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HomeMy WebLinkAboutEPIC LAND SOLUTIONS 1A-2015City of Santa Ana _ Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes _ No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with �1 c r! ^T)' .56ZL0716 N A-2015-161-01 No. _ was completed on (List all amendments. Use space below it needed.) Revised: 1 Q 18-16 5 D and final payment has been made. Department: l�� - L✓� �y�E Phone/Ext.: Signature: �� V C� `✓ i Date: NjUH AGE UN f itx WORK MAY PROrELD A-2016-009 UNTIL INSURAN(-"r= FXPIRi t- FIRST AMENDMENT TO CONSULTANT .--/0-1 -,...-.--...._....___...AGREEMENT WITH EPIC LAND SOLUTIONS CLERK OF COUNCII. OArF-t� THIS FIRST AMENDMENT TO AGREEMENT is entered into this 16t" day of December, 2015, by and between Epic Land Solutions, Inc. ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. On August 5, 2015, the City entered into Agreement #A-2015-161 with Epic Land Solutions, Inc. to provide acquisition and relocation services for the term of three years. B. In accordance with the teens and conditions of the Agreement, the parties desire to amend the compensation of the Agreement. THE PARTIES THEREFORE AGREE: Section 2, COMPENSATION, shall be amended to increase compensation in the amount not to exceed $400,000.00 during the term of this agreement. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement the date and year first above written. ATTEST: MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: Sonia R. Carvalho, City Attorney ey-,SESANDO Lief Assistant City Attorney R -CO ENDED FOR APPROVAL: R ,D MOUSAVIPOUR, P.E. Executive Director of Public Works Agency CIT t SANTA AN 7 t DAVIV,eAOS� City Manager C SULTANT B : cTGivv�,C.s Z. OvP1✓<.Gwu!)r J`v. Ti le: Vic, Page I of I EPIC LAND SOLUI"[ON S.4 20'I Li-1 ti'I RcVIEVVFIT BY EUNICE HF. REC PI�� 'I F 4) ROSEM CERTIFICATE OF LIABILITY INSURANCE DAT1 arE(MM;DD,YYYY, t 4rza15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) most 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 Rot confer rights to the certificate holder in lieu of such endorsements). PRODUCER License # OE67768 0 NTACT Dana Schwartz IDA Insurance Services PHONE --"-- """-NAx ` aPA&,Ns €xc (6t9) 574.6220 I IAIc,,N.),-"(��9�574_5288 4360 La Jolla Village Drive Suite 900 _ E-MAO-, . pana.Schwartzm�l1toausa.com ADDRESS,_ QI San Diego, GA 92122 INSURER(S)AFFORDING COVERAGE NAICI wsuRERA: VaNey Forge Insuranc,opany o Cm 20508 INSURED INSURERS:Trarisportation Insurance Company 20494 INSURER Epic Land Solutions INSURER D; 2601 Airport Drive Suite 115 Torrance, CA 90505--"-"-"- INSURER E : --- �— INSURER F : I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY 'THAT THE POLICIES OF INSURANCE LISTED BELOW 14AVE'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, LTg TYPEbPINSURA—NGE A LT37 INMIT POLICYE f POLICY NUMBER ''� MMIDD(Y Y ... PeLlbytX IDO ..............—..—." _ LIMITS A XABILITY �COMGLA ERA1 LIOGCUH EACH OCCURRENCE S 2000,000 MISMApkAL X X 4031022253 i 1010112015 f 10101K016 � oarerlce] a 1000 00MEb TXC,ont Liabl5evPREMISFsffa EXP (A y ens person; S 10,000 Owned Autos �'- PERSONALes A❑V INJURY $ - 2,000,000 AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE_ a G 4,000,00 GENII _.IPOLICY I X� JECT i 1 OG PRODUC IB COMPIOP AEG a 4,000,000 OTHER: 1 )Ded�ucttbl¢ _ S AUTOMOBILE LIABILITY I OaBNEO INNMLIhn S-"_1,000,00 A ANY AUTO -4031022263 10/0112015 101011201E4 BODILY INJURY tPerpamoN S t— __ AL OWNED SCHEDULED AUTOS AUTOS .............. _. I BODILY INJURY P r ecieient} ......� B X NON WINED HIRED AIITpa X AUTOS PROPERWDAMACE Perxcaldente -" A UMBRELLALIAR -- OCCUR EACH OCCURRENCE S 6,000,000 8 Exeses Una _� 60142539H0 1016112015110101 l2016 AGGREGATE s 6,00Q000 OED I X I RETENTION.a Oi a PR AND EMPLOVERSELIA ILII'Y YIN ! 17, ER4 A ANY PROVRIETORIPARTNER,eXECUTIVE 594617867 1010112015 101011201Q EL EACHACCIOENT s 1,000,000 OFFICERIMEMBFR EXCLUDED9 ❑!NIA IMmeldory In NVi F;.L.DISEASE-EAEMPLOYE- S 11000,000 If yes de.rilm onAm- ,DES(RIPTIONOFOP RATIONS balow E. L, OIREASE-POLICY LIMIT _ S 1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AAAItimml Remarks Sahelale, may ba attacbod if Pam space is metulred) Re: All Operations City of Santa AND, its offciers, employaos, agents, volunteers and representativs are Additional Insured's with respect to General Liability per the attached endorsement as required by written contract. Insurance is Primary and Non -Contributory, 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with tiro policy provisions. City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 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 7- ' i-i'1l. _ 401 @ 1988-2044 ACORD ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD reserved EPIC AND SOLUTIONS A 1R'I;5-161 RLtlIErNFD BY r ' f,. / t I-ONICI* HER[UlA (P69 CIF a� CNA Policy Number: 4031022253 613•1,16968-A Named Insured: Epic Land solutions, Ina. (Ed. 01f06) IMPORTANT. THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C„ OF THIS ENDORSEMENT FOR THESE DUTIES, THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS -COMPLETED OPERATIONS COVERAGE BLANKET WAIVER OF SUBROGATION Architects, Engineers and Surveyors This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A, WHO IS AN INSURED (Section C.) of the Businessowners Liability Coverage Form is amended to Include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury." B. The insurance provided to the additional insured is limited as follows: 1. That person or organization Is an additional insured solely for liability due to your negligence speoffieally resulting from "your work" for the additional insured which Is the subject of the written contract or written agreement. No coverage applies to liability resulting from the sole negligence of the additional insured. 2. The Limits of Insurance applicable to the additional insured are those specified In the written contract or writton agreement or In the Declarations of this policy, whichever Is less. These Limits of Insurance are Inclusive of, and not In addition to, the Urnits of Insurance shown in the Declarations. 3, The coverage provided to the additional insured within this endorsement and section titled LIABILITY AND MEDICAL EXPENSE DEFINITIONS — "Insured Contract' (Section F,9,) within the Businessowners Liability Coverage Farm, does not apply to "bodily injury' or "property damage" arising out of the "products -completed operations hazard" unless required by the written contract or written agreement. SS-146068-A (Ed. 01106) 4. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," "personal and advertising Injury" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including: a. The preparing, approving, or falling to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications by any architect, engineer or surveyor performing services on a project of which you serve as construction manager; or b, Inspection, supervision, quality control, engineering or architectural services done by YOU on a project of which you serve as construction manager. 5. This insurance does not apply to "bodily Injury, "property damage," or "personal and advertising Injury" arising out of; a. The construction or demolition work while you are acting as a construction or demolition contractor. This exclusion does not apply to work done for or by you at your premises. C. BUSINESSOWNERS GENERAL LIABILITY CONDITIONS — Duties In The Event of Occurrence, Offense, Claim or Suit (Section E.2.) of the Bushessowners Liability Coverage Form Is amended to add the following: An additional insured under this endorsement will as soon as practicable; 1, Give written notice of an occurrence or an offense to us which may result In a claim or "suit" under this insurance; Page 1 of 2 EPIC LAND SOL.0-1 W, A-2015-161 REVIEVIE.D BY I f ,,r'. ' EUMC'E Ht. d�.plA (PG B pF z11 2. Tender the defense and indemnity of any claim or "suit" to us for a loss we Cover under this coverage Part; 3. Tender the defense and Indemnity of any claim or "suit" to any other Insurer which also has insurance for a loss we cover under this Coverage Part; and 4. ,Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or Indemnity an additional Insured under this endorsement until we receive written notice of a claim or "suit" from the additional Insured. D. OTHER INSURANCE (Section H. 2. & 3.) of the Businessowners Common Policy Conditions are deleted and replaced with the following: 2. This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this Insurance be either primary or primary and noncontributing to the additional insured's own coverage. This insurance is excess over any other insurance to which the additional insured has been added as an additional insured by endorsement. 1 When this insurance Is excess, we will have no duty under Coverages A or B to defend the additional insured against any "suit" if any other insurer has a duty to defend the additional insured SB-•146968•A (Ed. 01106) SB-146966-A (Ed. 01106) against that "suit" If no other insurer defends, we will undertake to do so, but we will be entitled to the additional Insuied'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: (a) The total amount that all such other Insurance would pay for the loss in the absence of this Insurance; and (b) 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. E. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Section K.2.) of the Businessowners Common Policy Conditions Is deleted and replaced with the following: 2. We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery In a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organizabon and included within the "products -completed operations hazard." Page 2 of 2 EPIC LAND F(11 I71 IrJMS A 201f, 161 REVIEWED UY EUNICE 4iFRt Er {, (PG 4 OF 4) "---i EPICLAN-01 MMWATSC CERTIFICATE OF LIABILITY __— INSURANCE NS RANGGDATE {MMInnIYYYYJ 'I tl113/2015_ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Th115 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERBY AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, tho tolicy(les) must be endorsed. If SUBROGATION IS WANED, 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 ,CONTACT ...—' ---- INSURED Oklahoma City PnoNE�-"--��y 'sitY. OK 73118 E-MAen Blvd, #300 ,vc IL Ne, ex(r (405) 523.2100 . '- Epic Land Solutions, Inc. 2601 Airport Or, Suite 116 Torrance, CA 90SO5 COVERAGES CPRTIPIPATr he ...--- _ _ _---..".. "..._"..• Kt,VIW )N NUMBER: S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW FIAVE BEEN ISSUED THIINDICATED. TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITFISTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT I'O WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TI IF INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECFTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR �� _ - TYPE OFINSURANCE IN D _jN POLICYNUMBER {IAMDpIYYYY MMIDD'% LIt11T5_ COMMERCIALEFNERALUAeILIPY -- -- .,.—. -- ` CLAIMS MADE. 0 OCCUR EACH OCCURRENCE -CAMAOETO REN LD'm— $ PR "MISCS(t, SSE,,Mnee $ MEO E%F (MYane lxrr,ans �.g -- —'- PERSONAL k ADV INJURY j E --- OFN'L AGGREGATE LIMIT APPLIES PER: - EENERALAGGRECATE $ POLICY ❑ J[ T PRODUCTS -COMPIGP AEG $ u LOC OT11Eft� '—'-"----- AUTOMOBILE LIABILITY ANyAUTO MGLE LIMIT�"'S NEU --- AUTIODULEDI11R[9 Y (Perparson)AUTOS � NON OWNED Ccdtl Ill $ AU"r06 ' AUTOa A AG MAGLUMBRFLU LAGGREOATE LIAR OCCURRENCEENCESS LIAR CLAIMS1vIADE g DCD ., REIENTIOIJS WDRkERS COMPENSATION ANDEMPLOYERSUADID _ ANY PROPRICTPTNEftEXECUrVF YIN aRU'Aj OrFICE"EMaEXCLUDE p7 NfA EECCIDENT USE (MmPdPry1 HI Id ee under F.I.. CUSEA[A rMrPOLRTOIYEE$S " Ee OSfRIPTION OF OPER_ATION5 below _._ I EL.OISEASF POLICYLIh11T $ A Prafessional E&O H715106625 A Professional E&O H715106626 10101/2016 10/01120T6 per Clalul 2,000,000 IIYOV2015 1010112016 Aggregate 2,000,000 DESCRIPTION OF oPERgTION5ILOCATON5I4ENICLEe ACOR0101, AddlUoPill RCmaihs Schedule may be n_ I�tasbudJnroro spaco is requlrotl) !`PGTIPIC ATP Llnl nrr _ ... _.. _. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa ADD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza (M•21) ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1988 _.___....._..._..._.._ _ Santa Ana, CA 92102 Al1Tt10B2ED REPREGENTATVE '- ^ 01988.2014ACOROCORR0BATInM r..�lxu .eo Leu'I4Iu'U Ibe ACERB name and logo are registered marks of ACORD EPICLAN-01 ROSEM CERTIFICATE OF LIABILITY INSURANCE �••-�`" DATE 1 1013/2016 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(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 certificate holder in lieu of such endorsement(s). PRODUCER License # 0E67768 IOA Insurance Services 4350 La Jolla Village Drive Suite 900 CONTNAME: Dana Schwartz PHONE,AX IC No Ext : (619} 574.6223 50203 AIC, No At DRIE ss: Dana,Schwartz@iaausa.com San Diego, CA 92122 INSURER(S)AFFORDING COVERAGE NAIC q INSURER A: Valley Forge Insurance Company 20508 INSURED INSURER a: Transportation Insurance Company 20494 Epic Land Solutions 2601 Airport Drive Suite 115 INSURER C : American Casualty Company of Reading, Pennsylvania 20427 INSURER D: Underwriters at Lloyd's London IL) 15792 INSURER E : Torrance, CA 9D505 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CER`I'IPY `rHAI" 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 INSURANCE A SO R WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY E MM/DD(YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 2,000,000 X CLAIMS -MADE OCCUR K 4031022263 10/0112016 10101l2017 PREMISES Ea occurrence $ 1,000,000 X MED EXP (Any one person) $ 10,000 Cont Liab/Sev of Int PERSONAL & ADV INJURY $ 2,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 GEML POLICY ❑X JECT LOC PRODUCTS •COMPtOPAGG $ 4,000,000 $ 0 OTHER: I IDeductible AUTOMOBILE LIABILITY NED NGLE LIMIT COEa acM8cWantI $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO 4031022253 1010112016 10/01/2017 X X ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS N AUTOS Autos' Owned BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 6,000,000 AGGREGATE $ 6,000,00 B EXCESS LIAR CLAIMS -MADE 6014253989 10101/2016 1010112017 DED I X I RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNCR/EXECUTIVC ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 594617867 10/0112016 10/01/2017 X PER OT STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE • EA EMPLOYE $ 1,000,000 If Yes, describe under DESCRIPTION OF OPERATIONS below E,L. DISEASE -POLICY LIMIT $ 1,000,000 D Prof LiablClms Made PGIARK06632-00 1010112016 10/0112017 Per Claim 3,000,000 D Ded.: $25k Per Claim PGIARK06632-00 10101/2016 10/0112017 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached If more space Is required) Re: All Operations City of Santa Ana, its offciers, employees, agents, volunteers and representativs are Additional Insureds with respect to General Liability per the attached endorsement as required by written contract. Insurance is Primary and Non -Contributory. 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions. REVit-VVEt7 EiY EUNiC E HEREDIA (PG 6 OF ) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza (M-21) P.O. Box 1988 _T_ IJ 1 ©t� Santa Ann, CA 92702 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CrAfA Policy Number: 4031022253 Named Insured: Epic Land Solutions, Inc. SB-146968-A (Ed. 0 1 /06) IMPORTANT: T141S ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C., OF THIS ENDORSEMENT FOR THESE DUTIES, THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS -COMPLETED OPERATIONS COVERAGE BLANKET WAIVER OF SUBROGATION Architects, Engineers and Surveyors This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A. WHO 13 AN INSURED (Section C.) of the 4. Businessowners Liability Coverage Form is amended to include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement-, but the written contract or written agreement must be: 1. Currently In effect or becoming effective during the term of this policy: and 2. Executed prior to the "bodily injury," "property damage," or 'personal and advertising injury," B. The insurance provided to the additional insured is limited as follows: 1. That person or organization is an additional insured solely for liability due to your negligence specifically resulting from "your work" for the additional Insured which Is the subject of the written contract or written agreement. No coverage applies to liability resulting from the sole negligence of the additional insured. 2. The Limits of Insurance applicable to the additional insured are those specified In the written contract or written agreement or in the Declarations or this policy, whichever is less, These Limits of Insurance are Inclusive of, and not C. in addition to, the Limits of Insurance shown In the Declarations. 3. The coverage provided to the additional insured within this endorsement and section titled LIABILITY AND MEDICAL EXPENSE DEFINITIONS — "Insured Contract" (Section F,9,) within the Businessowners Liability Coverage Form, does not apply to "bodily injury" or "property damage" arising out of the "products -completed operations hazard" unless required by the written contract or written agreement, SB-146968-A (Ed. 01106) The Insurance provided to the additional insured does not apply to "bodily Injury," "property damage," "personal and advertising injury" arising out of an architects, engineer's, or surveyor's rendering of or failure to render any professional services including: a. The preparing, approving, or falling to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications by any architect, engineer or surveyor performing services on a project of which you serve as construction manager; or b. Inspection, supervision, quality control, engineering or architectural services done by you on a project of which you serve as construction manager. This insurance does not apply to "bodily Injury," "property damage," or "personal and advertising Injury" arising out of, a. The construction or demolition work while you are acting as a construction or demolition contractor. This exclusion does not apply to work done for or by you at your premises, BUSINESSOWNERS GENERAL LIABILITY CONDITIONS — Duties In The Event of Occurrence, Offense, Claim or Suit (Section E.2.) of the Businessowners Liability Coverage Form Is amended to add the following: An additional insured under this endorsement will as soon as practicable: 1. Give written notice of an occurrence or an offense to us which may result in a claim or "suit" under this insurance; Page I of 2 EIINICEHEREDIA(PC .tar 2, Tender the defense and indemnity ofany claim m �uit" to us for o loss we :over under this Coverage Part; 3. Tender the defense and indemnity "suit" to any other insurer which also has insurance for loss we cover under this Coverage Part; and 4. Agree to make available any other insurance which the additional insured has form loss we cover under this Coverage Part. We have no duty to defend or ]ndemnlfy an additional insured under this endorsement until we receive written notice of o claim or 'suit" from the additional insured. OTHER INSURANCE (Section H. 2. &3.) of the 8uoinomoo*nam Common Policy Conditions are deleted and replaced with the following: 2. This insurance |eexcess over any other insurance naming the additional Insured as an insured whether pdmmry, oxoasa, contingent or on any other basis un|auo o written contract or written agreement specifically requires that this {nuumn^a baeither primary orprimary and noncontributing to the additional |nmumd's own omvonsQo. This ioaumnoo Is excess over any other insurance to which the additional Insured has been added as anadditional insured byendorsement. 3. When this Insurance Is excess, wwill have no duty under Coverages A or B todefend the additional Insured against any "suit" |[ any other insurer has aduty h`defend the additional Insured SB-146968-A SB-148988-A against that "suit" Ifnoother insurer defends, wm will undertake ¢`do so, but we will be anU8od to the additional |noumdt rights mAm|omd all those other insurers. When this Insurance Is excess over other hmuramm, we will pay only our share of the amount of the |000, if any, that exceeds the sum of: (a) The total amount that all such Other insurance would pay for the |ooa in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other Insurance. Newill share the remaining loss, If any, with any other insurance that Is not described In this Excess |naummxa provision and was not bought mpeo|fiom||y to apply in excess of the Limits of |naormnm: shown in the Dan|orwtionm of this Coverage Part. E. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US of the Bua|nwamownomCommuo Policy Conditions isdeleted and replaced with the following: 2. We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery In a written contract or agreement because of payments we make for Injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included within the "prod ucts-com plated operations hazard," Page 2d2 EPICLAN-01 MCGRAWM ,4CORn CERTIFICATE OF LIABILITY INSURANCE DATE(M 9/29/201YYY) 2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 License # OE67768 CONTACT Dana Schwartz NAME: IOA Insurance Services PHONE FAX 4370 La Jolla Village Drive (A/C, No, Ext): (619) 574-6223 50203 (A/C, No):(619) 574-6288 Suite 600 E-MAIL ADDRESS: Dana.Schwartz@ioausa.com San Diego, CA 92122 ,. INSURER(S) AFFORDING COVERAGE NAIC # INSURED Epic Land Solutions 2601 Airport Drive Suite 115 Torrance, CA 90505 INSURERA-.:Valley. Forge Insurance Company INSURER B: Transportation Insurance Compan 120494 INSURER C :_Underwriters at Lloyd's London (KY) -_ 32727 INSURER D : I INSURER F : rn%1PDAMP4 !`CDTICIf'ATF pit IMRGD- DC\/I421AKl Kit n1AD1=0. 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. INS - ADDLSUBR: ..POLICY - POLICY EFF -.f POLICY EXP -- - TYPE OF INSURANCE NUMBER LTR D WVD MM D Y LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 __ CLAIMS MADE X ', OCCUR �14031022253 X 10/01/2017 �1 DAMAGE TO RENTED 10/011201$ pRE.MISEs (Ea_occurrence) ... $ 1,000,000 -- X Cont Liab/Sev of Int 10,000 MED EXP (Any one person) _ $ PERSONAL & ADV INJURY $ 2+000+000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4+000+000 POLICY X PEO LOC PRODUCTS - COMP/OP 4,000,000GG 'i OTHER: Deductible $ 0 A OMOBILE LIABILITY AUTacci COMBINED SINGLE LIMIT 1,060,000 ANY AUTO 14031022253 10/01/2017 10/0112018 BODILY INJURY,(Perperson) $ OWNS SCHEDULED AUTOONLY AUTOS, BODILY INJURY (Per accident) $ p oyy X AUTOS ONLY X..' AUTOS ONt � (Per accitlent�AMAGE $ XNo Co. Owned Autos .. $ B X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 6,000,000 EXCESS LIAB CLAIMS -MADE' 6014253989 j _ 10/01/2017 10/01/2018 AGGREGATE _„ _. $ 6,000,000 DED X RETENTION $ $ A i WORKERS COMPENSATION'S X,..STATUTE AND EMPLOYERS' LIABILITY Y/N 594617867 ' '. ERH 10/01/2017 10/011201$ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE i OFFICEOPRIET R/PARTNER/E NIA, E.L. EACH ACCIDENT $ (Mandatory in NH) ',� E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,OOU C Prof Liab/Clms Made PGIARK06632-01 10/01/2017 10/01/2018 Per Claim 3,000,000 C Ded.: $25k Per Claim !PGIARK06632-01 10/01/2017 10/01/2018 ',Aggregate 4,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations City of Santa Ana, its oficiers, employees, agents, volunteers and representativs are Additional Insureds with respect to General Liability per the attached endorsement as required by written contract. Insurance is Primary and Non -Contributory. 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions. �. RFVL WE:D BY: Il UNIf E HEREDIA (FG OF y) 1 C r1ULUC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza (M-36) (( ' + _ ` P.O. Box 1988 �` l � ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: 4031022253 �'� Named Insured: Epic Land Solutions, Inc. SB-146968-A (Ed. 01 /06) IMPORTANT. THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C., OF THIS ENDORSEMENT FOR THESE DUTIES. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS -COMPLETED OPERATIONS COVER -AGE BLANKET WAIVER OF SUBROGATION Architects, Engineers and Surveyors This endorsement modifies insurance provided under the following; BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A. WHO IS AN INSURED (Section C.) of the 4. Businessowners Liability Coverage Form is amended to include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be; 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury," B. The insurance provided to the additional insured is limited as follows: 1. That person or organization is an additional insured solely for liability due to your negligence specifically resulting from "your work" for the additional insured which is the subject of the 5 written contract or written agreement. No coverage applies to liability resulting from the sole negligence of the additional insured. The Limits of Insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy, whichever is less. These Limits of Insurance are inclusive of, and not C in addition to, the Limits of Insurance shown in the Declarations. 3, The coverage provided to the additional insured within this endorsement and section titled LIABILITY AND MEDICAL EXPENSE DEFINITIONS — "Insured Contract" (Section F.9.) within the Businessowners Liability Coverage Form, does not apply to "bodily injury" or "property damage" arising out of the "products -completed operations hazard" unless required by the written contract or written agreement. SB-146968-A (Ed. 01 /06) The insurance provided to the additional insured does not apply to "bodily injury," "property damage," "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications by any architect, engineer or surveyor performing services on a project of which you serve as construction manager; or b. Inspection, supervision, quality control, engineering or architectural services done by you on a project of which you serve as construction manager. This insurance does not apply to "bodily injury," "property damage," or "personal and advertising injury" arising out of: a. The construction or demolition work while you are acting as a construction or demolition contractor. This exclusion does not apply to work done for or by you at your premises. BUSINESSOWNERS GENERAL LIABILITY CONDITIONS — Duties In The Event of Occurrence, Offense, Claim or Suit (Section E.2.) of the Businessowners Liability Coverage Form is amended to add the following: An additional insured under this endorsement will as soon as practicable: 1. Give written notice of an occurrence or an offense to us which may result in a claim or "suit" under this insurance; Page 1 of 2 (nREVIE�F_ r34 __ EUNICE HEREDIA (PG .OF 2. Tender the defense and indemnity of any claim oi- 1, suit" to us for a loss we cover under this Coverage Part; 3. Tender the defense and indemnity of any claim or "suit" to any other insurer which also has insurance for a loss we cover under this Coverage Part; and 4, Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or "suit" from the additional insured. OTHER INSURANCE (Section H. 2. & 3.) of the Businessowners Common Policy Conditions are deleted and replaced with the following: 2. This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing to the additional insured's own coverage. This insurance is excess over any other insurance to which the additional insured has been added as an additional insured by endorsement. 3. When this insurance Is excess, we will have no duty under Coverages A or B to defend the additional insured against any "suit" If any other insurer has a duty to defend the additional insured SB-146968-A (Ed.01/06) SB-146968-A (Ed. 01/06) against that "suit" If no other insurer defends, we will undertake to do so, but we will be entitled to the additional 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: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) 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, E. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Section K.2.) of the Businessowners Common Policy Conditions is deleted and replaced with the following: 2. We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included within the "products -completed operations hazard." Page 2 of 2 EUNIC.E HEREDIA rG/)C)r )