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HomeMy WebLinkAboutCM Removal and Disposal ServicesAGREEMENT FOR REMOVAL AND DISPOSAL SERVICES
This Agreement is made and entered into this 17-ro day of J v,JC , 2015, by
and between the CITY OF SAN RAFAEL (hereinafter "CITY"), and THE AWAY STATION,
INC., a corporation (hereinafter "CONTRACTOR").
RECITALS
WHEREAS, the CITY wishes to repurpose tools, furniture, building materials, and other
useful items from the building at 1309 5`" Avenue, San Rafael, California prior to demolition; and
WHEREAS, the CONTRACTOR has a facility and offers services for repurposing items
such as those found in the building at 1309 5h Avenue, San Rafael, California;
AGREEMENT
NOW, THEREFORE, the parties hereby agree as follows:
1. PROJECT COORDINATION.
A. CITY'S Project Manager. The Sustainability and Volunteer Program Coordinator
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. The Executive Director 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 follows:
CONTRACTOR shall sort through items in the garage and basement at 1309 5fl' Avenue, San
Rafael, California and remove any items they deem able to be repurposed. CONTRACTOR shall
provide all necessary means of sorting and removing the items. CONTRACTOR shall limit their
work to one work day only to be scheduled with CITY's Project Manager.
3. DUTIES OF CITY.
CITY shall provide access to the building and information to assist with
CONTRACTOR'S duties.
4. COMPENSATION.
For the full performance of the services described herein by CONTRACTOR,
CONTRACTOR shall be compensated in a total contract amount not to exceed $550.00. It is
understood and agreed by the parties that payment of compensation hereunder shall be made as
follows: CONTRACTOR shall submit an itemized invoice with hourly rates and time spent to
CITY, which shall remit payment within thirty (30) of receipt thereof.
TERM OF AGREEMENT.
The term of this Agreement shall be for a period commencing on the date first hereinabove
written and ending on June 26, 2015. 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
or periods of up to (2) weeks.
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. 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. CITY agrees to CONTRACTOR's assignment of
all or a portion of its duties with respect to sorting and removal of the items from 1509 5 Street as
described in Paragraph 2 to Marin City Community Development Corporation, provided that
CONTRACTOR shall continue to be responsible for guaranteeing that such sorting and removal
activities are performed in a manner that is reasonably satisfactory to CITY, that CONTRACTOR
shall continue to have all the other obligations with respect to such activities under this Agreement.
8. INSURANCE.
A. Scope of Coverage. During the term 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. The commercial general liability insurance policy 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. 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.
4. The insurance policies shall provide for a retroactive date of placement
coinciding with the effective date of this Agreement.
5. 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.
6. 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.
9. RELEASE AND INDEMNIFICATION.
A. CONTRACTOR agrees, on behalf of CONTRACTOR, its officers and employees,
and agents, and the legal successors and assigns of all such persons, to release, waive, and discharge
the City of San Rafael, and its officers and employees, from any and all liability for any injury
including death, or property damage, arising out of or connected with the performance of
CONTRACTOR'S services hereunder.
B. CONTRACTOR agrees to indemnify, release, defend with counsel approved by
CITY, and hold harmless the City of San Rafael and its officers and employees volunteers
(collectively, the "City Indemnitees"), against all claims and liability, including attorney's fees,
arising out of the acts or omissions of CONTRACTOR, its employees, contractors and agents, in
the performance of services under or arising from 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, except that 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.
4
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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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,
15. 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 tern, condition, covenant of this Agreement or any
applicable law, ordinance or regulation.
16. 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.
17. 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
NANCY MACKLE, Itity Manager
CONTRACTOR
Name:
Title: " d c '^fv_ Vwedi
ATTEST:
ESTHER C. BEIRNE, City Clerk
APPROVED AS TO FORM:
_ �,/' ig,
ROBERT F. EPSTEIN, City AAomey
,-❑ NONPROFITS
INSURANCE
ALLIANCE OF CALIFORNIA
A Head for Insurance. A Heart for Nonprofits.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT
FOR PUBLIC ENTITIES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. SECTION II — WHO IS AN INSURED is amended to include any public entity as an additional insured for
whom you are performing operations when you and such person or organization have agreed in a written
contract or written agreement that such public entity be added as an additional insured(s) on your policy,
but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"
arising out of, in whole or in part, by:
1. Your negligent acts or omissions; or
2. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing
operations.
No such public entity is an additional insured for liability arising out of the "products -completed
operations hazard" or for liability arising out of the sole negligence of that public entity.
B. With respect to the insurance afforded to these additional insured(s), the following additional exclusions
apply.
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work, on the
project (other than service, maintenance or repairs) to be performed by or on behalf of the additional
insured(s) at the location of the covered operations has been completed; or
2. That portion of "your work" out of which injury or damage arises has been put to its intended use by
any person or organization other than another contractor or subcontractor engaged in performing
operations for a principal as a part of the same project.
C. The following is added to SECTION III — LIMITS OF INSURANCE:
The limits of insurance applicable to the additional insured(s) are those specified in the written contract
between you and the additional insured(s), or the limits available under this policy, whichever are less.
These limits are part of and not in addition to the limits of insurance under this policy.
D. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of
SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following:
4. Other Insurance
a. Primary Insurance
This insurance is primary if you have agreed in a written contract or written agreement:
NIAC E61 02 13 Page 1 of 2
(1) That this insurance be primary. If other insurance is also primary, we will share with all that
other insurance as described in c. below; or
(2) The coverage afforded by this insurance is primary and non-contributory with the additional
insured(s)' own insurance.
Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has
been added as an additional insured or to other insurance described in paragraph b. below.
b. Excess Insurance
This insurance is excess over:
1. Any of the other insurance, whether primary, excess, contingent or on any other basis:
(a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for
"your work";
(b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily
occupied by you with permission of the owner;
(c) That is insurance purchased by you to cover your liability as a tenant for "property
damage" to premises temporarily occupied by you with permission of the owner; or
(d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the
extent not subject to Exclusion g. of SECTION I — COVERAGE A — BODILY INJURY
AND PROPERTY DAMAGE.
(e) That is any other insurance available to an additional insured(s) under this Endorsement
covering liability for damages arising out of the premises or operations, or products -
completed operations, for which the additional insured(s) has been added as an
additional insured by that other insurance.
(1) When this insurance is excess, we will have no duty under Coverages A or B to defend the
additional insured(s) against any "suit" if any other insurer has a duty to defend the additional
insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we
will be entitled to the additional insured(s)' rights against all those other insurers.
(2) When this insurance is excess over other insurance, we will pay only our share of the amount
of the loss, if any, that exceeds the sum of:
(a) The total amount that all such other insurance would pay for the loss in the absence of
this insurance; and
(b) The total of all deductible and self-insured amounts under all that other insurance.
(3) We will share the remaining loss, if any, with any other insurance that is not described in this
Excess Insurance provision and was not bought specifically to apply in excess of the Limits
of Insurance shown in the Declarations of this Coverage Part.
c. Methods of Sharing
If all of the other insurance available to the additional insured(s) permits contribution by equal
shares, we will follow this method also. Under this approach each insurer contributes equal
amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever
comes first.
If any other the other insurance available to the additional insured(s) does not permit contribution
by equal shares, we will contribute by limits. Under this method, each insurer's share is based on
the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers.
NIAC E61 02 13 Page 2 of 2
AC40RDI 0 I DATE (MM/DDIYYYY)
CERTIFICATE OF LIABILITY INSURANCE
AC� 6/15/2015
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 Nicole Klink
NAME:
Merriwether 6 Williams Insurance Services (ac N Ext); [A/C, FAX No): (213)258-3099
License No.: 0001378 E-MAIL
ADDRESS: nicole@imwis.com
550 Montgomery St., Suite 550 INSURER(S) AFFORDING COVERAGE NAIC #
San Francisco CA 94111 INSURERA:Philadelphia Indemnity Ins Co 18058
INSURED INSURERB:RSUI Indemnity Company 22314
Marin City Community Development Corp. INSURER C:
441 Drake Ave. INSURER D:
INSURER E:
Marin City CA 94965 INSURER F:
COVERAGES CERTIFICATE NUMBER:CL1561507212 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE IA(, WVD POLICY NUMBER EMM/DDrf r"bYLJMMIDD/YYYYI, LIMITS
X COMMERCIAL GENERAL LIABILITY1,000,000
EACH OCCURRENCE $
A CLAIMS -MADE X OCCUR DAMAGE PREMISES
100 000
PREMISESS (RENTED
occurrence) 5 r
X PHPK1336779 5/9/2015 5/9/2016 MED EXP (Any one person) 5 5,000
PERSONAL & ADV INJURY S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000
POLICY PRO-
JECT LOC PRODUCTS - COMP/OPAGG $ 2,000,0001
X OTHER: S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1 000, 000
(Ea accidents
A ANY AUTO BODILY INJURY (Per person) S
ALL OWNED SCHEDULED PHPK1336779 5/9/2015 5/9/2016 BODILY INJURY (Per accident) S
AUTOS AUTOS
X HIRED AUTOS X NON -OWNED PROPERTY DAMAGE $
AUTOS LPer accident
5
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 1,000,000
A EXCESS LIAB CLAIMS MADE PHUB499685 5/9/2015 5/9/2016 AGGREGATE S 1,000,000
DED RETENTION $ S
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY Y / N STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVEN / A E.L. EACH ACCIDENT S
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E L DISEASE - EA EMPLOYEE 5
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 5
B Directors & Officers NHP660490 11/30/2014 11/30/2015 Each Occurrence $1,000,000
Liability Aggregate $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
The Certificate Holder is hereby named Additional Insured, but only with respects to their interest as it
may appear to the Named Insured's operations.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
The Away Station THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
109 Broadway Blvd. ACCORDANCE WITH THE POLICY PROVISIONS.
Fairfax, CA 94930
AUTHORIZED REPRESENTATIVE
i! P:: CI I. e R I. 1 Y'7 k r' N I V„ (.) (JE .✓
�s
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)
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 agreements/contracts (not just those requiring City Council approval).
This process should occur in the order presented below.
Step
Responsible
Description
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
NP
t`
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
agreement and forwards copies to the
r
�� is
contracting department.
�(1
To be completed by Contracting Department:
Project Manager: Cory Bvtof Project Name: Awav Station Salvage 1309 Stn
Agendized for City Council Meeting of (if necessary): NA
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.
A� II CERTIFICATE OF LIABILITY INSURANCE 1DATE
i E(MWDD�)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTAI NAME: Denise J. Billings
Anixter & Oser, Inc. PHONE FHt (415) 898-1600 FAX
I IANC. No): (415) 898-3922
License OE28888ADDRIESS:denise@properlyinsured.corn
205 San Marin Drive INSURERIS) AFFORDING COVERAGE NAIC #
Novato CA 94945-1227 IINSURER ANonprofits Ins Alliance of CA NIAC
INSURED Ij
INSURER B
The Away Station, Inc. I INSURER C :
P.O. BOX 276 INSURER D:
INSURER E:
Fairfax CA 94978 IINSURERF:
COVERAGES CERTIFICATE NLIMBER:CL1531111030 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUER POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MWDDIYYYY) IMMIDD/YYYYI LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
REMIS I
X COMMERCIAL GENERAL LIA131 TY PTO RENTED REMISES(Ea occurrence) $ 500,000
A I CLAIMS MADE FxI OCCUR 2015-27440 3/18/2015 3/18/2016 I MED EXP (Any one person) $ 20,000
X, Liquor Liability PERSONAL& ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN L AGGREGATE LIMN APPLIES PER I PRODUCTS - COMP/OP AGG $ 2,000,000
POLICY PF . F—]LOC $
AUTOMOBILE LIABILITY COMBINED tSINGLE LIMIT
fEa accident)
BId$ 11000,000
A X ANY AUTO I BODILY INJURY (Per person) $
ALL Or
SCHEDULED 2015-27440 3/18/2015 3/18/2016 I BODILY INJURY (Per acddent) $
AUTOS
AUTOS
HIRED AUTOS NON-OWNED I PROPERTY DAMAGE $
AUTOS (Per accidentl
Uninsured motorist combined $ 1.000,000
UMBRELLA LIARI I OCCUR EACH OCCURRENCE $
EXCESS LIAR IH CLAIMS-MADE I AGGREGATE IS
DED I I RETENTION $ I I $
WORKERS COMPENSATION I, I WC LAATU- I I OFR I
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETORFPARTNERIEXECUTIVEI E L EACH ACCIDENT I $
OFFICER+MEMBER EXCLUDED? � N/A
(Mandatory In NH) I EL DISEASE - EA EMPLOYE $
Ifyes describeunder
DESCRIPTION OF OPERATIONS below I EL DISEASE - POLICY LIMIT I $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
This certificate is provided as evidence of coverage for the named insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of San Rafael ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Cory
AUTHORIZED REPRESENTATIVE
D J. Billings/DENISE""`"rte
ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved.
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This is made and entered into this _& daof e
f,# y :�-U/u — 2015, b
Agreementy
and between the CITY OF SAN RAFAEL (hereinafter "CITY"), and THE AWAY STATION,
INC., a corporation (hereinafter "CONTRACTOR").
19 Ste 0 ".1i
WFEEREAS, the CITY wishes to repurpose tools, furniture, building materials, and other
useful items from the building at 1309 5h Avenue, San Rafael, California prior to demolition; and
WHEREAS, the CONTRACTOR has a facility and offers services for repurposing items
cuch as those found in the building at 1309 5h Avenue, San Rafael, California;
A. CITY'S Project Manager. The Sustainability and Volunteer Program Coordinator
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 singlv
PROJECT DIRECTOR to have overall responsibility for the progress and execution of this
Agreement for CONTRACTOR. The Executive Director 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.
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CONTRACTOR shall sort through items in the garage and basement at 1309 5th Avenue, San
Rafael, California and remove any items they deem able to be repurposed. CONTRACTOR shall
provide all necessary means of sorting and removing the items. CONTRACTOR shall limit their
work to one work day only to be scheduled with CITY's Project Manager.
CITY shall provide access to the building and information to assist with
CONTRACTOR'S duties.
4. COMPENSATION.
For the ftill perfon-nance of the services described herein by CONTRACTOR,
CONTRACTOR shall be compensated in a total contract amount not to exceed $550.00. It is
understood and agreed by the parties that payment of compensation hereunder shall be made as
follows: CONTRACTOR shall submit an itemized invoice with hourly rates and time spent to
CITY', which shall remit payment within thirty (30) of receipt thereof.
5. TERM OF AGREEMENT.
The to of this Agreement shall be for a period commencing on the date first hereiriabove
written and ending on June 26, 2015. 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
or periods of Lip to (2) weeks.
C. TERM]NATION.
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. 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 atterript to so assign this Agreement or any rights, duties or obligations
arising hereunder shall be void and of no effect. CITY agrees to CONTRACTOId's assi ent of
all or a portion of its duties with respect to sorting and removal of the items from 1509 5 Street as
described in Paragraph 2 to Marin City Community Development Corporation, provided that
CONTRACTOR shall continue to be responsible for guaranteeing that such sorting and removal
activities are perforined in a mariner that is reasonably satisfactory to CITY', that CONTRACTOR
shall continue to have all the other obligations with respect to such activities under this Agreement.
A. Scope of Coverage. During the term of this Agreement, CONTRACTOR shall
maintain, at noexpense to CITY, the following insurance policies:
I . A commercial general liability insurance policy in the minimum amount of
one million dollars ($1,000,000) per f million dollars ($2,000,000) aggregate, for
death, bodily injury, personal injury, or property damage.
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:
commercial general liability insurance policy shall be specifically
endorsed to include the CITY, its officers, agents, employees, and volunteers, as additionally
riamed insureds under the policies.
2. The additional insured coverage under CONTRACTOR'S insurance
Rolicies shall be primary with respect to any insurance or coverage maintained by CITY and shaJI
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. If the insurance is written on a Claims Made Form, then, following
termination of this Agreement, said insurance coverage shall survive fora period of not less than
five years.
4. The insurance policies shall provide for a retroactive date of placemen!
coinciding with the effective date of this Agreement.
5. 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
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.
I
6. 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 Attomey.
9. RELEASE AND INDEMNIFICATION.
A. CONTRACTOR agrees, on behalf of CONTRACTOR, its officers and employees,
and agents, and the legal successors and assigns of all such persons, to release, waive, and discharge
the City of San Rafael, and its officers and employees, from any and all liability for any injury
including death, or property damage, arising out of or connected with the performance of
CONI-RAcTOR'S services hereunder.
B. CONTRACTOR agrees to indemnify, release, defend with counsel approved by
CITY, and hold harmless the City of San Rafael and its officers and employees volunteers
(collectively, the "City Indemnitees"), against all claims and liability, including attorney's fees,
arising Out. of the acts or omissions of CONTRACTOR, its employees, contractors and agents, in
the performance of services under or arising from 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 Indenmitees, except that to the extent that liability is caused by
the active negligence or willful misconduct of the City Indemnitees, the CONT RACTOR's
indemnification obligation shall be reduced in proportion to the City Indemnitees' share of
liability for the active negligence or willful misconduct.
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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.
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.
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, liabties,
penalties, fines and all other consequences from any noncompliance or violation of any laws,
ordinances, codes or regulations.
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CITT and CONTRACTOR do not intend, by any provision of this Agreement, to create mi
any third party, any benefit or right owed by one party, under the terms and conditions of this
Agreement, to the other party.
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.
A. The terms and conditions of this Agreement, all exhibits attached, and all documents
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,
15. 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.
16. COSTSAND 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.
17. 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
NANCY MACKLE, Xty Manager
C�
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CONTILACTO
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Title: Ey'ec'fitl�.' ,f
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E T HER C. BEIRNE, City Clerk
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ROBERT F. EPSTEIN, City Adoey
RIMS
ALLIANCE OF CALIFORNIA
ADDITIONAL INSURED
FAIhMAY AK1'N1N-C1I`4TAIi5YT1AY EN lilt ASEM EN
FOR PUBLIC ENTITIES
A. .
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. SECTION 11 — WHO IS AN INSURED is amended to include any public entity as an additional insured for
whom you are performing operations when you and such person or organization have agreed in a written
contract or written agreement that such public entity be added as an additional insured(s) on your policy,
but only with respect to liability for "bodily injury"property damage" or "personal and advertising injury"
arising out of, in whole or in part, by:
1. Your negligent acts or omissions; or
2. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing
operations.
No such public entity is an additional insured for liability arising out of the "prod ucts-com pleteiW
operations hazard" or for liability arising out of the sole negligence of that public entity.
B. With respect to the insurance afforded to these additional insured(s), the following additional exclusions
apply.
1 . All work, including materials, parts or equipment furnished in connection with such work, on the
project (other than service, maintenance or repairs) to be performed by or on behalf of the additional
insured(s) at the location of the covered operations has been completed; or
2. That portion of "your work" out of which injury or damage arises has been put to its intended use by
any person or organization other than another contractor or subcontractor engaged in performing
operations for a principal as a part of the same project.
The limits of insurance applicable to the additional insured(s) are those specified in the written contract
between you and the additional insured(s), or the limits available under this policy, whichever are less.
These limits are part of and not in addition to the limits of insurance under this policy.
T. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of
SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following:
a. Primary Insurance
NIAC E61 02 13 Page 1 of 2
(1) That this insurance be primary. If other insurance is also primary, we will share with all that
other insurance as described in c. below; or
(2) The coverage afforded by this insurance m primary and non-contributory with the additional
insured(s)' own insurance.
Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has
been added as an additional Insured or to other insurance described in paragraph b. below.
b. Excess Insurance
This insurance is excess over.
1. Any of the other insurance, whether primary, excess, contingent or on any other basis:
(a) That is Fire, Extended Coverage, Builder's Disk, Installation Disk or similar coverage for
"your work";
(b) That is fire" lightning, or explosion insurance for premises rented to you or temporarily
occupied by you with permission of the owner;
(c) That is insurance purchased by you to cover your liability as a tenant for "property
damage" to premises temporarily occupied by you with permission of the owner; or
(d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the
extent not subject to Exclusion g. of SECTION I — COVERAGE A — BODILY INJURY
AND PROPERTY DAMAGE.
(e) That is any other insurance available to an additional insured(s) under this Endorsement
covering liability for damages arising out of the premises or operations, or products -
completed operations, for which the additional insured(s) has been added as an
additional insured by that other insurance..
(1) When this insurance is excess, we will have no duty under Coverages A or B to defend the
additional insured(s) against any "suit" if any other insurer has a duty to defend the additional
insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we
will be entitled to the additional insured(s)' rights against aII those other insurers.
(2) When this insurance is excess over other insurance, we will pay only our share of the amount
of the loss, if any, that exceeds the sum of:
(a) The total amount that all such other insurance would pay for the loss in the absence of
this insurance; and
(b) The total of all deductible and self-insured amounts under all that other insurance.
(3) We will share the remaining loss, if any, with any other insurance that is not described in this
Excess Insurance provision and was not bought specifically to apply in excess of the Limits
of Insurance shown in the Declarations of this Coverage Bart.
c. Methods of Sharing
If all of the other insurance available to the additional insured(s) permits contribution by equal
shares, we will follow this method also. under this approach each insurer contributes equal
amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever
comes first.
If any other the other insurance available to the additional insured(s) does not permit contribution
by equal shares, we will contribute by limits. Under this method, each insurer's share is based on
the ratio of its applicable limit of insurance to the total applicable limits of insurance of all Insurers.
NIAC E61 02 13 (Page 2 of 2
ACCERTIFICATE OF C, . D. «D
r ..+1 6/15/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES t OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE -POLICIES
BELOW
CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE
f {i ,, , � OR PRODUCER, . . ,. HOLDER.
IMPORTANT: If e certificate holderDD; r t be endorsed. subject ,
the terms and conditions of - policy,erequire an endorsement.
certificate holder in lieu of such ,,.
PRODUCER
Merriwether & Williams Insurance Services
PHONE (213)258-3083
3' • '
+f(213)258-3099
License No.: 0001378 E-MAIL
DD
550 Montgomery St., Suite 550 INSURER(S) AFFORDING COVERAGE NAIC #
San Francisco CA 94111 ,
IndemnityINSURER
hiladelphia Indemnity Ins Co 18058
INSURED INSURERB:RSUI
FIIp
COVERAGESMarin City Community Development Corp. INSURER C:
441 Drake Ave. INSURER D:
INSURER E:
Marin City CA 94965 INSURER F:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABBVE FOR THE POLICY PERIOD
INDICATED. O + DANY Q OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT O WHICH THIS
EXCLUSIONSCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
;i CONDITIONS O; SUCH POLICIES. LIMITS SHOWN MAYR ■ BY PAID CLAIMS.
INSR xe
POLICY ,
LTR TYPE OF INSURANCE INSD,y0 '4 DD(MMIDDNYYYI LIMITS,
COMMERCIAL ;
DAMAGE TO RENTED
.. CLAIMS MADE, !M100,000
CERTIFICATE HL CANCELLATION
------- -- --- ------------
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
The Away Station THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
109 Broadway Blvd. ACCORDANCE WITH THE POLICY PROVISIONS,
Fairfax, CA 9493
AUTHORIZED REPRESENTATIVE
©1988-2014 ACORD CORPORATION.All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
I 25 (20/401>
X PHPK1336779
5/9/2015 5/9/2016 MED EXP (Any one person)
S 5,000
PERSONAL & ADV INJURY
S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
S 2,000,000
POLICY PRO-
JECT LOC
PRODUCTS - COMP/OPAGG
S 2,000,000
OTHER.
S
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident)
S 1,000,000
ANY AUTO
BODILY INJURY (Per person)
S
ALL OWNED SCHEDULED PELPK1336779
AUTOS AUTOS
5/9/2015 5/9/2016 BODILY INJURY (Per accident)
S
X X NON -OWNED
PROPERTY DAMAGE
S
HIRED AUTOS AUTOS
(Per accident)
S
X UMBRELLA LIAR X OCCUR
EACH OCCURRENCE
S 1,000,000
A EXCESS LIAB CLAIMS -MADE PFI 499685
5/9/2015 5/9/2016 AGGREGATE
S 1,000,000
DED RETENTION $
S
WORKERS COMPENSATION
PER OTH
O EMPLOYERS' LIABILITY Y / N
STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
EL EACH ACCIDENT
S
OFFICER/MEMBER EXCLUDED? N / A
(Mandatory in NH)
EL DISEASE EA EMPLOYEE
S
If yes, describe under
DESCRIPTION OF OPERATIONS below
EL DISEASE - POLICY LIMIT
S
B Directors & Officers NHP660490
11./30/2014 11/30/2015 Each Oc,currervue
$1,000,000
Liability
AggrK,gAn
$1,000,000
DESCRIPTION OF OPERATIONSI LOCATIONS R VEHICLES (ACORD 101„ Additional Remarks Schedule„ may be attached If more space Is required)
,The Certificate Holder is hereby named d °tional
Insured, but only with respects to their interest as it
imay appear to the Named Insured's operations.
CERTIFICATE HL CANCELLATION
------- -- --- ------------
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
The Away Station THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
109 Broadway Blvd. ACCORDANCE WITH THE POLICY PROVISIONS,
Fairfax, CA 9493
AUTHORIZED REPRESENTATIVE
©1988-2014 ACORD CORPORATION.All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
I 25 (20/401>
1020, �1�1 ,
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 p_r9fes
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services a greements/co n tracts. (not just those requiring City Council approval).
to
Responsible
Description
Completion
Department
Date
I
City Attomey
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
agreement and forwards copies to the
contracting department.
Project Manager: Cory Bvtof Project c® Away Station SaNne 13Q9 to
Agendized for City Council Meeting of (if necessary): __—NA
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