HomeMy WebLinkAboutORANGE COUNTY TRANSPORTATION AUTHORITY (OCTA) (C-1-2486) (1ST) (2)INSURANCE ON RILE A-2016-175
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DATE:
1 AMENDMENT NO. 1 TO COOPERATIVE AGREEMENT NO. C-1-2486
2 BETWEEN
3 ORANGE COUNTY TRANSPORTATION AUTHORITY
4 AND
5 CITY OF SANTA ANA
6 FOR
7 SENIOR MOBILITY PROGRAM
8 THIS AMENDMENT NO. 1 is made and entered into this =day day of c >fi 2016 by and
9 between the Orange County Transportation Authority, a public corporation of the State of California
10 (hereinafter referred to as "AUTHORITY'), and the City of Santa Ana (hereinafter referred to as "CITY").
11 RECITALS
12 WHEREAS, by Agreement No. C-1-2486 dated June 9, 2011, AUTHORITY and CITY are entered
13 into a contract to provide the Senior Mobility Program (SMP) concerning senior transportation services;
14 and
15 WHEREAS, AUTHORITY and CITY agree to comply with all relevant elements of Orange County
16 Local Transportation Authority Ordinance No. 3; and
17 WHEREAS, AUTHORITY and CITY agree to comply with the M2 Project U SMP Funding and
18 Policy Guidelines ("Guidelines"); and
19 WHEREAS, AUTHORITY and CITY agree to extend the term of the Agreement through
20 June 30, 2021;
21 NOW, THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that
22 Amendment No. 1 to Cooperative Agreement No. C-1-2486 is hereby amended in the following
23 particulars only:
24 1. Amend ARTICLES 2 and 3: to delete in their entirety and replace with Attachment 1 to
25 this Amendment.
26 /
Page 1 of 3
AMENDMENT NO. 1 TO
AGREEMENT NO. C-1-2486
1 2. Amend ARTICLE 4. TERM OF AGREEMENT: Page 5 of 9, line 23 to delete
2 "June 30, 2016" as the expiration date of the Agreement, and in lieu thereof insert "June 30, 2021."
3 3. Amend ARTICLE 8. AUDIT AND INSPECTION OF RECORDS: Page 6 of 9, line 25, to
4 delete "four (4) years" as the period for audit and inspection record, and in lieu thereof insert
5 "five (5) years".
6 4. Amend ARTICLE 11. CONFLICT OF INTEREST: Page 7 of 9, line 23, to delete
7 "ARTICLE 11" and in lieu thereof insert "ARTICLE 12
8 5, Amend ARTICLE 12. CODE OF CONDUCT: Page 8 of 9, line 6, to delete "ARTICLE 12"
9 and in lieu thereof insert "ARTICLE 13".
10 6. Amend ARTICLE 13. FORCE MAJEURE: Page 8 of 9, line 11, to delete "ARTICLE 13" and
11 in lieu thereof insert "ARTICLE 14".
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Page 2 of 3
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AMENDMENT NO. 1 TO
AGREEMENT NO. C-1-2486
The balance of said Agreement remains unchanged.
Upon execution by both parties, this Amendment No. 1 to Cooperative Agreement
No. C-1-2486 shall be made effective on July 1, 2016.
IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 1 to Cooperative
Agreement No. C-1-2486 to be executed on the date first above written.
CITY OF SANTA ANA ORANGE COUNTY TRAbISPORTATION AUTHORITY
BY 4 BY
David Cavazos 0 Darrell Johns
City Manager Chief Executi fficer
By c1,G�M�S sJ H✓r7i
Maria D. Huizar
Clerk of the Council
By 64 )�/ . T
J n M. Funk
Assistant City Attorney
RECOMMENDED FOR APPROVAL
GERARDO MOUET,
Executive Director, PRCSA
APPROVED AS TO FORM:
t
general Counsel
APPROVED:
•v�\/V k V L
Beth McCormick
General Manager, Transit
Page 3 of 3
Attachment 1 to
AMENDMENT NO. 1 TO
AGREEMENT NO. C-1-2486
1 ARTICLE 2. RESPONSIBILITIES OF AUTHORITY
2 A. AUTHORITY agrees to provide funds per the following:
3 1. Services provided under the Senior Mobility Program are available to individuals
4 60 years of age and older.
5 2. Funds for the program are identified as one percent (1%) of Renewed
6 Measure M (M2) net sales tax revenue and will be allocated to all local jurisdictions based upon the
7 participating entity's respective percentage of the senior population of the entire county.
8 3. Senior population will be determined by using the most current official
9 decennial Census information provided by the U.S. Census Bureau.
10 4. All active participants will receive their portion of funding on a bi-monthly
11 basis.
12 B. AUTHORITY agrees that Net Revenues allocated shall be expended within three years
13 of receipt. AUTHORITY may grant an extension to the three-year limit, but extensions shall not be
14 granted beyond a total of five (5) years from the date of the initial funding allocation.
15 C. In the event the time limits for use of Net Revenues are not satisfied, then any retained
16 Net Revenues that were allocated to an Eligible Jurisdiction and interest earned thereon shall be
17 returned to AUTHORITY and these Net Revenues and interest earned thereon shall be available for
18 allocation to any project within the same source program at the discretion of AUTHORITY.
19 D. AUTHORITY may provide, at AUTHORITY's sole discretion, a refurbished surplus
20 paratransit vehicle, at no cost to CITY and no further responsibility to AUTHORITY after vehicle
21 donation. CITY may purchase additional vehicle(s) in excess of their vehicle allocation, based on
22 availability, at a cost equivalent to the refurbishment costs incurred by AUTHORITY.
23 ARTICLE 3. RESPONSIBILITIES OF CITY
24 A. CITY agrees that all funds received from AUTHORITY as specified in Article 2.A.
25 above will be used exclusively for providing accessible senior transportation services as specified in
26 Exhibit A entitled "Senior Mobility Program Service Plan."
Page 1 of 4
Attachment 1 to
AMENDMENT NO. 1
AGREEMENT NO. C-1-2486
1 B. CITY will ensure the Service Plan is adopted by their governing board in accordance
2 with Section 7.0 of the SMP Funding and Policy Guidelines.
3 C. CITY must satisfy all M2 eligibility criteria as specified in Orange County Transportation
4 Authority Ordinance No. 3 Requirements for Eligible Jurisdictions in order to receive their formula
5 allocation for this program.
6 D. CITY agrees to comply with all provisions of the SMP Guidelines included as Exhibit B.
7 E. CITY agrees that Net Revenues allocated shall be expended within three (3) years of
8 receipt. AUTHORITY may grant an extension to the three-year limit, but extensions shall not be
9 granted beyond a total of five (5) years from the date of the initial funding allocation.
10 F. In the event the time limits for use of Net Revenues are not satisfied, any retained Net
11 Revenues that were allocated to an Eligible Jurisdiction and interest earned thereon shall be returned to
12 AUTHORITY and these Net Revenues and interest earned thereon shall be available for allocation to
13 any project within the same source program at the discretion of AUTHORITY.
14 G. CITY agrees to match a minimum of twenty percent (20%) of the total annual program
15 expenditures. Local match may be made up of cash -subsidies, fare revenues, donations, or in-kind
16 contributions, such as salaries and benefits for the CITY employees who perform work on the
17 program.
18 H. CITY may contract with a third -party service provider to provide senior transportation
19 services provided that:
20 1. Contractor is selected using a competitive procurement process; and
21 2. Wheelchair accessible vehicles are available and used when requested.
22 I. CITY shall procure and maintain insurance coverage during the entire term of this
23 Agreement. Coverage shall be full coverage or subject to self-insurance provisions. CITY shall
24 provide the following insurance coverage:
25 /
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Page 2 of 4
Attachment 1 to
AMENDMENT NO. 1
AGREEMENT NO. C-1-2486
1 1. Commercial General Liability, to include Products/Completed Operations,
2 Independent Contractors', Contractual Liability, and Personal Injury Liability with a minimum limit of
3 $1,000,000.00 per occurrence and $2,000,000.00 general aggregate.
4 2. Automobile Liability Insurance to include owned, hired and non -owned autos with a
5 combined single limit of $1,000,000.00 each accident;
6 3. Workers' Compensation with limits as required by the State of California including a
7 waiver of subrogation in favor of AUTHORITY, its officers, directors, employees or agents;
8 4. Employers' Liability with minimum limits of $1,000,000.00; and
9 J. Proof of such coverage, in the form of an insurance company issued policy
10 endorsement and a broker -issued insurance certificate, must be received by AUTHORITY prior to
11 commencement of any work. Proof of insurance coverage must be received by AUTHORITY within ten
12 (10) calendar days from the effective date of this Agreement with AUTHORITY, its officers, directors,
13 employees and agents designated as additional insured on the general and automobile liability. Such
14 insurance shall be primary and non -contributive to any insurance or self-insurance maintained by
15 AUTHORITY.
16 K. CITY shall include on the face of the Certificate of Insurance the Cooperative Agreement
17 Number C-1-2486; and, the Senior Contract Administrator's Name, Sue Ding.
18 L. CITY agrees to provide AUTHORITY with monthly summary reports of CITY's Senior
19 Mobility Program. CITY shall submit monthly summary report by the end of the following month as
20 specified in Exhibit C "Senior Mobility Program Monthly Reporting Form," included in this
21 Agreement, which is incorporated into and made part of this Agreement.
22 M. CITY shall adopt an annual Expenditure Report to account for Net Revenues and
23 funds expended by the Eligible Jurisdiction, which satisfy the Maintenance of Effort requirements.
24 The Expenditure Report shall be submitted by the end of six (6) months following the end of the
25 jurisdiction's fiscal year and include the following:
26 /
Page 3 of 4
Attachment 1 to
AMENDMENT NO. 1
AGREEMENT NO. C-1-2486
1 1. All Net Revenue fund balances and interest earned.
2 2. Expenditures identified by type (i.e. capital, operations, administration, etc.) and
3 program or project.
4 N. In the event CITY obtains a retired AUTHORITY vehicle for SMP services, CITY
5 agrees to transfer vehicle title and registration within fourteen (14) calendar days from taking
6 possession of the vehicle. CITY also agrees to provide documentation to AUTHORITY confirming
7 transfer of vehicle title and registration from AUTHORITY to CITY within thirty (30) calendar days
8 from taking possession of the vehicle.
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Page 4 of 4
EXHIBIT A
Senior Mobility Program
Agency Service Plan
Agency: City of Santa Ana
Senior Mobility Program
OCTA Agency Service Plan
Jurisdictions and agencies participating in the Orange County Transportation Authority
(OCTA) Senior Mobility Program (SMP) must complete the following Service Plan in order to
receive SMP funding. The Service Plan must be developed in accordance with SMP
Guidelines, included as Attachment 1, and submitted to OCTA for review. Upon review from
OCTA, the Service Plan must be formally adopted by the agency's council or governing body
and approved by the OCTA Board of Directors. Any modifications to SMP services will
require submittal of a new Service Plan.
Participant Information:
Agency City of Santa Ana
Program Contact Juan L. Lara
Phone Number 714-571-4259
Service Description:
1. Program goals and objectives:
Date April 7, 2016
Email jlara@santa-ana.org
Provide transportation services to Santa Ana residents 60 years of age and older.
Assist participants with accessing programs, services and activities that enhance
thair minlih/ of lifer
2. Indicate how SMP service will be operated: (Please check all that apply)
❑7 Directly Operated
Contract Service Provider
❑ Volunteers
Subsidized Taxi Program
Other (Please describe)
3. Eligible trips provided under the Senior Mobility Program are limited to the following
categories. Please indicate the categories of service to be provided by your program:
(check all that apply)
❑✓ Senior Center
® Nutrition
❑ Medical
Personal Care
Shopping
571 Social/Recreational (please list locations)
Orange County Museums, Parks, Beaches, Libraries,Theaters and County Fairs.
4. SMP Guidelines restricts trips outside of Orange County to medical trips within
approximately 10 miles of the Orange County border. Do you intend to provide
medical trips outside of Orange County? O Yes @ No
If yes, please list the trip purpose and destinations: (e.g., medical trips to the VA Hospital
in Long Beach)
5. Fare structure:
Mot Applicable
6. Number of vehicles:
3
7. Projected annual ridership:
200
8. Source(s) of 20 percent match funding:
City General Fund
Program Requirements:
1. jurisdiction/Agency shall follow competitive procurement practices in selection of vendors for
all services which it does not provide using its own workforce. Any Request for Proposals (RFP)
for services shall specify the use of vehicles meeting Americans with Disabilities Act (ADA)
accessibility standards,
2. jurisdiction/Agency will perform, or ensure that a contracted vendor performs, maintenance of
all vehicles used in the Senior Mobility program, including, at a minimum:
a) Daily Pre -Trip inspections that meet or exceed the guidelines provided in the attached
Pre -Trip Inspection Checklist (Attachment 2)
b) Scheduled preventative maintenance that meets or exceeds the guidelines provided in
the attached PM Checklist, including the maintenance of all accessibility features of the
vehicles.
c) Maintain maintenance records for each vehicle for five (5) years and, if required,
cooperate fully in annual motor coach carrier terminal inspections conducted by the
California Highway Patrol.
1 Jurisdiction/Agency will ensure that its operators, or its contracted vendor's operators, are
properly licensed and trained to proficiency to perform duties safely, and in a manner which
treats its riders with respect and dignity, Disability awareness and passenger assistance will be
included in this training.
4, jurisdiction/Agency will establish and implement an alcohol and drug program that complies
with 41 U.S.C. sections 701-707, (the Drug Free Workplace Act of 1988), and will produce any
documentation necessary to establish its compliance with sections 701-707.
S. jurisdiction/t gency will submit a monthly report to OCT 4's CommunityTratisportation Services
Department as illustrated in Attachment 3.
G. jurisdiction/Agency will participate in OCTA marketing and outreach efforts to encourage use of
fixed route transit service by older adults.
7. jurisdiction/Agency will note OCTA sponsorship In any promotional material for service funded
under this agreernent and will display an OCTA Senior Mobility Program logo on vehicles used in
this program (excluding taxis),
8. jurisdiction/Agency will ensure that it maintains adequate oversight and control over all aspects
of services that are provided by a contracted vendor.
IN WITNESS WHEREOF, has formally adopted the Senior Mobility Program Scope of Work
as written above.
AGENCY REPRESENTATIVE
Name: Gerardo Monet
Title- Gerardo Mouet
OCTA REPRESENTAVVE
Name: Beth McCormick
Title: General Manager, Transit
01
/ awl 11 =
Senior Mobility Program
Project U Funding and Policy Guidelines
March 2016
1.0 Overview
The Measure M2 (M2) Project U —Senior Mobility Program (SMP) provides funding
to support local, community-based transportation service for seniors. Originally
established in 2001 using limited state funding for bus operations, M2 Project U
SMP funding was established to continue and expand the existing program.
A formula funding allocation was established for all Orange County local
jurisdictions based upon their senior population. One percent of M2 net revenue
is used to fund the program and local jurisdictions must provide a minimum 20
percent local match of the total annual program expenditures.
The Orange County Transportation Authority (OCTA) Board of Directors approved
these guidelines on March 28, 2016. The purpose is to provide structure and
definitions for all eligible M2 jurisdictions receiving SMP funding. OCTA shall
enforce the provisions spelled out in these guidelines.
2.0 Objectives
• To provide for local, community-based senior transportation services.
■ To allow local jurisdictions to develop and implement senior transportation
services to serve their community.
• To provide transit options for seniors which complement rather than duplicate
OCTA fixed route and ACCESS paratransit service.
3.0 Eligibility Requirements
Participation in the SMP is contingent upon maintaining M2 eligibility. Local
jurisdictions must be eligible to receive M2 funding, established on an annual basis
as specified in the M2 Ordinance Requirements for Eligible Jurisdictions, to receive
the formula allocation for this programa Adherence to strict funding guidelines is
required.
Local jurisdictions are required to submit a Service Plan as described in Section
7.0 and must enter into a cooperative funding agreement with OCTA that defines
the conditions of use of SMP funds prior to receiving their SMP funding allocation.
1 Orange County Transportation Authority Ordinance No. 3, Attachment B, Section III
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S:\TEMP\Sue D\Agencies\SMP-Attachment B,docx
4.0 Funding Allocation Method & Distribution
Funding for the program is identified as one percent of M2 net sales tax revenue
and will be allocated to eligible local jurisdictions based upon the participating
jurisdiction's percentage of the senior population of the county. Senior population
is determined by using the most current official decennial Census information
provided by the U.S. Census Bureau.
Funding allocations are based on actual sales tax receipts. Funding will be
distributed on a bi-monthly basis. SMP funds must be expended within three years
of receipt.
OCTA may grant a two-year extension beyond the three-year expenditure
limitation; however, an extension may not exceed five years from the date of the
initial funding allocation. Jurisdictions requesting an extension beyond the
three-year limitation must submit a justification letter for review and approval by
OCTA at least 90 days prior to the end of the third fiscal year.
In the event the time limits for use of SMP funds are not satisfied, any retained
SMP funds that were allocated to an eligible jurisdiction, including interest, shall
be returned to OCTA.
5.0 Match Requirements
Participating jurisdictions must provide a minimum 20 percent local match of the
total annual program expenditures. Match funding may be made up of cash
subsidies, fare revenues, donations, or in-kind contributions such as salaries and
benefits for the jurisdiction's employees who perform work on the program.
Jurisdictions may also be required to submit supporting documentation to
substantiate local match expenditures. Jurisdictions are not required to contribute
the minimum match requirement on a monthly basis; however, the minimum 20
percent match requirement must be met by the end of each fiscal year, defined as
June 30.
Jurisdictions not satisfying the annual 20 percent match shall be subject to
withholding of funds from future bi-monthly allocations equal to the difference
between the amount of Measure M funds actually spent and the amount of
Measure M funds actually matched.
2 1 P a g e
S:\TEMP\Sue D\Agencies\SMP-Attachment B.docx
EXHIBIT B
Example:
Total Program Expenditures $100,000
Total M2 Funding Allocation $ 80,000
20% Required Match $ 20,000
Actual Reported Match $ 15,000
Withholding Calculation:
Total M2 Funds Spent $ 80,000
M2 Funding Eligibility Based on Actual Reported Match 60,000
Withholding from Future Allocation(s) $ 20,000
6.0 Service Guidelines
Services provided under the SMP are available to individuals 60 years of age and
older. Jurisdictions have discretion in the types of trips provided within Orange
County, such as trips to/from senior centers, medical appointments, shopping,
personal care, and social/recreational activities. Jurisdictions should use discretion
when providing trips for social/recreational activities when developing their Service
Plan to ensure prudent and appropriate use of taxpayer funds. SMP trips outside
Orange County are restricted to medical trips only within approximately 10 miles
of the Orange County border.
Jurisdictions also have discretion in how the service is operated. Senior
transportation services may be operated using employees, volunteers, or the
jurisdiction may contract with a third -party service contractor. Contractors must be
selected using a competitive procurement process and the jurisdiction must ensure
the contractor is in compliance with program guidelines and provisions included in
the cooperative funding agreement.
Jurisdictions whose program offers subsidized taxi service for seniors must ensure
trips provided with SMP funding are consistent with the trip types as specified in
these guidelines.
Wheelchair accessible vehicles must be available for SMP service.
Jurisdictions will perform, or ensure that a contractor performs, maintenance of all
vehicles used in the Senior Mobility Program. Jurisdictions will ensure that its
operators, or its contracted operators, are properly licensed and trained to
proficiency to perform duties safely, and in a manner which treats its riders with
respect and dignity.
Jurisdictions may receive retired OCTA ACCESS paratransit vehicle(s) to support
their senior transportation program. Additional retired ACCESS vehicles may be
31 Page
S:\TEMP\Sue D\Agencies\SMP-Attachment 8.docx
EXHIBIT B
purchased, based on availability, for a cost equivalent to the refurbishment costs
incurred by OCTA.
7.0 Service Plan Adoption
Participating jurisdictions shall submit to OCTA a SMP Service Plan which defines
program services (Exhibit A). The Service Plan must be submitted using a
template provided by OCTA and must be adopted by the jurisdiction's governing
body and approved by the OCTA Board of Directors. Any deviation from the
adopted SMP Service Plan must be submitted to OCTA in advance for review and
approval and will require an amendment to the cooperative funding agreement
prior to implementing a change in program services.
8.0 Eligible Expenses
Participating jurisdictions shall ensure M2 funds are used for eligible direct
program -related expenses which may include contract service providers, staff
time, vehicle maintenance, fuel, insurance, vehicle acquisition, program supplies
and materials, marketing materials, and community outreach. Jurisdictions shall
ensure all costs are program -related and are fair and reasonable. Administrative
costs up to 10 percent are allowed and considered eligible program expenses. All
program expenses are subject to audit.
No M2 funding shall be used by a jurisdiction for other than transportation purposes
authorized in the M2 Ordinance.
9.0 Program Revenue
Participating jurisdictions must maintain adequate controls for collecting and
reporting program revenue, including donations, fees, and cash fares. Program
revenue must be used to support the transportation service and may be used as
part of the jurisdiction's 20 percent local match requirement.
10.0 Reporting
Participating jurisdictions are required to submit monthly reports using a reporting
template provided by OCTA (Exhibit B). Required monthly reporting data may
include, but is not limited to, the following:
o Number of Trips by Category
o Vehicle Service Hours
o Vehicle Service Miles
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�:1:Il-irie?
o Program Cost Detail by Expense Category and % of Total Operating Cost
o Fares, Fees and Other Operating Revenue
o Jurisdiction Total Contribution & Source
o Jurisdiction Share as % of Total Operating Cost
o Cumulative Jurisdiction Share to Date
o OCTA Contribution
o OCTA Contribution as % of Total Operating Cost
o Cumulative Contribution Received from OCTA
o Total Monthly Program Operating Cost
o Cumulative Total Program Operating Cost
Jurisdictions shall also be required to maintain supporting documentation to
substantiate reporting data. Supporting documentation may include, but is not
limited to, actual receipts, contractor invoices, trip sheets, payroll, timesheets, fuel
logs, and maintenance records/receipts.
Reports are due by the last day of the following month. A preliminary report may
be submitted; however, submission of a final report is required within 15 days of
the last day of the following month. Failure to meet the established reporting
deadline for two months at any time during the fiscal year may result in future
withholding of funding and/or other sanctions to be determined.
11.0 Audits & Inspection of Records
M2 funding is subject to audit. Jurisdictions shall maintain program documentation
and records for a period of no less than five years. Program documents and
records, including but not limited to payroll, trip sheets, invoices, vehicle
maintenance, fuel, and other program -related expenses, shall be available for
review by OCTA SMP administrators, auditors, and authorized agents upon
request. Jurisdictions must follow established accounting requirements and
applicable laws regarding the use of public funds. Failure to submit to an audit in
a timely manner may result in withholding or loss of future funding. Failure to
comply with the approved Service Plan will require remediation which may include
repayment, reduction in overall allocation, and/or other sanctions to be determined
by the OCTA Board of Directors.
Audits shall be conducted by the OCTA Internal Audit Department, or other
authorized agent, as determined by OCTA.
OCTA's failure to insist in any one or more instances of a jurisdiction's performance
of the provisions set forth in these guidelines shall not be construed as a waiver or
relinquishment of the jurisdiction's obligation to comply with these guidelines.
Moreover, only the OCTA Board of Directors shall have the authority to alter and/or
waive any requirements/obligations set forth in these guidelines.
51 Page
S:\TEMP\Sue D\Agencies\SMP-Attachment B.docx
M Senior Mobility Program
OCTA Monthly Reporting Form
41,4011-1111
Service for the - Month of: July
Program Name:
Participating Agency:
Agency Contact:
Contact Number:
Year of:
2016
Senior Center
fiedical
Shopping
Personal Care
Social Recreational
"MM
Service Contract
$
0.0%
0.0%
Drivers /Operators Dispatchers
0.0%
0.0%
Vehicle Maintenance /Fuel /Insurance
0,0%
0.0%
Marketing Outreach
$
0.0%
Administration
0.0%
0.0%
OCTA Contribution
0.0%1
0.0%
Agency Contribution
0.0%
Program Revenue
0.0%1
0.0%
Source(s) of Agency Contributions:
Agency hereby certifies that this report is a true, complete and correct statement of
program revenue, costs and operating data.
Please send this report by email to CTSPROGRAMS@OCTA.NET or by fax to 714-560-5927.
If there are any questions, please contact JOANNE JACOBSEN by email at JJACOBSENC@OCTA.NET
or JP GONZALEZ by email at JGONZALEZ1@OCTA.NET.
CERTIFICATE OF COVERAGE I 07/05/2016
PRODUCER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
Alliant Insurance Services, Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE MEMORANDUM OR POLICY
P.O. BOX 6450 BELOW:
NEWPORT BEACH, CA 92658-6450 COMPANIES AFFORDING COVERAGE
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FOR THE POLICY OR MEMORANDUM 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 COVERAGES AFFORDED BY THE
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OR POLICY. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPES MEMORANDUM MEMORANDUM MEMORANDUM
LTR OF OR OR POLICY OR POLICY LIMIT
COVERAGES POLICY NUMBER EFFECTIVE EXPIRES
EXCESS LIABILITY DIFFERENCE BETWEEN
A OCCURRENCE FORM BI & PD $10,000,000 POOL LIMIT
INCLUDING AUTOMOBILE
BO -05 07/01/2016 07/01/2017 COMBINED AND
$1,000,000
LIABILITY SELF-INSURED RETENTION
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS:
AS RESPECTS AGREEMENT #C-2-0148 SENIOR MOBILITY PROGRAM.
CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO BODILY INJURY AND PROPERTY DAMAGE
ARISING OUT OF OPERATIONS AS DESCRIBED BY OR ON BEHALF OF THE NAMED INSURED
SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. wed g,t�
Uev�S
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN
ORANGE COUNTY TRANSPORTATION AUTHORITY BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
ATTN: REBECCA POTTER, CPM LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
SENIOR PROCUREMENT ADMINISTRATOR REPRESENTATIVES,
550 S. MAIN STREET ---
ORANGE, CA 92863-1584 AUTHORIZED REPRESENT TIVE
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BIG INDEPENDENT CITIES EXCESS POOL MEMBER:
COMPANY LETTER
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ATTN: ED RAYA
RISK MANAGER
COMPANY LETTER
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P.O. BOX 1988
SANTA ANA, CA 92702-1988
COMPANY LETTER
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FOR THE POLICY OR MEMORANDUM 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 COVERAGES AFFORDED BY THE
MEMORANDUM OR POLICY(IES) DESCRIBED HEREIN ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUM
OR POLICY. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPES MEMORANDUM MEMORANDUM MEMORANDUM
LTR OF OR OR POLICY OR POLICY LIMIT
COVERAGES POLICY NUMBER EFFECTIVE EXPIRES
EXCESS LIABILITY DIFFERENCE BETWEEN
A OCCURRENCE FORM BI & PD $10,000,000 POOL LIMIT
INCLUDING AUTOMOBILE
BO -05 07/01/2016 07/01/2017 COMBINED AND
$1,000,000
LIABILITY SELF-INSURED RETENTION
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS:
AS RESPECTS AGREEMENT #C-2-0148 SENIOR MOBILITY PROGRAM.
CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO BODILY INJURY AND PROPERTY DAMAGE
ARISING OUT OF OPERATIONS AS DESCRIBED BY OR ON BEHALF OF THE NAMED INSURED
SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. wed g,t�
Uev�S
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN
ORANGE COUNTY TRANSPORTATION AUTHORITY BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
ATTN: REBECCA POTTER, CPM LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
SENIOR PROCUREMENT ADMINISTRATOR REPRESENTATIVES,
550 S. MAIN STREET ---
ORANGE, CA 92863-1584 AUTHORIZED REPRESENT TIVE
Al
THIS ENDORSEMENT DOES NOT CHANGE THE MEMORANDUM. PLEASE READ IT CAREFULLY.
ADDITIONAL COVERED PARTY - COVERED
INDEMNITY CONTRACT
This endorsement identifies coverage provided under the following:
BICEP MASTER MEMORANDUM OF LIABILITY COVERAGE
The following wording can be found in Section II, Definitions:
6. COVERED PARTY -- means:
f. Any person or entity holding a certificate of coverage duly issued by BICEP, as limited
therein ("ADDITIONAL COVERED PARTY"). An ADDITIONAL COVERED
PARTY is not covered for claims arising from the ADDITIONAL COVERED
PARTY's sole negligence or for claims by another COVERED PARTY.
g. Any person, entity or organization to whom the COVERED PARTY is obligated by
virtue of a COVERED PARTY INDEMNITY CONTRACT to provide coverage solely
with respect to BODILY INJURY AND PROPERTY DAMAGE arising out of:
i. Premises leased, used or occupied by the COVERED PARTY
ii. AUTOMOBILES leased or rented by the COVERED PARTY
iii. Equipment owned, leased, rented, maintained or used by the COVERED
PARTY
iv. Mortgagees of the COVERED PARTY; or
v. Property owners and property managers of property owned, leased, rented or
occupied by the COVERED PARTY,
vi. However, these COVERED PARTY INDEMNITY CONTRACT coverages do
not apply to:
aa. An OCCURRENCE which takes place prior to or after the COVERED
PARTY ceases to occupy the premise stated in the COVERED
INDEMNITY CONTRACT,
bb. Any structural alternation, new construction or demolition operations
performed by or on behalf of the COVERED PARTY
cc. Any PUBLIC ENTITY ERRORS AND OMISSIONS or EMPLOYMENT
PRACTICES.
h. The coverage set forth in subsection (g) immediately above will be limited to any limits
of coverage within the terms of the COVERED INDEMNITY CONTRACT or the
LIMITS OF COVERAGE within this MEMORANDUM, whichever is less, and will
apply in excess to any underlying insurance or the COVERED PARTY'S SELF-
INSURED RETENTION. BICEP will not be obligated for LIMITS OF LIABILITY
greater than that provided by this MEMORANDUM.
�oevr� PJ
� 4CS
712014 Ed BICEP MOC Attachment Page 1 of 1
CERTIFICATE OF COVERAGE 1 07/05/2016
PRODUCER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
Alliant Insurance Services, Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE MEMORANDUM OR POLICY
P.O. BOX 6450 BELOW:
NEWPORT BEACH, CA 92658-6450 COMPANIES AFFORDING COVERAGE
PH (949) 756-0271 / FAX (949) 756-2713
LICENSE NO. OC36861 COMPANY LETTER (A) BIG INDEPENDENT CITIES EXCESS POOL
--l-
COMPANY LETTER (B)
BIG INDEPENDENT CITIES EXCESS POOL MEMBER:
COMPANY
LETTER
(C)
CITY OF SANTA ANA
ATTN: ED RAYA
RISK MANAGER
COMPANY
LETTER
(D)
P.O. BOX 1988
SANTA ANA, CA 92702-1988
COMPANY
LETTER
(E)
COMPANY LETTER (F)
COVERAGES
THIS IS TO CERTIFY THAT THE MEMORANDUM OF COVERAGE OR POUCY(IES) LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE
FOR THE POLICY OR MEMORANDUM 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 COVERAGES AFFORDED BY THE
MEMORANDUM OR POLICY(IES) DESCRIBED HEREIN ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUM
OR POLICY. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPES MEMORANDUM MEMORANDUM MEMORANDUM
LTR OF OR OR POLICY OR POLICY LIMIT
COVERAGES POLICY NUMBER EFFECTIVE EXPIRES
EXCESS LIABILITY DIFFERENCE BETWEEN
A OCCURRENCE FORM BI & PD $10,000,000 POOL LIMIT
INCLUDING AUTOMOBILE
BO -05 07/01/2016 07/01/2017 COMBINED AND
$1,0
LIABILITY RETENTIONSELF-INSURED
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS:
AS RESPECTS AGREEMENT #C-2-0148 SENIOR MOBILITY PROGRAM.
CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO BODILY INJURY AND PROPERTY DAMAGE
ARISING OUT OF OPERATIONS AS DESCRIBED BY OR ON BEHALF OF THE NAMED INSURED
SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS.
CERTIFICATE HOLDER
ORANGE COUNTY TRANSPORTATION AUTHORITY
ATTN: REBECCA POTTER, CPM
SENIOR PROCUREMENT ADMINISTRATOR
550 S. MAIN STREET
ORANGE, CA 92863-1584
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
F
THIS ENDORSEMENT DOES NOT CHANGE THE MEMORANDUM. PLEASE READ IT CAREFULLY,
ADDITIONAL COVERED PARTY - COVERED
INDEMNITY CONTRACT
This endorsement identifies coverage provided under the following:
BICEP MASTER MEMORANDUM OF LIABILITY COVERAGE
The following wording can be found in Section II, Definitions:
6. COVERED PARTY -- means:
f. Any person or entity holding a certificate of coverage duly issued by BICEP, as limited
therein ("ADDITIONAL COVERED PARTY"). An ADDITIONAL COVERED
PARTY is not covered for claims arising from the ADDITIONAL COVERED
PARTY's sole negligence or for claims by another COVERED PARTY.
g. Any person, entity or organization to whom the COVERED PARTY is obligated by
virtue of a COVERED PARTY INDEMNITY CONTRACT to provide coverage solely
with respect to BODILY INJURY AND PROPERTY DAMAGE arising out of:
i. Premises leased, used or occupied by the COVERED PARTY
ii. AUTOMOBILES leased or rented by the COVERED PARTY
iii. Equipment owned, leased, rented, maintained or used by the COVERED
PARTY
iv. Mortgagees of the COVERED PARTY; or
v. Property owners and property managers of property owned, leased, rented or
occupied by the COVERED PARTY,
vi. However, these COVERED PARTY INDEMNITY CONTRACT coverages do
not apply to:
aa. An OCCURRENCE which takes place prior to or after the COVERED
PARTY ceases to occupy the premise stated in the COVERED
INDEMNITY CONTRACT,
bb. Any structural alternation, new construction or demolition operations
performed by or on behalf of the COVERED PARTY
cc. Any PUBLIC ENTITY ERRORS AND OMISSIONS or EMPLOYMENT
PRACTICES.
h. The coverage set forth in subsection (g) immediately above will be limited to any limits
of coverage within the terms of the COVERED INDEMNITY CONTRACT or the
LIMITS OF COVERAGE within this MEMORANDUM, whichever is less, and will
apply in excess to any underlying insurance or the COVERED PARTY'S SELF-
INSURED RETENTION. BICEP will not be obligated for LIMITS OF LIABILITY
greater than that provided by this MEMORANDUM.
712014 Ed BICEP MOC Attachment Page I of I