Loading...
HomeMy WebLinkAboutEHS INTERNATIONAL INC. 1BINSURANCE NOT ON FILE WORK MAY NIT PROCEED LERK OF COUNCIL MUTE !d Z,'� � Miguel A. Pulido MAYOR PRO TEM Sal Tinalero COUNCILMEMBERS Angelica Amezcua P, David Benavides Whole Martinez Roman A, Rayne Vincent F. Sarmiento September 24, 2013 EHS International Inc. CITY OF SANTA ANA PERSONNEL SERVICES AGENCY 20 Civic Center Plaza - PO Box 1988 Santa Ana, Callfamia 92702 Marjorie Del Toro 26741 Portola, Parkway, Suite I E 4823 Foothill Ranch, California 92610 Re: Agreement N -2012 -030 — Safety Training Services Dear Ms, Del Toro: � 1 f INTERIM CITY MANAGER Kevin O'Rourke CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Marla D. Huizar Pursuant to Agreement #N- 2012 -030, entered between EHS International Inc. and the City of Santa Ana, dated. July 1, 2012, Section 3 - Term, the time period of said Agreement is hereby extended through June 30, 2014, The insurance certificates and Additional Insured Endorsement are required to be extended and /or renewed to cover this extension. All other terms and conditions of said Agreement and the First Amendment to Agreement remain unchanged and in full force and effect. If you have any questions regarding this matter, please contact I3riza Morales in Risk Management at 714- 647 -5470. Sincerely, qjuv &,?-,, ci_—."" Edward Rays, Executive Director — Personnel Services Agency Approved as to 'Assistant City Attorney a: Clerk of the Council P ATTEST: MARIA D. HUIZAR U CLERK OF THE COUNCIL Jub"U -1 ur' W: bV CERTIFICATE OF LIABILITY INSURANCE DAT0513011 Y7 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 Ileu of such endorsement {s), PRODUCER Phone: 925.860.7050 NAME HUB International Insurance Fax: 925 - 366-8275 m o INSURER A. Peeriesa mairanp* Dompmry 2499$ IwsuREO EHS internatlonai, Inc. Golden 8aeta inauranae Carp 26741 Portola Parkway INSURER -8 10$30 Suite 1E #823 INSVRERC Preferred Employers In., Co. _ 10900 _ _ Foothill Ranch, CA 92810.1783 INSURER D: Admiral Inauranae Company 24$58 INSURER E: 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. RSR- aDt "aua POLSOYYY al7LT('.Y E%P UMRS L?5, TYPE DF INSURANCE :;6..YRUD. POLICYNUMEER ;",�1140LI t.TY7 .dMa�trioayrr.�! _ GENERALLIABadTY EACHCCCURRENOE $ 1,000,0 oAMA'R7'RENTr35 ... —_ A X COMMERCIAL GENERAL LIABIUTV X �CBP9599092 06101114 PREMSes tEemaunanc) S_ 100,0 .� CLAIMS MADE X OCCUR I pRgq{�'y, MED EXP (anyone parson) $ 6,0 PERSONAL* aavINJURY $ 1,000,0 GENERAL AGGREGATE $ 2,600,0 ,,..., ----- ._.. . .. . GENL AGGREGATE LIMIT APPLIES PER i �tT aN' PRODUCTS- COMPIOP ACC S 1,000,0 X POLICY I 1 Frtn" Loc - .jpS!8� pfT+t" _....,„,.„.,. AUTOMOBILE LIABILITY b.�t�l. +e`J [CPOMBINED SINGLE LIMIT 1,OOQ0 ,MInf„nt A _ ANYAU'r0 PB809 06101113 06101114 BODILY INJURY (Par person) $ _ AUTOS ALLOWNED _ AUTOS BODILY INJURY (Per accltlenn $ NON"OWNED PROPERTY DAMAGE X HIREDAUTOS X AUTOS ip -,Itla n $ Dad X UMBRELLA LIAB .00CUR - _ EACH OCCURRENCE B EXCESS UA9 CLAIMS -MADE CU8738010 06101113 06101114 AGGREGATE. s 2,000,0 OEDX STATU OTH, WORKERS COMPENSATION 1 X TORY AND EMPLOYEAV LIABILITY C ANY PROPRIETORIPARTNEWE XECUTIVEY /N KN118028.11 06101/13 06101114 E.L. EACH ACCIDENT $ 1,000,6 OF%CERIMEMBER EXCLUDED? F] NIA (Mandatory In NH) E.L. iDISEASE- EA EMPLOYEE)$ 1,000,6 DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more spec* Ix r*RUlred) Cho City of Santa Ana, its officers, agents, volunteers and employees are named as Additional Insured with respect to General Liability as required by mitten contract per the attached. Snoured'a General Liability coverage is Primary and Non - Contributory. Briza Morales City of Santa Ana Risk Management, M28 20 Civic Center Plaza Santa Ana, CA 92701 CITYSA5 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 ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD O A part of Polley Number: CBP9599092 Coverage Is Provided In PEERLESS INSURANCE COMPANY - A STOCK COMPANY Named Insured: Agent; EHS INTERNATIONAL INC HUB INTERNATIONAL INSURANCE SE RVICES INC Agent Code: 4293053 Agent Phone; (925)- 866 -7050 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Ornanlzation(s): ANY PERSON OR ORGANIZATION WHEN YOU AND SUCH PERSON OR ANGELES, ITS DEPARTMENTS, OFFICERS AND EMPLOYEES ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT, AGREEMENT OR PERMIT THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY TO PROVIDE INSURANCE SUCH AS IS AFFORDED UNDER THIS COVERAGE PART. SCHEDULED LOCATION OF COVERED OPERATIONS: ANY LOCATION AT WHICH YOU PERFORMED WORK DESCRIBED IN WRITING IN THE CONTRACT, AGREEMENT OR PERMIT FOR A PERSON OR ORGANIZATION THAT HAS BEEN QUALIFIED AS AN ADDITIONAL INSURED IN THIS ENDORSEMENT. 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: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to Its intended use by any person or organization other than another contractor or subcontractor engaged In performing operations for a principal as a part of the same project. © ISO Properties, Inc., 2004 CG 2010 07 04 Page 1 of 1 06/01/2013 9599092 NN189606 0605 PGDMO60D J29739 GEONLYST 00004449 Page 17 Ns 3 '....Lured: ehe International Inc, ro,. y Number: CBP9599092 Policy Term: 6/1/13 - 6/1/14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: . Kdk'FAluIA: ZN/ t1 We] :1gI4 :L10 4It\:31JYr'(KiDI:I:L[H :7G1:41 A. The following is added to provision a. Primary Insurance of paragraph 4. Other Insurance under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: However, when an additional insured has been added to this Coverage Part by attachment of an endorsement, we will not seek contribution from the "additional insured's own Insurance" provided that: (1) You and the additional insured have agreed in a written contract that this insurance is primary and non- contributory; and (2) The "bodily injury" or "property damage' occurs, or the "personal and advertising injury" is committed, subsequent to the execution of such contract. B. For the purposes of this endorsement the following is added to SECTION V — DEFINITIONS: "Additional insured's own insurance" means other insurance for which the additional insured is designated as a Named Insured. Includes copyrighted material of Insurance Services Office, Inc., with its pennission. 22.111 (01/07) Page 1 of 1