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HomeMy WebLinkAboutADLERHORST INTERNATIONAL LLC - 2017INSURANCE i(YI" ON : ILE A-2097-362 WORM MAY NOT PROCEED CLERK OF COUNCIL DATE: FEB 12 7090 AGREEMENT TO PROVIDE K-9 TRAINING SERVICES �c�i4+Mr u BETWEEN ADLERHORST INTERNATIONAL, LLC. AND THE CITY OF SANTA ANA THIS AGREEMENT, made and entered into this 19th day of December, 2017 by and between Adlerhorst International, Inc., a California Limited Liability Company, (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). RECITALS A, The City desires to retain a consultant having special skill and knowledge in the field .of providing police K-9 training for both police dogs and police K-9 handlers; and selecting appropriate dogs for use as a K-9 police dog. B. Consultant represents that Consultant is able and willing to provide such services to the City, C In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services to provide monthly training for police K-9s and their handlers, basic handler training as required for new K-9 handlers, new K-9 selection (Belgian Malinois or German Shepherd), training of new K-9s, Narcotic detection training for K-95 and handlers as needed, and miscellaneous equipment. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges set forth below. The total sum to be expended under this Agreement shall not exceed $89,800 during the three-year term of this Agreement as follows: Description of Services Coots. Montbly Training per Year $12,600 per year * 3=$37,800 New K-9 and Training Academy x 3 (Approximate Replacement dates: January 2018, July 2019, and December 2020) $15,000 each year. * 3 years = $45,000 TOTAL: 1 $89,800 b, Payment by City shall be made within 45 days (forty-five) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures, Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on December 18, 2020, unless terminated earlier in accordance with Section 13, below, 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employce relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and sttnilar taxes relating to employees and shall be responsible for all applicable witlfllolding taxes, 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below; a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles, The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence, Such insurance shall include coverage for owned, hired and non -owned automobiles. o, Worker's Compensation Insurance. In accordance with the provisions of Section 3700 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self- insurance, Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as sit architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: i. Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. ii. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. iii. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. iv, Consultant shall supply City with a fully executed additional insured endorsement. f. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. IND) MNUICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief" due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indenrnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 7, RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement, Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement, 8. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care, "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 10. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities, Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations, 11, EXCLUSIVITY AND AMENDMENT This Agreernont represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments bereto, the terns of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein. 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 13. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination, In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of City of Santa Ana 20 Civic Center Plaza (M-30) P,O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Chief of Police City of Santa Ana 60 Civic Center Plaza (M-97) P.O. Box 1988 Santa Ana, California 92702 Fax:714-245-8007 To Consultant: David Reaver Adlerhorst International, LLC, 3951 Vernon Avenue Jurupa Valley, California 92509 Sonia R. Carvalho City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Fax: 714- 647-6515 A party may change its address by giving notice in writing to the other party, Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time fames, weekends, federal, state, County or City holidays shall be excluded, [signature page to follow] IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: -,J • ll1,G �� Mar a D, uizar Clerk of the Council APPROVED AS TO FORM; SONIA R. CARV City Attomey 0 Assistant City Attorney RECOMMENDED FOR APPROVAL: �r r. �AVII7 V�LFN�r Acting Chief of Police CITY OF SANTA ANA Raul Godinez II �✓ City Manager CONSULTANT: ADLER-1 CHIP ID: BOBO Q� DATE WAVONYYYYi CERTIFICATE OF LIABILITY INSURANCE 08125f2017 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 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 endorsemant(s), PRODUCER COMA NAME;_ Roberta_R Roses Loomis insurance Services PHONE 92519 !, wsuaEo Adierhorstinternational, L1. LC 3951 Vernon Avenue Riverside, CA 92509 r.nVFRAI CFRTIFICATF. NTMBFR: REVISION NUMBER: THIS IS 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 10 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OCHER 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 PERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR� ,,.... _._. .....,4DDLRuUeR)._.-...- POC(LV GEP...L. POLICY EXP /._ _.._-_.. _.. . L TYPE OF INSURANCE MSR awn n, POLICY NUMBER IMWOOWYYYt . (M�/UWYV1'x�,y_ LIMIT'S .._ GENERAL RAL LLIABILITY FI ( i EACH OCOURS 1,000,000 X'_. I- DAMAGE"TU RENTED A axaMERaAL OFiNER(J.LwaalTv X - EW592208$ t}8t0817` t2408t0$J241$IPREM�sEs l„An,l """'•• 100,000 ,S,_ CLAIMS-MACE Ya F OCCUR ' MED EXP {AnTone personl S 5,000 _ PERSONAL SAW INJURY S 1000,000 w. .......... GENL AGGREG ATE LIMIT' APPLIES PER PRODUCTS COMPIOPAGG ! S _._ EXCLUDED G.. C I PRO. l ... __. ... �.6...,..l.w1Pria��....,...,.J.....,,,-�._ ,......_ T- ....-.,-,S A�OMOtllLE LIABILITY -COMBINED SINGLE LIMIT I BODILY INJURY IPer p r nl S i ANY AUTO ! IAL40WNED —SCHEDULED BODILY INJURY (f>er ec ltlenp�,% Ip. jL,� AUTOS AUT05 - NON OWNED iIFROPERTY DAMAGE S HIREDAUTOS _ _..AUTOS LOPER ACCIDENT) MORLLA R 1^— EAc.H OCCURRENCE rb OCCU eXG S$IiABAR S ,CLAIMS-M,4DE� ' AGGReGAT E Y ^mI_ OE-Q tETENTKINS1 t w S WORKERS COMPENSATION WC STATU- OTH 3 I AND EMPLOYERS' U SILITY Y r N TDRX3.mntTS_ ANY PROPRM ORmARTNER,EXECUTIVE ( E L EACri ACCIDENT ; S OFflCERAMEMBER EXCLUDED, ❑ ;NIA -- - - , (manJaio,y in NH) EL OISEASE EA EMPLOYEE S, If y24 tleso(ibeubtlel bC,?CRIPT,LO);t OFOPERATIONS below EL. DISEASE -POLICY LIMIT S I , DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES IAnapn 0.COR01e1, Additional Renla Ma SCOntlule, it more apace is required) The City of Santa Ana, its officials, officers, employees, agents, volunteers I representatives are named as Additional Insured. Coverage is Primary & Non --Contributory, 30 day Notice of Cancellation applies except. for 10 day Notice for Non-payment of Premium. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92701 AUTHORIZED REPRasENTATIVE ­.,__ (),. Q10,4I U 198U-ZU1U AGUKU cORr URAI ION. All rlgnts reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AY-'.svari2r� aco orr CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 7/5/2017 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(les) must 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 _ NAM Kellogg Stephani Clark N...__ __— ...._ ._.... xellogg &Moreland Agency, Inc, DBA (AIC.Nda E%I) (909)792 8950 n/c No (909)792 2030 Arroyo Insurance Services ADDRESS: Stephani c@arroyoins. com 1654 Plum Lane INSURER(Sf AFFORDING COVERAGE. _ NAIC# Redlands CA 92374-4532 wsuRERA Mercury Casual_ty._Company 11908 INSURED INSURER B: I. _..._.. ...._.. ._._____..__ ..._ ................. Adlerhorst International, Inc. NSURERc: 3951 Vernon Avenue fidello c,,. Riverside CA 92509 _ (INSURER F: COVERAGES CERTIFICATE NUMBER:CL177503877 REVISION NIIMRFR• 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 ...... -.. 0.DDL'9U BR".-. _.._._... ,...._....... ._...�_.� ... PG ICV'IT' f%OLIVY E%f' TYPE GF INSURANCE LT I INSD WVD. POLICY NUMBER (MMIDOIYYWI MMIDDIYVVY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 DAMAGE TO RENTED CLAIMS MADE _OCCUR I I .PR,J;fY hSE$(E31tcc to e) S,_ -.__ .....m.m. m W MEO EX.. (Anyone pars ) 5 _ PERSONAL& AOVINJURY 5 - GE N'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 5 POLICY L. HOC III _ PRODUCTS OTHR l 5 AUTOMOBILE LEO LIABILITY _�,..,..... CONBaG(LEI 0 s 1 000,000, NY INJURY Par wood) ALL OWNED SCHEDULED AUTOG1 AUTOS CCA0019199 e/29/2017 8/29/2018 .. � BODILY INJURY (Pe wdenq 5 -" NON OWNED A FIRED _- HIRED AUT09 X _ - PROPERTY DAMAGE I AUTOS I .der aScl,tle911,_.„ PL.ANOA HS 1,000,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE 6 EXCESS LIAB ;I AIMSMADE, AGGREGATES - DED RET EN110N5 _ R WORKERS COMPENSATION .Y AND EMPLOYERS' LIABILITY YIN. TATUTER�`-� _ SPER � F " ANY PROPRIETORIPARTNERIE%ECUTIVE--'" -II E L EACH ACCIDENT 5 OFFICERIMEMBER EXCLUDED? (NIA -...CCID.ENT --1 - -..-- (Mantlatory In NH) E L DISEASE " EA EMPLOYEE S II yes, drSenbe antler...... ........ .I - _- DESCRIPTION OF OPERA LIONS below E.L. DISEASE -POLICY LIMIT I S I ..� DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remerka Schedule, may be attached It more space Is required) Verification of Coverage CERTIFICATE HOI DER CANCFI I ATION jrose@sana-ana.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana Police Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE 3t ephana Clark/STEPH ©1988.2014 ACORD CORPORATION. Ali rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS029n6mAu � q e: POLICYHOLDER COPY P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 07-01-2017 SANTA ANA POLICE DEPARTMENT FISCAL DEPARTMENT DIVISION M-97 60 CIVIC CENTER PLZ SANTA ANA CA 92701-4050 SP GROUP: POLICY NUMBER: 9017352-2017 CERTIFICATE ID: 5 CERTIFICATE EXPIRES: 07-01 -2018 07-01-2017/07-01-2018 This Is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissionec..to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration, This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein, Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded dbby� the popoo'lliiic�cyy/described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT N2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-2012 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER AOLERHORST INTERNATIONAL POLICE K-9 KENNEL 3951 VERNON AVE JURUPA VALLEY CA 92509 (REVJ-2014) INC. DBA: ADLERHORST [P19,HOj PRINTED : 10-19-2017 SP ADLER-1 OP ID: RORO CERTIFICATE OF LIABILITY INSURANCE 1 D0807/201YY) ;o7i2o18 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 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). CONTACT PRODUCER NAME: Roberta R Rosas Loomis Insurance Services PHONE FAX PO BOX 3128 A/c No Ext:951-685-7478 ac Ne: 951-685-0665 Riverside, CA 92519 ADDRESS: Michael J Runner rrosas@loomis4insurance.com INSURER 5 AFFORDING COVERAGE NAIC # INSURER A:Northfield Insurance Compaq _ 27987 INSURED Adlerhorst International, LLC INSURER B: 3951 Vernon Avenue Riverside, CA 92509 INSURERC: INSURER D : INSURER E INSURER F COVFRAr;FS CFRTIFICATF NIIMBF_R- REVISION Nt1MRF_R- 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP LIMITS MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Y WS345380 08/08/2018 08/08/2019 I DAMAGE TO RENTED PREMISES_ Ea occurrence MED EXP (Any one person) $ 100,000 $ 5,000 $ 1,000,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER $ EXCLUDED PRODUCTS - COMP/OPAGG X POLICY PRO JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _Eaaccidenl___________ $ $ ANY AUTO I BODILY INJURY (Per person) ALL OWNED - ! SCHEDULED AUTOS ;- AUTOS BODILY INJURY (Per accident) S I PROPERTY DAMAGE PER ACCIDENT $ NON -OWNED HIRED AUTOS �i AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE WC STATU- OTH- T RY LIMITS I I ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA! j -------- E.L. DISEASE - EA EMPLOYEES -"----- If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officials, officers, employees, agents, volunteers & representatives are named as Additional Insured. Coverage is Primary & Non -Contributory, 30 day Notice of Cancellation applies except for 10 day Notice for Non-payment of Premium. CFRTIFICATF HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE � © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICYHOLDER COPY P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-01-2018 GROUP: POLICY NUMBER: 9017352-2018 CERTIFICATE ID: 77 CERTIFICATE EXPIRES: 07-01-2019 07-01-2018/07-01-2019 CITY OF SANTA ANA SP 60 CIVIC CENTER PLZ SANTA ANA CA 92701-4060 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. �7 Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-2012 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2018-08-01 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF SANTA ANA EMPLOYER ADLERHORST INTERNATIONAL LLC 3951 VERNON AVE JURUPA VALLEY CA 92509 (REV.7-2014) SP [P19,HO] PRINTED : 08-01-2018 SP SUPPLEMENTAL INSURANCE CHECKLIST v6 G3'3 TO: CLERK OF THE COUNCIL OFFICE 71 FROM: CONTRACT ADMINISTRATOR:EXT.: 7c( NAME OF CONSULTANT/ PARTY: Api-cAwocT : ttc- AGREEMENT NUMBER (IF APPLICABLE):./+-Z01') `36Z Please review the insurance section of the agreement to ensure all necessary certificates of insurances are submitted to the Clerk's Office. Please provide ALL documents listed to fully execute the agreement and avoid payment delay to the vendor. Please check all boxes below that apply to your agreement. BUSINESS AUTOMOBILE LIABILITY NON -OWNED HIRED OWNED GENERAL LIABILITY PROFESSIONAL LIABILITY WORKER'S COMPENSATION '1�. ❑ ❑ En 4.&/7- IQe owxe. a 1A ❑ ADLER-1 OP ID: RORO ACORO"` DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1 08/07/2018 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 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 CONTACT NAME: Roberta R Rosas Loomis Insurance Services PHONE FAX PO BOX 3128 AIc No Ezc , 961-685-7478 JAJC No): 951-685-0665 Riverside, CA 92519 E-MAIL rrosas@loomis4insurance.com Michael J Runner ADDRESS: INSURERS AFFORDING COVERAGE NAIC If INSURER A: Northfield Insurance Compaq 27987 INSURED Adlerhorst International, LLC INSURER B: 3951 Vernon Avenue Riverside, CA 92509 INSURERC: INSURER D : INSURER E: INSURER F : r r)%1PPAnP_q CFRTIFICATF NIIMRPR• RFV141t7N NHMRFR 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDPOLICNYYY MMI POLICYEFF IYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL LIABILITY Y WS345380 08/08/2018 08/08/2019 DAMAGE T RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE Fx� OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ EXCLUDED G E N'L AGG R EGAT E LIMIT APPLIES PER $ X POLICY I— PRO- — -- LUC AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT Ea a:adent $ ANY AUTO ,ODI LY INJURY (Per person) ALL OWNED r SCHEDULED AUTOS AUTOS I j BODILY INJURY (Per accident) $ S _ NON -OWNED HIRED AUTOS j _� AUTOS PROPERTY DAMAGE PER ACCIDENT $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LLIIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE WC STATU- OTH- TORY LIMITS _,I ER .— E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA—""-----"-------- (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE, S If yes, describe under DESCRIPTION OF OPERATIONS below ! _ _ E.L. DISEASE - POLICY LIMIT 5 � � II II I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officials, officers, employees, agents, volunteers & representatives are named as Additional Insured. Coverage is Primary & Non -Contributory, 30 day Notice of Cancellation applies except for 10 day Notice for Non-payment of Premium. L;tK I It ILA I t MULUtK k AIAI,LLLA I IUN The City of Santa Ana 20 Civic Center Plaza 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1 N S L'jf R A N C E' SE R V1 C E S September 7, 2018 Adlerhorst International, Inc. 3951 Vernon Avenue Riverside, CA 92509 Re: Business Auto Policy # ADAU917072 Dear David, Enclosed is your Business Auto renewal policy from Guard effective 08/29/18-19. Also included are the vehicle ID cards. After your review, please let me know if any changes are needed. If you would like a copy of this policy and vehicle ID cards mailed to you, I will be happy to do so. Thank you for your continued business. Sincerely, Patricia Cecile Detwiler 1654 Plum Lane Redlands, CA 92374 (909) 792-8950 Fax (909) 792-2030 License #0735912 www.arroyoins.com `, /Berkshire Hathaway Am GInsurance Companies Berkshire Hathaway GUARD P.O. Box A-H e 16 S. River Street Wilkes-Barre, PA 18703-0020 570-825-9900 (Toll -Free 800-673-2465) FAX 570-823-2059 www.guard.com Dear Policyholder; Please detach the Commercial Auto insurance card(s) below and keep in the glove compartment of the insured vehicle(s), If you have any questions, feel free to contact us at 1-800-673-2465. Thank you, Policy Services REG 890A (REV, 5/97) CALIFORNIA EVIDENCE OF LIABILITY INSURANCE DO NOT FOLD OR STAPLE - SUBMIT ORIGINAL TO DMV This insurance complies with CVC §16056 or §16500.5 SIGNATURE OF INSURANCE REPRESENTATIVE NAME VEHICLE IDENTIFICATION NUMBER (VIN) MAKE YEAR MODEL Adlerhorst International, LLC 1FTPW12574KC55850 FORD/F-150 2004 POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE INSURANCE COMPANY NAME ADAU917072 08/29/2018 06/29/2019 Am6UARD Insurance Company INSURANCE COMPANY STREET ADDRESS CITY STATE ZIP NAIC NUMBER P.O. Box A-H Wilkes-Barre PA 18703-0020 42390 _....................... . .... REG 890A(REV. 5/97) CALIFORNIA EVIDENCE OF LIABILITY INSURANCE DO NOT FOLD OR STAPLE - SUBMIT ORIGINAL TO DMV This insurance complies with CVC §16056 or §16500.5 SIGNATURE OF INSURANCE REPRESENTATIVE NAME VEHICLE IDENTIFICATION NUMBER (VIN) MAKE YEAR MODEL Adlerhorst International, LLC NMOKS9BN8AT018890 FORD/TRANSIT CONNECT 2010 POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE INSURANCE COMPANY NAME ADAU917072 08/29/2018 08/29/2019 Am GUARD Insurance Company INSURANCE COMPANY STREET ADDRESS CITY STATE ZIP NAIC NUMBER P.O. Box A-H Wilkes-Barre PA 16703-002D 42390 Al W/Berkshire Hathaway AN Insurance 10M GUIR KDCompanies Berkshire Hathaway GUARD P.O. Box A-H a 16 S. River Street Wilkes-Barre, PA 18703-0020 570-825-9900 (Toll -Free 800-673-2465) FAX 570-823-2059 www.guard.com Dear Policyholder: Please detach the Commercial Auto insurance card(s) below and keep in the glove compartment of the insured vehicle(s). If you have any questions, feel free to contact us at 1-800-673-2465. Thank you, Policy Services -.. _. .... ........ ...... .......... ... REG 890A(REV. 5/97) CALIFORNIA EVIDENCE OF LIABILITY INSURANCE DO NOT FOLD OR STAPLE - SUBMIT ORIGINAL TO DMV This insurance complies with CVC §16056 or §16500.5 SIGNATURE OF INSURANCE REPRESENTATIVE NAME VEHICLE IDENTIFICATION NUMBER (VIN) MAKE YEAR MODEL Adlerhorst International, LLC 1FTFW1C698FB84594 FORD/F-150 2011 POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE INSURANCE COMPANY NAME ADAU917072 08/29/2018 08/29/2019 AmGUARD Insurance Company INSURANCE COMPANY STREET ADDRESS CITY STATE ZIP NAIC NUMBER P.O. Box A-H Wilkes-Barre PA 18703-0020 42390 d_... .... .......... REG 890A(REV. 5/97) CALIFORNIA EVIDENCE OF LIABILITY INSURANCE DO NOT FOLD OR STAPLE - SUBMIT ORIGINAL TO DMV This insurance complies with CVC §16056 or F NAME POLICY NUMBER POLICY 41VE INSURANCE COMPANY STREET ADDRESS CITY STATE ZIP NAIC NUMBER DATE(MM/DD/YYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE il 1 9/19/2018 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 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 CONTACT Patricia Detwiler NAME: Kellogg & Moreland Agency, Inc. DBA HONE,Ext): (909)792-8950 I FA Kellogg Arroyo Insurance Services pDDRESS:Patriciad@arroyoins.com 1654 Plum Lane INSURER(S) AFFORDING COVERAGE NAIC tt Redlands CA 92374-4532 INSURERA_AmGUARD Insurance Company 42390 INSURED INSURER B Adlerhorst International LLC INSURER C 3951 Vernon Avenue INSURER D INSURER E Riverside CA 92509 I INSURER F: C()VFRAC1FS CERTIFICATE NIIMBFR-18-19 AL 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. INSR ADDL SU EXP LTR TYPE OF INSURANCE D POLICY NUMBER MM DD YYYY MMEFF DDYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S --� F DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES -(Ea occurrence)_ MED EXP (Any one person) S PERSONAL & ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ PO- PR POLICY LOC PRODUCTS =COMP/OP AGG S _ I OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea accident) _ �, ANY AUTO BODILY INJURY (Per person) S A i ALL OWNED X SCHEDULED ADAU917072 8/29/2018 8/29/2019 BODILY INJURY (Per accident. 5 i AUTOS AUTOS NON -OWNED X X PROPERTY DAMAGE S HIRED AUTOS AUTOS (Per accident) I 5 UMBRELLA LAB j OCCUR i EACH OCCURRENCE S _ _ _ EXCESS LIAB I CLAIMS -MADE AGGREGATE $ DED RETENTION 5 $ WORKERS COMPENSATION PER OT AND EMPLOYERS' LIABILITY Y / N STATUTE ERR- ANY PROPRIETOR/PARTNER/EXECUTIVE -- E.L. EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? N / A — - - - - - - (Mandatory in NH) E.L. DISEASE -_EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Verification of Coverage CERTIFICATE HOLDER CANCELLATION jrose@sana-ana.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana Police Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 60 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE Patricia Detwiler/PAT © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD I NS025 (201401) POLICYHOLDER COPY SP P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-01-2018 GROUP: POLICY NUMBER: 9017352-2018 CERTIFICATE ID: 77 CERTIFICATE EXPIRES: 07-01-2019 07-01-2018/07-01-2019 CITY OF SANTA ANA SP 60 CIVIC CENTER PLZ SANTA ANA CA 92701-4060 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-2012 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2018-08-01 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF SANTA ANA EMPLOYER ADLERHORST INTERNATIONAL LLC 3951 VERNON AVE JURUPA VALLEY CA 92509 (REV.7-2014) SP [P19,HO] PRINTED : 08-01-2018 ADLER-1 OP ID: ROI CERTIFICATE OF LIABILITY INSURANCE °^ I'd i°°nvvYl 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 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 andoreemAnffel. PRODUCER Loomis Insurance $erVICBS PO BOX 3128 Riverside, CA 92619 Michael J Runner NAMEACT Roberta R PHONE ac No Xt:951-985- E-MAIL Aco ss: rroeas to o.a.,neR A; ,,,mu maularroe a umpan -L79S7 INSURED Adlerhorst International, LLC 3951 Vernon Avenue INSURER B: Riverside, CA 92509 INSURER C: INSURER D : INSURER E : INSURER F: COVERAGES CFRTIFICATE!gUM0Co. ___.______. --" "' '_"' —' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE REVISION NUMBER: INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED WITH RESPECT TO WHICH THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY HEREIN IS SUBJECT TO ALL THE TERMS, INSR PAID CLAIMS. A °B TR TYPE OF INSURANCE POLICY NUMBER POLICY LIMITS GENERAL LIABILITY A X URRENCE $ 1,000,00 COMMERCIAL GENERAL UABILITY X S368307 08108/2019 Ea omurrenca $ 100,00 CLAIMS -MADE OCCUR Any one person) wi $ 5,00 L BADV INJURY $ 1,000,00 AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X PRO- S-COMPft)PAGG $ EXCLUDE POLICY LOC $ AUTOMOBILELUIBIUTY COMBINED SINGLEIMIT Eaaccitl I ALLOWNENY AUTO AU ONAJED SCHEDULED BODILY INJURY (Per person) $ BODILY INJURY (Per ecddeM) $ AUTOS AUTOSNON-OWNED HIRED AUrOS AUTOS NED AUTOB PROPERTY DAMAGE $ PER ACCIDENT E UMBRELLA OCCUR EXCESS EXCESS LIAB EACH OCCURRENCE $ AGGREGATE CLAIMS -MADE DED RETENTIONS WORKERS COMPENSATION $ AND EMPLOYERS' LIABILITY YIN WC STATU. OTH- L ANYPROPRIETORIPARTNERMXECUTIVE OFFICERMIEMBER EXCLUDED? ❑ NIA E.L. EACH ACCIDENT $ (Mand'a"n"in NH) E.L. DISEASE - EAEMPLOYE $ Ifyea,tleavibeunder DESCRIPTION OF OPERATIONS below E.L. DISEASE -POUCV LIMIT E DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) City of Santa Ana Risk Management Division is named as Additional Insured with regards to services rendered by the Named Insured as required by written contract. Coverage is Primary and Non -Contributory. REVIEWED & APPROVED By RIS ANAGEMENT DIVISION CFRTIFIr.ATF Wni ncu N i t City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th FI Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE XPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN M. LA RDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rinhte ro�or,.o.a I ne AcoHD name and logo are registered marks of ACORD O�yq \NTER/ygT'O W� tiT ADLERHORST INTERNATIONAL, LLC. a3951 Vernon Avenue * Jurupa Valley, CA 92W Tel: (961) 685-2430 • Fax: (951) 685-3630' Email: oRce@AdlenorstCom q, www.Adlerhoret.com �4�FK-9 AG�p� September 2, 2019 City of Santa Ana Risk Management Division 20 Civic Center Plaza 4th Floor Santa Ana, Ca. 92701 Reference your insurance requirements concerning Adlerhorst Int. LLC we offer the following information. While conducting training either on our facility or off site all our instructors use their own vehicles, insured by them personally. In the course of all instruction or training provided by Adlerhorst we do not use any sub contractors. If you have questions, please call. NEVIEWED & APPROVED y Risk/MANAGEMENT DIVISION Adlerhorst International LLC 52019 SAMA M. LAMBERT ivid