In that case, the additional period will be may also apply. deemed part of the last preceding period for purposes d. Obligations At The Insured's Own Cost of determining the Limits of fturance. E. LIABILITY AND MEDICAL EXPENSES No Insured will, except at that insured's own cost, voluntarily make a payment, assume GENERAL CONDITIONS any obligation, or incur any expense, other 1. Bankruptcy than for first aid, wfthiout our consent. Bankruptcy or insolvency of the insured or of e. Additional Insured"s Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part. Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an Offense, Claim Or Suit additional insured, such additional insured a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the other insurer for defense and indemnity. You or any additional insured must see to However, thus provision: does not apply to it that we are notified as soon as "occurrence" the extent that you have agreed in a practicable of an or an written contract, written agreement or offense which may result in a claim. To permit that this insurance is primary and permit the extent possible, notice should include-. with the additional (1) How, when and where the "occurrence" insured's own !insurance. or offense took place; f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit injured persons and witnesses; and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional insured only when such or damage arising out of the " "occurrence " "" offense, claim or "suit" is 1"occurrence" or offense. known to: b. Notice Of Claim (1) You or any additional insured that is If a claim is made or "suit" is brought an individual; against any insured, you or any additional (2) Any partner, if you or an additional insured must: insured is a partnership; (1) Immediately record the specifics of the (3) Any manager, if you or an additional claim or "'suit" and the date received-, insured is a limitiedi liability company; and (4) Any "executive officer" or insurance (2) Notify us as soon as practicable. managier, if you or an additional You or any additional insured must see to insured is a corporation; it that we receive a written notice of the (5) Any trustee, if you or an additional claim or "suit" as soon as practicable. insured is a trust; or c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you Insured or an additional insured is a political You and any other involved insured miust: subdivision or public entity. Form SS 00 08 04 05 Page 15 of 24 CEF.- TVC"r- 1X%1JW Sh�lff41 y0l _. DT a�^o 7 17 F-MMEMMUIT-14.- MMAMZMMIM*� W-A This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional insured. upon your representations. 3. Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy is certified as proof of Hazards financial responsIbillty for the future under If unintentionally you should fail to disclose, the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inceptoin date of this provided by the policy for "bodfly injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this, Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of T. Other Insurance insurance required by that law. If other valid and collectible insurance is b. With respect to "mobile equipment" to available for a loss we cover under this which this insurance applies, we will Coverage Part, our obliigations are limited as provide any liability, uninsured motorists, follows: underinsured motorists, no-fault or other coverage required by any motor vehicle a. Primary Insurance law. We will provide the required limits for This insurance is primary except when b. those coverages, below applies, If other insurance is also 4. Legal Action Against Us primary, we will share with all that other insurance by the rnethod described in c. No person or organization has a right under below, this Coverage Form: ia" To join us as a party or otherwise bring us b. Excess insurance into a "'suit" asking for damages from an This insurance is excess over any of the insured; or otheir insurance, whether primary, excess, b. To sue us on this Coverage Form unless contingent or on any other basis: all of its terms have been fuilly complied (1), Your Work with. That is Fire, Extended Coverage, A person or organization rnay sue us to recover Builder's Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for "your work"'; against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the temis of That is fire, lightning or explosion this insurance or that are in excess of 'the insurance for premises rented to you applicable limit of insurance. An agreed or temporarily occupied by you with settlement means a settlement and release of permission of the owner-, liability signed by us, the insured and the claimant or the claimant's legal representative. (3) 'Tenant Liability 5. Separation Of Insureds That is insurance purchased by you to Except with respect to tine Limits of Insurance, over your liability as a tenant for "property damage" to premises rented and any rights or duties specifically assigned to you or temporarily occupied by you in this policy to the first Named Insured, this with permission of the owner; insurance applies: (4) Aircraft, Auto Or Watercraft a, As if each Named! Insured were the only Named Insured; and If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to b. Separately to each insured against whom the extent not subject to Exclusion g. of a claim is made or "suit" is brought. Section A. — Coverages. 6. Representations (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of "property (1) The staternents in the Declarations damage" to borrowed equipment or are accurate and complete; the use of elevators to the extent not (2) Those statements are based upon subject to Exclusion k. of Section A. — representations you made to us; and Coverages. Page 16 of 24 Form SS 00 08 04 05 �7 C, 9,1 D �1, i !RVN, 5�,afry Y'orwj AM rp-,V age s of 1,' (6) When You Are Added ' As Ain Additional Insured To Other Insurance (7) When You d As 1 Addonal Insured To T Insurance 1 Form SS 00 08 04 05 R7 N,' 2ii.7v,fr. " ", An�lea Ehe_'ry Yo,m'g 4 ID A M 11 41 1 � 21��=F' If the insured has waived any flghts oif recovery against any person or organ:ization for afl or part of any payment, inicluding Supplementary Payments, we hiave miade under this Coverage Part, we also! waive that right, provided the insured waived their rights of recovery again!st such person or organization in a contract, agreement or permit that was executed pribr to the injury o;r damage, Page 17'of 24 Page 18 of 24 Form SS 00 08 04 05 2 li �?7 F,'-, 02 ITTVPI` w'Pgp fff Page 18 of 24 Form SS 00 08 04 05 2 li �?7 F,'-, 02 ITTVPI` w'Pgp r _111410*1 61 LKIE111-404111 671 DE07111910 insured — State Or Political Subdivision - (a) Any failure to make such Permits, but only with, respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normafly undertakes to subdivision has issued a permit. make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products; additional exclusion's apply: Demonstration, installation, This insurance does not apply to: servicing or repair operations, except such operations performed (1) "Bodity injury", "property damage" or at the vendors prernises in "' "personal and advertising injury" connection with the sale of the arising out of operations performed for product; the state or municipality; or (g) Products which, after distribution (2) "Bodily injury" or "property damage" or sale by you, have been labeled included in the "prodUct-completed or relabeled or used as a operations" hazard. container, part or ingredient of any T. Additional Insuired —Vendors other thing or substance by or for a. WHO iS AN iNSURED under Section C. is the vendor-1 or amilended to include as an additional (h) "Bodily injury" or "property insured the person(s) or organization:(s) damage" arising out of the sole (referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else Injury" or "property damage" arising out of acting on its behalf. However, this .'your products" which are distributed or exclusion does not apply to'. sold in the regular course of the vendors (i) The exceptions contained in business and only if this Coverage Part Subparagraphs (d) or (9; or provides coverage for 'bodily injury' or (ii) Such inspections, "property damage" included within the "products-completed adjustments, tests or servicing operations hazard". as the vendor has agreed to b. The insurance afforded to the vendor is make or normaUy undertakes subject to the following additional exclusions: to make in the usual course of This iinsurance does not apply to: business, in connection with (a) "Bodily injury"' or "property the distribution or sale of the damage" for which the vendor is products. obligated to pay damages by (2) This insurance doles not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products. (b) Any express warranty & Additional Insu'red — Controlling interest unauthorized by you; WHO IS AN INSURED under Section C. is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s), or organization(s) shown in the by the vendor; Declarations as an Additional Insured -- (d) Repackaging, unless unpacked Controlling Interest, but only with respect to solely for the purpose of inspection, their liability arising out of, demonstration, testing, or the a. Their financial control of you; or SLAbsttufion of parts under b. Premises they own, maintain or control instrUCtions from this manufacturer, while you lease or occupy these premises. and then repackaged in the original container-, Form SS 00 08 04 015 Page 1:19 of 24 2G7 7l52r,2 I IRVN, l _ "hef 14r,:'�9:'Qs , ""M This insurance does not apply to structural The firnits of insurance that apply to additional alterations, new construction and demolition insureds are described in Section D. — Limits Of operations performed by or for that person or InSUrance. organization, How this Insurance applies when other insurance 9. Additional Insured — Owners, Lessees Or is available to an additional insured is described in Contractors Scheduled Person Or the Other Insurance Condition in Section E. — Organization Liability And Medical Expenses General a. WHO IS AN' INSURED under Section C. is Conditions, amended to include as an additional G, LIABILITY AND MEDICAL EXPENSES insured the person(s) or organizationi(s) DEFINITIONS shown in the Declarations as an Additional Insured — Owner, Lessees Or Contractors, 1. "Advertisement" means the widespread public but only with respect, to liability for "bodily disslemination of information or images that injury", "property damage" or "personal has the purpose of inducing the sale of goods, and advertising injury" caused, in whole or products or services through: in part, by your acts or omissions or the a. (1) Ra6o; acts or omissions of those acting on your (2) Television; behalf: (3) Billboard; (1) In the performance of your ongoing (4) Magazine; operations for the additional insured(s): or J5) Newspaper; (2) In connection with "your work" b. The Internet but only that part of a web performed for that additional insured site that is about goods, products or and Ilincluded Within the "products- services for the purposes of inducing the completed operations hazard", but sale of goods, products or services; or only if this Coverage Part provides c. Any other publication that is given coverage for "bodily injury" or widespread public distribution. "property damage" included within the However, "advertisement" does not include:. " "products- compiete'd operations a. The design, printed material, information hazard". or images contained in, on or upon the b. With respect to the insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance products; or does not apply to "bodilly injury", "property ti� An interactive conversation between or damage" or "personal an advertising among persons through a computer network. injury" arising out of the rendering of, or the failure to render, any professional 2. "Advertising idea" means any idea for an architectural, engineering or surveying advertisement". services, including: 3. "Asbestos hazard"' means an exposure or (1) The preparing, approvi�ng, or failure to threat of exposure to the actual or alleged prepare or approve, maps, shop properties of asbestos and includes the mere drawings, opinions, reports, surveys, presence of asbestos in any form. field orders, change orders, designs or 4. "Auto"" means a land motor vehicle,, trailer or drawings and specifications; or semi-trailer designed for travel on public (2) Supervisory, inspection, architectuaral roads, including any attached machinery or or engineering activities.. equipment. But "auto" does not include 10, Additional Insured — Co-Owner Of Insured "mobile equipment". Premises 5. "Bodily injury" means physical: WHO IS AN INSURED under Section C. is a,. Injury; amended to include as an additional insured b. Sickness; or the p'erson(s) or Organization(s) shown in the c. Disease Declarations as an Additional Insured — Co- Owner Of insured Premises, but only with sustained by a person and, ff arising out of the respect to their liability as co-owner of the above, mental anguish or death at any time. prernises, shown in the Declarations, 6, "Coverage territory" meanis: Page 20 of 24 HO 2 P�"17C 2<) 2 T R %R T � '? /Z. � ' 4 " a �. t P ! 5 9 2 C, C, 10'1 � T P Form SS 00 08 04 05 A pon- pq PRODUCER Warner Pacific Insurance 32110 Agoura Rd Westlake village CA 91361 ...___!NSURER AEMPlqy�ASsuTarjce Co�ij INSURED EXCLUSIONS AND CONDMONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF EXP' LTR TYPE OF INSURANCE POLICY NUMBER 4MMIDafYYYYV fMM/DD0= LIMITS COMMERCIAL GENERAL LIABILITY WiBuRER.P PHASE 11 SYSTEMS INC, DBA: PARS 4350 VON KARMAN AVE _jNSLkkRC:_""_ _EACH OCCURRENCE DAMAGE T_0_R EINT� a INSURER D SUITE 100 CLAIMS-MADE OCCUR INSURER E_: NEWPORT BEACH CA 92660 1 INSURER F; nnvFP&nPq 1° 1=1 �TlCh�A' C �111 MA')OC MED EXP (Any ane IPeeson) THIS IS TO CERTIFY THAT THE PCUCIES 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 CONDMONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF EXP' LTR TYPE OF INSURANCE POLICY NUMBER 4MMIDafYYYYV fMM/DD0= LIMITS COMMERCIAL GENERAL LIABILITY _EACH OCCURRENCE DAMAGE T_0_R EINT� a CLAIMS-MADE OCCUR _?F mopp) $ — ------ MED EXP (Any ane IPeeson) PERSONAL & ADV INJURY . . . ... . . . ...... .... $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRO- POLICY J T LOC PRODUC OMNOP A29 1 OTHER $ AUTOMOBILE LIABILITY ---COMBINED SINGLE LIMIT $ ANY AUTO r BODILY INJURY (Per person) $ ALL OWNED SCHEDULED .1 .. AUTOS AUTOS BODILY INJURY Per acddeM) 5 NON-OWNED HIRED AUTOS AUTOS _P RUP­E_R_Ty 'b"A" M AG _E_ - Per aq(�L $ .. . UMBRELLA LIAR OCCUR"'!( ....... . . - OCCURRENCE $ EXCESS LIAB CLAIMS MADE . ........ ...... _ AGGREGATE $ DEO I II RETENTION$ S WORKERS COMPENSATION �PER OTH- AND EMPLOYERS' LIABILITY Y/N STATUTE ER . .......... . .. ANY PROPRIETCRiPARTNERIEXECUT'VE F --- I WA E.L. EACH ACCIDENT EXCLUIED? I I A In J31F'I�wEIIIEMBER Mandatory NH) N SMC002110613 4/1/2015 4/1/2016 E.L. DISEASE - EA EMPLOYEd $ GQO 00 It yes, dewIN under DESCRIPTION OF OPERATIONS below I E L. DISEASE - POLICY LIMIT 1$ 1,000,()00 DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attachad if more Woe Is requirsdl TEN DAYS NOTICE FOR CANCELLATION OF NON —PAS' NT. RJ;R Z4, 112 1z1 i MJ 4 #1; 4ZA )19 DATE(MMIDD)YYYY) AFRO® CERTIFICATE OF LIABILITY INSURANCE 712 712 01 5 THIS CERTIFICATE IS ISSU ION ONL 13ON 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 endomement(s). OIT PRODUCER NAMEp __ Risk StrateOlBS Compan .- Risk Strategies Company paoNe FAX 7040 Main [reet. Suite 450 sag- za2 -s2ao II Not; _ CA DOI License No. OF06675 INSURED Phase II Systems dba: PARS 4350 Von Karmen Ave. Ste 100 Newport Beach CA 92660 .,rClna/ .II IRAQ=R. NAIC % COVERAGES utzmi riamic nlunluc =r- col, lv» THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED - - -- ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, BY PAID CLAIMS__ INS9T LTR TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF MMIDDIVYYY 5/812015 POLICY E MMIOD/YY9Y 518/2016 LIMITS EACH OCCURRENCE $ $2,00_0,000 A I COMMERCIAL GENERALLIABILITY ✓ 172SBAAC2429 CLAIMS -MADE OCCUR �J - -- DAMAG�RENTED ­T - PREMISES IS. occunence) 5 $1:000,000 MED EXP (Any one Person)) $ $10,000 PERSONAL &AOV INJURY $ $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY. ✓ PRO LOC JECT PRODUCTS- COMPIOP AGG F:5 $4,000,000 A I OTHER. AUTOMOBILE LIABILITY ,BODILY ANY AUTO _ AUTOS OWNED SCHEDULED AUTOS NON -OWNED ✓.� HIREDAUTOS ✓ AUTOS ! 72SBAAC2429 5/8/2015 / 5/812016 COMBINED SINGLE LIMIT Ea_eccident _._ _ $ _ $2000000 INJURY (Per person) BODILY INJURY (Peraccidenp - PROPERTY DAMAGE Per accidantL_ $ S - - S UMBRELLA LIAR OCCUR O EACH OCCURRENCE $ EXCESS LIAR CIAIMS-_MADE ✓ AGGREGATE $ pER OTH- STATUTE ER _ $ /� _ DED RETENTION $ REPS CO A _ E.L. EACH ACCIDENT �$ AND RS' LI ILIT AND EMPLOYERS' LIABILITY YIN: ANY PROPRIETORIPARTNER)E%ECUTIVE XV E. L. DISEASE -EA EMPLOYEE 8 OFFICER/MEMBER E %GLUDED4 (Mandatory In NH) NIAI - B fyesdescribaunder DESCRIPTION CF OPERATIONS below Professional Liability LDUSA1504508 7130/2015 7/30/2016 E.L. DISEASE - POLICY LIMIT 8 Per Claim: $2,000,000 Aggregate: $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be Hach ad If coons space Is required) Projects as on file with the insured including but not limited to those usual to the insured's operationsIPARS Supplementary Retirement Plan. The City of Santa Ana, its officials, employees and volunteers are named as additional insureds on the general liability policy -see attached endorsement. CERTIFICATE HOLUtR — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Executive Director of Personnel Services ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORRED REPRESENTATIVE Santa Ana CA 92701 i Michael Christian a rnon rnoonCe TlnN All rinhfc reenrved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 2512'/1 C9 15 -16 CA GL- HNOA -PL Sherry Yowg 1 'x/21/2015 9:91:00 AM 1PDV I Pace 1 of 12 72SBAAC2429 BUSINESS LIABILITY COVERAGE FORM 2. Applicable To Medical Expenses Coverage e. A trust, you are an insured. Your trustees are also insureds, but only with respect to We will not pay expenses for "bodily injury": their duties as trustees. a. Any In::ured 2. ". Each of the following is also an insured: To any insured, except "volunteer workers a. Employees And Volunteer Workers b. Hired Person Your "volunteer workers" only while To a person hired to do work for or on behalf performing duties related the conduct of of any insured or a tenant of any insured. your business, or your "employees", other c. Injury On Normally Occupied Premises than either your "executive officers" (if you To a person injured on that part of are an organization other than a premises you own or rent that the person partnership, joint venture or limited liability normally occupies. company) or your managers (if you are a d. Workers' Compensation And Similar limited liability company), but only for acts within the scope of their employment by Laws you or while performing duties related to To a person, whether or not an the conduct of your business. "employee" of any insured, if benefits for However, none of these "employees" or the "bodily injury" are payable or must be "volunteer workers" are insureds for: provided under a workers' compensation or disability benefits law or a similar law. (1) "Bodily injury" or "personal and e. Athletics Activities advertising injury": To a person injured while practicing, (a) To you, to your partners or members (if you are a partnership instructing or participating in any physical or joint venture), to your members exercises or games, sports or athletic (if you are a limited liability contests. company), or to a co- "employee" f. Products- Completed Operations Hazard while in the course of his or her Included with the "products- completed employment or performing duties operations hazard ". related to the conduct of your g. Business Liability Exclusions business, or to your other workers" "volunteer workers while Excluded under Business Liability Coverage. duties related to the C. WHO IS AN INSURED conduct of your business; 1. If you are designated in the Declarations as: (b) To the spouse, child, parent, a. An individual, you and your spouse are brother or sister of that co- "employee" or that "volunteer insureds, but only with respect to the worker" as a consequence of conduct of a business of which you are the Paragraph (1)(a) above; sole owner. b. A partnership or joint venture, you are an (c) For which there is any obligation insured. Your members, your partners, and to share damages with or repay their spouses are also insureds, but only with someone else who must pay respect to the conduct of your business. damages because of the injury described in Paragraphs (1)(a) or c. A limited liability company, you are an (b) above; or insured. Your members are also insureds, (d) Arising out of his or her providing but only with respect to the conduct of your or failing to provide professional business. Your managers are insureds, but health care services. only with respect to their duties as your managers. If you are not in the business of d. An organization other than a partnership, providing professional health care services, Paragraph (d) does not apply joint venture or limited liability company, you to any nurse, emergency medical are an insured. Your "executive officers" and technician or paramedic employed by directors are insureds, but only with respect you to provide such services. to their duties as your officers or directors. Your stockholders are also insureds, but only (2) "Property damage" to property: with respect to their liability as stockholders. (a) Owned, occupied or used by. Page 10 of 24 Form SS 00 08 04 05 2S-,271 D4 15 -1E CA iL-H \OA -3L I Sherry Young 1 7/27/2015 9:41:00 AM IPDT1 page 2 of 12 (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees ", "volunteer workers ", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Real Estate Manager Any person (other than your "employee" or "volunteer worker "), or any organization while acting as your real estate manager. c. Temporary Custodians Of Your Property Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this insurance. e. Unnamed Subsidiary Any subsidiary and subsidiary thereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Part . The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not apply to injury or damage with respect to which an insured under this insurance is also an insurea under another policy or would be an insured under such policy but for its termination or upon the exhaustion of its limits of insurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, and Form SS 00 08 04 06 25]21:c4 15 -16 CA CL- HNOA -PL I Sherry V—no 1 7/27/2015 9:91:00 A PDT) 1 Page 1 of 12 BUSINESS LIABILITY COVERAGE FORM b. Coverage under this provision does not apply to: (1) "Bodily injury" or "property damage" that occurred; or (2) "Personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. 4. Operator Of Mobile Equipment With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is an insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co- "employee" of the person driving the equipment, or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 5. Operator of Nonowned Watercraft With respect to watercraft you do not own that is less than 51 feet long and is not being used to carry persons for a charge, any person is an insured while operating such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co- "employee" of the person operating the watercraft; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written Page 11 of 24 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement, or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; (f) Demonstration, installation, insured under this provision only for that servicing or repair operations, period of time required by the contract, except such operations performed agreement or permit. at the vendor's premises in However, no such person or organization is an connection with the sale of the additional insured under this provision if such product; person or organization is included as an (g) Products which, after distribution additional insured by an endorsement issued or sale by you, have been labeled by us and made a part of this Coverage Part, or relabeled or used as a including all persons or organizations added container, part or ingredient of any as additional insureds under the specific other thing or substance by or for additional insured coverage grants in Section the vendor; or F. — Optional Additional Insured Coverages. "property (h) "Bodily injury" or a. Vendors damage" arising out of the sole Any person(s) or organization(s) (referred to negligence of the vendor for its below as vendor), but only with respect to own acts or omissions or those of "bodily injury" or "property damage" arising its employees or anyone else out of "your products" which are distributed acting on its behalf. However, this or sold in the regular course of the vendors exclusion does not apply to: business and only if this Coverage Part (i) The exceptions contained in provides coverage for "bodily injury" or Subparagraphs (d) or (f); or ,.property damage" included within the .,products-completed operations hazard ". (ii) Such inspections, adjustments, tests or servicing as the vendor (1) The insurance afforded to the vendor has agreed to make or normally is subject to the following additional undertakes to make in the usual exclusionsi course of business, in This insurance does not apply to: connection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contract or agreement. or any ingredient, part or container, This exclusion does not apply to entering into, accompanying or liability for damages that the containing such products. vendor would have in the absence b. Lessors Of Equipment of the contract or agreement; (b) Any express warranty (1) Any person or organization from whom you lease equipment; but only unauthorized by you; with respect to their liability for "bodily (c) Any physical or chemical change injury", "property damage" or in the product made intentionally ..personal and advertising injury" by the vendor; caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 ]5]21104 11i 16 CA GL- HNDA -FL I S.net =y Y0v19 10/21/2C35 9A1:10 AM (PDT) Fage 4 of 12 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but "occurrence" which takes place after only with respect to operations you cease to lease that equipment. performed by you or on your behalf for C. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit . whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) "Bodily injury", "property damage" leased to you or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or insurance does not apply to: municipality; or (a) Any "occurrence" which takes (b) "Bodily injury" or "property damage" "products place after you cease to lease that included within the - ". land or be a tenant in that completed operations hazard premises; or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an insured under Paragraphs a. operations performed by or on through e. above, but only with behalf of such person or respect to liability for "bodily injury", organization. "property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or (1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or the acts or omissions of those acting only with respect to liability for "bodily "personal on your behalf: injury", "property damage" or and advertising injury" caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) In connection with your premises your behalf: owned by or rented to you; or (a) In connection with your premises; (c) In connection with "your work" and or included within the "products - (b) In the performance of your completed operations hazard ", but ongoing operations performed by only if you or on your behalf. (i) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (ii) This Coverage Part provides "bodily injury", "property damage" or coverage for "bodily injury" or "personal and advertising injury" "property damage" included "products arising out of the rendering of or the within the - ". failure to render any professional completed operations hazard services by or for you, including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "Bodily injury", "property damage" or reports, surveys, field orders, "personal and advertising injury" change orders, designs or arising out of the rendering of, or the drawings and specifications; or failure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including: activities. Form SS 00 08 04 05 Page 13 of 24 2S]27104 1 -16 CA .L NO PL S,_y Yacn9 "/!2]/2C 15 9:91:00 AM IPCT J Page 5 of 12 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to "property damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications, or explosion. (b) Supervisory, inspection, 3. Each Occurrence Limit architectural or engineering Subject to 2.a. or 2.b above, whichever activities. applies, the most we will pay for the sum of all The limits of insurance that apply to additional damages because of all "bodily injury", insureds are described in Section D. — Limits "property damage" and medical expenses Of Insurance. arising out of any one "occurrence" is the Liability and Medical Expenses Limit shown in How this insurance applies when other the Declarations. insurance is available to an additional insured is described in the Other Insurance Condition The most we will pay for all medical expenses in Section E. — Liability And Medical Expenses because of "bodily injury" sustained by any General Conditions. one person is the Medical Expenses Limit No person or organization is an insured with shown in the Declarations. respect to the conduct of any current or past 4. Personal And Advertising Injury Limit partnership, joint venture or limited liability Subject to 2.b. above, the most we will pay for company that is not shown as a Named Insured in the sum of all damages because of all the Declarations. "personal and advertising injury" sustained by D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal LIMITS OF INSURANCE and Advertising Injury Limit shown in the Declarations. 1. The Most We Will Pay 5. Damage To Premises Rented To You Limit The Limits of Insurance shown in the The Damage To Premises Rented To You Declarations and the rules below fix the most Limit is the most we will pay under Business we will pay regardless of the number of: Liability Coverage for damages because of a. Insureds: "property damage" to any one premises, while b. Claims made or "suits" brought, or rented to you, or in the case of damage by fire, C. Persons or organizations making claims or lightning or explosion, while rented to you or "suits ". temporarily occupied by you with permission of bringing the owner. 2. Aggregate Limits In the case of damage by fire, lightning or The most we will pay for: explosion, the Damage to Premises Rented To a. Damages because of "bodily injury" and You Limit applies to all damage proximately "property damage" included in the caused by the same event, whether such "products- completed operations hazard" is damage results from fire, lightning or explosion the Products - Completed Operations or any combination of these. Aggregate Limit shown in the 6. How Limits Apply To Additional Insureds Declarations. The most we will pay on behalf a person or b. Damages because of all other "bodily organization who is an additional nal insured injury", "property damage" or "persona l this Coverage Part is the lesser of: and advertising injury", including medical is the General Aggregate Limit a. The limits of insurance specified in a expenses, e shown in the Declarations. written contract, written agreement or permit issued by a state or political This General Aggregate Limit applies subdivision, or separately to each of your "locations" b. The Limits of Insurance shown in the owned by or rented to you . Declarations. "Location" means premises involving the Such amount shall be a part of and not in same or connecting lots, or premises addition to the Limits of Insurance shown in whose connection is interrupted only by a the Declarations and described in this Section. street, roadway or right -of -way of a railroad. Form SS 00 08 04 05 Page 14 of 24 2S -)27-04 1b 16 CA 3L- FNOA -PL I Sterry Young 1 7/31/2015 9:41:00 AM (POT) I Page 6 of 12 Form SS 00 08 04 05 Page 15 of 24 25127104 15 -16 CA GL-HNO -PL I She Y Yocng 1 9/21/2015 9:41:CC AM (PDT) I Page l 01 12 BUSINESS LIABILITY COVERAGE FORM If more than one limit of insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any claim or "suit ", the most we will pay legal papers received in connection "suit "; under this policy and the endorsements is the with the claim or single highest limit of liability of all coverages (2) Authorize us to obtain records and applicable to such claim or "suit ". However, this other information; paragraph does not apply to the Medical Expenses (3) Cooperate with us in the investigation, limit set forth in Paragraph 3. above. settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the "suit", and separately to each consecutive annual period and to (4) Assist us, upon our request, in the any remaining period of less than 12 months, starting enforcement of any right against any with the beginning of the policy period shown in the person or organization that may be Declarations, unless the policy period is extended liable to the insured because of injury after issuance for an additional period of less than 12 or damage to which this insurance months. In that case, the additional period will be may also apply. deemed part of the last preceding period for purposes d. Obligations At The insured's Own Cost of determining the Limits of Insurance. No insured will, except at that insured's own E. LIABILITY AND MEDICAL EXPENSES cost, voluntarily make a payment, assume GENERAL CONDITIONS any obligation, or incur any expense, other than for first aid, without our consent. 1. Bankruptcy Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part. Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an additional insured, such additional insured Offense, Claim Or Suit must submit such claim or "suit" to the a. Notice Of Occurrence Or Offense other insurer for defense and indemnity. You or any additional insured must see to However, this provision does not apply to it that we are notified as soon as the extent that you have agreed in a practicable of an "occurrence" or an written contract, written agreement or offense which may result in a claim. To permit that this insurance is primary and the extent possible, notice should include: non - contributory with the additional (1) How, when and where the "occurrence" insured's own insurance. or offense took place; f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit injured persons and witnesses; and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional insured only when such or damage arising out of the "occurrence ", offense, claim or "suit" is "occurrence" or offense. known to: b. Notice Of Claim (1) You or any additional insured that is If a claim is made or "suit" is brought an individual; against any insured, you or any additional (2) Any partner, if you or an additional insured must. insured is a partnership; (1) Immediately record the specifics of the (3) Any manager, if you or an additional claim or "suit" and the date received; insured is a limited liability company, and (4) Any "executive officer" or insurance (2) Notify us as soon as practicable. manager, if you or an additional You or any additional insured must see to insured is a corporation; it that we receive a written notice of the (5) Any trustee, if you or an additional claim or "suit" as soon as practicable. insured is a trust; or c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you Insured or an additional insured is a political You and any other involved insured must: subdivision or public entity. Form SS 00 08 04 05 Page 15 of 24 25127104 15 -16 CA GL-HNO -PL I She Y Yocng 1 9/21/2015 9:41:CC AM (PDT) I Page l 01 12 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional insured. upon your representations. 3. Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy is certified as proof of Hazards financial responsibility for the future under If unintentionally you should fail to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inception date of this provided by the policy for "bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7, Other Insurance insurance required by that law. If other valid and collectible insurance is b. With respect to "mobile equipment" to available for a loss we cover under this which this insurance applies, we will Coverage Part, our obligations are limited as provide any liability, uninsured motorists, follows: underinsured motorists, no -fault or other a. Primary Insurance coverage required by any motor vehicle law. We will provide the required limits for This insurance is primary except when b. those coverages. below applies. If other insurance is also primary, we will share with all that other 4. Legal Action Against Us insurance by the method described in c. No person or organization has a right under below. this Coverage Form: b. Excesslnsurance a. To join us as a party or otherwise bring us This insurance is excess over any of the into a "suit" asking for damages from an insured; or other insurance, whether primary, excess, contingent or on any other basis: b. To sue us on this Coverage Form unless all of its terms have been fully complied (1) Your Work with. That is Fire, Extended Coverage, A person or organization may sue us to recover Builder's Risk, Installation Risk or "your ": on an agreed settlement or on a final judgment similar coverage for work against an insured, but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of That is fire, lightning or explosion this insurance or that are in excess of the insurance for premises rented to you applicable limit of insurance. An agreed or temporarily occupied by you with settlement means a settlement and release of permission of the owner; liability signed by us, the insured and the (3) Tenant Liability claimant or the claimant's legal representative. That is insurance purchased by you to 5. Separation Of Insureds cover your liability as a tenant for Except with respect to the Limits of Insurance, "property damage" to premises rented and any rights or duties specifically assigned to you or temporarily occupied by you in this policy to the first Named Insured, this with permission of the owner, insurance applies: (4) Aircraft, Auto Or Watercraft a. As if each Named Insured were the only If the loss arises out of the maintenance Named Insured; and or use of aircraft, "autos" or watercraft to b. Separately to each insured against whom the extent not subject to Exclusion g. of a claim is made or "suit" is brought. Section A. — Coverages. 6. Representations (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of "property (1) The statements in the Declarations damage" to borrowed equipment or are accurate and complete; the use of elevators to the extent not subject to Exclusion k. of Section A. — (2) Those statements are based upon Coverages. representations you made to us; and Page 16 of 24 Form SS 00 08 04 05 rv29139 1 15 16 cN c1- HNOA -PL I ghe=rY Yuu-�g 1 7/27/2015 9:41:00 AM (POT) I Page a Of 12 BUSINESS LIABILITY COVERAGE FORM (6) When You Are Added As An When this insurance is excess over other Additional Insured To Other insurance, we will pay only our share of Insurance the amount of the loss, if any, that exceeds the sum of: That is other insurance available to liability for damages (1) The total amount that all such other you covering insurance would pay for the loss in the arising out of the premises or operations, or products and completed absence of this insurance; and operations, for which you have been (2) The total of all deductible and self - added as an additional insured by that insured amounts under all that other insurance, or insurance. (7) When You Add Others As An We will share the remaining loss, if any, with Additional Insured To This any other insurance that is not described in Insurance this Excess Insurance provision and was not That is other insurance available to an bought specifically to apply in excess of the additional insured. Limits of Insurance shown in the Declarations of this Coverage Part . However, the following provisions apply to other insurance available to c. Method Of Sharing any person or organization who is an If all the other insurance permits additional insured under this Coverage contribution by equal shares, we will follow Part this method also. Under this approach. (a) Primary Insurance When each insurer contributes equal amounts Required By Contract until it has paid its applicable limit of is if insurance or none of the loss remains, This insurance primary you whichever comes first. have agreed in a written contract, written agreement or permit that If any of the other insurance does not permit this insurance be primary. If other contribution by equal shares, we will insurance is also primary, we will contribute by limits. Under this method, each share with all that other insurance insurer's share is based on the ratio of its by the method described in C. applicable limit of insurance to the total applicable limits of insurance of all insurers. below. (b) Primary And Non - Contributory 8. Transfer Of Rights Of Recovery Against To Other Insurance When Others To Us Required By Contract a. Transfer Of Rights Of Recovery If you have agreed in a written If the insured has rights to recover all or contract, written agreement or part of any payment, including permit that this insurance is Supplementary Payments, we have made primary and non - contributory with under this Coverage Part, those rights are the additional insured's own transferred to us. The insured must do insurance, this insurance is nothing after loss to impair them. At our primary and we will not seek request, the insured will bring "suit" or contribution from that other transfer those rights to us and help us insurance. enforce them. This condition does not Paragraphs (a) and (b) do not apply to apply to Medical Expenses Coverage. other insurance to which the additional b. Waiver Of Rights Of Recovery (Waiver insured has been added as an Of Subrogation) additional insured. If the insured has waived any rights of When this insurance is excess, we will recovery against any person or have no duty under this Coverage Part to organization for all or part of any payment, defend the insured against any "suit" if any including Supplementary Payments, we other insurer has a duty to defend the have made under this Coverage Part, we insured against that "suit ". If no other also waive that right, provided the insured insurer defends, we will undertake to do waived their rights of recovery against so, but we will be entitled to the insured's such person or organization in a contract, rights against all those other insurers. agreement or permit that was executed prior to the injury or damage. Page 17 of 24 Form SS 00 08 04 05 21]2]1'39 15 -16 CA GL- HNGA -FL I S_"e y Yo¢n� ]/2]/1015 9:91:C0 AM (PL)':1 2aC¢ 9 O`_ 12 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED 3. Additional Insured - Grantor Of Franchise COVERAGES WHO IS AN INSURED under Section C. is amended to include as an additional insured If listed or shown as applicable in the Declarations, the person(s) or organization(s) shown in the one or more of the following Optional Additional Declarations as an Additional Insured - Insured Coverages also apply. When any of these Grantor Of Franchise, but only with respect to Optional Additional Insured Coverages apply, their liability as grantor of franchise to you Paragraph 6. (Additional Insureds When Required 4. Additional Insured - Lessor Of Leased by Written Contract, Written Agreement or Permit) Equipment of Section C., Who Is An Insured, does not apply to the person or organization shown in the a. WHO IS AN INSURED under Section C. is Declarations. These coverages are subject to the amended to include as an additional terms and conditions applicable to Business insured the person(s) or organization(s) Liability Coverage in this policy, except as shown in the Declarations as an Additional provided below: Insured — Lessor of Leased Equipment, "bodily 1. Additional Insured - Designated Person Or but only with respect to liability for 'personal injury", "property damage' or Organization and advertising injury" caused, in whole or WHO IS AN INSURED under Section C. is in part, by your maintenance, operation or amended to include as an additional insured use of equipment leased to you by such the person(s) or organization(s) shown in the person(s) or organization(s). Declarations, but only with respect to liability 'property b. With respect to the insurance afforded to for "bodily injury", damage' or "personal and advertising injury" caused, in these additional insureds, this insurance 'occurrence" does not apply to any which whole or in part, by your acts or omissions or takes place after you cease to lease that the acts or omissions of those acting on your behalf: equipment. a. In the performance of your ongoing 5. Additional Insured - Owners Or Other From Whom Land Has Been operations; or Interests b. In connection with your premises owned Leased WHO IS AN INSURED under Section C. is by or rented to you. a. amended to include as an additional 2. Additional Insured - Managers Or Lessors insured the person(s) or organization(s) Of Premises shown in the Declarations as an Additional a. WHO IS AN INSURED under Section C. is Insured — Owners Or Other Interests From amended to include as an additional insured Whom Land Has Been Leased, but only the person(s) or organization(s) shown in the with respect to liability arising out of the Declarations as an Additional Insured - ownership, maintenance or use of that part Designated Person Or Organization; but only of the land leased to you and shown in the with respect to liability arising out of the Declarations. ownership, maintenance or use of that part of b, With respect to the insurance afforded to the premises leased to you and shown in the these additional insureds, the following Declarations. additional exclusions apply: b. With respect to the insurance afforded to This insurance does not apply to: these additional insureds, the following (1) Any 'occurrence' that takes place additional exclusions apply: after you cease to lease that land; or This insurance does not apply to: (2) Structural alterations, new (1) Any 'occurrence' which takes place construction or demolition operations after you cease to be a tenant in that performed by or on behalf of such premises; or person or organization. (2) Structural alterations, new 6. Additional Insured - State Or Political construction or demolition operations Subdivision — Permits performed by or on behalf of such a. WHO IS AN INSURED under Section C. is person or organization. amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Form SS 00 08 04 05 Page 18 of 24 1nn:e9 15 16 �A 11 110A P. I Sherry YJu -7j 1 7/20 /2015 9:91:00 " (PDT) ' - 'a of 13 BUSINESS LIABILITY COVERAGE FORM Insured — State Or Political Subdivision - (e) Any failure to make such inspections, adjustments, tests or Permits, but only with respect to servicing as the vendor has agreed operations performed by you or on your to make or normally undertakes to behalf for which the state or political make in the usual course of subdivision has issued a permit. business, in connection with the b. With respect to the insurance afforded to distribution or sale of the products; these additional insureds, the following (f) Demonstration, installation, additional exclusions apply: servicing or repair operations, This insurance does not apply to: except such operations performed (1) "Bodily injury ", "property damage" or at the vendor's premises in "personal and advertising injury" connection with the sale of the ari -ing out of operations performed for product; the state or municipality; or (g) Products which, after distribution (2) "Bodily Injury" or "property damage" or sale by you, have been labeled included in the "product- completed or relabeled or used as a operations" hazard. container, part or ingredient of any 7. Additional Insured— Vendors other thing or substance by or for WHO IS AN INSURED under Section C. is the vendor, or a. amended to include as an additional (h) "Bodily injury" or "property the sole insured the person(s) or organization(s) damage" arising out of negligence of the vendor for its (referred to below as vendor) shown in the own acts or omissions or those of Declarations as an Additional Insured - Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However, this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendor's (i) The exceptions contained in business and only if this Coverage Part Subparagraphs (d) or (f); or provides coverage for "bodily injury" or (ii) Such inspections, "property damage" included within the adjustments, tests or servicing "products- completed operations hazard ". as the vendor has agreed to b. The insurance afforded to the vendor is make or normally undertakes subject to the following additional exclusions: to make in the usual course of (1) This insurance does not apply to: business, in connection with the distribution or sale of the (a) "Bodily injury" or "property products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by of the assumption of insured person or organization from reason liability in a contract or agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products. warranty 8. Additional Insured — Controlling Interest (b) Any express C. is unauthorized by you; WHO IS AN INSURED under Section (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor; Declarations as an Additional Insured — (d) Repackaging, unless unpacked Controlling Interest, but only with respect to their liability arising out of: sc',ely for the purpose of inspection, demonstration, testing, or the a. Their financial control of you; or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container; Page 19 of 24 Form SS 00 08 04 05 2572"104 15 -16 CA GL-YNCA -PL I '.Irl Yocnq �/29/YO15 9:93:00 AM (PDT) Page 11 of 12 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural alterations new construction and demolition operations performed by or for that person or organization. 9. Additional Insured — Owners, Lessees Or Contractors — Scheduled Person Or Organization a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured — Owner, Lessees Or Contractors, 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: (1) In the performance of your ongoing operations for the additional insured(s); or (2) In connection with "your work" performed for that additional insured and included within the "products - completed operations hazard ", but only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products- completed operations hazard ". b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to "bodily injury", "property damage" or "personal an advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. 10. Additional Insured — Co -Owner Of Insured Premises WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or Organization(s) shown in the Declarations as an Additional Insured — Co- Owner Of Insured Premises, but only with respect to their liability as co -owner of the premises shown in the Declarations. The limits of insurance that apply to additional insureds are described in Section D. — Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 1. "Advertisement" means the widespread public dissemination of information or images that has the purpose of inducing the sale of goods, products or services through: a. (1) Radio; (2) Television; (3) Billboard; (4) Magazine; (5) Newspaper; b. The Internet, but only that part of a web site that is about goods, products or services for the purposes of inducing the sale of goods, products or services; or c. Any other publication that is given widespread public distribution. However, "advertisement" does not include: a. The design, printed material, information or images contained in, on or upon the packaging or labeling of any goods or products; or b. An interactive conversation between or among persons through a computer network. 2. "Advertising idea" means any idea for an "advertisement ". 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4. "Auto" means a land motor vehicle, trailer or semi - trailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment". 5. "Bodily injury" means physical: a. Injury; b. Sickness; or c. Disease sustained by a person and, if arising out of the above, mental anguish or death at any time. 6. "Coverage territory" means: Form SS 00 08 04 05 Page 20 of 24 2s'R 1109 =5 d6 cA GL HNOA -el I ShIlly i.c, z /27/2015 9:91:00 AM ("T) sage 12 ` 12 o THE CITY OF SANTA ANA PUBLIC AGENCY RETIREMENT SYSTEM (PARS) SUPPLEMENTARY RETIREMENT PLAN RESTATED EFFECTIVE JULY 1, 2011 DEFINED BENEFIT NBI:790420.2 TABLE OF CONTENTS Page ARTICLE I­ PARTICIPATION 1.1 Eligibility for Benefits .................. ................................................. .................................. 5 1-2 Commencement uf Benefits ............................................................................................... 6 1.3 y .................. —............................................................ ^................................... 6 1.4 Approved Leave of Absence ......... —........ .................. --.......................................... ..6 ARTICLE ]0-BENEFITS 2.1 Retirement Benefitn— ....................................................... ................................................ 7 2.2 Survivor Continuance Benefit .......................................... ................................................. 7 2.3 Benefit ... ................................................................................. 7 2.4 Death BemtfiL-------..--_---_ .......... ............................... 7 ARTICLE III -VESTING 3] Vesting ............ .................................. ............................................................................... 4 3.2 Full orPartial ---.---------------_-----------,..0 3.3 Attairu-nent of Normal Retirement Age ................................ —................. ...................... 9 8'4 Effect of Vesting .................................................. ............................................................. y ARTICLE IV - DISTRIBUTIONS 4.1 Normal }Porozof Benefit --.... .................................................. ................................... lU 4.2 ()nfomal Fon-nm0f Benefit ............................................................................................... ll 4[3 Limitations ...................... ........................... .................................................................... Il 4.4 Cash Out of Small Benefits .................. ........................................................................... |X 4.5 /\o1uuzol Equivalence .......................................... .................................... ................... is 4.6 Direct Rollovers ......................................................................................... .... — ........ ..... 18 AR71 I ICLE V - ADMDNISTRATION AND AMENDMENT OF PLAN 5.1 Mnzobcc"o Rights not Subject Co Execution ........ ............................................................ 2X 5.2 Rules and Regulations --------_----------_--___---------2l 5.3 Amendment and 1[uo-niooti0o ......... .................................. ........................... ...... .......... 23 5.4 Military Service ... ......................... ..... ............................ .............. — ............. ............. Z} 5.5 Administrative Expenses ................ -----....................... ............... ........... _ ....... 23 No|�7wn%02 2 CONT. TABLE OF CONTENTS ARTICLE VI - ANNUAL BENEFIT LIMITATIONS 6,1 Definitions and Application .................................. ............. ............................................ 24 6.2 Annual Limitation on Benefits ............................................................................... - ........ 25 ARTICLE VII - DEFINITIONS 7.1 Definitions ......... ................................................................... ....... ................................ - 29 N 131:790420.2 3 INTRODUCTION The City of Santa Ana (hereinafter referred to as the "Employer") has adopted this tax- qualified governmental defined benefit plan for the benefit of its eligible employees to provide supplemental retirement beriefits, to eligible Employees of the Employer in addition to the benefits employees will receive frorn the California Public Employees' Retirement System ("CalPERS"). This document is a full and complete restatement of the City of Santa Ana PARS Supplementary Retirement Plan adopted effective April 18, 2011, and further amended effective July 1, 2011 and October 21, 2011, respectively. It is intended that this Plan and the Trust established to hold the assets of the Plan shall be qualified under Section 401(a) and tax-exempt under Section 501(a) of the Internal Revenue Code of 1986, together with any amendments thereto ("Code"). It is further intended that this Plan and the Trust established hereunder shall meet the requirements of a pension trust under California Government Code Sections 53215 - 53224, or their successor sections ("Act") Furthermore, this Plan is intended to satisfy the requirements of a "governmental plan" as defined in Section 414(d) of the Code and that the Plan is exempt from the nondiscrimination requirements and minimum coverage requirements of Section 401 (a) of the Code. At any time prior to the satisfaction of all liabilities with respect to Members and their Beneficiaries under the Trust created pursuant to this Plan, the Trust assets shall not be used for, or diverted to, purposes other than the exclusive benefit of Meinbers or their Beneficiaries, as prescribed in Section 401(a)(2) of the Code. It is intended that the Plan satisfy the requirements of the applicable provisions of the legislation, regulations and other guidance set forth in Notice 2014-77, and that the provisions of this Plan reflecting such requirements are hereby made effective as of the dates required by the legislation, regulations, or guidance referred to in this sentence. NB 1:790420.2 4 ARTICLE I PARTICIPATION 1.1 Eligibility for Benefits An Employee shall be eligible to receive Retirement Benefits under this Plan if he or she meets the eligibility requirements under one of the following tiers: Tier I (a) is an Employee of the Employer represented by the Police Officers Association on or after July 1, 2009; (b) is at least fifty (50) years of age and has completed at least five (5) years of continuous employment with the Employer immediately preceding the last day of employment with the Employer; (c) received a salary increase on July 1, 2009 and/or January 1, 2010, which was not recognized by CalPERS for purposes of computing Final Pay; (d) has terminated employment with the Employer and concurrently retired under CalPERS on or before December 31, 2010, and remains in retired status under CalPERS; and (c) has applied for benefits under this Plan. Tier 11 (a) is an Employee of the Employer serving as the Union President for the Police Officers Association on July 1, 2011; (b) is at least fifty (50) years of age and has completed at least five (5) years of continuous employment with the Employer immediately preceding the last day of employment with the Employer; (c) received a Union Pay Premium which was not recognized by CalPERS for purposes of computing Final Pay; (d) has terminated employment with the Employer and concurrently retires under CalPERS on or before December 31, 2011, and remains in retired status under CalPERS; and (e) has applied for benefits under this Plan. NB 1:790420.2 5 1.2 Commencement of Benefits Benefits shall commence as of the first day of the first month after an Employee meets the eligibility requirements of Section 1. 1, and may be made retroactive to such date. 1.3 Participation An Employee will be credited with one (1) Year of Participation for any year during which the Employee meets the requirements of Section 1.1(a). 1.4 Approved Leave of Absence An Employee whoo is on an approved leave of absence pursuant to the Employer's personnel rules shall not incur a break in service for purposes of this Plan. NB I ! 790420.2 6 ARTICLE 11 BENEFITS 2.1 Retirement Benefits The Retirement Benefit shall be paid in the Normal Form of Benefit and shall be an amount equal to one-twelfth (1/12) of the product of the Member's Benefit Service, times the Member's Final Pay, times the CaIPERS Benefit Factor at retirement. 2.2 Survivor Continuance Benefit No Survivor Continuance Benefit shall be provided under the Plan. 2.3 Pre-Retirement Disability Benefit No Pre-Retirement Disability Benefits shall be provided under the Plan. 2.4 Pre-Retirement Death Benefit No Pre-Retirement Death Benefits shall be provided under the Plan. 2.5 Designation of Beneficiary (a) Each Member shall have the right to designate a Beneficiary to receive the death benefits, if any, that arc payable to a Beneficiary from this Plan. Such designation does not pernift the Member to change a person identified under another provision of the Plan as being eligible to receive a benefit. Such designation iriust be evidenced by a written instrument filed with the Employer, on a form prescribed by the Employer, and signed by the Member, (b) The Beneficiary for a married Member shall be the Member's spouse at the date of death, unless the written consent of such spouse is provided upon a form acceptable to the Employer. Each such designation for death benefits must be evidenced by a written instrument filed with the Employer, on a form prescribed by the Employer, and signed by the Member. If NB 1 :790420 2 7 no such designation is on file with the Employer at the time of the death of the Member, or if for any reason at the sole discretion of the Employer, such designation is defective, then the spouse of such Member shall be conclusively deemed to be the Beneficiary designated to receive such benefit. (c) The signature of the Member's spouse shall be required on a designation of beneficiary forrn or an application for a benefit under the Plan if the spouse is not the beneficiary, unless the Member declares in writing that one of the following conditions exists: (1) The Member is not married; (2) The Member does not know, and has taken all reasonable steps to determine the whereabouts of the spouse; (3) The spouse is incapable of executing the acknowledgment because of an incapacitating mental or physical condition; (4) The Member and spouse have executed a marriage settlement agreement that n-iakes the community property laws inapplicable to the marriage; or (5) The current spouse has no identifiable community property interest in the benefits. (d) Effective January 1, 2005, for purposes of this Section 2.5 only, all references in this Section 2.5 to the term "marriage" shall also include the terin "registered domestic partnership." All references to the term "married" shall also include "registered domestic partnership" and all references in this Section 2,5 to the term "spouse" shall also include the term "registered domestic partner." The inclusion of "registered domestic partner" in the definition of "spouse" shall not apply for the purposes of Sections 4.3, 4.6 and 6.2. NB I :790420.2 8 ARTICLE III VESTING 3.1 Vesting A Member will be fully Vested in his or her Retirement Benefit upon meeting the requirements of Section 1.1, 3.2 Full or Partial Termination Notwithstanding the vesting schedule, upon the complete discontinuance of Employer contributions to the Plan or upon any full or partial termination of the Plan, the Member's Retirement Benefit shall become one hundred percent (I O0%) Vested. 3.3 Attainment of Normal Retirement Age A Member shall be fully Vested in his or her Retirement Benefit upon attainment of Normal Retirement Age and fulfilling all requirements established in Section 1.1. 3.4 Effect of Vesting Vesting shall entitle a Member to payment during his or her lifetime of the Retirement Benefit at the times and upon the conditions specified herein, and shall entitle the Member's survivor or Beneficiary to any death benefits provided herein. Any unpaid Retirement Benefits are forfeited upon the Member's death under the Normal Form of Benefit. NB 1!790420.2 9 ARTICLE IV DISTRIBUTIONS 4.1 Normal Form of Benefit Payments to a Member of a Retirement Benefit shall be made in the form of monthly payments commencing pursuant to Section 1.2 and ending on the first day of the month, in which the Member's death occurs, in the amount specified in Section 2.1. The Retirement Benefit shall be subject to an annual compounding cost-of-living adjustment effective on the anniversary date of commencement of the Retirement Benefit. The amount of such cost of living adjustment shall be two percent (2%) per year, provided that the payment for any year shall not exceed the payment that would have resulted from the cumulative application since the date of benefit commencement (on an annually- compounded basis) of the lesser of (i) a two percent (2%) annual increase, or (ii) an annual increase equal to the increase in the Consumer Price Index for All Urban Consumers issued by the Bureau of Labor Statistics. For avoidance of doubt, if the application of the foregoing proviso causes the increase to the payment in any year to be less than two percent (2%), then the increase to the payment in any subsequent year may be greater than two percent (2%). Furtben-nore, in no circumstances shall the amount of the payment be decreased. This form of payment shall be the "Normal Form of Benefit." The Retirement Benefit shall cease for any Member who returns to active CalPERS status and shall recommence as of the first day of the month after the Men-iber returns to retired status under CaIPERS at the same benefit amount and option inii-nediately prior to the suspension of benefits. NB 1 :790420.2 10 4.2 Optional Forms of Benefit No Optional Forms of Benefit are permitted under this Plan. All references throughout the Plan to other forms of payout, with the exception of Section 4.4, survivor continuance benefits, and/or Beneficiary designation shall have no bearing on the Plan until such time, if any, the Plan is amended to provide for other forms of payout. 4.3 Limitations (a) In the case of a Member who attains age 70-112, distribution of such Member's entire interest must commence not later than the first day of April following the later of the calendar year in which such Member attains age 70-1/2 or the calendar year in which the Member retires (the "Required Beginning Date"). In all cases, distributions shall be made in at least the amounts determined in accordance with Section 401(a)(9) of the Code and the regulations thereunder, as described in Section 4.3(b) below. (b) With respect to required i-ninimum distributions under this Section 4.3 for calendar years beginning after December 31, 2002, the following rules shall apply: (1) All distributions required under this Section 4.3 shall be determined and made in accordance with the Treasury Regulations under Section 401(a)(9) of the Code. The requirements of this Section 4.3 will take precedence over any inconsistent provisions of the Plan, provided that this Section 4.3 shall not be considered to allow a Member or Beneficiary to delay a distribution or elect an optional form of benefit not otherwise provided in the Plan. (2) Time and Manner of Distribution (A) The Member's entire interest will begin to, be distributed to the Member no later than the Member's Required Beginning Date as defined in Section 4.3(a). NB 1:790420.2 (B) If the Member dies before distributions begin, then the Member's entire interest will begin to be distributed no later than as follows: (1) If the Member's surviving spouse is the Member's sole designated Beneficiary, then distributions to the surviving spouse will begin by December 31 of the calendar year immediately following the calendar year in which the Member died, or by December 31 of the calendar year in which the Member would have attained age 70-1/2, if later. (11) If the Member's surviving spouse is not the Member's sole designated Beneficiary, then distributions to the designated Beneficiary will begin by December 31 of the calendar year immediately following the calendar year in which the Member died. (111) If there is no designated Beneficiary as of September 30 of the year following the year of the Member's death, the Member's entire interest will be distributed by December 31 of the calendar year containing the fifth anxilversary of the Member's death. (IV) If the Member's surviving spouse is the Member's sole designated Beneficiary and the surviving spouse dies after the Member but before distributions to the surviving spouse begin, this Section 43(b)(2)(B), other than Section 43(b)(2)(13)(1), will apply as if the surviving spouse were the Member. For purposes of this Section 4.3(b)(2)(B) and Section 43(b)(5), distributions are considered to begin on the Member's Required Beginning Date (or, if Section 43(b)(2)(B)(IV) applies, the date distributions are required to begin NBI:790420.2 12 to the surviving spouse under Section 43(b)(2)(13)(1)). If annuity payments irrevocably commence to the Member before the Member's Required Beginning Date (or to the Member's surviving spouse before the date distributions are required to begin to the surviving spouse under Section 4.3(b)(2)(13)(1)), the date distributions are considered to begin is the date distributions actually commence. (C) Unless the Member's interest is distributed in the form of an annuity purchased from an insurance company or in a single sum on or before the Required Begim-fing Date, as of the first distribution calendar year distributions will be made in accordance with Sections 4.3(b)(3), (4) and (5). If the Member's interest is distributed in the form of an annuity purchased from an insurance company, distributions there-Linder will be made in accordance with the requirements of Section 401 (a)(9) of the Code and the Treasury Regulations. (3) Determination of Amount to be Distributed Each Year (A) If the Member's interest is paid in the form of annuity distributions under the Plan, payments under the annuity will satisfy the following requirements: (I) the annuity distributions will be paid in periodic payments made at intervals not longer than one year; (11) the distribution period will be over a life (or lives) or over a period certain not longer than the period described in Sections 4,3(b)(4) or (5); (111) once payments have begun under a fixed-term payout under Section 4.2 (if such a benefit is available), the fixed-term payout period NB 790420.2 13 will not be changed even if the period certain is shorter than the maximum permitted; (IV) payments will either be non-increasing or increase only as follows: (1) by an annual percentage increase that, does not exceed the annual percentage increase in a cost-of-living index that is based on prices of all items and issued by the Bureau of Labor Statistics; (11) to the extent of the reduction in the amount of the Member's payments to provide for a survivor benefit upon death, but only if the Beneficiary whose life was being used to determine the distribution period described in Section 43(b)(4) dies or is no longer the Member's Beneficiary pursuant to a qualified dornestic relations order within the meaning of Section 414(p) of the Code; or (iii) to pay increased benefits that result from a Plan amendment, (13) The arnount that must be distributed on or before the Member's Required Beginning Date (or, if the Member dies before distributions begin, the date distributions are required to begin tinder Sections 43(b)(2)(13)(1) or (11)) is the payment that is required for one payment interval. The second payment need not be made until the end of the next payment interval even if that payment interval ends in the next calendar year. Payment intervals are the periods for which payments are received, e.g., bi-monthly, monthly, semi-annually, or NBI:790420.2 14 annually. All of the Member's benefit accruals as of the last day of the first distribution calendar year will be included in the calculation of the amount of the annuity payments for payment intervals ending on or after the Member's Required Beginning Date, (C) Any additional benefits accruing to the Member in a calendar year after the first distribution calendar year will be distributed beginning with the first payment interval ending in the calendar year immediately following the calendar year in which such amount accrues. (4) Requirements For Annuity Distributions That Commence During Member's Lifetime (A) If the Member's interest is being distributed in the form of a benefit described in Section 4.2 for the joint lives of the Member and a nonspouse Beneficiary, annuity payments to be made on or after the Member's Required Begiiining Date to the designated Beneficiary after the Member's death must not at any time exceed the applicable percentage of the annuity payment for such period that would have been payable to the Member using the table set forth in Q&A-2 of Section 1,401(a)(9)-6 of the Treasury Regulations. If the form of distribution combines a benefit described in Section 4.2 for the Joint lives of the Member and a nonspouse Beneficiary and a fixed -term payout annuity, the requirement in the preceding sentence will apply to annuity payments to be made to the designated Beneficiary after the expiration of the fixed -term payout period. (B) Unless the Member's spouse is the sole designated Beneficiary and the fora -i of distribution is a fixed -term payout annuity, the fixed -tens payout period for an annuity distribution commencing during the Member's lifetime may N[31:790420.22 1 5 not exceed the applicable distribution period for the Member under the Uniform Lifetime Table set forth in Section 1.401(a)(9)-9 of the Treasury Regulations for the calendar year that contains the annuity starting date. If the benefit commencement date precedes the year in which the Member reaches age 70, the applicable distribution period for the Member is the distribution period for age 70 under the Uniform Lifetime Table set forth in Section 1.401(a)(9)-9 of the Treasury Regulations plus the excess of 70 over the age of the Member as of the Member's birthday in the year that contains the benefit commencement date. If the Member's spouse is the Member's sole designated Beneficiary and the form of distribution is a fixed-term payout annuity, tlie fixed-term payout period may not exceed the longer of the Member's applicable distribution period, as determined under this Section 4.3(b)(4), or the joint life and last survivor expectancy of the Member and the Member's spouse as determined under the Joint and Last Survivor Table set forth in Section 1.401(a)(9)-9 of the Treasury Regulations, using the Member's and spouse's attained ages as of the Member's and spouse's birthdays in the calendar year that contains the benefit commencement date. (5) Requirements For Minimum Distributions Where Member Dies Before Date Distributions Begin (A) If the Member dies before the date distribution of his or her interest begins and there is a designated Beneficiary, the Member's entire interest will be distributed, beginning no later than the time described in Sections 4.3(b)(2)(B)(1) or (11), over the life of the designated Beneficiary or over a fixed -tern payout period not exceeding: NB I �790420.2 16 (1) unless the benefit commencement date is before the first distribution calendar year, the life expectancy of the designated Beneficiary is determined using the Beneficiary's age as of the Beneficiary's birthday in the calendar year immediately following the calendar year of the Member's death; or (11) if the benefit commencement date is before the first distribution calendar year, the life expectancy of the designated Beneficiary is determined using the Beneficiary's age as of the Beneficiary's birthday in the calendar year that contains the benefit commencement date. (B) If the Member dies before the date distributions begin and there is no designated Beneficiary as of September 30 of the year following the year of the Member's death, distribution of the Member's entire interest will be completed by December 31 of the calendar year containing the fifth anniversary of the Member's death. (C) If the Member dies before the date distribution of his or her interest begins, the Member's surviving spouse is the Member's sole designated Beneficiary, and the surviving spouse dies before distributions to the surviving spouse begin, this Section 4.3(b)(5) will apply as if the surviving spouse were the Member, except that the time by which distributions must begin will be determined without regard to Section 4.3(b)(2)(B)(1). (6) Definitions (A) Designated Beneficiary. The individual who is designated as the Beneficiary Linder Section 2.5 and is the designated Beneficiary under Section NB 1:790 420.2 17 401(a)(9) of the Code and Section 1,401(a)(9)-I, Q&A-4, of the Treasury Regulations. (B) Distribution Calendar Year. A calendar year for which a minimum distribution is required. For distributions beginning before the Member's death, the first distribution calendar year is the calendar year immediately preceding the calendar year that contains the Member's Required Beginning Date. For distributions beginning after the Member's death, the first distribution calendar year is the calendar year in which distributions are required to begin pursuant to Section 4.3(b)(2)(B). (C) Life Expectancy, Life expectancy as computed by use of the Single Life Table in Section 1.401(a)(9)-9 of the Treasury Regulations. (D) Required Beginning Date. The date set forth in Section 4.3(a). 4.4 Cash Out of Small Benefits If the Actuarial Equivalence of a Member's Normal Retirement Benefit is less than $5,000 at the time of termination of employment, such benefit shall be paid as a single cash lump sum, if authorized by the Plan Administrator, in lieu of any other benefits hereunder, 4.5 Actuarial Equivalence Actuarial Equivalence shall be determined using the mortality assumption based on the 1.983 Group Annuity Mortality (GAM) table and the interest assumption shall be 6% per annum. 4.6 Direct Rollovers (a) Notwithstanding any provision of the Plan to the contrary that would otherwise limit a distributee's election under this Plan, a distributes may elect, at the time and in the manner prescribed by the Plan Administrator, to have any portion of an eligible rollover distribution paid NE31:7904202 1 8 directly to an eligible retirement plan specified by the distributce in a direct rollover. A distributee includes an Ernployce or former Employee. In addition, the Employee's or former Employee's surviving spouse and the Employee's or former Employee's spouse or former spouse who is the alternate payee under a qualified domestic relations order, as defined in Section 414(p) of the Code, are distributces with regard to the interest of the spouse or former spouse. (b) A Beneficiary who is not the spouse of the Member may elect a direct trustee to trustee transfer that qualifies as an eligible rollover distribution under this Section 4,6. Such transfer shall be made to an individual retirement plan described in Section 40,8(a) of the Code or a Roth IRA described in Section 408A of the Code that is established for the purpose of receiving the distribution on behalf of such Beneficiary. Such individual retirement account shall be deemed an inherited IRA pursuant to the provisions of Section 402(c)(1.1) of the Code. Also, in this case, the determination of any required minimum distribution under Section 401(a)(9) of the Code that is ineligible for rollover shall be made in accordance with Notice 2007-7, Q&A 17 and 18, 2007-5 I.R.B. 395. (1) Definitions (A) Eligible Rollover Distribution An eligible rollover distribution is any distribution of all or any portion of the balance to the credit of the distributee, except that an eligible rollover distribution does not include the following: (i) any distribution that is one of a series of substantially equal periodic payments (not less frequently than annually) made for the life (or the life expectancy) of the distributee or the .joint lives (or joint life expectancies) of the distributee and the distributee's designated Beneficiary, or for a specified period of ten (10) years or more; (ii) any distribution to the extent such distribution is required Linder Section 401(a)(9) of the Code; and (iii) any hardship NB 1:79042U 19 distribution. A portion of a distribution shall not fail to be an eligible rollover distribution merely because the portion consists of after -tax employee contributions which are not includible in gross income. However, such portion may be transferred only: (A) to an individual retirement account or annuity described in Section 408(a) or (b) of the Code, a Roth IRA described in Section 408A of the Code or (B) to a qualified defined contribution, defined benefit or annuity plan described in Section 401(a) of the Code or Section 403(b) of the Code, that agrees to separately account for amounts so transferred (and earnings thereon), including separately accounting for the portion of the distribution that is ineludible in gross income and the portion of the distribution that is not so includible. (B) Eligible Retirement Plan An eligible retirement plan is an individual retirement account described in Section 408(a) of the Code, an individual retirement annuity described in Section 408(b) of the Code, a qualified plan described in Section 401(a) of the Code that accepts the distributee's eligible rollover distribution, an annuity contract described in Section 403(b) of the Code, a Roth IRA described in Section 408A of the Code and an eligible plan under Section 457(b) of the Code which is maintained by a state, political subdivision of a state, or any agency or instrumentality of a state or political subdivision of a state and which agrees to separately account for amounts transferred into such plan from this Plan, The definition of eligible retirement plan shall also apply in the case of a distribution to a surviving spouse, or to a spouse or former spouse who is the alternate payee under a qualified domestic relation order, as defined in Section 41.4(p) of the Code. (C) Direct Rollover A direct rollover is a payment by the Plan to the eligible retirement plan specified by the distributes. N131:790420.2 20 ARTICLE V ADMINISTRATION AND AMENDMENT OF PLAN 5.1 Member's Rights Not Subwect To Execution The right of a. Member to a benefit under this Plan is not assignable and is not subject to execution or any other process whatsoever, except to the extent permitted by the Code of Civil Procedure and the Family Code of the State of California, Any payment hereunder required under the California Family Code to a person other than the Member must not alter the form or amount of benefits hereunder, except that to the extent provided in a valid court order, an Actuarial Equivalent payment may be made to the spouse or child of a Beneficiary pursuant to a qualified domestic relations order (as defined in Section 414(p) of the Code) prior to the Member's retirement. 5.2 Rules and Rel4ulations The Employer has full discretionary authority to supervise and control the operation of this Plan in accordance with its terms and may snake rules and regulations for the administration of this Plan that are not inconsistent with the terms and provisions hereof. The Employer shall deterinine any questions arising in connection with the interpretation, application or administration of the Plan (including any question of fact relating to age, employment, compensation or eligibility of Employees) and its decisions or actions in respect thereof shall be conclusive and 'binding upon any and all persons and parties. The Employer shall have all powers necessary to accomplish its purposes, including, but not by way of limitation, the following: (a) To determine all questions relating to the eligibility of Employees to participate; (b) To construe and interpret the terms and provisions of the Plan, NB I3 790420 2 21 (c) To compute, certify to, and direct the Trustee with regard to the amount and bind of benefits payable to the :Members and their Beneficiaries; (d) To authorize all disbursements by the Trustee from the Trust; (e) To maintain all records that may be necessary for the administration of the flan other than those maintained by the Trustee, and (f) To appoint a flan Administrator or, any other agent, and to delegate to them or to the Trustee such powers and duties in connection with the administration of the Man as it may from time to time prescribe, and to designate each such administrator or agent as a fiduciary with regard to matters delegated to him. With respect to management and control of investments, the Employer shall have the power to direct the Trustee in writing with respect to the investment of the Trust assets or any part thereof. Where investment authority, management and control of Trust assets have been delegated to the Trustee by the Employer, the Trustee shall be a fiduciary with respect to the investment, management and control of the Trust assets contributed by the Employer and Members with fimll discretion in the exercise of such investment, management and control. Where investment authority, management and control of Trust assets are not specifically delegated to the Trustee, the Trustee shall be subject to the direction of the Employer. Expenses and fees in connection with the administration of the plan and the Trust shall be paid from the Trust assets to the fullest extent permitted by law, unless the Employer determines otherwise. To the extent determined by the Employer or its delegates, elections and consents made by n -ieans of electronic media shall be permissible if made according to the relevant provisions of Treasury regulation Section 1.401 (a)-2 1. NB 1:790420.2 22 5.3 Amendment and Termination The Employer shall have the right to amend, modify or terminate this Plan at any time. In the event of the complete discontinuance of this Plan, the entire interest of each Member affected thereby shall immediately become 100% Vested. All benefits hereunder shall be payable solely from the assets of the Trust. After all liabilities of this Plan to Members and their Beneficiaries have been satisfied, any residual assets of this Plan shall be used for such purposes as determined by the Employer, including a distribution of the assets to the general funds of the Employer. 5.4 Military Service Effective December 12, 1994, and notwithstanding any provision of this Plan to the contrary, contributions, benefits, and service credit with respect to qualified military service will be provided in accordance with Section 414(u) of the Code. In the case of a Member who dies while performing qualified military service, the survivors of the Member are entitled to any additional benefits (other than benefit accruals relating to the period of qualified military service) provided under the Plan had the Member resumed and then ten-ninated employment on account of death. A Member receiving a "differential wage payment," as defined in Section 3401(h)(2) of the Code shall be treated as an Employee of the Employer, and the differential wage payment shall be treated as Compensation, 5.5 Administrative Expenses In accordance with Section 53217 of the Act, the Employer may make contributions to the Trust sufficient to defray all or part of the expenses of administering the Plan or inay pay such expenses directly. NB 1:790420,2 23 ARTICLE VI ANNUAL BENEFIT LIMITATIONS 6.1 Definitions and Application As used in this Article VI, the following terms shall have the meanings specified below. Unless otherwise stated below, the provisions of this Article VI shall apply to Limitation Years beginning on or after July 1, 2009. "Affiliated Company" means a company required to be aggregated with the Employer for purposes of Sections 414(b) and (c) of the Code, provided, however, the determination under Section 414(b) and (c) of the Code shall be made as if the phrase "more than 50 percent" were substituted for the phrase "at least 80 percent" each place it is incorporated into Section 414(b) and (c) of the Code. "Annual Benefit" means a benefit payable annually in the forrn of a straight life annuity (with no ancillary benefits) under a plan to which Employees do not contribute and tinder which no rollover contributions are made, or to which assets have been transferred from a qualified plan that was not maintained by the Employer. If the benefit is payable in a form other than a straight life annuity, such form must be adjusted actuarially to be the equivalent of a straight life annuity before applying the limitations of Section 6.2(a), The actuarial adjustment to the equivalent of a straight life annuity will apply to all plan benefits except as set forth herein. The actuarial adjustment shall be made in accordance with the provisions of Treasury Regulation Section 1.415(b)-I(c), which are incorporated herein by reference. No actuarial adjustment is required for the following: qualified joint and survivor aimulty benefits, pre-retirement disability benefits, pre-retirement death benefits, post-retirement medical benefits, and the Value of all automatic benefit increase feature made in accordance with applicable Treasury Regulations. "Employer" means the Employer and any Affiliated Company that adopts this Plan. NB 1:790420.2 24 "Limitation Year" means a twelve-consecutive month period beginning on the Anniversary Date, If the Limitation Year is amended to a different twelve-consecutive month period, the new Limitation Year must begin on a date within the Limitation Year in which the amendment is made. "Related Plan" means any other defined benefit plan (as defined in Section 415(k) of the Code) maintained by the Employer. "Year of Participation" means the Employee shall be credited with a Year of Participation for each year in which the Employee has met the requirements of Section 1.1(a). An Employee who is permanently and totally disabled within the meaning of Section 415(c)(3)(C)(i) of the Code for an accrual computation period shall receive a Year of Participation with respect to that period. In addition, for an Employee to receive a Year of Participation for an accrual computation period, the Plan must be established no later than the last day of such accrual computation period. In no event will more than one Year of Participation be credited for any twelve-month period, 6.2 Annual Limitation on Benefits Notwithstanding any other provision of the Plan: (a) The Annual Benefit payable with respect to a Member under the Plan for any Limitation Year shall not exceed an amount equal to $160,000, or such other dollar limitation determined for the Limitation Year by automatically adjusting the $160,000 limitation by the cost of living adjustment factor prescribed by the Secretary of the Treasury under Section 415(d) of the Code in such manner as the Secretary shall prescribe. The now dollar limitation shall apply to Limitation Years ending within the calendar year of the date of the adjustment, Cost of living adjustments to the dollar limitation occurring after severance from employment are taken into account. NB 1 :7904202 25 (b) If the Member has less than ten Years of Participation with the Employer, the limitation in Section 6.2(a) shall be reduced by multiplying it by a fraction, the numerator of which is the Member's full and partial Years of Participation, and the denominator of which is ten. To the extent provided in Treasury Regulations or in other guidance issued by the Internal Revenue Service, the preceding sentence shall be applied separately with respect to each change in the benefit structure of the Plan. The reduction provided in this paragraph does not apply to payments made to the Member if his payments commence after he has become disabled (within the meaning of Section 415(b)(2)(1) of the Code), and does not apply to payments made on account of the Member's death. (c) If the Annual Benefit of a Member begins prior to age 62, the limitation under Section 6.2(a) applicable to the Member at such earlier age is an Am-mal Benefit payable in the form of a straight life annuity beginning at the earlier age that is the actuarial equivalent of the limitation applicable to the Member at age 62 (adjusted under subsection 6.2(b) above, if required). The limitation applicable at an age prior to age 62 shall be determined in accordance with the provisions of Treasury Regulation Section 1,415(b)- I (d), which are incorporated herein by reference. The reduction in this Section 6.2(c) shall not apply for a Member who is a "qualified participant," as defined in Section 415(b)(2)(H) of the Code. (d) If the Annual Benefit of a Member begins after age 65, the limitation under Section 6.2(a) applicable to the Member at such later age is an Annual Benefit payable in the form of a straight life annuity beginning at the later age that is the actuarial equivalent of the limitation applicable to the Member at age 65 (adjusted under subsection 6.2(b) above, if required), The limitation applicable at an age after age 65 shall be determined in accordance with the: provisions of Treasury Regulation Section 1.415(b)- I (c), which are incorporated herein by reference, I N13 1:790420.2 26 (e) Pursuant to Treasury Regulation Section 1.415(b)-I(a)(7)(iii), the rate of a Member's accrual shall not be limited by this Article VI (but at all times the annual benefit payable to the Member is subject to the limits set forth in this Article VI), (0 The limitation in Section 6.2(a) is deemed satisfied if the Annual Benefit payable to a Member is not more than $ 1,000 multiplied by the Member's number of years of service or parts thereof (not to exceed ten) with the Employer, and the Employer (or a predecessor employer) has not at any time maintained a defined contribution plan in which such Member participated. If the Employer maintains one or more defined benefit plans, in addition to this Plan, covering an Employee who is also a Member in this Plan, the surn of the Annual Benefits of all the plans will be treated as a single benefit for the purposes of applying the limitations of Section 6.2(a), For purposes of the preceding sentence, Annual Benefits under a "qualified governmental excess benefit arrangement," as described in Section 415(m)(3) of the Code, shall be disregarded. If the Annual Benefits exceed, in the aggregate, the limitations of Section 6.2(a), the Annual Benefits under this Plan will be reduced (but not below zero) until the sung of the benefits of the Related Plan(s) satisfy the limitations. In the case of an individual who was a Member in one or more defined benefit plans of the Employer as of the first day of the first Limitation Year beginning after December 31, 1986, the application of the limitations of this Section 6.2 shall not cause the limitation under Section 6.2(a) for such individual under all such defined benefit plans to be less than the individual's Current Accrued Benefit, The preceding sentence applies only if such defined benefit plans met the requirements of Section 415 of the Code, for all Limitation Years beginning before May 6, 1986. For purposes of this Section 6.2(f), an individual's Current Accrued Benefit means a Member's Accrued Benefit under the Plan, determined as if the Member had separated from service as of the close of the last Limitation Year beginning before January 1, 1987, when expressed as an annual benefit within L) I N B 1 :790420.2 27 the i-neaning of Section 415(b)(2) of the Code. In determining the amount of a Member's Current Accrued Benefit, the following shall be disregarded: (1) any change in the terms and conditions of the Plan after May 5, 1986; and (ii) any cost of living adjustments occurring after May 5, 1.986. (g) If a Member makes one or more contributions to the Plan to purchase "permissive service credit," as defined in Section 415(n)(3) of the Code, then the limitations of this Article VI shall be treated as met only if either (i) the limitations provided in Section 415(b) of the Code are met, deten-nined by treating the accrued benefit derived from such contributions as an annual benefit for purposes of Section 415(b) of the Code, or (ii) the requirements of Section 415(c) of the Code are met, determined by treating all such contributions as annual additions for purposes of Section 415(c) of the Code. N131:790420.2 28 ARTICLE VII DEFINITIONS 7.1 Definitions Whenever the following ternis are used in the Plan, with the first letter capitalized, they shall have the meanings specified below, "Act" means California Government Code, "Anniversary Date" means July 1, "Beneficiary" means the person, persons, trust or trusts designated by a Member, or, in the absence of a designation, entitled by will or the laws of descent and distribution, to receive the benefit, if any, specified under this Plan if the Member dies and means the Member's executor or administrator if no other beneficiary is designated and able to act under the circumstances. "Benefit Final Pay" means the salary increase granted on July 1, 2009 and/or January 1, 2010, or the Union Pay Premium, which was not recognized by CalPERS for purposes of computing Final Pay. "Benefit Service" means the total credited CalPERS service credit earned with the Employer, not to exceed thirty (30) years if classified as a safety employee. "CalPERS" means the California Public Employees' Retirement System. "CalPERS Benefit Factor" means the age factor determined by the Member's age at retirement based on the CalPERS Local Miscellaneous 2.7% at 55 table or the CalPERS, Local Safety 3% at 50 table, whichever is applicable to the Member's employment classification with the Employer. N13 1:790,120.2 29 "Code" means the Internal Revenue Code of 1986, as amended frorn time to time, "Compensation" means all compensation for that portion of the Plan Year during which the Employee was a Member, paid in cash by the Employer to the Member for personal services. Compensation in excess of $255,000 (as adjusted through 2013) shall be disregarded. Such amount shall thereafter be adjusted for increases in the cost of living in accordance with Section 401(a)(1 7) of the Code, except that the dollar increase in effect on January I of any calendar year shall be effective for the Plan Year beginning with or within such calendar year. For any short Plan Year the Compensation limit shall be an amount equal to the Compensation limit for the calendar year in which the Plan Year begins multiplied by a ratio obtained by dividing the number of full months in the short Plan Year by twelve (12). "Effective Date" means, unless otherwise indicated herein, April 18, 2011. "Eligible Class of Employees" means the eligible class of employees as provided herein and in the applicable governing body policies and regulations promulgated thereunder by the Employer. "Eligible Employee" means an Employee who meets the requirements as described in Section 1. 1, "Employee" means an employee of the Employer, "Employer" means City of Santa Ana that has adopted this Plan. "Final Pay" means the highest annual compensation recognized by CalPERS for purposes of calculating retirement benefits paid to an Employee during any twelve consecutive months of employment with the Employer. "Ineligible Employee" means an ineligible employee as provided herein and in the applicable governing body policies and regulations promulgated thereunder by the Employer. NB I 790420,2 30 "Member" means an Employee eligible to receive benefits under this Plan. "Normal Form of Benefit" means the form of benefit described in Section 4.1. "Normal Retirement Age" means age fifty (50) for safety employees and age sixty-two (62) for miscellaneous employees, and meeting the requirements of Section 1.1. "Plan" means the City of Santa Ana PARS Supplementary Retirement Plan. "Plan Administrator" means the individual or position designated by the Employer to act on behalf of the Employer in matters relating to this Plan. If no designation is made, the Employer shall be the Plan Administrator. If a Plan Administrator has been appointed the word "Employer" as used in this Plan shall mean Plan Administrator unless the context indicates a different meaning is intended. "Plan Year" means the consecutive twelve-month period beginning on July I and ending on June 30, "Public Agency" means an employer authorized under California Government Code Article 1.5, Sections 53215 through 53224 to establish a pension trust. "Regulations" means the regulations adopted or proposed by the Department of Treasury from time to time pursuant to the Code. "Retirement Benefits" means the benefits payable to the Member following retirement, as described in Article 11. "Trust" means the trust established as part of the Public Agency Retirement System to hold the assets of the Plan, "Trustee" means the trustee of the Trust. "Vested" means the nonforfei table portion of any account maintained on behalf of a Member. N[31:790420,2 ADOPTION OF THE CITY OF SANTA ANA PARS SUPPLEMENTARY RETIREMENT PLAN The City of Santa Ana PARS Supplementary Retirement Plan is hereby adopted. By: Edward Ray,a Title: Executive Director of Personnel Services Date: / 2 / -7 /( �;- -f'U4� Jon M. Funk, Assistant City Attorney NB 1:790420.2 A - Z 011 - ) ` ` CERTIFICATE OF LIABILITY INSUITAV&= DATE (MMJDDrYYYYI 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). NAME: Ris,k Stratec�ies Company N CAME: Risk Strategies Company 2040 Main Street, Suite 450 Irvine, CA 9'2614 E-MAIL .. .. . ...... 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. IN'SR A D I$IJFIR . . .. . ......... — P—OLICYEFF LTR TYPE OF INSURANCE IN8D WVD POLICY NUMBER (MMIDDNYYY) lMM1DDNYYYI LIMIT$ A COMMERCIAL GENERAL LIABILITY 72SBAAC2429 5/8/2016 51812017 EACH OCCURRENCE $ $2,000,000 CLAIMS-MADE EV/1 OCCUR DA _T�FNITED PREMISES [Ea- occturrenee $ $1,000,000 MED EXP (Any one person) $ $10. DOD PERSONALS ADv INJURY s $2 DDD 0D0 GEN'L AGGREGATE LIMIT APPLIES PER: PRO POLICY _� LOC -GENERALAGGREGATE PRODUCTS -CO P/OPAGG S $4,000,000 . . .. ....... S $4,000,000 V LIABILITY 72SBAAC2429 51812016 5/8/2017 COMBINED SINGLE LIMIT (E,p,accideny _ _ $ $2,0D0,000 ANY AUTO BODILY INJURY (Per person) 0VVNF0 SCHEDULED BODILY INJURY (Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED P-R— _ ___ ­ 17 . ' S AUTOS ONLY AUTOS ONLY UMBRELLA LIAS OCCUR EACHOCCURRENCE s EXCESS L-7113 LAWS- AGGREGATE WORKERS COMPENSATION PFR CTH- AND EMPLOYERS' LIABILITY Y/N L-SIATUTE ANYPROPRIETOMPARTNERIEXECUTIVE E L. EACH ACCIDENT $ OFFICEMM EMBER FXC LUD ED? N (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE S If ns describe Linder -- DESCRIPTION OF OPERATIONS below E . DISEASE POLICY TWIT I B Professional Liability LDUSA1504508 7/30/2015 7/30/2016 Per Claim: $2,000,000 ..... . ....... Aggregate: $2,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES JACORD 101, Additional Remarks Schedule, Maybe attached if more space Is required) Projects as on file with the insured including but not limited to those usual to the insured's operations/PARS Supplementary Retirement Plan. The City of Santa Ana, its officials, employees and volunteers are named as additional insureds on the general liability policy-see attached endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Executive Director of Personnel Services 20 ACCORDANCE WITH THE POLICY PROVISIONS, Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Michael Christian @ 1988-2015 ACORD CORPORATION, Ali rights reserved. ACORD 25 (2016103) The ACORD name and logo, are registered marks of ACORD 297;5973 1 1111 IF t-, CA GL-HNQA, 113-1Pi I'[, I ,.oerry YoUrig 1 1,12912.01.6 !!SQ:32 ?M (EIDT) 11 Pane 2 of, 12 728BAAC2429 BUSINESS LIABILITY COVERAGE FORM 2. Applicable Tm Medical Expenses Coverage We will not pay expenses for "bodily injury": a Any Insured Tn any insured, except "volunteer workers". b. Hired Person Toa person hired todu work for oronbehalf of any insured ma tenant of any insured, c. Injury Dn Normally Occupied Premises To o person injured on that part of pmpnniaea you own or rent that the person normally occupies, d. Workers' Compensation And Similar Laws To a peraon, whether or not an "employee" of any imoured, if benefits for the "bodily injury" are payable or must be provided under a workers' compensation or disability benefits |mvv ore similar |evv. w. Athletics Activities To a panynn injured while praotidn0, instructing or participating in any physical exercises or gameu, sports or athletic contests, f. Prod ucts-Comp|eted Operations Hazard Included with the ''produota'oomp|etmd operations hazard". g. Business Liability Emo|os|oos Excluded under Business Liability Coverage. 1. If you are designated m the Declarations as: a. An individual, you and your spouse are insunads, but only with respect to the conduct ofabua�nemaof which you are the sole owner. b. 8 partnership or joint ventura, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect hr the conduct of your business, c. A limited liability uompany, you are an insured. Your members are a�soinsureds, but only with respect to the conduct of your business. Your managers are ineuredn, but only with respect to their duties as your managers. dL An organization other than a partnership, joint venture or limited liability company, you are ouinsured. Your "executive officens''and directors are inuureda, but only with respect to their duties as your officers or Oreotora. Your stockholders are also insureds, but only with respect tm their liability aastockholders. o. A trust, you are an insured, Your trustees one also insureds, but only with respect to their duties untrustees. 2. Each of the following ismisueninounadL e. Employees And Volunteer Workers Your "volunteer workora" only while performing duties related to the conduct mf your buminoan, nr your °empfoyeee^. other than either your "executive officers^ (if you are on organization other than a partnership, ]om1 venture or limited liability company) or your managers (if you are e bnnbed liability oompany), but only for acts m/hhm the uoupa of their employment by you or while performing duties related to the conduct of your business, However` none of these "employees" or 'vohunhser workers" are insureds for (1) "Bodily injur/' or "personal and advertising injury": (e) To you, to your partners or members ffyou are m partnership or joint ven1uma), to your members (if you are a limited #ebi|ity company), or to a co-"employee" while in the course of his or her employment or performing duties ne|eted to the conduct of your business' or to your other ..volunteer workers" while performing duties related to the conduct of your buminemu� (b) To the spouse, child, parent, brother or sister of that co- ..employee' or that "volunteer worker" as a consequence of Paragraph (1)(a)above; (n) For which there in any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (b)mbove�or (d) f`namg out of his or her providing or failing to provide professional health care services, If you are not in the bus�neon of pnovi6ng professional health care aemioeo. Paragraph (d) does not apply to any nume, emergency medical technician or paramedic employed by you ho provide such services. (2) "Property damage" to property� (u) Owned, occupied or used by, Page i0mf24 Form SS 00 080405 (b) Romhad b», in the care, custody or control of, or over which physical control is belng exercised for any purpose by yuu, any of your ^'emp|mymma". "volunteer workom'', any partner or member (if you are o partnership or joint vemtuns), or any member (if you are a limited liability company). b. Real Estate Manager Any person (other than your 'emp)oyee''or "volunteer mmrker'), or any organization while acting ao your real estate manager. c. Temporary Custodians Of Your Property Any person or organization having proper temporary custody of your property if you die. but only'. (1) With respect to liability arising out ofthe maintenance or use ofthat pmperty�and (2) Until your legal representative has been appointed, d. Legal Representative |f You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this insurance, e. Unnamed Subsidiary Any subsidiary and subsidiary tbereuf, of yours which iso|ogsA|y incorporated entity of which you own a financial interest of more than 5OY6of the voting stook on the effective date of this Coverage Part. The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not apply to injury or damage with respect towhich an insured under this insurance is also an insured under another policy or would be an insured under such policy but for its termination or upon the exhaustion of its limits ofinsurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability uompmny, and over which you maintain financial interest of more than 50% of the voting stook, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: m. Coverage under this provision is afforded only until the 1801h day after you aoqu�ne or form the organization or the end of the policy period, whichever is earlier-, and BUSINESS LIABILITY COVERAGE FORM b^ Coverage under this pnoveion dmaa not applyb»� (1) "Bodily injug/' or "property damage" that occurred; or (2) "Personal and advertising injury" arising out ofan offense committed before you acquired or formed the /& Operator Of Mobile Equipment With respect to "mobfla equipment" registered in your name under any motor vehicle registration |aw, any person is an insured white driving such equipment along m public hlghwmy with your pennission, Any other person or organization responsible for the conduct of such person is also am insured, but only with, respect Loliability arising out of the operation of the equipmant, and only ifno other insurance of any kind imama||abYe 0z that person or organization for this liability. Nmwevar, no person or organization in an insured with respect to: m. "Bodily injury" to a co-"employee" of the person driving the equipment or b. "Property damage" tn property owned by, rented to, in the charge ufo/occupied by you or the employer of any person who is an insured under this provision. S` Operator mfNonownodWatercraft With respect to watercraft you do not own that is less than 51 feet long and hs not being used &o carry persons for a charge, any person |aan insured while operating such watercraft with your permission. Any other person or oqJanizafiun responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the wmhercnaft, and only if no other insurance of any kind is avoi|ab�m to that person or organization for this |iabi|ity� However, no person or organizeuion is an insured with respect to: n. "Bodily irjury" to a co-"employee" of the person openaWng the watercraft; or b. "Property demoge''tV property owned by, rented to, in the charge mforoccupied by you or the employer ofany person who in an insured under this prov�aion. 8. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in avvrdten Form SS00O8W4U5 Page 11wf24 BUSINESS LIABILITY COVERAGE FORM contract, w6tten agreement or because of m (n) Any failure to make such permit issued by a state or pu|bioa| inapeuions, adjusbnmnhe, tests or subdivimion, that such person or organization servicing as the vendor has be added as an additional insured on your ogmaad to make or normally pw|icy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of bumineas, in connection agreement, or the issuance cf the permit. with the distribution or sale ofthe A person or organization is an additional products-, insured under this provision only for that (# Demonstrctmn^ ino(ai|ation, period of time required by the contrao, servicing or repair operationm, agreement orpermit. except such operations performed Homever, no such person or organization ' vendor's �t the vendor's prom�see �n additional insured under this provision if such connection with the mm|o of the person or organization is ino|uded as an produot- ' additional insured by an endorsement issued (g) Products vvhiuh, after distribution by us and made a part of this Coverage Pmrt, or sale by you, have been |obe|*6 including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient ofany additional insured coverage grants in Section other thing or substance by or for F.— Optional Additional Insured Coverages. the vendor; or a. Vendors (h) "Bodily injury" or "property Any person(s) ororgmnizm' �mh� (na�rnad to damage" arising out of the sole below as vendor), but only with respect 0z neg|�Qence of the vendor for its, , hodi|y injury" or"property damage" arising own acts or omissions or those of out of "your products" which are distributed its employees or anyone else omtingomitabeh�� Hm�*ver, this � or add in the regular course of the vendor's exclusion does not apply to: ' business and only Part this Coverage P� provides coverage for "bodily injury" or (i) The exceptions contained in "property damage" included within the Subparagraphs (d)mr(f); or "prod uuts-comp|mted operations haza/d^ (i[) Such inspections, adjustments, (1) The insurance afforded to the vendor heu�o or servicing the vendor is subject to the following additional has agreed to make mrnormally exclusions: undertakes to make �n the usual This insurance does not apply to � course of business, in connection with the distribution (o) "Bodily injury" or '"property nr sale nf the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such pmduotn liability in a contract mragnaennmn1 ' or any ingredient, part or container This exclusion does not apply to entering |ntn ' eocompamying o' ' liability for damages that the containing such prmduda � vendor would have in the absence mf the contract oragreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized byyou; whom you lease e#uiprmont but only (c) Any physical or chemical change with respect to their liability for "bodily "property in the product made intentionally injury^ damage" or ' .,personal and advertising injury" by the vendor ' oaueed, in whole or in paM, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment iaooed to you by such imspeoion, denuonstraion, temting, person ororganization. or the substitution of parts under instructions from the manufacumr, and them repackaged in the original container� Page t2of24 Form GS$0V8O�405 (2) With respect to the insurance afforded e. Permits Issued By State (Jr Political to these additional insureds, this Subdivisions inmuoanuo does not apply to any (1) Any state or pofihima| subdivision, but . � counenoe" which takes place after only with respect to operations you cease to lease that equipment. performed by you nron Your behafffor c. Lessors Of Land Or Premises which the state or pnU1ioa| subdivision (1) Any person or organization from has issued mpermit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional inauredm, this uf the ownership, maintenance oruse insurance does not apply to: of that part of the land or premises (a) "Bodily injury", "property damage" leased tuyou. or "personal and advertising (2) With respect to the insurance afforded injury^ arising out of operations to these additional insureds. this performed for the state or insurance does not apply to: municipality; or (a) Any "occurrence' which takes (b) "Bodily injury^ or "property damage" place after you cease tu lease that included within the "products- land or be e tenant in that completed operations hazand" pnaminea�or f. Any Other Party (h) Structural alterations, mmm (1) Any other person or organization who construction or demolition is not an insured under Paragraphs a. operations performed by or on through e. mbowe, but only with behalf of such person or respect to Uabifity for "bodily injury", organization , ' \property dunoaOe' or "personal and d. Architects, Engineers Or Surveyors advertising injury" cauued, in whole or (1) Any archkeo, enQinaer, or uunmyo/, but in pah, by your acts or omissions or only with respect to liability for ''bodily the acts or omissions of those acting irjury''. "property damage" or"personal on you, and advertising injury" caused, in whole (a) In the performance of your or in part, by your mota or omissions or onQoingnpenafionm� the acts or omissions of those acting on (b) In connection with your premises your behalf: owned byor rented tu you; ur (e) In connection with your pnemiaau� ' (c) |n connection with "your work" and or mo|uded within the "products- (b) In the performance of your completed operations hezard". but ongoing operations performed by only if you orVn your behalf. (U) The written contract or written (2) With respect to the msunamceaffrmded agreement requires you to to those additional insurede, the provide such coverage to following addftionm| exclusion applies: such additional insured; and This insurance duoa not apply to (ii) This Coverage Part provides "bodily injury". "property damage" or coverage for "bodily injury" or "personal and advertising irju0/' ^p*operty damage" included arising out of the rendering of or the within the "products- failure to render any professional completed operations hazard^ services byor for you � ' including: (2) With respect tnthe insurance afforded (e) The prepmring, approvimg, or to theme additional inounada, this failure to prepare or approve, insurance does not apply to: mapa, shop drawings, opinions, "Bodily irjury''. "property dameQe" or repods, surveya, field ondom. ''permona| and advertising injury^ change orders, designs or mrimimg out ofthe rendering of, or the drawings and specifications; nr fei8urm to render, any professional (b) 8upen/ioury, inspediom, mmhiteo1una|, engineering or surveying architectural or engineering oemioeo, inoYudiog� activities. Form S�S08O804O5 Page 13uf 24 (o) The pnapmhng, approving, or teWoxa to prepare or oppnove, mapa, shop drewingm, mpinimma, naporto, sumeys, field mrdem, change onders, designs or drawings and specifications; o/ (b) 8upervisory, inapauion, architectural or engineering aofivb|es, The limits of insurance that apply hoadditional imsmn*do are described in Section D. — Limho Of|naunanoe. Ho* this insurance applies when other insurance in available to an additional insured is described im the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions, No person or organization is an insured with respect to the conduct of any current or past partnemhip, joint venture or limited liability company that is not shown amm Named Insured in the Declarations. FA 1. The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most vve will pay regardless cf the number of: a. Insureds; b. Claims made or^auhs^ brought; mr c. Persons or organizations making claims ur bringing "suits", 2. Aggregate LhnMm The most me will pay for: a. Damages because, of "bodily injury" and property damage" included in the ~prodmctm-ommp|eied operations hazard" in the Products-Completed Operations Aggregate Limit shown in the Declarations. b. Damages because of all other "bodily injury^. "property damage" or "penoona� and advertising injury", including medical expenses, is the General Aggregate Limit shown in the Declarations. This General Aggregate Limit applies umperateUy to each of your "locations" owned byor rented toyou. "Location" means premises involving the same or connecting |m1m, or premises, whose connection is interrupted only by street, roadway or right-of-way of a This General Aggregate Nmit does not apply to "property dmmege', to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of fire. |i8htmm0 or explosion, 3. Each Occurrence Limit Subject to 2.o. or 2 .b mbove, whichever applies, the most we will pay for the sum ofaM damages because of ail "bodily injury", ^'prmperty damage" and medical expenses arising out of any one "occurrence" is the Liability and Medical Expenses Limit shown in the Declarations. The most wuwill pay for all medical expenses because of "bodily injury~ sustained by any one person is the &4ediomU Expenses Limit shown in the Declarations. 4. Personal And Advertising Injury Limit Subject to 2.b. abqve, the most wewill pay for the sum of all damages because of all " personal and advertising injury" sustained by any one person or organization is the Personal and Advertising Injury Limit shown in the Qeciamtione. 5. Damage To Premises Rented To You Limit The Damage To Pnarnimaa Ranted To You Limit �a the most wewill pay under Business Liab0ity Coverage for damages because of "property damage" tn any one premises, while rented to you, orin the case of damage byfire, lightning or exp|oaimn, while rented 10 you or temporarily occupied by you with permission of the owner. In the case of damage by fire, figh8ninQ or explosion, the Damage to Premises Rented To You Limit applies to all damage pnzxinweta|y caused by the same event whether such damage nenuhm from fire, lightning or explosion or any combination ofthese. G. How Limits Apply To Additional Insureds The most vvewill pay on behalf ofa person or organization who is an additional insured under this Coverage Part im the lesser of: a. The limits of insurance specified in a written cmntrau1, written agreement or permit issued by a state or political aubdiv[emnor b. The Limits of Insurance shown in the Declarations. Such amount mhoU be a pert of and not in addition to the Llnni1e of Insurance shown in the Declarations and described inthrnSection. Page 14of24 Form SS 00 88 0405 If more than one Unnb of insurance under this (1) Immediately aamd us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any o|airn or "suit", the most we will pay legal papers received in connection under this policy and the endorsements is the with the claim or"muit',, single highest limit of liability of all coverages 2) Authorize us to obtain naounda and applicable to such n|e�m or "'suit". However, this ' ` other )nfomnuiom� paogrephdoennotapp�totheked�a|Expenaos set forth in Paragraph 3. above. u in the investigation, (3) Cooperate with u settlement of the claim or defense The Limits of Insurance of this Coverage Port apply against the ^euit''; and separately toeach consecutive annual period and to (4) Assist us, upon our request, in the any remaining period of less than 12months, starting enforcement of any right against any with the beginning of the policy period shown inthe Declarations, unless the policy period |e extended ' person or organization that may be after issuance for an additional period ofUame than 12 liable to the insured because of injury months, In that case, the additional period will be or damage to which tNo insurance deemed pm�nf the last preceding pehodfor purposes may also app|y � ofd�erminimgtheLimitsof|noumanoe� d. [}h|iQetioos��t The |nsured'eOwn Coat E. L|����|L|T\� ��N[> ��EDi{���L EXPENSES Noimmuradwi|| e�ce��attha��nmu�d'u own ' GENERAL CONDITIONS cost, voluntarily make s payment, assume any ob||gskion, or incur any expense, other 1. Bankruptcy than for first aid, without our consent. Bankruptcy or ina6v*ncy of the insured or of e. Additional |nemred's Other Insurance the inomred'm estate vxHA not relieve us of our If we cover u claim or "suit" under this obligations under this Coverage Part. Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an Offense, Qm|nm Or Suit additional insumed, such additional insured a. Notice Of Occurrence OrOffense must submit such claim or "suit" to the other insurer for defense and indemnity, You ormny additional insured must see to ft that we are notified as soon as However, this provis,ion does not apply to practicable of an "uoommsmoe/' or an the extent that you have agreed in u offense which may result in a claim, To written uontnmo1^ written agreement or the extent pmmeib�e. notice u�ouId include-. permit that this insurance �s Vnmary and non-contributory with the additional additional (1) Hmw, when and where the "occurrence" inaured'mmwn insurance, or offense took place; f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim C)rSuit injured persons and witnesses; and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional insured only when such or damage arising out of the "occurnanca^, offense, claim or "suit" is ~occunenme'oroffense. known to: b ' �obm�OfOkoim (1) You or any additional insured that is If m claim is made or "suit" is brought an individua|� against any inuured. you or any additional 2) Any partner, if you or an additional insured must: insured iaupartnership; (1) Immediately record the specifics ofthe ( 3) Any mmnager, if you or an additional o|ainn or "suit" and the date reoeived- ' insured iam limited liability oompany� and (2) Nodfyuoam soon aapnao�ab|e. (4) Any "executive officer" insurance manager, if you or an additional You or any additional insured must see to insured isocorporation; it that we receive m written notice of the (5) Any trusbae, if you or an additional u|airn or "suit" as soon as practicable, insured is atnuat; or c ' /�s|���nce And Cooperation Of The (6) Any elected or appointed official, if you Insured or an addtimna| insured is m political You and any other involved insured nousL subdivision or public entity. Form SS80 08 04US Page 15of24 Th�s Paragraph i mpphen separately to you and any additional insured. 3. Financial Responsibility Laws a. When this policy is certified as proof of financial responsibility for the future under the pnzvaions of any motor vehicle financial responsibility law, the insurance provided by the policy for "bodily ir@ury' liability and "property damage" liability will comply with the provisions of the law to the extent of the coverage and limits of insurance required by that law, h. With respect to "mobile equipment" to which this insurance applies, we will provide any |iabi|ity, uninsured motndmto, underinsured motorists, no-fauft or other coverage nequ�red by any motor mahiu|o law, We will provide the required |imftnfwr those coverages, 4. Legal Action Against Us No person or organization has u hQh1 under this Coverage Fomm� a. To join us as a party or otherwise bring um into a 'suit' asking for damages from an insured; or b To sue us on this Coverage Form un�ess aU of its 0enna have been fuAy complied With. — A person or organization may sue us to recover on an agreed settlement or on m final judgment against an inmurod� but we will not be liable for damages that are not payable under the terms of this insurance or that are in excess of the applicable |imft of insurance. An agreed settlement means e settlement and release of liability signed by um, the insured and the claimant or the claimant's legal representative, 5. Separation Of Insureds Except wth respect to the Lhnho of Insurance, and any rights or duties specifically assigned in this policy to the first Named Inaunad, this insurance applies: m. As if each Named insured were the only Named Insured-, and b. Separately to each insured against whom a claim is made or'`suit^isbrought. G. Representations a. When You Accept This Policy By accepting this policy, you agree: (1) The statements in the Declarations are accurate and complete; (2) Those statements are based upon representations you made tm us; and Page 16of 24 (2) VVe have issued this poKoyin reliance upon your representations. b. Unimbymdomd Failure To Dhadmae Hazards |f unintentionally you ohou|dhaQ to disclose all hazards relating to the conduct of your business at the inception date of this Coverage Part, we shall not deny any coverage under this CowanmQm Part because of such failure. 7. Other Insurance K other vafid and onQectibk* insurance is available for a iomm we cover under this Coverage Part, our obligations are limited as a. Primary Insurance This insurance is primary except when b. below appBes, |f other insurance is o�so pMmary, we w8] share with all that other insurance by the method described in o. b. Excess Insurance Th�s insurance is excess over any of the other insurance, whether primary, excess, contingent ormn any other beois: (1) Your Work Th� �S Fire. Extended CovenaQe, BuMe(e Risk, Installation Risk or similar coverage for "your wum('; (2) Premises Rented ToYou That is fire. lightning or explosion insurance for premises rented to you or temporarily occupied by you with pecmias�onof the owner; (3) Tenant Liability That is insurance purchased 6y you bo cover your liability as a tenant for "pnzpedy damage" to premises rented to you or temporarily ocoup�ed by you with permission of the owner; (4) Aircraft, Auto Or Watercraft If the loss arises out of the maintenance nr use of aircraft, "aukza^or watercraft to the extent not subject to Exclusion Q. of Section /\.—Coverages. (5) Property Damage To Borrowed Equipment 0rUse Of Elevators If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion k. of Section A. — Coverages. Form SS 00 08 04 O5 (6) When You Are Added As An When thm�nsurance is excess over other Additional Insured To Other insurance, we will pay only our ehmna of Insurance the amount of the loss, if any, that That is other insurance available to exceeds the sum of: you covering |im6Wdy for damages (1) The total amount that all such other ohein8 out of the premises or insurance would pay for the loss inthe operations, mr products and completed absence nf this insurance; and operations, for you have been (2) The total of all deductible and self- added as an additional insured by that insured amounts under all that other insurance-, ' insurance. (7) When You Add Others As An VVe will share the remaining |ums ��ny with ' ' Additional Insured To This any other insurance that ia not described in Insurance 1NuExoass Insurance provision and was not That is other insurance available to am bought specifically to apply in excess of the additional insured. Limits of Insurance shown in the However, the /u||ovv�nQ provisions Declarations of this Coverage Part. apply to other insurance available to u. Method QfSharing any person or organization who is an If all the other insurance permits additional insured Linder this Coverage contribution by equal shares, we will follow Po�� � this method also. Under this approach, (a) Primary Insurance When monh insurer contributes equal amounts Required By Contract mnd| it has paid its applicable limit of This insurance is primary if you insurance or none of the loss mmnnaima, have agreed inawritten oontrmot, whichever comes first, written agreement or permit that Kf any of the other insurance does not permit this insurance be primary. If other contribution by equal uhares, we will insurance is also primary, wewill contribute by limits. Under this method, each uharowith 0 thot other insurance insurer's ehens is based or the ratio of its by the method described in o. app|icaNe limit of insurance 8o the total below. app|icabha limits cf insurance of all insurers, (b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against To Other Insurance When Others ToUs Required ByContract m. Transfer Of Rights OfRecovery If you have agreed in a written If the insured has rights to recover all or oonimao|, written agreement or part of any payment, including permit that this insurance is Supplementary Payments, vve have made primary and non-contributory with under this Coverage Part, those rights are the additional inaune6"u own transferred to us. The insured must do insurance, this insurance is nothing after |omm 10 impair them, At our primary and we will not seek naq«eat, the insured will briny ''suit" or contribution from that other transfer those rights to um and help us insurance. enforce them. T1­0o condition does not Paragraphs (a) and (b)do not apply to apply to Medical Expenses Coverage, other insurance tn which the additional b. Waiver [)fRights Of Recovery (Waiver insured has been added as an Of Subrogation) additional insured, If the insured has waived any rights of When this insurance is excess, we will recovery against any person or have no duty under this Coverage Part to organization for all or pad of any payment de�ndthe insured against any `'muit'ifany inc|udrmg Supplementary Payments, vv` other insurer has a duty to defend the have made under this Coverage Po m/- insured against that "ou�t" If no other also waive that right provided the in— na- insured insunar defends, �m will undertake br do ` ��k/ed their rights of recovery against no bw�wmvviU be to the inauned'a ' such person or organization in a uontraot �Qhteagainst mUthose other insurers. ` agreement or permit that was executed prior to the injury mrdamage, Form SS O�OQO0485 Page 17wf24 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED 1 Additional Insured -Grantor Of Franchise COVERAGES WHO IS AN INSURED under Section C. in |fUatedor shown amappUceh|eim the Declarations, amended �o �nm�ude sm an additional insured additional one or more of the fmUovvmg Optional Additional the person(s) or organization(s) shown in the Insured Coverages also apply. When any of these Declarations as an Additional Insured Optional Addifiona| Insured Coverages apply, Grantor Of Franchioe, but only with respect to Paragraph 8. (Additional Insureds When Required their liability ao grantor of franchise hmyou. by Written Contract, Written Agreement orPermit) 4. Additional Insured - Lessor Of Leased ofSeotilon C.. Who Is An |naunad, does not apply Equipment to the person or organization shown in the a. WHO IS AN INSURED under Section C. is Declarations. These coverages are subject tuthe amended to include as an additional bsnns and conditions applicable to 8meioeua insured the person(s) or organization(s) Liability Coverage in this po|icy, except an shown in the Declarations as an Additional providedbe|ow� Insured — Lessor of Leased Equipment. i. Additional Insured - Designated P*nemn Or but only with respect to liability for "bodily OnQam|zat|mo injury^'. "property dmmage" or "personal WHO IS AN INSURED under Section C. is and advertising injury" caused, in whole or amended to include as an additional immured in part, by your maintenance, operation or the person(s) ornnQon|zation(e) shown in the use of equipment leased to you by such Deo|arations, but only with respect to liability person(s) or organization (o) � for "bodily injury", ~property damage" or b. With respect tothe insurance afforded 1m ..personal and advertising irjury^' rouoed, in these additional insureds, this insurance whole or in part, by your acts or omissions or dnmo not apply to any "occurrence" which the acts or omissions of those acting on your takes place after you cease to lease that behalf: equipment, m. In the performance of Your ongomg 5. Additional Insured - Owners Or Other operations; or Interests From Whom Land Has Been b. In connection m/[ih your premises owned Leased by or rented to you. a. WHO IS AN INSURED under Section C. is 2. Additional Insured ' N1enmgorm Or Lessors amended to ino�ude as an additional Of Premises insured the person(s) or organization(s) shown in the Declarations msemAdditional u ' WHO IS AN INSURED under Section C. �n Insured7 [ Or Other Interests F nded Whorn'�and,'Has Been Leased, but only or aniz tion(�) shown in the the person'i�j . prg a with respect to liability arising out of the Declarations, as an Additional Insured 7 ownership, maintenance or use of that part Designated Person Or Organization; but only of the la I n I d lea I sed to you and shown in the with respect to liability arising out of the ownership, maintenance or use of that part of the premises^``����� b` With re spect to the insurance afforded to � ( _x� , � ` theme additional inmurada, the following additional apply- b. With , ) ^� following This i s°'a"~=°°=° ,"`apply "Unaae additional ' (1) "occurrence" that takes place ' Thimbnnu d apply tp|eomm�tkyn��or � ' ` ' - (1) Any "mpgH takes place (?) ' � ° alterations, new 'W�Iqh ~^— ' after you be —tenant in that construction or demolition operations premises,- or performed by or on behalf of such (2) Structural alterations, new person ororganization. construction or demolition operations ' 8 Additional Insured - State Or Political performed brmed by or on behalf of such — Permits person or organization. a. WHO |8A0 INSURED under Section �C, is amended to include as an add�donm[ insured the state or Ao<idosy subdivision shown in the Declarations as an Additional Pagm18mf24 Form SS 0008 04 05 Insured —Stak* Or Polifical Subdivision - Pennhn, but only with respect to openat�one performed by you or on your behalf for which the state or political subdivision has issued a permit. b. With respect iothe insurance afforded to these additional insunads, the following additional exclusions app]y� This insurance does not apply to: (1) "Bodily injury". "property damage" or ,.personal and advertising inju?y' arising out of operations performed for the state ormunicipality; or (2) "Bodily injuryp or "property damage" included in the "prod uot'mompletad operations" hazard. 7. Additional Insured —Vendors m. WHO USAW INSURED under Section C.is amended to include as an additional insured the person(s) or organization(s) (referred to below uo vendor) shown inthe Declarations as an Additional Insured - Vendor, but only with respect to "bodily injury" or "property damage" arising out of ''your products"' which are distributed or mm|d in the regular course of the vendor's business and only if this Coverage Pad '^ providem coverage for "bodily injury" or property damage" included within the ^prod octo-nnmp|eted operations hazard" b. The insurance afforded to the vendor is subject to the following additional axo|uuionm� (1) Ths insurance does not apply to: (a) "Bodily injury" or "property damage" for which the mamdnr is obligated to pay damages by reason of the assumption of liability in a contract oragreement. This exclusion does not apply ho liability for damages that the vendor Would have in the absence of the contract oragpuemen1� (b) Any express warranty unauthorized byyou; (c) Any physical or chemical change in the product made intentionally by the vendor-, (c) Repmckeging, unless unpacked solely for the purpose mfinspection, demonatratiom, testng, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original (e) Any failure to make such innpeciona, adjuabmenta, tests or memdng mm the vendor has agreed to make or nunnuUy undertakes to make in the umua| course of bumineso, in connection with the distribution orooAeof the pmducts-, (f) Demonetradion, inehaUadmn, servicing or repair operahons, ,except such operations pedbmnad at the vendor's premises in connection with the oo|e of the product� (Q) Products whioh, after distribution or sale byyou, have been labeled or relabeled or used as a conhainer, part mr ingredient ufany other thing or substance by or for the vendor; or (h) "Bodily injury" or ~property damage" arising out of the sole negligence of the vendor for its mmm acts orom�moimns or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Subparagraphs (d)or(f)�or (ii) Such inmpmotiona, adjustments, tests orservicing as the vendor has agreed to make or normally undertaken io make inthe usual course cf bosiness, in connection with the distribution or om|e of the produot& (2) This insurance does not apply Loany insured person or organization from whom you have acquired such pnoduda, or any ingnsdient, part or omnioiner, entering inVo, accompanying or containing such products. 8. AddithznoAynsured — Control|ing|ntereat WHO IS AN INSURED under Section C. is amended to include as an additional insured dheparenn(e) orwpgmnization(a)shown in the Declarations as an Additional Insured — ControHhng Interest, but only with respect to their liability arising out of: a. Th6r financial control ofyou�or b. Premises they own, maintain or control while you lease or occupy these premises, Form SS80 08 04OS Page 19 of 24 This insurance does not app�y to structural aUermions, new construction and demolition operations performed by or for that person or organization. 9. Additional Insured — Owners, Lommmmm or Contractors — Scheduled Person Or Organization a. WHO |SAN INSURED under Section C.is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations aoanAdditional Insured — Owner, Lessees OrContractors, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising irjury"omuued. in whole or in part, by your mcCm or omissions or the acts or omissions of those acting on your behalf: (Y) In the performance of your ongoing operations for the additional inau/ed(m); or (2) In connection with "your work" performed for that afttionm| insured and included within the "products- completed operations hmzand^, but only if this Coverage Pad provides coverage for "bodily injury" or property damage" included within the ^products-oomp|eted operations b. With respect to the insurance afforded to these edditiona� ineunado, this insurance does not apply to"bodily injury", "property damage" or "personal an advertising irjug/' arising out of the rondahmQ of, or the failure to render, any professional apohiteotumaf, engineering or surveying services, including: (1) The preparing, approving, orfailure to prepare or approve, mepa, shop drawings, opinions, reportm, nurveym, field orders, change orders, dem�Qnmor drawings and spe6fioationn�mr (2) Supen/ioory, inspectiom, architectural or engineering activities, 10. Additional Insured —Co-Owmer Of Insured Premises WHO IS AN INSURED mnderSeokm C. is amended to include on an oddifimna| insured the parsom(o) orDrganization(s) shown in the Duo|orotioom as an Additional Insured — Co- Owner Of Insured Premiaea, but only with respect to their liability as co-owner of the premises shown in the Declarations, The |hnUu of insurance that apply to additional |nmunade are described in Section O. — Limho Of Insurance. How this insurance applies when other insurance is available toen additional insured is described in the Other Insurance Condition in Section E. — Liability And KX*dico| Expenses General Conditions. G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 1. "Advertisement" means the widespread pub0o dissemination of information or images that has the purpose cf inducing the sale ofgoods, products nr services thnough� a. (1) Radio; (2) Television; (3) Billboard; (4) Magazine; (5) Newspaper; b. The Internet, but only that part of a web site that is about goods, products or services for the purposes of inducing the sale cf goods, products nr services; or c. Any other publication that is given widespread public distribution, However, "advertisement" does not include: m. The demgm, printed mateno|, information or inno8mu contained in, on or upon the packaging or labeling of any goods or pnoduota� or d` An interactive uonwymadmn between or among persons through m computer network, 2. "Advertising idea" means any idea for an ,.advertisement". 3. "Asbestos hazard" means an exposure or thnsed of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form, 4. ')4mtd' means a land motor vuho|e, trailer or semi-trailer designed for travel on public rmado, including any attached machinery or equipment, But ''auio" does not include "mobile equipment". 5. "Bodily injury" means physical: a. |njum� b. Sickness; or o. Disease sustained by e person end' if arising out ofthe above, mental anguish or death sd any time. 6. "Coverage territory" means: Page 2Qof24 Form S80O08O4O6 DATE IMMIrDoryYYV) AC"RIX CERTIFICATE OF LIABILITY INSURANCE la,�° 5/4/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AF'FIRMATIVE'LY 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 PR'ODUC'ER, AND THE CERTIFICATE HOLDER. IMPORTANT; If the certificate holder is an ADDITIONAL INSURED„ the policy(les) 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 NAMP. Warner Pacific insurance 32110 Agoura Rd Westlake Village _.. CA 91.361 INSUR €RA.E1p�C9�rFI£i Assuxance ��>mPan� � _._ 25402 INSURED LTR TYPE OF INSURANCE POLICY NUMBER iat.16M1DDffYYY MMfp Y INSURER S COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S PRASE 51 SYSTEMS INC, DBA: PARS INSURER cm_ I 'MED EXI (Any one po scan) 4350 VON KAVYIAN AVE PERSONAL & AOV INJURY SDITE100 GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE S INSURER E.i___. ..._,.....,._�. — _�......... .._._._._.__� ._....._ ...................._ ,._,.... ., ..- ...,._.., NEWPORT BEACH CA. 92663 1 INSURER F C M I tNG F UUMII t S a r,=wrtcark A'rj= KH mxr�r_P- r,..T.1. F54 MS-56.5 b F1/IS.I()N N[IMIRFR! THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOLIMEMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VATH 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, 3I7TJL POLICY OFF PpLIGY ZXP ° -.. . LIMNS LTR TYPE OF INSURANCE POLICY NUMBER iat.16M1DDffYYY MMfp Y COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S I ]CLAIMS-MADE OCCUR _PREMISES,[E� currenceZ S_ I 'MED EXI (Any one po scan) PERSONAL & AOV INJURY GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE S POLICY 1 J�CT � � LOC PROC1UC15 . CCiMpaFJF AGG $ S OTHEt C M I tNG F UUMII t S AUTOMOBILE LIABILITY ANY AUTO EE BODILY INJURY (Per person) S -__. .. .___ ._.__ .....,.,._ .v ..._ ALL t)ANNEU SChIErYULEq i BODCLY INJURY (Per arc desni) S S ALL OS �. AUTOS NON -OWNED 7 I I PR(7PEI2iY DAItAGF ..�� HIRED AUTOS AUTOS $ ' UMBRELLA LIAR OCCUR � � � p EACH OCCURRENCE p I EXCESS LIAR CLAIMS MADE'.. I � AGGREGATE... ....�.._._.._. _ _ -E_ _......,_ DED RETENTBON $ i S WORKERS COMPENSATION .' o a PER t OTH STATUTE FIR AND EMPLOYERS' LIABILITY YIN ANY PROPRIETC3RMARTNERIEXEGU7IVE I E !, I�ACI'I ACCIDENT S OFFICERWEMBER EXCLUDED? �� NIA A inNH) SMC002110614 4/1/2016 4/1/2017 EL ®1SEASI EAFMPLOYE S 1,G3Bib CB(i __..._ �(Mandatory If yes desctbeunder DESCRIPTION OF OPERATIONS bedew L O.SEASE P(N ICY LIMIT $ 1 000 000 I 1 u DESCRIPTION OF OPERATIONS I LOCATIONS. J VEHICLES (ACORD 101, Addifional Remarks Schedule, may be attached If more spacer Is required).... TEN DAYS NOTICE FOR CANCELLATION OF NON - PANT. M 71-79i�Eiw'1. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Executive Director of Personnel Se ACCORDANCE WITH THE POLICY PROVISIONS. 0 Civic Center Plaza Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE I LA - - - _u C 1988.2014 A DI'CORPORATION. All rights reserved. ACORD 26 (2014101' The ACORD name and logo are registered marks of ACOR INS025 I201401) A �'® CERTIFICATE OF LIABILITY INSURANCE ATE 7M6 /2016YY) 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 CER'6 F =LCATL HO,'LQEI ": IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 certife - 14eF1nelte`0 bf such- erIorsement(s). PRODUCER Risk Strate les Company f, - ("- g 2040 Maln Street, Suite 450 Irvine, CA 92614 ACC TART NAME; Risk Strategies Company PRGN o 949 -242 -9240 aIC No: E -MAIL ADDRESS: s oun risk- strate ies.com INSURERS AFFORDING COVERAGE NAILA COMMERCIAL GENERAL LIABILITY INSURERA: Sentinel Insurance Co. 11000 www.risk- strategies.com CA DOI License No. OF06675 INSURED Phase II Systems dba: PARS INSURER B: LLO ds of London EACHOCCURRENCE INSURERC: INSURER D: 4350 Von Karman Ave. Ste 100 Newport Beach CA 92660 INSURER E: INSURER F: DAMAGE TO RENT—ED PREMISES Ea occurrence) COVF_RAGES CERTIFICATE NIIMRER- anOAR1n1 REVISION NIIMRER- 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. LTR TYPE OF INSURANCE AODLSUBR INSO WYE POLICYNUMBER POLICY EFF UANI POLICY EXP MMIDDPIYYY LIMITS A COMMERCIAL GENERAL LIABILITY �/ 72SBAAC2429 5/8/2016 5/8/2017 EACHOCCURRENCE $ $2,000,000 CLAIMS -MADE 12 OCCUR DAMAGE TO RENT—ED PREMISES Ea occurrence) $ $1,000,000 MED EXP (Any one person) $ $10:000 PERSONAL &ADV INJURY $ $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ $4,000,000 POLICY ❑ JECT LOC PRODUCTS- COMP /OPAGG $ $4,000,000 $ OTHER: A AUTOMOBILE LIABILITY 72SBAAC2429 518/2016 518/2017 E0 a gdyDiSINGLE LIMIT _ $ $2,000,00 BODILY INJURY (Per person) $ ANYAUI'0 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ ✓ PROPERTY DAMAGE Per accident $ _ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE t ,e DIED 7FRIETENTION S $ e WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YI❑N d STATUTE OERH ANYPROPRIETOR /PARTNER /EXECUTIVE EL EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? NIA 0/T (Mandatory in NH y EL DISEASE - EA EMPLOYEE $ If Yyas, describe under - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Professional Liability LDUSA1604508 7/30/2016 7/30/2017 Per Claim: $2,000,000 Aggregate: $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is requlred) Projects as on file with the insured including but not limited to those usual to the insured's operations /PARS Supplementary Retirement Plan. The City of Santa Ana, Its officials, employees and volunteers are named as additional insureds on the general liability policy -see attached endorsement. u? City of Santa Ana Attn: Executive Director of Personnel Services 20 Civic Center Plaza 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 art "V reserved. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD 30946141 1 16-17 CA GL- HNOA -PL I $hairy Young 1 7/18/2016 9:41:07 AM (PDT) I Page 1 of 12 IreAy:TeTIRz107M BUSINESS LIABILITY COVERAGE FORM 2. Applicable To Medical Expenses Coverage e. A trust, you are an insured. Your trustees We will not pay expenses for "bodily injury ": are also insureds, but only with respect to a. Any Insured their duties as trustees. To any insured, except "volunteer workers" 2. Each of the following is also an insured: b. Hired Person a. Employees And Volunteer Workers To a person hired to do work for or on behalf Your "volunteer workers" only while of any insured or a tenant of any insured. performing duties related to the conduct of c. Injury On Normally Occupied Premises your business, or your "employees ", other "executive than either your officers" (if you To a person injured on that part of are an organization other than a premises you own or rent that the person partnership, joint venture or limited liability normally occupies, company) or your managers (if you are a d. Workers' Compensation And Similar limited liability company), but only for acts Laws within the scope of their employment by To a person, whether or not an you or while performing duties related to "employee" of any insured, if benefits for the conduct of your business. the "bodily injury" are payable or must be However, none of these "employees" or provided under a workers' compensation "volunteer workers" are insureds for: or disability benefits law or a similar law. (1) "Bodily injury" or "personal and e. Athletics Activities advertising injury": To a person injured while practicing, (a) To you, to your partners or instructing or participating in any physical members (if you are a partnership exercises or games, sports or athletic or joint venture), to your members contests. (if you are a limited liability f. Products - Completed Operations Hazard company), or to a co-"employee" while in the course of his or her Included with the "products- completed employment or performing duties operations hazard ". related to the conduct of your g. Business Liability Exclusions business, or to your other Excluded under Business Liability Coverage. "volunteer workers" while performing duties related to the C. WHO IS AN INSURED conduct of your business; 1. If you are designated in the Declarations as: (b) To the spouse, child, parent, a. An individual, you and your spouse are brother or sister of that co- insureds, but only with respect to the "employee" or that "volunteer conduct of a business of which you are the worker" as a consequence of sole owner. Paragraph (1)(a) above; b. A partnership or joint venture, you are an (c) For which there is any obligation insured. Your members, your partners, and to share damages with or repay their spouses are also insureds, but only with someone else who must pay respect to the conduct of your business. damages because of the injury c. A limited liability company, you are an described in Paragraphs (1)(a) or insured. Your members are also insureds, (b) above; or but only with respect to the conduct of your (d) Arising out of his or her providing business. Your managers are insureds, but or failing to provide professional only with respect to their duties as your health care services. managers. If you are not in the business of d. An organization other than a partnership, providing professional health care joint venture or limited liability company, you services, Paragraph (d) does not apply are an insured. Your "executive officers" and to any nurse, emergency medical directors are insureds, but only with respect technician or paramedic employed by to their duties as your officers or directors. you to provide such services. Your stockholders are also insureds, but only (2) "Property damage" to property: with respect to their liability as stockholders. (a) Owned, occupied or used by, Page 10 of 24 Form SS 00 08 04 05 30946141 1 16 -17 CA GL- HNGA -PL I Sherry Young 1 7/18/2016 9:41:89 AM (POT) I Page 2 of 12 (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees ", "volunteer workers" any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Real Estate Manager Any person (other than your "employee" or "volunteer worker "), or any organization while acting as your real estate manager. c. Temporary Custodians Of Your Property Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this insurance. e. Unnamed Subsidiary Any subsidiary and subsidiary thereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Part. The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not apply to injury or damage with respect to which an insured under this insurance is also an insured under another policy or would be an insured under such policy but for its termination or upon the exhaustion of its limits of insurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and Form SS 00 08 04 05 30946141 116 -17 CA GL-HNOA -PL I Sherry Young 1 7/16/2016 9,91:07 AM (PDT) I Page 3 of 12 BUSINESS LIABILITY COVERAGE FORM b. Coverage under this provision does not apply to: (1) "Bodily injury" or "property damage" that occurred; or (2) "Personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. 4. Operator Of Mobile Equipment With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is an insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co- "employee" of the person driving the equipment; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 5. Operator of Nonowned Watercraft With respect to watercraft you do not own that is less than 51 feet long and is not being used to carry persons for a charge, any person is an insured while operating such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co- "employee" of the person operating the watercraft; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written Page 11 of 24 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement, or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit, except such operations performed However, no such person or organization is an at the vendor's premises in connection with the sale of the additional insured under this provision if such product; person or organization is included as an additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you, have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F. — Optional Additional Insured Coverages. the vendor; or a. Vendors (h) "Bodily injury" or "property Any person(s) or organization(s) (referred to damage" arising out of the sole negligence of the vendor for its below as vendor), but only with respect to own acts or omissions or those of "bodily injury" or "property damage" arisin g its employees or anyone else out of "your products" which are distributed acting on its behalf. However, this or sold in the regular course of the vendor's exclusion does not apply to: business and only if this Coverage Part provides coverage for "bodily injury" or (i) The exceptions contained in "property damage" included within the Subparagraphs (d) or (f); or "products- completed operations hazard ". (ii) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual This insurance does not apply to; course of business, in connection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contract or agreement. or any ingredient, part or container, This exclusion does not apply to entering into, accompanying or liability for damages that the containing such products, vendor would have in the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only with respect to their liability for "bodily (c) Any physical or chemical change injury", "property damage" or in the product made intentionally "personal and advertising injury" by the vendor; caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 10946141 1 16 -17 CA GL- HNOA -PL I Sherry Yohng 1 9/10/2016 9,01,09 AM (PDT) I Page 4 of 12 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but "occurrence" which takes place after only with respect to operations you cease to lease that equipment, performed by you or on your behalf for c, Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) "Bodily injury", "property damage" leased to you. or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or insurance does not apply to: municipality; or (a) Any "occurrence" which takes (b) "Bodily injury" or "property damage" place after you cease to lease that included within the "products - land or be a tenant in that completed operations hazard ". premises; or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an insured under Paragraphs a. operations performed by or on through e. above, but only with behalf of such person or respect to liability for "bodily injury" organization. "property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or (1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or only with respect to liability for "bodily the acts or omissions of those acting injury" "property damage" or "personal on your behalf: and advertising injury" caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) In connection with your premises your behalf: owned by or rented to you; or (a) In connection with your premises; (c) In connection with "your work" and or included within the "products - (b) In the performance of your completed operations hazard ", but ongoing operations performed by only if you or on your behalf. (i) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (ii) This Coverage Part provides "bodily injury", "property damage" or coverage for "bodily injury" or "personal and advertising injury" "property damage" included arising out of the rendering of or the within the "products - failure to render any professional completed operations hazard ". services by or for you, including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "Bodily injury ", "property damage" or reports, surveys, field orders, "personal and advertising injury" change orders, designs or arising out of the rendering of, or the drawings and specifications; or failure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including: activities. Form SS 00 08 04 05 Page 13 of 24 30996191 16 -17 CA GL- HNOA -PL I ShaixY Young 1 9/18/2016 9:91:07 AM (PDT) I Page 5 of 12 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to additional insureds are described in Section D. — Limits Oflnsurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 1. The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits ". 2. Aggregate Limits The most we will pay for: a. Damages because of "bodily injury" and "property damage" included in the "products- completed operations hazard" is the Products - Completed Operations Aggregate Limit shown in the Declarations. b. Damages because of all other "bodily injury ", "property damage" or "personal and advertising injury", including medical expenses, is the General Aggregate Limit shown in the Declarations. This General Aggregate Limit applies separately to each of your 'locations" owned by or rented to you "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway or right -of -way of a railroad. Page 14 of 24 309M16141 16 -19 cA CL- HNOA -PL I Sherry Young 1 7/10 /20].6 9:41,09 AM (PDT) I Page 6 of 12 This General Aggregate limit does not apply to "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of fire, lightning or explosion, 3. Each Occurrence Limit Subject to 2.a. or 2.b above, whichever applies, the most we will pay for the sum of all damages because of all "bodily injury ", "property damage" and medical expenses arising out of any one 'occurrence" is the Liability and Medical Expenses Limit shown in the Declarations. The most we will pay for all medical expenses because of "bodily injury" sustained by any one person is the Medical Expenses Limit shown in the Declarations. 4. Personal And Advertising Injury Limit Subject to 2.b, above, the most we will pay for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization is the Personal and Advertising Injury Limit shown in the Declarations. 5. Damage To Premises Rented To You Limit The Damage To Premises Rented To You Limit is the most we will pay under Business Liability Coverage for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of these. 6. How Limits Apply To Additional Insureds The most we will pay on behalf of a person or organization who is an additional insured under this Coverage Part is the lesser of: a. The limits of insurance specified in a written contract, written agreement or permit issued by a state or political subdivision; or b. The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to the Limits of Insurance shown in the Declarations and described in this Section. Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM If more than one limit of insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any claim or "suit ", the most we will pay legal papers received in connection under this policy and the endorsements is the with the claim or "suit "; single highest limit of liability of all coverages (2) Authorize us to obtain records and applicable to such claim or "suit ". However, this other information; paragraph does not apply to the Medical Expenses (3) Cooperate with us in the investigation, limit set forth in Paragraph 3, above. settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the "suit" and separately to each consecutive annual period and to (4) Assist us, upon our request, in the any remaining period of less than 12 months, starting enforcement of any right against any with the beginning of the policy period shown in the person or organization that may be Declarations, unless the policy period is extended liable to the insured because of injury after issuance for an additional period of less than 12 or damage to which this insurance months. In that case, the additional period will be may also apply. deemed part of the last preceding period for purposes of determining the Limits of Insurance. d. Obligations At The Insured's Own Cost E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that insured's own cost, voluntarily make a payment, assume GENERAL CONDITIONS any obligation, or incur any expense, other 1. Bankruptcy than for first aid, without our consent. Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part, Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an Offense, Claim Or Suit additional insured, such additional insured a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the other insurer for defense and indemnity. You or any additional insured must see to However, this provision does not apply to it that we are notified as soon as "occurrence" the extent that you have agreed in a practicable of an or an offense which may result in a claim. To written contract, written agreement or the extent possible, notice should include: permit that this insurance is primary and non - contributory with the additional (1) How, when and where the "occurrence" insured's own insurance. or offense took place; f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit injured persons and witnesses; and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional insured only when such or damage arising out of the "occurrence ", offense, claim or "suit" is "occurrence" or offense. known to: b. Notice Of Claim (1) You or any additional insured that is If a claim is made or "suit" is brought an individual; against any insured, you or any additional (2) Any partner, if you or an additional insured must: insured is a partnership; (1) Immediately record the specifics of the (3) Any manager, if you or an additional claim or "suit" and the date received; insured is a limited liability company; and (4) Any "executive officer" insurance 2 Notify us as soon as practicable. () Y P n manager, if you or an additional You or any additional insured must see to insured is a corporation; it that we receive a written notice of the (5) Any trustee, if you or an additional claim or "suit" as soon as practicable, insured is a trust; or c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you Insured or an additional insured is a political You and any other involved insured must: subdivision or public entity. Form SS 00 08 04 05 Page 15 of 24 30946141 116 -17 CA GL- HNOA -PL I Sherry Yohng 1 7/10/2016 9:41,07 AM (POT) I Page 7 of 12 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional insured. upon your representations. 3, Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy is certified as proof of Hazards financial responsibility for the future under If unintentionally you should fail to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inception date of this provided by the policy for "bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7, Other Insurance insurance required by that law. b. With respect to "mobile equipment" to If other valid and collectible insurance is which this insurance applies, we will available for a loss we cover under this Coverage Part, our obligations are limited as provide any liability, uninsured motorists, follows: underinsured motorists, no -fault or other coverage required by any motor vehicle a. Primary Insurance law. We will provide the required limits for This insurance is primary except when b. those coverages. below applies. If other insurance is also 4. Legal Action Against Us primary, we will share with all that other No person or organization has a right under insurance by the method described in c. this Coverage Form: below. a. To join us as a party or otherwise bring us b. Excess Insurance into a "suit" asking for damages from an This insurance is excess over any of the insured; or other insurance, whether primary, excess, b. To sue us on this Coverage Form unless contingent or on any other basis: all of its terms have been fully.complied (1) Your Work with. That is Fire, Extended Coverage, A person or organization may sue us to recover Builder's Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for "your work" against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of That is fire, lightning or explosion this insurance or that are in excess of the insurance for premises rented to you applicable limit of insurance. An agreed or temporarily occupied by you with settlement means a settlement and release of permission of the owner; liability signed by us, the insured and the claimant or the claimant's legal representative. (3) Tenant Liability 5. Separation Of Insureds That is insurance purchased by you to Except with respect to the Limits of Insurance, cover your liability as a tenant for "property and any rights or duties specifically assigned damage" to premises rented in this policy to the first Named Insured, this to you or temporarily occupied by you insurance applies: with permission of the owner; a. As if each Named Insured were the only (4) Aircraft, Auto Or Watercraft Named Insured; and If the loss arises out of the maintenance b. Separately to each insured against whom or use of aircraft, "autos" or watercraft to a claim is made or "suit" is brought, the extent not subject to Exclusion g. of Section A. —Coverages. 6. Representations (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of "property (1) The statements in the Declarations damage" to borrowed equipment or are accurate and complete; the use of elevators to the extent not (2) Those statements are based upon subject to Exclusion k. of Section A. — representations you made to us; and Coverages. Page 16 of 24 Form SS 00 08 04 05 30946141 1 16-11 CA Gtr HNCA -PL Sherry You "9 7/10/2016 9',41:09 AM (POT( I Page 8 of 12 (6) When You Are Added As An Additional Insured To Other Insurance That is other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional insured by that insurance; or (7) When You Add Others As An Additional Insured To This Insurance That is other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non - Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non - contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under this Coverage Part to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit ". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. Form SS 00 08 04 05 30946141 116 -17 CA GL-HNOA -PL I Sherry Young 1 7/18/2016 9z4109 AN. PV1') I Page 9 of 12 BUSINESS LIABILITY COVERAGE FORM When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self - insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 8. Transfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. This condition does not apply to Medical Expenses Coverage. b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. Page 17 of 24 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED 3. Additional Insured- Grantor Of Franchise COVERAGES WHO IS AN INSURED under Section C. is If listed or shown as applicable in the Declarations, amended to include as an additional insured one or more of the following Optional Additional the person(s) or organization(s) shown in the Insured Coverages also apply. When any of these Declarations as an Additional Insured - Optional Additional Insured Coverages apply, Grantor Of Franchise, but only with respect to Paragraph 6. (Additional Insureds When Required their liability as grantor of franchise to you. by Written Contract, Written Agreement or Permit) 4. Additional Insured - Lessor Of Leased of Section C., Who Is An Insured, does not apply Equipment to the person or organization shown in the a. WHO IS AN INSURED under Section C. is Declarations. These coverages are subject to the amended to include as an additional terms and conditions applicable to Business insured the person(s) or organization(s) Liability Coverage in this policy, except as shown in the Declarations as an Additional provided below: Insured — Lessor of Leased Equipment, 1. Additional Insured - Designated Person Or but only with respect to liability for "bodily Organization injury ", "property damage" or "personal WHO IS AN INSURED under Section C. is and advertising injury" caused, in whole or amended to include as an additional insured in part, by your maintenance, operation or the person(s) or organization(s) shown in the use of equipment leased to you by such Declarations, but only with respect to liability person(s) or organization(s). for "bodily injury ", "property damage" or b. With respect to the insurance afforded to "personal and advertising injury" caused, in these additional insureds, this insurance whole or in part, by your acts or omissions or does not apply to any "occurrence" which the acts or omissions of those acting on your takes place after you cease to lease that behalf: equipment. a. In the performance of your ongoing 5. Additional Insured - Owners Or Other operations; or Interests From Whom Land Has Been b. In connection with your premises owned Leased by or rented to you. a. WHO IS AN INSURED under Section C. is 2. Additional Insured - Managers Or Lessors amended to include as an additional Of Premises insured the person(s) or organization(s) shown in the Declarations as an Additional a. WHO IS AN INSURED under Section C. is Insured — Owners Or Other Interests From amended to include as an additional insured Whom Land Has Been Leased, but only the person(s) or organization(s) shown in the with respect to liability arising out of the Declarations as an Additional Insured - ownership, maintenance or use of that part Designated Person Or Organization; but only of the land leased to you and shown in the with respect to liability arising out of the Declarations. ownership, maintenance or use of that part of the premises leased to you and shown in the b. With respect to the insurance afforded to Declarations. these additional insureds, the following additional exclusions apply: b. With respect to the insurance afforded to these additional insureds, the following This insurance does not apply to: additional exclusions apply: (1) Any "occurrence" that takes place This insurance does not apply to: after you cease to lease that land; or (1) Any "occurrence" which takes place (2) Structural alterations, new after you cease to be a tenant in that construction or demolition operations performed by or on behalf of such premises; or person or organization. (2) Structural alterations, new 6. Additional Insured - State Or Political construction or demolition operations Subdivision — Permits performed by or on behalf of such person or organization. a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 30946111 116 -17 CA GL- HNGA -PL 15➢erry Ya4n9 1 7/10/2016 9,41,07 AM (PNT) I Page 10 of 12 BUSINESS LIABILITY COVERAGE FORM Insured — State Or Political Subdivision - (e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of b. With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products; additional exclusions apply: (f) Demonstration, installation, This insurance does not apply to: servicing or repair operations, except such operations performed (1) "Bodily injury", "property damage" or at the vendor's premises in "personal and advertising injury" connection with the sale of the arising out of operations performed for product; the state or municipality; or (g) Products which, after distribution (2) "Bodily injury" or "property damage" or sale by you, have been labeled included in the "product- completed or relabeled or used as a operations" hazard. container, part or ingredient of any 7. Additional Insured — Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C. is the vendor; or amended to include as an additional (h) "Bodily injury" or "property insured the person(s) or organization(s) damage" arising out of the sole (referred to below as vendor) shown in the negligence of the vendor for its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on its behalf. However, this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendor's (I) The exceptions contained in business and only if this Coverage Part Subparagraphs (d) or (f); or provides coverage for "bodily injury" or "property (ii) Such inspections, damage" included within the "products- completed operations hazard" adjustments, tests or servicing as the vendor has agreed to b. The insurance afforded to the vendor is subject to the following additional exclusions: to make in the usual course of (1) This insurance does not apply to: business, in connection with (a) "Bodily injury" or "property the distribution or sale of the damage" for which the vendor is products. obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement. whom you have acquired such This exclusion does not apply to products, or any ingredient, part or liability for damages that the container, entering into, vendor would have in the absence accompanying or containing such of the contract or agreement; products. (b) Any express warranty 8. Additional Insured — ControllingInterest unauthorized by you; WHO IS AN INSURED under Section C. is (c) Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s) or organization(s) shown in the by the vendor; Declarations as an Additional Insured -- (d) Repackaging, unless unpacked Controlling Interest, but only with respect to solely for the purpose of inspection, their liability arising out of: demonstration, testing, or the a. Their financial control of you; or substitution of parts under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container; Form SS 00 08 04 05 Page 19 of 24 30946141 1 ].6 -19 CA AL- HNOA -PL I Sherry Young 1 7/10/2016 9:91:07 AM PUT) I Page 11 of 12 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. 9. Additional Insured — Owners, Lessees Or Contractors — Scheduled Person Or Organization a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured — Owner, Lessees Or Contractors, 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: (1) In the performance of your ongoing operations for the additional insured(s); or (2) In connection with "your work" performed for that additional insured and included within the "products - completed operations hazard ", but only if this Coverage Part provides coverage for "bodily injury" or "property damaae" included within the "products- completed operations hazard ". b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to "bodily injury ", "property damage" or "personal an advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. 10. Additional Insured — Co -Owner Of Insured Premises WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or Organization(s) shown in the Declarations as an Additional Insured — Co- Owner Of Insured Premises, but only with respect to their liability as co -owner of the premises shown in the Declarations. The limits of insurance that apply to additional insureds are described in Section D. — Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS Page 20 of 24 30946141 1 16 -1] CA GL- HNOA -PL I Sheixy Young 1 7/18/2016 9;4].,D9 AM (POT) I Page 12 of 12 1. "Advertisement" means the widespread public dissemination of information or images that has the purpose of inducing the sale of goods, products or services through: a. (1) Radio; (2) Television; (3) Billboard; (4) Magazine; (5) Newspaper; b. The Internet, but only that part of a web site that is about goods, products or services for the purposes of inducing the sale of goods, products or services; or c. Any other publication that is given widespread public distribution. However, "advertisement" does not include: a. The design, printed material, information or images contained in, on or upon the packaging or labeling of any goods or products; or b. An interactive conversation between or among persons through a computer network. 2. "Advertising idea" means any idea for an "advertisement ". 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4. "Auto" means a land motor vehicle, trailer or semi - trailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment ". 5. "Bodily injury" means physical: a. Injury; b. Sickness; or c. Disease sustained by a person and, if arising out of the above, mental anguish or death at any time. 6. "Coverage territory" means: Form SS 00 08 04 05