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HomeMy WebLinkAboutTSCM CORPORATIONMAYOR INSti[vN'ul:, ON Miguel A, Puildo thlOrIK PQ<}Y pl,r-, MAYOR PRO TEM LiidlILINSURAN' Michele Martinez fl I I I COUNCILMEMBERS P. David Bonavides CLE11K Vicente Sarrniento NiTE. Jose Selene SalTinajero Juan Juan Villages w ?} 4111"1 1 - November 13, 2017 Professional Liability Insurance required if contractor i5 or employs a licensed professional 14 2017 AEMA A A MA PUBLIC WORKS AGENCY 20 Civic Center Plaza M-21 • P.O. Box 1988 .. Santa Ana, California 92702 -_...... vvww,santa-ana.ora A-2014-355-01. _ CITY MANAGER Raul Godinez 11 CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Hulzar Frank J, Pappano Senior Vice President TSCM Corporation 17791 Jamestown Lane Huntington Beach, CA 92647 Re: Second Extension of Consultant Agreement No. A-2014-355 to continue services for power washing and sweeping of streets and sidewalks Dear Mr. Pappano: - Pursuant to Section Three ("Tern") of Agreement A-2014-355 entered into by the City of Santa Ana and TSCM Corporation, the parties opted on October 12, 2016, to extend the Agreement for the first of the two (2) one year extension from the period of January 1, 2017 through December 31, 2017. The parties, by operation of this letter, choose to exercise their option for a second and final one (1) year extension of the term for the period from January 1, 2018 through December 31, 2018. All insurance certificates are required to be extended and/or renewed to cover this extension, All other terms and conditions of said Agreement remain unchanged and in full force and effect. Sincerely, FrledMousavipour CTTY"O N NA Executive Director Raul Godinez II Public Works Agency City Manager APPROVED AS TO FORM: ATTEST: Sonia R. Carvalho City Attorney _. J n M. Funk -4"' Mar D. l luizar Assistant City Attorney Clerk of the Council SANTA ANA CITY COUNCIL Kgual X Polido Michele Martinez Vicente Sarmiento Jnse swrio P. David 6anevid.a Juan Viilegas Sat onajaro Mayor Maya Pro Tem, Ward 2 Ward Wald3 ward Ward Ward m iid Cars Cana mimar6nexto�santa-ane mo 4sarrtc,nto scala ana.arotsdorinto%santa.ana.nrm daenevidea{ffisanta.ana req i»y.g.,a 2santaana org 4,,�tnalarq(fisartia-ane ao c'c7Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) TYPE OF INSURANCE —ABdC 612 612017 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the polloy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 18 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this cartifleate does not confor rights to the certificate holder In (leu of such endoreement(0, PRODUCER Spectrum Risk Management 74 Discovery Irvine, CA 92818 Do Accognijvleg@ger HONE AX WI 949.756-6730 c 949-768-67M10 r Mt I nnpREseoftice(a�apeotrumrisk.Gom INSURERe AFFORDING COVERAGE NAIOH wwwspsctrumrisk,com OC77a65 _ _ INeuREnA: Nevlaators Speo!Elty Insurance Co 36056 INSURED TSCM Corporation TSCM Corporation of Arizona INSURERS American States lnsUranCa COmpBI1Y 1D7�A INSURERC National Unlon Flre Insurance Co. of Plthburgh PA _ 18446 INSURER 01 Cypress Insurance Co 86Q G Pappano Investment Group, LLC _ INSURERS: _ 17791 Jamestown Lane Huntington Beach CA 92647— — NsusERF: GEN -1. AGGREGATE LIMIT APPLIES PER: POLICY 0 jCCT LOC E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 1'0 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 05RTIFICATE 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. M TYPE OF INSURANCE —ABdC POLICYNUMBER M IOFOLICDV EF POI yt YLICYEXP LIMITS ACOMMERCIAL GENERAL LIABILITY CLAIMS-MADE1�1 OCCUR Dednctlble-$2600 LAI 7COLO195681C - 1/1/2017 ! 1/1/201$ EACH OCCURRENCE ,OOQ000 __ e Ee acs rte ,�qc -L-1 $ 100,000 MED EXP Am one reach $ 5,000 Contractual Llablift. PERSONAL AADV E 1,000,000 GEN -1. AGGREGATE LIMIT APPLIES PER: POLICY 0 jCCT LOC E _INJURY GENERAL AGGREGATE $ 21000,000 PRODUCTS. OQWP2PAGG $ 2,000,000 $ IS AUTOMOBILE ✓ LIABILITY ANYAUTO _ OWNED SCI (FOULED AUTOS ONLY AUTOS A 0 - EO ADTD6 ONLY AUi060NLY D 01 -CI -869920-10 I 1/1/2017 1/1/2016 I ° ecltlooa G 1 $ 1.D00000 BODILY IN40RY(Per parson) s BODILY INJURY (Poraroldeny $ OPERTY OAMnOE erexl an $ $ C UMBRELLALIAO OCCUR E%CE98 LIAR GLAIMB-MME ED ✓ ENTIONSO BE 066322235 1/112011 111/2016- EACH OCCURRENCE $ 6000000 AGGREGATE $ 6,000,000 S D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXEDUNVE OFFICEWMEMRER EXCLUDED? (Mandatary In NH) Iron dnecdbe under GE86RIPTION OF OPCRA71ONS bole, NIA TSWC010196 711/2017 7/1/2018 EF T T T E. L, EACH ACCIDENT 1,000,000 C.L. DISEASE - EA EMPLOYEE r1_1 000000 EL.DISEASE-POLICY LIMIT 1,000,000 DESCRIPTION GF OPERATIONS/ LOCATIONS (VEHICLES IACORD 1010 Additional Remarks SMAdelo, may be MWO1106 If Moro apace la raqulred) Re: The Depot at Santa Ana -1000 E. Santa Ana Blvd, Sante Ana CA Dino, Its officers, agents and employees and the City, Its officers, agents and employees are oddlHonai Insureds th respect to the general liability per the attached blanket carrier form. Primary and non-contributory wording applies. REVIEWED BY. ,FUNICE HEREDIA(PO OF Santa Ana RegionalTran%portatlonCenter SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE C/O Santa AnPublic Works Agency THE EXPIRATION DATE TFIEREOP, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza, M-21 9 Y ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE , Ilm \nlnlorA.,nm � 1 �} All AUUI%U ZG t2U101UJ) I ne ALIUKU name and logo are registered marks of ACORD 16E5ID14 I omnia 1 2017 All Linen I Ginnie BUoeemnnro I e/2e/2on 5,4111a 11 (Poll I Pngn , or 3 612612017 POLICY NUMBER; LAI7CGL0196661C COMMERCIAL GENERAL LIABILITY GG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsernenl modifles Insurance provided under ilia following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/OOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organlzatlon(s) Location And Description Of Completed Operations Any person ororganization for whom you are performing operations when you and such person or organization have agreed In writing In a contract or agreement that such person or organlzatlon be added as an additional Insured on your policy, Informatlon required to complete this Schedule, If not shown above, will be shown in the Declarations A. Section II - Who Is An Insured Is amended to Include as nn eddlilonal insurad the person(s) or organizatlon(s) shown In the Schedule, but only with respect to Ilabllity for "bodily Injury" or "property damage" caused, in whole or In part, by "your work" at the location deal ggnaled and described In the Schedule of this endorsement performed for that additional Insured and Included In the "produots-completed operations hazard". 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 Insurance afforded to such additional Insured will not be broader than that which you are required by the contractor agreement to provide for such additional Insured, CG 20 37 0413 B. With respect to the Insurance afforded to these addlflonel Insurerls, the following Is added to Section 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; 1. Requl red by the contract or agreement; or 2, Available under the applicable Limits of Insurance shown In the Declarations; whichever Is leas, This endorsement shall not Increase the applicable Limits of Insurance shown In the Declarations, REVIEwE- --- ..:.. __ EUNICE MERE!?IA fP4 4F } .- sU Insurance Services Office, Inc„ 2012 36351024 1 019Aie 1 2017 All Uoe" I Mn"O vu"eemaneo 1 612012017 siO,23 ew nor) I nano 2 of 3 Page 1 of 1 6/28/2017 LA17CGLO196681C COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. 0 11-11 ki This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following Is added to the Other Insurance Condition and supersedes any provision to the contrary, Primary And Noncontributory Insurance This Insurance Is primary to and will not seek contribution from any other Insurance available to an additional insured under your policy provided that: (1) The additional Insured Is a Named Insured under such other Insurance; and CG 20 0104 13 (2) You have agreed In writing In a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured, REVIEWED_BY: EUNICE HEREDIA (PG pF%j.. © Insurance Services Office, Inc., 2012 3535104 I W.L. 1 2017 All Immo 10"4" euecamancn 1 6/26/Ml 1,11,11 11 {1111 11a,e a , J Page 1 of 1 ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 12/28/2017 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 endorsement(s). Spectrum Risk Management 74 Discovery Irvine, CA 92618 CONTPRODUCER NAME: Account Manager aCNNo, Ext: 949-756-5730 FAX No: 949-756-5740 E-MAIL ADDRESS: office@spectrumrisk.com INSURERS AFFORDING COVERAGE NAIC # 1A18CGLO195681C INSURER A: Navigators Specialty Insurance Co. 36056 www.spectrumrisk.com OC77485 INSURED TSCM Corporation TSCM Corp. Arizona INSURER B: West American Insurance Company 44393 INSURERC : National Union Fire Insurance Co. of Pittsbur h PA 19445 INSURERD: Cypress Insurance Co. 10855 Pappano Investment Group, LLC 17791 Jamestown Lane Huntington Beach CA 92647 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 39619216 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, INTR OF INSURANCE ADDLTYPE JUM WVQ SUER POLICY NUMBER MM/DDYLICY EFF MMLDD EXP LIMITS A �/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ✓ OCCUR 1A18CGLO195681C 1/1/2018 1/1/2019 EACH OCCURRENCE $1,00000_0 DAMAGE O RE D PREMISES Ea occurrence $100,000 MED EXP (Any one person) $5,000 ✓ Deductible- $2500 ✓ Contractual Liability PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY ✓] JE 0 F—] LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: B AUTOMOBILE LIABILITY BAW (19) 57 03 17 97 1/1/2018 1/1/2019 COMBINED tSINGLELIMIT $1000000 BODILY INJURY (Per person) $ ✓ ANY AUTO OWNEDSCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE $ Per accident $ ✓ Dedcutible-0 C UMBRELLA LIAB �/ OCCUR BE 066322235 1/1/2018 1/1/2019 EACH OCCURRENCE $5000,000 AGGREGATE $5,000,000 EXCESS LIAB CLAIMS -MADE DED I ✓ I RETENTION $0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OF ICER/ EMB REXCLUDEANYPROPRIETOR/PARTNER/D?ECUTIVE ❑ N/A TSWC810195 7/1/2017 7/1/2018 VSTATUTE ERH E.L. EACH ACCIDENT $1,000000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: The Depot at Santa Ana -1000 E. Santa Ana Blvd. Santa Ana CA Dlnc, its officers, agents and employees and the City, its officers, agents and employees are additional insureds with respect to the general liability per the attached blanket carrier form. Primary and non-contributory wording applies. REVIEWED BY: EUNICE HEREDIA (PG I OF ) %,r -m I Irn A I r- MULUCR %,ANLolI IA I IUN Re: The Depot at Santa Ana -1000 E. Santa Ana Blvd. Santa Ana CA Santa Ana Regional Transportation Center C/O Santa Ana Public Works Agency 20 Civic Center Plaza, M-21 Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �/� -- Jim Waterhouse '�/` U 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 39619216 1 Ginnie 1 2018 All lines I Ginnie Bustamante 1 12/28/2017 4:35:30 PM (PST) I Page 1 of 3 12/28/2017 POLICY NUMBER: LA18CGLO195681C COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endursernenl modifies insurance pruvided under the fullowiny. COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization he added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard", 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 insurance 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. B. With respect to the insurance afforded to these additinnal insrireds, the fnlinwing is nddad to Section 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: 1. Required by the contract or agreement; or 2. 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 Declarations. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (PGZOF �) 39619216 1 Ginnie 1 2018 All lines I Ginnie Bustamante 1 12/28/2017 9:35:30 PM (PST) I Page 2 of 3 LAI 8CGLO195681C COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. l REVIEWED BY: EUNICE HEREDIA (PG 5OF ) 39619216 1 Ginnie 1 2018 All lines I Ginnie 0ustamante 1 12/28/2017 4:35:30 PM (PST) I Page 3 of 3 -w ACC)R"� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) TYPE OF INSURANCE 6/26/2018 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 endorsement(s). S4ectrum Risk Management 74PDiscovery Irvine, CA 92618 CONTACTPRODUCER NAME., Account Manager A/CNNo Ext: 949-756-5730 FVC No: 949-756-5740 E-MAIL ADDRESS: office@spectrumrisk.com INSURERS AFFORDING COVERAGE NAIC # www.spectrumrisk.com OC77485 INSURER A: Navigators Specialty Insurance Co. 36056 INSURED TSCM Corporation TSCM Corp. Arizona INSURER B: West American Insurance Company 44393 INSURERC: National Union Fire Insurance Co. of Pittsbur h PA 19445 INSURER D: Cypress Insurance Co. 10855 Pappano Investment Group, LLC 17791 Jamestown Lane Huntington Beach CA 92647 INSURER E: INSURER F CUVtHA[ii-S - CFRT71-1CATF NIIMRFR• A077007CZ ID1=1/1C1nKI Kit IMQCD, 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. ILTR TYPE OF INSURANCE ADDL D SUBR WVD POLICYNUMBER POLICY EFF MM/DDNYW POLICY EXP MM/DDIYYYY LIMITS A ,/ COMMERCIALGENERALLIABILITY CLAIMS -MADE ❑✓ OCCUR ✓ Deductible- $2500 LA18CGLO195681C 1/1/2018 1/1/2019 EACH OCCURRENCE $11000,000 DAMAGE TO RE TED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $5,000 ✓ Contractual Liability PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE� LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ B AUTOMOBILE ✓ ✓ LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Dedcutible-0 BAW(19)57031797 1/1/2018 1/1/2019 OMBINeDtSINGLE LIMIT $1000000 BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE $ Per accident $ C ✓ UMBRELLA LIAB EXCESS LIAB ✓ OCCUR CLAIMS -MADE EBU 019083645 1/1/2018 1/1/2019 EACH OCCURRENCE $5,000,000 _ AGGREGATE $5,000,000 DED I ✓ RETENTION $0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE 1 1 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A TSWC913746 7/1/2018 7/1/2019 / STATUTE ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1.000.000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: The Depot at Santa Ana -1000 E. Santa Ana Blvd. Santa Ana CA Dino, its officers, agents and employees and the City, its officers, agents and employees are additional insureds with respect to the general liability per the attached blanket carrier form. Primary and non-contributory wording applies. R VIE VED RYA EUNICE HE_ IA_ OF zs - �,r_m i triwA i r- nvLLir-m GANtiCLLA1IVN He: I he Depot at Santa Ana -1000 E. Santa Ana Blvd. Santa Ana CA Santa Ana Regional Transportation Center SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE San Santa Ana Public Works t enc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN C/ Civic Center Plaza, or Agency ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE ��jj /!»� .. Jim Waterhouse U 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 42778276 1 Ginnie 1 2018 All lines I Ginnie Bustamante 1 6/26/2018 12:08:53 PM (PDT) I Faye 1 of 3 POLICY NUMBER: LA18CGLO195681C COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ UTCAREFULLY. This endomorumixmdDcminsurance pnuvkjmdunder.ihu[b|low|oQ: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization for whom you are performing operations when you and such person or organization have agreed In writing In a contract or agreement that such person or organization he added as an additional insured on your policy, Information required to complete this Schedule, If not shown above, will be shown in the Declarations. A. Section K - Who |aAnInsured isamended to inrlijdp as an additionalInsured organlzation(s) shown In the Schedule, but only with respect to liability for "bodily injury' or "property damage" caused, in whole or In part, by "your work" at the location designated and described In the Schedule of this endorsement performed for that additional insured and included In the "products -completed operations hazard", 1.The insurance afforded to such additional insured only applies to the extent permitted by |mvv and 2.|fcoverage provided hzthe additional insured |o required bvmcontract oragreement, the insurance afforded tnsuch additional Insured will not babroader than that which you are required bvthe contract oragreement to provide for such additional insured. Ek With respect to the insurance afforded to these Section 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: 1. Required bvthe contract m[agreement; nr 2. Available under the applicable Limits of Insurance shown inthe Declarations; whichever |oless. This endorsement shall not increase the mpp||omb|e L|mitaofInsurance shown |nthe Declarations. CG 20 37 04 13 C Insurance Services %=!::� LAI8CGL0195681C COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (PG�3OF } 42778276 1 Ginnie 1 2018 All lines I Ginnie Bustamante 1 6/26/2018 12:08:53 PM (PDT) Page 3 of 3 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) F12x21/2018 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 endorsement(s). PRODUCER Spectrum Risk Management 74 Discovery Irvine, CA 92618 CONTACT NAME: Account Manager PHONE FAX _(& No• 949-756-5730 AD No): 949-756.5740 AOI RESS: office@s ep ctrumrisk.com INSURER(S) AFFORDING COVERAGE I NAIC Y INSURERA: Navigators Specialty Insurance Co. 1 36056 www.spectrumrisk.com OC77485 INSURED TSCM Corporation TSCM Corporation of Arizona Pappano Investment Group, LLC INSURER B: West American Insurance Company 44393 INSURERC: Western World Insurance Company 13196 INSURER D: Cypress Insurance Co. 10855 17791 Jamestown Lane Huntington Beach CA 92647 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 46106928 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOIWITHSTANDING 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. ILTR TYPE OF INSURANCE DLI i INSD VIVOUBRI POLICY NUMBER POLICY EFF POLICY DDIYYYY LIMITS A ,/ COMMERCIAL GENERAL LIABILITY LA19CGLO195681C 1/1/2019 1/1/2020 EACH OCCURRENCE S1,000,000 CLAIMS -MADE MCCCUR -DA, MTGETbRENT ED - PREMISES (Ea occurrence $100,000 MED EXP (Any one person) S5,000 ✓ Deductible- $2500 ✓ Contractual Liability PERSONAL & ADV INJURY $1,000,000 GEMLAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE 52,000,000 ET a JC PRODUCTS COMPIOPAGG $2,000,000 S OTHER: B AUTO MOBILELIABILITY BAW (20) 57 03 17 97 1/1/2019 1/1/2020 ECOMBINED BcciISINGLE LIMIT S1,000,000 BODILY INJURY (Per person) S ✓ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) 5 HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE S Per a.,dent t✓ I s Dedcutible- C �/ I UMBRELLA LIAB ✓ OCCUR GLX1001341-00 1/1/2019 1/1/2020 EACHOCCURRENCE 55,000,000 AGGREGATE 55,000,000 EXCESS LIAB CLAIMS -MADE OED I ✓ I RETENTION -O s DWORKERS COMPENSATION AND EMPLOYIE71L. ILITY YIN ANYPROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER£XCLUDEDT NIA TSWC913746 7/1/2018 7/1/2019 ,/ STATUTE ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS bebw E.L. DISEASE - POLICY LIMIT S 1.000 000 I I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re: The Depot at Santa Ana -1000 E. Santa Ana Blvd. Santa Ana CA Dlnc, its officers, agents and employees and the City, its officers, agents and employees are additional insureds with respect to the general liability per the attached blanket carrier form. Primary and non-contributory wording applies. REVIEWED BY: aT EUNICE HEREDIA (PG 1 OF' CERTIFICATE HOLDER CANCELLATION Santa Ana Regional Transportation Center SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE San Santa Ana Public Works Transportation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN C/O20 Civic Center Plaza, Works Agency ACCORDANCE WITH THE POLICY PROVISIONS. -21 Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Jim Waterhouse r ©1988-2015 ACORD CORPORATION. All rights reserve ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 46106929 1 Ginnie 1 2019 GL/XS -AUT. 2018 WC 1 Ginnie Bustamante 1 12/21/2016 11:00:29 AN (PST) I Page 1 of 3 12121/2018 POLICY NUMBER: LA19CGLO195681C COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endursernenl rnudifies insurance provided under the fulluwiny: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization he added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to inrirrda a. an adrlitinnal inslnrPrt tha pPrSnn(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your WOW' at the tocationt deslynatcd and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". 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 insurance 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. CG 20 37 04 13 B. With respect to the insurance afforded to these adrlitinnal insurads, tha following is ndriari to Section 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: 1. Required by the contract or agreement; or 2. 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 Declarations. © Insurance Services Office, Inc., 2012 Page 1 of 1 46306920 1 Ginnie 1 2019 GL/::5 +AUT. 2010 n_ 1 Ginnie Busts ,,ntr 1 12/21/2010 •^Q �a— REVIEWED BY: 4f EUNICE HEREDIA (PGZOF ) LA19CGLO195681C COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be primary contrary: and would not seek contribution from any other Primary And Noncontributory insurance insurance ovallab!c to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 Jc10e?JP 1 Gini, 1 2019 GL/AS -AUT. 301H KC. I Gilniu B-1:—:mte I 13/21/2010 11:00:39 M4 (PSI') I Page 3 of 3 1 REVIEWED BY: EUNICE HEREDIA (PG o )