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HomeMy WebLinkAboutTHOMAS HOUSE (8) - 201511104AN't, uN J-111- W A- 2014- Q88 -0190A ORK MAY pROGEEI tINTIL INSURAN0E FXI'IF1h: i9- /0 _/ -_ / °° ° ° "` AMENDMENT TO AGREEMENT FOR USE Y % GL[KOF COUNC I r--- OF EMERGENCY SOLUTIONS GRANT FUNDS OATS 5°d7 —/:5 THIS AMENDMENT, made and entered into this I" day of .January 2015, by and between Thomas House, a California nonprofit organization ( "Subrecipient ") and the City of Santa Ana, a charter city and municipal corporation of the State of California ( "City "). RECITALS A. The City and Subrecipient entered into that certain Emergency Solutions Grant Subrecipient Agreement Between the City of Santa Ana and Thomas House dated July 1, 2014 (Agreement #A -2014- 088 -019) hereinafter referred to as "said Agreement ", for Subrecipient to receive Emergency Solutions Grant Funds (ESG) in the amount of $13,888.00 for the operation of an emergency shelter program for the homeless. B. The parties hereto now desire to amend the amount of the grant to increase it with an additional Two Thousand Dollars ($2,000.00) for this fiscal year. This additional money is part of prior year funding that had been awarded to other subrecipients that were unable to expend their entire grant amounts in the federally mandated 24 -month period. C. City Council authorized this reallocation at its regular meeting of April 1, 2014, in the Request for Council Action by stating that any unallocated FY 2013 -14 funds shall be redistributed proportionately among the subrecipients. WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter contained and made, and subject to all of the terns and conditions of said Agreement as hereby amended, the parties hereto do hereby agree as follows: 1. The total Grant Award to Subrecipient will be amended to include an additional Two 'Thousand Dollars ($2,000.00) for a total grant award of Fifteen Thousand Eight Hundred Eighty Eight Dollars ($t5,888.00) in ESG funds. 2. Except as hereinabove modified, the terns and conditions of said Agreement remain unchanged and in full force and effect. IN WITNESS 'WHEREOF, the parties hereto have executed this Amendment to said Agreement the date and year first above written. ATTEST: Maria D. Iluizar, Clerk oxthe Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney Liga Storck Assistant City Attorney RECOMMEND APPROVAL: elly Rea es, xecut' Director CommuniC Development Agency CI OF SANTA AN - David Cavazos, ity M tiger SUBRECIPIENT THOMAS HOUSE Director Client #: 758615 THOMHOUS ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DD/YYYY) 1 0/0 912 01 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. 1F 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 HUB se Insurance Serv. Inc. License #0757776 6701 Center Dr. West #1500 CD TACT NA E: Tarry Decker PHONE 714. 922.4229 A Ex1; No); e•Maa° „(AC ADDRESS; Cal.CPU @hubinternational.com -- --- - -- INSURER 3) AFFORDING COVERAGE NAIC If Los Angeles, CA 90045 INSURER A: Great American Co. 26344 INSURED Thomas House Temporary Shelter PO BOX 2737 INSURER B: State Compensation Ins. FLlnd 35076 INSURER C: $1,000,000 INSURER D: X, COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:9 OCCUR Garden Grave, CA 92842 INSURER E: INSURER P: PREMISS AENTE enea $100,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER' - -- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LTR TYPE OF INSURANCE N MR SUB 0 POLICY NUMBER POLICY EFF MMIDD/YYW POLICY E %P MMIDO/YYVY LIMITS • GENERAL LIABILITY PAC0594539 10/031201410/031201 EACH OCCURRENCE $1,000,000 X, COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:9 OCCUR PREMISS AENTE enea $100,000 MED EXV (Any one person) $51000 PERSONAL &ADV INJURY $100000Q GENERAL AGGREGATE $2,000 000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: JGCI' LOC PRODUCTS - COMP/OP AGG $2,000000 • AUTOMOBILE LIABILITY PAC0594539 10/031201410/03 /201 CeaecgeDtswGLEUMIT 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUT03 X AUTOS BODILY INJURY For accident) .$ PROPERTY DAMAGE Perac"," $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS.MAOE! EACH OCCURRENCE $ AGGREGATE $ LED RETENTION$ $ B WORKERS COMPENSATION ANOEMPLOVERS'LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICERIMEM3ER EXCLUDED NIA 488156614 10101/201410/01 /201 X WC STAT -U OTH- _TQRYLIML E.L. EACH ACCILENT $1000000 E.I.. DISEASE - EA EMPLOYEE S1,000,OOO (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below _ E.L. GISEASE POLICY LIMIT $1 000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS [VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Santa Ana, its officers, officials, agents, and employees are additional insured in regard to General Liability per attached form CG822412101. City of Santa Ana Attn: Terri Eggars 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 (2090105) 1 of 1 #S3131489/M3116229 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL DE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U Teee -ZULU AWKU CORPORATION: All rights reserved, The ACORD name and logo are registered marks of ACORD SC45 Administrative Offices 580 Walnut Street q Cincinnati, Ohio 45202 GREATi` M,r, ICAN. Tel: 1- 513 - 369-5000 �+ a� .t INSURANCE DROUP CG 02 24 (Ed. 12 01) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, SOCIAL SERVICE AGENCY GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following provision is added to SECTION II - WHO IS AN INSURED 5. AUTOMATIC ADDITIONAL INSURED(S) a. Additional Insured ^ Manager or Lessor of Premises (1) This policy is amended to include as an insured any person or or- ganization (hereinafter called Ad- ditional Insured) from whom you lease or rent property and which requires you to add such person or organization as an Additional Insured on this policy under: (a) a written contract; or (b) an oral agreement or con- tract where a Certificate of Insurance showing that per- son or organization as an Additional Insured has been issued; but the written or oral contract or agreement must be an "insured contract," and, (I) currently in effect or be- come effective during the term of this policy; and (Ii) executed prior to the "bodily injury," "property damage," "personal and advertising in- jury." (2) With respect to the insurance af- forded the Additional Insured identified in Paragraph A.(1) of this endorsement, the following additional provisions apply: (a) This insurance applies only to liability arising out of the ownership, maintenance or use of that portion of the premises leased to you. (b) The Limits of Insurance ap- plicable to the Additional In- sured are the lesser of those specified in the written con- tract or agreement or in the Declarations for this policy and subject to all the terms, conditions, and exclusions for this policy. The Limits of Insurance applicable to the Additional Insured are inclu- sive of and not in addition to the Limits of Insurance shown in the Declarations. (c) In no event shall the cov- erages or Limits of Insurance in this Coverage Form be in- creased by such contract. (d) Coverage provided herein is excess over any other valid and collectible insurance available to the Additional In- sured whether the other in- surance is primary, excess, Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/011 XS (Pace 1 of 4) GW b �Ml contingent or on any other basis unless a written con- tractual arrangement specifi- cally requires this insurance to be primary. (3) This insurance does not apply to: (a) Any "occurrence" or offense 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 "Additional Insured." b. Additional Insured - Funding Sources (1) This policy is amended to include as an Insured any Funding Source which requires you in a written contract to name the Funding Source (hereinafter called Addi- tional Insured) as an Insured but only with respect to liability aris- ing out of your premises, "your work" for such Additional Insured, or acts or omissions of such Ad- ditional Insured in connection with the general supervision of "your work" and only to the extent set forth as follows: (a) The Limits of Insurance ap- plicable to the Additional In- sured are the lesser of those specified in the written con- tract or agreement or in the Declarations for this policy and subject to all the terms, conditions, and exclusions for this policy. The Limits of Insurance applicable to the Additional Insured are inclu- sive of and not in addition to the Limits of Insurance shown in the Declarations. tomarily provided by the policy forms specified in and required by the contract. (c) In no event shall the cov- erages of Limits of Insurance in this Coverage Form be in- creased by such contract. c. Additional Insured - Contractual Obligations (1) This policy is amended to include as an Insured any person or or- ganization (hereinafter called Ad- ditional Insured) that you are re- quired by a written "insured con- tract" to include as an Insured, subject to all of the following provisions: (a) Coverage is limited to liability arising out of: (i) your ongoing oper- ations performed for such Additional Insured; or (ii) that Insured's financial control of you; or (iii) the maintenance, opera- tion or use by you of equipment leased to you by such Additional Insured; or (iv) a state or political sub- division permit issued to you. (b) Coverage does not apply to any "occurrence" or offense: (i) which took place be- fore the execution of, or subsequent to the completion or expira- tion of, the written "in- sured contract ", or (b) The coverage provided to Up which takes place after the Additional Insured(s) is you cease to be a ten - not greater than that cus-- ant in that premises. Includes copyrighted material of Insurance Service Office with its permission. Copyright, ri ht, Insurance Services Office, Inc., 2001 j U� CG 82 24 (Ed. 12/01) XS (Pace 2 of 4)' (o) With respect to architects, engineers, or surveyors, coverage does not apply to "Bodily Injury," "Property Damage," "Personal and Ad- vertising Injury" arising out of the rendering or the fail- ure to render any profes- sional services by or for you including: (i) the preparing, approv- ing, or failing to pre- pare or approve maps, drawings, opinions, re- ports, surveys, change orders, designs or specifications; and (ii) supervisory, inspection, or engineering services. If an Additional Insured endorsement is at- tached to this policy and specifically names a person or organization as an Insured, then the coverage in Section II - WHO IS AN INSURED 5. Automatic Additional Insured(s) does not apply to that person or organization. 2. BLANKET WAIVER OF SUBROGATION SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Item B. is replaced with: 8. Transfer of Rights of Recovery Against Others to us and Blanket Waiver of Subrogation a. If an Insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The Insured must do nothing after loss to impair them. At our request, the Insured will bring "suit" or transfer those rights to us and help us enforce them. b. If required by a written "insured con- tract", we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products- completed operations hazard." 3. NON -OWNED OR CHARTERED WATER- CRAFT Section I - Coverages, Coverage A, Item 2.9.(2) is replaced with: (2) A watercraft you do not own that is: (a) less than 51 feet long; and (b) not being used to carry persons or property for a charge. 4. BROADENED PERSONAL AND ADVERTISING INJURY Unless "Personal and Advertising Injury" is ex- cluded from this policy: SECTION V - DEFINITIONS Item 14, is re- placed by: 14. "Personal and Advertising Injury" means injury, including consequential "bodily in- jury," arising out of one or more of the following offenses: a. false arrest, detention or imprison- ment; b. malicious prosecution; c. the wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies by or on behalf of its owner, landlord or lessor; d. oral, written, televised, videotaped, or electronic publication of material, in any manner, that slanders or libels a person or organization or disparages a person's or organization's goods, pro- ducts or services; e. oral, written, televised, videotaped, or electronic publication of material, in any manner, that violates a person's right of privacy; or rj Includes copyrighted material of Insurance Service Office with its permission. 6C Copyright, Insurance Services Office, Inc., 2001 6,v " CG 82 24 (Ed. 12/01) XS (Pace 3 of 4) �� " f. mental injury, mental anguish, humili- ation, or shock, if directly resulting from Items 14.a. through 14,e, g, the use of another's advertising idea in your "advertisement "; or h, infringing upon another's copyright, trade dress or slogan in your "adver- tisement" 5. MENTAL INJURY, MENTAL ANGUISH, HUMILIATION, OR SHOCK INCLUDED IN BODILY INJURY DEFINITION Section V - Definitions, Item 3. is replaced with: 3. "Bodily injury" means physical injury, sick- ness, or disease, including death of a per- son. "Bodily injury" also means mental in- jury, mental anguish, humiliation, or shock if directly resulting from physical injury, sickness, or disease to that person. B. MEDICAL PAYMENTS A. The Medical Expense Limit in Paragraph 7. of SECTION III - LIMITS OF INSURANCE is replaced by the following Medical Ex- pense Limit. The Medical Expense Limit provided by this policy shall be the greater of: a. $10,000; or b. The amount shown in the Declarations for Medical Expense Limit. B. This provision 7. is subject to all the terms of SECTION III - LIMITS OF INSURANCE. C. This provision 7. does not apply if COVERAGE C. MEDICAL PAYMENTS is excluded either by the provisions of the Coverage Part or by endorsement. 7. DAMAGE TO PREMISES RENTED TO YOU LIMIT Subject to 5. above, the Damage to Prem- ises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to your building, or to personal property of others in your care, custody and control while at premises rented to you or temporarily occupied by you with permission of the owner, arising out of any one fire. The Damage to Premises Rented To You Limit is replaced by the following Damage to Premises Rented To You Limit. The Damage to Premises Rented To You Limit is the greater of: (1) $300,000; or (2) the amount shown in the Declarations for Damage to Premises Rented to You Limit. B. This provision is subject to all the terms of SECTION III - LIMITS OF INSURANCE. C. This provision 5, does not apply if Damage to Premises Rent to You Liability of COV- ERAGE A (SECTION 1) is excluded either by the provisions of the Coverage Part or by endorsement. B. SUPPLEMENTARY PAYMENTS A. In the SUPPLEMENTARY PAYMENTS - COVERAGES A and B provision, Item 1.1b., and 1.d are replaced with: 1.b. Up to $500 for cost of bail bonds required because of accidents or traf- fic law violations arising out of the use of any vehicle to which the Bodily In- jury Liability Coverage applies. We do not have to furnish these bonds. 1.d. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the claim or "suit," including actual loss of earnings up to $500 a day because of time off work. A. SECTION III - LIMITS OF INSURANCE, This endorsement does not change any other Item 6, is replaced with: provision of the policy. �J Includes copyrighted material of Insurance Service Office with its permission, Os/ Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12(01) XS (Pace 4 of 4) J'