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COAST LIVE OAK SCHOOL (2) - 2014
City of Santa Ana '-� Clerk of the Council AGREEMENT TERMINATION FORM COTC Office Use Only 22 FM 4 nJ Please complete this form when the attached agreement and all amendments (if any) are no longer in effect. CITY OF SANTA ANA CL�RK O; COUNCIL Return form to the Clerk of the Council Office (M-30). Call 647-6520 if you have any questions. I The agreement with No. N-2014463 was completed on t and final payment has been made. (List all amendments. Use space below if needed.) Department: V— s Amendment: N-2001-128 completed on 6/30/2002 Phone/Ext.: Signature: az� Date: - f3) Revised 08-23-10 INSURANCE ON PILE WORT( MAY PROCEED N-2014-153 UNTIL INSURANCE EXPIRES 9—act—IS CLERK OF COUNCIL p,.t'RCS ATE: �� RECREATION SERVICES AGREEMENT DEC 2 THIS AGREEMENT made and entered into this 1" day of January 2015, by and between ast Live Oak School, Inc. (hereinafter "Provider") 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 recreation service provider having special skills, resources and knowledge to conduct nature classes in its leisure class program. B. Provider represents that Provider is able and willing to provide such services to the City. C, In undertaking the performance of this Agreement, Provider represents that it is knowledgeable in its field and that any services performed by Provider under this Agreement will be performed in compliance with such standards as may reasonably be expected. 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; 1. SCOPE OF SERVICES Provider shall perform those services as set forth in Exhibit A to this Agreement, 2. COMPENSATION In consideration for the right to provide the programs set forth in Exhibit A, City agrees to pay the Provider seventy percent (70%) of all gross revenue received from program participants. Anticipated revenue from this class shall not exceed $25,000 annually. Payment to Provider shall be made within thirty (30) days following completion of each class. 3. TERM This Agreement shall commence on January 1, 2015 and terminate on December 31, 2016, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of Parks, Recreation raid Community Services and the City Attorney. 4. INDEPENDENT CONTRACTOR Provider 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 manner in which Provider performs the services which are the aubject matter of this Agreement; however, the services to be provided by Provider shall be provided in. a manner consistent with all applicable standards and regulations governing such services. Provider shall pay all salaries and wages, employer's social security tees, unemployment insurance and similar taxes relating to employees and slid be responsible for all applicable withholding taxes. Provider is not an agent, representative or employee of City and Provider shall have no authority to act on behalf of the City. S. INSURANCE Prior to undertaking performance of work under this Agreement, Provider shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance, Provider 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 Provider'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 and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insured's provisions. b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Provider, if Provider 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, Provider agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. c. The following requirements apply to the insurance to be provided by Provider pursuant to this section: (i) Provider shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (ii) 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 Provider fails or refuses to produce or maintain the insurance required by this section or tails 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 Provider's right to be paid for its time and materials expended prior to notification of tennination. Provider 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 Provider agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, Providers, special counsel, and representatives from liability for personal injury, damages, just compensation, restitution, 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 operations of the Provider 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. The Provider 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 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. CONFLICT OF INTEREST Provider 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 Linder this Agreement. 8. LIVE SCAN BACKGROUND CHECK Providers, and any employees or substitutes, in contact with minors under eighteen (18) years of age shall arrange for and submit to a Live Scan electronic background check for criminal history available through the California Department of Justice as a condition of this Agreement and provide proof of compliance prier to performing services hereunder. 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 maul, ,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 Council, City of Santa Ana 20 Civic Center Plaza, (M-30) P.O. Box 1.988 Santa Ana, CA 927024988 Telefacsimile (714) 647-6956 With copy to: Executive Director of Parks, Recreation and Commin ity Services City of Santa Ana 26 Civic Center Plaza (M-75) P.O. Box 1988 Santa Ana, California 92702 Telefacsimile (714) 571-4211 To Provider: Marls Hay dba Coast Live Oak School 316 Edgewood Road Santa Ana, CA 92706 Phone (714) 307-9481 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 telefacsimile, commumication 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 Provider, 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 Provider. 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 Provider or 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 is not embodied herein. 11. ASSIGNMENT/SUBSTITUTES a. Assignment. The experience, knowledge, capability and reputation of Provider were a substantial inducement for City to enter into this Agreement. Therefore, Provider 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. Provider must personally teach at least seventy-five percent (7.5%) of its offered classes. b. Substitutes. In the event Provider is not able to teach a class due to illness or some other cause beyond Provider's reasonable control, Provider must procure, at its sole expense, a qualified substitute instructor to teach the class at its regular time and place. Provider shall ensure that substitute instructors comply with the City's insurance and live scan requirements contained herein. Provider must immediately notify the City of the substitute instructor's name, qualifications, address and phone number. If Provider cannot procure a qualified substitute and the City is unable to assist in this regard, then the class shall be canceled and a. make-up class must be added to the session. Provider mast notify participants as soon as possible of any class cancellation and make-up class. 4 12, TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. Termination or cancellation of classes by the Provider must be given to the City at least thirty (30) days prior to termination/cancellation, Failure to provide adequate cancellation notice to the City may put future contracting of business with the City at risk and will result in the City's retention of ten (10%) percent of the final payment to Provider. 13, DISCRIMINATION Provider 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, Provider affirms that it is an equal opportunity 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 connection with or by reason of this Agreement, 15. LICENSES Provider 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. 16. SEVERABILITY In the event that one or more of the phrases, sentences, clauses, paragraphs or sections contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be interpreted to carry out the intent of the parties hereunder. 17. EXHIBITS All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 18. AUTHORITY The person(s) executing this Agreement on behalf of the parties hereto warrant that they are daily authorized to execute this Agreement on behalf of said parties and that be so executing this Agreement, the parties hereto no fornally bound to the provisions of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: MARIA D. H'UIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City7Attey z�'a�� By: Zee St a sistant City Attorney RECOMMENDED FOR APPROVAL: GERARDO MOU"rks, Executive Directo Recreation and Community Service CITY OF SANTA ANA DAVID A OS City Manager PROVID Mark N Preside C- 0'0'�U i Ac B+XHIBIT A SCOPE OF SERVICES — Coast Live Oak School Provider will teach Nature Skills Camp for children age 7-14 years old A. Nature Skill Camp consists of weekly classes, held 2 days M & T per week, 6 hours per day - $100/Month B. Nature Skill Camp consists of weekly classes, held 2 days Th & Fri per week, 6 hours per day - $100/Month C. The classes will be held during the Fall (Sept -Dec). & Winter (Jan -Mar) of 2013-2014. D. Provider will provide and be responsible for equipment, records, and personnel and clean up of the facilities and materials necessary to ensure the safety and effectiveness of said instruction. E. If Provider allows others to teach his/her class, those teachers must be over 21, have obtained and maintain an instructor rating, live scan and be covered by Provider's insurance. Provider shall provide City with documentation to verify instructor and insurance requirements. .CLASS SIZE 1) Each class must have a minimum of 5 paid students and no more than a maximum of 10. 2) No registration will be accepted after the second meeting of class. 3) In the event the minimum number of enrollees is not realized by the second meeting of the class, the class shall be canceled. Provider will be under no obligation to provide services and the City will have no obligations to pay Provider compensation CLASS FEES 1) Each participant shall pay $100.00 class registration per session. Anticipated revenue from this class shall not exceed $25, 000.00 annually. 2) No refunds will be made to participants after the first week of class unless the class is canceled by the City. 3) The City shall collect registration fees from each participant during the registration period. Provider shall not collect fees, but shall refer all interested participants to City for registration. 4) Provider shall receive seventy percent (70%) of the total fees collected each month. City and Provider agree that City shall retain thirty percent (30%) of the fees collected as an administration fee. 5) Provider agrees that City is entitled to audit Provider's records and classes to insure compliance with this Agreement. 6) Provider may not waive class participation/registration fees. 7) City shall prepare class rosters and provide a copy to Provider. Only registered participants may participate in class. ACIII CERTIFICATE OF LIABILITY INSURANCE AT 922014D/YYYY) 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. APORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(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 PRODUCER LUNIAbr - Vy Selller-Flynn Wood Gutmann & Bogart License#0679263 - FAX PHONE (AIC,NoEXt1714-505-7000_ _�(Pic,Noll 714-573-1770 15901 Red Hill Ave., Suite 100 E-MAIL ,vy@wgbib.com - APORESS Tustin CA 92780 INSURER(S) AFFORDING COVERAGE NAIC# _- _COAST06 -. __.. INSURER Indemnity Ins CO. INSURED I INSURER B: Coast Live Oak School _ INSURER C: Mark Hay -- - 316 Edgewood Road INSURER D Santa Ana CA 92706 9C)4y---0c) INSURER E INSURER F UUVERAGES CERTIFICATE NUMBER: '192200dti/1 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. DD SUBR� INSRi ANSD WVD POLICY NUMBER LTR' TYPE OF INSURANCE POLICY EFF POLICY EXP MWDDIYYYYI ffAM/DD1YYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY PHPK1220574 9/22/2014 9/22/2015 EACH OCCURRENCE $1000000 CLAIMS -MADE OCCUR DAMAGE TO RENTEDPREMISES.(Eaaoccurrence) - - - _ -XI $ID0000 - _ MED EXP (Any one person) $5,000 PERSONAL A ADV INJURY $1000000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2000000 PRO 1'. POLICY l LOC •, JECT PRODUCTS COMPIOP AGG $2000000 OTHER _. $ AUT AUTOMOBILE - _ LIABILITY 1� MBINED SI G LIMIT ANY AUTO C.L, - S G DI INJURY( Perperoan) $ _ ALTOS SCHEDULED AUTOS AUTOS �t1,..�a WT $ BODILY INJURY Peraccment ( ) _ NON OWNED HIRED AUTOS AUTOS � PROPERTY DAMAGE -.. I4 $ _-i _ _ �h (Per accitlenl) UMBRELLA LIAR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE!�$_ _ AGGREGATE DED RETENTI� $OCCUR S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/Ni PER OTH _ STATUTE _� ER I ANY PROPRIETORIPARTNEWEXECUTVE NIA EL EACH ACCIDENT OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E L DISEASE - EA EMPLOYEE 5 If yes tlescrlbe under - -- - DESCRIPTION OF OPERATIONS below l E.L. DISEASE - POLICY LIMIT $ i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Atltllllonal Remarks Schedule, may he attaches If more space is required) City of Santa Ana, its officers, agents and employees are named as additional insured on the General Liability per attached PI GILD VS 01 08. Cancellation verbiage as per IL0017 11 98 attached. Primary and Non -Contributory applies on the General Liability per attached PI GILD VS 01 08. THIS CERTIFICATE SUPERCEDES ANY PREVIOUSLY ISSUED, City of Santa Ana; Parks, Recreation and Community Services Agency Attn: Carmen Acosta 1825 W, Civic Center Drive Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r24' xn�0`7 @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD PI-GLD-VS (01/08) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT SCHOOLS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. if such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page # Damage to Premises Rented to You $300,000 2 Extended Property Damage included 2 Non -Owned Watercraft Less than 56 feet 2 Supplementary Payments - Ball Bonds $2,500 2 Supplementary Payment - Loss of Earnings $500 per day 2 Medical Payments $15,000 3 Medical Payments -Extended Reporting Period 3 years 3 Employee Indemnification Defense Coverage for Employee $25,000 3 Additional Insured - Medical Directors and Administrators Included 3 Additional Insured - Managers and Supervisors Included 3 Additional Insured - Broadened Named Insured Included 3 Additional Insured - Funding Source Included 3 Additional Insured - Managers or Lessors of Premises Included 4 Additional Insured - By Contract, Agreement or Permit Included 4 Additional Insured - Broad Form Vendors Included 4 General Aggregate - Per Campus Included 5 Duties in the Event of Occurrence, Claim or Suit Other Insurance - Primary Additional Insured Included Included 6 6 Other Insurance - You Are An Additional Insured On Another Person's Or Organization's Policy. Included 7 Unintentional Failure to Disclose Hazards Included 8 Liberalization Included 8 Bodily Injury - includes Mental Anguish Included _ 8 Personal and Advertising Injury - includes Abuse of Process Discrimination Included a Transfer of Rights of Recovery Against Others To Us Clarification 8 Science Laboratory "Occurrence" $50,000 9 Medical Incident Liability -Nurse and Athletic Trainer Included 9 Page 1 of 9 n Includes copyrighted material of Insurance Services Office, Inc., with its permissions j t PI-GLD-VS (01108) A. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in, a. The last paragraph of SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III - LIMITS OF INSURANCE, Paragraph 6.; c. SECTION V - DEFINITIONS, Paragraph 9.a. 2. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the words "Fire insurance" are changed to "insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in: a. SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance 1 The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: a. $300,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. B. Extended "Property Damage" SECTION I -COVERAGES. COVERAGE A, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted and replaced by the following: a. Expected or Intended Injury "Bodily Injury' or "Property Damage" expected or intended from the standpoint of the insured, This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. C. Non -Owned Watercraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Supplementary Payments Under the SUPPLEMENTARY PAYMENTS - COVERAGE A AND B provision, Items 1.b, and 1.d. Page 2 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ,QA_ — 1(") PI-GLD-VS (01/08) are amended as follows: 1. The limit for the cost of ball bonds is changed from $250 to $2,500; and 2. The limit for loss of earnings Is changed from $250 a day to $500 a day. E. Medical Payments - Limit Increased to $15,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1, The Medical Expense Limit is changed subject to all of the terms of SECTION III -LIMITS OF INSURANCE to the greater of: a. $15,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2, SECTION I — COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, the second part of Paragraph a. is amended to read: provided that: (2) The expenses are incurred and reported to us within three year's of the date of the accident; F. Employee Indemnification Defense Coverage Under the SUPPLEMENTARY PAYMENTS - COVERAGES A AND B provision, the following is added: 3, We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding. The most we will pay for any "employee" who is alleged to be directly Involved in a criminal proceeding is $25,000 regardless of the numbers of "employees", claims or "suits" brought or persons or organizations making claims or bringing "suits". G. SECTION it - WHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a. is changed to read: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators -Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. b. Managers and Supervisors - if you are an organization other than a partnership or joint venture, your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. c. Broadened Named Insured - Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part, However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits ofinsurance. d. Funding Source - Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or Page 3 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 13t-7C% cx t.��rPti PI-GLD-VS (01108) (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Managers or Lessors of Premises - Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: This insurance does not apply to: (1) Any °occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. f. By Contract, Agreement or Permit - Any person or organization with whom you agreed, because of a written contract or agreement or permit, to provide insurance such as is afforded under this policy, but only with respect to your operations, "your work" or facilities owned or used by you. (1) This provision does not apply: (a) Unless the written contract or agreement has been executed or permit has been issued prior to the "bodily injury," "property damage," "personal and advertising injury": (b) To any person or organization included as an insured under g. Broad Form Vendors below; or (c) To any person or organization included as an insured by an endorsement issued by us and made a part of this Coverage Part. (2) When an engineer, architect or surveyor becomes an insured under this Coverage Part, the following additional exclusion applies: (a) "Bodily injury", "property damage", "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (i) The preparing, approving, or failing to approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; and (it) Supervisory, Inspection, or engineering services, (3) When a lessor of leased equipment becomes an insured under this Coverage Part, the following additional exclusions apply: (a) To any "occurrence" which takes place after the equipment lease expires; or (b) To "bodily injury" or "property damage" arising out of the sole negligence of the lessor. (4) When owners or other interests from whom land has been leased become an insured under this Coverage Part, the following additional exclusions apply: (a) Any "occurrence" which takes place after you cease to lease that land; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of the owners or other interests from whom land has been leased. g. Broad Form Vendors - Any person or organization with whom you agreed, because of a written contract or agreement to provide insurance, 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, subject to the following additional exclusions. (1) The insurance afforded the vendor does not apply to: (a) "Bodily injury° or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, unless unpacked solely for the purpose of Inspection, demonstration, testing or substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 4 of 9 Includes copyrighted material of insurance Services Office„ Inc., with its permission. Pi -GILD -VS (01108) (a) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual 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 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. (2) This provision 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. (3) This provision does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Coverage Part. (4) This provision does not apply if "bodily injury" or "property damage" Included within the "products -completed operations hazard" is excluded either by the provisions of the Coverage Part or by endorsement. H. Per Campus — General Aggregate 1. SECTION III — LIMITS OF INSURANCE, Paragraph 2., is amended to the following: The General Aggregate limit is the most we will pay: a. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I — COVERAGE, COVERAGE C MEDICAL PAYMENTS which can be attributed only to operations at a single designated "campus" shown in the Declarations. (1)A separate General Aggregate Limit is applicable to each single designated "campus" shown in the Declarations and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. (2) The General Aggregate Limit Is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or'property damage" included in the "products -completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of; (a) Insureds; (b) Claims made or "suits" brought; or (c) Persons or organizations making claims or bringing "suits (3)Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the General Aggregate Limit for that designated "campus". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other General Aggregate Limit for any other designated "campus' shown in the Declarations. (4) The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable single designated "campus" General Aggregate Limit. 2. SECTION V — DEFINITIONS is amended by adding the following: Page 5 of g Includes copyrighted material of Insurance Services Office, Inc., with Its permission, PI-GLD-VS (01108) "Campus" is defined as premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 1. [duties in the Event of Occurrence. Claim or Suit 1. The requirement in Paragraph 2.a. of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we are notified as soon as practicable of an "occurrence" or an offense, applies only when the "occurrence" or offense is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An executive officer or insurance manager, if you are a corporation. 2, The requirement in Paragraph 2.1b, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we receive notice of a claim or "suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or "suit" is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An executive officer or insurance manager, if you are a corporation, J. Other Insurance — Primary Additional Insured 1. If the written contract or agreement or permit requires this insurance to be primary for any person or organization with whom you agree to include in SECTION II - WHO IS AN INSURED, then SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance is replaced by the following: If other valid and collectible insurance is available for a loss we cover under COVERAGE A of this Coverage Part, our obligations are limited as follows: a. Primary Insurance -This Insurance is primary. We will not seek contributions from other Insurance available to the person or organization with whom you agree to include in SECTION II - WHO IS AN INSURED, except when 2. below applies. b, Excess Insurance -This insurance is excess over any of the other insurance whether primary, excess, contingent or any other basis: (1) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for ..your work"; (2) That is Fire, lightning or explosion insurance for premises rented to you; or temporarily occupied by you with permission of the owner; or (3) if the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit" that any other insurer has a duty to defend. 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. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-VS (01t08) (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 other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this excess insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. C. Method of Sharing - If all the other insurance permits contribution by equal shares„ we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes First. If any or the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's contribution is based on the ratio of its applicable limits of insurance of all insurers. 2. This provision only applies with respect to your operations, "your work" or facilities owned or used by you. K. Other Insurance — You Are An Additional Insured On Another Person's Or Oraanization's Policy If you are an insured under SECTION If - WHO IS AN INSURED, then SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. OTHER INSURANCE, Paragraph b. Excess Insurance is replaced by the following: This insurance is excess over any other insurance, whether primary, excess, contingent or on any otherbasis: 1. That is Fire, Extended Coverage, Builders Risk, Installation Risk or similar coverage for "your work"; 2. That is Fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; 1 if the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g.; or 4. When any of the Named Insureds, under this Coverage Part, are additional insureds under a commercial general liability policy or similar insurance of another party. When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit" that any other insurer has a duty to defend. 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 Insureds. When this insurance is excess or other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of; 1. The total amount that all such other insurance would pay for the loss in the absence of this insurance; and 2. The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part, Page 7 of 9 Includes copyrighted material of Insurance Services Office, Inc,., with its permission. 3 1 PI-GLD-VS (01/08) L, Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. M. Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. N. Bodily lniury - Mental Anguish SECTION V — DEFINITIONS, Paragraph 3. is changed to read: "Bodily Injury": a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and In. Except for mental anguish, includes death resulting from the foregoing (item a. above) at any time. O. Personal and Advertising Injury —Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V — DEFINITIONS, Paragraph 14. b. is revised to read: b. Malicious prosecution or abuse of process: 2. SECTION V — DEFINITIONS, Paragraph 14. is amended to include the following: "Personal Injury" also means discrimination based on race, color, religion, sex, age or national origin, except when: a, Done intentionally by or at the direction of, or with the knowledge or consent of: (I) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. P. Transfer of Rights of Recovery Against Others To Us As a clarification, the following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 8, Transfer of Rights of Recovery Against Others To Us: Page 8 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ,� fig t� ,C.a� �'i ,_ 1 w✓'i PI-GLD-VS (01l08) Therefore, the insured can waive the Insurer's Rights of Recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. O. Science Laboratory "Occurrence" SECTION I —COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph f. does not apply to any "bodily injury" or "physical damage" arising out of a fire or "occurrence" in any of your science laboratories while teaching Is being conducted in that laboratory, subject to a $50,000 per policy limit. R. Medical Incident Liability -Nurse and Athletic Trainer 1. SECTION II — WHO IS AN INSURED, Subparagraph 2.a. (1) (d) Is deleted and replaced by the following: (d) Arising out of his or her providing or failing to provide professional medical services. This paragraph does not apply to a registered or practical nurse or athletic trainer, while acting within the scope of his or her duties for the Named Insured and arising out of a "medical incident'. 2. SECTION V — DEFINITIONS, 13. is deleted and replaced by the following: "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions, and "medical incident", 3. The following definition is added to SECTION V — DEFINITIONS: "Medical Incident" means any act or omission in the furnishing or failure to furnish professional medical services by the Insured or any person acting under the personal direction, control, or supervision of the insured. Any such act or omission together with all related acts or omissions in the furnishing of such services to any one person shall be considered one "medical incident". 'Medical incident" does not include any actual, alleged or threatened emotional: physical, or sexual abuse of any patient or professional medical services recipient. Page 9 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. r , .„, l .t 1, ,,, DATE (MM/DD.fYYYY) q+ct�► n CERTIFICATE OF LIABILITY INSURANCE 9/22/2015 THIS CERTIFICATE, IS ISSUED AS A MATTER OF INFORMATIONONLY 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 endorsements . PRODUCER Wood Gutmann & Bogart License #0679263 15901 Red Hill Ave., Suite 100 CONTACT Seliler-I lynn _ PHONE FAX 714-505-7000 (ALC_Noi 714-573-1770 �I�O�`Iss..'�yWgbib.com INSURERS AFFORDING COVERAGE NAIC q Tustin CA 92780 INSURER A : Philadelphia In emnity Ins Co. INSURED CO.AST66 ' INSURER B Coast Live Oak School 6 EMk dgewood Road 113 -ill), 1 _k _1 INSURER C : INSURERD: INSURER E : Santa Ana CA 92706 INSURER F : COVERAGES CERTIFICATE Nt1MRFR- 15479060,47 REV!S!0N !4 IfuR=0r 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 INSURANCEIN D WVD POLICY' NUMBER POLICY EFF MMIDD POLICY E%P DOfYYYY - LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE l .1 OCCUR. PHPK1220574 9/22/2015 912212D16 EACH OCCURRENCE $1,000,000 F PREMISES Ea occurr n j $100„000 MED EXP (Any one person) $5,000 PERSONAL .&ADVINJURY $1,000„000 GEN1 . AGGREGATE LIMIT APPLIES PER: POLICY =. JECO'T � LOC I 1 GENERAL AGGREGATE $2,004,000 PRODUCTS - COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY .. t9. . a aRINF k SINGLE ANY AUTO - BODILY INJURY IPer person)' $ ALL8WNED SCHEDULED N-OAUT S AUTOS HIRED AUTOS AUTOS NED ' AUTOS F � N _;,� �>� - � � BODILY INJURY (Per & ) $ ER Y AMAG Peraccldenl� S _ $ .,..� UMBRELLA LIAR. OCCUR EACH OCCURRENCE $ -- EXCESS LIAR CLAIMS -BADE \e r�I� AGGREGATE $ DED I I RETENTIONS $ COMPENSATION S' AND EMPLOYERLIA9ILITY YIN ANDEROPRIErOER EAR NEERE XECUTNVE; OFF❑. NIA + ,! '( �a STATUTE H.KERS E.L... EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE: $ (Mandatary In NH) If yes, describe under N ISEASE -POLICY LIMIT ''.. S ''.. DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of Santa Ana, its officers„ agents and employees are named as additional insured on the General Liability per attached PI GLD VS 01 08, Cancellation verbiage as per IL0017 11 98 attached. Primary and Non -Contributory applies on the General Liability per attached PI G'LD VS 01 08, Ttil'S CERTIFICATE SUPERCEDES ANY PREVIOUSLY ISSUED. _1_ 11C 'VM 1 G N'14/4..WQFX t.J4V1%.r_LLA I IUN City of Santa Ana; Parks, Recreation and Community Services Agency Attn: Carmen Acosta 1825 W. Civic Center Drive Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE24 . 1 "" & @ 1988-2014 ACORD CORPORATION. All right's reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD PI-GLID-VS (01108) GENERAL LIABILITY DELUXE ENDORSEMENT SCHOOLS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL, LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other speeific coverage for the indicated IQSS exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement, The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Damage to Premises Rented to You Limit of Insurance $3Q0,0©0 Page # 2 Extanded Property Damage included 2 Non -Owned Watercraft Less than 58 feet 2 5upplernerI Payments - Bait Bonds $2,500 2 Supplementary Payment -- Loss of Earnings $500 per day 2 Medical Payments $i15,O00 _ 3 Medical Payments -Extended Reporting Period 3 years 3 Employee Indemnification Defense Coverage fo€ Employee Additional insured - Medical Directors and Administrators $25,000 Included 3 3 Additional Insured - Managers and Supervisors Included 3 Additional Insured - Broadened Named Insured Included 3 Additional Insured - Funding Source � Included 3 Additional Insured - Manegers`or Lessors of Premises. Included 4 Additional Insured - By Contract, Agreement or Permit Included 4 Additional Insured -- Broad Form Vendors General Aggregate - Per Campus Included 1 4 5 Duties in the Event of Occurrence, Claim or Suit Included 6 Other Insurance -- Primary Additional Insured included 6 Other Insurance - You Are An Additional insured On Another Person's Or Organization's Policy. In diedb , 7 Unintentional Failure to Disclose Hazards � 8 Liberalization I� 8 Bodily Injury - includes Mental Anguish dry 8 Personal and Advertising Injury - includes Abuse of Process, Discrimination y T-ncluded 8 Transfer of nights of Recovery Against Others To Us Clarification 8 Science Laboratory "Occurrence" Medical Incident Liability -Nurse and Athletic Trainer $50,0O0 Included 9 9 Page 'I of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-VS (O W08) A. Darner a to Premises rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears im a. The last paragraph of SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION III - LIMITS OF INSURANCE, Paragraph 6.; c. SECTION V — DEFINITIONS. Paragraph 9.a. 2. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Dart, the words "Fire insurance" are changed to "insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where It appears in: a. SECTION IV- COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of; a. $300,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. B. Extended "Prcaraga Damage" SECTION I - COVERAGES, COVERAGE A, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted and replaced by the following: a. Expected or Intended Injury "Bodily Injury" or "Property Damage" expected or intended from the standpoint of the insured, This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. C. Non -Owned Watercraft SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PPOPERTY MM AGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is amended to rea�ci as fol viewed by (2) A watercraft you do not own that is., (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is �� 1 fW use of a watercraft, This insurance is excess over any other valid and collecti ' available to the insured whether primary, excess or contingent. PRC A/Rec radon D. SuppleMentary Payme t Under the SUPPLEMENTARY PAYMENTS - COVERAGE A AND B provision, Items i.b. and 1.d. Rage 2 of 9 Includes copyrighted material of Insurance Services office, Inc., with its permission. PI-GLD-VS (01108) are amended as follows: 1. The limit for the cost of ball 0onds Is changed from $250 to $2,500; and 2, The limit for loss of earnings Is changed from $250 a day to $500 a day. E. Medical Pa ments - Limit Increased tea 15 O00 Extended Repo rtinPeriod If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of: a. $15,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION I— COVERAGE, COVERAGE C MEDICAL. PAYMENTS, Subsection 1. Insuring Agreement, the second part of Paragraph a. is amended to read. provided that: (2) The expenses are Incurred and reported to us within three years of the date of the accident; F. Employee Indemnification Defense Coverage Under the SUPPLEMENTARY PAYMENT'S - COVERAGES A AND B provision, the following is added: 3. We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding, The most we will pay for any "employee" who is alleged to be directly Involved In a criminal proceeding is $25,000 regardless of the numbers of "employees", claims or "suits" brought or persons or organizations making claims or bringing "suits G. SECTIO I - YMHids IN§gBgp is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, Paragraph 3.a, is changed to read: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: Reviewed by a. Medical Directors and administrators - Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. b. Managers and Supervisors - if you are an organization other than a partner I )joint venture, your managers and supervisors are also insureds, but only with resp ct d as your managers and supervisors, Carmen ACOSW c. Broadened Named Insured - Any organization and subsidiary therey;Ceh 1 Ji actively manage on the effective date of this Coverage Part. Howev r, c oes not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits ofinsurance. d. Funding Source - Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or Page 3 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-VS (01/08) (2) Premises they own, maintain or control whine you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Managers or Lessors of Premises - Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structurai alterations, new construction or demolition operations performed by or on behalf of that person or organization. f. By Contract, Agreement or Permit - Any person or organization with whom you agreed, because_of.a..written-contract_or..agreement.or. permit,_to..provide_ins urance_such..as- is afforded under this policy, but only with respect to your operations, "your work" or facilities owned or used by you, (1)'This provision does not apply: (a) Unless the written contract or agreement has been executed or permit has been issued prior to the "bodily injury," "property damage," "personal and advertising Injury": (b) To any person or organization included as an insured under g. Broad Form Vendors below; or (c) To any person or organization included as an insured by an endorsement issued by us and made a part of this Coverage Park. (2) When an engineer, architect or surveyor becomes an insured under this Coverage Part, the following additional exclusion applies: (a) "Bodily injury", "property damage" "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including; (i) The preparing, approving, or railing to approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; and (11) Supervisory, inspection, or engineering services, (3) When a lessor of leased equipment becomes an insured under this Coverage Part, the following additional exclusions apply: (a) To any "occurrence" which takes place after the equipment lease expires; or (b) To "bodily injury" or "property damage" arising out of the sole negligence of the lessor. (4) When owners or other interests from whom land has been leased become an insured under this Coverage Part, the following additional exclusions apply; (a) Any "occurrence" which takes place after you cease to lease that land; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of the owners or other interests from whom land has been leased. g. Bread Farm Vendors . Any person or organization with whom you agreed, because of a written contract or agreement to provide insurance, but only with respect to "bodfly injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions. (1) The insurance afforded the vendor does not apply to: Reviewed by (a) "Bodily injury„ or "properly damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the abse f the contract or agreement,, (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally WMOAC sta (d) Repackaging, unless unpacked solely for the purpose of inspectru� fros�t�� testing or substitution of parts under instructions from the rnanuf c , repackaged in the original container; Page 4 of 9 Includes copyrighted material of Insurance Services Office. Inc., with its permission. PI-GLD-VS (€71I08) (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 vendors premises in connection with 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. (2) This provision 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. (3) This provision does not apply to any vendor included as an insured by an endorsement --- --- ----- issued by-us_and-made a part of this Coverage Pad.-- --- -- -- - --- ---- - '- (4) This provision does not apply if "bodily injury„ or "property damage" Included within the "products -completed operations hazard" is excluded either by the provisions of the Coverage Part or by endorsement. H. Per Campus - General Aggregate 1. SECTION III- LIMITS OF INSURANCE, Paragraph 2., is amended to the fallowing, The General Aggregate limit is the most we will pay, a. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under SECTION I - COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I - COVERAGE, COVERAGE C MEDICAL. PAYMENTS which can be attributed only to operations at a single designated "campus" shown In the Declarations. (1) A separate General Aggregate Limit is applicable to each single designated "campus" shown in the Declarations and that limit Is equal to the amount of the General Aggregate Limit shown in the Declarations, (2) The General Aggregate Limit is the most we will pay for the sum of a;I damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of, (a) Insureds; (b) Claims mane or "suits" brought; or (c) Persons or organizations making claims or bringing "suits". (3) Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the General Aggregate Limit for that designated "campus". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other General Aggregate Limit for any other designated "campus" shown in the Declarations, (4) The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the Gener g�eer Limit shown in the Declarations, such limits will be subject to the applicable by designated "campus" General Aggregate Limit 2. SECTION V - DEFINITIONS is amended by adding the following'. Page 5 of 9��� . Includes copyrighted material of Insurance Services office, Inc., with its perGaimen Acosta P CS /Recreation PI-GL©-VS (01108) "Campus" is defined as premises involving the same or connecting lots, or premises whose connection Is interrupted only by a street, roadway, waterway or right-of-way of a railroad, 1. Duties in the Event of OccurrEnCe, glaiM,or Suit 1. The requirement In Paragraph 2.a. of SECTION IV n COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to It that we are notified as soon as practicable of an "occurrence" or an offense, applies only when the "occurrence" or offense is known to: a. You, if you are an individual; b. A partner, if you are a partnership; or c. An executive officer or insurance manager, if you are a corporation. 2. The requirement in Paragraph 2.b. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we receive notice of a claim or "suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or "cult" is known to: a. You, If you are an individual; b, A partner, if you are a partnership; or c. An executive ofcer or insurance manager, if you are a corporation. J. Other Insurance.- Prirt>ap Additional Insured 1. If the written contract or agreement or permit requires this insurance to be primary for any person or organization with whom you agree to include in SECTION II - WHO IS AN INSURED, then SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4, Other Insurance is replaced by the following: If other valid and collectible insurance Is available for a lass we cover under COVERAGE A of this Coverage Part, our obligations are limited as follows: a. Primary Insurance - This insurance is primary. We will not seek contributions from other insurance available to the person or organization with whom you agree to Include in SECTION Il - WHO IS AN INSURED, except when 2, below applies. b. Excess Insurance -This insurance is excess over any of the other insurance whether primary, excess, contingent or any other basis: (1) That is Fire, Extended Coverage, Builder's Risk, Installation Pisk or similar coverage for "Your work"; (2) That Is Fire, lightning or explosion insurance for premises rented to you; or temporarily occupied by you with permission of the owner; or (3) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I - COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit" that any other insurer has a duty to defend, If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against a "e"d by insurers. When this insurance is excess over other insurance, we will pay only ours r of the amount of the loss, if any, that exceeds the sum of: Page 6 of 9 Carmen n Acosta Includes (,opyrighted material of Insurance Services Office, Inc., witP I Recr- 'afion PI-GLD-VS (OV08) (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 seff insured amounts under all other insurance. We will share the remaining loss, it any, with any other insurance that is not described in this excess insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part, c. Method of Sharing - If all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributss equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any or the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's contribution is based on the ratio of its applicable limits of insurance of all insurers. 2. This provision only applies with respect to your operations, `your work" or facilities owned or used by you, K. Other Insurance — You Are An Additional Insured On Another Person's Or Or anization's polligy If you are an insured under SECTION II - WHO IS AN INSURED, then SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. OTHER INSURANCE, Paragraph b, Excess Insurance is replaced by the fo#fowing: This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis: 1. That is Fire, Extended Coverage, Bullders Risk, Installation Risk or similar coverage foi' "your work", 2. That is Fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; 3. If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I -- COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g.; or 4. When any of the blamed Insureds, under this Coverage Part, are additional insureds under a commercial general liability policy or similar insurance of another party. When this Insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit" that any other Insurer has a duty to defend. 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 insureds, When this insurance is excess or 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 foss, 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 LimifMi0swWdiby shown in the Declarations of this Coverage Part. f,5 (U, Page 7 of 9 �SRX%R n Acosta Includes copyrighted material of Insurance services Office, Inc., with its p r PI-GLD-VS (01/08) L. Unintentional Failure To Disclose Hazards It Is agreed that, based on our, reliance on your, representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage part, we shall not deny coverage under this Coverage Part because of such failure, M. Liberalization If we revise this erdorsement to provide more coverage without additional prernium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state, N. Bodilv In u - Mental An wish SECTION V -- [DEFINITIONS, Paragraph 3. Is changed to read: "Bodily Injury": a, Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (item a. above) at any time. O. Personal and Advertising Injury -Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Fart, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V - DEFINITIONS, Paragraph 14. b. is revised to read: b. Malicious prosecution or abuse of process: 2. SECTION V - DEFINITIONS, Paragraph 14. is amended to include the following: "Personal Injury„ also means discrimination based on race, color, religion, sex, ago or national origin, except when: a, Gone intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any execrative officer, director, stockholder, partner or member of the insured; or b, Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d, Insurance fvr such discrimination is prohibited by or meld in violation of law, public policy, legisfation, court decision or administrative ruling, The above does not apply to fines or penalties imposed because of discrimination. Reviewed by P. Transfer of Rights of Recove Against Others To Us Asa clarification, the following is added to SECTION IV- COMMERCIAL GENERAL LIA LITY CONDITIONS, Subsection 8. Transfer of Rights of Recovery; Against Others To Us: Carmen Acosta Page 8 of 9 PRCSAIRecreation Includes copyrighted material of Insurance Services Office, Inc„ with its permission. PI-GLD-VS (01l98) Therefore, the insured can waive the insurer's Rights of Recovery prior to the occurrence of a loss, provided the waiver Is made in a written contract. Q. science Laborato Occurrence" SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph f. does not apply to any "bodily injury" or "physical damage" arising out of a fire or "occurrence" in any of your science laboratorles while teaching is being conducted in that laboratory, subject to a $50,000 per policy limit. R. Medical Incident Liability -Nurse and Athletic Trainer 1, SECTION 11— WHO IS AN INSURED, Subparagraph 2.a. (t) (d) is deleted and replaced by the following: (d) Arising out of his or her providing or failing to provide professional medical services. This paragraph does not apply to a registered or practical nurse or athletic trainer, while acting within the scope of his or her duties for the Named Insured and arising out of a "medical Incident 2. SECTION V — DEFINITIONS, 13. is deleted and replaced by the following; "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions, and "medical incident". 3. The following definition is added to SECTION V — DEFINITIONS: „Medical Incident" means any act or omission in the furnishing or failure to furnish professional medical services by the insured or any person acting under the personal direction, control, or supervision of'the Insured. Any such act or omission together with all related acts or omissions in the furnishing of such services to any one person shall be considered one "medical incident". "Medical incident" does not include any actual, alleged or threatened emotional, physical, or sexual abuse of any patient or professional medical services recipient. Reviewed by Carmen Acosta Page 9 of 9 includes copyrighted material of Insurance Services Office, Inc,, with its permission. A► c CERTIFICATE OF' LIABILIITY INSURANCE 10p / (MM/DDYYYY, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONONLY 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 INOT 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 NAMEVy Selfier-Flynn Wood Gutmann & Bogart License 0679263 PHONE 714-505-7000 FAX 714 573 1770 (AIC, No, E.xt): (All, me): 15901 Red Hill Ave., Suite 100 E-MAIL W bib.com ADDRESS: v Y Tustin CA 02780 INSURER(S) AFFORDING COVERAGE _.. NAIL # ..INSURER'B INSURER Rhlladelphia Indemnity ins Co, ..__. ._. INSURED COAST06 : Coast Live Oak. School INSURERC: -. ._"... ... Mark Hay .... ...._ w' ,-.- 316 Edgewood Read � � M n INSURER D : '..Santa Ana CA 92706 INSURER E.: '. INSURER F : r`nktI=7A1':.CQ. r`COTICIP A Tr_ All IRAmon. *,)A cif An1Rn nwd rinar,.r. 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 _...._ ...TYPE OF IN',...... IADDL SUBR. ......... POLICY EFF INSURANCE LTR INSD WVD'.... POLICY NUMBER MMIDD/YYYY ......... ...._... POLICY EXP MMlDDNYYY LIMITS A X ,..COMMERCIAL GENERAL LIABILITY PHPKI531933 9122/2016...... 9/22/2017 EACH OCCURRENCE $1,000,000 .. CLAIMS -MADE XODOUR '...... ... DAMAGE TO RENTED.... PREMISES ,(Fa occurrence) $100,000 ......... .. ',.... ',..... M.,ED EXP (Any one person) $5,000 ....... .. ....... -. '.., PERSONAL & ADV INJURY $1,000,000 ...GENT AGGREGATE LIMIT APPLIES ..PER ''. ',. GENERAL AGGREGATE.... $2„000,000 X POLICY PRO- JECT LOC PRODUCTS $2,00U000 ....._ "...... OTHER:. $ ... ..... AUTOMOBILE LIABILITY COMBINED SINGLE L $ ;._(Ea accident).._. ........... ANY AUTO tl� BODILY INJURY (Per person) $ _.. ALL OWNED SCIIC , AUTOS AUTOS Y ' BODILY HNJURY (Per accident) $ _. _.... _ NON - OWNED OWNED "`a'�`y ',... HIRED AUTOS AUTOS '4r PROPERTYDAMAGE..... QPrr acc'sdentj $ ......... ^^ . UMBRELLA LIARC7CCURvy11 EACH OCCURRENCE...... $ EXCESS LIA6 CLAIMS -MADE I � � �' ` ......... ......._.. i AGGRFGA F $ ........ ...._.. DED RETENTION.£ „� $ WORKERS COMPENSATION ).. PER OTH AND EMPLOYERS' LIABILITY YINp PROP'RIELORIPARTNERIEXECUTIVE STATUTE _ ERANY' OFFICERIMEM.BER EXCLUDED? D',, N CA . E.L. EACH ACCIDENT $ ........ (Mandatory in NH)...... E.L.. DISEASE- EA EMPLOYEE'.. $ If yes.., desianbe under ........ DESCRNPTION OF OPERATIONS below , E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is requiredl City of Santa Ana, its officers, agents and employees are named as additional insured on the General Liability per attached PI GLD VS 01 08. Cancellation verbiage as per IL0017 11 98 attached. Primary and Non -Contributory applies on the General Liability per attached PI GLD VS 01 08.. THIS CERT"IFICAT'E SUPERCEDES ANY PREVIOUSLY ISSUED. 1'-M 1 G RtlLUCr'i. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana; Parks, Recreation and Community THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Services Agency ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Carmen Acosta 18255 W. Civic Center Drive Santa Ana GA 92701 AUTHORIZED REPRESENTATIVE Q 1988-20114 ACORD CORPORATION, Alt rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks Of ACORD Policy No. PHPK1531933 GENERAL LIABILITY DELUXE ENDORSEMENT SCHOOLS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided Linder this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable tinder this policy, unless otherwise rioted on this endorsement, The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page 4 Damage to Premises Rented to You $300,000 2 Extended: Property Damage Non -Owned Watercraft Supplementary Payments — Bail Bonds included Less than 58 feet $2,500 2 2 2 Supplementary Payment — Loss of Earnings $500 per day 2 Medical Payments PQK_a xtended Reporting Period $15,000 3 years 3 Employee Indemnification Defense Coverage for Employee $25,000 3 Additional Insured Medical Directors and Administralors Included 3 Additional Insured Managers and Supervisors Included 3 Additional Insured — Broadened Named Insured Additional Insured — Funding Source Included Included 3 3 Additional Insured — Managers or Lessors of Premises Included 4 Additional Insured By Contract, Agreement or Permit Included 4 Additional Insured Broad Form Vendors Included 4 General Aggregate — Per Campus Included 5 Duties in the Event of Occurrence, Claim or Suit Included 6 Other Insurance — Primary Additional Insured Included 6 Other Insurance - You Are An Additional Insured On Another Person's Or Og anization's Policy. Unintentional Failure to Disclose Hazards oltided � included 7 8 Liberalization Included 8 Bodily Injury — includes Mental Anguish ykIncluded 8 Personal and Advertising Injury — includes Abuse o __1' Process, Discrimination :f< Included 8 Transfer of Rights of Recovery Against Others J�fUs Clarification 8 Science Laboratory "Occurrence`" Medical Incident Liability -Nurse and Athletic Trainer $50,000 Included 9 Page 1 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-VS (01/08) A. Damage to Premises Rented to You! 1. If damage by fire to premises rented to You is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in; a. The last paragraph of SECTION I — COVERAGES. COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; b. SECTION fit - LIMITS OF INSURANCE, Paragraph 6.; c, SECTION V — DEFINITIONS, Paragraph 9.a. 2. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the words "Fire insurance" are changed to "insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in: a. SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance 3. The Damage To Premises Rented To You Urnit section of the Declarations is amended to the greater of: a. $300,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. �=W, ARMNrE SECTION I - COVERAGES. COVERAGE A, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted and replaced by the, following: a. Expected or Intended Injury "Bodily Injury" or "Property Damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. C. Non -Owned Watercraft SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMA(io'z(� LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is amended to read as follo z1v (2) A watercraft you do not own that is: (a) Less than 58 feet long; aind (b) Not being used to carry persons or properly for a charge; rye This provision applies to any person, who with Your consent, either uses or is re ponsible or the use of a watercraft, This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Supplementary Payments Page 2 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission, PI-GLD-VS (01/08) are amended as follows: 1. The limit for the cost of bail bonds is changed from $250 to $2,500,- and 2. The limit for loss of earnings is changed from $250 a day to $500 a day. E. Medical Payments - Limit Increased to 115,000, Extended Rel2orting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded frorn this Coverage Pail: 1. The Medical Expense Limit is changed subject to all of the terms of SEC11ON III -LIMITS OF INSURANCE to the greater of: a. $15,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Pail. 2. SECTION I — COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, the second part of Paragraph a. is amended to read: provided that: (2) The expenses are incurred and reported 10 LIS within three years of the date of the accident; F. Employee Indemnification Defense Coverage Under the SUPPLEMENTARY PAYMENTS - COVERAGES A AND B provision,, the following is added: 3. We will pay, on your behalf, defense costs incurred by an "ernployee" in a Criminal proceeding. The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of "ernployees", cla4ris or. `"suits" brought or persons or organizations making claims or bringing "suits". G. SECTION 11 -VVHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from t..' Coverage Part, Paragraph 3.a. is changed to read: a. Coverage underthis Provision is afforded until the end of the policy period, 2. Each of the following is also an insured: a. Medical Directors and Administrators - Your medical directors and administrators, bRonly while acting within the scope of and during the course of their duties as such. b, Managers and Supervisors - If you are an organization other than a partnership or joint venture, your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. c. Broadened Named Insured - Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance, d. Funding Source - Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or Page 3 of 9 Includes copyrighted material of Insurance Services Office, Inc,, with its permission. PI-GLD-VS (01/08) (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural afterations, new construction and: demolition operations performed by or for that person or organization. e. Managers or Lessors of Premises - Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: This insurance does not apply to� (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by of on behalf of that person of organization, f. By Contract, Agreement or Permit - Any person or organization with whom you agreed, because of a written contract or agreement or permit, to provide insurance Such as is afforded under this policy, but only with respect to your operations, "yourwork" or facilities owned or used by you. (1) This provision does not apply: (a) Unless the written contract or agreement has been executed or permit has been issued prior to the "bodily injury," "property darnage," "personal and advertising injury": (bi) To any person or organization included as an insured under g. Broad Form Vendors below; or (c) To any person or organization included as an insured by an endorsement issued by us and made a part of this Coverage Part. (2) When an engineer, architect or surveyor becomes an insured under this Coverage Part, the following additional exclusion applies: (a) "Bodily injury", "property damage", "personal and advertising injury" arising Out Of the rendering of or the failure to render any professional services by or for you, including: (i) The preparing, approving, or failing to approve maps, drawings, opinions, reports, surveys, change Orders, designs or specificafions; and (ii) Supervisory, inspection, or engineering services. (3) When a lessor of leased equipment becomes an insured tinder this Coverage Part, the following additional exclusions apply: (a) To any "occurrence' which takes place after the equipment lease expires; or (b) To "bodily injury" or "properly damage" arising out of the sole negligence of the lesson (4) When owners or other interests from whom land has been leased become an insured under this Coverage Part, the following additional exclusions apply-, (a) Any "occurrence" which takes place after you cease to lease that land; or (b) Structural alterations, new construction or demolition operations performed by or on behalf of the owners or other interests from whom land has been leased. g. Broad Form Vendors - Any person or organization with whom you agreed, because of a written contract or agreement to provide insurance, 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, Subject to the following additional exclusions, ,� 1 11 1111,1 (1) The insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay es _2 by reason of the assumption of liability in a contract or agreement, This ex , ion doh §' not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by You; (c) Any physical or chemical change in the product made intentionally by the v, r; (d) Repackaging, unless unpacked solely for the purpose of inspection, de str tiori? testing or substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 4 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-VS (01108) (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; Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, pail or ingredient of any other thing or substance by or for the vendor. (2) This provision 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. (3) This provision does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Coverage Part. (4) This provision does not apply if "bodily injury' or "property damage" included within the "products -completed operations hazard" is excluded either by the provisions of the Coverage Part or by endorsement. H. Per Campus — General Aciaregate 1, SECTION III — LIMITS OF INSURANCE, Paragraph 2., is amended to the following: The General Aggregate limit is the most we will pay: a. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" Under SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I — COVERAGE, COVERAGE C MEDICAL PAYMENTS which can be attributed only to operations at a single designated "carnpus" shown in the Declarations. (1) A separate General Aggregate Lirnit is applicable to each single designated "campus" shown in the Declarations and that limit is equal to the: amount of the General Aggregate Limit shown in the Declarations, (2) The General Aggregate Limit is the most we will pay for the sum of ail damages under COVERAGE A, except damages because of "bodily injury" or"property damage" included in the "products -completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of: (a) Insureds-, (b) Claims made or "suits' brought; or (c) Persons or organizations making claims or bringing "suits". (3) Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the General Aggregate Limit for that designated "campus". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other General Aggregate Limit for any other designated "'campus' shown in the Declarations. (4) The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable single designated "campus" General Aggregate Limit, 2. SECTION V — DEFINITIONS is amended by adding the following: Page 5 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permissio, PI-GLD-VS (01/08) "Campus' is defined as premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 1. Duties in the F-vent of Occurrence, Claire or Suit 1. The requirement in Paragraph 2.a. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS that You must see to it that we are notified as soon as practicable of an "occurrence" or an offense, applies only when the "occurrence" or offense is known to: a. You, if you are all individual; b. A partner, if you are a partnership; or c. An executive officer or insurance manager, if you are a corporation, 2. The requirement in Paragraph 2.b. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS that you must see to it that we receive notice of a claim or "suit" as soon as practicable will not be considered breached unless the breach occurs after such claim or "suit"" is known to: a. You, if you are an individual; b- A partner, if you are a partnership; or c. An executive officer or insurance manager, if you are a corporation, I __ - 0 1 - 11110111a, 1. If the written contract or agreernent or permit requires this insurance to be primary for any person or organization with whom you agree to include in SECTION 11 -WHO IS AN INSURED, then SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance is replaced by the following'. If other valid and collectible insurance is available for a loss we cover under COVERAGE A of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary. We will not seek contributions from other insurance available to the person or organization with whom you agree to include in SECTION 11 - WHO IS AN INSURED, except when 2, below applies. b. Excess Insurance -This insurance is excess over any of the other insurance whether primary, excess, contingent or any other basis: (1) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work",- (2) That is Fire, lightning or explosion insurance for premises rented to you; or temporarily occupied by you with permission of the owner; or (3) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g, When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit" that any other insurer has a duty to defend. 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. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: Page 6 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Fj* (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 other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this excess insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method of Sharing - If all the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first, If any or the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each Insurer's contribution is based on the ratio of its ,applicable limits of insurance of all insurers. 2. This provision only applies with respect to your operations, 'your work' or facilities owned or used by you, K. Other Insurance — You Are An Additional Insured On Another Person's Or r anization's E2LI C-1 If you are an insured under SECTION 11 - WHO IS AN INSURED, then SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. OTHER INSURANCE, Paragraph b. Excess Insurance is replaced by the following: This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis: I . That is Fire, Extended Coverage, Builder's Risk, Installation Risk or sitnilar coverage for "your work"; 2, That is Fire, lightning or, explosion insurance for premises rented to YOU or ternporarily occupied by you with permission of the owner; 3. If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g.; or 4, When any of the Named Insureds, under this Coverage Part, are additional insureds under a commercial general liability policy or sirnilar insurance of another party. 'When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit" that any other insurer has a duty to defend. 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 insureds. When this insurance is excess or 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. k A I- W the ;: ; 1 ;11 M, +k ; that 11 4 described A ; f� VV share V remaining 1 IC3 " I IV uzn�. U"Y, W any tither "Dulallkv a Z) "U uo�'l r, 11kZ) Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. (11A,�Q Page 7 of 9 Includes copyrighted material of Insurance Services, Office, Inc., with its permission PI-GLD-VS (01/08) L. Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because Of Such failure. M, Liberalization If we revise this endorsement to provide more coverage without additional prernium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. SECTION V — DEFINITIONS, Paragraph 3. is changed to read: a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting frorn the foregoing (item a. above) at any fir"ne. 0. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V — DEFINITIONS, Paragraph 14. b. is revised to read b. Malicious prosecution or abuse of process: 2. SECTION V — DEFINITIONS, Paragraph 14. is amended to include the following: "Personal Injury" also means discrimination based on race, color, religion, sex, age or national origin, except when a. Done intentionally by or at the direction of, or with the knowledge or consent of (1) Any insured-, or (2) Any executive officer, director, stockholder, partner or member of the insured- or b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or c, Directly or indirectly related to the sale, rental, lease or sublease or prospective saies, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. P. Transfer of Rights of.Recovery Against Others To Us s� I e6 NI , 40 As a clarification, the following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 8. Transfer of Rights of Recovery Against Others To Us: Page 8 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-GLD-VS (01/08) Therefore, the insured can waive the insurer's Rights of Recovery prior to the occurrence of a loss, provided the waiver is made in a written contract, Q Science Laboratory "Occurrence"' SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph f. does not apply to any "bodily injury" or "physical damage' arising out of a fire or "occurrence' in any of your science laboratories while teaching is being conducted in that laboratory, Subject to a $50,000 per policy limit R. Medical Incident Liability -Nurse and Athletic Trainer 1. SECTION 11 — WHO IS AN INSURED, Subparagraph 2.a. (1) (d) is deleted and replaced by the following: (d) Arising out of his or her providing or failing to provide professional medical services, This paragraph does not apply to a registered or practical nurse or athletic trainer, while acting within the scope of his or her duties for the Named Insured and arising out of a "medical incident". 2. SECTION V — DEFINITIONS, 13. is deleted and replaced by the following: "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions, and "medical incident". 3. The following definition is added to SECTION V — DEFINITIONS: "Medical Incident" rneans any act or omission in the furnishing or failure to furnish professional medical services by the insured or any person acting under the personal direction, control, or, supervision of the insured. Any such actor omission together with all related acts or omissions in the fun,iishing of such services to any one person shall be considered One "medical incident". "Medical incident" does not include any actual, alleged or threatened emotional, physical, or sexual abuse of any patient or professional medical services recipient. Page 9 of 9 Includes copyrighted material of Insurance Services Office, Inc,, with its permission AORK!"'IRS'COMPE'NSATION DECLARATION I tikkly A- hereby affi rin under penalty of perj nry, the (Name/Tilly) following declaration I certify on behalf,of L that durinc, the term of my ACC s¢ C> 'onigrvicemy Name) with -i the City of Santa Ana, I will PW 's contract for 'I not employ any person in any manner so as to become subject to the workers compensation laws of California, and agree that if I should 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. DATE: By: Name: ...... .... Telephone: WARNING: FAILURFITO SECURE WORKERS' COCA COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. 99,