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HomeMy WebLinkAboutPREMIER VENDGROUP INC. 2 - 2017�., City of Santa A .....- .... �t t Clerk of the Council C:oTc 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TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect.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. s the agreementf,1 ER OF agsE COUNCILs) a permanent record? Yes No AW 2 eL e Pt0:32 Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with N-2017-263 (1 da 0 No. was completed on it and final payment has been made. (List all amendments. Use space below if needed.) !)—'-'�C'V1_0U3-0� Department: 17 Phone/Ext.: Signature: i Ck , el J "I zo_ Date: % /Q-IQ-1 Revised: 10-18-16 ",NSURA"NCF ON FILE lCvORK MY PROULD UNIX INSURANCE FkNIRI:S CLERK OF CO NCI 18 ' 0; PRCS (/ ) Silvia Cuevas VENDING AGREEMENT BETWEEN THE CITY OF SANTA ANA AND PREMIERE VENDGROUP INC. N-2017-263 This Agreement is made and entered into this 6th day of December, 2017, by and between Premier Vendgroup Inc., a California corporation ("Vendor"), and the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the state of California ("City"). RECITALS A. The City desires to retain a vending company to provide beverage and/or snack vending machines at various City -owned properties. B. Vendor represents that Vendor is able and willing to provide such services to the City. Vendor offers soft drinks, water, iced tea, juice and snack products for sale in Vendor -awned vending machines. Vendor desires to place its vending machines at various agreed upon City -owned and operated facilities ("the Premises"). C. Vendor ensures that no less than fifty percent (50%) of the food and beverages provided in all vending machines located on the Premises will be of a healthy variety in compliance with the City's policy regarding healthy snacks in vending machines at City -owned facilities. D. Vendor represents that it is experienced in its field and that any services performed by Vendor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional vending company. WHEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties hereto do hereby agree as follows: 1. TERM The teen of this Agreement shall be for an initial term of one (I) year, commencing on December 1, 2017 and expiring one year thereafter on November 30, 2018, unless earlier terminated by either party as provided herein- This Agreement will have two one (1) year options for renewal exercisable at the City's sole discretion. The parties acknowledge that vendor has been providing services consistent with the terms of this Agreement since October 1, 2017. 2. VENDING RIGHTS The City hereby grants Vendor the right to install and maintain their soft drink and snack vending machines ("vending machines") throughout the Premises for the term of this Agreement. 3. COMPENSATION TO CITY Vendor agrees to pay, and City agrees to accept as payment for its granting the right to install and maintain vending operations on City -owned property, Six Hundred Dollars ($600.00) per month payable to the City on the 5"' day of each month. 4. RESPONSIBILITY FOR VENDING MACHINES Vendor will provide vending machines on the Premises as mutually agreed upon between Vendor and the Executive Director of Parks, Recreation and Community Services Agency throughout the term of this Agreement. All vending machines shall at all times remain the property of Vendor. Vendor will repair and maintain the vending machines and agrees to keep them in good working order and condition at all times. Vendor shall have the exclusive right and obligation to repair, replace, or remove any and all vending machines. City shall not replace, relocate, move or remove any vending machines. Notwithstanding the foregoing, City agrees to use reasonable efforts to keep the vending machines in clean and sanitary condition, wholly free of all advertising at all times. In addition, City agrees to promptly notify Vendor of any need for repair or service, and to fully cooperate with Vendor in effecting such necessary repairs or set -vice. City shall bear no responsibility whatsoever for any vandalism or theft occurring with regard to Vendor's equipment and vending machines. Further, Vendor shall be responsible for the costs of repair or replacement necessitated by vandalism, graffiti or theft. Should vandalism occur to the same vending machine for a second time, City may elect one to either relocate or remove said vending machine. Vendor and the Executive Director shall mutually agree on all locations to relocate vending machines if needed. 5. VEND RATES AND COMMISSION The current pricing is attached hereto as Exhibit A "Pricing". Vendor shall maintain all vending machines stocked with at least 50% healthy foods, such as such as baked chips, fruit, pretzels, granola, nuts, bottled water, tow fat milk products, sports drinks and natural fruit jtrice drinks in compliance with the City's policy regarding healthy snacks, healthy eating and active living (City of Santa Ana Resolution No. 2006-053 and Resolution No. 2011-003). 6. VENDING MACHINE PLACEMENT A detailed list reflecting the proposed placement of all vending machines and equipment is set forth in the "Existing Sites" list, (attached hereto as Exhibit A— Page 2). Vendor shall provide vending machines at all listed locations. Additional vending machines may periodically be added to the list subject to prior written approval of the Executive Director. Should the proposed locations of the vending machines be found not to be in the best interest of Vendor or the City, both parties must mutually agree as to whether or not to relocate the vending machines. I'f the Executive Director of Parks, Recreation, and Community Services Agency agrees that relocation is necessary, he/she has the authority to exercise discretion as to the most appropriate new location for placement of said vending machine on behalf of the City. An updated list evidencing the placement of the vending machines shall be kept by the Executive Director. DEFAULT AND TERMINATION; This Agreement may be terminated by the City with thirty (30) days' notice to the Vendor. Vendor may terminate this Agreement if City materially fails to perform or comply with this Agreement or any provision hereof, Vendor may cancel the Agreement by sending a Nan -Compliance Notice describing the non-compliance to the City, Upon receipt of such Non -Compliance Notice, the City shall have thirty (30) days from the date of such notice to cure any such non-compliance. If such non-compliance is not cured within the required thirty (30) day period, Vendor shall have the right to cancel this Agreement. The rights of termination referred to herein are not intended to be exclusive and are in addition to any other rights available to either party in law or in equity. 8. RIGHTS UPON TERiMINATION Upon termination of this Agreement by either party, City shall permit Vendor reasonable access to the Premises free florm any claims of trespass, for the purpose of removing any vending machines within thirty (30) days from termination of this Agreement. Until such time as all vending machines are removed, each party's obligations shall continue as set forth in section 3 and 4. Vendor shall use its best efforts to leave each of the vending sites within the Premises in the condition in which it existed prior to installation, excepting reasonable wear and tear. 9. 'ENTIRE AGREEMENT This Agreement contains the entire understanding and agreement between the panties hereto regarding the rights and responsibilities pertaining to vending machines on the Premises and supersedes all other agreements between the parties respecting such. This Agreement may be amended or modified only by written agreement, signed by each of the parties. 10. INDEMNIFICATION Vendor shall indemnify, defend, and hold harmless the City of Santa Ana, its officers, agents, employees, and volunteers from damage to property and for injury to or death of any person and from all claims, demands, actions, liability, or damages of any kind or nature arising out of or in connection with Vendor's use of the Premises, except those which arise out of a dangerous/defective condition of the Premises or due to the sole negligence of the City, I I. INSURANCE Prior to undertaking performance of work under this Agreement, Vendor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability hrsurance. Vendor shall maintain commercial general liability insurance naming the City, its officers, agents, volunteers, and employees 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 Vendor'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. Vendor 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, Vendor, if Vendor 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, Vendor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Vendor 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 Vendor pursuant to this section: (i) Vendor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (I I) Certificates of insurance shall be fiirnished 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) clays prior written notice to the City. f. If Vendor 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 terminate this Agreement. Such termination shall not affect Vendor's right to be paid for its time and materials expended prior to notification of termination. Vendor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 12. NOTICE Any notice or instrument required to be given or delivered to either party to this Agreement may be delivered by personal delivery or by depositing the same in the United States Mail, postage prepaid, addressed to: If to the City: With courtesy copies to: and Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 Executive Director Parks, Recreation and Commtmity Services Agency City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 Fax 714-571-4211 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Fax 714- 647-6515 5 To Vendor: Premier Vendgroup, Inc. 6814 Suva Street Bell Gardens, CA 90201 Phone: (562) 928-1301 FAX: (562) 928-5501 Any notice of a change of address shall be delivered in the same manner as any other notice provided herein. Notice by mail shall be effective three (3) days after mailing by the above -described procedure. 13, MISCELLANEOUS PROVISIONS a. Vendor covenants that it presently has no interest, and shall not have any interest, direct or indirect, which would conflict in any manner with the performance of services required hereunder. b. Vendor certifies that it will not discriminate against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, martial status, sex or age, in compliance with Government Code 1.2900, ct seq. Vendor agrees to take affirmative action to insure that applicants are employed, and that employees are treated during employment, without regard to their race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex or age. c. The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. d. This Agreement shall be governed by and construed in accordance with the laws of the State of California, with venue in Orange County. e. Each undersigned represents and warrants that its signature hereinbelow has the power, Agency and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify Agency fully, including reasonable costs and attorney's fees, for any injuries or damages to Agency in the event that such Agency or power is not, in fact, held by the sigmatory or is withdrawn. f. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body ofthis Agreement. [Signatures on following page] N-2017-263 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and Year first above written, ATTEST: /Wl(�MARIA D. H4ZAR Clerk of the Council . zg� APPROVED AS TO FORM: Sonia R. Carvalho City Attorney iptLaura A. Rossini Senior Assistant City Attorney RECOMMEND APPROVAL: 'k,�. lq-:zt- Gerardo �MouetEx&ufive Director Parks, Recreation & Community Services Agency CITY OF SANTA ANA g ji Raul Godinez, if City Manager VENDOR: PREMIER VENDGROUP, INC, 4a cr VjCpsident EXHIBIT A PROPOSED SCOPE OF SERVICESNE\DOR RESPONSIBILITIES I. Provide baveragm am.11orsnacic trondlrt6 rnttchines, approved locations. 2. Gnsure that no less than M percent of the foot( and heverage provided in all vendinz machines locatod at Cky- m tied facilities are of a healthy variety. 3. Provide tva.nwnatwa, service and cleaning of those machines at regular intervals and "or as needed. 4, The vending operaeion shall be run in an efficient and courteous manner. Vending services staff member(;) shall be Olean and neatly dressed, presenting a positive image for City facilities. Special consideration will be offered to bidders able to dennonstrate superior cusmnrer service. 5. For the safety of the public patrons who uPilize City facilities and;or maintenancc concerns regarding City facilities, restrictions may be necessary including items sold, packaging, etc. The City must approve all menu items, packaging, and machines, and machine locations (or changes to the above), 6, The vendor sha;i obtain a business license to operate within the City of Santa Ana and rnaimain current liability insurance coverage_ 7. The vendor(;) shall attend meetings with City staff as required. S. The vendors) shall coordinate with other Agencies as required. 9, The vendor shall provide a rcvcnucsespenditure report if requested by the City-' of Santa Ana. A The revenue to the City shall lie S600 per month. CITY RESPONSIBILITIES The 014 will provide the foltrwving: I. Dectris •v and alcctrical maintenance for approved vmdhig machines w be installed. "_. Approval aPsites and number and t}pes ofmachines to be installed. 3, Staff lisimi For uomnnnmieation and problem re;oluticn. Ekfffflff ,l PRICING ^� pricing F,��argeSen iite Size Chips 12oz S 1.00 Fresh Pastries Cookies $i.)0 Deluxe Bag Shacks S 1,00 C ndy_-che oi.l`` si.00 I Gnel;& Bars S2.00 CTU111 VEms $1.00 Drinks Pricing —�� -- 20oz Soda,'V acr Beveeaj;e ' S 125 't-z SQla Cn1) S1.00 til�lpp�e � �L50 I 2007 GaLor tde Bottle S 7� nugti Dluls 16oz,[Z dBultBoz $275 uice Drinks Coffee �— Priciu� --� Soz Cup 0,7. 1.202 Cup C '$1.00 TiXIIIBIT zk E\fSTT.NG ,S11 ES PRC s k Park/Facilit3 Sites Address PI Salvador Park v �f 82-5 1k Civic Center Memorial Park 2102 S. Flower 5t. [sistin. Pt'Oposed Number/Type NLtchinus OfMachrnes _ _ I I cod di rink and i snack 2 driad. And I snack Rosita Park and Salado 700 N. Newhupe St, 2 i di ink and i sn aide Recreation Cure Samna _Ana Public Library P21ivic Ccniet Plata ' I cola drml: and I snack S tnta:Ana Senior Center (S-CSC)W. 3"Street I I cold dtink'sn, wmbo i I Srn,t1 .nest Senior Center Su'SC) 2201 W. blcPacklen Ave. ? � I cold drink and I snack Santa ,-Aj;a ltauional 1000 Gist Santa Ana Blvd 3 2 cold drinit and I Snack Fran portanon Center (;SARTQ Scott Ana Police DelaarUnent, 60Civic CcnterPlum ( ' cold drink, I hot drink, Codc 7 Cal` :uid I mach Sm(a Aoa Police Dcparoucia. 60 Civic Ccnler Plaza I I cold drinit I " Floor .�__ S cot t `vna My Hall 20 Civic Corner Plaza ? ( ooid dunk and I smck�l Santa Anu (Iu ti ard, 220 S, Daisc -Av:? I cold drink and ( snack AdMinisirahve Buddin Santa rina Cit1 Yard, 220 S Daisy Ave. 2 1 cold di ink and I snaol% hIwLNlaintenancc I 2 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYV) 1as'" 7/24t2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. _IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on _ this certificate does not confer rights to the certificate holder in lieu of such endorsements , PRODUCER CONTACT Erika Sokollk Arthur J. Gallagher & Co. NAMS PHONE- - FAx - -- nsuranee Brokers of CA Inc .LIC #0726293 UArv,N CDL 818-534 3558 -_ tAlc NRJ.,_818-316-0990 ?1820 Burbank Blvd. Suite 175 AMAIL Erika Sokolik@ajg.com - - -- Woodland Hills CA 91367 INSURED Downey Vendors 1 JCS 1 (" )` ' 6814 Suva Street Bell Gardens, CA 90201 RDBESS, INSURERSAFFORDNG COVRAGE NAICq ts,U) Ea A Insurance Company of the West '27847 ,SURF-R B ,SURER C INSURER f __ CFIVFRAr;FA CGDTICIr• ATC Pn H ARPCM. 12400974cG o rt: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW 41AVE BEEN ISSIJIiD 'r0 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECI TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, -. _..ADDC'SUBR... _ _.... .. .. _. INSP LTR TYPE OF INSURANCE INSO W O' POLICYNUMBER .. POLICYEFF POLICY E215 (MMIDOIYYYY) (MMIODIYVYY) LIMITS CO, COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE g CLAIMS MADE OCCUR OAMAGETUREPTEO I?RFMI5E5 (F,@occurrence) '$ M CD E XP(Any one Person) $ PERSONAL&ADD INJURY $ GE.N'L AGGREGATE Limit r APPLIES PER - GENERALAGGREGATE g POLICY".. JECT _.. LO9 '.,. PRODUCr9-COMPIOPAGG S ', OTHER: ADTOMOSILE LIABILITY E _ (Ea accident)__ ANY AUTO ._.....,. _--- _......_.. HOURLY INJURY (Per Person)'$ pVVNEU SCHEDULED AUTOS ONLY AUTOS HDDIIYINJDRY (Par ac(ident) g . HIRED NON.OWMED AUTOS ONLY AUTOS ONLY', PI'tOpERIV DAMAGT ._ _.... .......... g (Per atndant_ UMBRELLA LIAB OCCUR .._.. _, - EACH OCCURRENCE g EXCESS LIAB CLAIMS -MADE- _.. --- ..........- AGGREGATE g DED RETENTION 8 A;'NORKERS COMPENSATION', wVE503733300 'AND 7/2512017 ., 712612010 X IyER OTH -"- EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNEWEXECUTIVE EXC.UOEDP L_�NIA E.L. EACH ACCIDENT $1000000 !OFFICIERIMHMBER (Mandatory in NH) y... If es. tles'cribe lmdor - L.L.SEASE-CA EMPLOYEE g1000,000 --- _ _ __. ....._ -_DESCRIPTION GFOPE RATIONS belov, - E.LDISEASE- POLICY LIN111i S 1,00D,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101, Additional Remarks ScHotlula, may Do attaChed Irmoro spauryycpa 1) Evidence of insurance only. ReV�GV� •�. L1. . {� P60,0 R City of Santa Ana 20 Civic Center an Floor Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE REPRESENTATIVE i�p2>�r� r7 C 1988.2015 ACORD CORPORATION. All rights resented. 4COK0 zb (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDOIYYYYI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on PRODUCER \rthur J. Gallagher & Co. nsurance Brokers of CA. LIC #0726293 t1011 Warner Center Lane Noodland Hills CA 91367 INSURED _ Downey Vendors 5814 Suva Street Bell Gardens CA 90201 81 INSURER West American Insurance Company INSURERS American Fire and.. Casualty Company O11VPRAOFS ne0TIL91-A7= w,aeoeo. lC.1RRR7R97 .. �..,......, .�......__ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR--....._._..... DOL-SUB77-__._._—_.—_._ _ LTR TYPE OF INSURANCE PULICY EFF POLICY E%P Ir WVD'. POLICY NUMBER -. MMIDDIYYYY MIODfYI'YY ----------.""---'— - LIMITS A X COMMERCIAL GENERAL LIABILITY Y BKVV56585014-4/1/2017 4/112018 ^�' EACH OCCURRENCE $1000000 - CLAIMS -MADE XOCCUR ^OAMAGETORENTED ...-...-_..__-- ; PREMISES (Ea occurrencaj ,$100000 ____ __ _... ',. MED EXP(Any one person) 510,000 -- - PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERALAGGREGATE I$2,000,000 X _ POLICY PRO JELDC ,.. _ CT ''. PRODUCTS-COMP/OP AGO - $2,000.000 _......... OTHER; ......_ A AUTOMOBILE LIABILITY -BAW565B5014 4/1/2017 4/1/2018 COMBINED SI LIMIT .aaccident__ ''.. $1,000,000 - XANY AUTO ', ;BODILY INJURY (Per person) ', $ . OWNED '. SCHEDULED AUtOSONLY AUTOS BODILY de-------- LY INJURY (Par acc nt) $ X ` HIRED X" NON-0WNED AUTOS ONLY AUTOS ONLY PROP PROPERTY :PROPERTY DAMAGE MADE $ - c Unlined moto Com '.$1,000.000 B X 11 UMBRELLA LIAO _X OCCUR -'. USA56585014 411/2017 4/1/2018 EACHOCCURRENCE $10,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE $10,000,000 DED I RETENTIONS - $ WORKERS COMPENSATION PER TH- '.ANDEMPLOVERWLIABILITY YIN 8rAI UrE... ER ANY PROPRIETORIPARTNFWEXECUTIVE ❑ NIA OFFICERIMEMBER EXCLUDED? EL EACH ACCIDENT $ - -- __.......___.. (Mandatory in NH) ELDISEASE-EAEMPLOYEE_$ yes, describe antler D DESCRIPTION OF OPERATIONS below E L DISEASE -POLICY LIMIT $ A Hired Auto PC BAW58565014 Hired Auto PD 4/1/2017 4/1/2018 Comp & Coll Ded�.\ _ $50,000 i a $1,000 0 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES(ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) �\ a Re: Operations of the Named Insured for the Certificate Holder. !}.� ,{�.'` ��� City of Santa Ana, Santa Ana City Hail, Santa Ana Police Dept., Santa Ana City Santa Ana City CJ and Yard and Santa Ana Library of Santa Ana its officers, employees agents, volunteers and representatives are named Additional Insureds with Primary Wording per attached '�4U\,88q,0 D413, City of Santa Ana 20 Civic Center, 8th Floor Santa Ana CA 92702 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE ©1988.2015 The ACORD name and logo are registered marks of ACORD rinhfe ra¢orved COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGEPART INDEX SUBJECT NON -OWNED AIRCRAFT NON -OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY - ELEVATORS EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B ,,UDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY. ADDITIONAL INSURED EXTENSION ^ADM' InNAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALIZATION CLAUSE a BODILY INJURY REDEFINED d��o EXTENDED PROPERTY DAMAGE 5 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US •� WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU 5 e�G EAO 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 8 8 Q 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Servioes Office, Inc.,with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section 1 - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It Is hired, chartered or loaned with a trained paid crew; _ 3. The pilot in command holds a currently effective certificate, Issued by the duly constituted authority of ® the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the Insurance afforded by this provision does not apply If there is available to the Insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically g in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I • Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft Is replaced by,the following: This exclusion does not apply to: Pua (2) A watercraft you do not own that is: (a) Less than 52 feet long; and Q jt .' z \ ' (b) Not being used to carry persons or property for a charge C. PROPERTY DAMAGE LIABILITY • ELEVATORS .. +1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury`And•"Iprc or@ Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion J. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators "do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. %'2r- The following is added to Section IV - Commercial General a lability Conditions,, Condition 4. Other Insurance, Paragraph b. Excess Insurance: 'The Insurance afforded by this provision of this endorsement is excessover any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You Is not otherwise excluded from this Coverage Part: 1 r Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and property Damage Liability: a. The fourth from the last paragraph of exclusion J. Damage To Property Is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property, damage (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or: - (ii) Contents that you rent or lease as part of a premises rental orlease 'agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. © 2013 Liberty Mutual insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with. its permission, Page 2 of 3 b. The last paragraph of subsection 2. Exclusions Is replaced by the following: Exclusions c. through n, do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of Insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection Sys- tems; or b. Contents that you rent or lease as part of a premises rental 'or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED, DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) • Paragraph Re. of Definition's" is replaced with the following: 9.a. A contract for a lease of premises. However, that portion -of the contract for a lease of premises that indemnifies any person or organization for damage by;f,"ire, lightning, explosion, ,smoke, or leakage from automatic fire protection systems to premises "while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an 'Insured contract E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments Is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B- 1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by tl e,gollowing: ` b. Up to $3,000 for cost of bail bonds required because of accidents or traffic laviolatlons rising out of the use of any vehicle to which the Bodily Injury Liability Coverage ales. ,We d 1pt have to furnish these bonds. �`�J\,'t��� .\�• 2. Paragraph 1.d. is replaced by the following: v d. All reasonable expenses incurred by the Insured at our request to assist us i igatlon or defense of the claim or "suit', including actual loss of earnings up to $503yi}%7:ause of time off from work. (� s G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2, under Section 11 -Who Is An Insured is amended to Include as an Insured any person or organization whom you have agreed to add as an additional Insured In a written contract, written agreement or permit. Such person or organization is an additional insured but onlyc,with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional Insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc„with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. operations performed by you or on your behalf for which the state or political subdivision has Issued a permit subject to the following additional provisions: (1) Thls Insurance does not apply to "bodily Injury", "property damage", or "personal and ad- vertlsing injury" arising out of the operations performed for the state or political subdivision; (2) This Insurance does not apply to "bodily Injury" or "property damage" Included within the "completed operations hazard" (3) Insurance applies to premises you own, rent, or control but only with respect to the following — hazards: MM (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, sMW hoist away openings, sidewalk vaults, street banners, or decorations and similar expo - Ell_ sures; or (b) The construction, erection, or removal of elevators; or (c) The ownershlp, maintenance, or use of any elevators covered by this Insurance. However: 1. The Insurance afforded to such additional Insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the Insur- ance afforded to such additional Insured will not be broader than that which you are required by the contract or agreement to provide for such additional Insured. With respect to Paragraph 1.e. above, a person's or organization's status as an additional Insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the Injury or damage arises has been put to Its Intended use by any person or organization other than another contractor or subcontractor engaged In performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional Insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this Insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor, s The Insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or"property damage". We have no duty to defend an additional Insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial O1er�rat Llabilit Condi- tions. - ;,���� 10 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Seroicas Office, Inc,with its permission. Page 4 of 8 2. With respect to the Insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I -Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "properly damage" arising from the sole negligence of the additional Insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising Injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, Including: (1) The preparing, approving, or falling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing In the supervision, hiring, employment, training or monitoring of others by that Insured, if the "occur- rence" which caused the "bodily Injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished In connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project, e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the Insurance afforded to these additional Insureds, the following is added to Sectlon III -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form s or endorsement under this policy. Condition 4. Other Insurance of SECTION IV -COMMERCIAL GENERAL LIABILITY CON TJONS Is amend- ed as follows: U a. The following is added to Paragraph a. Primary Insurance: 5 ��\��4: ccJJ__.`\a If an additional insured's policy has an Other Insurance provision malrirfg Its pall �srid you have agreed in a written contract or written agreement to provide the additional x, rage on a primary and noncontributory, basis, this policy shall be primary and we will cEribution from the additional insured's policy for damages we cover. Q © 20131.1berty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 5 of 8 b. The following Is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional Insured does not require this insurance to be primary or primary and non-contrlbutory, this Insurance is excess over any other Insurance for which the eddi- tional Insured is designated as a Named Insured. Regardless of the written agreement between you and an additional Insured, this Insurance is excess over any other Insurance whether primary, excess, contingent or on any other basis for which the additional Insured has been added as an additional insured on other policies. I. ADDITIONAL INSURED$ - EXTENDED PROTECTION OF YOUR, "LIMITS OF INSURANCE" This provision applies to any person or organization who qualities as an additional Insured under any form or endorsement under this policy. 1. The following is added to Condition 2, Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional Insured under this endorsement will as soon as practicable: RM a. Clive written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; Is. Tender the defense and indemnity of any claim or "suit" to all Insurers whom also have Insurance available to the additional Insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or Indemnify an additional insured under this endorsement until we receive written notice of a "suitt' by the additional insured. 2. The limits of Insurance applicable to the additional Insured are those specified in a written contract or written agreement or the limits of Insurance as stated in the Declarations of this policy and defined In Section ill - Limits of Insurance of this policy, whichever are less. Thege limits are Inclusive of and not in addition to the limits of insurance available under this Polk}&`( J. WHO IS AN INSURED .INCIDENTAL MEDICAL ERRORS I MALPRACTICE�� I� WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION . MANAGEMENT EMPLl� Paragraph 2.a.(1) of Section 11 Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (If you are a partnership or joint van ), t `P members (If you are a limited liability company), to a co -'"employee" while In the curse of h s ar_her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"enr ioyoe"" or "volunteer worker" as a consequence of Paragraph (1) (a) above; a (c) For which there Is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, If you are not In the business of providing professional health care services or providing profes- sional health care personnel to others, or If coverage for providing professional health care ser- vices Is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who Is acting In a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and 0 2013 Liberty Mutual Insurance CO 88 10 04 13 Includes copyrighted material of Insurance5ervices Office, Ine,with its permission. Page 6 of 8 advertising Injury" arising out of their willful conduct, which is defined as the purposeful or willful Intent to cause "bodily Injury" or "personal and advertising injury", or caused In whole or in part by their Intoxica- tion by liquor or controlled substances. The coverage provided by provision J. Is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section 11 • Who Is An Insured Is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority Interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily Injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization Is an Insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured In the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV -Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M, KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV -Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in Itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following,. 3. "Bodily Injury" means physical injury, sickness or disease sustalned�$+ person. mental anguish, mental Injury, shock, fright or death that results from such phy1 ness or disease. �� `` © 2013 Liberty Mutual insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Ine.,with its permission. Page 7 of 8 "a a P. EXTENDED PROPERTYOAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY Is replaced by the following: a. Expected Or Intended Injury "Bodily Injury" or "property damage" expected or intended from the standpoint of the Insured. This exclusion does not apply to "bodily Injury' or "property damage" resulting from the use of reasonable force to protect persons or property. 0. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans. far Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for Injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included In the "products -completed operations hazard" provided: 1. You and that person or organization have agreed In writing In a contract or agreement that you waive such rights against that person or organization; and 2. The Injury or damage occurs subsequent to the execution of the written contract or written agree- ment. 0 2013 Liberty Mutual insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission, page 8 of 8 A40" h® CERTIFICATE OF LIABILITY INSURANCE DAM(MMI DRYYYY ) 018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER CONTACT NAME: Erika Sokolik Arthur J. Gallagher & Co. Insurance Brokers Of CA Inc .LIC #0726293 PNONE FAX uC No Eat: 818-534-3558 LAIC, No:818-316-0990 aooaEss: Edka Sokolik a' .com 21820 Burbank Blvd. Suite 175 INSURERS AFFORDING COVERAGE NAICN Woodland Hills CA91367 INSURER A: Insurance Company of the West 27a47 INSURED Downey Vendors .1 11 O2> INSURER B : 6814 Suva Street I Bell Gardens, CA 90201��� b, / INSURERC: INSURERD: INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 1245914796 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRR TYPE OFINSURANCE ADDL SUER. POLICY NUMBER I POLICY EFF POLICY EXP MMIDD/YYYY MWDDNM LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ TRENTED Cl-AIMS-MADE1:1DAMAGE OCCUR PREMISES (Ea occurrence) _$ _ MED EXP(Any one person) $ PERSONAL &ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $ POLICY _ PRO- JECT J LED PRODUCTS-COMP/OP AGO $ OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident ANY AUTO BODILY INJURY (Per person) $ OPMED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ _ HIRED NON-OMED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY (Peraccitlentl - $ UMBRELLAUAB OCCUR EACH OCCURRENCE $ 11 EXCESS LIAB CLAIMS -MADE_ AGGREGATE $ DED I RETENTION$ S A WORKERS COMPENSATION 1 WVE503733301 726/2018 7262019 X PER OTH- STATUTE ER_ AND EMPLOYERS' LIABILITY ANYPROPRETORIPARTNER/EXECUTIVE V� EL EACH ACCIDENT $1,OOgWO OFFICERIMEM BER EXCLUDED'! NIA (Mandatory in NH) E L DISEASE - EA EMPLOYEE $ 1pOg0D0 If yyes, describe under -- --- DESCRIPnON OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requir'tl� Evidence of insurance only.e� f �GgP City of Santa Ana 20 Civic Center Sth Floor Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE /Z 9)1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD "`MCERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOrr" THIS CERTIFICATE IS ISSUED AS CERTIFICATE DOES NOT AFFIRM MA rIVE1.1i R OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH 11/6/2019 CERTIFICATE HOLDER. THIS BELOW. THIS CERTIFICATE OF I SURAI OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE CE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE AFFORDED BY THE POLICIES REPRESENTATIVE OR PRODUCER, kND Tli ISSUING E CERTIFICATE HOLDER. INSURER(S), AUTHORIZED IMPORTANT: If the certificate holds is an DDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, sublet this certificate does to th terms and conditions of the Policy, certain policies may require an endorsement. A statement on not confer right to the ertificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher & Co. CONTAC Edka SOk011k 77 PNONE 818534-3558 FAx x . 818.316.0990 Insurance Brokers of CA, Inc. LIC 2629 21820 Burbank Blvd. Suite 175 EMAIL , Edka Sokolik a' Woodland Hills CA 91367 .corn INSURED Downey Vendors 6814 Suva Street Bell Gardens, CA 90201 COVERAGFS rebTrnrArc .rr r..rs,•... ..._.. .. _._ THIS INSR IS TO CERTIFY THAT THE POLICI NOTWITHSTANDING ANY MAY BE ISSUED OR MA AND CONDITIONS OF SUC TYPE OF INSURANCE X S OF I EOUIR PERT POLIC ADDL Y SURANCE MENT, IN, ES. BRL LISTED BELOW HAVE BEEN TERM ORCONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN POLICY NUMBER ISSUED TO CONTRACTOR THE POLICIES REDUCED BY PVUDCDYEFF 4/1/2019 THE INSURED OTHER DESCRIBED PAID CLAIMS. FOLICOYEXPLIMBA YYYYj Kt:VISIO NAMEDN DOCUMENT HEREIN I BOOVE ED I TjPOLICYIODINDICATED. WITH RESPETHISCERTIFICATE SUBJECT TMS,EXCLUSIONS COMMERCIALGENERALUABILRY CLAIMS.MADE�OCCUR BKW56585014 4/1/2020EACH OCCU RENCE APREMI S ewes ce MED EXP one arson PERSONAL S ADV INJURY $1,000,000 GEN1 AGGREGATE UMRAPPUES PER: GENERALA REGATE $2,000,000 A X JPERR1:1 LOC POLICY OTHER: AUTOMOBILE LIABILITY X ANY AUTO BAW56585014 4/1/2019 4/1/2020 PRODUCTS- OMP/OPAGG $2000000 COMBINERS NGLEUMIT $ $1,000,000 Y(Per person) $ OWNED AUTOSONLY AUTSCHO$EDULEO AUT X HIRED X NONONMED AUTOS ONLY AUTOS ONLY BODILY INJU BODILY INJU Y (Por ecGdenl) s PROPS Ee D AGEiftr E RENCE E $10.000,000 B X UMBRELALVU! X OCCUR EXCESS LIAR ClA1Ms-MAD USA56586014 4H/2019 4/72020 EACH OCCU DED X RETENTION$ AGGREGATE S10,000,000 WORKERS COMPENSATION E AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBEREXCLUDED9 (Mendatery In NMI NIA I STATUTI ERµ E.L. EACH ACCIDENT $ E.L DISEASE EA EMPLOYEE E byes, describe antler DESCRIPTION OF OPERATIONS below E.LDISEASE SI,= E1,000 POLICYLIMIT S A HIrsd AV PD CoUelon Dee. BAW56585014 4/1/2019 4/1/2U20 DESCRIPTION OFOPERATIONS ILOCATIONSIVEHI City of Santa Ana, Risk Management, it's General Liability coverage on a primary an U:S'AC fOcels, non c D 101,AddItlonal Remarks B .dule,rsaybeH .hedXrsoreapece lerago.d) mployees, agents, representatives, and volunteers are included as Additio ntdbUtory basis per attached form CG 88100413. 30 days Notice of Cancel al Insureds with respect to allon Applies. R VIE & APPROVED CERTIFICATE HOLDER MAKISK MANVIGEMENT UIVISIUN --Z=.._.. -_.__. V 13 2019 SHOULD ANY OF THE ABOVE DESCRIBED THE EXPIRATION DATE THEREOF, Ni City of Santa Ana ACCORDANCE WITH THE POLICY PROVISII Risk Management M. LAMBERT 20 Civic Center PI AUTHGRIZEDREPRESENTATWE Santa Ana CA 92702 /jiYr �t• avv-Av rO qt, ACORD 25 (2016103) TheACORD name and logo are registered marks of ACORD ES BE CANCELLED BEFORE WILL BE DELIVERED IN rights c a a COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CO MERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENEF AL LIABILITY COVERAGE PART INDEX SUBJECT NON -OWNED AIRCRAFT NON -OWNED WATERC" PROPERTY DAMAGE LIAE EXTENDED DAMAGE TO I MEDICAL PAYMENTS EXl EXTENSION OF SUPPLEM ADDITIONAL INSUREDS - PRIMARY AND NON-CONT ADDITIONAL INSUREDS - WHO IS AN INSURED - INC INSURED - FELLOW EMPLI NEWLY FORMED OR ADD[ FAILURE TO DISCLOSE HA KNOWLEDGE OFOCCURR. LIBERALIZATION CLAUSE BODILY INJURY REDEFINE EXTENDED PROPERTY DAI WAIVER OF TRANSFER OF WHEN REQUIRED IN A COI CG 88 10 04 13 -,ELEVATORS :RTY RENTED TO YOU (Tenant's Property Damage) 2Y PAYMENTS -COVERAGES A AND B INTRACT, AGREEMENT OR PERMIT ORY- ADDITIONAL INSURED EXTENSION JDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 'AL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN EXTENSION -MANAGEMENT EMPLOYEES LLY ACQUIRED ENTITIES 5, AND PRIOR OCCURRENCES i OFFENSE, CLAIM OR SUIT OF RECOVERY AGAINST OTHERS TO US '� OR AGREEMENT WITH YOU ® 2013 Liberty Mutual Insurance yrlg led material of Insurance Services Office, Inc., with its permission. PAGE 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 8 a Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy applN unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Properly Damage Liability, exclusion g. Aircraft, A ito Ot Watercraft does not apply to an aircraft provided: 1. It is not owned by ny insured; 2. It is hired, charterec or to 3ned with a trained paid crew; 3. The pilot in comma id hc Ids a currently effective certificate, issued by the duly cor stituted authority of the United States o Ame ica or Canada, designating her or him a commercial or aii line pilot; and 4. It is not being used to car persons or property for a charge. However, the insurance affonled by this provision does not apply if there is available to the insured other valid and collectible ins rant , whether primary, excess (other than insurance written to apply specifically e in excess of this policy) contingent or on any other basis, that would also apply to this loss covered under this provision. B. NON -OWNED WATERCRAFT s Under Paragraph 2. Exclusions of Section 1- Coverage A - Bodily Injury And Property D mage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft yo i do rot own that is: (a) Less than 2 feet long; and a (b) Not being i ised t carry persons or property for a charge. C. PROPERTYDAMAGE LI BILI -ELEVATORS 1. Under Paragraph 2. Excit sions of Section I - Coverage A - Bodily Injury And Prop rty Damage Liabil- ity, Subparagraphs (3), ( ) and (6) of exclusion j. Damage To Property do not appy if such "property damage" results In: m th use of elevators. For the purpose of this provision, elevE tors do not include vehicle lifts. Vehicle lifts re lifts or hoists used in automobile service or repair open Itions. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragrap I b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any roperty insurance, whether primary, a cess, contingent or on any other basis. D. EXTENDED DAMAGE TO PRO ERTY RENTED TO YOU (Tenant's Property Damage) C If Damage To Premises I lentecTo You is not otherwise excluded from this Coverage Pa : 1. Under Paragraph 2. Exclusions of Section I -Coverage A -Bodily Injury and Property Damage Liability: it a. The fourth from the I at paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), 3) an (4) of this exclusion do not apply to "property damage,, other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented t 3 you for a period of 7 or fewer consecutive days; or (11) Contents th 3t you rent or lease as part of a premises rental or lease agreen lent for a period of more than days. Paragraphs (1), (3) arid (4) of this exclusion do not apply to "property dame e" to contents of premises rented to yoY for a p iod of 7 or fewer consecutive days. A separate limil of isu nce pplies to this coverage as described in Sa ion III - Limits of Insurance. ® 2013 Leert u al Insurance CG 88 10 04 13 Includes pydgjtted material of Insurance services Office, Inc., with its permission. Page 2 of 8 I b. The last paragi aph c f subsection 2. Exclusions is replaced by the following: Exclusions c. throug i n. do not apply to damage by fire, lightning, explosio , smoke or leakage from automatic fire protection systems to premises while rented to you or tern Jorarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Secti n III - Limits Of Insurance is replaced by the following: 6. Subject to Par igrapt 5. above, the Damage To Premises Rented To You Until is the most we will pay under Cov, rage A for damages because of "property damage" to: a. Any one pi emis (1) While rentec to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents t iat yo i rent or lease as part of a premises rental or lease agreerr ant. 3. As regards coveraC a pro Aded by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Pro ertyDamage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that Indemnified any person or organization for damage by fire, lightning, explosion, smoke, or leakage from Autorridtic fire protection systems to premises while rented to you or temporarily occupied by y u with the permission of the owner, or for damage to contents of such premises that are include in ybur premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS I If Coverage C Medical are amended as follows: Under Paragraph 1 (b) of Paragraph a. (b) The expenses F. EXTENSION OF SUPPLI 1. Under Supplementi b. Up to $3,000 h out of the use to furnish these 2. Paragraph 1.d. Is re d. All reasonable defense of the off from work. G. ADDITIONAL INSURED; 1. Paragraph 2, under organization whom agreement or perm liability for "bodily or in part by: a. Your acts or on of your on going written agreem sonal and adve written agreem) CG 88 10 04 13 Includes is not otherwise excluded, the Medical Payments Agreement of Section I - Coverage C - Medical Pa by the following: I and reported within three years of the date of the PAYMENTS -COVERAGES A AND B - Coverages A and B, Paragraph 1.b. is replaced costlof bail bonds required because of accidents or traffic any ehicle to which the Bodily Injury Liability Coverage a by the following: incurred by the insured at our request to assist us in "suit", including actual loss of earnings up to $500 a BY CONTRACT, AGREEMENT OR PERMIT ided by this policy nits, Subparagraph dent; and the following: violations arising is. We do not have he investigation or ey because of time iecticjn II - Who is An Insured is amended to include as an Ins red any person or you (have agreed to add as an additional insured in a writ contract, written Su h person or organization is an additional insured but o ly with respect to )jury", "property damage" or "personal and advertising injury' caused in whole or the acts or omissions of those acting on your behalf, in the performance tons for the additional insured that are the subject of the written contract or ivided that t 'bodily injury" or "property damage" occurs, or the "per - injury" �s co itted, subsequent to the signing of such written contract or '� si ® 2013 Libe utu I s rants tied material of Insurance Services office, Inc., with Its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenan e, operation or use by you of equipment rented or leased to y u by such person or organization; or d. Operations performed by you or on your behalf for which the state or politcal subdivision has issued a permii subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising i jury" arising out of the operations performed for the state or political subdivision; (2) This insur nce oes not apply to "bodily injury" or "property damage" included within the .completec ope tions hazard". (3) Insurance appIle3 to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or reryoval of advertising signs, awni gs, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The c nstru ion, erection, or removal of elevators; or a (c) Theo ners p, maintenance, or use of any elevators covered by this Insurance. However: 1. The insurance afforded to such additional insured only applies to the extent peTnitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded o suc additional insured will not be broader than that which you are required by c the contract or agreement to provide for such additional insured. With respect to P rags h 1.a. above, a person's or organization's status as a additional insured under this endorse ent Ends when: (1) All work, i cludl materials, parts or equipment furnished in connection with such work, on the project (oche than service, maintenance or repairs) to be performed b or on behalf of the additional nsure (s) at the location of the covered operations has been roi ipleted; or (2) That portio of 'your work" out of which the injury or damage arises ias been put to its intended use by any person or organization other than another contract r or subcontractor engaged in perfo ming operations for a principal as a part of the same proj ct. With respect to Paragraph 1.b. above, a person's or organization's status as ar additional insured under this enclorsei ent ends when their written contract or written agreement with you for such c premises or fadlitieE ends. a With respects to P , graph 1.c. above, this insurance does not apply to any "occu once" which takes place after the equif ment rental or lease agreement has expired or you have return ad such equipment to the lessor. a The insurance provi ad this endorsement applies only if the written contract oi written agreement is signed prior to the "bodi y injury" or "property damage". We have no duty t defend an additional insured under this endorsement until we receive written notice of a "suit" b the additional insured as required in Paragraph b. of Conditi n 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. /i�11�1I CG 88 10 04 13 Includes copyri hted material ofInsurance ' Services office, ff e, Inc., with its permission. Page 4 of 8 n a 3 2. With respect to the insu�ance provided by this endorsement, the following are aided to Paragraph 2. Exclusions under Section I -Coverage A -Bodily Injury And Property Damage Liability: This insurance dos not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injuryor 'property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury" "proerty damage" or "personal and advertising injury" arisi g out of the render- ing of, or the allure to render, any professional architectural, engineering oi surveying services, including: (1) The preps ing, ipproving, or failing to prepare or approve, maps, shop drawings, opinions, reports, s rveys, field orders, change orders or drawings and specifications; or (2) Supervisorr, ins action, architectural or engineering activities. This exclusion app !as ei an if the claims against any insured allege negligence or Aher wrongdoing in the supervision, hi ing, amployment, training or monitoring of others by that insured, if the "occur- rence" which caw ad th 3 "bodily injury" or "property damage", or the offenSE which caused the "personal and adv rosin injury", involved the rendering of, or the failure to render, any professional architectural, engin eying or surveying services. d. "Bodily injury" or"pioperty damage" occurring after: (1) All work, i cludi g materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed b or on behalf of the additional insure (s) at the location of the covered operations has been coi npleted; or (2) That portion of your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in perfo ming operations for a principal as a part of the same prof ct. e. Any person or rgani ation specifically designated as an additional insured for ongoing operations by a separate kDDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the nsuraiice afforded to these additional insureds, the following is added to Section III -Limits Of Insuranc : If coverage provided tote additional insured is required by a contract or agreement, the most we will pay on behalf of the additi nal Insured is the amount of insurance: a. Required by the contr ct or agreement; or b. Available under the a plicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement s all n t increase the applicable Limits of Insurance shown in th Declaratio ns. H. PRIMARY AND NON -CO TRIBLITORY ADDITIONAL INSURED EXTENSION This provision applies t any I arson or organization who qualifies as an additional insu ed under any form or endorsement under It is pollcy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CON ATIONS is amend- ed as follows: a. The following is add ad to Paragraph a. Primary Insurance: If an additional insu ed's policy has an Other Insurance provision making its poll excess, and you have agreed in a wri en c ntract or written agreement to provide the additional insured coverage on a primary and noncontibutor t basis, this policy shall be primary and we will not seek contribution from the additional insure 's pc Icy for damag we cover. ® zu'I ur 'iislIra,,,ce CG 88 10 04 13 Includes opydg ted material of Insurance Services e, Inc., with Its permission. Page 5 of 8 g t b. The following is added t¢ Paragraph b. Excess Insurance: When a written coi itract lor written agreement, other than a premises lease, facilibi is rental contract or agreement, an equ Amen rental or lease contract or agreement, or permit issued Dy a state or political subdivision betwe n . I and an additional insured does not require this insure to be primary or primary and non- ntribytcry, this insurance is excess over any other insurance for which the addi- tional insured is de ignattd as a Named Insured. Regardless of the vritten agreement between you and an additional insured, this insurance is excess over any other ins rant whether primary, excess, contingent or on any other basis for which the additional insured as b an added as an additional insured on other policies. ADDITIONAL INSURE[ This provision applies or endorsement under 1. The following An additional a. Give writti this insur® b. Tender th, insurance c. Agree to r cover unde d. We have r we receive -EXTENDED PROTECTION OF YOUR "LIMITS OF anylperson or organization who qualifies as an additional d to Condition 2. Duties In The Event Of Occurrence, OI under this endorsement will as soon as practicable: ;e of an "occurrence" or an offense that may result in a us; defense and indemnity of any claim or "suit" to all insure ,ailadle to the additional insured; and ike vailable any other insurance which the additional insur this overage Part. d under any form ,a, Claim or Suit: m or "suit" under whom also have has for a loss we to defend or indemnify an additional insured under thig endorsement until notice of a "suit" by the additional insured. 2. The limits of in ;uran applicable to the additional insured are those specified in a written contract or written agreamers or the limits of Insurance as stated in the Declarations of this policy and defined in Sec ion I 1 - Limits of Insurance of this policy, whichever are le s. These limits are inclusive of anc not iri addition to the limits of insurance available under this PC licy. J. WHO IS AN INSURED -1 MCIDENTAL MEDICAL ERRORS/MALPRACTICE WHO IS AN INSURED - ELLC W EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEE Paragraph 2.a.(1) of Sec ion II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partric is or members (if you are a partnership or joint venture), to your members (if you are a limited liab lity company), to a co -"employee" while in the course o his or her employ- ment or performing Julies related to the conduct of your business, or to your other "volunteer workers" while perfor ing duties related to the conduct of your business; (b) To the spouse, child, I parent, brother or sister of that co -"employee" or "volu teer worker" as a consequence oil Paragraph (1) (a) above; (c) For which therE is arty obligation to share damages with or repay someone else who must pay damages becau 5e of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of In s or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing profession I health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) a ova cc not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is a ting I i a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities ssign by you, includes the direct supervision of other "employ- ees" of yours. However, non of thes "em to ees" 1a2re)' sureds for "bodily injury" or "personal and ® 3 L e tu$1 T"ns Inc CG 88 10 04 13 Includes copyrighted material of Ins ante Services Office Inc., with Its permission. Page 6 of 8 a advertising injury" arising cause "bodily injury" or " tion by liquor or controlled The coverage provided by your "employee". K. NEWLY FORMED OR ADDI Paragraph 3. of Section II 3. Any organization interest, will cual organization. lloA a. Coverage urn which the ant b. Coverage A d acquired crfc c. Coverage B i committed be d. Records a d t No person or organi venture or limited I as an insured under L. FAILURE TO Under Section IV - sentations: Your failure to disc) se shall not prejudice he prior "occurrences" is M. KNOWLEDGE OF Under Section IV - In The Event of Occ Knowledge of an ' insured shall not in 1. of Section II - WI "occurrences", offe "employee". N. LIBERALIZATION If we revise this Cam additional premium cl effective in your state. O. BODILY INJURY Under Section V - 3. "Bodily Injury" mental anguist ness or disease CG 88 10 04 13 Includes of their willful conduct, which is defined as the purpose�l or willful intent to mal and advertising injury", or caused in whole or in art by their intoxica- J. is excess over any other valid and collectable itjsurance available to NALLY ACQUIRED ENTITIES io Is An Insured is replaced by the following: newly acquire or form and over which you maintain o nership or majority as a Named Insured if there is no other similar insurer ce available to that ler this provision is afforded only until the expiration of the policy period in ty was acquired or formed by you; oes not apply to "bodily injury" or "property damage" that occurred before you rm d the organization; and loss not apply to "personal and advertising injury" arising out of an offense forg you acquired or formed the organization. les riptions of operations must be maintained by the first Named Insured. is On insured with respect to the conduct of any current or p st partnership, joint co pany that is not shown as a Named Insured in the Deal rations or qualifies wi ion. ZA RDS AND PRIOR OCCURRENCES rci 31 General Liability Conditions, the following is added to Condition 6. Repre- a I hazards or prior "occurrences" existing as of the inceptic n date of the policy cqq erage afforded by this policy provided such failure to disclose all hazards or no intentional. MN�E, OFFENSE, CLAIM OR SUIT arci 0 General Liability Conditions, the following is added to Condition 2. Duties Offense, Claim Or Suit: :urr nce", offense, claim or "suit" by an agent, servant or "employee" of any elf 3onstitute knowledge of the insured unless an insured listed under Paragraph Is An Insured or a person who has been designated by them to receive reports of ss, claims or "suits" shall have received such notice from the agent, servant or feral Liability Extension Endorsement to provide n policy will automatically provide the coverage as of 3. is replaced by the following: physical injury, sickness or disease sustained by a injury, shock, fright or death that results from such ® 2013 4ibrtyu yuallsu�r�ce material of Insurance Services OM a nc., with its permission. coverage without day the revision is This includes I Injury, sick - Page 7 of 8 P. EXTENDED PROPERI Exclusion a. of COVI following: a. Expected Or "Bodily injui) This exclusion reasonable fc Q. WAIVER OF TRANSFI CONTRACT OR AGRE Under Section IV - Cc far Of Rights Of Reco% We waive any righ make for injury < x = contract with that provided: 1. You and that waive such ric 2. The injury or ment. CG 88 10 04 13 Includes i i )A GE iGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the Boded Injury or 'property damage" expected or intended from the stand oint of the insured. foe not apply to "bodily injury" or "property damage" resu ting from the use of to protect persons or property. OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A ENT WITH YOU mer'ial General Liability Conditions, the following is added t� Condition 8. Trans- y A�ainst Others To Us: of re�overy we may have against a person or organization be use of payments we damage arising out of your ongoing operations or "your ork" done under a erson or organization and included in the "products -completed operations hazard" or organization have agreed in writing in a contract nst that person or organization; and occurs subsequent to the execution of the written c �I� � .-��77��yyjjrr// 20 Lib�M�It)alsurance Ited material of Insurance Services Office, Inc., with its permission. agreement that you or written agree - Page 8 of 8 YYNEY VENDORA INC. PEMIER VEND GROUP 6814 SUVA ST. ELL GARDENS, CA 90201 PHONE: (562) c128-1801 FAX: (562) 9'rf, 8.5501 November 1 Re: City of Santo Ana Please accept #his 4ocumentation that Downey Vendors, Inc. DB?,� is Premier VendlGro D. If you have a questions or need additional information, please der not hesitate to contact tae. Thank fjFM CNT �}iViSIJN 2019 LAMBERT