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TORRES, MARTIN 9 - 2015
City of Santa , Aa . .... ....... - Clerk of the Council iOffice Use --------------- -- ......................... .. . AGREEMENT TERMINATION FORM M AUG 21 PM 4' �8 Please complete this form when the attached agreement and all CITY OF SANTA ANA amendments (if any) are no longer in effect. CLERK OF COUNCIL Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with N-2015-099 No. was completed on (List all amendments. Use space below if needed.) (01,301%a and final payment has been made. Department: Phone/Ext.: Signature: Date: Revised 10-31-12 INSURANCE ON FILE N-2016-099 WORK MAY PROCEED UNTIeL, INSURANCE EXPIRES �t " —t N CLERK OF COUNCIL DATE: JUN 15 2015 RECREATION SERVICES AGREEMENT O PRCSI C 0 Silvia Cue as THIS AGREEMENT is made and entered into this 7s' day of April, 2015, by and etwoen Mat -tin Tomes (hereinafter "Provider") and the City of Santa Ana, a chatter 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, resourcesand knowledge to conduct various martial arts 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: I. 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. Total revenue to Provider shall not exceed $25,000 annually. Payment to Provider shall be arcade within thirty (30) days following completion of the last class taught by Provider that month. City shall be responsible for collecting all fees from program participants. Provider shall I not collect fees but will refer all interested participants to City for registration information. Provider agrees that City shall retain thirty percent(30%) of all gross revenue received from program participants as an administrative fee. 3. 'TERM The Tern of this Agreement shall be for two (2) years; commencing on July 1, 2015 through June 30, 2017, unless terminated earlier in accordance with Section 12, below. 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•employce relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the mamaer in which Provider performs the services which are the subject 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 taxes, unemployment insurance and similar taxes relating to employees and shall 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. 5. INSURANCE Prior to undertaking performance of work tinder 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, and $2,000,000 in the aggregate. 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 tinder 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. (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 fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's. election, to forthwith terminate this Agreement. Such tennination shall not affect Provider's right to be paid for its time and materials expended prior to notification of termination. 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, contractors, 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 death, 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 actin; on their behalf which relates to the set -vices 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 arising by reason of the terms of, or effects arising from this Agreement. City may snake all reasonable decisions with respect to its representation in any legal procceding. 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 under this Agreement. S. LIVE SCAN BACKGROUND CHECK Providers, and any employees, subcontractors or substitutes, in contact with minors cinder 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 prior 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 property given if delivered in person or Mailed by first class or certified mail, postage prepaid, or sent by fax 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 1988 Santa Ana, CA 92702.1988 Fax (714) 647-6956 With copy to: Executive Director of Parks;_ Recreation and Community Services City of Santa Ana 26 Civic Center Plaza (M-75) P.O. Box 1988 Santa Ana, California 92702 Fax(714) 571-4211 To Provider: Martin Torres 12692 Rancho Way Garden Grove, CA 92843 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) clays after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed its set forth above. If sent by fax, communication shall be effective or deemed to Have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal; state, CuLmty 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. 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 are at least twenty-one (21) years of age and comply with the City's insurance and live scan requirements contained herein. Evidence of compliance with City's insurance and live scan requirements shall be provided upon request. 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 must notify participants as soon as possible of any class cancellation and make-up class. Provider must personally teach at least seventy-five percent(75%) of its offered classes. 12. TERMINATION a. This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Provider shall be entitled to receive, and City shall pay Provider, compensation for all services rendered prior to the effective date of termination. b. Termination or cancellation of classes by the Provider outside of Section I I.b, 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 fixture 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. RECORDS Provider shall use attendance sheets generated and supplied by the City to record attendance in each class. Provider shall keep these and any other records in connection with the work to be performed under this Agreement and shall permit City, upon request, to review such records for a period of three (3) years from the date of final payment to Provider under this Agreement. 14. 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, teaching, 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. 15. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation; performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 16. 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 tither governmental agencies. 17. 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. 18. EXHIBITS All Exhibits referenced herein and attached hereto shall be incorporated as if filly set forth in the body of this Agreement. 19. AUTHORITY The person(s) executing this Agreement on behalf of the parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said parties and that by so executing this Agreement, the parties hereto are formally 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. Iluizar Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney Lisa Storek Assistant City Attorney CITY OF SANTA ANA Davi 111III Cavazos City Manager RECOMMENDED FOR APPROVAL: PROVID '— 9L-t, 9t-c-si Gerardo Monet actin Torres Executive Director of Park4s, Recreation and Community Services Agency Exhibit A SCOPE OF SERVICES - Martin Torres A. Provider shall conduct Martial Arts techniques for children 4 & older B. Baby Karate Do Kai class will consist of monthly classes, held 2 days per week, 1 hour per day- $35/per monthly, ages 4-7 yrs. old C. Baby Karate Do Kai, Family discount class will consist of monthly classes, held 2 days per week, 1 hour per day, per 2 students - $60/monthly, all ages D. Karate Do Kai Beghmer/Advance class will consist of monthly classes, held 2 days per week, 1 hour per day- $35/per month, ages 7 &older E. Karate Do Kai Beginner/Advance, Family discount class will consist of monthly classes, held 2 days ,per week, 1 hour per day, per 2 students - $60/monthly -all ages R Karate Do Kai All ages class will consist of monthly classes, hold 2 days per week; t hour per day- $35/per month, or 2 students for $60 - all ages G. Provider will provide and be responsible for equipment, records, and personnel and cleanup of the facilities and materials necessary to ensure the safety and effectiveness of said instruction. 1-1. If Provider allows others to teach his/her class, those teachers must be over,21, have obtained and maintain an instructor rating, and be covered by Providers' insurance, Provider shall provide City with documentation to verify instructor and insurance requirements. Black -belt rated students may warra up beginning Students, however, Provider must be present at all times. CLASS SIZE REGISTRATION 1. The minimum number of participants is 5 per class, the maximum is 50. 2. No registration will be accepted after the second week of classes. 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, FEES I. Each participant shall pay a $35/$60 class registration fee per monthly session. 2. No refunds will be made to participants after the commencement of a session unless the class is cancelled by the City. 3. Provider may not waive class participation/registration fees. Only registered participants may participate in class. PHILADELPHIA INSURANCE COMPANIES A htember of the `l okw [Marine Group One Gala Plaza, Suite 100, Bala Cynwyd, Pennsylvania 19004 610.617.7900 - Fax 610.617,7940 • PHLY.com 01/08/2015 Martin Torres 12692 Ranchero Way Garden Grove, CA 92843- Re: Account t#: 81322557 Policy!#: PHPK977541.002 Dear Valued Customer: Thank you very much for choosing Philadelphia Insurance Companies (PHLY) for your insurance needs. Our first class customer service, national presence and A++ (Superior) A.M. Best financial strength eating have made us the selection by over 150,000 policyholders nationwide. I realize you have a choice in insurance companies and truly appreciate your business. I wish you much success this year and look forward to building a mutually beneficial business partnership which wilt prosper for years to come. Welcome to PHLY and please visit PIILY.com to learn more about our Company! Sincerely, Robert D. O'Leary Jr. v President & CEO Philadelphia Insurance Companies Philadelphia Consolidated Holding Corp. • Philadelphia Indemnity Insurance Company • Tokio Marine Specialty Inammnce Company ^ Maguire Insurance Agency, Inc. �co ct CERTIFICATE OF LIABILITY INSURANCE PRODUCER Magslire lnwranae Agency, to, 27101 Peerta Rem smte 200 Mission Viejo, CA 92691- 821.4381459 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, INSURERS AFFDRDING L4VERAGE NAICB INSURED Martin Tnrtaa 12692 RanOleto W aY Garden Grow, CA 02843 INSURER A: Philadelphia Indemnity Insurance Cum any 19058 INSURER 9: INSURER C+ INSURER 0: INSURER 9: fPl\/WRAf.CS 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 CERIFICATION MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTB ADD 'L INSBO TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE DATE(MMPoD/YYYYJ POLICY EXPIRATION DATE (MM/DDIYYYVI LIMITS A % GENERAL % LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7 OCCUR PROFESSIONAL LIABILITY AGGREGATE LIMIT APPLIES MEN POUCY PROJECT LOC PHP077541002 02(106/2015 02/05/2016 EACH OCCURENCE 54Mq,01A PREMISES Ea occurrent $LOgOW MED Far (Any One retain) p-Scig % GFMI. X PERSONAL &ADV INJURY Sl,DWydets GENERAL AGGREGATE PRODUCTS-CONIPJOPAGG AUTOMOBILE LIABILITY ANY AU FO ALLOWNEDAL)"NOS SCHEDULEDAUTOS Hn1EGAUFOS NON OWNED AUTOS COMBINED SINGLE LIMIT (EA accident) BODILY INJURY (Per Parson) BODILY INJURY (Pat acrld¢ntl PROPERTY DAMAGE IPw pmldpn) GARAGEUABILITY ANYAUTO AUTO ONLY -EA ACCIDENT OTHERTHAN FA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY OCCUR CLAIMSMADE RETENTION EACH OCCURENCE AGGREGATE EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR /PDEARTNER/EXECUTIVE IL...�JI OFFICER/MEMBER E%CLUD4 Pl ardaMty He NHL if ymi desedbe Undar PROVISIONS Uelow IDRYL MITS ER E.L. EACH ACCIDENT E.L. DISEASE - EA AMPLOYEE 7SPEO(AL DISEASE -POLICY LIMIT OTHER OESCRIPTIDN OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT( SP6GRL PROVISIONS it is and rstood and agreed that the Relieving amity is added as an aJditUnal insured but only ynth,eayed(A to the 4reratians of ode named insured except that liability resulting from the addhiolW aeaseaN XXV npgERence. L.OR L IPR[A i c TTVLUOIS a r.ars1— Ce,.FSanta Ana 1325 west Civet Center Drive Santa Ana, CA 92703. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPRW DRAW THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL LO DAYS WRITTEN HONCE W 11% CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHA0.IMPOSE NO MUWTION US ACORD 25 (2009/01) C) 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD is Indemnity Insurance Com is 19004 iff;loiil G olzWel31'. Conunercir Lines Policy THIS POLICY CONSISTS OF: - DECLARATIONS - COMMON POLICY CONDITIONS -- ONE OR MORE COVERAGE PARTS. A COVERAGE PART CONSISTS OF: - ONE OR MORE COVERAGE FORMS - APPLICABLE FORMS AND ENDORSEMENTS BJP-190-1 (12l98) IN WITNESS WHEREOF, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless signed by our authorized representative. President & CEO Secretary BJP-190-1 (12/98) Commercial General Liability CG00011207 b. Contractual Liability "Bodily injury" or "property damage" for which the insured 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: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "Insured contract", reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an Insured are deemed to be damages because of "bodily injury" or "property damage", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract" and (b) Such attorney fees and litigation expenses arc) for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability "Bodily injury" or "property damage" for which any insured may be hold liable by reason of: (1) Causing or contributing to the Intoxication of any person; (2) The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's Liability "Bodily injury" tw (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above, This exclusion applies whether the Insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the Insured under an "Insured contract". f. Pollution (1) "Bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any insured. However, this subparagraph does not apply to: (i) "Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot produced by or originating from equipment that is used to heat, cool or dehumidify the building, or equipment that is used to heat water for personal use, by the building's occupants or their guests; (ii) "Bodily injury" or "property damage" for which you may be held liable, if you are a contractor and the owner or lessee of such premises, site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any insured, other than that additional insured; or (10) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire", (b) At or from any premises, site or location which is or was at any time used by or for any insured or others for the handling, storage, disposal, processing or treatment of waste; `i ^ CG 00 01 1207 0 ISO Properties, Inc. , 2000 �I �� Page 2 of 16 Commercial General Liability CG 00 01 12 07 (c) Which are or were at any time transported, handled, stored, treated, disposed of, or processed as waste by or for: (i) Any insured; or (it) Any person or organization for whom you may be legally responsible; or (d) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the "pollutants" are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor. However, this subparagraph does not apply to; (i) "Bodily injury" or "property damage" arising out of the escape of fuels, lubricants or other operating fluids which are needed to perform the normal electrical, hydraulic or mechanical functions necessary for the operation of "mobile equipment" or its parts, if such fuels, lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them. This exception does not apply if the "bodily Injury" or "property damage" arises out of the intentional discharge, dispersal or release of the fuels, lubricants or other operating fluids, or if such fuels, lubricants or other operating fluids are brought on or to the premises, site or location with the intent that they be discharged, dispersed or released as part of the operations being performed by such insured, contractor or subcontractor; (it) "Bodily injury" or "property damage" sustained within a building and caused by the release of gases, fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor; or (ill) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire (a) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants". (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (b) Claim or "suit" by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants" However, this paragraph does not apply to liability for damages because of "property damage" that the Insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or "suit" by or on behalf of a governmental authority. g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 25 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (A) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; or CG 00 01 12 07 0 ISO Properties, Inc. , 2000 �,\\ Page 3 of 16 PI-APG-004 (01/07) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Section IV Y Commercial General Liability Conditions: 1. Changes The Certificate of Insurance contains all the agreements between you and us concerning the insurance afforded. The first Named Certificate Holder shown In the Certificate of Insurance is authorized to make changes in the terms of the Certificate of Insurance with our consent. The Certificate of Insurance terms can be amended or waived only by endorsement issued by us and made a part of the Certificate of Insurance. 2. Transfer of Your Rights and Duties Under The Certificate of insurance: Your rights and duties under the Certificate of Insurance may not be transferred without our written consent except in the case of death of an individual Named Certificate Holder. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative Is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Page 1 of 1 PI-FW-006 (01l07) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY SEXUAL ABUSE ENDORSEMENT This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Sexual Abuse Limits of Insurance Sexual Abuse Each Occurrence Limit: $100,000 Sexual Abuse Aggregate Limit $300,000 A. Except as otherwise provided by this endorsement, this policy does not apply to "bodily injury," "property damage" or "personal and advertising injury" caused by, based upon or arising, in whole or in part, out of any: 1. Actual, threatened or alleged "sexual abuse" or "sexual harassment"; or 2. "Negligent employment" of any person who caused or commits or is alleged to have caused or committed "sexual abuse" or "sexual harassment." As respects coverage afforded by this endorsement, the following changes apply to the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: B. Paragraph 1. of Section I — Coverages — Coverage A — Bodily Injury And Property Damage Liability is deleted and replaced by the following: 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages, including any "suit" alleging that the "bodily Injury" arose out of "sexual abuse" caused or committed by the insured. However, we will have no duty to defend or continue to defend any insured against: (1) any "suit" seeking damages for "bodily injury" to which this insurance does not apply; (2) any "suit' for which the insured is found to have in fact caused or committed an act of "sexual abuse"; or (3) any "suit" for which the insured has admitted to have in fact caused or committed an act of 'sexual abuse." We may, at our discretion, investigate any "oocurrence" and settle any claim or "suit" that may result. But: (a) The amount we will pay for damages is limited as described in Section F — Limits Of Insurance of this endorsement; and (b) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments, settlements or "defense expenses" under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided under Section D of this endorsement — Supplementary Payments — Coverage A and B. b. This insurance applies to "bodily injury" only if: Page 1 of PI-FW-006 (01/07) (1) the "bodily Injury" Is caused by an 'occurrence" that first commences in the "coverage territory' at a specific date and time on or after the effective date of this endorsement and during the policy period; (2) the "bodily injury" arises out of "sexual abuse" caused or committed by your "employee"; and (3) the "sexual abuse" arises out of your "negligent employment" of that "employee." C. The insurance provided by this endorsement is subject to the following additional exclusions: 2. Exclusions This Insurance does not apply to; a. Any person who: (1) Has admitted to or been found guilty of, or pled guilty or nolo contendere to any act involving "sexual abuse"; (2) Participated In, directed or knowingly allowed "sexual abuse"; or (3) Has failed to comply with any applicable law, ordinance or regulation which requires the reporting of "sexual abuse" after having knowledge of the "sexual abuse." b. Any expense associated with a criminal trial, proceeding or investigation, or to any expense for appeals for any "suit" against you or any person insured. c. Any claim for damages arising out of "sexual abuse" which is part of a series of related acts of "sexual abuse" If the first of such series of acts took place before the effective date of this endorsement. d. Any claim for damages arising out of "sexual abuse" alleged to have been caused or committed by any "employee" who had previously committed such an act of which any insured had knowledge. a. Any liability of others assumed by you under any contract or agreement, either oral or written. I. Any claim made against an insured by another Insured. g. Any "sexual abuse" caused or committed by or which is alleged to have been caused or committed by any independent contractor or employee or agent of such independent contractor.. h. "Sexual harassment." 1. "Bodily injury` arising from any violation or alleged violation of the civil rights of any person, D, SUPPLEMENTARY PAYMENTS -COVERAGES A AND B With respect to the insurance provided by this endorsement, Paragraph 1.a. and Paragraph 2, of Section I — Supplementary Payments — Coverages A and B are deleted. E. WHO IS AN INSURED With respect to the insurance provided by this endorsement, Paragraph 2, of Se#Ion It — Who Is An Insured is deleted. F. LIMITS OF INSURANCE For purposes of the coverage provided by this endorsement, the following is added to Section Ili — Limits Of Insurance of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM and applies solely to this coverage; Page 2 of 4 PI-FW-006 (01/07) 1. The Sexual Abuse Limits of Insurance shown in the SCHEDULE of this endorsement and the rules below fix the most we will pay for damages and "defense expenses", regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits." 2. The Sexual Abuse Aggregate Limit shown in the SCHEDULE of this endorsement is the most we will pay for the sum of all damages and "defense expenses" because of all "bodily injury" arising out of "sexual abuse." 3. Subject to 2. above, the Sexual Abuse Each Occurrence Limit shown in the SCHEDULE of this endorsement is the most we will pay for the sum of all damages and "defense expenses" because of all "bodily injury" arising out of 'sexual abuse" from any one "occurrence." 4. Subject to 1., 2., and 3. above, covered damages for which Insurance Is afforded by this endorsement will apply against and reduce the General Aggregate Limit of this policy, as described In Paragraph 2. of Section III - Limits Of Insurance of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown In the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed to be part of the last preceding period for purposes of determining the Limits of Insurance. G, For purposes of the coverage provided by this endorsement, the following definitions are added to Section V - Definitions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: 1. "Defense expenses" means: a. Fees, costs and expenses charged by attorneys retained by us; and b. Reasonable and necessary fees, costs and expenses resulting from the investigation, adjustment, defense or appeal of a claim. "Defense expenses" do not include: a. Salaries, loss of earnings, reimbursement for the insured's time or attendance required at any investigation, defense or appearance; or b. Other remuneration by or to any insured. 2. "Negligent employment" means negligent selection, investigation, supervision, training or retention of an "employee," 3. "Sexual abuse" means actual or alleged physical abuse arising out of a single, continuous or repeated exposure of one or more persons to acts of a sexual nature involving Inappropriate physical contact caused by or committed by: a. One person; or b. Two or more persons acting together or In related acts or series of acts. All related, interrelated, repeated or continuous episodes of "sexual abuse' involving the same claimant or perpetrator shall be deemed to be a single "occurrence." 4. "Sexual harassment" means inappropriate non-physical actions or verbal comments or suggestions of a sexual nature, H. For purposes of the coverage provided by this endorsement, Paragraph 13. of Section V - Definitions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to Include: Page 3 of 4 PI-FW-006 (01/07) 13. "Occurrence" means any act of "sexual abuse." 7 �. Page 4 of 4 , PI-FW-009 (06/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Blanket Additional Insured Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION II — WHO IS AN INSURED is amended to include the following as an additional insured, but only with respect to liability arising out of your operations, and in accordance with a required Certificate of Insurance: 1. Managers, Owners or Lessors of the Premises Leased, Rented, or Loaned to You, but only with respect to that part of the premises leased, rented or loaned to you subject to the following additional exclusions: This insurance does not apply to: a. Any "occurrence" which takes place after you cease to be a tenant in that premises; b. Structural alterations, new construction or demolition operations performed by or on behalf of the manager, owner or lessor of the premises; c. Any design defect or structural maintenance of the premises or loss caused by a premises defect. 2. Lessor of Leased Equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, In whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s) subject to the following additional exclusions: This insurance does not apply to: Any "occurrence" which takes place after the equipment lease expires. 3. Sponsors, but only with respect to their liability as a sponsor to you. 4. Co -Promoters, but only with respect to their liability as a co -- promoter to you 5. Subcontractors 6. Grantor of Franchise, but only with respect to their liability as grantor of franchise to you. With respect to any additional Insured covered under this policy, this insurance does not apply to the sole negligence of such additional insured. Page 1 of 1 Cr AC.'C R PRODUCER Maguire Imnrante A,,,,, Int. 29101 Poorly AIal Saba 200 "By'. Viejo, CA 92691 877,4387459 Martin lames 12692 Ranch... Was Garden Grove, CA 92R43- COVERAGES CERTIFICATE OF LIABILITY INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THE POLICIES OF INSURANCE ISTED 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 CERIFICATION MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR AUOL INSRO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DO YYYY POLICY EXPIRATION DATE MM DOYM LIMITS A X GENERALUABILITY X COMMERCML GENERAL LIABILITY CLAIMS MADE OCCUR PROFESSIONAL LIABILITY AGGREGATE LIMIT APPLIES PER: pa— PROJECT F7 LOC PHPX9T7541.002 (2/06,2015 02AE/20L6 CAN OCCURENCE $1,O0,000 PREMISES Ea ac."noc¢ $100,000 MED ESP IF, one person) $2,500 X GEWL X PERSONAL$ ADV INJURY $1,000,000 GENERALAGGREGATE $3,000,000 PRODUCTS—COMP/OPAGG $3,0001000 AUTOMOBILE UASIUW ANYAUTO ALLOWNEOAUTOS 5CHBOULK)AU[OS HIREDAUTOS NOMOMPROD AUTOS COSP INEU SINGLE LIMIT {EAottidentl BODILYINIURY {Perpermn) BODILY INM" (Perattddent) PROPFRTYDAMAGE (Per anaRlenq GAUGE UABIUR AHYAUTO AM ONLY —EA ACCIDENT OTHPRTHAN EA ACC AUTO ONLY, AGO MM I UMBRELLA LIABILITY OCCUR ® CLAIMS MADE OEOUCn@LE A"UH10N EACH gSURENCE AGGRECA1F- _ EMPLOYERS UAMUIV YN ANY PROPRIETpiUPA(TTNERjF RECUDVE OFRCERIMEM9ER E%CLUOFU. (M.Pichaaryin NNl R esHT60 »enomler sPicIN.PRGVnIaNs I>Lww tt%IY LIMITS ER £L. EACH ACCIDENT ELL. DISEASE —EA AMPLOYEE E.L. DISEASE -PouGYLIMIT OTHER DESCRIPTION OF OPERAT(ONSf WCATIONS/ VEHIC ES1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS It is endam cd acid Rimed That &a YvRpvdng early is added as an additional insured but only with rezpecd,) to the operandi or the wool resound euxal brat Utility, resulting Yrom ttre additional Insured§ sole negligence. 6MT L SLL6l I IVN THEREOF, THE BELONG INSURER WILL, ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LER, OUT 6AILLRE TO 00 $0 SHALL IMPOSE NO OBLIGATION OR eo-J4�og ACORD 25 (2O09/01) O 1988-2009 ACORD CORPORATION. All rights reserved.+Ei� A The ACORD name and logo are registered marks of ACORD �rf� Commercial General Liability CG 00 01 12 07 Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit", (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or 13 of ���t---hi`s Coverage Part, our obligations are limited as follows: r a. rrimary Insurance J This insurance is primary except when Paragraph b. below applies. If this Insurance is primary, our obligations are not affected unless any of the other Insurance is also primary. Then, we will share with all that other Insurance by the method described in Paragraph c. below. b. Excess Insurance (1) This Insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your WOW; (it) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner, (fit) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner, or (iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g, of Section I — Coverage A— Bodily Injury And Property Damage Liability, n CG 00 01 12 07 © Ajllf', ISO Properties, Inc. , 2000 i1V':� \ `� CPage o .. POLICY NUMBER: PHPK977541-002 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. r 01 e This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section tl — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. in the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 O ISO Properties, Inc., 2004 1Page 1 of 1 01 IMPORTANT if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does It affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2009/01) EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2016-25 CERTIFICATE OF INSURANCE SPECIAL EVENT IAABL1.ITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Set -vices, Inc. in Conjunction with City of Santa Ana Apex Insurance Services 20 Civic Center Plaza P. O. Box 6450 Santa Ana, CA 92701 Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Martin Torres TYPE: Martial Arts 12692 Ranchero Way DATE(S): 01/20/16 — 12/31/16 Garden Grove, CA 92843 LOCATION: Jerome Center ik *Liquor Liability Yes [:1 No "Liquor Liability after 12 am ends before 2 am L] This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ics) unless amended as described in Special Conditions. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: SEP41020 MASTF R POLICY DATES: EFFECTIVE: JANUARY 1, 2016 EXPIRATION: JANUARY 1, 2017 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE- NONE General Aggregate Limit 2,000,000 Products & Cornpleted Operations 1,000,000 SPLCIAL CONDITIONS. Personal & Advertising Injury 1,000,00() The following endorsements attached to Each Occurrence Limit 1,000.000 the Master Policy do not apply to this Damage To Premises Rented To YOU (Any One Premises) 100,000 Certificate Of Insurance: Medical Payments (Any One Person) 5,000 Liquor Liability (if purchased) 1,000.000 1"6 \A Optional Limits Purchased F-1 $1,000,00053,000,000 v0\ /A F1 $2,000,00052,000,000 Darnage To Property (if put -chased) The limits 01'insurance apply separately too each event insured by this policy as if@ separate policy of insurance hasN -issued for that event. OTHER ADDITIONAL INSUREDS CANCELLATION Should the above described policy be cancelled before the expiration date thereof, notice Nvill be delivered in accordance with the policy provisions. a a, AUTHORIZED REPRESENTATIVE: DATE ISSUED: — January 20�, 2016..by Briza Morales EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2017-23 CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM 1PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. in conjunction with City of Santa Ana Apex Insurance Services 20 Civic Center Plaza P. O. Box 6450 Santa Ana, CA 92701 Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Martin Torres TYPE: Martial Arts 12692 Ranchero Way DATE(S): 1/09/17 — 12/31/17 Garden Grove, CA 92843 LOCATION: Jerome Center *Liquor Liability YesE] No Z "Liquor Liability after 12 am ends before 2 amEl This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless amended as described in Special Conditions. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: SEP41023 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2017 EXPIRATION: JANUARY 1, 2018 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit $2,000,000 Products & Completed Operations 1,000,000 SPECIAL CONDITIONS: Personal & Advertising injury 1,000,000 The following endorsements attached to Bach Occurrence Limit 1,000,000 the Master Policy do not apply to this Damage To Premises Rented To You (Any One Premises) 100,000 Certificate OfInsurance: Medical Payments (Any One Person) 5,000 Liquor Liability (if purchased) 1,000,000 Optional Limits Purchased . \e."t4e6 Ell $1,000,000/$3,000,000 El $2,000,000/$2,000,000 Damage To Property (If purchased) The limits of insurance apply separately to each event insured by this policy as if a separate policy opWhas been issued for that event, OTHER ADDITIONAL INSUREDS Itzel Barrios CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. AUTHORIZED REPRESENTATIVE: DATE ISSUED: Jan.uary..9, 2017 by Stella Fajardo