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HomeMy WebLinkAboutSUPER ANTOJITOS 3 - 2017City of Santa Ana f Clerk of the Council core office use only AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. _ ° teRK IN THE Is the agreement(s) a permanent record? Yes No i( : = Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with No. N-2017-182 was completed on and final payment has been made. (List all amendments. Use space below if needed.) (� /� Department: P 1 ILS A Phone/Ext.: �iCc -A Signature: a 1wiy Date: /aG1q Revised: 10-1 & 16 �t1 L (W N-2017-182 INSURANCE NOT ON FILE/Y's1) WORK MAY NOT PROCEED CLERK OF COUNCIL CATERING SERVICES AGREEMENT DATE:* 14 UT THIS AGREEMENT is made and entered into this lo'Ay of September, 2017, by and between Super Antojitos ("Provider") 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 ("City"). RECITALS A. The City desires to retain a service provider having special skills, resources and knowledge to provide food catering for the Fiestas Patrias 2017 event. B. Provider represents that Provider is able and willing to provide such services to the City. C. In uuudertaking the performance of this Agreement, Provider represents that it is knowledgeable in the field and that any services performed by Provider under this Agreement will be performed in compliance with such standards as may reasonably be expected. 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: 1. SCOPE OF SERVICES Provider shall perforrn those services as set forth in Exhibit A to this Agreement. 2, COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed Five Thousand Five Hundred Seventy Seven Dollars ($5,577.00) during the term of this Agreement. This amount includes a 10% contingency of up to $507,00 for services as may be provided by Consultant at the sole discretion of City. b. Payment by City shall be made within thirty (30) days following full execution of this agreement, 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. 3. TERM This Agreement shall commence on the date first stated above and terminate on September 17, 2017 unless terminated earlier in accordance with Section 11, below. Page I of 7 4. INDEPENDENT CONTRACTOR Provider 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 employcr-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the manner in which Provider performs the services which are the subject matter of this Agreement; however, the services to be provided by Provider shall be provided in a manner consistent with all applicable standards and regulations governing such services. Provider 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. Provider is not an agent, representative or employee of City and Provider shall have no authority to act on behalf of the City. S. INSURANCE Prior to undertaking performance of work under this Agreement, Provider shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Provider shall maintain commercial general liability insurance which 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 Provider's negligent 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 and $2,000,000 in the aggregate, Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insured provisions. 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 California State law, Consultant, if Provider 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, Provider agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. The following requirements apply to the insurance to be provided by Provider pursuant to this section: (i) Provider shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. Page 2 of 7 (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City. (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. e. if Provider fails or refuses to produce or maintain the insurance required by this section or fails or refuses to famish 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 terminate this Agreement. Such termination shall not affect Provider's right to be paid for its time and materials expended prior to notification of termination. Provider waives the right to receive compensation and agrees to indemnify the City for any work perfo teed prior to approval of insurance by the City. 6. INDEMNIFICATION Provider agrees to and shall defend, 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 death, and claims for property damage, which may arise from the negligent operations of the Provider 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 Provider 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, 71 CONFLICT OF INTEREST Provider 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. &. 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 fax or other telegraphic communication in the manner provided in this Section, to the following persons: Page 3 of 7 To City: Clerk of the Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax (714) 647-6956 With copy to: Executive Director of Parks, Recreation and Community Services City of Santa Ana 26 Civic Center Plaza (M-23) P.O, Box 1988 Santa Ana, California 92702 Fax (714) 571-4211 To Provider: Super Antojitos 1702 North Bristol Santa Ana, CA 92703 Phone: (714) 835-3619 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, 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 fax, 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. 9. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Provider regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terns 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 Provider. 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 Provider or 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 is not embodied herein. 10. ASSIGNMENTS The experience, knowledge, capability and reputation of Provider were a substantial inducement for City to enter into this Agreement. Therefore, Provider may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any Page 4 of 7 such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. 11. TERMINATION This Agreement may be terminated by the City at any time upon written or verbal notice of termination. In such event, Provider shall be entitled to receive, and City shall pay Provider, compensation for all services rendered prior to the effective date of termination. 12. NON DISCRIMINATION Provider 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, teaching, training, utilization, promotion, termination or other employment related activities, or in any activities under this Agreement. Provider affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. JURISDICTION — VENUE 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. 14. LICENSES Provider 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. 15. SEVERABILITY In the event that one or more of the phrases, sentences, clauses, paragraphs or sections contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree of a court of competent jurisdiction, such invalidity or tmenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be interpreted to carry out the intent of the parties hereunder. 16. EXHIBITS All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 17. AUTHORITY Page 5 of 7 The person(s) executing this. Agreement on behalf of the parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said parties and that be so executing this Agreement, the. parties hereto are founallybounifto theprovisions of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and. year first above written, ,ATTEST! C(�ML� Z- - d— MA D. HUIZAR ,CIer1C of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: JOHN FUNK Assistant City Attorney RECOMMENDED FOR APPROVAL: GERAY-00 MOUET . . ExecutivQ'Director of Parks, Recreation and Community Services Agency CITY OF SA19TA ANA Interim C4 Manager 'PROVIDER: 8UPE12ANTOJITO$ Tax ID: Page 6:d 7 EXHIBIT A Page 7 of 7 m Purpose of expense: F1ESTA EVENP VIP CA'1'MNG RICE BEANS ME SUPER ANTOJITOS 1702 N. BRISTOL SANTA ANA CA 92703 714 835.3619 INVOICE CITY OF SANTA ANA 250 PEOPLE 9/ 16/ 17 250 PEOPLE 9/ 17/ 17 2 CONTAINERS ORDER OF SALSA 3 TYPES CHICKEN, PORK, PASTOR AGUAS TAMARINDO, LEMON, HORCHATA 40 VIP/APPLUZE S ASSORTED $8.00 $320.00 $320,00 TAX INCLUDED 10.00 GRAND TOTAL 1$5,0 CERTIFICATE OF LIABILITY INSURANCE °A04125/201�w" THIS CERTIFICATE 15 ISSUED ASA 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 ACONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTAW,, IfthecertlRcate holder is an ADDITIONAL INSURED, the policy(lea) must haveADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subled to Use terms and conditions of the polity, Certain polictesmay require an endorsement, A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements). ............... ..... ..... .............. . .... ......_ ...._-.. __.. _... ......__—_.-. _.___—_ _. _.__.-._..... PRODUCER CONTACT NAME: Wendy Munoz ' Wendy MUnOZ(976134A) 'PHONE FAX 2441 N Tustin Ave Ste E (A/C, NO, EXT): 714-550-1100 (A/C, No): 714-550.7170 .�5-MAIL Santa Ana CA 02705-1061 ADDRESS: WmUTIOZ )farmersagent corn INSURER(5)AFFORDING COVERAGE NAICN INSURED-INSURERA: Truck Insurance Exchange 21709 .... ....__.... INSURER& Farmerslnsurance Exchange 21652 ELIZALDE, GUILLERMO --- --- ---- --- ---- IDEA: SUPER ANTOJITOS EXPRESS INSURERc Mid Century Insurance Company 21687 1702 N BRISTOL ST STE D INSURERD --- _..... ....... ._ ...._. ___ . -. SANTA ANA CA 92706 INSURERE '.. INSURERF: .._..-.___. _.__,.. ......__.._.. __....._.__ . .. _. _. .._ ..._..._-_..--- _—_...._ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ._.. _ ..._._.._._ _._.——..._— HE_I .___.E .__.O IN TO NCE THIS I EMENT. TERM CONDITICIESOFINSURATRACTOR BELOWHAVE BEEN IESUEDTOTHEIO WHIC NAME ABOVE FOR MAYKIISSUCY E OR INOICATA THEINSURANC AFFORDED REQUIREMENT. TERM OREIN5ITBJECT ION ANY WNTRACTOR OTHERDOCUMENTC NDITIOSPECTTCHPOITHIS CERTIFICATE SHOWN MAY1SSUEDEN REDUCETAIN,THEINSURANCEAFFORD@BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHETERMS, EXGLUSIONSAND CONDITIONSOF SUCH POLICIES. LIMITS SHO'NNMAVHAVEBEEN REDUCE.. BY PAID CLAIMS. INSR Type OF INSURANCE AOOTL SUER POLICYNUMBER POLICY SEE POLICY EXP OMITS LTR INS° WVD (MM/DD/)rYYY) (MM/OD/YYYY) Z/I COMMERCWL GENERAL UARUTY EACHOCCURRENCE $ 1,000,000. I I.,.__7 CLAIMS-MAOE X j OCCUR DAMAGETORENTED $ - PREMISE5(EaOccurrence) 250.000 ~- MED EXP(Anyone person) $ 5 000 A __ Y Y 605416467 11/01/2016 ` 11101/2017 PERSONAL&ACV INJURY $ 1,000,000 _._._._......,. GEN'L AGGREGATE LIMIT APPLI ES PER: GENERAL AGGREGATE $ 2000000 , ,I POLICY PROJECT L �; LOC PRODUCTS COMP/OP AGO $ 2,000,000 OTHER: 'q AUTOMOBILELNLBILITY COMBINEDSINGLEUMIT $ " (Ea accident) ANYAOTO ,...,....__. .. ... BODILY INJURY(nerperson) ._...._..__J. E 4 OWNEDAUTOS SCHEDULED T ONLY AUTOS '.' BODILY INJURV(Per accident)$ 'HIREDAUTOS NON -OWNED '- ,Ay, ��•° PROPERTY DAMAGE $ -, ONLY 1 AUTOSONLYU .. (Peraccident) ..... ..,. .. UMBRELLA LIAB OCCUR EXCESS LIAR CLAIMS MADE EACHOCCURRENCE S AGGREGATE _ $ _ .._DED RETENTION$ ..._.. ...' �� ,✓•�e ,YAfir. ..... ____ —. -. AND EM SCO RS'LUM ILIT ',. AND EMPLDYERS'LIABILITY - PER STATUTE OTHER $ ANY PROPRIETOR/PARTNER/ YIN �(•. P 11 EL EACH ACCIDENT $ EXECUTIVE OFFICER/MEMBER N/A -"" - EXCLUDEDI(Manditory in NH) ; E.L. DISEASE -EA EMPLOYEE $ DESCRIPTION Of �_......-..._-.:... _.._. ._._........._. OPERATIONS OPERATIONS below below/ E.L DISEASE -POLICY LIMIT S DESCRIPTION OF (ACORD IDI, Additional Remarks Schedule, maybeattachad Ifmpreapace lsreRuimd) 1702 IN BRISTOL ST,TISANTA ANANCA 92706 CERTIFICATE HOLDER CANCELLATION THE CITY OF SANTA ANA. . ..__.._� .____... _._ .... _.. _.... .. SHOULD ANY OFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION 20 CIVIC CENTER PLAZA DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICYPROVISIONS, A11�������ESENTATiVE ........ _—..._........ .__SANTAANA .... _.. . _CA -92701 ACORD 25 (2016/03) 01988.2015 ACORD CORPORATION. All Rights Reserved 31-1759 11.15 The ACORD name and logo are registered marks of ACORD A,e-"'/l v3l^f� 'I'llCERTIFICATE QF LIABILITY INSURANCE rMoai262017 THISCERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOTAFFIRMATIVELYOR NEGATIVELY AMEND, EXTENU ORALTER 1'HE COVF-RAGEAFFORDP.D BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTEA CONTRACTBET WREN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT; Ifthe cordecate holder Is an ADDITIONAL INSURED, the pollcy(las) must have ADDITIONAL INSURED provisions or he endorsed. IfSUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, contain policlesmayrequire an ondorsement.Astatementon this certificate doesnotconfer Narrate the certlBcnteholder In lieu ofsuch endorsoment(s). ....,...........,......»_, PRODUCER CONTACT PARKSIDE INSURANCE SERVICES, INC 18511 Bmokhurst $t NAME: CUYEN HOANG PHONE (A/C, NO, EXT): 714-705.0453 FAX (A/C, Noy 714.839.7381 Fountain Valley CA 92708 E-MAIL ADDRESS: PARKSIDEIN8@GMAIL.COM INSURER(S)AFFORDING COVERAGE NAICF INSURED INSURERA: EMPLOYERS PREFERRED INSURANCE CO ELIXALOE, OUIL.LERMO INSURERS: INSURER01 DBA; SUPER ANTOJITCS EXPRESS 1702 N BRISTOL ST STE D INSURERS: INSURERE: SANTA ANA CA 02706 INSURERF: w VtKFW1Lg1t NVMetR: REVISIO14NUMHER: THIS ISTO CERTIFYTHATTHE POLICIES OFINSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANOINGANY REQUIREMENT, TERM OR CONDITION OFANYCONTRACT OR OTHER OOCUMENT WITH RESPECTTO WHICH THIS CERTIPICATE MAYBE ISSUED OR MAYPERTAIN. THE INSURANCEAFFORDED HYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPEOFINSURANCE ADDn. INSD SURR me POLICY NUMBER POLICY SEE (MM/DD/YYYY) POLICYEXP (MM/DD/YYYY) LIMITS COMMERCIALGENERALLIABILIYY � � EACH OCCURRENCE $ CLAMS -MADE OCCUR DAMAOFTO RENTED PREMISES(Ea Occurrence) $�� MED EXP(AnypPO person) $ PERSONAL&ADY INIURY $ GEN'L AGGRErGATIE LIMITAPPLIES PER: GEN ERAL AGGREGATE $ POLICY PROJECT LOC a PRODUCTS-COMP/OP AGG $ OTHER: $ AU'POMOBILE LIABILITY ANYAUTO _ ° COMBINED SINGLE LIMIT (Eaaccldorn) $ BODILY INJURY (Per person) $ OWNEDAUTOS SCHEDULED ONLY AUTOS HIREp AUTO5 NON-ON/NED!':3.� ONLY AUIOSONLY �\ ��� �a�`'� a -gym ." BODILY INJURY(Peracrvdent)$ PROPERTY DAMAGE (Peraecidenp $ $ UMBRELLALIA3 OCCUR �r EACHOCCURRENCE $ EXCESS LIAR CLAIMS -MADE �.T 1 AGGREGATE $ SfD RETENTION$ ._-,.. $ ._... WORNER5COMPENSATION AND EMPLOYERS'LIAWLITY X PER STATUTE OTHER $ A ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER E%CLUDEDI(Mandatory In NH) Y N/A EIG229134900 11/01/2016 11/01/2017 F-.L. HIGH ACCIDENT E 1,000,000 E.L, DISEASE - EA EMPLOYEE 11000,000 Yves, descolueuaderDESCRIPTION OF OPERATIONShebw E-L. DISEASE-POUCYLIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101, Audi III Remarks Schedule, May be attached Rumors spare b required) v Certificate holder, its officers, agents, and employees are named as Additional Insured . Should any of the above described policies be cancelled before the expiration date thereof, the issuing Insurer will endeavor to mall 30 days written notice to the additional Interest named below, but (allure to mail such notice shall Impose no obligation or liability of any kind upon the Insurer, Its agents or representatives. 1D- days notice of cancellation for nonpayment CERTIFICATE HOLDER CANCELLATION ----Urlyot Santa Ana SHOULD ANY OF TH E ABOVE DESCRI BED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn: PRCSA DATE THEREOF NOTICE WILL BEOELIVERED IN ACCORDANCEWITH THE POLICY PROVISIONS, 20 CIVIC Center Plaza M-23 Atabq&? 6ESENTATIVE � Santa Ann «r".A.�2ZOL..�._.._.w.,. ........_...� _,.._...........,........ _..._............-...,..,_,._. ACORD 25 (201603) ©1988-2015 ACORD CORPORATION, All Rights Reserved 31-1769 11-15 The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED ENDORSEMENT Insurance Company_�ryyt���� This endorsement modifies such Insurance as is afforded by the provisions of Polley ® u° / Grp/ 6 a relating to the following; 1, The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative are named as additional insureds ("additional Insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named Insured, 2, With respect to claims arising out of the operations and uses performed by or on behalf of the named Insured, such Insurance as Is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds, 3• This Insurance applies ssparataly to Bach insured against whom claim is made or suit is brought except with respect to the company's Ilmlts of liability. The inclusion of any person or organization as an Insured shall not affect any right which such person or organization would have as a claimant If not so Included, 4• With respect the additional Insureds, this Insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has boon given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, Including countorsignature, Is required to make this endorsement effective,) Effective _q5 � , this endorsement form as part of Policy #_al�lp� Issued to oDpsr,...Hri P6101` Namas d Counterslgned b 7 ��a MIL3689190 - vicrOM SANDOVALLOPEZ - 11) Cards California Insurance ID Card Alliance United Insurance Company PO BOX 6042 Camarillo, CA 93011-6042 NAIC # 10920 Policy Number Effective Date Expiration Data MIL3689190 09/2212017 0312212018 (0 card Valid only it poky is in -force) Named Insured: Named Drivers; VICTOR J SANDOVALLOPEZ -VICTOR J SANDOVALLOPEZ 2132 S ROSS ST -MADE JESUS SANDOVAL SANTA ANA, CA 92707-2717 Broker: TEPA INSURANCE SERVICES lNC - 001 Phone: (714) 835-5159 Vehicle Information: Year Make Model VIN # 2006 CHEV EXPRESS G3500 1GAHG35UO61270014 If You Are In An Accident 1. Do not leave the scene. 2, Call the police to report the accident. 1 Call Alliance United Insurance Company at (800) 508-5833. 4, Do not admit fault, Do not discuss the accident with anyone except the police and your Alliance United Insurance Company representative, 5. Exchange information with the other driver. Ask for the following: . Name, address, driver's license number, and phone numbers of other drivers and witnesses. 0 Year, make, model, and license plate number of all vehicles involved, 0 Name of Insurance Company and policy number of other drivers.