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HomeMy WebLinkAboutSOLOMON, STEPHEN HOWARD (2) -2014INSURANCE NOT ON FILE N-2014-130 WORK MAY NUT PROCEED CLERK OF COUNCIL. DATE: SEP 1 5 2014 CONSULTANT AGREEMENT THISAGREEMENT made and entered into this) day of 0=aj 2014 by and between Stephen H. Solomon (hereinafter "Contractor"), and the CITY 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 Contractor having special skill and knowledge in the field of arbitration and mediation to provide professional administrative herring services, B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor 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 Contractor will provide professional Administrative Hearing services for the City of Santa Ana Community Preservation Department and Public Works Department, as set forth in Exhibit A, attached hereto and incorporated herein by this reference. Such hearings may include Vehicle Abatement, Administrative Citation Appeals, and Alternative Public Nuisance Abatement. Administrative Hearing officer services may be utilized by other agencies with the City of Santa Ana. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended for Administrative Hearing Services provided by all contracted Hearing Officers shall not exceed $25,000 during the terns of this Agreement. However, this Agreement does not guarantee that any set amount of the authorized $25,000 will be expended on any particular Contractor. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. 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. 3. TERM This Agreement shall commence on the date first written above and terminate three (3) years from said commencement date or upon the depletion of the maximum contract amount as stated in Section 2 above, unless terminated earlier in accordance with provisions, below. The tern of this Agreement may be extended for my be extended up to two additional one-year periods, upon a writing executed by both parties, including the City Manager and the City Attorney for the City. 4. INDEPENDENT CONTRACTOR Contractor 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 Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor 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. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Contractor, if Contractor 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, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. b. Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim, subject to $1,000,000.00 aggregate. e. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor 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. d. If Contractor 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 affect Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Contractor agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability for personal injury, damages, just compensation, restihrtion, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect negligent 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 l of this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief 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 Contractor further agrees to indemnify, hold harmless 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. 7. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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 Contractor without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSE Contractor 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. 9. 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 telefacsimile 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 telefacsimile (714) 647-6956 With courtesy copies to: and Executive Director of Planning and Building Agency City of Santa Ana 20 Civic Center Plaza (M-20) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-5897 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6515 To Contractor: Stephen H. Solomon 17853 Santiago Blvd. 9107-188 Villa Park, California 92861 A party may change its address by giving notice in writing to the other party. 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 telefacsimile, 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. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor, 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 Contractor. 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 either Contractor or the City. Each party to this Agreement aelaiowledges 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. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor 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. 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. hi such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. Asa condition of such payment, the Executive Director may require Contractor 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 Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of perfomlance specified in the Recitals of this Agreement. 13. DISCRIMINATION Contractor 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. Contractor affirms that it is an equal opporhulity employer and shall comply with all applicable federal, state and local laws and regulations. 14. 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 comzection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Contractor 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. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. 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. 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. HIJJZAR C1erL of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City 4t ey Ryan RECOMMENDED FOR APPROVAL: t KAREN HALUZA Interim Executive Director Planning & Building Agency CITY OF SANTA ANA DAVID CAVAZ g City Manager CONTRACTOR LL 4, ST HEN H. SOLOMON Tax ID# 5Z, , s g —l1 (o EXHIBIT A SCOPE OF SERVICES (Attached) EXHIBIT A SCOPE OF SERVICES BACKGROUND In order to provide effective and expeditious hearings to individuals cited for violations of the Santa Ana Municipal Code (SAMC), the City would like to develop a list of Hearing Officers to conduct Administrative Hearings. The selected Hearing Officers will be assigned cases on a rotating, as -needed basis. The Hearing Officer will conduct Administrative Hearings for the City of Santa Ana. Primarily, the Hearing Officer will hear administrative citation appeals, alternative nuisance abatement proceedings and vehicle abatement proceedings associated with action of the City's Planning and Building agency. The Hearing Officer may also be asked to provide administrative hearings for other City Agencies (i.e. Public Works Agency). The Hearing Officer will be charged with making a just determination as to whether a municipal code was violated, whether the property owner is still in violation, and will also make determinations as to whether the process for the abatement of a nuisance, including inoperative vehicles, will move forward. Hearings will be held in accordance with the City of Santa Ana Municipal Code (Chapter 2 Sections 1-21 through 1-21.8, Chapter 16 Section 119, Chapter 17 Sections 17-108 and 135). GENERAL INFORMATION It is the intent of the City to establish a list of qualified Hearing Officers. The actual number of hearing officers utilized will depend on the total number of qualified candidates established by the proposal process, and the number of hearings required. A. When appropriate, the City will provide forms and information in its possession relevant to the conduct of a fair hearing, including, but not limited to, Notices of Violation, Administrative Citations, and Vehicle Abatement Notices. B. The Hearing Officer shall be responsible for the review of documents provided by the City prior to the hearing. C. All documents and other products used or developed during preparation for a hearing will become the property of the City. D. The Hearing Officer shall preside over the City's Administrative Hearings. The Hearing Officer will be required to independently evaluate the facts of each case and make a determination as to the merits of that case based upon the information presented at the hearing and the Santa Ana Municipal Code. The Hearing Officer must be experienced and knowledgeable in administrative hearing procedures. The Hearing Officer shall be responsive and maintain excellent working relationships with property owners, residents, business representatives, and City staff. The Hearing Officer's service will include preparation of finding of facts, hearing dispositions, billing statements, and other documents as necessary. JOB REQUIREMENTS FOR ADMINISTRATIVE HEARING OFFICERS The selected consultant shall meet the following expectations and/or provide the following services: A. The Hearing Officer must be independent and impartial. In this regard, a hearing officer may not: 1. Be an employee of the City of Santa Ana or any public agency that is involved in testifying at a hearing; 2. Be a member of any board or commission of the City of Santa Ana; 3. Have a personal or professional interest that would conflict with his/her objectivity in the hearing. B. All hearings will be conducted at Santa Ana City Hall, at dates and times to be determined by the City. C. A hearing officer must possess the necessary support and equipment to perform his/her duties as a hearing officer including telephone, computer, internet and e- mail access. D. A hearing officer must possess standards of neutrality and confidentiality. E. A hearing officer must organize and maintain individual case files along with detailed records of activity on each case, such as research, drafting of orders, decisions and correspondence. F. A hearing officer must comply with all legal and contractual timelines, including, but not limited to: Rendering a final written decision, including findings of fact disposing of all issues raised by the parties in a hearing not later than 10 -days after the date of the hearing; 2. Mailing the final written decision to the appellant, with a copy to the City, on the date the decision is rendered; 3. Returning individual case files to the City within 30 -days of rendering a final decision. The files, which must be organized and maintained by the hearing officer are the property of the City and must be maintained in accordance with the Agency's record retention schedule. It is therefore imperative that the files are returned to the Agency within 30 - days of the date of the final decision. 4. Upon notification that the agency has received a request for a document pursuant to the Public Information Act, the relevant document must be provided to the City immediately. G. The hearing officer shall prepare and submit to the Planning and Building Agency a standard invoice detailing the activities and expenses by case. Payment for services and reimbursement of expenses by the City to the hearing officer are further conditioned upon: 1. The reasonableness of the amount of time spent by the hearing officer on the case(s) for which the hearing officer is seeking payment/reimbursement. 2. The hearing officer's timely submission of reasonable and acceptable documentation supporting all expenses being claimed by the hearing officer; and 3. The hearing officer's prompt return to the City of all file materials relating to closed cases; H. Providing hearing officer services to other clients is not barred so long as the hearing officer does not decline the request for hearing services more than two consecutive times; specifically, the hearing offer must: 1. Maintain the ability to respond to requests for hearings and prehearing motions within 24 -hours; 2. Meet all applicable time lines; and 3. Demonstrate that such outside practice does not conflict with contractual work with the City of Santa Ana. 4. Comply with the decision format requirements set by the City pursuant to the rules governing a hearing officer's decision as per the SAMC (Chapter 2 Sections 1-21 through 1-21.8, Chapter 16 Section 119, Chapter 17 Sections 17-108 and 135). The decisions of the hearing officer must include formal findings of fact, and meet in all respects the minimum requirements applicable to the decisions of executive agencies conducting contested cases. 5. There is no guarantee as to the number of cases that will be assigned to a hearing officer. The City anticipates that it will establish a list of qualified hearing officers and assign hearings based on a rotation of names on the list. COMPENSATION The City agrees to pay and the applicant agrees to accept as total compensation for all services and costs, a rate of $100 per hour, to the nearest quarter hour, for all hearing officer services provided to the City. Said services include review of the materials provided by the City, holding of the hearing and providing findings and determination. The City will not pay costs associated with providing hearings including City validating parking receipts for the time that hearing officer is performing services for the City and travel time to and from the hearing site. =:<i3S=N:_N Nom.: f?_Sr –? -\SACT-' OX\0.: 74� 4 Ais :"I ICRIZATION NC.: (UNiR:a'�2 )94CP'_035-.z dndorsemeat to Mi der Cer:,f icate No. C$M 1-- 13 AI2131I'12ATORS,I-IL'ARINt:, OFI.ICL'RS AND MF,DIAMRS PROFESSIONAL LIABILITY INSURANCE issued to the NATIONAL ASSOCIA 10N OF SALARIFD PROFESSIONALS pURCIiASING GROUP, INC. and SPECIFIED MEMBERS EVIDENCE OP INSURANCE effected with certain UNDERWRITERS AT LLOYD'S, LONDON P4RTICIPA-ION HEREON: 100% Specified STEPHEN H. SOLOMON MemberIlii�i�e t 7.s�'�",3 5,+917/fi Villa Park CA 92861 _IMJTS OF LIABILITY: Coverage A - Professional Liability and Personal Injury Coverage Eac,t claim: $1,000,000.00 Aggregate: $1,000,000.00 Coverage B - Defense Cost Coverage Each rlaun Aggregate: $1,000,000.00 $-'1000,001).00 Aggregate Limit of Liability Maximurn insurance available for ;:overages- A and B combined $2,000,000.0D Deductible - each claim including; Cost of De;eoso. $:1,000.00 Retroactive Date: NONE REMIUrbI (Including endorsements): $614.00 Purchasing Group Tax for CA @ 3% $18.42 CTAI_I-LOYD'S RFMIUM (Including Pzxes): $632.42 -MOD OF INSI"RANCE croru June 1, 20'412:01 a.m. to rune 1, 2015 12:01 a.m., at the Specified Member's address above - Special Conditions: See attached Summary pane :n consideration cf the premium paid and in rehauce U'sm the statements in the application attached heretq the above specified ember is an Assured under :-e Mav[er Certificate ^'Certificate') issued :a tire NaticnJ Associm or. of Sala,xd Professionals Purchasing 6rou [no. of Illinoism ::cyd's, Loner (, of incorporated) for the Period of ;nsu rrnce and Limits of Livability specified above. AL otter terms, coaditions,and Cxclu o�erwrs of the -uufiau are unchanged -his cerui io, that the attached Certificate is a tn:e cope d [he origin.] da.cment issued to the Aseeciatiao, which is hereby issued to the Specified Mernimr_ Dated: June 9,2914 11 A-1 lee (-'11/13) aedCrrtn —IC6 (PO) IDJPLICATE COPY UNDIRWRITERS AT LLOYD'S, LONDON Complete Equity Markets, Inc- dbaComplete Equity Markets Insurance Agency, Inc. (CASL#UD44077) Lawrence T.P. Molloy i d 699b-�F616L uowolDS H ueydalS Stephen H. Solomon 4-52'-488b AC4[:)R[3 CERTIFICATE OF LIABILITY INSURANCE 6/15/2015 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 POLICES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SI, AUTHORIZED REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER. IMPORTANT: M the cerdfieete bonder is an ADDITIONAL INSURED, the pulleyltes) mutt be endomeo. If SUBROGATION 15 WAIVED, subject to the Mme and ConLRtEone of the policy, carbin policies my require an endorsement. A statement on this certificate does net confer rights to the cerllli holder in lieu of such endersament(si• C0114PLETE EQUITY XMU0TS INC 1190 Flax Court Lake Zurich, IL 60047 �r�1au INSURED Stephen H. Solomon 18861 Ridgewood Lane Villa Park CA 92861 847) 541-0900 IQ P,(8471541-044 r + INsJREF n Unl mSJREF e L INSJRFF__. 1 A 01%01111e COYERAOE ters at Lloyd's INSURER F _ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO -IF INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT ')R -)7-ER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Al, THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED EY PAID CLAIMS. _Ta TYPE OF INSURANCE ADPL P TAT MYP PCLICY NUMBER PoriMMAOnrr_ rFrr LAWD - LIMPS OOMa6nCMl YiFMmAL uab0.ITT EACH OCCIiRRENCIF S_ CLAIMS -MADE FD OCCUR PREMISES 5--- _;Ea_¢c.rrorce,_ � (� LED PxP lAnr or,e va ecn; s _ —_--. PERSONALSADVINJURY_ S GERL AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE E T POLICY J JECat ' LOC PRODUCTS - CCMPIOP AGG E OTHER: AUTOMORILF. LIABILT' /Y/. S W.J\ II aW Ili - LIMITS BODILY INJURY es Person) S AVYAVTO ALI, OWNED --SCHEDULED A',TOS AUTOS I BOOILYWJURYIRera,c,c l $—_- NON-OV/NEO ` HIRED AUTOS AUTOS ._UMBRELLA LRB OCCUR EACH OCCJRRENCE E AGGREGATE S EXCESS LIPS CLAW MADE RETENIONS T E ANOCOMPENSATIONDED COMPENSATION AND EMPLOYERS EMPIAYER3 lIABILITY YIN ANY OFFIW� E%C1u1 - I N/A _ EL EACH ACCIDENT E ____ 1 EL. DISEASE EA EMPLOYES IN&IisW Ilyredbsaibe urMer DESCRIPTION OF OPERATIONS cab.E -j' ---- L USEASE ILIMI S Professional l —r.— $1,000,000 Each Claim A Liability 854505 o6loT;a 06/01/16 $1,000,000 Aggregate :ESCRPTION OF OPERATIONS fLOCATIONS I VEHICLES (AGOiRD 101, AJd,lk l Remail. S,mmu,F:. n., aI altarad ! mole apace Is m4uNec) 'his is a four page certificate. 'ERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF -HE ABOVE DESCRIBED POI. CIES BE CANCELLED BEFORE Civic Center THE EXPIRA TON DATE THEREOF. NOTICE WILL BE DELIVERED iN � 20 Civic Center Plaza ACCORDANCL IN Te THE POLICY PROVISIONS Santa Ana CA 92701 AUTHORIZED RE'RESENTATIE W1 1 1969-2013ACORD CORPORATION. Allrigntsmse"ed. \CORD25(2013104) The ACORD name and logo are registered marcs of A(' ORD Stephen H. Solomon 0 Certificate of Insurance STEPHFN H. SOLOMON Policy Number: 654505 714-921-4889 Sabject to all policy terms, conditions, exclusions and endorsements of the policy. The City of Stata Ana is listed as an additional insured but only per the terms & conditions of the endorsement generated and subject to all policy terms, conditions, exclusions, and endorsements. SURPLUS LINES NOTICE TO POLICYHOLDER - PLEASE SEE ATTACHED :J Wren T.P. Molloy �'j \0� me, ?,., PV - binders" Stephen H. Solomon '14-921-4089 NOTICE: � �1 �� L THE INSURANCE POLICY THAT YOU HAVE P/URC SED IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED BY THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED "NONADMITTED" OR "SURPLUS LINE" INSURERS. 2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY REGULATION AND ENFORCEMENT THAT APPLY TO CALIFORNIA LICENSED INSURERS. 3. THE INSURER DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED. 4. THE INSURER SHOULD BE LICENSED EITHER AS A FOREIGN INSURER IN ANOTHER STATE IN THE UNITED STATES OR AS A NON-UNITED STATES (ALIEN) INSURER. YOU SHOULD ASK QUESTIONS OF YOUR INSURANCE AGENT, BROKER, OR "SURPLUS LINE" BROKER OR CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT THE FOLLOWING TOLL-FREE TELEPHONE NUMBER: 1-800-927-4357. ASK WHETHER OR NOT THE INSURER IS LICENSED AS A FOREIGN OR NON-UNITED STATES (ALIEN) INSURER AND FOR ADDITIONAL INFORMATION ABOUT THE INSURER- YOU NSURERYOU MAY ALSO CONTACT THE NAIC'S INTERNET WEB SITE AT WWW.NAIC.ORG. 5. FOREIGN INSURERS SHOULD BE LICENSED BY A STATE IN THE UNITED STATES AND YOU MAY CONTACT THAT STATE'S DEPARTMENT OF INSURANCE TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 6. FOR NON-UNITED STATES (ALIEN) INSURERS, THE INSURER SHOULD BE LICENSED BY A COUNTRY OUTSIDE OF THE UNITED STATES AND SHOULD BE ON THE NAIC'S INTERNATIONAL INSURERS DEPARTMENT (IID) LISTING OF APPROVED NONADMITTED NON-UNITED STATES INSURERS. ASK YOUR AGENT, BROKER OR "SURPLUS LINE" BROKER TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. mn&rsq3S Stepnen H. Solomon 714-921-4885 I. 4 7. CALIFORNIA MAINTAINS A LIST OF APPROVED SURPLUS LINE INSURERS. ASK YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST, OR VIEW THAT LIST AT THE INTERNET WEB SITE OF THE CALIFORNIA DEPARTMENT OF INSURANCE: WWW.INSURANCE.CA.GOV. 8. IF YOU, AS THE APPLICANT, REQUIRED THAT THE INSURANCE POLICY YOU HAVE PURCHASED BE BOUND IMMEDIATELY, EITHER BECAUSE EXISTING COVERAGE WAS GOING TO LAPSE WITHIN TWO BUSINESS DAYS OR BECAUSE YOU WERE REQUIRED TO HAVE COVERAGE WITHIN TWO BUSINESS DAYS, AND YOU DID NOT RECEIVE THIS DISCLOSURE FORM AND A REQUEST FOR YOUR SIGNATURE UNTIL AFTER COVERAGE BECAME EFFECTIVE, YOU HAVE THE RIGHT TO CANCEL THIS POLICY WITHIN FIVE DAYS OF RECEIVING THIS DISCLOSURE. IF YOU CANCEL COVERAGE, THE PREMIUM WILL BE PRORATED AND ANY BROKER'S FEE CHARGED FOR THIS INSURANCE WILL BE RETURNED TO YOU. D-2 (Effective July 21, 2011) ?je. yI-K b,der.M CERTIFICATE OF LIABILITY INSURANCE DATE INMJDDIj THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 7Hf CERTIFICATE ODES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EIrTEND OR ALTER THIN COVERAGB AFFORDED BY THE PULICIE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the POIICy(ies) must have ADDITIONAL INSURED provisions or be endorser If SUBROGATION IS WAIVED, subject to the terms and conditions of the Policy, certain Policies may require an endorsement. A statement o this certificate does notconfer rights to the certificate holder In Kau of such endorsement(s). PRODUCER COMPLETE EQUITY (MARKETS INC 1190 Flex Court Lake Zurich, IL 60047 db. Complete Equity MarkM hiSbvInCe Ageney. _Inc INSURED Stephen H. Solomon 18861 Ridgewood Lane COVERAGES CERTIFICATE NUMBER: REy ISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECF TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'LSIR TR TYPE W INSURANCE A110L 9UBR pOUCY NUMBER PO OGYEFF Po cy p LIMITS COMMERC W L GBIgItNL LIABILRY CLAIMSMIIOE ❑OCCUR EACH OCCURRENCE :' S NAAG PR NE:ES Ea oxurrenca . S Man EX (Aw cne Persan) s _ PERS( tl 1.4ADVINJURY s - GEN'L AGGREGATE LIMIT APPLIES PER POLICY .�:] j�T � LOC I GENEBALAGGREGATE s PRODUCTS-COMROPAGs I S OTHER: �s L. lrOMOBLE UARIUTY (ANY AUTO OWNER SCHEDULED HIRED ONLY AUTOS HIRED NON -OWNED i AUTos ONLY AUTOS ONLY ' I COMBIIN�51, LE LIMIT - N S . BDDILYINJORY (Pet Prrson7 5 BODILYINJURY IRO aWont) S PROPERTY DAMAGE 5 Pera¢tlenl _ S EXCESS I DAB EXCESS LIAe OCCUR OWMSMADE EACHOCWRRENCE IISC AGGREGATE I DED RETENT"ONI ITION AND BVILS YERSF 15AILIT AND EMPLOYERS LIABILITY YIN ANY PROPRIETOCERNEMBER EXCLUDED? ECJTNE OFFICEoR IXCLUDEO? NfA s PER DTH- F STAME P,C_ EL. EACH AOCIpFM IS inBER (eandabry in NHI II s. tlescnba utnle' DESCRIPTION OF OPERATIONS beb EL pISPASE-EA EMPLOY s E.LOISEASE-POUCYUMT $ X tlFSffRmNln Professional Liability f1C noeoennue,r nnennuc,.�arL X rv. 857634 06/01118 06/01119 Each Claim 1,000,000 Aggregate $1,000,000 . •�..« .n ....,.� ,AddW iRn ;I, samdmo, may eeattach.d Bmore zpacam mwxed) Subject to all policy terms, conditions, exclusions and endorsements. The City of Santa Ana is listed as an additional insured but only per the terms & conditions of the endorsement generated and subject to all policy terms, conditions, exclusions, and endorsements. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Civic Center ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE wir-~ 77 © 1988-2015 ACORD CORPORATION. Ail rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Ld 69217- 26-17 LL UOLUCIOS H uegda)S