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Home My WebLink AboutDONNA DESMOND ASSOCIATES (3) -2011A-2011-070 INSURANCE NOT ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL DATE: BUSINESS GOODWILL APPRAISAL O t 1,VA / 0 �� C I-) SERVICES AGREEMENT 70ur, �Ir�!'t�t!11 THIS AGREEMENT, made and entered into this 21" day of March, 201 1, by and between DONNA DESMOND ASSOCIATES, a California corporation (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of business goodwill appraisal services. B. Consultant represents that it is able and willing to provide such services for Santa Ana. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SERVICES Consultant shall provide services, as set forth in City's Request for Proposals -Right of Way Consulting and Related Services, dated November 15, 2010, attached hereto as Exhibit A, and as more specifically described in Consultant's Proposal, attached hereto as Exhibit A-1, and both exhibits incorporated by reference. 2. DELIVERY OF WORK PRODUCT - OWNERSHIP Consultant warrants and represents that it has the absolute right to enter into and perform this Agreement and will perform its obligations hereunder in accordance with standards and practices prevailing in the industry. Consultant's contribution to the Project, including works to be produced by Consultant hereunder, will not infringe or misappropriate the proprietary or personal rights of any third person or party. Consultant shall deliver to City any work product which results from the services provided. Said work product shall be submitted in hard copy and produced in a form compatible with City's information systems, as agreed between the City's Project Manager and Consultant. In regard to all material produced as a deliverable under this Agreement, including but not limited to records, papers, drawings, specifications, programs, systems and other materials prepared by Consultant, Consultant agrees, for itself and its affected officers, employees, agents, contractors, and volunteer workers, that (a) other such material shall be the property of the City, and may not be copyrighted without prior review from the City, and (b) the authors of all such material, whether copyrighted or not, award to the City, and to its officers, agents and employees acting within the scope of their official duties, as a condition of payment to the Consultant, a royalty -free, nonexclusive, irrevocable license throughout the world for governmental purposes to disclose, publish, translate, reproduce, and use such materials. 3. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Consultant's Fee Schedule, attached hereto as Exhibit B. The total sum to be expended on all consultants providing goodwill appraisal services and furniture, fixture and equipment appraisal services shall not exceed an aggregate of $300,000, during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. The invoice shall include a detailed breakdown of the services provided, the project title, the tasks, the hours, and hourly rates. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City_ 4. TERM This Agreement shall commence on March 1, 201 1 and terminate on the later of February 28, 2012, or the expenditure of allocated funds, unless terminated earlier in accordance with Section 13, below. The City shall have the option to extend the term for an additional one-year period. 5. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance_ Consultant shall maintain commercial general liability insurance which shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1 ,000,000 per occurrence. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 combined single limit. Such insurance shall include coverage for owned, hired and non -owned automobiles. c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim, and $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. f. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its time and materials expended prior to notification oftermination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 7. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 8. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 10. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by facsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 facsimile (714) 647-6956 With courtesy copies to: Public Works — Design Engineering City of Santa Ana 20 Civic Center Plaza (M-36) P.O. Box 1988 Santa Ana, California 92702 facsimile (714) 647-5635 and City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 facsimile (714) 647-6515 To Consultant: Donna Desmond Associates 265 Beverly Glen Blvd. Los Angeles, California 90024 facsimile (310) 475-6266 Attn: Donna Desmond A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by facsimile, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 13. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. However, any use of unfinished work product shall be at City's sole risk. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 14. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 15. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 16. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 17. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. Captions and headings in this Agreement, including the title of this Agreement, are for convenience only and are not to be considered in construing this Agreement. c. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: MARIA D. HUIZAR Clerk ofthe Council APPROVED AS TO FORM: JOSEPH STRAKA Interim City Attorney By: La a eedy Assistant City Attorney RECOMMENDED FOR APPROVAL: 1 _ PAUL GODINEZ, II Executive Director — P A CITY OF SA TA ANA ID N. REAM i Manager DONN D NO ASSO D OND Pr ident Tax I D# EXHIBIT SCOPE OF WORK GENERAL REQUIREMENTS — RIGHT OF WAY SERVICES Consultants under contract with the City of Santa Ana will provide support to City of Santa Ana staff or their designee. The Consultants shall be thoroughly familiar with the Statement of Work prior to submitting a response to this Request for Qualifications (RFQ). • The Consultant shall perform work to produce a high quality, professional and complete work product. • Consultant must have experience with State and Federally funded projects. All work shall be performed in conformance with all applicable regulations, policies, procedures and standards. • Real estate appraisers provided by the Consultant must be certified and a Member of the Appraisal Institute. • All acquisition agents and property managers, performing work for the City, must hold a valid California Real Estate License. Salespersons must be registered with California Department of Real Estate (DRE), as working solely under the Consultant's supervising broker of record. Work may include, but not be limited to, the following: onsite review of the project area; review of existing records; conducting research and performing analysis; information gathering; negotiations; development of strategies. • The Consultant shall carry out the instructions received from the City and shall cooperate with the City and other agencies. • The Consultant has total responsibility for the accuracy and completeness of the work produced. The work will be reviewed by the City for conformity with the requirements of the Agreement. Reviews by the City may NOT include a detailed review for the accuracy of items submitted. The responsibility for accuracy and completeness of such items remains solely that of Consultant. • The Consultant shall be responsible for coordination and supervision of all work performed by its sub -consultants. The Consultant shall review all work performed by its sub -consultants and the responsibility for accuracy and completeness of work performed remains solely that of Consultant. • The Consultant shall have a Quality Control Plan in effect during the entire time work is being performed under the Agreement. The Quality Control Plan shall establish a process whereby work products are independently checked, corrected and back checked. All projects related correspondences and documents should be maintained and bound in appropriate project files. • The Consultant shall diligently work on each assignment and complete each task in accordance with the schedule and accommodate the City's needs. The Consultant's work will be subject to inspections by City, County, State and Federal representatives. • Project files including copies of all correspondences, reports, documents, and electronic files shall be submitted to the City when requested. • All work, including reports, analysis, data, and intellectual properties developed during the life of the Agreement shall become the properties of the City. • The Consultant will receive written notification of the award of the contract. Upon on such notification, the Consultant will proceed with the services required by the Agreement. • The Consultant shall complete work under the direction of City staff. The Consultant will be expected to provide experienced and knowledgeable professional staff which will be responsive and maintain excellent working relationships with property owners, tenants, and City staff. The Consultant shall be committed to provide adequate staffing levels at all times in order to adhere to established schedules. The Consultant shall be knowledgeable and very familiar with federal, state and local regulations, policies and procedures as pertain to the right of way services provided. Specific Scope of Work for BUSINESS GOODWILL APPRAISAL SERVICES includes: Consultant services will include providing: Budgetary Estimates of Goodwill Loss Budgetary estimates are used by public agencies in planning and preparing a project budget. Consultant's estimates of goodwill loss will be based upon a "drive by" site inspection of the subject businesses, limited market research, and any publicly available data. In addition, these estimates will take into consideration Consultant's experience in preparing goodwill loss appraisals of comparable businesses, as well as our knowledge of relevant statutes and case law, negotiated settlements and jury awards in eminent domain proceedings. Consultant's results will be presented in a brief letter. Goodwill Loss Acquisition Appraisals During the early stages of property acquisition, Consultant can provide preliminary estimates of goodwill loss. Acquisition appraisals are based upon data, which may be provided by the business' ownership at its discretion. Such information may include: leases; background on the business provided via owner/management interviews; historical and prospective financial data; and information about proposed relocation sites. In addition, Consultant shall perform basic transactional research in light of our understanding of the business' operations and financial condition. Consultant will also coordinate with real estate and fixtures and equipment appraisers to avoid duplication of compensation. Further, Consultant's analyses will be guided by relevant statutory and case law pertaining to compensation for loss of goodwill. The result of each acquisition appraisal study is presented in a brief report with attached schedules. Included within this document are the purpose of the assignment, the sources of information utilized, a brief description of the subject business and the valuation methods employed. Consultant will note any assumptions made in performing the analysis, as well as all information requested from the business' ownership, but not received, which, upon review by Consultant, may have an impact on the value conclusion. EXHIBIT A-1 CONSULTANT'S PROPOSAL YYCDP RK PLAN In providing goodwill loss appraisal services, DDA proposes the following work process for each appraisal assignment: o Meet with project team to gain an understanding of the project and potential - impacts; o Provide preliminary estimates of goodwill for budgetary purposes, if requested; o Inspect the business facility; o Interview the business owner and management to determine history of operations and relocation needs; o Review business' historical financial statements, tax returns and lease agreements; o Review all parcel appraisal reports and coordinate with real estate and fixtures and equipment appraisers to avoid duplication of compensation; o Coordinate with agency staff and legal counsel to discuss strategy and approach; o Coordinate with relocation agents to determine relocation options, feasibility of relocation, mitigation issues and to avoid duplication ofcompensation; o Perform market research to determine the business' marketability and external influences; o Implement valuation methodology, including market based and income approaches, to determine the business' goodwill value in the before condition; .d o Inspect potential or actual relocation site(s); m a Review all relevant and available documentation from relocation site, including lease, financial statements and unreimbursed capital expenditures; 15 of 23 DONNA OESMONO ASSOCIATES '� RESPONSE TO THE CrrY OF SANTA ANA'S RFP FOR RIGHT OF WAY CONSULTING ANn RELATED SERVICES o Implement valuation methodology to determine the loss of goodwill suffered. by the business, including giving consideration to betterment, if any; o Prepare a full or summary narrative appraisal report or declaraiion of value; and o Provide support in negotiations and litigation (as needed). All of the above tasks would be completed by Donna Desmond. All appraisal services provided by Donna Desmond Associates are performed in conformance with the Uniform Standard of Professional Appraisal Practice ("USPAP"). Appraisal reports can be completed within four weeks of receiving all applicable documentation from the business ' owners. Goodwill loss appraisals are often delayed by business owners' reluctance to provide financial documents, including income tax returns_ DDA works closely with project staff and the relocation consultants to ensure business owners understand the necessity of providing such documentation_ Further, DDA continues to engage the business owners in order to provide a level of comfort with the process. 16 of 23 GONNA OESMONO ASSOCIATES RESPONSE TO THE CITY OF SANTA ANA'S RFP FOR RIGHT OF WAY CONSULTING AND RELATED SERVICES Donna Desmond provides all appraisal services to her clients. Therefore, less e experienced staff members are not performing appraisal tasks or billing hours for �+ bringing the responsible appraiser up to speed. As a result, the appraisal process is streamlined, typically resulting in a more cost effective fee structure for appraisal services, quicker turnaround time and a high level of quality. �f �a 16 of 23 GONNA OESMONO ASSOCIATES RESPONSE TO THE CITY OF SANTA ANA'S RFP FOR RIGHT OF WAY CONSULTING AND RELATED SERVICES - PROPOSED STAFFING AhI� PROJECT �RGANIZATIdN �• K1CY PERSONNUE Donna Desmond, ASA Donna Desmond, President of Donna Desmond Associates, has specialized in business s" valuation since 1987. She has completed thousands of goodwill loss appraisal assignments for both public agencies and private parties throughout the State of v California since 1987. Ms. Desmond has qualified as an expert in goodwill loss and business damages in the Superior Court of California in Los Angeles, Orange, San Diego, Kern, Santa Clara, San Francisco and Contra Costa counties and in the states of Nevada -. and Texas, and has testified extensively in arbitration and mediation throughout ..a California. Prior to founding DDA in 1997, she was a principal with Desmond, Marcello ox & Amster, responsible for appraisal management and testimony. Ms. Desmond was employed with Desmond, Marcello 8c Amster from 1986 through 1997. From September 1986 through December 1990, Ms. Desmond was a financial analyst with the firm. From ,. 1990 through 1994 she was a project manager and from 1994 through 1997 was a principal with the firm. Ms. Desmond is a senior member of the American Society of Appraisers in the Business Valuation Discipline. This designation was attained in 1995. She is also a member of the V' Institute of Business Appraisers. Ms. Desmond has written articles for International Right of Way Association newsletters a• and the California Redevelopment Journal. She is also a contributing author to the 13 of 23 DONNA DESMOND ASSOCIATES �' RESPONSE TO THE C� OF SANTA ANA'S RFP FOR RIGHT OF WAY CONSULTING AND REIATED SERVICES �. Handbook of Small Business Valuation Formulas, published in 1987 and revised in 1988. Ms. Desmond regularly gives seminars to public agencies, attorney groups, and J.I redevelopment and right of way organizations relative to issues pertinent to goodwill loss in eminent domain actions and billboard appraisal. Ms. Desmond graduated with a bachelor's degree from the University of California, Los xi* Angeles in 1986 and continues to attend professional education courses in appraisal, y finance and accounting. ' Ms. Desmond will be directly responsible for all appraisal services provided to the City of Santa Ana. ' Ms. Desmond will be available to provide goodwill loss appraisal services far the duration ofthe contract with the City of Santa Ann. No other person wi/! replace Ms. -.. Desmond. .a, 14 of 23 DONNA DESMOND ASSOCIATES RESPONSE TO THE CITY OF SANTA ANA'S RFP FOR RIGHT OF WAY CONSULTING ANO REI..ATEO SERVICES ti EXHIBIT B FEE SCHEDULE COST 8c PRICifVG BATA COST & PRICING DATA Donna Desmond Associates bills for appraisal services based upon hourly rates. Tbg 2010/2011 hourly rates areas follows: Appraisal Preparation $265.00 Litigation Support $265.00 - $365.00 Deposition and Court Testimony $365.00 PRICING DETAIL Goodwill loss appraisal fees are based on the relative complexity of the assignment and litigation requirements. Goodwill loss appraisal fees for various types of businesses are as follows: Business Type/Complexity Budgetary Estimate of Goodwill Loss Small Sole Proprietorship (i.e. accountant, hair salon, liquor store) Retail Type Business (i.e. restaurant, gasoline station, 99¢ Store) Larger Industrial/Manufacturing Typical Appraisal Fee $2,000 $3,500 - $4,500 $4,500 — $6,500 $6,500 - $12,000 Actual appraisal fees could vary for individual appraisal assignments, depending on the facts surrounding the matter. No subconsultant costs would be incurred. 18 of 23 DONNA DESMOND ASSOCIATES RESPONSE TO THE CITY OF SANTA ANA'S RFP FOR RIGHT OF WAY CONSUL ING AND REIATEO SERVICES PROPOSED REIMBURSABLES - Donna Desmond Associates does not charge for any costs, with the exception of trial exhibits produced by an outside firm. However, these costs are typically paid for by legal counsel. �Q 6i 19 of 23 GONNA OESMONO ASSOCIATES �a RESPONSE TO THE CITY OF SANTA ANA'S RFP FOR RIGHT OF WAY CONSULTING ANO RELATEn SERVICES mi CERTIFICATE OF LIABILITY INSURANCE OPID SG DATE(MWDWYWY) DESMO-1 11 30 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LTR ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE JOHN T- MATSOCFC 6 ASSOC. INC_ 1750 N WAINGTON ST SH \ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DATE M W NAPERVII.LE IL 60563 Phone .' 630-505-7888 /� I —O INSURERS AFFORDING COVERAGE MAIC B INSURED INSURER Hartford I-0-=aInC@ Co njr 00914 INSURER & INSURER C: Donna D@smondA8yy80(GC�1at.@S INSURER D: x.06 Ang@ iao CA 9D024@n BIVd_ INSURER E 83SBAVZ5827 THE POLICIES CF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD WDICATED. NOTWITHSTANDING ANYREQUIREMENT• TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PMD CLAIMS. LTR NSR TYPE OF MSURANCE POLICY NUMBER DATE M W DATE M LIMITS RWRESEaIrnrnlM. AVTHO REPRESENTATIVE GENERAL LIABILITY EACH OCCURRENCE 51,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR 83SBAVZ5827 12/01/10 12/01/11 $300,000 ME 1O 000X PERSONAL 6 ADV INJURY 31 OOO 000 GENERAL AGGREGATE S 2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/CP AGG i2 OOO OOO X POLICY jECOT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea ar ,M) S 1000 OOO BODILY INJURY (pw P_n) S ALL OWNED AUTOS SCHEDULED AUTOS A A X X HIRED AUTOS NON -OWNED AUTOS 83SBAVZ5827 83S33AVZ5827 12/01/10 12/01/10 12/01/11 12/01/11 BODILY INJURY (Pa eC1 _> s PROPERTY DAMAGE i (PH —W—) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT i OTHER THAN EA ACC S ANY AUTO Fl AUTO ONLY' AGG E EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE qpP RU v IiJ AGGREGATE i i i DEDUCTIBLE RETENTX)N K MPFIJBATION AND EMPLOYERS• LIABILITY YI1 ANYPROPRIETOR/PARTNER _ IV XECUTfLJ OFFICERIMEMBER EXCLUDED? ASSISI "- Ill ... TORY LIMIT6 ER E.L. EACH ACCIDENT i E.L. DISEASE - EA EMPLOYE i (Manaalory .n NH) r yea. a SPECIALPROVISIONS pBlw E L DISEASE -POLICY LIMIT S OTHER A Property S@Ction 83SBAVZ5827 12/01/30 12/01/11 $500 DED $5,000 DESORPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDBD BY ENODRSEMENT /SPECIAL PROVISIONS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEERS AND REPRESENTATIVES//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICAMMS ARE St7B.7ECT TO ALL POLICY TERMS AND CONDITIONS . CERTIFICATE HOLDER CANCELLATION Z& (zoDB/DT) , --qwrTqvS-EOOIrACORD CORPORATIOpI_ All rights reserved_ The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION SANTAAN DATE THEREOF, THE ISSUING INSURER VOLL ENDEAVOR TO MAIL 10 DAYS WRITTEN CITY OF SANTA ANNA NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SMALL PUBLIC WORKS AGENCY IMPOSE NO OBLIGATION OR LIABILITY OF AMY RVND UPON THE INSURER ITS AGENTS OR ATTR : !CENT JORGENSEN 20 CIVIC CST7TER PLAZA M-36 RWRESEaIrnrnlM. AVTHO REPRESENTATIVE SANTA ANNA CA 92701 Z& (zoDB/DT) , --qwrTqvS-EOOIrACORD CORPORATIOpI_ All rights reserved_ The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed_ A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s)- DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. YLYDLTTe�LT. \1 BUSINESS LIABILITY COVERAGE FORM Wnen 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 ofthis 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. Form SS 00 08 04 05 Page 17 of 24 (6) When You ,-..e 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 a Insurance w That is other insurance available to an additional insured. c However, the following provisions o apply to other insurance available to any person or organization who Is an 00 additional insured under this Coverage LO Part: m (a) Primary Insurance When o Required By Contract NThis 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 a primary and non-contributory with i� 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 Maio 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 _N1111111111111 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. BUSINESS LIABILITY COVERAGE FORM Wnen 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 ofthis 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. Form SS 00 08 04 05 Page 17 of 24 BUSINESS LIABILITY COVEP' ,E 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 6. (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 organization(s) 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 premises owned by or rented to you. 2. Additional Insured - Managers Or Lessors Of Premises 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 - Designated Person Or Organization; but only with respect 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 person or organization. 3. Additional Insured - 43rantor Of Franchise 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 - Orantor 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(s) or organization(s). Ix 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. 5. 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(s) or organization(s) shown in the Declarations as an 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 part 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. 6. AdditionalInsured - State 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 09 04 05 Insured — State Cr Political Subdivision - Permits, but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or -� (2) "Bodily injury" or "property darnage" included in the "product -completed 0 operations" hazard. 0 7. Additional Insured —Vendors m a. WHO IS AN INSURED under Section C. is `^ amended to include as an additional N insured the person(s) or organization(s) N (referred to below as vendor) shown in the a Declarations as an Additional Insured - 0 N Vendor, but only with respect to "bodily + injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the f� "products -completed operations hazard". b. The insurance afforded to the vendor is -- subject to the following additional exclusions: _ (1) This insurance does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is 0 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 e unauthorized by you; ® (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, unless unpacked 992211 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, BUSINESS LIABILITY COVERAGE FORM (e) 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 course 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: (t) The exceptions contained in Subparagraphs (d) or (f); or (ii) Such Inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business. In connection with the distribution 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. 8. Additional Insured — Controlling Interest VMO 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 — Controlling Interest, but only with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVER' = FORM This insurance does not apply to structural The limits 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 organization(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 dissemination 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) Radio; ads 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 (5) 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 included 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 -completed operations hazard". a. The design, printed material, information or images contained In, on or upon the b. With respell to the Insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance products; or does not apply to "bodily injury", "property damage" or "personal an advertising b. An interactive conversation between or injury" arising out of the rendering of, or among persons through a computer network. 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, approving, 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, architectural 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 S. "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 person(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, if arising out of the respect to their liability as co-owner of the above, mental anguish or death at any time. premises shown In the Declarations. 6. "Coverage territory- means: Page 20 of 24 Forth SS 00 08 04 05 ACORO CERTIFICATE OF LIABILITY INSURANCE I DATEDEC 2010 ' TM. PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION E.L.M. INSURANCE BROKERS, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. BOX 2668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1990 E. GRAND "ESTE 210 CA LIC OD28706 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. EL SEGUNDO CA 90245-1768 PHONE: 310-322-1301 Agenc�INSURERS AFFORDING COVERAGE " NAIC 1r _Lic#_0028706 INSURED INSURERA: Lia yds of London DONNA DESMOND ASSOCIATES INSURER B: 265 S_ BEVERLY GLEN --_- ----- --- -- INSURER C_ LOS ANGELES CA 90024 ------------- ---- ------ p _INSURER D: :INSURER E:_____-___— TME 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 TOWHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AUTHORIZED REPRESENTATIVE -SR TV—OF INSURANCE POLICY NUMBER POLIO EFFECTIVE rPOLIGv EXPEIArOR LIMITS LTA. GATE MWPN GATE MW GENERAL LIABILITY NOT INCLUDED EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY OM.IAGE TO RENTED § CLAIMS MADE OCCUR MED. EXP (qny One Person) § • PERSONAL A ADV INJURY S GENERAL AGGREGATE S _ _____ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO. S -- POLICY I - AUOMOBILE UABIUTV T NOT INCLUDED -00 BINED SINGLE uMrr _ _ _ ANY AUTO - (Ea accment) § ALL OWNED AUTOS I BODILY INJURY _— — SCHEDULED AUTOS APPROVED AS TO FORM (Pe. HIRED AUTOS BODILY INJURY § NON -OWNED AUTOS � (Par acciden) - - - Laura Stitt Cedy. • PROPERTY DAMAGE f GARAGE LIABILITYOrney -AUTO ONLY -EA ACCIDENT f ANY AUTO OTHER THAN EA ACC f --- AUTO ONLv: f AGGI EXCESS/ UMBERELLA LIABILITY NOT INCLUDED EACHOCCURRENCE !f OCCUR - CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION S �f f WORKERS COMPENSATION ANDw0 NOT INCLUDED STATU- OTHER I EMPLOYERS' LIABILRY _�yyMt_ ---" -� - ---- — E.L. EACH ACCIDENT S AKYPROeWETOBIFMTNEIVEXECDTIVE OFFK:EK/YaMBER EX0.UQEDi E.L. DISEASE -EA EMPLOYEE—S- e yu,es,lM 9FECIALFROVtlION9bNor E.L. DISEASE -POLICY LIMIT 'If OTHER: MISCELLANEOUS 1038013509/010 DEC 4 10 DEC 4 11 IS1,000,000 / $1,000,000 LIMITS/// A PROFESSIONAL LIABILITY (CLAIMS MADE FORM) DESCRIPTION OF OPERATIONS/LOCATION/VEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NOT ADDED AS AN ADDITIONAL INSURED TO THE REFERENCED POLICY. CERTIFICATE IS FOR PROOF OF PROFESSIONAL LIABILITY COVERAGE. NOTHING IN THIS CERTIFICATE SHALL ALTER, AMEND OR EXTEND COVERAGE PROVIDED BY THE ABOVE MENTIONED POLICY. ALL OTHER TERMS AND CONDITIONS OF THE REFERENCED POLICY REMAIN IN FULL FORCE AND EFFECT. 12/4/97 PRIOR ACTS DATE/// CERTIFICATE HOLDER . ADDITIONAL INSURED; MSURER LETTER: CANCELLATION CITY ATTORNEY CITY OF SANTA ANA 20 CIVIC CENTER PLAZA (M-29) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE P.O. BOX 1988 INSURER, ITS AGENTS OR REPRESENTATIVES. SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE Attention: ACORD 25 (2001/08) Certificate p 4322 Frederick J. Fisher 0607799 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. /CORD 25-5 (2001!08) Certificate #4322 Alvarado, Judi From: Donna Desmond [d.desmond@verizon.net] Sent: Wednesday, December 22, 2010 10:08 AM To: Alvarado, Judi Subject: Insurance Certificates Attachments: City of Santa Ana COI.pdf; Santa Ana City.pdf Here you go. Please let me know if I can provide anything further Have a very happy holiday! Donna Desmond DONNA DESMOND ASSOCIATES 265 S. Beverly Glen Blvd. Los Angeles, CA 90024 Tel_ (31 O) 475-1114 Fax (31 0) 475-6266 d(lesmond Cci)donnadesmond.com Please consider the environment before printing this e-mail ACORD CERTIFICATE OF LIABILITY INSURANCE DAT TM. NOV26 E (MMI 3 PRODUCER E.L.M. INSURANCE BROKERS, INC. P.O. BOX 2668 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1960 E. GRAND AVE STE 370 CA LIC OD28706 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. EL SEGUNDO CA 90245.1768 POLICYNUMBER PHONE: 310.322.1301 Agency Lic#: OD28706 INSURERS AFFORDING COVERAGE NAIC # Int I Pr INSURED INSURER A: G f IIN-VR INC OM At DONNA DESMOND ASSOCIATES INSURER B: 265 S. BEVERLY GLEN LOSANGELES CA 90024 INSURER C: U,; y ;:y, ANA INSURER D: t INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTF TYPE OF INSURANCE POLICYNUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDM LIMITS GENERAL LIABILITY NOTINCLUDED EACH OCCURRENCE $ COMMERCIAL GENERAL LI ABILITY CLAIMS MADE OCCUR DAMAGE TO RENTED PREMISES Eeoccurence $ MED. EXP (Any One Person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG. $ 17 POLICY AUTOMOBILE LIABILITY ANYAUTO NOTINCLUDED COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS NON-OWNEDAUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY NOTINCLUDED AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: qGG $ EXCESS I UMBERELLA LIABILITY NOT INCLUDED EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY NOTINCLUDED "77$ TORY umiTS °THeR E.L. EACH ACCIDENT $ ANY PR°PRIETORIPARTNERIEXECUTIVE E.L. DISEASE -EA EMPLOYEE $ OFFICE61MeMSER EXCLUDED? If yes, describe under E.L. DISEASE -POLICY LIMIT $ SPECIAL PROVISIONS below OTHER: PROFESSIONAL LIABILITY ( VCPL062409 DEC 413 DEC 414 $1,000,0001$1,000,000 LIMITS A CLAIMS MADE FORM) RETRO DATE: 121411997 DESCRIPTION OF OPERATIONS/LOCATIONfVEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NOT ADDED AS AN ADDITIONAL INSURED TO THE REFERENCED POLICY. CERTIFICATE IS FOR PROOF OF PROFESSIONAL LIABILITY COVERAGE. NOTHING IN THIS CERTIFICATE SHALL ALTER, AMEND OR EXTEND COVERAGE PROVIDED BY THE ABOVE MENTIONED POLICY. ALL OTHER TERMS AND CONDITIONS OF THE REFERENCED POLICY REMAIN IN FULL FORCE AND EFFECT. *10 DAYS WRITTEN NOTICE OF CANCELLATION IN THE EVENT OF CANCELLATION FOR NON-PAYMENT/// AUUI I IUNHL INJUKt U; INi UKtK Lt ILK: CITY OF SANTA ANA kap [D'f,\ O V LD AS 'rO FOR WOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 20 CIVIC CENTER PLAZA M-37 L E (RATION DATE THEREOF, THE ISSUING COMPANY WILLENDEAVORTO MAIL30' ( DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT P.O. BOX 1988 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITYOF ANY KIND UPON THE SANTA ANA, CA 927025x/ e� Pte, INSURER, IT'S AGENTS OR REPRESENTATIVES. Laur�--a S'�0`aAUTHORIZED REPRESENTATIVE iltt itt 9 • or Assistant City Attorney - Attention: JASON GABRIEL ACORD 25(2001/081 Certificate ft 4717 Frederick.(. Fisher 06077gA IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S (2001108) Certificate #4717 DESMO-1 OP ID: AM CERTIFICATE OF LIABILITY INSURANCE O11/06/201 YY) 11/06/2013 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, 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 endorsements). PRODUCER John J. Matsock $ Assoc. Inc. 1750 N Washington Street Naperville, IL 60563 Steven L. Monteith CAMEACT Steven L. Monteith PHONE FAN a E# :630-505-7886 'V No): E-MAIL ADDRESS:.._._........._-.-...._._-...-._ GENERAL LIABILITY INSURERIS) AFFORDING COVERAGE NAIC k INSURER A : St Paul Travelers - AMD 25674 INSURED Donna Desmond Associates 265 South Beverly Glen Blvd. Los Angeles, CA 90024 INSURER a: INSURER C: INSURER b INSURER E: _ // 7� ...............-..-.-_ IINSURER F: �oll - a /'"j LJ 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. INSR TR OF INSURANCE ADDLTYPE INSRIVWD SU POLICY NUMBER POLICY POLICY DYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIALGENERALLIABILITY CLAIMS -MADE F7x OCCUR X 680.1B716605 12/0112013 12/0112014 PREMISESE.o urgncceL__ $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL &AOV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 $ 17 POLICY PRO= LOC IECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident $ BODILY INJURY (Per person) $ AANY AUTO 680-1 B716505 12/0112013 12/01/2014 BODILY INJURY (Per acciden) $ ALL OWNED SCHEDULED AUTOAUTOS X HIRED SAUTOS j( NOI,OWNED AUTOS PROPERTY DAMAGE $ PER ACCIDENT $ UMBRELLA LIAO EXCESS LIAR OCCUR CLAIMS-MAOE > qC ? ,9PPROj ED AS t YaA l yJ ) 1 �--/T;'as�A EACH OCCURRENCE $ AGGREGATE $ DE_D RETENTION $ $ WORKERS COMPENSATION ANDEMPLOYERS'LIASILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEEXCLUDED? ❑ NH) NIA YSS15L3n[ ,LjilllJTnfv .. WC STATU- OTH- TORY LIMITS E.L. EACHACCIDENT $ E.L. DIBEASE- EAEMPLOYEE $(Mandawryho E1 DISEASE -_POLICY LIMIT $ Ifyes,describeunder DE8 RIPTION OF OPERATIONS 01.w A Property Section 680-18716605 12/01/2013 12/01/2014 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEERS AND REPRESENTATIVES//ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY TERMS AND CONDITIONS. CFRTIFICATE HOLDER CANCELLATION SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PUBLIC WORKS AGENCY ATTN: JASON GABRIEL 20 CIVIC CENTER PLAZA M-36 AUTHORIZED REPRESENTATIVE �. SANTA ANNA, CA 92701 O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. PLANKET ADDITIONAL ".-OWNERS OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1. WHO IS AN INSURED (SECTION II) is amended to include as an insured any person or organiza- tion (called hereafter "additional insured") whom you have agreed in a written contract, executed prior to loss, to name as additional insured, but only with respect to liability arising out of "your work" or your ongoing operations for that addi- tional insured performed by you or for you. 2. With respect to the insurance afforded to Addi- tional Insureds the following conditions apply: a. Limits of Insurance — The following limits of liability apply: 1. The limits which you agreed to provide; or 2. The limits shown on the declarations, whichever is less. b. This insurance is excess over any valid and collectible insurance unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. 3. This Insurance does not apply: a. on any basis to any person or organization for whom you have purchased an Owners and Contractors Protective policy. b. to "bodily injury," "property damage," "per- sonal injury," or "advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, in- cluding: 1. The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change or- ders, designs or specifications; and 2. Supervisory, inspection or engineering services. CG D1 05 04 94 Copyright, The Travelers Indemnity Company, 1994, Page 1 of 1 Includes Copyrighted Material from Insurance Services Office, Inc. ACORD TM. CERTIFICATE OF LIABILITY INSURANCE DATE (Mi I NOV 2613 PRODUCER E.L.M. INSURANCE BROKERS, INC. P.O. BOX 2668 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 19,60 E. GRAND AVE STE, 370 CA LIC OD28706 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, EL SEGUNDO CA 90245-1768 POLICY EFFECTIVE POLICY EXPIRATION PHONE: 310-322.1301 Agency Lid : OD28706 INSURERS AFFORDING COVERAGE ... . ........ . NAIC # INSURED INSURER GEMINI INSURANCE COMPANY DATE (Mi INSURER. B: DONNA DESMOND ASSOCIATES__-- 265 S. BEVERLY GLEN LOS ANGELES CA 90024 INSURER C: . . ....... . INSURER D: $ INSURER E: COMMERCIAL GENERAL LIABILITY COV11i FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDIG THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE N ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DAMiMMI.-ly) DATE (Mi GENERAL LIABILITY NOT INCLUDED EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES L Ci III OCCUR l - MEXP �l, One Person) ili $ . . .... PERSONAL & ADV INJURY $ ............... GENERAL AGGREGATE GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG. $ 1-1 POLICY 1:1 121 Ll LOC, AUTOMOBILE LIABILITY NOT INCLUDED COMBINED SINGLE LIMIT ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS . . . ...... .. HIRED AUTOS BODILY INJURY $ NON-OWNE0 AUTOS (Per accident) . . ...... PROPERTY DAMAGE $ GARAGE LIABILITY NOTINCLUDED AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY� AGG $ EXC ESS I UMBERELLA LIABILITY NOT INCLli EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE DEDUCTIBLE ax . ......... . .. .. $ - $ RETENTION KVa. $ WORKERS COMPENSATION AND NOTINCLUDED WCSTATU-a rHrR 1ORYLIMIT, EMPLOYERS" LIABILITY E.L. EACH ACCIDENT ANY PROPRIETORIPARTNERIEXECUTIVE . .. . ........... . OFFICERIMeMBER EXCLUDED? El DISEASE EA EMPLOYEE If yes, describe under . . . . .... ...... SPECIAL PROVISIONS b.1— E.L. DISEASE -POLICY LIMIT OTHER: PROFESSIONAL LIABILITY VCPL062409 DEC 4 13 DEC 414 $1,000,0001 $1,000,000 LIMITS A CLAIMS MADE FORM) RETRO DATE: 12/411997 DESCRIPTION OF OPERATIONSILOCATIONIVEHICLESIEXCLUSIONS ADDED ENDORSEMENTI SPECIAL PROVISIONS CERTIFICATE HOLDER IS NOT ADDED AS AN ADDITIONAL INSURED TO THE REFERENCED POLICY. CERTIFICATE IS FOR PROOF OF PROFESSIONAL LIABILITY COVERAGE. NOTHING IN THIS CERTIFICATE SHALL ALTER, AMEND OR EXTEND COVERAGE PROVIDED BY THE ABOVE MENTIONED POLICY. ALL OTHER TERMS AND CONDITIONS OF THE REFERENCED POLICY REMAIN IN FULL FORCE AND EFFECT. *10 DAYS WRITTEN NOTICE OF CANCELLATION IN THE EVENT OF CANCELLATION FOR NON-PAYMENT/11 r-11EPTIFill"ATIP woi nii 8 ADDITIONAL INSURED; INSURER LETTER: r.AKI('Fl I ATi CITY OF SANTA ANA 20 CIVIC CENTER PLAZA (M-37) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BF CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT P.O. BOX 1988 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABli Or ANY KIND UPON THE SANTA ANA, CA 92702 INSURER, IT'S AGENTS OR REPRESENTATIVES. Attention, JASON GABRIEL AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) Certificate # 4717 Frederick J. Fisher 0607799 L 4 ZP# eae04!3i e0 (8omoz) S-97 a loov •uoa.aaq} palsll saiollod ay} Aq pap.�oIje Oft-JOnoo aq} .rales JD pua}xa 'puawe Ajanl}ebau as �fjani;euaaijje j! saop jou '.raploq a}eoippeo aq; pus 'jeonpoid ao ani}s}uasaadaj paziao.yjne '(s)aaansui 5uinssi aq) uaemleq }oea}uoo a a}n;l}suoo;ou scop wjoj sly;10 apis asaanaa aq; uo aoueansul;o a;eoi}ijaaO aqj •(s)juawasiopue gons }o nail ul japloq a;eogwoo aq} o} slgbla aa;uoo;ou saop aleoipliao slq} uo juawalels y -juawasiopue ue ajinbai Aew saloilod ulepao 'Aoilod aql;o suoillpuoo pue somal aq} of joafgns 'g3nldM SI NOIIVOO�I8f1S jI #)xuawasiopue gons }o nail ul japloq a}eoilivao eq} o} s;qbu jaluoo jou saop a}eoilrPeo sly} uo }uewele}s y •posiopue aq Isnw (sal)Aollod ayj '(1Mj 1SNl IVNOIlICIC]H us sl aaploq GleollPoo aqj }I 1NVINOM D ESMO-1 OP ID: AM CERTIFICATE OF LIABILITY INSURANCE D/1 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 'YYj 1,106120/3 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. CONTACT NAME: Steven L Monteith John J. MatsOCk Assoc. Inc. 1750 N Washington Street J FAX A"rcNrd . EXt1.530-505 7335..__._ E-MAIL ADDRESS: Naperville, IL 60563 Steven L. Monteith EACH OCCURRENCE INSURER(P)AFFORDING COVERAGE NAEC N X INSURER A: Bt Paul Travelers - AMD 25674 INSURED Donna Desmond Associates. � INSURER 8: 1210112013 65 South Beverly Olen Blvd. ITi vt T RENTED �_PERk� MED EXP (Any persona 300,00 $ 10,00 Los Angeles, CA 90024 INSURER C. $ 1,000,00 INSURER D INSURER. E INSURER F: $ 2,000,00 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICI'LS 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. ADDU UB r POLXCY NUMBER POLICY ESE_... MMIDD/YYYY f'OL.ICY EXP MMIDDFYYYY LIMITS.. 20 CIVIC CENTER PLAZA M-36 GENERAL. LIABILITY EACH OCCURRENCE $ 1.,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X 680-18716605 1210112013 1 z1a112a14 ITi vt T RENTED �_PERk� MED EXP (Any persona 300,00 $ 10,00 -ane PERSONAL F ADV INJURY $ 1,000,00 '.. GENERAL AGGREGATE $ 2,000,00 _ GEN`L AGGREGATE LIMIT APPLIES PER.m. ..._ PRODUCTS - COMPIOP AGG $ 2,000,00 POLICY 0PRO Loc $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,aaa,o,a BODILY INJURY (Per person) s AANY AUTO 680-1 B716605 12101/2013 1210112014 _X l ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accidenij $ NON-OWNED HIRED AUTOS LxAUTOS PROPERTY DAMAGE PER ACCIDENT $ �$ UMBRELLA LIAR EXCESS LIAR [_d OCCUR CLAIMS-MADE� u 1 �'W"„ p ,. a) Lt°o- �' �a EACH OCCURRENCE ii $ e— AGGREGATE ii,, $ DED RETCNT'14hY.5 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIFTORIPARTNrRIEXECUUVF Oi"FICER1MEr+IUER ER EXCLUDED? . (Mandatory In N f A ,..:». , ( ". .-. .�.. :°m r f I �.', ,.. ...,._...m .� I �,,, � ,.. WC STATU- OTH- RY LIMn"SR L EACH ACCIDENT $ N ` .L. DISEASE - EA EMPLOYEE $ If' yes. describe under m._..__................_.e._.-._._.._.,�. DESCRIPTION OF OPERATIONS befow E.A. DISEASE - POUCY LIWT $ A Property Section T[I 680-1 B716605 1210112015 1210112014 DESCRIPTION OF OPERATIONS I LOCATIONS C VEHICLES (Attach ACORD 1.01, Additional Rernarhs Schedule, it more space is requl.red) ADDITIONAL INSURED WITH RESPECTS TO GENF-PAL LIABILITY; CITY OF SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENT'S, VOLUTEERS AND REPRESENTATIVES//ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY TERMS AND CONDITIONS. CERTIFICATE HOLDER CANCELLATION SANTAAN SHOULD ANY OF THE ABOVE DESCRIBER POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY' PROVISIONS. PUBLIC WORKSAGENCY ATTN: JASON GABRIEL 20 CIVIC CENTER PLAZA M-36 AUTHORIZED REPRESENTATIVE s�rx SANTA ANNA, CA 92701 ACORD 2,5 (2010105) Ca 1988-2.010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD •ouj'aol440 saojnjoS aomnsul uwj} leuejeW palgBljAdo0 sopnloul 6 to b eBed V66b 'AuedWoo Al!uujappi sjelaAejl aql 'lg6!JAdo0 V6 ti0 90 W00 •sao!AJas 6uljeawbua jo uojloodsu! 'AJostAja ft 'Z pus `suolleoljloads.Jo su6lsap'sjap -jo 06uego sAaluns `spodej `suquldo 'sou!mejp 'sduw 9Aoiddg jo ajedajd ol. 6u!llal Jo 6U!AOJdde 16upedajd aq.L :6utpnlo -u! 'noA Jo} jo Aq saajnjes leuolssa}ojd Aue jopuaJ of ajnpl .atdl jo jo BujjapuOJ agl jo Ino bujspe ,fun[Ul 6uls]V9npe„ Jo ,,Ajnfui Jews -Jed„ „`Gb?wep Aljadojd„ ,,Ajn[Ul Alipoq„ of 'q .Ao!lod anlloolojd SJoloeJluo0 pue sjaumo us pasegnjnd aAeq noA wogm JOJ u014e20e6ja Jo uosaed Aue of sjseq Aue uo 'e :Aldde lou soop eouejnsu! slgl 'E •stseq Ajoingpjuoo jo Ajewjjd e uo Aldde of aouejnsijl slgl Jot loejluoa t[allljM e ul paaJ68 aAeq noA ssalun eousinsui olggoalloo pue p!Ien Aue Jana Ssaoxo si. eoumnsul ssgL `q -sSal SE JaAagalgM 'suolleJeloep agl uo umogs sl!ua!l aqJ `Z Jo ;ap!Aojd of peoi6e noA gotgm Shull agl 1 :Aldde Allllgell to sllwll 6utmgjoj ag_L — ooueJnsul 10 sliwi l •e :A!dde suolllpuoo 6ulmo110} agl sPa nsul leuoll -lppy of papj01je aoueansul aql of loadsaJ gljAA 'Z 'noA jo} Jo noA Aq pawjoped pajnsuj leuoll -jppe legl jol suojlejado 6u!o6uo jnoA jo .�Jom jnoA„ jo lno 6ulspe All1!gell of loadsoj gjim Aluo lnq 'pomsul Ieuolljppe se auwu of 'ssol of jojjd polnoaxe 'loejluoa uallpm a ul paoj6e aAeq noA tuogm („poAnsuj leuojl!ppe„ jeVeAq palleo) uoll -eziue6jo Jo uosjed Aue peJnsul ue se apnloui of popuawe sl (11 NOI.l.03S) Q3wSNI NV SI OHM 'b SNOISIAO8d i2Xd 30Vd'0A00 AUI IISVII IV83N30 IVIDU3WW00 :6ulmollol eql jepun pap€Aojd oomnsul salljpow luawasjapua slgi 'Ai-1C1nsvD .Ll aVaU 3SV3 1d 'A0110d 31HI S3VNVHO IN3w s-doaNd S1H1 KLII18'dll Td 3N30 IVIG 3ININ00 DESMO-1 OP ID: SG DATE (MM/DD/YYYY) CERTIFICATE LIABILITY 02/05/2015 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 John J. Matsock & Assoc. Inc. NAME: _ Steven L. MonteithPHONE � 1750 N Washington Street A/C No.EXt :630-505-7888 �— jA"c, NOL _— Naperville, IL 60563 E-MAIL Steven L. Monteith ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Prop Cas Co _ 25674 _ INSURED Donna Desmond Associates — INSURER B: of America_ 265 South Beverly Glen Blvd. INSURER C : _ v Los Angeles, CA 90024 — — INSURER D: INSURER E: INSURER F : COVFRA(CFS CERTIFICATF NI IMRFRtil IRARI=P• 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 INSR WVDSUB POLICY NUMBER EFF MM DD YYYY MPOLICY MLDDYYICY YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X 680-16716605 12/01/2014 12/01/2015 DAMAGE RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A X Ind Contractors 680-1 B716605 GENERALAGGREGATE $ 2,000,000 GEN L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,®®O,O®® Ea accident _i110001000 BODILY INJURY (Per person) $ A ANY AUTO 680-16716605 12/01/2014 12/01/2015 _ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ PER ACCIDENT UMBRELLA LIAB Id OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECuriVE OFFICER/MEMBER EXCLUDED? ❑ N / A TORY LIMITS ER E.L. EACH ACCIDENT $ — - E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Property Section 680-1B716605 12/01/2014 12/01/2015 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEERS AND REPRESENTATIVES//ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY//AGREEMENT NUMBERS A°-201.1.-070 and A--2014-°038//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY TERMS AND CONDITION DONNA A N) aMC I1D ASSOCIATES REVIEWED BY, / � EUN C. E I- EREDIA (PG, 1 of 6) iiiillRigW1li lel►` M•r +♦ ^-r w AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD DC 680—IB716605 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -OWNERS, LESSEES OR GONTRACTORS COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1, WHO IS AN INSURED (SECTION 11) is amended to Include as an insured any person or organiza- tion (called hereafter "additional Insured') whom 3. you have agreed In a written contract, executed prior to loss, to name as additional Insured, but only with respect to liability arising out of "your work" or your ongoing operations for that addi- tional Insured performed by you or for you. 2. With respect to the Insurance afforded to Addi- tional Insureds the following conditions apply: a. Limits of Insurance — The following limits of liability apply: 1. The limits which you agreed to provide; or 2. The limits shown on the declarations, whichever Is less. b. This Insurance Is excess over any valid and collectible insurance unless you have agreed DONNA DESMOND ASS0CJAJ is In a written contract for this insurance to apply on a primary or contributory basis. This insurance does not apply: a, on any basis to any person or organization for whom you have purchased an Owners and Contractors Protective policy, b. to "bodily Injury," "property damage," "per- sonal injury," or "advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, In- cluding: 1. The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change or- ders, designs or specifications: and 2. supervisory, Inspection or engineering services. Copyright, The Travelers Indemnity Company. 1994. Includes Copyrighted Material from Insurance Services Office, Inc,REV�E�NBD BY� i EL)NICE HERED�A (FIG 3 of 0) ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY I Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # (,'�Q ' l V4,,:jL(a(,,Orelating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured, 2. With respect to claims arising out of the operations and uses performed by or on, behalf of the named insured, such insurance as is afforded -by -this -policy is primary and isnot additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included, 4. With respect to the additional insureds, this insurance shall riot be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy 4, Issued to this endorsement form as a pail of Named Insured Countersigned by I Authori-d Xepr6elsen:tative DONNA DESMGIND ASSOCIATES REVIEWED BY EUMCE FiEREDIA (PG 4, of 6) ACC)M90' CERTIFICATE ., A 1311 ELM Insurance Brokers 1960 E. Grand Ave., 4370 El Sound©, CA 90245 (310) 322-1301 Dontia Domand Associates 265 S. Beverly Glen Los Angeles .CA 90024 1T 1 INSURANCE DATE(MMIDONYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC INSURER A. Gemini Insurance Company NSURER B: INSURER C: INSURER D' INSURER E: THE POLICIES OF INSURANCE LI&TED BELOW HAVE BEEN ISSUED TIS THE INSURED NAMED ABOVE FOR THE ANY RE4UIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER pOCUMEN'T WITH RESPECT TO W PERTAIN, THE INSURANCE AFFORDED 8Y THE POLICIES DESCRIBED HEREIN IS SUBJEC"f TO ALL THE TERM' POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADD'Lr TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION INSRp{ PdLICY NUMBER -- . - r -y GENERAL LIABILITY �J ® COMMERICAL GENERAL LIABILITY ®❑ CLAIMS MADE 0 OCCUR GEN`LAGGREGATE LIMIT APPLIES PER: POLICY L.._f PROJECT [:J LOC ® AUTOMOBILE LIABILITY NIA ❑ ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS ❑ HIRED AUTOS NON.OWNEO AUTOS 12/4114 1 12AA5 DESCRIPTION OF OPERATIONS 1 LOCATIONSI VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT ISPECIAL PROVISIONS CERTIFICATE HOLDER 13 NOT ADDED AS AN ADDITIONAL INSURED TC) THE. REFERENCED POLICY. C LIABILITY COVERAGE. NOTHING IN THIS CERTIFICATE SHALL ALTER, AMEND OR EX'TE'NT) C OVERA( POLICY. ALL OTHER TERMS AND CONDITIONS OF THE RFFERENCED POLICY REMAIN IN FULL FORCE OF CANCELLATION IN THE EVENT OF CANCELLATION FOR NON-PAYMENT/// w City Of Santa Ana 20 Civic Center Plaza (IVt•37) P.O, BOX 1958 Santa Ana,CA 92702 •`r DONNA DESMOND ASSOCIATES ICELLATION SHOULD ANYOF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NOW" ,,limilllimimi. - illillaillamii INSU IIER, ITS AGENTS OR REP ,,. z _ k. - S. POLICY PERIOD INDICATED. NOTWITNSTANDlNG ITCH THIS CERTIFICATE MAY BE ISSUED OR MAY GARAGE LIABILITY LIMITS 0 NIA ANY AUTO PREMISES Ea raccurrenca $ MED EXP (Any one person) $ EXCESWUMBRELLA LIABILITY 5 GENERAL AGGREGATE N/A. ❑ OCCUR [:]CLAIMS MADE PRODUCTS • COMPIOP AGG $ ® DEDUCTIBLE COMBINED SINGLE LIMIT Q RETENTION $ (Each Occurrence) $ WORKERS COMPENSATION AND (Per pe—) EMPLOYERS' LIABILMY NIA BODILYINJURY ANY P RC PR IETORIPARTN E RJEXEC U- $ PROPERTYOAMAGE TIVE OFFICERFMEMBER EXCLUOED7 (Per accidern) $ If yes, describe under S OTHER THAN EA ACC SPECIAL PROVISIONS below AUTO ONLY: A G G, $ OTHER VCPL0631 i4 $ AGGREGATE PROFd S5IONAL LIABILITY 12/4114 1 12AA5 DESCRIPTION OF OPERATIONS 1 LOCATIONSI VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT ISPECIAL PROVISIONS CERTIFICATE HOLDER 13 NOT ADDED AS AN ADDITIONAL INSURED TC) THE. REFERENCED POLICY. C LIABILITY COVERAGE. NOTHING IN THIS CERTIFICATE SHALL ALTER, AMEND OR EX'TE'NT) C OVERA( POLICY. ALL OTHER TERMS AND CONDITIONS OF THE RFFERENCED POLICY REMAIN IN FULL FORCE OF CANCELLATION IN THE EVENT OF CANCELLATION FOR NON-PAYMENT/// w City Of Santa Ana 20 Civic Center Plaza (IVt•37) P.O, BOX 1958 Santa Ana,CA 92702 •`r DONNA DESMOND ASSOCIATES ICELLATION SHOULD ANYOF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NOW" ,,limilllimimi. - illillaillamii INSU IIER, ITS AGENTS OR REP ,,. z _ k. - S. POLICY PERIOD INDICATED. NOTWITNSTANDlNG ITCH THIS CERTIFICATE MAY BE ISSUED OR MAY I, EXCLUSIONS AND CONDITIONS OF SUCH LIMITS EACH OCCURENCE $ DAMAGE TO RENTED PREMISES Ea raccurrenca $ MED EXP (Any one person) $ PERSONAL &ADV INJURY 5 GENERAL AGGREGATE S PRODUCTS • COMPIOP AGG $ COMBINED SINGLE LIMIT (Each Occurrence) $ BODILY INJURY (Per pe—) $ BODILYINJURY (Per aorldent) $ PROPERTYOAMAGE (Per accidern) $ AUTO ONLY- EA ACCIDENT S OTHER THAN EA ACC $ -- AUTO ONLY: A G G, $ EACH OCCURRENCE $ AGGREGATE g OTH- ® TWOSTATU- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE, S E.L, DISEASE -POLICY LIMIT $. LIMITS: 1 [vt[I..11 M E1. RETRO DATE: 1214/[997 'sRTIFICATE IS FOR PROOF OF PROFESS IONA1, E PROVIDED BY THE ABOVE MENT[ONED AND EFFECT. *10 DAYS WRITTEN NOT[CF. ID ACORD COF �p0 REVIEWED -VILVEB/ � E U M(E H._ A Wi p ( P( 5 of p ) mm If the certificate holder is an ADDITIONAL INSURED, the policy(Nes) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such enclorgement(s). A ons G—fTfFe- policy. certain policies may require an endorsement. A statement on this certificate does not confer rights to the andocertificate holder in lieu of such rsement(s), The Certificate of Insurance on the reverse side of this 41 '1 . t wi ;W W TITI i I rg I I r� 11,[4 1 a I I L a, n' L 72; LikupMe 1W101*1JL9j1;; ACRD 25 (2001/08) DCNHA DESMOND ASSOCiATES REVIEWED BY��', EUMCE FIEREDdA (FIG, 6 of 0. 1t DESMO-1 OP ID; SG -DATE JMMIDWYYYY) CERTIFICATE OF LIABILITY INSURANCE 4702/2015 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 statemBrit on this certificate does not confer rights to the certificate holder in lieu of such endorsement(sl- PRODUCERCONTACT John J. Matsock & Assoc. Inc, 1750 N Washington Street Naperville, IL 60563 �NAM Steven L. Monteith _Wj_ E. PHONE A_M_NR,..Egt(330-505-7888 E-MAIL Steven L. Monteith -ARDRESS: INSURER A: Travelers Prop Cas CID 25674 INSURED Donna Desmond Associates �NSURER a: of America Phone #310-475-1114 265 South Beverly Glen Blvd. Los Angeles, CA 90024 MNSURBE D., . ...... INSURER E IINSURER F: COVERAGES CFRTIFIr.ATF NI]MRF=R: r%"wi71Vry rquivior-m; THIS 13 TO CERTIFY THAT THE POUCIPS 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 RESPEc-r 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. I NSR _A155 —POLICY-ETF� _POUCY EXP TR TYPE OF INSURANCE wVn IN POLICY NUMBER (MMIDDNYYY) (MMIDDIYYYYI LIMITS GENERAL LIABILITY A x ! COMMERCIAL GENERAL LIABILITY x I, 680-1 B716605 1210112015 12101/2016 EACH OCCURRENCE 1,000,000 AIiAGE To RE --I' 5;�] MAIMS -MADE LA J OCCUR PIiEMI5E5 Ea MED F)�P (Ary ane person} 300,000 10,000, A Ind Contractors 680-1 B716605 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPYOP AGG $ 2,000,000 POLICY El 1211i LOC AUYOM0131LE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ A 680-1 BODILY INJURY (Per person) $ ANY AUTO B716605 1210112015 12101/2016 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED I N RED AUTOS X AUTOS P-R-(YPE _RTYOAMAZ_�_ $ �x UMBRELLA LIAB OCCUR TILCIA111 -A F OCCLIRR�ENCE. $ EXCESS LIAR MADE AGGREGATE $ 0EDE_ 7111ENTiON $ WORKERS COMPENSATION -7- vvc sTATu- i IoTH- AND EMPLOYERS' LIABILITY Y/N E L.. EACH ACCIDENT I ED) E N�� $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER JMFMHFR EXCLUDED? F /A DISEASE - EA EMPLOYEF. ---- $ (Mandatory In NHI yes, describe undef E. L. DISEASE -POLICY LIMIT DESCRIPTION DESCRIPTION OF OPERATIONS below A lProperty Section 680-18716605 5 12101/2016 CESCWPTION OF OPERATIONS / LOCATIONS I VEHICLES(Attach ACORD tial, AddItIonal Remarks Schedule, if more space is required) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEtRS AND RE PRE SENTATTVRS / /ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY AGREEMENT NUMBERS A-2011-070; A-2014-038 & A-2015-159//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY, TERMS AND CONDITION EUNKE I IEREDJA (PG OF SANTAAN CITY OF SANTA ANA PUBLIC WORKS AGENCY ATTN: JASON GABRIEL 20 CIVIC CENTER PLAZA M-36 SANTA ANNA, 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 REPRESENTATWE P. vI v 00'4U` IU ALUKL) tUKVUKA I NUN. Ali rights reserved, ACID RD 25 (2010105) The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED END0RSEjvjENLr FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company' --k, This endorsement modifies such insurance as is afforded by the provisions of Policy relating to the following: I . The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701 x its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense Of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or On behalf of the named insured, such insurance as is afforded by this policy is Primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included, 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endonserrielit effective.) Effective �-IaC, , this endorsement form as a part of Policy # - Issued to Narned Insured Countersigned by —s Author ed Representative ------ ---------- --- - - ...... WORICERS'QQMLENS&�FJQN DECLARAILON I Donna Desmond, President hereby affirin undcr penalty of perjury, the (Narie/Title) fol I owing declaration: I certify on behalf of Donna Desmond Associates —that during the ten -n of my (Consultant/Company Name) contractfior Goodwill Loss Appraisal serviceswith the City of Santa Ana, I will not employ any person in any manner so as to become siibject to the workers' compensation laws of California, and agree that if I sho-uld become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof of workers' compensation coverage, 1230/2015 DATE. / CONT AC #: A-201 4/679 andA-2015-159 Nalne: Donna Desmond Title: President Teleplhone: , (310)475-111,4 WARNING" FAILURE TO SECURE WONIERS' COMPENSATION COVERAGE IS 'UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO (.-MIMINAL PENALTIES AND CIVIL FINES UPTO ONE HUNDRED THOUSkND DOLLARS (S 100,000). M ADMION TO THE COST F COMPENSATION, DAMAGESAS PROVIDED FOR IN SECTION 3706 OF THE, LIWOR CODE, INTERI,ST, AND ATTORNEYS FEES. REVIEVVE) BY' , EUNICE B'ERELAA (P(r",V501F,w �) DESMO-1 OP ID: SG —.ATE CERTIFICATE OF LIABILITY INSURANCE 11/28/2016 Y} 11!28!2016 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 pollcy(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 endorsements). PRODUCER John J. Matsock & Assoc. Inc. 1750 N Washington Street Naperville, IL 60563 Steven L. Monteith CONTACT NAME: Steven L. Monteith _......- AH] N Ext,630-505-7888` aC Na, E-MAIL ADDRESS;__, INSURER(S) AFFORDING COVERAGE Al. It INSURER A: Travelers Prop Cas CO F2574 INSURED Donna Desmond Associates INSURER B: of America A Phone #310-475-1114 X 265 South Beverly Glen Blvd. INSURER C: 12/01/2017 DAMAGE TO RENTED -----.._... PREMISES Ea occurrence $ 300,00 MED EXP Ani ane person) $ 10,00 Los Angeles, CA 90024 INSURER D: INSURER E: 680-18716605 INSURER F: PERSONAL & ADV INJURY $ 1,000,00 COVERAGES CERTIFICATE NIIMRFR' PPV[Czlnm NI IMRr-0. 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 AI)OL 5 B POLICY NUMBER pOtICY EFF MWDD/YYYY —POLICY EXP MMIDDIYYYY '- LIMITS 20 CIVIC CENTER PLAZA M-36, GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY _...._ CLAIMS -MADE � OCCUR X 680-16716606 1210112016 12/01/2017 DAMAGE TO RENTED -----.._... PREMISES Ea occurrence $ 300,00 MED EXP Ani ane person) $ 10,00 A X Ind Contractors 680-18716605 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,00_0,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PROJE,- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 O00 ,000 Ea acpLct ) $ ., _ BODILY INJURY (Per person) $ A ANY AUTO 680-1 B716606 12101/2016 12/01/2017 'X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ ( ) HIRED AUTOS X NON -OWNED AUTOS - PROPERTY DAMAGE -� ER ACCIDE T}_,__ _ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE DED I I RETENTION $ $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA WC STATU-OTH- T_Q U _ 1 '-- E.L. EACH ACCIDENT $ - E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) Ifs, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Property Section 680-1B716605 12/01/2016 12/01/2017 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEERS AND REPRESENTATIVES//ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY AGREEMENT NUMBERS A-2011-070; A-2019-038 & A-2015-159//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY TERMS AND CONDITION REVCEIPVELt F LAY: Et.OI IICE IEFdEDIA (PGG OF ) E CFRT1FIr:ATP I-Ir1[ 111;0 !1Ak1r%M1 i A"^&I V V e SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PUBLIC WORKS AGENCY ATTN: JASON GABRIEL AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLAZA M-36, SANTA ANNA, CA 92701 ACORD 25 (2010/06) U 1958-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD HOLDER CODE SANTAAN DESMO-1 PAGE 2 NOTEPAD. INSURED'S NAME Donna Desmond Associates OP ID: SG Date 11/28/2016 CONDITIONS OF SUCH POLICIES REVIEWED BY. WIN EM110E HEREDIA (PGOF COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -OWNERS, LESSEE OR CONTRACTORS I This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1. WHO |SANINSURED (SECTION U>isamended toinclude aaaninsured any person ororganiza- tion (oeUod hereafter "additional insured") whom you have agreed in a written contraot, executed prior to loss, to name as additional insured, but only with respect to liability arising out of "your work" or your ongoing operations for that addi- tional insured performed byyou nrfor you. 2. With respect tothe insurance afforded hzAddi- tional Insureds the following conditions apply: m. Limits of |nsuranoe—ThefoUmwing limits of liability apply: 1. The limits which you agreed (oprovide; or 2. The limits shown onthe declarations, whichever ieless. b. This insurance is excess over any valid and collectible insurance unless you have agreed in a written contract for this insurance to apply onaprimary orcontributory basis. 3. This insurance does not apply: o. on any basis to any person or organization for whom you have purchased on Owners and Contractors Protective policy. b. to "bodily injury." "property damage." "per- sonal pmp sono| injury," or "advertising injury" arising out ofthe rendering oforthe failure torender any professional services by or for you. in- cluding: 1. The pnepohng, approving or failing to prepare or approve mapo, dnavvinga, opinione, reports, aurveye, change or- ders, designs or specifications; and r-dem.deeignoorapeoificoUone;mnd 2. Supemieory, inspection or engineering services. CG Di 05 0494 Copyright, The Travelers Indemnity Company. 1804. Page 1 of 1 AC'QR®® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) �,,. 12/2/2016 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(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 CONTACT Megan Lindquist-Obrotka PL Risk Advisors Inc. PHONE (201)847-9165 FAX (201) 847-9174 _(A/C, No, Ext): _._ ._. __. _. _(A/C, No): 795 Franklin Avenue, Suite 204 E-MAIL mlind ast@ lrisk.com ADDRESS: P PERSONAL & ADV INJURY $ INSURER(S) AFFORDING COVERAGE NAIC # Franklin Lakes NJ 07417 INSURERA:Ace American Ins Company 22667 INSURED INSURER B: Donna Desmond Associates INSURER C : 265 S. Beverly Glen Blvd INSURER D: (Ea accident) INSURER E: LOS Angeles CA 90024 INSURER F COVERAGES CERTIFICATE NUMBER:CL1612206667 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X CLAIMS -MADE OCCUR DAMAGE TO RENTED .PREMISES (Ea occurrence) $ X Errors & Omissions G27931546 002 12/4/2016 12/4/2017 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED ..._._.._ AUTOS ............ AUTOS BODILY INJURY (Per accident) $ NON -OWNED PROPERTY DAMAGE $ HIRED AUTOSAUTOS (Per accident) UMBRELLA LIAB OCCUR', EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE', AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- -AND EMPLOYERS' LIABILITY Y / N ' STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH)--- E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage applies solely for the insured performance of professional services as a business valuation service provider for others REVIEWED BY: EUNICE HEREDIA (PG VOF CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza (M-37) ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1988 AUTHORIZED REPRESENTATIVE Santa. Ana, CA 92702 Alice Sroga/ALICE -" ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DESMOA Op Inr SC 16- c ' CERTIFICATE OF LIABILITY INSURANCE DATE 1/151201 YY) 11/1512017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDIER. THIS CERTIFICATE DOES NOT AF'F'IRMATIVELY 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 I$ 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). John J Matsock& Assoc. Inc. 1760NWashingtonStreet Naperville, IL 60663DPD Steven L. Monteith A Steven L. Monteith B ;630-505.7888 c ss. INSURER AFFORDINP COVERAO. 9 NAIL # A A INSURERA:TraveI9jrs;.Prop Cas Co 25674 INSURED Donna Desmond Assoc fates Phone #310-475-1114 265 South Beverly Glen Blvd, INSURER e: of America INPUREB C: INSURER a Los Angeles, CA 90024 INSURER E r R F TO D n a 'ir nce $ 300,00 INSURER F CO THIS IS TO CERTIFY TWAT THE POLICIES O� INSURANCE LISTED BELOW HAVE SEEN ISSUED Tp THE INSURED NAMED A6(?VE FOR TWC 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 7O ALL' THE TERMS, EXCLWSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1S -TYPt OPINSURANCg BuellCLIP POLICY NUMBER EFP O IQY P LIMIYa A A GENERAL LIABILITY X OMOLAIMIS -MADAL E X AOCCUR X Ind Contractors X 6tt0�18716605 660-1B716605 1210912017 12/U112018 EAOH OCCURRENCE $ 1,000,00 R F TO D n a 'ir nce $ 300,00 MED EXp An ale arson) $ 10,00 PERSONAL AADVINJURY $ 1,000100 GENERAL AGGRGATE $ 2,000,00 f�EN'L AGGREGATE I.IMITAPPLIt S PER X1 POLICY ::- LOO PRODUCTS - OMPIOP AGa $ 2+000,00 $ A AUTOMOBILE X LIABILITY ANY AUTO- ALI. gWNIED SCHEDULED AUTOS AUTOS ,HIREDAUTOS X NON -OWNED AUTOS 680.1 B716606 1210112017 12/011.2018 CQM EDLE LIMIT Ea amide 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY per accident $ . ( � CID $ $ HEXCESS UMBRELLA LJAU LIA13 OCCUR CLAIM$ MAGE EACH OCCURRENCE M AGGREGATE $ "D�D RET NTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I ANY PROPRIETORIPARTNERIEXECUnVU-M OFFIaRIMEMBER EXCLUDED? � (Mralda0scr In NH) WRIfes doscribe uncia, IP OP RA IO $ bel NIA WC TA - OTH E.L EACIIACCIDENT $ P.L. DISEASE • EA EMPLOYEE $ E,L, DISEASE -POLI Y LIMIT A Property Secklon _ - 680.18716605 12101/2017 1210112018 DESCRIPTION OP OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Romadce Sohadulo, if more spsoois requirod) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, ZNPLOYZt$, AGEINTS, t1OLUTEERS ,AND REPAUS9NTATIVAS//ADlD1T'XONA1 INSURED IS PRX Y AND NON CONTRIBUTORY AGREEMENT NIMBRS A--2011-0701 A-2014-038 & A^-201.5.159//AS REQUIRED BY WRITT�4N CONTRACT, CERTIE'TCATHS ARM SUBJECT TO ALL POLICY TERMS AND CONDIPqN REVIEWED BY: EUNICE. H :REDIA (PG OF ) itsr:rvr�r v v rc t,:AlNVr_L,L.A1 VN SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, PUBLIC WORKS AGENCY ATTN: JASON GABRIEL AUTHORIZEDREPR9SENTATIVF 20 CIVIC CENTER PLAZA M-36 SANTA ANNA, CA 92701 V IUUU-201U AUUKU GORI'OKA7'ION, All rights reserved, ACORD 26 (2010106) The ACORD name and Toga are registered marks of ACORD NOTEPAD, HOLDER C06F SANTAAN ' INSURED'S NAMS Donna Desmond Associates CONDMON9 OV SUCH P0LXCXES DCSM0.1 PAGE 2 OP ID: SG Dare 11/15/2017 REVIEWED BY: Ij EUNICE HEREDIA (PG Donna Desmond Associates': -- Policy #680-1 B716605 COMMERGIAI. GENERAL LIABILITY THIS ENDORSEMENT CHANCES THE POLICY. PLEASE DEAD IT CAREFULLY, BLANKET ADDITIONAL INSURED - a NER LESSEES � � OR CONTRACTORS - This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART i PROVISIONS: g 9, WHO IS AN INSURM (SECTION 11) is amended in a written contract for this Insurance to -to include as an insured any person or organixa- - apply on a primary or contributory basis. tion (caged hereafter "additional insured"} whom you have agread In a written contract, executed 3. This insurance does not applyi y prior.,to loss, to name as additional: insured, but a. on any basis: t4 any person: or organization only :with respect to nobility-arisIng.out of "your for whom you have "purchased an Owners work'_` or, your ongoing operations for that add!- and Contractors Protective policy. tlonal- insured performed by you or far you. b. to "bodily injury," "property :damage," , °per 2: With respect to the insurance afforded to Adds- sonal injury;" or "advertisln ,� g g injury arising tlonal insureds the following conditions apply: out of the rendering of or the failure to render a. Limits of Insurance -� The following limits of any professional services by or for you, inW In- ciuding; liability apply Tho limits which you agreed to provide; 1" The preparing, approving or fading to i - or -- - -:- prepare or approve maps, drawings, opinions, reports, surveys, change or. 2. The limits shown on the declarations, ders, designs or specifications; and Whichever is less, 2. Supervisory, Inspection or engineering b. This Insurance Is excess over any valid and services, collectible Insurance unless you have agreed CC D1 oa 04 94 Copyright, The Travelers Indemnity Company, 1994, Page 1 of 1 Includes Copyrighted Material from Insurance Services Office, Inc. REVIEWED BY: FUNICE HEREDIA (PG OF;, } Donna Desmond Associates - - Policy #680-1 B716605 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ iT CAREFULLY, UHER INSURANCE - ADDITIONAL INSUREDS GG DO 37 04 05 Copyright 2006 The St. Paul Travelers Companies, Inc, All rights reserved, Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (Pe OF � This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS b. The "personal Injury" or "advertising injury„ for COMMERCIAL GENERAL LIABILITY CONDITIONS which coverage Is sought arises out of an of ' (Section IV), paragraph 4. (Other Insurance), is fense committed amended as follows; Subsequent to the signing and execution of that `I -The -,following-Is added to Paragraph a, Prlmary contract or agreement by you. _ _lnsuranca: 2. The first Subparagraph (2) -of Paragraph- b. Ex. However, if you specifically agree in a written con, cess insurance regarding any other primary In - tract or -written agreement that the Insurance pro- surance nvdilable to.you is deleted. vlded toan ; a�d)tlor- Insured under this Coverage (part must apply oh a primary basls,-or 3. The following Is added to Paragraph b, Excess insurance, as an additional subparagraph under a primary and _non-contributory basis, this insur- Subparagraph (1): anco Is primary to other insurance -that. Is avall. "able tp'suah `additional Insured which covers such That is available to the insured when the insured. additional Insured as a named Insured, and we is added as an additional Insured under any other policy, including any umbrella or excess policy, f will not share with that other Insurance, provided f that, ; a, The "bodily injury" or "property damage" fbr which coverage is sought occurs; and I i, i GG DO 37 04 05 Copyright 2006 The St. Paul Travelers Companies, Inc, All rights reserved, Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (Pe OF � DESMO-1 OP ID: SG ACRO CERTIFICATE OF LIABILITY INSURANCE DATE 12/10/201 YY) 12/1012018 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 John J. Matsock & Assoc. Inc. 1750 N Washington Street CONTACT _NAME: Steven L. Monteith AICC No Ezt : 630-505-7888 FAX No Naperville, IL 60563 Steven L. Monteith E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Prop Cas Co 125674 INSURED Donna Desmond Associates INSURER B: of America Y Phone #310-475-1114 680-16716605 265 South Beverly Glen Blvd. INSURER C: DAMAGETORENTED PREMISES Ea occurrence $ 300,000 Los Angeles, CA 90024 INSURER D: INSURER E: X Ind Contractors 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. INSR LTR TYPE OF INSURANCE ADDL SUBR' POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A�17CLAIMS-MADE MERCIALGENERALLIABILITY XOCCUR Y 680-16716605 12/01/2018 12/01/2019 DAMAGETORENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 A X Ind Contractors 680-1B716605 GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 �GEN'L n POLICY PROJEC- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 Ea accident ,000,000 BODILY INJURY (Per person) $ AI AUTO 680-1 B716605 12/01/2018 12/01/2019 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ PER ACCIDENT $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATIONWC STATU- OTH - AND EMPLOYERS' LIABILITY YIN TORY LIMITS R EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? ❑ N I A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ A Property Section 680-18716605 12(01/2018 12/01/2019 I i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEERS AND REPRESENTATIVES//ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY AGREEMENT NUMBERS A-2011-070; A-2014-038 & A-2015-159//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY TERMS AND CONDITION' REVIEWED BY: EUNICE HEREDIA (PG ( OF " ) SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PUBLIC WORKS AGENCY ATTN: JASON GABRIEL AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLAZA M-36 SANTA ANNA, CA 92701 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Donna Desmond & Associates Policy #680-1B716605 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED --OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1. WHO IS AN INSURED (SECTION ll) is amended to include as an Insured any person or organiza- tion (called hereafter "additional insured") whom you have agreed in a written contract, executed prior to loss, to name as additional insured, but only with respect to liability arising out of "your work" or your ongoing operations for that addi- tional insured performed by you or for you. 2. With respect to the insurance afforded to Addi- tional Insureds the following conditions apply: a. Limits of Insurance — The following limits of liability apply: 1. The limits which you agreed to provide; or 2. The limits shown on the declarations, whichever is less. b. This insurance is excess over any valid and collectible insurance unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis, 3. This insurance does not apply: a. on any basis to any person or organization for whom you have purchased an Owners and Contractors Protective policy. b. to "bodily injury," "property damage," "per- sonal injury," or "advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, in- cluding: 1. The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change or- ders, designs or specifications; and 2. Supervisory, inspection or engineering services. CG D1 05 04 94 Copyright, The Travelers Indemnity Company, 1994, Page 1 of 1 Includes Copyrighted Material from Insurance Services Office, Inc. REVIEWED BY: EUNICE HEREDIA (PG F ) Donna Desmond & Associates Policy #680-1B716605 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance., However, If you specifically agree in a written con- tract ontract or written agreement that the insurance pro- vided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and noncontributory basis, this insur- ance is primary to other insurance that is avail- able to such additional Insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily Injury" or "property damage" for which coverage is sought occurs; and Ilr b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other primary In- surance available to you is deleted. 3. The following Is added to Paragraph b, Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured Is added as an additional insured under any other policy, Including any umbrella or excess policy. CG DO 37 04 06 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Page 1 of 1 Donna Desmond A S S o C i A T E S 265 S. Beverly Glen Blvd., Los Angeles, CA 90024 (310) 475-1114 • ddesmond@donnadesmond.com December 10, 2018 City of Santa Ana Attn. Insurance & Contract Compliance Manager Re: Insurance Requirements for Consulting Set -vices Agreement #A-2045-159 To whom it may concern: I am in receipt of the City of Santa Ana's request for a certificate evidencing coverage for Worker's Compensation Insurance. Donna Desmond Associates does not carry Worker's Compensation Insurance for the following reason: The corporation's 100% shareholder, Donna Desmond, is the only employee of the company and is therefore exempt from the State of California's worker's compensation insurance requirement. I therefore request a waiver of this requirement for work performed for the City of Santa Ana. If Donna Desmond Associates hires any employees, which it does not plan to, then the firm will obtain Worker's Compensation Insurance and provide the City of Santa Ana with a certificate of insurance. Thank you for your attention to this matter. Please contact me with any additional questions or requests. Very truly yours, DONNA DESMOND ASSOCIATES Donna Desmond, ASA REVIEWED BY: EUNICE HEREDIA (PG VF )