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HomeMy WebLinkAboutCM No Smoking Signage DesignAGREEMENT FOR PROFESSIONAL SERVICES
FOR NO SMOKING SIGANGE DESIGN AND PRODUCTION SERVICES
This Agreement is made and entered into as of the 25th day of April, 2016, by and between
the CITY OF SAN RAFAEL (hereinafter "CITY"), and Afstudio Design, a Sole Proprietorship
(hereinafter "CONTRACTOR").
RECITALS
WHEREAS, on March 7, 2016 the City Council directed staff to increase pedestrian -
friendly signage in Downtown San Rafael to inform the public about smoking laws; and
WHEREAS, on April 18, 2016 the City Council approved amendments altering smoking
laws in the Downtown such that new signage and storefront decals is required; and
WHEREAS, CONTRACTOR has the skills and experience necessary to provide such
services.
AGREEMENT
NOW, THEREFORE, the parties hereby agree as follows:
1. PROJECT COORDINATION.
A. CITY'S Project Manager. The Senior Management Analyst 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'S Project Director. CONTRACTOR shall assign a single
PROJECT DIRECTOR to have overall responsibility for the progress and execution of this
Agreement for CONTRACTOR. Andrew Faulkner 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 services as described in
CONTRACTOR's Proposal dated April 18, 2016, attached hereto as Exhibit "A" and incorporated
herein.
3. DUTIES OF CITY.
CITY shall pay the compensation as provided in Paragraph 4, and perform the duties as
described in Exhibit "A."
Rev. Date: 7130/15
u - 3 ,- l.P 0 E
4. COMPENSATION.
For the full performance of the services described herein by CONTRACTOR, CITY shall
pay CONTRACTOR as described in Exhibit "A."
Payment will be made upon receipt by PROJECT MANAGER of itemized invoices
submitted by CONTRACTOR. One-third of total costs will be billed as an initial retainer and due
within 14 days of commencing work. The balance due will be billed upon completion of each phase
of the project. Total fee billings, including any reimbursable expenses, will be within the price range
as indicated in Exhibit "A," and shall not exceed $5,000.
5. TERM OF AGREEMENT.
The term of this Agreement shall commence on April 25, 2016 and shall terminate on
October 30, 2016. Upon mutual agreement of the parties, and subject to the approval of the City
Manager the term of this Agreement may be extended for an additional period of up to (6) 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.
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
Rev. date: 7 30 15 2
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.
10. INSURANCE.
A. Scope of Coverage. During the terns of this Agreement, CONTRACTOR shall
maintain, at no expense to CITY, the following insurance policies:
1. A commercial general liability insurance policy in the minimum amount of
one million dollars ($1,000,000) per occurrence/two million dollars ($2,000,000) aggregate, 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) dollars per occurrence.
3. 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. CONTRACTOR'S
worker's compensation insurance shall be specifically endorsed to waive any right of subrogation
against CITY.
B. Other Insurance Requirements. The insurance coverage required of the
CONTRACTOR in subparagraph A of this section above shall also meet the following
requirements:
1. 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.
2. The additional insured coverage under CONTRACTOR'S insurance
policies shall be primary with respect to any insurance or coverage maintained by CITY and shall
not call upon CITY's insurance or self-insurance coverage for any contribution. The "primary and
noncontributory" coverage in CONTRACTOR'S policies shall be at least as broad as ISO form
CG20 0104 13.
3. Except for professional liability insurance, the insurance policies shall
include, in their text or by endorsement, coverage for contractual liability and personal injury.
Rev. date: 7/30/15 3
4. The insurance policies shall be specifically endorsed to provide that the
insurance carrier shall not cancel, terminate or otherwise modify the terms and conditions of said
insurance policies except upon ten (10) days written notice to the PROJECT MANAGER.
5. 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.
6. The insurance policies shall provide for a retroactive date of placement
coinciding with the effective date of this Agreement.
7. The limits of insurance required in this Agreement may be satisfied by a
combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall
contain or be endorsed to contain a provision that such coverage shall also apply on a primary and
noncontributory basis for the benefit of CITY (if agreed to in a written contract or agreement)
before CITY'S own insurance or self-insurance shall be called upon to protect it as a named
insured.
8. It shall be a requirement under this Agreement that any available insurance
proceeds broader than or in excess of the specified minimum insurance coverage requirements
and/or limits shall be available to CITY or any other additional insured party. Furthermore, the
requirements for coverage and limits shall be: (1) the minimum coverage and limits specified in this
Agreement; or (2) the broader coverage and maximum limits of coverage of any insurance policy or
proceeds available to the named insured; whichever is greater.
C. Deductibles and SIR's. Any deductibles or self-insured retentions in
CONTRACTOR's insurance policies must be declared to and approved by the PROJECT
MANAGER and City Attorney, and shall not reduce the limits of liability. Policies containing any
self-insured retention (SIR) provision shall provide or be endorsed to provide that the SIR may be
satisfied by either the named insured or CITY or other additional insured party. 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.
D. Proof of Insurance. CONTRACTOR shall provide to the PROJECT
MANAGER or CITY'S City Attorney all of the following: (1) Certificates of Insurance
evidencing the insurance coverage required in this Agreement; (2) a copy of the policy
declaration page and/or endorsement page listing all policy endorsements for the commercial
general liability policy, and (3) excerpts of policy language or specific endorsements
evidencing the other insurance requirements set forth in this Agreement. CITY reserves the
right to obtain a full certified copy of any insurance policy and endorsements from
CONTRACTOR. Failure to exercise this right shall not constitute a waiver of the right to
exercise it later. The insurance shall be approved as to form and sufficiency by PROJECT
MANAGER and the City Attorney.
11. INDEMNIFICATION.
Rev. date: 7/30115
A. Except as otherwise provided in Paragraph B., regarding bodily injury or property
damage only. CONTRACTOR shall, to the fullest extent permitted by law, indemnify, release,
defend with counsel approved by CITY, and hold harmless CITY, its officers, agents,
employees and volunteers (collectively, the "City Indemnitees"), from and against any claim,
demand, suit, judgment, loss, liability or expense of any kind, including but not limited to
attorney's fees, expert fees and all other costs and fees of litigation, (collectively "CLAIMS"),
arising out of CONTRACTOR'S performance of its obligations or conduct of its operations
under this Agreement. The CONTRACTOR's obligations apply regardless of whether or not a
liability is caused or contributed to by the active or passive negligence of the City Indemnitees.
However, to the extent that liability is caused by the active negligence or willful misconduct of
the City Indemnitees, the CONTRACTOR's indemnification obligation shall be reduced in
proportion to the City Indemnitees' share of liability for the active negligence or willful
misconduct. In addition, the acceptance or approval of the CONTRACTOR's work or work
product by the CITY or any of its directors, officers or employees shall not relieve or reduce the
CONTRACTOR's indemnification obligations. In the event the City Indemnitees are made a
party to any action, lawsuit, or other adversarial proceeding arising from CONTRACTOR'S
performance of or operations under this Agreement, CONTRACTOR shall provide a defense to
the City Indemnitees or at CITY'S option reimburse the City Indemnitees their costs of
defense, including reasonable attorneys' fees, incurred in defense of such claims.
B. Where the services to be provided by CONTRACTOR under this Agreement are
design professional services to be performed by a design professional as that term is defined
under Civil Code Section 2782.8, CONTRACTOR shall, to the fullest extent permitted by law,
indemnify, release, defend and hold harmless the City Indemnitees from and against any
CLAIMS that arise out of, pertain to, or relate to the negligence, recklessness, or willful
misconduct of CONTRACTOR in the performance of its duties and obligations under this
Agreement or its failure to comply with any of its obligations contained in this Agreement,
except such CLAIM which is caused by the sole negligence or willful misconduct of CITY.
C. The defense and indemnification obligations of this Agreement are undertaken in
addition to, and shall not in any way be limited by, the insurance obligations contained in this
Agreement, and shall survive the termination or completion of this Agreement for the full period
of time allowed by law.
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.
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
Rev. date: 7130115 5
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's Project Manager:
TO CONTRACTOR's Project Director:
16. INDEPENDENT CONTRACTOR.
Rebecca Woodbury
City of San Rafael
1400 Fifth Avenue
P.O. Box 151560
San Rafael, CA 94915-1560
Andrew Faulkner
Afstudio Design
1010 B Street, Suite 215
San Rafael, CA 94901
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.
Rev. date: 7130115
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 term, 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.
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. CITY shall not be required to pay for
any work performed under this Agreement, until CONTRACTOR has provided CITY with a
completed Internal Revenue Service Form W-9 (Request for Taxpayer Identification Number and
Certification).
Rev. date: 7.30 15
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
JIM, H TZ, i a er
ATTEST:
ESTHER C. BEIRNE, City Clerk
APPROVED AS TO FORM:
QAI �Fc
ROBERT F. EPSTEIN, ity Attir€y�
Rev. date: 7/30/15 8
CONTRACTOR
By:
J
Name: Andrew Faulkner
Title: Owner, Afstudio Design
EXHIBIT A
PROPOSAL
Project City of San Rafael No Smoking Signage/Stickers
Presented to. Rebecca Woodbury
Date. 4/18/16
AFSTU DIO
DES GN
1010 B STREET
SUITE 215
SAN RAI AES_ CA
94901
T- 415 459 4300
F 415 223 4919
AFSTUDfO COM
EXHIBIT A
FSTUDIO
ES GN
// PROJECT O\/ t PVI EW
t. Discovery: The Discovery Phase uncovers all the necessary information to develop concepts
to discourage smoking in downtown San Rafael. AFstudio will discuss format options for stickers
and signage with client and determ ne best applications for messaging. At the time of this
proposal the quantity and s zes of both st ckers and signs was still to be determined.
2. Concept: Once all of the goals are set, Afstud o will pursue creat ve options using type and
illustration. Color may be used on a limited basis and some simple illustration may be explored.
3. Presentation: ..ese t desig- opt o, s to client and rune �s eec ed.
4. Production: o, so ut on is agreed up•: n, Afst_d o will create fin:r artwork to provide to
e r a t.
9]
EXHIBIT
AFSTUDIO
DESIGN
// ESTIMATED COSTS
Afstudio will Provide the following deliverables to create concepts for the City of San Rafael for
print and signage applications. Our process and estimated fees are summarized below. This is
calculated as flat `project phase Fees" which includes work on all aspects of the project.
Project Management & Presentation $400
This is a crucial part of the budget because it insures an efficient workflow and economical
use of everyone's time. This includes all meeting time for the entire project and creating and
overseeing a schedule to follow that includes presentation (on boards as well as online), and
review cycles. This phase is also concerned with gathering and establishing design criteria for the
project. It includes all research done on client's brand landscape.
Discovery Concept Development and Exploration $600
When the designer and client have reached an agreement concerning the basic goals, visual
solutions are pursued to reflect agreed upon objectives. At least 3 -4 solutions w,ll be developed
For use in Doth st cker and sign format. This First meeting wil be concerned with getting client
feedback which will most efficiently lead to the success of the design development phase wrere
final directions are created This fee includes 3 rounds of revisions.
Design Development for Digital & Print Materials $1400
Des gne s will also present examples (to scale) of signage and sticker applications for approval.
This phase will result in a final presentatFon to client with refined app'ications. Any changes
to budget and schedule are agreed upon at this point. This fee includes 2 rounds of revisions.
Additional revisions will be billed at studio rate of $125/hour. All applications will be presented
for final approva
Implementation & Production for Letterhead and Identity $1400
This Fee covers refinement of accepted design, including general format, typography color,
and photography or illustration elements if needed. Final decisions are made on art direction,
typography, copyrighting, layouts and d.gital files at th s point. The client_ may make changes in
files or on press only through the designer. Designer can only make changes to the design with
cl ent's approval at this pont. This fee includes full transfer of ownership of all final des gns ro
client.
Signage and Sticker material Production Costs Not to Exceed $1200
Designer will get estimate from signage and sticker vendors and consider material and
production costs as part of total project fee. If costs go over estimated costs, then cost will
come out of design fee. At the time of this proposal the quant1ty and sizes of both the stickers
and signs was still to be determined.
TOTAL: Includes all Project Phases $5,000
4
Terms and Conditions
AFSTUDIO
DES IGNI
1. Professiona` fees quoted do not include out-of-pocket expenses for such things as legal
searches, typography, computer resources, photostats, photography, photographic slides, or
Mals and supplies which may be required to demonstrate or execute
our recommendations. Out-of-pocket costs will be billed at cost plus ten percent (10%) for
administration. Any travel expenses will be billed at cost.
2. Billing procedures for Afstudio are as follows: One-third (1/3) of total costs per project will
be billed as an initial retainer, and due within 14 days of commencing work. The balance due will
be billed upon completion of each phase of the project. Total fee billings will be within the price
ranges as indicated in thi,; proposal, unless c- anges to the scope of work are m:,tually defined and
agreed to in the Form of Addenda to this Proposal.
3. The initial retainer is due within 14 days, and balances are due within 30 days of invoice. An
interest charge of 1.5% per month is charged for invoices outstanding after 30 days. If it is
necessary For the client to cancel any project during its course, the client will be billed for work
completed up to the point of cancellation.
4 To the extent that the designs, names, marks, and materials created by Afstudio and used by
City of San Rafael are copyright -able, it shall be the property of City of San Rafael. Any rights
Afstudio may possess in any of the designs, names, marks, and materials created by Afstudio and
used by City of San Rafael are herby assigned to City of San Rafael.
5. The designs, names, marks, and materials created by Afstudio are believed not to infringe upon
the rights of others. However, Afstudio cannot warrant that its clients will be immune from the
claims of others due to the complexity of the laws and regulations governing such rights and the
virtual impossibility of searching names and designs worldwide. It is recommended that clients
consult their own legal counsel as to both availability and register -ability of the proposed designs,
names, marks and other materials as soon at those items are approved.
Reviewed and agreed to by:
Andrew Faulkner, Afstudio design - date Rebecca Woodbury, City of San Rafael - date
3
^� ® APG DATE (NIM DD YYYY)
ACRO CERTIFICATE OF LIABILITY INSURANCE 8001 2/24/2016
THIS CERTIFICATEIS 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 SUBROGATIONIS 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
MCNAMARA INSURANCE SVCS INC/PHS
110567 P:(866) 467-8730 F:(888)
PO BOX 33015
SAN ANTONIO TX 78265
INSURED
NAME.
FAX
(NoE.1) (866) 467-8730 I(AIC,No) (888:: 443-611%
4 43— 61121 ADDRESS
INSURER(S) AFFORDING COVERAGE NAIC#
INSURERA Sentinel Ins Co LTD 110�J
INSURER B
INSURER C
ANDREW FAULKNER IINSURER
1010 B ST STE 333 IINSURER
SAN RAFAE L CA 94901 I INSURER F
COVERAGES CERTIFICATE NUMBER:
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.
INNR TYPE OF INSURANCE AUDI. SUHR POLICYNUNRHR POIIL'YEFF
POLICYEXP LIVIT.S
ITR INNR 9`14) Of{f/DDIV1111
IAIM/DD/YYYRI
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
;1, 000, 000
CLAIMS-MADEOCCUR
DAMAGE TO RENTED
$1 000, 000
PREMISES (Ea occurrence)
/
A X General Liab X 57 SBA BE312C 02/08/2015
02/08/2016 MED EXP (Any one person)
510/ 000
PERSONAL & ADV INJURY
$1, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
s2, 000/ 000
POLICY= PRO LOC
JECT
PRODUCTS - COMP/OP AGG
s2, 000, 000
OTHER
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
1,000, 0 0 0
i
(Ea accident)
ANY AUTO
BODILY INJURY (Per person)
A ALL OWNED SCHEDULED 57 SBA BE3120 02/08/2015
02/08/2016 BODILY INJURY (Per amdent)
_ AUTOS AUTOS
5
X HIRED AUTOS X NON -OWNED
PROPERTY DAMAGE
AUTOS
(Per accident)
$
S
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS -MADE
AGGREGATE
5
DED( (RETENTION 5
$
WORKERS CUAIPEN.SA THIN
I I I
AMD .S' LIARII.ITY
EMPLO}ER
STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
E.L. EACH ACCIDENT
5
OFFICERIMEMBER EXCLUDED? N/A
(Mandatory in NH) ❑
E.L.DISEASE- EA EMPLOYEE
$
If yes, describe under
5
DESCRIPTION OF OPERATIONS below
E.L. DISEASE- POLICY LIMIT
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Those usual to the Insured's Operations. City of San Rafael is an additional
insured per the Business Liability Coverage Form SS0008 attached to this
policy.
CERTIFICATE HOLDER CANCELLATION
City of San Rafael SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
ATTN : REBECCA WOODBURY BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
1400 FIFTH AVE AUTHORIZED REPRESENTATIVE
PO BOX 151560_
SAN RAFAEL, CA 94915
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
APG DATE(nIM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 8001 12/24/2016
THIS CERTIFICATEIS 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 SUBROGATIONIS 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
MCNAMARA INSURANCE SVCS INC/PHS
110567 P: (866) 467-8730 F: (888)
PO BOX 33015
SAN ANTONIO TX 78265
INSURED
NAME.
PHONE
(A/C, No Ext): (8 6 6) 467-8730
443-61121 ADDRESS
INSURER(S) AFFORDING COVERAGE
INSURERA Sentinel Ins Co LTD
INSURERS
INSURER C
I(aC,No) (888;• 443-6112
NAIC#
11000
ANDREW FAULKNER
IINSURER
1010 B ST STE 333
IINSURER
SAN RAFAE L CA 94901
I INSURER F
COVERAGES CERTIFICATE
NUMBER:
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.
INNR TYPE OF INSURANCE ADDL SUHR
ITR INCR MID
POI,ICYNUMRER P0111TEFF
(111f/DD/YM)
POLICIIEXP
1A/.1//I)r1/WYYI
!GUTS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$1, 000, 000
CLAIMS-MADEOCCUR
I DAMAGE TO RENTED
PREMISES (Ea occurrence)
$1/ 000, 0 0 0
A X General Liab X
57 SBA BE3120 02/08/2016
02/08/2017 I MED EXP (Any one person)
$10, 000
PERSONAL & ADV INJURY
$1, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER
I GENERAL AGGREGATE
52, 000, 000
POLICYF PRO LOC
JECT
I PRODUCTS- COMP/OP AGG
$2, 000, 000
OTHER
$
AUTOMOBILE UABIUTY
COMBINED SINGLE LIMIT
000, 000
_
(Ea accident)
51 /
ANY AUTO
I BODILY INJURY (Per person)
$
SCHEDULED
A
57 SBA BE3120 02/08/2016
02/08/2017 I BODILY INJURY (Per accident)
ALL OWNED
AUTOS
$
X HIRED AUTOS X NON -OWNED
PROPERTY DAMAGE
I
$
AUTOS
(Per accident)
S
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS UAB
CLAIMS -MADE
I AGGREGATE
$
DED( (RETENTION S
WORKERS COMPENSA TION
I (STER OTH-
I IER
AND EIfPI OYERS' I.fARI1.ITT'
ATUTE
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
I E.L. EACH ACCIDENT
S
OFFICER MEMBER EXCLUDED?
(Mandatory in NH) El N/A
I E.L. DISEASE- EA EMPLOYEE
S
If yes descnbe under
DESCRIPTION OF OPERATIONS below
EL DISEASE- POLICY LIMIT
S
DESC.:IPTION OF OPERATIONS. LOCATIONS, VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Those usual to the Insured's Operations. City of San Rafael is an additional
insured per the Business Liability Coverage Form SS0008 attached to this
policy.
CERTIFICATE HOLDER CANCELLATION
City of San Rafael SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
ATTN : REBECCA WOODBURY BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
1400 FIFTH AVE AUTHORIZED REPRESENTATIVE
PO BOX 151560
SAN RAFAEL, CA 94915
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
lfTHE
HARTFORD
Select Customer Insurance Center
3600 WISEMAN BLVD.
SAN ANTONIO TX 78251
Policyholder, please callus at: (866) 467 8730
Agent, please callus at: (866) 467-8730
SERVICE.TX@THEHARTFORD.COM
INSURANCE ENDORSEMENT
ATTACHED
*** PLEASE REVIEW THE CHANGE ***
Enclosed is an endorsement for your business insurance policy. Please review it at your convenience. If you have
questions or need to make further changes:
Policyholder, please call us at: (866) 467 8730
Agent, please call us at: (866) 467-8730 between 7 A. M. and 7 .M. CENTRAL TIME
The premium billing will be mailed to you separately. You can expect to receive it soon.
Thank you for allowing us to service your business needs.
MCNAMARA INSURANCE SVCS INC/PHS
THE HARTFORD SELECT CUSTOMER INSURANCE CENTER
The Hartford
Hartford Fire Insurance Company and its Affiliates
One Hartford Plaza, Hartford, Connecticut 06155
POLICY NUMBER: 57 SBA BE3120
THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN
RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISE(
INSURANCE ACT.
DISCLOSURE PURSUANT TO TERRORISM RISK
INSURANCE ACT
SCHEDULE
Terrorism Premium:
$12.00
A. Disclosure Of Premium
In accordance with the federal Terrorism Risk
Insurance Act, as amended (TRIA), we are required
to provide you with a notice disclosing the portion of
your premium, if any, attributable to coverage for
"certified acts of terrorism" under TRIA. The portion
of your premium attributable to such coverage is
shown in the Schedule of this endorsement.
B. The following definition is added with respect to the
provisions of this endorsement:
1. A "certified act of terrorism" means an act that is
certified by the Secretary of the Treasury, in
accordance with the provisions of TRIA, to be
an act of terrorism under TRIA. The criteria
contained in TRIA for a "certified act of
terrorism" include the following:
a. The act results in insured losses in excess
of $5 million in the aggregate, attributable to
all types of insurance subject to TRIA; and
b. The act results in damage within the United
States, or outside the United States in the
case of certain air carriers or vessels or the
premises of an United States mission; and
c. The act is a violent act or an act that is
dangerous to human life, property or
infrastructure and is committed by an
individual or individuals as part of an effort
to coerce the civilian population of the
Form SS 83 76 0115
United States or to influence the policy or
affect the conduct of the United States
Government by coercion
C. Disclosure Of Federal Share Of Terrorism
Losses
The United States Department of the Treasury will
reimburse insurers for a portion of insured losses,
as indicated in the table below, attributable to
"certified acts of terrorism" under TRIA that exceeds
the applicable insurer deductible:
Calendar Year
Federal Share of
Terrorism Losses
2015
85%
2016
84%
2017
83%
2018
I 82%
2019
81%
2020 or later
80%
However, if aggregate industry insured losses under
TRIA exceed $100 billion in a calendar year, the
Treasury shall not make any payment for any
portion of the amount of such losses that exceeds
$100 billion. The United States government has not
charged any premium for their participation in
covering terrorism losses.
© 2015 , The Hartford
(includes copyrighted material of the Insurance Services Office, Inc., with its permission.)
Pagel of 2
D. Cap On Insurer Liability for Terrorism Losses
If aggregate industry insured losses attributable to
"certified acts of terrorism" under TRIA exceed $100
billion in a calendar year and we have met, or will
meet, our insurer deductible under TRIA, we shall
not be liable for the payment of any portion of the
amount of such losses that exceed $100 billion. In
such case, your coverage for terrorism losses may
be reduced on a pro -rata basis in accordance with
procedures established by the Treasury, based on
its estimates of aggregate industry losses and our
estimate that we will exceed our insurer deductible.
In accordance with the Treasury's procedures,
amounts paid for losses may be subject to further
adjustments based on differences between actual
losses and estimates.
E. Application of Other Exclusions
The terms and limitations of any terrorism exclusion,
the inapplicability or omission of a terrorism
exclusion, or the inclusion of terrorism coverage, do
not serve to create coverage for any loss which
would otherwise be excluded under this Coverage
Form, Coverage Part or Policy.
F. All other terms and conditions remain the same.
Form SS 83 76 01 15 Page 2 of 2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY CHANGE
This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated
'LiGiow:
Policy Number: 57 SBA BE3120 DX
Named Insured and Mailing Address; ANDREW FAULKNER
1010 B ST STE 333
SAN RAFAEL CA 94901
Policy Change Effective Date: 02/01/16 Effective hour is the same as stated in the
Declarations Page of the Policy.
Policy Change Number: 001
Agent Name: MCNAMARA INSURANCE SVCS INC/PHS
Code: 110567
POLICY CHANGES:
SENTINEL INSURANCE COMPANY, LIMITED
ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING
STATEMENT. IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK
ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS
THIS IS NOT A BILL.
NC PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE
BUSINESS LIABILITY OPTIONAL COVERAGES ARE REVISED
ADDITIONAL INSUREDS) ARE ADDED
THE FOLLOWING ARE ADDITIONAL INSURED FOR BUSINESS LIABILITY COVERAGE IN
THIS POLICY.
LOCATION 001 BUILDING 001
PERSON/ORGANIZATION: SEE FORM IH 12 00
PRO RATA FACTOR: 0.019
THIS ENDORSEMENT DOES NOT CHANGE. THE POLICY EXCEPT AS SHOWN.
Form SS 12 1104 05 T Page 001 ( CONTINUED ON NEXT PAGE)
Process Date: 02/24/16 Policy Effective Date: 02/08/15
Policy Expiration Date: 02/08/16
POLICY CHANGE (Continued)
Policy Number: 57 SBA BE3120
Policy Change Number: 001
FORM NUMBERS OF ENDORSEMENTS DELETED AT ENDORSEMENT ISSUE:
SS 50 19 03 12 SS 83 76 03 12
FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT ISSUE:
SS 50 19 01 15 SS 83 76 01 15
IH12001185 ADDITIONAL INSURED - PERSON -ORGANIZATION
Form SS 12 11 04 05 T Page 002
Process Date: 02/24/16 Policy Effective Date: 02/08/15
Policy Expiration Date: 02/08/16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM
This endorsement modifies insurance provided under the following:
BUSINESS LIABILITY COVERAGE FORM
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM
SPECIAL PROPERTY COVERAGE FORM
STANDARD PROPERTY COVERAGE FORM
UMBRELLA LIABILTY PROVISIONS
A. Disclosure Of Federal Share Of Terrorism Losses
The United States Department of the Treasury will
reimburse insurers for a portion of such insured
losses, as indicated in the table below that exceeds
the applicable insurer deductible:
Calendar Year Federal Share of
Terrorism Losses
2015 85%
2016 I 84%
2017 83%
2018 82%
2019 I 81%
2020 or later 80%
However, if aggregate industry insured losses,
attributable to "certified acts of terrorism" under the
federal Terrorism Risk Insurance Act, as amended
(TRIA), exceed $100 billion in a calendar year, the
Treasury shall not make any payment for any
portion of the amount of such losses that exceeds
$100 billion. The United States government has not
charged any premium for their participation in
covering terrorism losses.
B. Cap On Insurer Liability for Terrorism Losses
A "certified act of terrorism" means an act that is
certified by the Secretary of the Treasury, in
accordance with the provisions of federal Terrorism
Risk Insurance Act, to be an act of terrorism under
TRIA. The criteria contained in TRIA for a "certified
act of terrorism" include the following:
1. The act results in insured losses in excess of $5
million in the aggregate, attributable to all types
of insurance subject to TRIA; and
Form SS 5019 01 15
2. The act results in damage within the United
States, or outside the United States in the case
of certain air carriers or vessels or the premises
of an United States mission; and
3. The act is a violent act or an act that is
dangerous to human life, property or
infrastructure and is committed by an individual or
individuals acting as part of an effort to coerce
the civilian population of the United States or to
influence the policy or affect the conduct of the
United States Government by coercion.
If aggregate industry insured losses attributable to
"certified acts of terrorism" under TRIA exceed $100
billion in a calendar year, and we have met, or will
meet, our insurer deductible under TRIA, we shall
not be liable for the payment of any portion of the
amount of such losses that exceed $100 billion. In
such case, your coverage for terrorism losses may
be reduced on a pro -rata basis in accordance with
procedures established by the Treasury, based on
its estimates of aggregate industry losses and our
estimate that we will exceed our insurer deductible.
In accordance with the Treasury's procedures,
amounts paid for losses may be subject to further
adjustments based on differences between actual
losses and estimates.
C. Application Of Exclusions
The terms and limitations of any terrorism exclusion,
the inapplicability or omission of a terrorism
exclusion, or the inclusion of terrorism coverage, do
not serve to create coverage for any loss which
would otherwise be excluded under this Coverage
Form or Policy, such as losses excluded by the
Pollution Exclusion, Nuclear Hazard Exclusion and
the War And Military Action Exclusion.
© 2015, The Hartford
(Includes copyrighted material of Insurance Services Office, Inc. with its permission)
Page 1 of 1
POLICY NUMBER: 57 SBA BE3120
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - PERSON -ORGANIZATION
CITY OF SAN RAFAEL
ATTN: REBECCA WOODBURY
1400 FIFTH AVE
PO BOX 151560
SAN RAFAEL CA 94915
Form IH 12 00 11 85 T SEQ. NO. 002 Printed in U.S.A. Page 001
Process Date: 02/24/16 Expiration Date: 02/08/16
PROFESSIONAL SERVICES AGREEMENT/CONTRACT
COMPLETION CHECKLIST AND ROUTING SLIP
Below is the process for getting your professional services agreements/contracts finalized and
executed. Please attach this "Completion Checklist and Routing Slip" to the front of your
contract as you circulate it for review and signatures. Please use this form for all Drofessional
services aeree m ents/co n tracts (not just those requiring City Council approval).
This process should occur in the order presented below.
Step
Responsible
DescriptionI
Completion
Department
Date
1
City Attorney
Review, revise, and comment on draft
agreement.
2
Contracting Department
Forward final agreement to contractor for
their signature. Obtain at least two signed
originals from contractor.
3
Contracting Department
Agendize contractor -signed agreement for
Council approval, if Council approval
necessary (as defined by City Attorney/City
Ordinance*).
4
City Attorney
Review and approve form of agreement;
bonds, and insurance certificates and
endorsements.
,
5
City Manager / Mayor / or
Agreement executed by Council authorized
Department Head
official.
6
City Clerk
City Clerk attests signatures, retains original
EN ,
agreement and forwards copies to the
contracting department.'
To be completed by Contracting Department:
Project Manager: Rebecca Woodbury Project Name: No smoking sip-na2e desip-n
Agendized for City Council Meeting of (if necessary): n/a FPPC: ❑ , check if required
If you have questions on this process, please contact the City Attorney's Office at 485-3080.
* Council approval is required if contract is over $20,000 on a cumulative basis.