HomeMy WebLinkAboutCC Resolution 11715 (Village Loch Lomond Project)RESOLUTION NO. 11715
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL
AUTHORIZING THE CITY MANAGER TO EXECUTE AN AGREEMENT FOR
PROFESSIONAL PLANNING SERVICES WITH PAUL JENSEN FOR SERVICES AS
PROJECT PLANNER FOR "THE VILLAGE AT LOCH LOMOND MARINA"
PROJECT
(Agreement Term: March 22, 2005 through March 21, 2007, amount not to exceed $40,375)
WHEREAS, the City of San Rafael has determined that professional services are needed
to provide project management services in the capacity of project planner for "The Village at
Loch Lomond Marina" project; and
WHEREAS, at the City's request, Paul Jensen (Consultant) has submitted a proposal to
provide assistance to the City for the work described above, including a list of anticipated
activities/tasks and an estimated budget, and said proposal is attached to the Agreement for
Professional Services; and
WHEREAS, the costs associated with the Consultant's services as Project Planner will be
recouped from application and permit processing fees collected from the project developer during
the course of the development review process for the project.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of San Rafael
does hereby authorize the City Manager to execute, on behalf of the City of San Rafael, an
Agreement for Professional Planning Services with Paul Jensen, in the form attached as
"Attachment 1".
I, JEANNE M. LEONCINI, Clerk of the City of San Rafael, hereby certify that the foregoing
Resolution was duly and regularly introduced and adopted at a regular meeting of the City
Council of said City held on Monday, the 21 st day of March, 2005 by the following vote, to wit:
AYES: COUNCILMEMBERS: Cohen, Heller, Miller, Phillips & Mayor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
JE AAM. LEONCIl�]I, City Clerk
AGREEMENT FOR
PROFESSIONAL PLANNING SERVICES
This Agreement is made and entered into this 21st day of March 2005, by and between the
CITY OF SAN RAFAEL (hereinafter "CITY'), and PAUL A. JENSEN, AICP (hereinafter
"CONTRACTOR").
RECITALS
WHEREAS, given the current workload of staff and the pace of land planning and
development activity, the CITY has determined that professional services are needed to supplement
existing staffing through re -assignment oversight responsibilities for "The Village at Loch Lomond
Marina" project to an experienced consultant familiar with San Rafael's development processes.
AGREEMENT
NOW, THEREFORE, the parties hereby agree as follows:
1. PROJECT COORDINATION.
A. CITY. The City Manager shall be the representative of the CITY for all purposes
under this Agreement. The Principal Planner (Current Planning) is hereby designated the PROJECT
MANAGER for the CITY, and said PROJECT MANAGER shall supervise all aspects of the
progress and execution of this Agreement.
B. CONTRACTOR. CONTRACTOR shall assign a single PROJECT DIRECTOR
to have overall responsibility for the progress and execution of this Agreement for
CONTRACTOR. Paul A. Jensen is hereby designated as the PROJECT DIRECTOR for
CONTRACTOR. Should circumstances or conditions subsequent to the execution of this
Agreement require a substitute PROJECT DIRECTOR for any reason, the CONTRACTOR shall
notify the CITY within ten (10) business days of the substitution.
2. DUTIES OF CONTRACTOR.
CONTRACTOR shall perform the duties and/or provide professional services as Contract
Planner. These services shall be performed under the supervision of the Principal Planner, in
conjunction with the CITY's processing of development entitlements for "The Village at Loch
Lomond Marina" project. Duties shall include the tasks described in the attached Exhibit "A",
incorporated herein.
03/04/05
3. DUTIES OF CITY.
CITY shall pay the compensation as provided in Paragraph 4, and perform the duties as
follows: the CITY shall provide suitable workspace, if necessary, which is accessible to telephone
and computer facilities. CITY shall provide CONTRACTOR with copies/sets of local plans,
ordinances and reports that are pertinent to the project that has been assigned to the
CONTRACTOR.
4. COMPENSATION.
For the full performance of the services described herein by CONTRACTOR, CITY shall
pay CONTRACTOR an hourly rate of $95.00 per hour. The billing amounts authorized under this
agreement shall not exceed $40,375.00.
Payment will be made monthly upon receipt by PROJECT MANAGER of itemized
invoices submitted by CONTRACTOR.
5. TERM OF AGREEMENT.
The term of this Agreement shall be for 24 months commencing on March 22, 2005, and
ending on March 21, 2007. Upon mutual agreement of the parties, and subject to the approval of
the City Manager and the PROJECT MANAGER the term of this Agreement may be extended for
an additional period of 12 months.
6. TERMINATION.
A. Discretionary. Either party may terminate this Agreement without cause upon
thirty (30) days written notice mailed or personally delivered to the other party.
B. Cause. Either party may terminate this Agreement for cause upon fifteen (15) days
written notice mailed or personally delivered to the other party, and the notified party's failure to
cure or correct the cause of the termination, to the reasonable satisfaction of the party giving such
notice, within such fifteen (15) day time period.
C. Effect of Termination. Upon receipt of notice of termination, neither party shall
incur additional obligations under any provision of this Agreement without the prior written consent
of the other.
D. Return of Documents. Upon termination, any and all CITY documents or
materials provided to CONTRACTOR and any and all of CONTRACTOR's documents and
materials prepared for or relating to the performance of its duties under this Agreement, shall be
delivered to CITY as soon as possible, but not later than thirty (30) days after termination.
03/04/05 2
7. OWNERSHIP OF DOCUMENTS.
The written documents and materials prepared by the CONTRACTOR in connection with
the performance of its duties under this Agreement, shall be the sole property of CITY. CITY may
use said property for any purpose, including projects not contemplated by this Agreement.
8. INSPECTION AND AUDIT.
Upon reasonable notice, CONTRACTOR shall make available to CITY, or its agent, for
inspection and audit, all documents and materials maintained by CONTRACTOR in connection
with its performance of its duties under this Agreement. CONTRACTOR shall fully cooperate
with CITY or its agent in any such audit or inspection.
9. ASSIGNABILITY.
The parties agree that they shall not assign or transfer any interest in this Agreement nor the
performance of any of their respective obligations hereunder, without the prior written consent of
the other party, and any attempt to so assign this Agreement or any rights, duties or obligations
arising hereunder shall be void and of no effect.
I[1�12M917V[a)
A. During the term of this Agreement, CONTRACTOR shall maintain, at no expense
to CITY, the following insurance policies:
1. A comprehensive general liability insurance policy in the minimum amount
of one million dollars ($1,000,000) per occurrence for death, bodily injury, personal injury, or
property damage.
2. An automobile liability (owned, non -owned, and hired vehicles) insurance
policy in the minimum amount of one million dollars ($1,000,000) per occurrence.
B. The insurance coverage required of the CONTRACTOR by section 10. A., shall
also meet the following requirements:
1. The insurance shall be primary with respect to any insurance or coverage
maintained by CITY and shall not call upon CITY's insurance or coverage for any contribution.
2. Except for professional liability insurance, the insurance policies shall be
endorsed for contractual liability and personal injury.
3. Except for professional liability insurance, the insurance policies shall be
specifically endorsed to include the CITY, its officers, agents, employees, and volunteers, as
additionally named insureds under the policies.
03/04/05
4. CONTRACTOR shall provide to City's Risk Manager, (a) Certificates of
Insurance evidencing the insurance coverage required herein, and (b) specific endorsements naming
CITY, its officers, agents, employees, and volunteers, as additional named insured under the
policies.
5. The insurance policies shall provide that the insurance carrier shall not
cancel, terminate or otherwise modify the terms and conditions of said insurance policies except
upon thirty (30) days written notice to City's Risk Manager.
6. If the insurance is written on a Claims Made Form, then, following
termination of this Agreement, said insurance coverage shall survive for a period of not less than
five years.
7. The insurance policies shall provide for a retroactive date of placement
coinciding with the effective date of this Agreement.
8. The insurance shall be approved as to form and sufficiency by PROJECT
MANAGER and the City Attorney.
C. If it employs any person, CONTRACTOR shall maintain worker's compensation
and employer's liability insurance, as required by the State Labor Code and other applicable laws
and regulations, and as necessary to protect both CONTRACTOR and CITY against all liability
for injuries to CONTRACTOR's officers and employees.
D. Any deductibles or self-insured retentions in CONTRACTOR's insurance policies
must be declared to and approved by the City's Risk Manager and the City Attorney. At CITY's
option, the deductibles or self-insured retentions with respect to CITY shall be reduced or
eliminated to CITY's satisfaction, or CONTRACTOR shall procure a bond guaranteeing payment
of losses and related investigations, claims administration, attorney's fees and defense expenses.
11. INDEMNIFICATION.
CONTRACTOR shall indemnify, release, defend and hold harmless CITY, its officers,
agents, employees, and volunteers, against any claim, demand, suit, judgment, loss, liability or
expense of any kind, including attorney's fees and administrative costs, arising out of or resulting in
any way, in whole or in part, from any acts or omissions, intentional or negligent, of
CONTRACTOR or CONTRACTOR's officers, agents and employees in the performance of their
duties and obligations under this Agreement.
12. NONDISCRIMINATION.
CONTRACTOR shall not discriminate, in any way, against any person on the basis of age,
sex, race, color, religion, ancestry, national origin or disability in connection with or related to the
performance of its duties and obligations under this Agreement.
03/04/05 4
13. COMPLIANCE WITH ALL LAWS.
CONTRACTOR shall observe and comply with all applicable federal, state and local laws,
ordinances, codes and regulations, in the performance of its duties and obligations under this
Agreement. CONTRACTOR shall perform all services under this Agreement in accordance with
these laws, ordinances, codes and regulations. CONTRACTOR shall release, defend, indemnify
and hold harmless CITY, its officers, agents and employees from any and all damages, liabilities,
penalties, fines and all other consequences from any noncompliance or violation of any laws,
ordinances, codes or regulations.
14. NO THIRD PARTY BENEFICIARIES.
CITY and CONTRACTOR do not intend, by any provision of this Agreement, to create in
any third party, any benefit or right owed by one party, under the terms and conditions of this
Agreement, to the other party.
15. NOTICES.
All notices and other communications required or permitted to be given under this
Agreement, including any notice of change of address, shall be in writing and given by personal
delivery, or deposited with the United States Postal Service, postage prepaid, addressed to the
parties intended to be notified. Notice shall be deemed given as of the date of personal delivery, or
if mailed, upon the date of deposit with the United States Postal Service. Notice shall be given as
follows:
TO CITY: Bill Meeker
Principal Planner
City of San Rafael
1400 Fifth Avenue (P.O. Box 151560)
San Rafael, CA 94915-1560
City Risk Manager
City of San Rafael
1400 Fifth Avenue (P.O. Box 151560)
San Rafael, CA 94915-1560
TO CONTRACTOR: Paul A. Jensen, AICP
77 Mark Drive, Suite 32
San Rafael, CA 94903
03/04/05 5
16. INDEPENDENT CONTRACTOR.
For the purposes, and for the duration, of this Agreement, CONTRACTOR, its officers,
agents and employees shall act in the capacity of an Independent Contractor, and not as employees
of the CITY. CONTRACTOR and CITY expressly intend and agree that the status of
CONTRACTOR, its officers, agents and employees be that of an Independent Contractor and not
that of an employee of CITY.
17. ENTIRE AGREEMENT -- AMENDMENTS.
A. The terms and conditions of this Agreement, all exhibits attached, and all documents
expressly incorporated by reference, represent the entire Agreement of the parties with respect to the
subject matter of this Agreement.
B. This written Agreement shall supersede any and all prior agreements, oral or written,
regarding the subject matter between the CONTRACTOR and the CITY.
C. No other agreement, promise or statement, written or oral, relating to the subject
matter of this Agreement, shall be valid or binding, except by way of a written amendment to this
Agreement.
D. The terms and conditions of this Agreement shall not be altered or modified except
by a written amendment to this Agreement signed by the CONTRACTOR and the CITY.
E. If any conflicts arise between the terms and conditions of this Agreement, and the
terms and conditions of the attached exhibits or the documents expressly incorporated by reference,
the terms and conditions of this Agreement shall control.
18. SET-OFF AGAINST DEBTS.
CONTRACTOR agrees that CITY may deduct from any payment due to
CONTRACTOR under this Agreement, any monies which CONTRACTOR owes CITY under
any ordinance, agreement, contract or resolution for any unpaid taxes, fees, licenses, assessments,
unpaid checks or other amounts.
19. WAIVERS.
The waiver by either party of any breach or violation of any tern, covenant or condition of
this Agreement, or of any ordinance, law or regulation, shall not be deemed to be a waiver of any
other term, covenant, condition, ordinance, law or regulation, or of any subsequent breach or
violation of the same or other term, covenant, condition, ordinance, law or regulation. The
subsequent acceptance by either party of any fee, performance, or other consideration which may
become due or owing under this Agreement, shall not be deemed to be a waiver of any preceding
breach or violation by the other party of any term, condition, covenant of this Agreement or any
applicable law, ordinance or regulation.
03/04/05 6
20. COSTS AND ATTORNEY'S FEES.
The prevailing party in any action brought to enforce the terms and conditions of this
Agreement, or arising out of the performance of this Agreement, may recover its reasonable costs
(including claims administration) and attorney's fees expended in connection with such action.
21. CITY BUSINESS LICENSE / OTHER TAXES.
CONTRACTOR shall obtain and maintain during the duration of this Agreement, a CITY
business license as required by the San Rafael Municipal Code. CONTRACTOR shall pay any
and all state and federal taxes and any other applicable taxes. CONTRACTOR's taxpayer
identification number is 560-06-6782, and CONTRACTOR certifies under penalty of perjury that
said taxpayer identification number is correct.
22. APPLICABLE LAW.
The laws of the State of California shall govern this Agreement.
IN WITNESS WHEREOF, the parties have executed this Agreement as of the day, month
and year first above written.
CITY OF SAN RAFAEL
ROD GOULD, City Manager
ATTEST:
JJMIZ, .
M. LEONCINI, City Clerk
APPRa EDJ A T 'O ORM:
GARY T" 9GHIANTI, C ty Attorney
Attachment:
CONTRACTOR
Name: Paul A. Je�en
Title: Sole Proprietor
■ Proposal for Planning Services — February 21, 2005 - Paul A. Jensen
03"04/05
7
RG_t J B
Zt FEB 2 4 2005
PAUL A. JENSEN, AICP CITY OF fN INGFAEL
Policy/Environmental Planning and Processing
77 Mark Drive, Suite 32 San Rafael, California 94903
(415) 479-9438 FAX (415) 472-3187
February 21, 2005
Bill Meeker, Principal Planner
Community Development Department
City of San Rafael
1400 Fifth Avenue
P.O. Box 151560
San Rafael, CA 94915-1560
Subject: Loch Lomond Marina Development, San Rafael; proposal for
planning services
Dear Mr. Meeker:
Thank you for contacting me to discuss planning services for the Loch Lomond Marina
development, proposed by Thompson/Dorfman Partners, LLC. The City of San Rafael is
currently processing planning applications for the redevelopment of the 128 -acre site,
which is located south of Point San Pedro Road in the Loch Lomond neighborhood.
Per your request, I have prepared a proposal and scope of work for planning services on
this redevelopment project. The first section of this letter outlines my understanding of
the project and the City's consultant service needs. The section outlines consultant
tasks and activities for completing planning services. These tasks and activities are
broken down by phase, with an estimated budget for completing each phase. The
estimated budget is based on an hourly billing rate of $95.00 per hour. A reduced hourly
rate for services is proposed given my longstanding relationship with the City of San
Rafael.
A. Understanding of Project and Needed Services
My understanding of the proposed project and service needs is as follows:
The City of San Rafael has received planning applications proposing the
redevelopment of the Loch Lomond Marina property. The project proposes a
mixed-use development, which includes residential, neighborhood commercial,
office, marina and passive recreation uses. To date, an Initial Study has been
completed and a Notice of Preparation has been published. Preparation of an
Environmental Impact Report (EIR) is underway.
2. The planning applications that have been filed include a General Plan
Amendment, Rezoning, Environmental and Design Review Permit and a
Tentative Map. These applications will require review and recommendations
from the Design Review Board and the Planning Commission with final action
Bill Meeker, Principal , Ener
February 21, 2005
Page 2
required by the City Council. I understand that the applications have been
deemed complete for processing.
3. The environmental review process for this project has commenced with the
preparation of an Initial Study. A Notice of Preparation (NOP) was published in
late 2004, which recommends that an EIR be prepared. However, recent
revisions to the project will necessitate revisions to and a re -publication of the
NOP. RBF Consulting has been hired to prepare the EIR.
4. The purpose to the planning services is to oversee the processing of and
overseeing the environmental and merits review required for this project.
Essentially, I would serve as the project planner and manager under the direction
of the City Planning Division. I would be expected to be involved in all phases of
the land use and planning entitlement process.
5. The City of San Rafael would serve as the client. However, all contract planning
services would be funded by the project sponsor. It is understood that I would
not be responsible for funding or preparing any special studies or reports that are
required for CEQA clearance and project processing.
B. Scope of Services — List of Perceived Tasks
Based on my understanding of the Loch Lomond Marina project, the current status of the
planning applications and the necessary steps for action on the planning applications,
the following tasks will likely be the responsibility of the project planner:
Phase I - Application Review and Project Research
a. Complete a review of all project application plans, files, materials,
background reports/studies and correspondence to become familiar with the
project and community issues.
b. Complete a review of the San Rafael General Plan 2020 and accompanying
FEIR to understand the City goals and policies that are pertinent to the
project site and neighborhood.
C. Coordinate distribution of project plans and materials to various City
departments for review and comment, if necessary.
d. Coordinate and attend meetings with City staff, project sponsor and others,
as directed by supervisor.
e. Prepare written summary addressing project compliance/non-compliance with
the San Rafael General Plan 2020.
Estimated Budget for Phase l: 60 hours @ $95.00 per hour. $5,700.00
2. Phase 11 — Environmental Review Process
Bill Meeker, Principal I ner
February 21, 2005
Page 3
a. Assist in preparing and publishing the revised NOP.
b. Oversee management of and coordinate with the environmental consultant in
the preparation of an Administrative Draft EIR (ADEIR).
C. Coordinate distribution and in-house review of ADEIR. Organized and
consolidate comments on the ADEIR provided by City staff and project
sponsor.
d. Review screen check DEIR completed by environmental consultant prior to
document publication.
e. Prepare Notice of Completion (NOC), public notice and mailing list.
f. Coordinate distribution of NOC and DEIR for 45 -day public review period with
City staff.
g. Prepare Planning Commission staff report and attend public hearing on
DEIR.
h. Organized comments received on DEIR and meet with environmental
consultant to address issues.
i. Assist environmental consultant in preparing responses to comments on the
DEIR and MMRP
j. Coordinate distribution and in-house review of Administrative Draft Final
EIR/Response to Comments (AFEIR) and MMRP. Organized and
consolidate comments on the AFEIR provided by City staff and project
sponsor.
k. Review screen check FEIR and MMRP completed by environmental
consultant prior to document publication.
I. Prepare notice of FEIR availability.
M. Prepare draft and final resolutions for EIR certification to include findings
consistent with the CEQA Guidelines.
Estimated Budget for Phase U: 150 hours @ $95.00 per hour. $14,250.00
3. Phase III — Project Merits Review
a. Review and formulate recommendations on project applications under
direction of the Planning Division.
b. Coordinate and review comments and conditions from City departments,
services, utilities and pertinent agencies.
C. Prepare and coordinate distribution of public meeting and hearing notices for
Design Review Board, Planning Commission and City Council review.
d. Prepare and submit staff report(s) for project review by the Design Review
Board (for two meetings).
e. Prepare draft findings and conditions of project approval for review by City
staff, City Attorney and project sponsor. Meet with project sponsor to discuss
conditions of approval.
Bill Meeker, Principal' Iner
February 21, 2005
Page 4
f. Prepare and submit Planning Commission staff report for review by the
Planning Division and City Attorney.
g. Prepare and submit City Council staff report for review by the Planning
Division and City Attorney.
Estimated Budget for Phase lll: 150 hours @ $95.00 per hour. $14,250.00
4. Phase IV — Attendance at Public Hearings and Meetings
a. Prepare for and attend two public meetings with the San Rafael Design
Review Board, two public hearings with the Planning Commission and two
public hearings with the City Council.
b. Attendance at up to three community meetings, when deemed necessary.
Estimated Budget for Phase IV: 50 hours @ $95.00 per hour: $4,750.00
5. Phase V — Post Action Processing
a. Prepare Notice of Determination (NOD). Coordinate filing of NOD with Marin
County Clerk.
b. Coordinate distribution of final resolutions listing conditions of project
approval to City staff and project sponsor.
C. Close-out/process City project files as complete.
Estimated Budget for Phase V. 15 hours @ $95.00 per hour. $1,425.00
Total Estimated Budget for Services: 425 hours @ $95.00 per hour. $40,375.00
Thank you for the opportunity to provide you with a proposal for planning services. If
you have any questions, please feel free to contact me at 415.479.9438 or e-mail at
iensenaicp(cDaol.com.
Sincerely, /
Paul A. Jensen, AICP
Enclosure
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ACORD. CERTIFICA . A_` OF LIABILITY INSURA..i,EDATE
01-12-2005
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH OF NO CALIFORNIA INS—PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
110308 P:(888)474-5987 F:(877)905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. 0. BOX 33015
SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE
INSURED INSURER A. Hartford Casualty Ins Co
(INSURER B:
PAUL A. JENSEN, AICP
I INSURER C:
ANY AUTO
77 MARK DRIVE, SUITE 32
INSURER D:
AUTO ONLY: AGG S
SAN RAFAEL CA 94903
I INSURER E:
I OCCUR u CLAIMS MADE
COVERAGES
I Is
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY
PAID CLAIMS.
WORKERS COMPENSATION AND
INSR TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE
DATE IMMIDD/YY)
POLICY EXPIRATION
DATE (MM/DD/YYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE I $1,000,000
A COMMERCIAL GENERAL LIABILITY 57 SBA ELS 9 0 8
03/24/05
03/24/06
FIRE DAMAGE IAny one fire) 1 000,000
I CLAIMS MADE u OCCUR
MED EXP (Any one person) I $10, 000
X Business Liab
PERSONAL &ADV INJURY I $l, 000, 000
GENERAL AGGREGATE s2, 000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
I PRODUCTS - COMP/OP AGG s2,000,000
POLICY I I PRO-
JECT I X I LOC
I I
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT 000, OOO
A ANY AUTO 57 SBA EL5908
03/24/05
03/24/06
(Ea accident) $Z ,
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
X HIRED AUTOS
BODILY INJURY
$
X NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
IPer accident)
GARAGE LIABILITY
I AUTO ONLY - EA ACCIDENT I S
ANY AUTO
OTHER THAN EA ACC S
AUTO ONLY: AGG S
EXCESS LIABILITY
I EACH OCCURRENCE I $
I OCCUR u CLAIMS MADE
I AGGREGATE I $
I Is
DEDUCTIBLE
I I $
RETENTION $
$
WC STATU-
WORKERS COMPENSATION AND
I TORY LIMITS I IOER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Those usual to the Insured's Operations.
CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: A
City of San Rafael
Community Development Dept.
Attn: Kristie Richardson
P.O. Box 151560
San Rafael, CA 94915-1560
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE
HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENT E
ACORD 25-S (7/97) ?1 ACORD CORPORATION 1988