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HomeMy WebLinkAboutRINCON CONSULTANTS, INC. 4A -2015INQ,U8ANCr, ON f II.Ei ORK MAY PROCEED U TIL INSURRAN E EXPIRESXCLERKOF /NCIL.-.�.------ DATE: 1✓644 FIRST AMENDMENT TO AGREEMENT FOR PROVISION OF ENVIRONMENTAL CONSULTANT SERVICES THIS FIRST AMENDMENT TO AGREEMENT is made and entered into this 15th day of December, 2015, by and between Rincon Consultants, Inc., a California corporation (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). RECITALS A-2015-302 A. City and Consultant entered into Agreement No. N-2014-020, dated January 1, 2014, for a consultant having special skill and knowledge in the field of environmental consulting services ("said Agreement"). B. In accordance with the terms and conditions of said Agreement, the Parties desire to add additional funds to said Agreement to ensure sufficient funding is available to move forward with current and upcoming projects. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions of said Agreement, except as herein modified, the parties agree as follows: 1. Section 4, COMPENSATION, shall be amended to increase the compensation by an additional $65,000.00 such that the total sum to be expended under said Agreement shall riot. exceed $90,000.00 during the term of said Agreement. The compensation shall continue to be based upon the rates and charges identified in Consultant's Fee Schedule attached to said Agreement. 2.. Except as hereinabove modified, all terrns and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Agreement the date and year first above written. ATTEST: MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attqney, a By: - - Ryan mey RECOMMPKIDED FOR APPROVAL KELLY RE E ERS Executive Director - CDA 2 CITY OF SANTA ANA DAVID CAVAZOS City Manager RINCON CONSULTANTS, INC. ��- dseph P. Power Vice President ® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDl1'YYY) 12/15/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Tolman & Wiker Insurance Services LLC #OE52073 196 S. Fir Street PO BOX 1388 Ventura CA 93002-1388 CONTACT Pam Ayerle AIMS PHONE o. Exl (BD5)585-6737 FAX No: (805)585-6837 -MAIL payerle@tolmanandwiker. com INSUREI AFFORDING COVERAGE NAICIf INSURER A:Travelers Prop Cas Co of Amer 025674 INSURED Rincon Consultants Inc. 180 N. Ashwood Ave. Ventura CA 93003 INSURERB:State Compensation Ins Fund 35076 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:15/16 AU/WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF POLICY EXP DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE 11 OCCUR DAMAGE TO RENTED PREMISES Eaoccurrence$ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ GEN'L POLICY E PRO- JECT D LOC PRODUCTS-COMP/OP AGO $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ A JX ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BA -50112538 -15 -CAG 12/17/2015 12/17/2016 BODILY INJURY (Per accident) $ PRO PERT Y DAMAGE $ Per accident) NON -OWNED HIREDAUTOS AUTOS _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE OEO RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A I STATUTE ERH B ANY PROFRIETC)WPARTNFF(IEXEOII;;VE rIYIN OFFICEWMEMBER EXCLUDED? J (Mandatory In NH) NIA 9086946-2015 2/1/2015 2/1/2016 E.L. EACH ACC HENT $ 1,000,000 E.L. DISEASE -EA EMPLOYE $ 1,000,000 E.L.DISEASE- POLICY LIMIT $ 1,000 000 DIf yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTO: Certificate Holder is Additional Insured as respects to operations of the Named Insured per form CAT4740215 which applies only as required by written contract during the policy term. t O; City of Santa Ana Housing and Neighborhood Development Department PO Bax 1988 M-26 Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE David Shore/PAMELA (c)1988-2014 ACORD CORPORATION. All riahts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II. 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an addi- tional insured person or organization is the first named insured when the written contract or agreement between you and that person or or- ganization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy pe- riod, requires this insurance to be primary and non-contributory. a DSS`a- CA T4 74 02 15 © 2015 The Travelers Indemnity Company. All rights reserved, Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. RINCCON•01 MANAWILM AC't3h'CX CERTIFICATE OF LIABILITY INSURANCE �-^""• OA11118/2014Y} 11/18/2014 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 .INSURE C7,.the peilcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER License # OE67788�NAMTI Legends Environmental Ins. Services 110 Vantis, Suite 250 Aliso Vlajo, CA 82695 r Ryan Jac: Los PHONE' gyp,,<a;(800)992.6999 �Ai No: 800 909.3957 Aoogsss: Ryan.Jacquesaloausa.com INSURERIS)AFPORDING COVERAGE NAIO # INsuRERA:Crum&Forster SpecialtylnsuranoaCompany 44520 INSURED Y INSURERa: 5 3,000,000 INSVNARC: CMS�MADE OX OCCUR LPI Macon Consultants, Inc. _ INSURER D: EPKAD5307 210 N Ashwood Ave Ventura, CA 93033 _ INSURERS: 8 50,040 INSURER P': X Pollution Liability 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 THEPOLICY 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 SUBJECTTO ALL THE TERMS,, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN. MAY HAVE BEEN REDUCED BY PAID CLAIMS. I SR T TYPEOFINaURANCE "-TN SBIVO POLICYNUMSER MMO bO� MMI�O Y _ Umn's A X COMMEnCS498{tE-Rfc4LUMNL#i'Y y. EACH OCCURRENCE 5 3,000,000 CMS�MADE OX OCCUR LPI X EPKAD5307 09/22/2014 -091224:edtfi' PRE I•Es E�aLap> 8 50,040 X Pollution Liability Aca MED EXPIAeyooepereun) 5 10,000 y. Tran5pO1'tat{On Pol.` t PERSONAL &ADV INJURY $ _ 3,000,000 u GEML AGGREGATE LIMIT APPLIES PER: _ GENERAL. AGGREGATE ® 4000,000 X POLICY PRO LOG ECT PRODUCTS-COMP/OPAGG § 40DO,000 _ OlHeRl Trans . PoIL'I 5 1,000,000 -AVTOMOBILe LIAaltn'Y co Ds1NGLE MI BODILY INJURY (Pee pnrsan) S ANY AUTO AALL UTOS OWNED AUTOS SCHEDULED 00011YINJURY(Per acciden) $ PR EATYDAMvGG' NONLOWNcD HIRED AUIDs AUTOS a UMBRELLA LIAR X OCCUR -... EAGIf_OGCURRENCE 5. 9,000,000 4,,,REGATE S 5,000,00 A X EXCESS LAE CLAIMS -MADE X �EFX,101817 0972212014 �OSI22W15` ED X RETENTION• 10,000 _ WORT ERS COMPENSATION EE AND EMPCOYERB' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERAGeMBER EXCLUDED? NIA E.L.EACHACCIOEAH $ -- (MaudatorylnNH} EL. IXSEASE-EA EMPLOYE $. If yes, descdtie ondal DE SCRIPTION OF OPERATIONS below ,�. ..... E.L. DISEASE -POLICY LIMIT .$ A Professional Llab.* EPK-105357 09/2212014.'09122/201fi Included in Above GL BE$CRIPTION OF OPERATIONS I LOCATIONS I VEHICLE$ (ACORD 101, Addulonal Remarks Schedule, may Be attached if more space Is required) -The City of Santa Ana, its officers, employees, agents and volunteers are included Be additional Insureds with regard to liabli ty and defense of suits arising from work performed by or behalf of the named insured. General Liability is Primary and Nan -Contributory. 30 days notice of cancellation except for 10 days for non-payment of premium. AX CERTIFICATE HOLDER CANCELLATCON O 1988.2014 ACERB CORPORATION. All rights. reserved. ACORD 25 (2014/01) Tho ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE. DESCRIBED POLICIES BE CANCEI.LED BEFORE THE. EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE. POLICY PROVISIONS.- AUTHORIZED REPRESENTATIVE City of Santa Ana 20 Civic Center Plaza _.. _ISUIptut Ana CA 92702 I O 1988.2014 ACERB CORPORATION. All rights. reserved. ACORD 25 (2014/01) Tho ACORD name and logo are registered marks of ACORD POLICY NUMBER: EPK-105397 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organiza- tion s Locations Of Covered 0 erations Any person or organization when you have agreed in writing in a contract or agreement that such person or organization be added as an Additional Insured. here specified by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. Section II — Who Is An Insured is amended to include as an additional insured the persons) or organization(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, 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 OO ISO Properties, Inc., 2004 Page 1 of 1 El POLICY NUMBER: EPK-105397 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organiza• Location And Description Of Completed tions Operations Any person or organization when you have agreed in writing in a contract or agreement that such person or organization be added as an Additional Insured for Completed Opera Information required to complete this Schedule, If not shown above, will be shown in the Declarations, Section It — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional Insured and Included in the "products - completed operations hazard". CG 20 37 07 04 Q ISO Properties, Inc., 2004 Page 9 of 1 13 EPK-105347 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, PRIMARY NON CONTRIBUTORY INSURANCE ENDORSEMENT FOR SPECIFIED PROJECT This Endorsement shall not serve to Increase our limits of insurance, as described in SECTION III - LIMITS OF INSURANCE. In consideration of the payment of premiums, it is hereby agreed as follows. Solely with respect to the specified project listed below and subject to all terms, conditions and exclusions of the policy, this insurance shall be censidere4-prjmary to the Additional Insured listed below if other valid and collectible insurance is available to the Additional Insured for a loss we cover for the Additional Insured under COVERAGE A. It is also agreed that any other insurance maintained by the additional Insured shall benon'-contributory. Additional insureds Specified Project Any person or organization when you have agreed in writing in a contract or agreement that such person or organization be added as an Additional Insured on a rima and non contributory basis. Where specified_ by written contract. All other terms, conditions and exclusions under the policy are applicable to this Endorsement and remain unchanged. 01 036 10 13 Includes copyrighted material of American Safety Indemnity Company with Page 1 of 1. its permission Copyright@2004 American Safety Indemnity Company EPK-105397 COMMON POLICY CONDITIONS All Coverage Parts Included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or deliv- ering to us advance written notice of cancella- tion. 2. We may cancel this policy by mailing or deliver - Ing to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of premi- um; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mall or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and rec- ords as they relate to this policy at anytime during the policy period and up to throe years afterward. D, Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; IL 00 17 1198 b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1, and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations, 4. Paragraph 2. of this condition does not apply to any Inspections, surveys, reports or reccm- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E, Premiums The frst Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in- sured. 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 repre- sentative. Until your legal representative is ap- pointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 ❑ .� A►" r�hP CERTIFICATE OF LIABILITY INSURANCE DATE (MMCDDfYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 1/26%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 INSURER(S), 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 CONTACT Pam A erle AIMS NAME: PHO�AICNNO Ext�(805)585-6737 AIC No): (SOS)SOS-5837 Tolman & W11Cer Insurance Services LLC #0E52073 E-MAIL a*�eileti71lt4clrka)7{w]�1 er. CCfffi ADDRESS: 196 S. Fir Street Piz Box 1388 INSURER(S) AFFORDING COVERAGE MAIC # Ventura CA 93002-1388 _......-...... _ ........ ............ -- -- - INSURER A: Travelers Prop Cas Co of Amer 025679.__...... ....... INSURED INSURERB;TOrUs National Ins Co25496 INSURER C Rineon Consultants Inc. INSURER D: INSURER E : 180 N. Ashwood Ave. INSURER F: Ventura CA 93003 J COVFRAGFS CERTIFICATE NUMBER:15/16 AU/WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITION'S OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ... ........ - ILTR ADDL SUER PdLICIf EFF POLICY EXP TYPE OF INSURANCE....... POLICY NUMBER MMIDD LIMITS PO Bax 1988 M-26 COMMERCIAL GENERAL LIABILITY AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 EACH OCCURRENCE. j $ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES IEa occurrence) $ MED EXP (Any one person) 1 $ _ PERSONAL. & ADV INJURY $.. .._... ............. _ GENT AGGREGATE AGGREGATE LIMIT APPLIES PER: ...... ...._.._ GENERAL AGGREGATE $ POLICY LOC 'PRODUCTS - CO ACG, -d $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMCT Ea accident)$ 1, 000, 000 ANY AUTO BODILY INJURY (Per person) 5.... A ALL OWNED SCHEDULED AUTOS BA,-SG112538-15-CAG 12/17/2015 12/17/2016 ..,_.,_,._._ BODILY INJURY (Per accident) $ AUTOS — NON -OWNED ...._...- _ PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per_accu,_dant UMBRELLA LIAR OCCUR E,hCH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DEO RETENTIONS $ WORKERS COMPENSATION,... PER OTH X STATUTE_ ER.- AND EMPLOYERS' LIABILITY Y I N ANY PROPRIET7RIPARTNERIEXECUTIVE E.L. EACH A 1,000,000 B (Mandatory in NH) NIA A x10160329 2/1/2016 2/1/2017 . .,__ .. E . DISEASE- EA EMPLOYEE !I yes, describe under...— DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMf`I $ 1 000 OU0 DESCRIPTION OF OPERATIONS P LOCATIONS I VEHICLES IACORD 101., Additional Remarks Schedule, may be attached If more space Is required) AUTO: Certificate Molder is Additional Insured as respects to operations of the Named Insured per form CAT4740215 which applies only as required by written contract during the policy term. n-neco14-e�AIrTr ` o �5= CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101) IN S025 (201401) 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana Housing THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN and Neighborhood Development Department ACCORDANCE WITH THE POLICY PROVISIONS. PO Bax 1988 M-26 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 David Shore/PAMELA ACORD 25 (2014101) IN S025 (201401) 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RINCON CONSULTANTS CA. STATE LICENSE : 904732 CONTRACTOR'S LICENSEIS (COPY OF LICENSE) CERTIFICATE OF GENERAL LIABILITY INSURANCE W%CITY ADDITIONAL INSURED ENDORSEMENT WORKERSCERTIFICATE OF COMPENSATION INSURANCE AUTOMOBILE LIABILITY INSURANCE CITY OF SANTA ANA BUSINESS LICENSE RINOCON-01PHILI C -EY, - ERTIFICATE OF LIABILITY INSURANCE �.. --;ATM',-DNYYJ 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 pofty(les) 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 endorsemermYsi. PRODUCER License # OE67768 C TACT Elizabeth Leach Liaends Environmental Ins. Services 130 Vantin PHONE JA#c, No. exit: (949) 297.5537 52011 Nol,(949) 297 -5960 Suite 250E MA JM-f'kS.L Eliza —beth - Leach QL0a Aliso Viejo, CA 92656 —Usa-Com INSURER A. Crum & Forster eClalty Insurance Coapn)L INSURED I Trumbull Insurance �27120 Rincon Consultants, Inc. 210 N Ashwood Ave INSURER c:AtairStone National lnsqLance C�omPL3!2y— 25496 Ventura, CA 93033 IN S2RER D; [--- !�QIF 4,000,000 INSURPR 15 F �7, POLICY Lo ry Contractors PoiJon L�iabffln� :111:�:IR�R F COVERAGES CERTIFICATE NIJMRFR- cc flive-11,1 1,11 ImAra— THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTW'CHSTANDiNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHERDOCUMIHNTWITH 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. MISR, ADDLISUBR POLICY NUMBER POLICY EFFJ "'POLICY EXP LIMITS -Lig_TYPEOFINSURANCE A X COMMERCIAL GENERAL WABILiry -IMM1QDN`YYYI a4MLQP=.I CCURHtEN E 3,000,000 CLAIMS -MACE '7X OCCUR X X EPKI14165 0912 7J2016 09122J2018 DAMAG= TO RENTED 'REW'$-E 50,000 X Transporation Poll, %IFO FXP [Anv or, 10000 s �OY.It, LAIRY -S 3,000,000 GEN't- AGGREOATE� UNItT APPLIES PER, -I !�QIF 4,000,000 F �7, POLICY Lo ry Contractors PoiJon L�iabffln� ��AL,��LQRE.r 4,000,000 I A I OHER ,Deductible 2,500 �±YTOMOSKE LIABILInY1,000000 CFOMINED *SINGLE LANT X i ANY AUTO x x 172UUNPT4318 12/1712016 12/117=17' FOOILY INJURY CAINECAINE D SCHEDULED ALTO$ HRI�D x N AUT US ONLY -!2�1 061 'Cj N4� Eqn9cail Dad A_. UMBRELLA LIAB 1 x � OCCUR X EXCESS LIAB —JC L S MACE 1 06084 109/2Z2016 0912212017 �ctiEFX1 s 51 00,000 5,000,000 AGGREGATE CEO I X I REI-ENTIONS C WORKERS COMPENSATION X SPTARTU7E OTH.- AND EMPLOYER$'LIASILITY YIN ANY PRCPR1ETOR,PARTNERiEXFCUTIVE F-1 x T10170329 0210112017 02JO112018 �AL. EA FI IDENT — 3 1,000,000 ,,-rll� a F�'rJ Eke, L 1 R e n NIA L ", E.L. DISEASE EA EMPLO 110030,01060 YYA�fp des urder F 1-. DISEASE - POLICY LIMIT S 1,000,000: ona SCJRIPTICNC�.SPR RATICNS below A (Professional Liab.* i EPK,114155 0912212016 Ul—212018 Per Claim 3,000,000, A iPmfiessional Liab,* IEPI(114155 0912212016; 0912212018 Aggregate 4,000,000 . . .......... DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES JACORD 101. Additional Remarks Schedule. may be AftAched H inure space Is required) Liability and Transportation Pollution are written on a Claims Made basis. When required by written contract, the General Liability and Pollution (*Professional Liability Limits are on a Per Project basis while dedicated; the Professional Liability is on a Per Policy basis. The City of Santa Ana and Community Development Agency, 20 Civic Center Plaza, M-26 Santa Ana, CA 92702, their officers, employees, agents and volunteers are Included as additional insureds for General Liability and Auto Liability with respect to work performed for them by the Named Insured as, required by written contract, per Blanket Additional Insured endorsement CO20100704, 0020370704 & HA99160312. Liability Coverage Is Primary and Non - Contributory as required by written contract, per endorsement CFENV 01 036 10 13 & HA99160312. Blanket Waiver of Subrogation applies to General Liability, SEE ATTACHED ACORD 101 SHOULD ANY OF THE AE30VE DESCRIBE[) POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE City of Santa Ana 20 Civic Center Plaza, M-26 ACORD 26 (2016103) (D 1988-2015 ACORD CORPORATION, All rights reserved, The ACORD name and logo are registered marks of ACORD ',A AGENCY CUSTOMER ID: RINCCON-01 PHILLIPSC LOC ACC)RD ADDITIONAL REMARKS SCHEDULE Page 1 of I AGENCY License # OF -677681 NAMED INSURED Legends Environmental Ins, Services Rincon Consultants, Inc. .____,j210NAshwoodAv POLICY NUMBER Ventura, CA 93033 SEE PAGE I CARRIERNAIC CODE SEE PAGE I iSEE P 1 EPFECTIVE DATEa SEE PAGE 1.__ ALIUMU - NALKLMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: -AC-ORD 25 FORM TITLE: CertificateofLlabilty-lns.yrap.ce Description of Operations/Locations/Vehicles: Auto Liability and Workers Compensation as required by written contract, per Endorsement CG 24 04 10 93, HA99160312 WC000313. Excess policy follows General Liability, Auto Liability and Employers Liablility form. I t4wWD'u I I i9;eUU8 Ak;VKL) k;UKPQRA I'ION, All rights reserved, The ACORD name and logo are registered marks of ACORD POLICY ##: EPK114155 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following; Name of Additional Person(s) or Organ iiati on Location And Description Of Completed Operations Where Required by Written Contract. Where Required by Written Contract, Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. Section Ill — Who Is An Insured within the Common Provisions is amended to include as an insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". EN0320-0211 Page 1 of 1 POLICY #: EPKI 14155 III WROM � 11 V ! II��I I IIII, I'll Pill, 1111, 111 111 Il' 1�i ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: �Pn Name Of Additional Insured Person(s) Or Orqanizationsj: Location(s) of Covered 02erations Where Required by Written Contract, Where Required by Written Contract. Information reguired to complete this Schedule if not shown above, will be shown in the Declarations. A. Section 1111111 — Who Is An Insured within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", '`property damage" or "personal and advertising injury" cause, in whole or in part, by: 1. Your acts or omissions-, or 2'. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 3. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insureds) at the location of the covered operations has been completed; or 4. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. EN0321-0211 Page 1 of 1 HA 99 16 03 12 Ir 111 I� �! Kil 111111111 I� k IN -'r T1110 ENDORSEMEUT This endorsement modifies insurance provided under the following: To the extent that the provisions of this endorsement provide broader benefits to the "'insured" than other provisions of the Coverage Form, the provisions of this endorsement apply, 1. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations The Named Insured shown in the Declarations is amended to include: (1) Any legal business entity other than a partnership or joint venture, formed as a subsidiary in which you have an ownership interest of more than 50% on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership or joint venture, (b) That is an "insured" under any other policy, (c) That has exhausted its Limit of Insurance under any other policy, or (d) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization B. Employees as Insureds Paragraph A.I. - WHO IS AN INSURED - of SECTION 11 - LIABILITY COVERAGE is amended to add: d. Any "employee" of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A. 1, - WHO IS AN INSURED - of Section 11 - Liability Coverage is amended to add: e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor and (2) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered ",auto"' you hire. D. Additional Insured If Required by Contract (1) Paragraph A.1. - WHO IS AN INSURED - of Section 11 - Liability Coverage is amended to add: f. When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured", but only to the extent such person or organization is liable for ""bodily injury" or "property damage" caused by the conduct of an "Insured" under paragraphs a. or b, of Who Is An Insured with regard to the ownership, maintenance or use of a covered "auto." @ 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 of ISO Properties, Inc., with its permission) Page I of 5 The insurance afforded to any such additional insured applies only if the "bodily injury" or "property damage'° occurs: (1) During the policy period, and (2) Subsequent to the execution of such written contract, and (3) Prior to the expiration of the period of time that the written contract requires such insurance be provided to the additional insured, (2) How Limits Apply If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the most we will pay on behalf of such additional insured is the lesser, of: (a) The limits of insurance specified in the written contract or written agreement; or (b) The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. (3) Additional Insureds Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this insurance is primary and non- contributory with the additional insured's own insurance, (4) Duties in The Event Of Accident, Claim, Suit or Loss If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the additional insured shall be required to comply with the provisions in LOSS CONDITIONS 2. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM , SUIT OR LOSS — OF SECTION IV -- BUSINESS BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. E. Primary and Non-Co6tributory if Required by Contract Only with respect to insurance provided to an additional insured in 1.D, - Additional Insured if Required by Contract, the following provisions apply: (3) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Other Insurance 5,d. (4) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (3) and (4) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this Insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sura of. (1) The total amount that all such other insurance Would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance, We will share the remaining loss, if any, by the method described in Other Insurance 5.d. 2. AUTOS RENTED BY EMPLOYEES Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire. The OTHER INSURANCE Condition is amended by adding the following: @ 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 of ISO Properties, Inc,, with its permission.) Page 2 of 5 If an "employee's" personal insurance also applies on an excess basis, to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. 3. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5, - FELLOW EMPLOYEE - of SECTION 11 - LIABILITY COVERAGE does not apply if you have workers' compensation insurance in -force covering all of your "'employees". Coverage is excess over any other collectible insurance. 4. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any '"auto" you own, then the Physical Damage Coverages provided are extended to "'autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired ,.auto" is: IMEEM (2) The actual cash value of the damaged or stolen property at the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own, We will also cover loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident". This extension of coverage does not apply to any "auto" you hire or borrow from any of your "'employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households, 5, PHYSICAL DAMAGE ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1,000. Under SECTION III - PHYSICAL DAMAGE COVERAGE, in the event of a total "ioss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the loan/lease, "Outstanding balance" means the amount you owe on the loan/lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and teat charges; lease termination fees; security deposits not returned by the lessor; costs for extended warranties, credit life Insurance, health, accident or disability insurance purchased with the loan or lease; and carry-over balances from previous loans or leases. 7, AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE, the foilowing is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag, 8. ELECTRONIC EQUIPMENT - BROADENED COVERAGE a. The exceptions to Paragraphs BA - EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE are replaced by the following: Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that, at the time of "loss", is: (1) Permanently installed in or upon the covered "auto"; (2) Removable from a housing unit which is Permanently installed in or upon the covered "auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above; or C 2011, The Hartford (Inciudes copyrighted material Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 3 of 5 (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered auto's" operating system, b. Section III — Version CA 00 01 03 10 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C,2 and Version CA 00 01 10 01 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C are each amended to add the following: $1,500 is the most we will pay for "loss" in any one "accident" to all electronic equipment (other than equipment designed solely for the reproduction of sound, and accessories used with such equipment) that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is: (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently installed housing unit as described in Paragraph 2,a. above or is an integral part of that equipment; or (3) An integral part of such equipment, c, For each covered "auto", should loss be limited to electronic equipment only, our abiigation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 9. EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A. - COVERAGE - of SECTION III - PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 10. GLASS REPAIR -'WAIVED OF DEDUCTIBLE Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 11. TWO OR MORE DEDUCTIBLES Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group, Inc, company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident", the following applies: (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Buslness Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT,CLAIM, SUIT OR LOSS - of SECTION IV - BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the Inception date of your policy, we will not deny coverage under this Coverage Form because of such failure, 14. HIRED AUTO - COVERAGE TERRITORY Paragraph e, of GENERAL CONDITIONS 7. - POLICY PERIOD, COVERAGE TERRITORY - of SECTION IV - BUSINESS AUTO CONDITIONS is replaced by the following: e. For short-term hired "autos", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the "insured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit," the "Suit" is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. IS. WAIVER OF SUBROGATION TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - of SECTION IV - BUSINESS AUTO CONDITIONS is amended by adding the following: @ 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 of ISO Properties, Inc,, with its permission•) Page 4 of 5, We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form, 16. RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V - DEFINITIONS is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death resulting from any of these. 17, EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS - CANCELLATION - applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation, 18. HYBRID, ELECTRIC, OR NATURAL GAS VEHICLE PAYMENT COVERAGE In the event of a total loss to a "non -hybrid" auto for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended as follows: a.If the auto is replaced with a "hybrid" auto or an auto powered solely by electricity or natural gas, we will pay an additional 10%, to a maximum of $2,500, of the "non -hybrid" auto's actual cash value or replacement cost, whichever is less, b. The auto must be replaced and a copy of a bill of sale or new iease agreement received by us within 60 calendar days of the date of "loss," c. Regardless of the number of autos deemed a total loss, the most we will pay under this Hybrid, Electric, or Natural Gas Vehicle Payment Coverage provision for any one "loss" is $10,000. For the purposes of the coverage provision, a.A "non -hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas, b.A "hybrid" auto is defined as an auto with an internal combustion engine and one or more electric motors; and that uses the internal combustion engine and one or more electric motors to move the auto, or the internal combustion engine to charge one or more electric motors, which move the auto. 19, VEHICLE WRAP COVERAGE In the event of a total loss to an "auto'" for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended to add the following: in addition to the actual cash value of the "auto", we will Pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss, Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage provision for any one "loss" is $5,000, For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. @ 2011, The Hartford (includes copyrighted material For rm HA 99 16 0312 of ISO Properties, Inc,, with its permission.) Page 5 of 5 POLICY # EPK114155 J I I PRIMARY AND NON-GONTRIBUTORY ADDITIONAL INSURED WITH WAIVER OF SUBR;OGATION This endorsement modifies insurance provided under the following: •111 y. 1 - - • - L IIS MINOR- 01116110=12611111 in -m -1612m, giNgueakyj Narne Of Additional Insured Person(s) or Organization(s) -------- 7, e Required By Written Contract, A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability arising out of "your work" for that person or organization performed by you, or by those acting on your behalf. B, As respects, additional insureds as defined above, this insurance also applies to "bodily injury" or "property damage" arising out of your negligence when the following written contract requirements are applicable: 1. Coverage available under this coverage part shall apply as primary insurance. Any other insurance available to: these additional insureds shall apply as excess and not contribute as primary to the insurance afforded by this endorsement. 2, We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for injury or damage arising out of "your work" performed under a written contract with that person(s) or organization(s). 3. The term "additional insured" is used separately and not collectively, but the inclusion of more than one 'additional insured" shall not increase the limits or coverage provided by this insurance. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. N0147-1111 Page 1 of 1 WORKERS Ok LIABILITY INSURANCE POLICY We have the right to recover our payments from anyone liable for an injury covered by this policy, We will not enforce our right against the person or organization .named in the Schedule, (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule r I � � ,�,� � � � MM r, � MV ♦ IAM s it 1 Per Poky MIn1muM Waiver Premium by State $5007 AL, AR, CA, CO, GT, CSC 1177, IL, lN, 1A, KS, ME, MO. Mf, MS, MT, NV, NM, OH, OK, OR, PA, RI, SD, UT, VT, VA, VVA, wV $25Q AK, DE, LA, NY $100: NC $50: wVl NPA: AZ, PL, GA, Hl, MA,, MN, MO, NE, SC, TN, T This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated- (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 02/01/17 Policy No. 710170329 Endorsement No. 8 Insured Rincon Consultants, inc Policy Effective Gate 02/01/17 Insurance Company Star -Stone National Insurance Company Countersigned By. a WC 00 03 13 (Ed. 4-84) Copyright 1983 National Council on COMpensation Insurance. 'heck A License - License Detail Page I of Contractor's License Detail for License # 904732 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7671,17 , only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply Mth the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database, Business Information RINCON CONSULTANTS INC 180 N ASHWOOD AVENUE VENTURA, CA 93001 Business Phone Number:(805) 644-4455 Entity Corporation Issue Date 10/11/2007 Expire Date 10131/2017 License Status - ...... . ... . ............. ... .... ........ ... . . .. . . .... .. .. .. ..... .. . ...... .... ....... .... ............ This license is current and active. MI information below should be reviewed. . . ...... . .... ............ ....... ...... ......... ...... ..... - ------------ .......... . ............... Classifications . .... ...... A - GENERAL ENGINEERING CONTRACTOR C27 - LANDSCAPING . . .......... ... Certifications . ....... .... ...... ..... . ...... -.- ........ ... - ..... . . . ....... ----------- . .... ... ... .. . - ------- - --- ........ ....... HA. Z - HAZARDOUS SUBSTANCES REMOVAL .... . .... .. . ..... . . ..... .... . Bonding Information Contractor's Bond its license has a Contractor's Cash Deposit on file with CSLB. and Number: T16471-1 and Amount: $15,000 ffective Date: 01/01/2016 ontractor's Bond History Bond of Qualifying Individual ...... . ...... .. This license filed Bond of Qualifying Individual number T1158400 for R SCOTT ENGLISH in the amount of $12,500 with CASH DEPOSIT FROM A BANK. Effective Date: 10/11/2007 .. . . ..... ------ ... . .... . ...... Workers' Compensation ttps://www2.cslb.ca.gov/onlineservices/CheckLicenselI/LicenseDetail.aspx?LlcNum=904732 3/6/201 'heck A License - License Detail licy Number:TI0160329 ective Date: 02/01/2016 Aire Date: 02/01/2017 rrkers'Cornpensafion His Miscellaneous Information ... . ... .. ..... 11/06/2015 - CASH DEPOSIT LTR SENT $15,000 01/14/2016 - CASH DEPOSIT 15K FOLLOW UP LTR SENT . . ..... ..... .. ....... . ............ .... . ... 2 of ttps://www2.csib.ca.gov/onlineservices/CheekLicenselI/LicenseDetail.aspx?LicNum�90,4732 3/6/201 Licensing Classifications - Cont—ictors State License Board Page 1 of 2 1±ome I About Us I Library I Licensing Classifications I A - General Engineering Contractor S =ha re Tweet A - General Engineering Contractor Business & Professions Code Division 3, Chapter 9,. Contractors, Article 4. Classifications 7056. A general engineering contractor is a contractor whose principal contracting business is in connection with fixed works requiring specialized engineering knowledge and skill, including, the following divisions or subjects: irrigation, drainage, water power, water supply, flood control, inland waterways, harbors, docks and wharves, shipyards and ports, dams and hydroelectric projects, levees, river control and reclamation works, railroads, highways, streets and roads, tunnels, airports and airways, sewers and sewage disposal plants and systems, waste reduction plants,, bridges, overpasses, underpasses and other similar works, pipelines and other systems for the transmission of petroleum and other liquid or gaseous substances, parks, playgrounds and other recreational works, refineries, chemical plants and similar industrial plants requiring specialized engineering knowledge and skill, powerhouses, power plants and other utility plants and installations, mines and metallurgical plants, land leveling and earthmioviing projects, excavating, grading, trenching, paving and surfacing work and cement and concrete works in connection with the above mentioned fixed works, Laws Board Members History and Background Library About Us Popular Pages Forms and Applications Employment Opportunities Office Locations DCA Leadership CSILB's Headquarters http://www.eslb.ca.gov/About—Us/Library/Licensing_Classifications/A---GENERAL—EN... 3/6/2017 Licensing Classifications - Coi--actors. State License Board Page I of 3 hLorne I About Us � Library I Li.cen.sing Classifications I HAZ - Hazardous Substance Removal Certification [S care �re T w e e. G Business & Professions Code Division 3, Chapter 9. Contractors, Article 4. Classifications 7058.7. (a)No contractor shall engage in a removal or remedial actilon, as defined in subdivision (d), unless the qualifier for the license has passed an approved hazardous substance certification examination. M (1) The Contractors' State License Board, the Division of Occupational Safety and Health of the Department of Industrial Relations, and the Department of Toxic Substances Control shall jointly select an advisory committee, which shall be composed of two representatives of hazardous substance removal workers in California, two general engineering contractors in California, and two representatives of insurance companies in California who shall be selected by the Insurance Commissioner. (2) The Contractors' State License Board shall develop a written test for the certification of contractors engaged in hazardous substance removal or remedial action, in consultation with the Division of Occupational Safety and Health, the State Water Resources Control Board, the Department of Toxic Substances Control, and the advisory committee, (c)The Contractors' State License Board may require additional updated approved hazardous substance certification examinations of licensees currently certified based on new public or occupational health and safety information. The Contractors' State License Board, in consultation with the Department of Toxic Substances Control and the State Water Resources Control Board, shall approve other initial and updated hazardous substance certification examinations and determine whether to require an updated certification examination of all current certificate holders. (d) For purposes of this section "removal or remedial action" has the same meaning as found in Chapter 6.8 (commencing with Section 25300) of Division 20 of the Health, and Safety Code, if the action requires the contractor to dig into the surface of the earth and remove the dug material and the action is at a site listed pursuant to Section 25356 of the Health and Safety Code or any other site listed as a hazardous waste site by the Department of Toxic Substances Control or a site listed on the National Priorities List compiled pursuant to the Comprehensive Environmental Response, http://www.cslb.ca.gov/AboLit—Us/Library/Licensing_ClassificationsIHAZ---HAZARDOU... 3/6/2017 Licensing Classifications - Coif -actors State License Board Page 2 of 3 Compensation, and Liability Act of 1980 (42 U.S.C. Sec. 9601 et seq), "Removal or remedial action" does not include asbestos-related work, as defined in Section 6501.8 of the Labor Code, or work related to a hazardous substance spill on a highway. (e) (1) A contractor shall not install or remove an underground storage tank, unless the contractor has passed the hazardous substance certification examination developed pursuant to this section. (2) A contractor who is not certified may bid on or contract for the installation or removal of an underground tank, as long as the work is performed by a contractor who is certified pursuant to this section. (3) For purposes of this subdivision, "underground storage tank" has the same meaning as defined in subdivision (x) of Section 25281 of the Health and Safety Code. (Amended by Stats. 1990, Chapter 1366 (SB 2004), eff Sept. 26, 1990, amended by Stats. 1992" Chapter 1289 (AB 2743), Chapter 1290 (AB 3188), eff Sept. 30, 1992; amended by Stats. 1993, Chapter 168 (AB 427)) RM Board Members History and..Ba,ckgrOLind About Us PopWar Pages Forms and Applications Employment Opportunities Office Locations DCA Leadershi CSLB's Headquarters 14KNInumm, http://www,cslb,ca.gov/About Us/Library/Licensing Classifications/HAZ HAZARD,OU... 3/6/2017 .... .. ... . .... ..... .. . ... .... 0 w 3 CD c- =7 W' FD (D rDCi rD �3 w ("D CUQ In 0 w rD 70 w Q(,D� 0 CD CD 0 M Ln Z Ln co C m 0 aq 3 :T 0 Cn CU m In M o CDn -1 rQ n - ora rD Z C) 0 n (7 G) m o ru as c C7 Ln rZD3 In n cr CD ID m fl- 0-04 0 r) 0 CD (D Z4 • (D 0 co Z) C) CL 0 (D .(D Z37 CD 0 73 Ci ). - 0 U) 0 - U) 0 . . ........... ..... . .... . .. .. .... ... ................ CITY OF SANTA ANA BUSINESS TAX SECTION (M-15) 20 CIVIC CENTER PLAZA, FIRST FLOOR, P.0. BOX 1964, SANTA ANA, CA 92.702 (714) 647-5447 CITY OF SANTA ANA BUSINESS LICENSE TAX RECEIPT BUSINESS TAX NUMBER: 6599 TAX PERIOD., 4/112016 - 3131/2017 BUSINESS NAME: RINCON CONSULTANTS INC AMOUNT PAID: $37.00 BUSINESS ADDRESS: 180 N ASHWOOD AVE, VENTURA, CA 93oo3 DATE PAID; 03/2v26!6 OWNER NAME: GIALKFTSIS, MICHAEL THIS IS NOT A BILL ATTACHED BELOW IS YOUR CITY OF SANTA ANA BUSINESS LICENSE TAX RECEIPT PLEASE DETACH AND POST IN A CONSPICUOUS LOCATION (SEE REVERSE SIDE OF BUSINESS LICENSE TAX RECEIPT FOR POSTING REQUIREMENTS) CITY OF SANTA ANA BUSINESS LICENSE TAX RECEIPT This business license tax account is void upon sale or transfer of a business • Every business is responsible for the annual renewal of their business license tax account • It is the responsibility of the applicant1hicensee to ensure that the business complies with all applicable City codes, City zoning ordinances and all Local, State and Federal Laws. • Contact the Business License Tax Office at (714) 647-5447 prior to any of the following changes: • Name change • Location Change • Ownership or representative change • Business activity change • The business license tax receipt must be displayed at the place of business, See reverse side for posting requirements. Sec. 21-18�. - No required permits waived. The business license Issued pursuant to the provisions of this Chapter [Santa Ana Municipal Code (SAMC) Chapter 211 constitutes a receipt for the license fee paid and shall have no other legal effect. A business license is a requirement, not a permit, to transact and carry on any business activity within the city. The business license tax receipt is evidence only of the fact that such tax has been paid. Neither the payment of the tax nor the possession of the business tax receipt authorizes, permits or allows the doing of any act which the person paying or holding the same would not otherwise be entitled to do'; and any permit, license, variance or other instrument of approval or evidence that any conditions exist as required by any other Section of this Code [SAMC] or by any statute or code provisions of the state must first be obtained or complied with before the doing of any act or thing for which it is required. (Ord, No. NS -1922, § 1, 7-20-87) The person, firm or corporation named below has been issued this business license tax reccipt pursuant to the provisions of the City Business License Tax Code (SAMC Chapter 21). Issuance of this receipt for the business license tax paid shall have no other legal effect (SAMC Sec. 21-18) and is not an endorsement, nor certification of compliance with other ordinances or laws, It is the responsibility of the applicantilicensee to ensure that the business is operated in compliance with the laws, ordinances and regulations that are now or may hereafter be In force by the United States Government, State of California, and the City of Santa Ana pertaining to such business. In the event, it Is determined that the applicanVilcensee fraudulently applied for or renewed this business license tax account, the account may be suspended or revoked. This business license tax account is nontransferable. Please note that it is your responsibility to renew and update this license annually, CITY OF SANTA ANA - TREASURY M-15 20 CIVIC CENTER PLAZA -PO BOX 1964 SANTA ANA, CALIFORNIA 92702 PHONE (714) 647-5447 RINCON CONSULTANTS INC 180 N ASHWOOD AVE. VENTURA, CA 93003.1810 THIS LICENSE MUST BE DISPLAYED AT THE PLACE OF BUSINESS BUSINESS TAX NO. 6599 TAX PERIOD: 411/2016-313112017 BUSINESS TYPE: CONSULTING, MISC. BUSINESS ADDRESS: 180 N ASHWOOD AVE. VENTURA, CA93003 BUSINESS NAME: RINCON CONSULTANTS INC OWNEPJRER GIALKETSIS, MICHAEL €XPIiATION DATE: 03131112 3/912017 Search Results, I System for Award Management LJ[sernarne For. of Usemarne? NO, Current Search Terms: rincon* consultants* inc* Your search for "rincon* consultants* inc*" returned the following results... Pa,s%vord 1, Forciot password? arroate an Account .. ....... ............. Aossa ry Notice; This printed document represents only the first page of your SAM search results. More results may be available. To print your complete search results, you can doavnload the PDF and pnrliz it. Search Results Fntity Pincon Consultants, Inc. Status: Active 4+�l Entity Exclusion DUNS; 836949552, CAGE Code: IFCKS Vie w Details agLa-r—ch Has Active Exclusion?. No DoDAAC: Filters Expiration Date: 12/05/2017 Delinquent Federal Debt? No By Record Purpose of Registration: Ali Awards SUIW� By Record Type https:liwww.sam.gov[portaVSAMI?navigationalstate=JBPNS—rOOABXdcACJqYXZheC5mYWNlcy5wb3JObGVOYnJpZG,dILINUQVRFXOIEAAAAAQApdmlldzph... 1/1