HomeMy WebLinkAboutLIFESIGNS, INC. 1 - 2002INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURAN E EXPIRES
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CLERK OF. COUNCI
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STANDARD CONSULTANT AGREEMENT
sly,
N- 2002 -104
THIS AGREEMENT, made and entered into this --51 day of 2002 by
and between LifeSigns, Inc., a California corporation (hereinafter "Consultant'), d the City of
Santa Ana, a charter city and municipal corporation organized and existing under the
Constitution and laws of the State of California (hereinafter "City ").
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the field of
Sign Language Interpreting.
B. Consultant represents that Consultant is able and willing to provide such services to the
City.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this
Agreement will be performed in compliance with such standards as may reasonably be
expected from a professional consulting firm in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
SCOPE OF SERVICES
Consultant shall perform those services as set forth only in paragraph 3 of Exhibit A to
this Agreement.
COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services,
the rates and charges identified only in paragraph 4 of Exhibit A. The total sum to be expended
under this Agreement, shall not exceed $ 10,000.00 during the term of this Agreement.
b. Payment by City shall be made within thirty (30) days following receipt of proper
invoice evidencing work performed, subject to City accounting procedures. Payment need not
be made for work which fails to meet the standards of performance set forth in the Recitals
which may reasonably be expected by City.
TERM
This Agreement shall commence on the date first written above and terminate on June 30,
2003, unless terminated earlier in accordance with Section 12, below. The term of this
Agreement may be extended upon a writing executed by the Executive Director of the Personnel
Services Agency and the City Attorney.
4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor
shall it be construed to create an employer - employee relationship, a joint venture relationship, or
to allow the City to exercise discretion or control over the professional manner in which
Consultant performs the services which are the subject matter of this Agreement; however, the
services to be provided by Consultant shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Consultant shall pay all salaries and
wages, employer's social security taxes, unemployment insurance and similar taxes relating to
employees and shall be responsible for all applicable withholding taxes.
5. INSURANCE
Prior to umdertaking performance of work under this Agreement, Consultant shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Consultant shall maintain commercial
general liability insurance naming the City, its officers, employees, agents, volunteers and
representatives as additional insured(s) and shall include, but not be limited to protection against
claims arising from bodily and personal injury, including death resulting therefrom and damage
to property, resulting from any act or occurrence arising out of Consultant's operations in the
performance of this Agreement, including, without limitation, acts involving vehicles. The
amounts of insurance shall be not less than the following: single limit coverage applying to
bodily and personal injury, including death resulting therefrom, and property damage, in the total
amount of $1,000,000 per occurrence. Consultant shall supply City with a fully executed
additional insured endorsement in substantially the form attached hereto as Exhibit B upon
execution of this Agreement and shall be approved in form by the City Attorney.
b. Business automobile liability insurance, or equivalent form, with a combined single
limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for
owned, hired and non -owned automobiles.
c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300
of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against
liability for worker's compensation or to undertake self - insurance. Prior to commencing the
performance of the work under this Agreement, Consultant agrees to obtain and maintain any
employer's liability insurance with limits not less than $1,000,000 per accident.
d. If Consultant is or employs a licensed professional such as an architect or engineer:
Professional liability (errors and omissions) insurance, with a combined single limit of not less
than $1,000,000 per claim.
e. The following requirements apply to the insurance to be provided by Consultant
pursuant to this section:
(i) Consultant shall maintain all insurance required above in fall force and
effect for the entire period covered by this Agreement.
(ii) Certificates of insurance shall be furnished to the City upon execution of
this Agreement and shall be approved in form by the City Attorney.
(iii) Certificates and policies shall state that the policies shall not be canceled
or reduced in coverage or changed in any other material aspect without
thirty (30) days prior written notice to the City.
f If Consultant fails or refuses to produce or maintain the insurance required by this
section or fails or refuses to furnish the City with required proof that insurance has been procured
and is in force and paid for, the City shall have the right, at the City's election, to forthwith
terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its
time and materials expended prior to notification of termination. Consultant waives the right to
receive compensation and agrees to indemnify the City for any work performed prior to approval
of insurance by the City.
6. INDEMNIFICATION
Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents,
employees, consultants, special counsel, and representatives from liability: (1) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims
for personal injury, including health, and claims for property damage, which may arise from the
direct or indirect operations of the Consultant or its contractors, subcontractors, agents,
employees, or other persons acting on their behalf which relates to the services described in
section 1 of this Agreement; and (2) from any claim that personal injury, damages, just
compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects
arising from this Agreement. This indemnity and hold harmless agreement applies to all claims
for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to
have been suffered, by reason of the events referred to in this Section or by reason of the terms
of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold
harmless, and pay all costs for the defense of the City, including fees and costs for special
counsel to be selected by the City, regarding any action by a third party challenging the validity
of this Agreement, or asserting that personal injury, damages, just compensation, restitution,
judicial or equitable relief due to personal or property rights arises by reason of the terms of, or
effects arising from this Agreement. City may make all reasonable decisions with respect to its
representation in any legal proceeding.
CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant agrees
that it shall not use or disclose such information except in the performance of this Agreement,
and further agrees to exercise the same degree of care it uses to protect its own information of
3
like importance, but in no event less than reasonable care. "Confidential Information" shall
include all nonpublic information. Confidential information includes not only written
information, but also information transferred orally, visually, electronically, or by other means.
Confidential information disclosed to either party by any subsidiary and /or agent of the other
party is covered by this Agreement. The foregoing obligations of non -use and nondisclosure
shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is,
through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful
possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Consultant without
reference to information disclosed by the City.
8. CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interests and shall not have interests, direct
or indirect, which would conflict in any manner with performance of services specified under
this Agreement.
9. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this
Agreement shall be in writing and shall be deemed to be properly given if delivered in person or
mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other
telegraphic communication in the manner provided in this Section, to the following persons:
To City:
Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M -30)
P.O. Box 1988
Santa Ana, California 92702 -1988
telefacsimile (714) 647 -6956
With courtesy copies to:
Executive Director
Personnel Services Agency
City of Santa Ana
20 Civic Center Plaza (M -24)
P.O. Box 1988
Santa Ana, California 92702 -1988
telefacsimile (714) 647 -6930
and,
City Attorney
City of Santa Ana
20 Civic Center Plaza (M -29)
P.O. Box 1988
Santa Ana, California 92702
telefacsimile (714) 647 -6515
To Consultant:
LifeSigns, Inc.
2222 Laverna Avenue
Los Angeles, California 90041
Telefacsimile (323) 550 -4215
Attn: Denise M. Madland, Director.
A party may change its address by giving notice in writing to the other party. Thereafter,
any notice, tender, demand, delivery, or other communication shall be addressed and transmitted
to the new address. If sent by mail, any notice, tender, demand, delivery, or other
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or
other communication shall be effective or deemed to have been given twenty -four (24) hours
after the time set forth on the transmission report issued by the transmitting facsimile machine,
addressed as set forth above. For purposes of calculating these time frames, weekends, federal,
state, County or City holidays shall be excluded.
10. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant; and supersedes any and all other agreements, oral or written, between the parties. In
the event of a conflict between the terms of this Agreement and any attachments hereto, the
terms of this Agreement shall prevail. This Agreement may not be modified except by written
instrument signed by the City and by an authorized representative of Consultant. The parties
agree that any terms or conditions of any purchase order or other instrument that are inconsistent
with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor
the City. Each party to this Agreement acknowledges that no representations, inducements,
promises or agreements, orally or otherwise, have been made by any party, or anyone acting on
behalf of any party, which are not embodied herein.
11. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without
the City's prior written consent shall be considered null and void. Nothing in this Agreement
shall be construed to limit the City's ability to have any of the services which are the subject to
this Agreement performed by City personnel or by other consultants retained by City.
12. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of termination,
subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to deliver
to the City all work product completed as of such date, and in such case such work product shall be
the property of the City unless prohibited by law, and Consultant consents to the City's use thereof
for such purposes as the City deems appropriate.
b. Payment need not be made for work which fails to meet the standard of performance
specified in the Recitals of this Agreement.
13. DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital
status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited
by applicable law, in the recruitment, selection, training, utilization, promotion, termination or
other employment related activities. Consultant affirms that it is an equal opportunity employer
and shall comply with all applicable federal, state and local laws and regulations.
14. JURISDICTION - VENUE
This Agreement and all questions relating to its validity, interpretation, performance, and
enforcement shall be government and construed in accordance with the laws of the State of
California. This Agreement has been executed and delivered in the State of California and the
validity, interpretation, performance, and enforcement of any of the clauses of this Agreement
shall be determined and governed by the laws of the State of California. Both parties further
agree that Orange County, California, shall be the venue for any action or proceeding that may
be brought or arise out of, in connection with or by reason of this Agreement.
15. PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United States, the State of California,
the City of Santa Ana and all other governmental agencies. Consultant shall notify the City
immediately and in writing of her inability to obtain or maintain such permits, licenses,
approvals, waivers, and exemptions. Said inability shall be cause for termination of this
Agreement.
16. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
indemnify City filly, including reasonable costs and attorney's fees, for any injuries or damages to
City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set
forth in the body of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year
first above written.
ATTEST:
PATRICIA E. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W.FLETCHER
City Attorney , /1'
Attorney
role"
Hen Alva
Executive D' e or
Personnel efvices Agency
City of Santa Ana
CITY ANTA
DAVID N. REAM
City Manager
AL: NSULTANT
Denise M. Madland
Director
LifeSigns, Inc.
Employer ID # or Individual SS #
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AN IM I%Pn PER REFERML SERVICE
Dear Customer:
Enclosed is a copy of LIFESIGNS' Policies and Procedures that apply to services
provided on an as- needed basis.
Please carefully read the enclosed Policies and Procedures and complete page 5.
This form must be completed and returned before services can be provided.
You may either fax or mail the completed forms.
Please note that we have enclosed an optional Interpreter Request Fax Form if
you wish to fax your request. The Interpreter Referral Specialists will contact
you to confirm that the request has been received and if an interpreter was
secured.
Because LIFFSIGNS strives to provide excellent service, we have enclosed an
optional survey to give you the opportunity to let us know how we're doing.
Please take a few moments to fill it out and fax or mail it to LIFESIGNS.
We appreciate the opportunity to provide excellent service to you. Please
contact the Interpreter Referral Specialists if you have any questions or concerns
at(323)550 -4210.
I i
1H l
Denise M. Madland
Director
EXHISi i A
LIFESICNS, INC ADMINISTRATIVE OFFICES: 2222 LAVERNA AVENUE. LOS ANmE5. <A 90041 (323) 550 -4210 TTY /V (323) 5F'
StRviNG LOS ANCELES KERN ORANGE VENTURA SANTA BARBARA SAN LUIS OBISPO RIVERSIDE SAN BERNARDINO COUNT'
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AN INLERFRMR REFERRAL SERVICE
SIGN LANGUAGE INTERPRETER SERVICE AGREEMENT
Specifications and Responsibilities:
1, Intent
LIFESIGNS, Inc. provides communication services to individuals, businesses and
organizations who are covered by Section 504 of the Rehabilitation Act, Americans with
Disabilities Act and similar state and federal laws requiring the provision of auxiliary
aids and services as necessary to ensure effective communication with deaf, hard of
hearing or deaf -blind persons.
Subject to the availability of interpreters, LIFESIGNS agrees to provide communication
services on request to CUSTOMER. CUSTOMER agrees to the following conditions,
rates and services listed below. The following conditions, rates and services apply for
communication services provided by LIFESIGNS on an as- needed basis.
2. Definitions
After- hours: Monday through Friday after 5:00 p.m. and before 7:30 a.m , weekends and
holidays.
Business hours: Monday through Friday, between 7:30 a.m. to 12:00 p.m, and 1:00 p.m.
to 5:00 p.m. excluding weekends and holidays.
Emergency Interpreting: Interpreting services requested by medical, mental health or
law enforcement with less than 24- hour notice.
3. Communication Services
Sign Language Interpreting: LIFESIGNS staff and subcontracting interpreters are
certified by either the National Association of the Deaf (NAD) or Registry of Interpreters
for the Deaf (RID). Most certificate holders have completed professional interpreter
training and have extensive professional interpreting experience.
Legal Interpreting: Legal interpreting requires specialized knowledge and rigorous
training of legal interpreting, settings and the language used in the legal system.
Team Interpreting. Interpreting demands constant mental and physical stamina,
therefore some assignments, particularly those that are lengthy or complex, will require
a team of two interpreters rotating at intervals of 20 to 30 minutes.
LIEE516N5, INC ADMINISTRATIVE OFFICES: 2222 LAVERNA AVENUE, Los ANGELES, CA 90041 (323) 550 -4210 TTY /V (323) 550 - 4217x.
SERVING Los ANCELES KERN ORANGE ' VENTURA ' SANTA BARBARA SAN LUIS 0815oo RIVERSIDE ' SAN BERNARD I- CVUNTI
LIFESIGNS reserves the right to determine if an assignment based on its length or
complexity requires two interpreters rotating at intervals of 20 to 30 minutes. Generally,
assignments exceeding 2 hours will require team interpreters.
Tactile Interpreting: This service is a form of sign language interpretation specifically
for deaf -blind individuals.
Intermediary Interpreting. An intermediary interpreter (deaf interpreter) may be
needed when the communication mode of a deaf consumer is so unique that it cannot be
adequately accessed by interpreters who are hearing.
Oral Interpreting. This service involves interpretation by use of facial expression,
lip /mouth movement and hand gestures for deaf and hard of hearing individuals who
do not rely on sign language for communication.
Emergency Interpreting: Emergency requests for medical, mental health and law
enforcement interpreting are given top priority. Certified sign language interpreters are
on call 24 -hours a day, 7 days a week specifically for life threatening emergencies.
To request emergency interpreting services during business hours please call (323) 550-
4210. To request emergency interpreting services after -hours please call (800) 633 -8883.
Please do not call the emergency line to make appointments. This line is for
emergencies that require immediate response.
Since the interpreter will arrive within 45 minutes, it is recommended that the request be
made immediately. Cost of service is incurred to CUSTOMER only when an interpreter
is dispatched.
On rare occasions if LIFESIGNS reasonably believes a client may be a danger to the
interpreter, LIFESIGNS has the right to refuse service for that client.
4. Fee Schedule:
Fee Schedule is subject to annual 10% rate increase upon automatic renewal.
Sign Language, Oral and Tactile Interpreting: $50.00 per hour with a 2 -hour minimum.
Team Interpreting. Assignments requiring a team of two interpreters rotating at
intervals of 20 to 30 minutes will be charged $50.00 per hour, per interpreter with a 2-
hour minimum.
Emergency Interpreting: $65.00 per hour with a two -hour minimum.
Legal Interpreting: Due to the nature and complexity of legal appointments (i.e.
Litigation, Depositions and Mediations) LIFESIGNS requires two interpreters be present
for all legal appointments. LIFESIGNS will charge a minimum half -day (four hours) at
2
$300.00 per interpreter. Any appointments over four hours is considered a full day and
is charged at $400.00 per interpreter.
5. Policies and Procedures for CUSTOMER
Communication Services Request
Due to the high demand for communication services, LIFESIGNS requires that all
requests must be made with a minimum of 3 to 5 working days advance notice.
LIFESIGNS cannot guarantee interpreters for any request made in less than the
required notice, however every effort will be made to secure an interpreter.
When requesting an interpreter, please provide the following information:
1. Date of service
2. Time span of service
3. Address of assignment (including cross street, room numbers, building,
parking location and fees or any other pertinent information)
4. Contact person and phone number at the interpreting site
5. Nature of the assignment
6. Billing information (authorized person, attention to whom and purchase
orders if required etc...)
Cancellation Policy
Cancellation for assignments lasting two hours or less will require 24 -hours advance
notice of cancellation. Cancellation for assignments lasting longer than two hours will
require a 48 -hour advance notice of cancellation. LIFESIGNS requests that
CUSTOMER fax or e-mail cancellation notices.
Cancellation must be made during business hours. If the cancellation is not made
within the specified amount of time, the CUSTOMER will be billed for the total amount
of time requested.
The failure of CUSTOMER'S client or patient to show up for the scheduled
appointment will not discharge the CUSTOMER from responsibility of the
cancellation notice policy.
Remittance for Service
Payment of invoice(s) is required within 30 days of receipt.
Independent Contractor Status
The CUSTOMER and LIFESIGNS understand and agree that the interpreters made
available to the CUSTOMER are and shall remain independent contractors and are not,
and will not be considered employees of LIFESIGNS, or the employees of the
CUSTOMER.
Grievance Procedures
Suggestions for improving LIFESIGNS are always welcome. At some time during the
contractual relationship, the CUSTOMER may have a complaint, suggestion or question
regarding LIFESIGNS Policies and Procedures or services. Good -faith complaints,
questions and suggestions are also of concern to LIFESIGNS. Please use the following
guidelines when addressing concerns:
Within a week of the occurrence, please inform the Director of
LIFESIGNS who will then investigate and attempt to provide a solution
or explanation. If the complaint is regarding the Director, the
CUSTOMER has the right to bring the situation to the attention of the
Deputy Director of the Greater Los Angeles Council on Deafness, Inc.
(Parent organization).
2. CUSTOMER may also state the concern in writing and present it to the
Director of LIFESIGNS.
In order to resolve an issue through grievance procedures, a written statement must
contain the following:
• Provide a specific complaint, suggestion or question
• Describe what took place
• Furnish date /s of incidents. Include names and title of individuals who
are part of the grievance, suggestion or question.
• Include all supporting documentation
• State a resolution or suggestion on an action to bring resolution
• Avoid assumptions, use facts.
Termination of Services
This agreement shall commence on July 1, 2001 and shall continue in effect for one (1)
year, automatically renewing at each anniversary date for an additional one (1) year
period unless terminated by either party by written notice of termination at least thirty
(30) days prior to expiration of the then current term.
Attorney's Fees and Costs
If any action at law or in equity is necessary to enforce or interpret the terms of this
Agreement, the prevailing party shall be entitled to reasonable attorney's fees, costs and
necessary disbursements in addition to any other relief to which such party may be
entitled.
Governing Law and Partial Invalidity
The laws of the State of California shall govern this agreement. If any provision is held
by any court to be invalid, void or unenforceable, the remaining provisions shall
nevertheless continue in full force.
The undersigned understands and agrees to comply with the policies and procedures for
utilizing Communication Services from LIFESIGNS, Inc.
CUSTOMER INFORMATION
of Santa Ana
Agency Name
Martha McCart
Contact Person
(714) 647 -5355
Contact Phone Number
Enrique J. Alva
Y ulho ed AgentName p ed i a e
Denise.M. Madland
Director of LIFESIGNS, Inc.
Po Box 1988
20 Civic Center Plaza M24
Billing Address
Santa Ana, CA 92702
City, State, Zip
(714) 647 -6930
Contact Fax Number
Executive Director,
Personnel Services
Title
Date
Interpreter Referral Specialists
Contact Name
(323) 550 -4210
Contact Phone
(,323) 550 -4215
Contact Fax
Communications Service Request
Fax Form
Date: To be determined Time: 3:30 to 5:00
M T W Th F Sat Sun
Name ofRequestor: Martha McCarthy Phone #: (714) 647 -5355
Agency Name: City of Santa Ana Fax #: $714) 647 -6930
ASSIGNMENT INFORMATION
Deaf Consumer: Jacob Aina (Cit
Facility: City Hall, City of Santa Ana
Assignment Address: 20 Civic Center Plaza Santa Ana
(Street) (City)
Personnel Services Department, 5th Floor
Cross Street: 6th and Flower Streets
Parking:Enter at 6th and Flower (between Civic Center Blvd and
Santa Ana Blvd)
Nature of Assignment: Provide Interpretive Services at discussion
between employee and supervisors
Contact Person: Martha McCarthy (714) 647 -5355
BILLING INFORMATION
Billing Address: c/o Personnel Services Department M24
City, State, ZIP: 20 Civic Center Plaza Santa Ana, CA 92701
Attention: Martha McCarthy
PO # (if applicable)
Authorized Signature
Today's Date
LIFESIGNS, Inc.
COMMUNICATION SERVICES SURVEY
OPTIONAL: (So we may contact you for more information if necessary)
Name Phone
Please fax this form to LIFESIGNS, Inc. at (323) 550 -4215.
Thank you for choosing LIFESIGNS, we appreciate your business!
Your feedback is important to us for better meeting our customers' needs
1 = Needs improvement 2 = Average 3 = Outstanding
1.
Professionalism, courtesy and friendliness of staff on the phone 1
2
3
NA
2.
Ability to contact or reach staff during regular office hours 1
2
3
NA
3.
Ability to obtain interpreter services when requesting in advance 1
2
3
NA
4.
How would you rate the interpreter's appearance? 1
2
3
NA
5.
Was the interpreter on time for the appointment? 1
2
3
NA
6.
Was the interpreter professional, courteous and friendly? 1
2
3
NA
7.
Customer service regarding complaints, questions or information 1
2
3
NA
8.
Would you recommend our service to others? Yes
No
NA
OPTIONAL: (So we may contact you for more information if necessary)
Name Phone
Please fax this form to LIFESIGNS, Inc. at (323) 550 -4215.
Thank you for choosing LIFESIGNS, we appreciate your business!
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127/02
ISPIr �'EEN1NRr
t
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HueO AUTOS
tDG�IteWURY
L^
NCN•OYPIED AUT08
'
441
PROPER7YONM0r
—
ANYAUW
aY9$$$ UAWLIT
Ai UMBRULAFORM
DINER THAN VNAIRELM rC
West”" COMP$N$AHCN AND
rEPVLOYARN• LIAa1LITY
PHA$Q%943
imm 159335401
12137/01 12117/02
08/01/01 1 08/01/02
E
CITY of Santa Alm its officers, emplayees, agaatt> volnoteers and rapraEentativat art named aE Additional 9BSnisd uodar HIS Gencrat LiaDiiltp
respects 10 the work perfbrmea Dy the named insured for the Additional Insured.
City of $Asia ma � YNOMP ANY OF THE AanWE 5WAinav PoL " ee CAKI"EO ess O g TNt ..
20 Civic Ceater Plana WIRATION OATE THE, 04E MUIW caiMANT M,, EEpeAWOR To MAN
P -0. sox 19$$ 30 d N17TIC£ TO TMe CIapTlrie,ATn 16CLOER RAML'A To THE LAFI.
Santa Ann, CA 92701- BUT FAILURE TO MAM. SUCH NbAbE MALI IMP®$a NO CaLtAATION OR >Aaeatrr
APPROVED AS 'TO NORM
L/aura Sheedy
Deputy City Attorney
Jul -29 -02 02:52P LIFESIGNS,INC.wa
Jul, U2 FLJUC 11: 1:emm Hr LMit KJl.1 Ji2UU
oe / ;0 /20e; 0 0 FAA
.JUH 29 2qp 10ta7RM HP LRSERJET 32oa
aa/30/1002 16: PAZ
Mity.Y2 -02 :R4.P 43Sw 8$TCFfF� IrtG.�a
Yd..
�7
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;r
TWO
it e
EX&DJUI'T B
'IfifigRun-jal PAL
Iris�nccoml:uy
323 - 550 -4215
az4-sr0 -42x0
'Philadelphia
Tms• Co.
nw4iflwr arch it urancc m ii a19M vd by tlar pvovlatotis of Policy
ralar]ag to Qua 16vawi4,:
P.02
p. c
Cg OC;
IL 90) p.3
P.Os
I
Tha C. ity erstarts Ana,'20 C Ma COntrr PWva, Swom eons, Ca liJ'orda 9001. its
.• ,. ailScors,
pk+YerR agentr, veluoa�la salO ft.�tlwtaif6'CVrs sic mlexftcd As amWitpat-ai inam�mLm
(`c"IiU
w witn,eg..,t to ti.wrrr.nd d.Y«ISO of=" misiog rte, t?,e ov-rW;,mv
sad uafae
wr&npud by or on 1;htl f aF tiara taamed ina ve d.
2
With "Mpg" 10 chiomtr Etliiag aIN Of I2w pperat MM and LM04 per*=ed by Ot OA
b,4mirvi
jw fiwTmA iNmrm , "rJi iv wmicem is afffmtdcdbyfba(a potioy inp0mayy rnd Is am
ad
WdFCOapRratin JiWith tatynthatitalft,. ells *dlteledbyorShHlabcal0fitoFlhe
,.,....
...
Lta1G SS:CCEPT FOR GFUSS nG;T TCFXCr AND 1212 VL
lurorod aWJim whom eli tt it made or
.wa
aA 0rpi with iaspau m tJe camprriyS l (tnha of liability A7mo ittat sFian ur aa}r
panaaeztatiauoa
Tcdn4
an imurod shall no a( WE arty rillhe which amb pman or ocgftnitation
wcs
a olaimetlt if not so tltcloded.
Wit%rwpad to ihaadt$ti�u>,M { ncurede ;ahtslasNralLCas11s11awttaced
)A cevecaga at Radix omrept anmr thirty(M) dsya wiftNA itotica hu been
gi ven to el
a City argamt s Am, 20 Civic Cantu playa, SAM Aaa� CaGSa.tala 027o1-
(Cmt2vI
of the lYaripwias, (hCludiryt wtatl+m:lgi;aulm, is lb ®tt{tfM1 to make this andonfemt:bt
s}dt+c
N&k4
12/2711,11 %his ondmaa imt tisntf u a pan of
Policy 4
- -
;M5K6 -- --
1s6ltCa% u
Gaeae, I on DWne,.s.L Inc, , , .., •
41nn'n3d MuTrwd
Caueeaasigsfodby_
A.ommllLaa RaEI(�otlOatr.�
a
APPROVED AS TO FORM
1
Laura Sheedy
Deputy City Attorhey
,Jun -04 -02 09:50A LIFESIGNS,INC.'a 323 -550 -4275
POLICY r1UMBER, PNPK017078 COMMERCIAL GENERAL. LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL, INSURED - DESIGNATED PERSON or
ORGANIZATION
This endorsement modifies insurance provided under the fallowing:
COMMERCIAL. GENERAL UAB!LITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of San" Aaa
20 CIWO Canter Plaza
P.O. BOX 1906
Santa Ana CA 97!01
(if no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section 17) is amended to include as an insured the person or orgoni ation shown in
tnc Schedule, but only with respect to 9;Wity arising out of your operations or premises owned by or
rented to you.
the City of Santa Ana it ittsluded as an additional Insured on a primary, oon•Contributory basis with the eXCFyben of sole
t+eyilgence andfor wi ffutl misconduct on Lfie part of the Additional Insured.
CG 20 26 11 86 Copyright, ! nsurance Service Office, 1r , 1984
P-02
Jun-04-02 09:50A LIFIESIGNS,INC.Wa 323-550-4215
AN lNMRPRMR Rl I EPIM4 itlm,
FACS(MILE TRANSMITTAL SHEET
M; FRQMt
I Ro r- 4�� DerIdsc M.'Nbdland, Director
DA 11,
FAX NI MbElk
4 TOTAL No. OP PAGES 11NICILUDING (.(jvER-.
EE ShNDER'5 PAX WVMBEF,
15
37NULK5 PHONE NINBER,
(323) 550-4219
13 URC 2 NT * FORREVIEW 0 PLEASE CCMTIIFNF 13 PLEASE REPLY C3 PLEASE KECYCi,F�
P.01
Lsu$ioms, INC A MINIM L>22 LAVE RNAA,'e'K.C, 10; ANNE-E5 CA ''()04' (323) H50 -;'O 7rY/V `g0 4_215c
5P , v, 1,1c Los t V :. rv'rb RA SnrvTU gaAro. Luis U b p o f, I A P4 9 E