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HomeMy WebLinkAboutMETRO PRO ROAD SERVICES, INC. DBA A&P TOWING 1A - 2013CWPIV Vw y INSURANCE NOT ON FILE WORK MAY M1 PROCEED CLERK OF COUNCIL N- 2013 - 047 -001 DATE: JUL 1 S 2013 FIRST AMENDMENT TO AGREEMENT O :SRP Q C�) RSCCA /t.$, THIS FIRST AMENDMENT TO AGREEMENT is entered into on/ � zI , 2013, by Ro))Cff V and between Metro Pro Road Services, Inc., dba A &P Towing, a California corporation (:a")) ( "Contractor ") 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 ( "City "). RECITALS: A. The parties entered into Agreement # N- 2013 -047, dated April 1, 2013, (hereinafter "said Agreement') by which Contractor will provide police tow services on a rotational basis. B. Said Agreement requires that Contractor utilize Dispatch & Tracking Solutions (DTS) software in implementation of the contract. C. In accordance with the terms and conditions of said Agreement, the parties wish to amend the authorized fee schedule to authorize the recovery of the DTS fee from the vehicle owner. WHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this First Amendment to Agreement, the parties agree as follows: 1. Exhibit B, Fee Schedule, shall be amended to include as a fee which Contractor is authorized to collect, a DTS fee in the amount Contractor pays to the Orange County Sheriff, currently $9.25 per dispatch call. 2. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Agreement on the date and year first written above. ATTEST: MARIA D, HUIZAR I Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: Q� Lau a Sheedy / Assistant City Attorney CITY OF SANTA ANA CARLCTS ROJAS Acting Chief of Police METRO PRO ISM A� a® CERTIFICATE OF LIABILITY INSURANCE DATE 08 /05IDDI13 08/05/2013 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(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 1- 800 - 955 -8700 Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. NAME: Arthur J. Gallagher & Co. PHONE FAX A (949) 349 -9800 aC No: (949) 349 -9967 E -MAIL ADDRESS: 18201 Von Kaman Ave, Suite 200 INSURERS AFFORDING COVERAGE NAIC# Irvine, CA 92612 INSURER A: INSURANCE CO OF THE WEST 27847 Jerry Niewiadomski INSURED MetroPro Road Services, Inc. INSURER B COMMERCIAL GENERAL LIABILITY —71 CLAIMS -MADE � OCCUR Al-9013 J �/�'7 s'r� 2550 South Carnally Street Al -9013 �® 7 d`V� I INSURER C: INSURER D: $ NSURER E $ Santa Ana, CA 92707 NS USER F: COVERAGES CERTIFICATE NUMBER: 35085348 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 R TYPE OF INSURANCE ADDLSUBR INSR POLICY NUMBER MMIDDIYYYVY MMIDDIYVYV LIMITS USA GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY —71 CLAIMS -MADE � OCCUR rove 0-5 \�)��y /� I T9V7 N DAMAGEE( RENTED PREMISES Ee occurrence $ MED EXP (Any one person) $ PERSONA 8 PINJURY -0 $ GENERAL )i. II IRIAATE ; �J $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCT$ COMP /OP AGf^Y $ // ■� ��� J "— POLICY PRO LOD JET F iup"l $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT i He accident .' ., ....I ^ BODILY INJURY (Per person $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY {Per acciddR j., $ PROPERTY A� u„ Per accident $ NON -OWNED HIRED AUTOS AUTOS �,rPJE $ UMBRELLA LIAB OCCUR EACH OCCU $"' $ AGGREGATE " $ EXCESS LIAB CLAIMS -MADE ❑ED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X WSD502374500 04/01/1 04/01/14 X TWO STATIC OTH- E E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Waiver of subrogation applies to certificate holder on workers compensation liability policy, per the attached form WC990634800. Re: Work performed by the named insured as required per written contract with respects to City of Santa Ana Certificate holder continued: City of Santa Ana, its officers, officials, employees, agents, and volunteers CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010/05) Tamie123 35085348 ©1988.2010 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 ACCORDANCE WITH THE POLICY PROVISIONS. Clerk of the Council 20 Civic Center Plaza (M -30) AUTHORIZED REPRESENTATIVE P.O. Box 1988 Santa Ana, CA 92702 -1988 USA ACORD 25 (2010/05) Tamie123 35085348 ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET WC 99 06 34 (Ed. 8 -00) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium otherwise due. Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER, Policy Number: WSD 5023745 00 Endorsement Effective: 4/1/13 Issue Date: 5/16/13 WC 99 06 34 (Ed. 8 -00) Schedule Job Description RE: ALL CALIFORNIA OPERATIONS. Insured: MetroPro Road Services, Inc. Coverage Provided by: Insurance Company of the West Countersigned by: ACORD,. CERTIFICATE OF LIABILITY INSURANCE MAY PERTAIN, THE INSURANCE AFFORDED BY'1'HE POLICIES DESCRIBED HEREIN IS SUBJEC I TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH OR /05, ° ° "13 PRODUCER Centerpointe Insurance $M AUG AUG California License #0735759 807 - B Camarillo Sprin tgotadn- Camarillo, CA 93012-946'411 i 1 _"' 10 -� ` ? PH 2: 09 c, A r. L. }-L¢ ANA r ..<A A THIS CERTIFICATE IS ISSUED AS A HOLDER. TTHISOCERT FICATERDOES ALTER THE COVERAGE AFFORDED MATTER OF INFORMATION NOTOAMEND, EXTEND OR THE CERTIFICATE BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE POLIGYE % PRATION BAT NAIC# INSURED METROPRO ROAD SER W' t %('I$YC�. ,L VL DBA:A &P TOWING & DBA: HARBOR TOWING 2550 S GARNSEY STREET SANTA ANA, CA 92707 METR00 INSURERA: NATIONWIDE MUTUAL INSURANCE CO 23787 INSURER S: *REVISED* 07/24/2014 EAGI I OCCURRENCE NSURER c INSURER D: INSURER E, DAMAGE TO RENTED PREMISES( Ea occurep9e)_.,$ 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'1'HE POLICIES DESCRIBED HEREIN IS SUBJEC I TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR D N ❑ 20 CIVIC CENTER PLAZA POLICY NUMBER POLICY EFFECTIVE M ❑ POLIGYE % PRATION BAT LIMITS • GENERAL LIABILITY ACP 7825094878 07/24/2013 07/24/2014 EAGI I OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES( Ea occurep9e)_.,$ ,_ 100,000 CLAIMS MADE Ej OCCUR MEDEXP(Anyonepe,.,,)_ $_ 51000 �p� 1v-C; w13 —0q1 �° 00/ P_ERSONAL &AOV INJURY $ 1, 000,000 GENERAL AGGREGATE _ $ 2, 000,000 �W if" GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY PRO LOC ECT • AUTOMOBILE LIABILITY SOP 7825094878 07/24/2013 07/24/2014 COMBINED SINGLE LIMIT' ANYAUTO (EanccMenp $ 1,000,000 BOOILV INJURV _ $ ALLOWNEDAUTOS X SCHEDULEDAUTOS (Per Peraorp BODILY INJURY $ X HIREDAUTOS X NON- OWNEDAUTOS (Paraacld.,U PROPERTY DAMAGE $ (Paraccjdenl) A GARAGE LIABILITY ADD 7825094878 07/24/2013 07/24/2014 AUTO ONLY -EA ACCIDENT $ OTHERTHAN EAACC $ 1,000,000 ANYAUTO $ X OTHER THAN AUTO AUTOONLY: AGG EXCESSIUMBRELLA LIABILITY APPROVED A TO FOR EACH OCCURRENCE AGGREGATE - $ OCCUR a CLAIMS MADE , $ DEDUCTIBLE Laura A. Rossini $ RETENTION $ WORKERSCOMPENSATIONAND Assistant Ci Attorney I WCSTATU- OTH- U I T R_ EMPLOYERS LIABILITY E.L. EACIIACCIDENT $ ANY PROPRIETORIPARTNER/EXECUTIVE _ E.L. DISEASE - EA EMPLOYE OFFICERMEMBER EXCLUDED? Ifyyas,de cdbe under Is At. PROVISIONS below E.L. DISEASE- POLICY LIMIT A OTHER Ace 7825094878 07/24/2013 07/24/2014 PER VEH.SCIdED, 600000 iON- HOOK /GARAGEKEEPERS $1000 DEDUCTBL DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS sp GARAGEKEEPERS LEGAL LIABILITY - $600,000 LIMIT PER LOCATION UNINSURED MOTORIST BODILY INJURY - $1,000,000 THE CITY OF SANTA ANA, ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED AS RESPECTS TO THE GENERAL LIABILITY AND AUTOMOBILE LIABILITY POLICY LIMITS AS PER ATTACHED ENDORSEMENTS. ACORD 101 (2008 /01)FORM ATTACHED. CERTIFICATE HOLDER CANCELLATION ACORD25(2001108) ' ACORD CORPORATION 198$ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI CITY OF SANTA ANA DATE THEREOF, THE ISSUING INSURER WILLXF}HSXla MKIO MAILS 0 DAYS WRITTEN ATTN: PURCHASING DEPARTMENT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEF '11UMP4'.YXIN7§XXlX5:3'A�$T+YLL 20 CIVIC CENTER PLAZA X% XaiXHIXT79 :C27[LYauxvsxx">txF4;@}C9i3C SANTA ANA, CA 92701 -4010 Ht}OISt{c'E�s45,xxdc AUTHORIZED REPR r§, ATIVE 1J DS ACORD25(2001108) ' ACORD CORPORATION 198$ AGENCY CUSTOMER ID; METR00 LOC # ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of AGENCY Centerpointe Insurance Services, Ltd. NAMEDINSURED METROPRO ROAD SERVICES, INC DBA: A &P TOWING & DBA: HARBOR TOWING 2550 S. GARNSEY STREET SANTA ANA, CA 92707 POLICY NUMBER ACP 7825094878 CARRIER NATIONWIDE MUTUAL INSURANCE CO NAIC CODE 23787 EFFECTIVE DATE: 07/24/2013 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance For compliance reasons, the attached document includes: 1. This certificate is issued as a matter of Information only and confers no rights upon the certificate holder. This certificate does not affirmatively or negatively amend, extend, or alter the coverage, terms, exclusions, conditions, or other provisions afforded by the policies referenced herein. This certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer and the certificate holder. 2. Should any of the above described policies be canceled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. ACORD APPROVED AS O FORM .. A- Laura A. Rossini Assistant City Attorney The ACORD name and logo are registered marks of ACORD POLICY NUMBER: ACP7825094878 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person {s) Or Organization(s): CITY OF SANTA ANA, ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS 20 CIVIC CENTER PLAZA SANTA ANA, CA 927014010 APPROVED AS TO i+OW,,. Laura A. Rossini Assistant City Attorney Information required to complete this Schedule, if not shown above, will be. shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury ". "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In Connection with your premises owned by or rented to you. However: 1. The insurance afforded to surh additional Insured only applies to the extent permitted by law; and 2. It coverage provideo to the additional insured is required by a contract or agreement, the insurance afforded to such addilional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 04 13 ACP GLO 7825094878 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a Contract or agreemont,'the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement SI all riot increase the applicable Limits cf Insurance shown in the Declarations, All terms and conditions apply unless modified by this endorsement. C Insurance Services Office, Inc., 2012 LMYR 13199 AGENT COPY Page 1 of 1 78 0011855 '`� °® CERTIFICATE OF LIABILITY INSURANCE D08 /05I °0Y3 08/05/2013 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(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 1- 800 - 955 -8700 Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. 18201 Von Karmen Ave, Suite 200 AMME : CONTACT N Arthur J. Gallagher & Co. NAME PHONE FA% c No Ext: (949) 399 -9000 AIC No): (949) 399 -9967 EMAIL ADDRESS: INSURER (S) AFFORDING COVERAGE NAIC N Irvine, CA 92612 INSURERA: INSURANCE CO OF THE WEST 127847 Jerry Niewiadomski INSURED INSURER B MetroPro Road Services, Inc. DAMAGE TO REED NT PREMISES lEa coourrencel INSURER C: MED EXP (Any one person INSURER D: PERSONAL &ADV INJURY 2550 South Garnsey Street INSURER E: Santa Ana, CA 92707 INSURER F: COVERAGES CERTIFICATE NUMBER: 35085348 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 R TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMDDIYYVY MMIDITYVY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_ OCCUR DAMAGE TO REED NT PREMISES lEa coourrencel I $ MED EXP (Any one person - $ PERSONAL &ADV INJURY $ _ GENERAL AGGREGATE $ PROVED S T FORM GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS- COMPIOP AGG $ $ POLICY PRO LOG JECT � AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT En accidenp_ La�r'd A. RoESSYnl Laura BODILY INJURY Per person) (P_.._ ) ANY AUTO ALL OWNED SCHEDULED AUTOS _._ AUTOS Assistant rt ®rne _____ BODILY INJURY(Poraccidenl) $ PROPERTY DAMAGE Per..Monl _ i$ NON -OWNED HIRED AUTOS AUTOS Ht l..J ,r UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS ILIAD CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION Math AND EMPLOYERS' LIABILITY Y N X WS ➢502374500 04/01/1 04/01/14 WCSTATU- Ol'H- X ' Y LIMITS E.L. EACH ACCIDENT $1,000,000 OFFICER /MEMBER EXCLUOEOP ❑ NIA EL DISEASE - EA EMPLOYEE $ 1,000,000 NORIPARTNER/EXECDTIVE (Mandatory $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mere apace Is required) Waiver of subrogation applies to certificate holder on workers compensation liability policy, per the attached form WC990634800. Re: Work performed by the named insured as required per written contract with respects to City of Santa Ana Certificate holder continued: City of Santa Ana, its officers, officials, employees, agents, and volunteers City of Santa Ana Clerk of the Council 20 Civic Center Plaza (M -30) P.O. Be. 1980 Santa Ana, CA 92702 -1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE /�/ /y USA ✓ Q� reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD TS.ie123 35085348 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8 -00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium otherwise due. Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER. Policy Number: WSD 5023745 00 Endorsement Effective: 4/1/13 Issue Date: 5/16/13 WC 99 06 34 (Ed. 8.00) Schedule Job Description RE: ALL CALIFORNIA OPERATIONS. r ROVED AS'�0 E' 01 r r� Laura A. Rossini s ;r.atti COV Attorney Insured: MetroPro Road Services, Inc. Coverage Provided by: Insurance Company of the West Countersigned by: -� ,a Ac"R CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 3;3112014 THIS CERTIMICATE CERTIFICATE BELOW. THIS IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENT)4TIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT the terms an It the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to I conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certlflcate hJder in lieu of such endorsement(s). PRODUCER Arthur J. Gallo her $ Co. CONT NAME: PHONE NC N: o - - Eat) 949-349-9800 Insurance Brolilers of CA, Inc. y/ �/ v 18201 Von Karrnan, Suite 200 w ` J `��� ��� Irvine CA 9261P E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAM I, INSURER A: T 784 INSURED INSURER B: MED EXP (Any ore pfften) _ INSURERC: etroPro Tow g, Inc dba Santa Ana Towing INSURER D: ? INSURER E: — M South Garnsey Street Santa Ana, CA 92707 INSURER F: PERSONAL A ADV INJURY r!=R !CMCATCNIIMRLR• ia4nannnic MEviSiOIN NUMBER; THIS IS TO CRRTIFY 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. INTq pE OF INSURANCE POLICY NUMBER POLICY EFF MMIDD!YYYY POLICY EXP MIDDIYYYV LIMITS GENERAL/ BILITY COMMEIC 1AL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE T PREMISES aaccurrence $ MED EXP (Any ore pfften) $ CL IMS -MADE El OCCUR PERSONAL A ADV INJURY $ Sc ,E'O GENERALAGGREGATE S I GEN'LAGGR GATE LIMIT APPLIES PER'./� POLICY�I PRO- LOC PRODUCTS- COMP /CP AGG $ VLNIB V $ ) AUTOMOBIL LIABILITY ANY AUtO �Or' K J' ne! IT Eaamltlera B ODILY INJURY(Per person) $ BODILY INJURY (Per acaldan0 S ALL ONJ ED F SCHEDULED AUTOS , 'AUTOS HIRED A)1TOS AUTO OWNED ASS \5iaht ( PROPERTY DAMAGE Perarcbera $ $ UMBRE LA LIAB OCCUR EACHOCCURRENCE $ _ AGGREGATE $ EXCESS LIAB CLAIM S-MADE DED WORKERSC AND EMPLO ANY PFgPRIf;I'ORWARTNERIFXECUTIVE❑ OERICEI I (Mandatory Iq RETE NTION$ MPENSATION ERS'UABILITV yIN, HER EXCLUDED? NH) WC STATU- OTH- X R i A NIA SD502374601 /1/2014 0/2015 EL. EACH ACCIDENT i $1,000,000 EL DISEASE -EA EMPLOYEE $1,000,000 - 0 yes, desai DESCRIPTIO under OFOPERATIONS below E L. DISEASE - POLICY LMAR $1,000,000 DESCRIPTION OF OPERATIONS( LOCATIONS (VEHICLES ( Attach ACORD 101, Additional Renneraa Schedule, It moreapaw lsrequired) ry N O Proof of insura Ce. I o ECIE) 1 SHOULD ANY OF THE ABOVE DESCRIBEDP CIES�U CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE Why BE DELIVERED IN Cry of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza (M -30) P . Box 1988 AUTHORIZED REPRESENTATIVE S nta Ana CA 92702 -1988 USA ®1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (20110/05) The ACORD name and logo are registered marks of ACORD