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HomeMy WebLinkAboutWATER WISE PRO TRAINING (2)-2018City of Santa Ana 1 Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement angg# V 23 IN S; 30 amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements CITY' OF SANTA AI! "A have been satisfied prior to signing the termination form. CL5RK OF C O IK IL Is the agreement(s) a permanent record? Yes No ) Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with W'Pely- wi,s-e PF-o i J1.1 b No. N- 201& 0`-tl was completed on (O/S0f 14 and final payment has been made. (List all amendments. Use space below if needed.) Department: P W I- Phone/Ext.: 3 3�1 Signature: ��/�z, l" ' � - Date: 10i iz 11 g Revised: 10-18-16 INSURANCE -NOT OWFILE WORK MAY NO�i PROCEED Cn�ERK Of COUNCIL N-2018-041 DATEE,,' 26 PREEMENT TO PROVIDE WATER TREATMENT TRAINING COURSE � >7vVA'C THIS AGREEMENT' is made and entered into this lath day of February, 2018 by and between WaterWisePro Training ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a contractor to provide an water treatment training course. B. Contractor represents that it is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional contracting 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 Contractor shall furnish the services that are described in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed $12,000. b, Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work that fails to meet the standards ofperformance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date stated above and continue through June 30, 2018, unless terminated earlier in accordance with Section 13, below, The exact date(s) of the course shall be scheduled to occur during the term of the Agreement by mutual agreement by the parties, 4. INDEPENDENT CONTRACTOR Contractor 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-ornployee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a mariner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. -Commercial General Liability Insurance. Contractor 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 Contractor'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, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self insurance programs maintained by the City; and (c) contain standard separation of insureds provisions, b. Business. automobile liability insurance, or equivalent form, with a combined single limit of not Tess than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. c. Workers'.. Compensation Insurance. In accordance with the California Labor Code, Contractor, if Contractor has any employees, is required to be insured, against liability for workers' compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Contractor 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 with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor shall maintain all insurance required above in fall 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. 2 (iv) Contractor shall supply City with a fully executed additional insured endorsement. f. If Contractor 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 Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor 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. INDEMNIFICATION Contractor agrees to and shall indemnify, defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability; (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligence or willful misconduct of the Contractor or its, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terns 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 Contractor 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. Contractor's indemnification obligations in this section shall survive expiration of this Agreement. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor shall maintain complete and accurate records with respect to the costs incurred rmder 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 Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor 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, Contractor 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 Contractor under this Agreement. 8. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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 Contractor disolosed in a, publicly available source; (c) is in rightful possession of the Contractor an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with the performance of services specified under this Agreement. 10. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.Q. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 With courtesy copies to: To Contractor: Executive Director Public Works Agency City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92702 WaterWisePro Training P.O. Box 772 Watsonville, CA 95078 Attn: Steve Hernandez A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax., communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 0 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor regarding the subject matter therein, grid 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 hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of 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 Contractor 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 are not embodied herein, 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor 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 Cit3A 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 seven (7) days written notice of termination, In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, City may require Contractor to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate, b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. 14. NONDISCRIMINATION Contractor 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 or in connection with any activities under this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations, 15. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, N-2018-041 California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 16. PROFESSIONAL LICENSES Contractor shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 17. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: 4 ' Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney ^� By: d John YNFunk Assistant City Attorney RECOMMENDED F AP OVAL: Y� Executive Director Public Works Agency CITY OF SANTA ANA Rau] Godinez City Manager CONTRACTOR: Name: e- Title: '44,e5'n-v r h,- Exhibit A WWP. WaterWisePro Training November 26, 2017 Attn: Kathie Reyes / Rudy Rosas City of Santa Ana, Water Resources Division 220 S. Daisy Ave., Santa Ana, Ca 92703 Re: The following scope of work and proposal is for the requested (4) CaSWRCB Exam Prep Courses (2-Distribution and 2 Treatment). The following scope of work and proposal is for the requested (4) CaSWRCB Exam Prep Courses (2- Distribution and 2 Treatment). WaterWisePro Training will provide an onsite operator training for City of Santa Ana Staff at the City facility on TBD dates. Courses provided will benefit both, employees preparing for the California SWRCB Water Distribution Exams Grades 1-5 and Water Treatment Exams Grades 1-4 as well as those that are in need of 8 approved SWRCB contact -hours for Certification renewal. Courses Includes. 1-day/8hr. Water Distribution Refresher Course for March I h 2018 Exam o (40) 60-page WWP Distribution Study Guides for CaSWRCB Grades 1-5 0 8-Contact hour certificate for SWRCB credit for all attendee o Lunch and refreshments for the day for all attendees 1-day/8hr. Water Treatment Refresher Course for Mav 14MI, 2018 Exam o (40) 60-page WWP Study Guides for CaSWRCB Grades 1-4 0 8-contact hour certificate for SWRCB credit for all attendee o Lunch and refreshments for the day for all attendees The class is exclusive to City of Santa Ana employees not to exceed 40-staff members Exhlblt A Qualified Trainer: WWP Training has taught over 900+ operators in the state of California in the past 18-months and is an Approved Continuing Education Provider in California and Nevada. Our courses are conducted by Steve Hernandez, an 18-year water professional with 9-years in management and possessing a ©5lT4 certification and currently managing on the Central Coast. He will bring his teachings to your agency with an energetic, informative and up to date course that everyone can relate to and feel comfortable engaging in. His classes have an 80.85% passing rate on all grade levels that attend the courses. Cost of Services: • The cost of services for professional water operator training is not to exceed, $8,000[eadh day o Cost is based on: ■ 40 attendees ■ $150/attendeel8hr. Course There Is No charge for travel Pricing is 50% lower than comparable competitors Ond skill provides more services Please note that the average cost for this lev4t ot. training is anywhere from $:175 - $400/person for an 8hr. course but ddes not include:, exclusive onslte tra►iing travel expenses and/or lunch. If there are any questions or concerns about.the above' scope ofi'wai k, please contact us. Thank you again forthis training opportunity and•the consideration of bur services, we look forward to building a positive relationship.with you and your staff. Sincerely, A� ®� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 04/18/2017 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 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: Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA 520 Madison Avenue PHON o EW' (888) 202-3007 FAXA/CNo: E MAIL contact@ �hISCOX.COm hiscox.com INSURERS AFFORDING COVERAGE NAICk 32nd Floor N�2o�o-04A INSURERA: Hiscox Insurance Company Inc 10200 New York, NY 10022 1 V 1 INSURED INSURER B: Steven Hernandez INSURER C: 1521 Memorial Drive INSURERD: Apt. C INSURER E: Hollister CA 95023 INSURER F: - OUVtKAUt:S CERTIFICATE NUMBER: aFvlslnm NII INnaco. 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 gDDL SUBR POLICY NUMBER POLICY EFF OLICYYYY POLICY EXP MM/DDIYYYV LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 2,000,000 DAMAGET RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 2,000,000 A UDC-1955669-CGL-17 04/18/2017 04/18/2018 GEN'L x AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ SR Gen. Agg. $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT To accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PRO PERTYDAMAGE Peraccident $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE_ _ $ DED RETENTION $ $ WORKERS COMPENSATION ANDEMPLOVERS'LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICE RIMEMSEREXCLUOE09 ❑ NIA PER OTH- _STATUTE ER E.L. EACH ACCIDENT $ EL DISEASE-EAEMPLOYEE $ IMandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) �8 fd -e eaj'=2 City of Santa Ana,its officers, employees, agents, and representative are named as additional insured. Specifically the City Water Division, who services will be given to. 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 L0,14 3 1988-2014 ACORD C reserved. AI Umu LD (LU'l4/U'1) I he ACURD name and logo are registered marks of ACORD ADDITIONAL INSURED ENDORSEMENT Insurance Company T"Sw Mm fir..,, r MAC This endorsement modifies such insurance as is afforded by the provisions of Policy # VDir0551100-'Wi;rrela ing to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 'Ryeua(V this endorsement form as part of Policy#UDG IgSSbbw- /CAL —I$ Issued to S+w-e. Name Insured Countersigned by ,/Uif 9r V 4jvc z-vf 3 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury, the (Namerritle) following declaration: I certify on behalf of W N 41 (hl1 17ro 1� u www that during the term of my (Consaltant/Company Name) contract for Al f wwi-(— ° N.h, services with the City of Santa Ana, I will not employ any person in any manner so as to become subject to the workers' - compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof of workers' compensation coverage. DATE: 21?01 u 1 lb By: Wa+( WCS ?Yo TrNt)ttYv'. Name: Title:Y1S�✓yl.i d✓ Telephone: 31. � 71 -g1)13 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES- 3%4P/i�� ACORO CERTIFICATE OF LIABILITY INSURANCE `� DATE(MM/DDNYYY) 04/18/2018 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 Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA 520 Madison Avenue 32nd Floor CONTACT NAME: PHONE N Ea,($$$) 202-SOOT ac No E'MAIL ADDRESS, contact(dJhiscox.com INSURFRISI AFFORDING COVERAGE NAICi1 New York, NY 10022 INSURERA: Hiscox Insurance Company Inc 10200 INSURED Steven Hernandez dba Water Wise Pro 1621 Memorial Drive INSURER B INSURER C: Apt. C INSURER D : R INSUREE Hollister, CA 95023 NSURER F: L;UVI=KAUt:b CERTIFICATE NUMBER: RFVISInM 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. MISS LTR TYPE OFINSURANCE AODL SUBR POLICY NUMBER POLICY EFF MM/DD/1'YYY POLICYEXP MMIDD/YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I —XI OCCUR EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED-- PREMISES Ea umumencel $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL S ADV INJURY $ 2,000,000 A Y Y UDC-1955669-CGL-18 04/18/2018 04/18/2019 AGGREGATE LIMIT APPLIES PER: POLICY EPRI Ea FILOC GENERAL AGGREGATE $ 2.000,000 GEN'L X PRODUCTS - COMP/OP AGG sSIT Gen. Agg $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Peraoddent) $ HIRED AUTOS AUTOSWNED PROPERTY DAMAGE Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNEWEXECUTIVE OFFICER/MEMBEREXCLUDEDI ❑ NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) City of Santa Ana, its officers, employees, agents and representatives are named as additional insured. Specifically the city water division whose services will be given to. `i�lg118 � PePfG %aft City of Santa Ana its officer ves 220 S Daisy Ave Santa Ana, CA 92703 employees, agents and representati 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 � N R 4. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD All rights reserved_ N-20fv- oyl ,E11013` California Evidence of Liability Insurance 1-800-841-3000 gelleC.cmirril GEICO INDEMNITY COMPANY PO BOX 509090 SAN DIEGO, CA 92150-9090 NAIC Code: 22055 Policy Number Effective Date 4188065843 03-21-18 Year Make Model 2004 CHEV SILVER19 Insured: ROSANA LOMELI STEVENJASON HERNANDEZ 1521 MEMORIAL DR APT C HOLLISTER, CA 95023-5778 Expiration Date 08-20-18 Vehicle ID No. 2GCEK13T341346582 Evidence of Insurance Here are your Evidence of Liability Insurance Cards. One card must be carried in the proper insured vehicle. Proof of insurance is required to register or renew the registration of your vehicle. A law enforcement officer can ask you to prove that you have liability insurance meeting the basic requirements of California law. A violation of these requirements can result in a fine of up to: $1,000 for the first time $2,000 for additional times Also, a judge can have your vehicle Impounded. False proof of insurance may result in a fine up to $750 and 30 days in prison. Th. a.y.wepmNdedbyMisp Ncymeals ,haminimum reeunamentsofsectlons16056&165oo.5ofIns cajd.mle Due to space limitations on the ID card, only the Vehicle code, minimum llabnny l lmns prei by law. Named Insured and the Co-insured are listed. Fora full list of drivers covered under this policy, please reference the Drivers section of your Declarations Page, which is included with your insurance packet. It you would like additional ID cards you can go online to geico.com or call us at 1-800-841-3000. What to do at the time of an accident. • Do not admit fault. • Do not reveal the limits of your liability coverage to anyone. Exchange contact information; get year, make, model, plate number, insurance carrier and policy number of all involved. Also, identify witnesses and collect contact information. • Contact the police or 911 if applicable. • Contact GE ICO by calling 1-800.841-3000 or visit gelco.com to report the accident. 11-4-CA (11-09)