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07-0905_INFINITE IMAGING SERVICES_Personal Services AgreementPERSONAL SERVICES AGREEMENT THIS AGREEMENT is made and entered into this ,5l""day of '- V 200, by and between the City of San Juan Capistrano (hereinafter referred to as the "City") and Infinite Imaging Systems (hereinafter referred to as "Consultant"). RECITALS: WHEREAS, City desires to retain the services of Consultant regarding the City's proposal to imaging documents on CD -Rom; and WHEREAS, Consultant is qualified by virtue of experience, training, education and expertise to accomplish such services. NOW, THEREFORE, City and Consultant mutually agree as follows: Section 1. Scope of Work. The scope of work to be performed by Consultant shall consist of those tasks as set forth in Exhibit "A," attached and incorporated herein by reference. Consultant warrants that all of its services shall be performed in a competent, professional and satisfactory manner and in accordance with the prevalent standards of its profession. Section 2. Term. The services provided under this agreement shall begin upon execution of this agreement by all parties. This agreement shall be for a one-year (1 year) period of time with two (2) one-year (1 year) extensions. Agreement extensions shall be based on staff review of consultant's performance. Section 3. Compensation. 3.1 Amount. Total compensation for the scope of services for this Project shall not exceed Ninety thousand Dollars ($90,000 ), as set forth in Exhibit "B," attached and incorporated herein by reference. 3.2 Rate Schedule. The services shall be billed to the City at the hourly rate set forth in Exhibit "C," attached and incorporated herein by reference. Included within the compensation are all the Consultant's ordinary office and overhead expenses incurred by f � � 9 0 it, its agents and employees, including meetings with the City representatives and incidental costs to perform the stipulated services. Submittals shall be in accordance with Consultant's proposal. 3.3 Method of Payment. Consultant shall submit monthly invoices based on total services which have been satisfactorily completed and specifying a percentage of projected completion for approval by the City. The City will pay monthly progress payments based on approved invoices in accordance with this Section. For extra work not part of this Agreement, a written authorization from City is required prior to Consultant undertaking any extra work. 3.4 Records of Expenses. Consultant shall keep complete and accurate records of all costs and expenses incidental to services covered by this Agreement. These records will be made available at reasonable times to City. Section 4. Independent Contractor. It is agreed that Consultant shall act and be an independent contractor and not an agent or employee of City, and shall obtain no rights to any benefits which accrue to City's employees. Section 5. Limitations Upon Subcontracting and Assignment. The experience, knowledge, capability and reputation of Consultant, its principals and employees were a substantial inducement for City to enter into this Agreement. Consultant shall not contract with any other entity to perform the services required without written approval of the City. This Agreement may not be assigned, voluntarily or by operation of law, without the prior written approval of the City. If Consultant is permitted to subcontract any part of this Agreement by City, Consultant shall be responsible to City for the acts and omissions of its subcontractor as it is for persons directly employed. Nothing contained in this Agreement shall create any contractual relationships between any subcontractor and City. All persons engaged in the work will be considered employees of Consultant. City will deal directly with and will make all payments to Consultant. Section 6. Changes to Scope of Work. In the event of a change in the Scope of Work provided for in the contract documents as requested by the City, the Parties hereto shall execute an addendum to this Agreement setting forth with particularity all terms of the new agreement, including but not limited to any additional Consultant's fees. 11 Section 7. Familiarity with Work and Construction Site. By executing this Agreement, Consultant warrants that: (1) it has investigated the work to be performed; (2) it has investigated the proposed construction site, including the location of all utilities, and is aware of all conditions there; and (3) it understands the facilities, difficulties and restrictions of the work under this Agreement. Should Consultant discover any latent or unknown conditions materially differing from those inherent in the work or as represented by City, it shall immediately inform City of this and shall not proceed with further work under this Agreement until written instructions are received from the City. Section 8. Time of Essence. Time is of the essence in the performance of this Agreement. Section 9. Compliance with Law. Consultant shall comply with all applicable laws, ordinances, codes and regulations of federal, state and local government. Section 10. Conflicts of Interest. Consultant covenants that it presently has no interest and shall not acquire any interest, direct or indirect, which would conflict in any manner or degree with the performance of the services contemplated by this Agreement. No person having such interest shall be employed by or associated with Consultant. Section 11. Copies of Work Product. At the completion of the contract period, Consultant shall have delivered to City at least one (1) copy of any final reports and architectural drawings containing Consultant's findings, conclusions, and recommendations with any support documentation. All reports submitted to the City shall be in reproducible format. All services to be rendered hereunder shall be subject to the direction and approval of the City. Section 12. Ownership of Documents. All reports, information, data and exhibits prepared or assembled by Consultant in connection with the performance of its services pursuant to this Agreement are confidential to the extent permitted by law, and Consultant agrees that they shall not be made available to any individual or organization without prior written consent of the City. All such reports, information, data, and exhibits shall be the property of the City and shall be delivered to the City upon demand without additional costs or expense to the City. The City acknowledges such documents are instruments of Consultant's professional services. 0 0 Section 13. Indemnity. Consultant agrees to protect, defend and hold harmless City, its elected and appointed officials and employees from any and all claims, liabilities, expenses or damages of any nature, including attorneys' fees, for injury or death of any person or damage to property or interference with use of property and for errors and omissions committed by Consultant arising out of or in connection with the work, operation or activities of Consultant, its agents, employees and subcontractors in carrying out its obligations under this Agreement. Section 14. Insurance. Insurance required herein shall be provided by Admitted Insurers in good standing with the State of California and having a minimum Best's Guide Rating of A- Class VII or better. 14.1 Comprehensive General Liability. Throughout the term of this Agreement, Consultant shall maintain in full force and effect Comprehensive General Liability coverage in the following minimum amounts: $500,000 property damage; $500,000 injury to one person/any one occurrence/not limited to contractual period; $1,000,000 injury to more than one person/any one occurrence/not limited to contractual period. 14.2 Comprehensive Automobile Liability. Throughout the term of this Agreement, Consultant shall maintain in full force and effect Comprehensive Automobile Liability coverage, including owned, hired and non - owned vehicles in the following minimum amounts: $500,000 property damage; $500,000 injury to one person/any one occurrence/not limited to contractual period; $1,000,000 injury to more than one person/any one occurrence/not limited to contractual period 14.3 Worker's Compensation. 0 0 If Consultant intends to employ employees to perform services under this Agreement, Consultant shall obtain and maintain, during the term of this Agreement, Worker's Compensation Employer's Liability Insurance in the statutory amount as required by state law. 14.4 Proof of Insurance Requirements/Endorsement. Prior to beginning any work under this Agreement, Consultant shall submit the insurance certificates, including the deductible or self -retention amount, and an additional insured endorsement to the Consultant's general liability and umbrella liability policies using ISO form CG 20 10 11 85 (in no event with an edition date later than 1990) to the City's General Counsel for certification that the insurance requirements of this Agreement have been satisfied. 14.5 Errors and Omissions Coverage Throughout the term of this Agreement, Consultant shall maintain Errors and Omissions Coverage (professional liability coverage) in an amount of not less than One Million Dollars ($1,000,000). Prior to beginning any work under this Agreement, Consultant shall submit an insurance certificate to the City's General Counsel for certification that the insurance requirements of this Agreement have been satisfied. 14.6 Notice of Cancellation/Termination of Insurance. The above policy/policies shall not terminate, nor shall they be canceled, nor the coverages reduced, until after thirty (30) days' written notice is given to City, except that ten (10) days' notice shall be given if there is a cancellation due to failure to pay a premium. 14.7 Terms of Compensation. Consultant shall not receive any compensation until all insurance provisions have been satisfied. 14.8 Notice to Proceed. Consultant shall not proceed with any work under this Agreement until the City has issued a written "Notice to Proceed" verifying that Consultant has complied with all insurance requirements of this Agreement. Section 15. Termination. City and Consultant shall have the right to terminate this Agreement without cause by giving thirty (30) days' advance written notice of termination to the other party In addition, this Agreement may be terminated for cause by providing ten (10) days' 0 0 notice to the other party of a material breach of contract. If the other party does not cure the breach of contract, then the agreement may be terminated subsequent to the ten (10) day cure period. Section 16. Notice. All notices shall be personally delivered or mailed to the below listed addresses, or to such other addresses as may be designated by written notice. These addresses shall be used for delivery of service of process: To City: City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Attn: Director of Administrative Services To Consultant: Infinite Imaging Systems 23011 Moulton Parkway, Suite A-13 Laguna Hills, CA 92653 Section 17. Attorneys' Fees. If any action at law or in equity is necessary to enforce or interpret the terms of this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees, costs and necessary disbursements in addition to any other relief to which he may be entitled. Section 18. Dispute Resolution. In the event of a dispute arising between the parties regarding performance or interpretation of this Agreement, the dispute shall be resolved by binding arbitration under the auspices of the Judicial Arbitration and Mediation Service ("JAMS"). Section 19. Entire Agreement. This Agreement constitutes the entire understanding and agreement between the parties and supersedes all previous negotiations between them pertaining to the subject matter thereof. 0 0 IN WITNESS WHEREOF, the parties hereto have executed this Agreement. ATTEST: Cheryl Johnson, City Clerk APPROVED AS TO FORM: n4A�� John R. Shaw dry Attorney CIT) In CONSULTANT JORDAN ANAST CITY OF SAN JUAN CAPISTRANO M CAMPBELL, MAYOR 0 M4PHERSON GEE 18055826191 10/22 '04 08:35 N0.378 02102 _ PoliCy Number 690-135OW704 a Date EntemO: 4/24/2004 ACORDTM CERTIFICATE OF LIABILITY INSURANCE 0/21/ a 4 PRODUCER 3713 ALAMO STREET 2ND FLOOR SIMI. VALLEY CA 93063 LICENSE B OD94590 (005)578-3863 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC 0 INSURED ACCELERATED IMAGING SERVICES 3.03 N. POINTS LAXE FOREST, CA 9263D PISUREMATRAVELERO PROPEILTY CASUALTY POLICY EPPFCINE INSURER B. PROCRESSI VL LAFR ,NSURERC'PHILMISLPBTA INDSHIRITY INSORARCZ COXPUfY NSURER D, M6URER E' COVFRAGFS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REOUIREMFNT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN RADO - POLICY NMMBGR POLICY EPPFCINE POLICY EAPRIATON LAFR GENERAL LIABILITY EACH OCCURRENCE 51,000,000 A �/ /�, COMMERCIAL GENERAI. LIAOILITY GAMS MADE zOCCUR 680-1398N704 4/24/2004 4/24/2005 F IbffiJEe oaurwlAl MED PAP wy aw en:,m 5 15,000 PERSONAL 6 AOV,NJURY 51.000,000 �J GENERAL AGGREGATE 13,000,000 GEN -1. AGORECATE LIMIT APPLIES PER PRODUCTS - COMPiOP AGO f 2 • 000, D00 PIAArY PpCT F-1 RD LOG B X AUTOMOBIIS UABILItt ANY Auro 0-16-49-664-1 5/1/2004 5/1/2005 COMBINED SINGLE LINT IESSUJI°"Ii 11,000,000 ODDLY INJURY (P-RvwA 1100,000 AIL0WNi0 AUTOS SCNEOUIFDAUTOS BODILY ,Ov . AaIA17 Ivcdmrm 1 300,000 NNF,O AUT06 NDNOWNcn AUTOS PROPERTY OAMAOE (M eO.MAMI 150,000 ' GARAOF LIMRRY AUTO ONLY. FA ACCIDENT f OTnERTHAN Cn ACC 1 ANYALTO L AUTO ONLY, ADD EXCESBIUMPREUA MAEFJtt GAMS MAD: RRENCF iOCCuR 5tAEDUGTIPLF.1RF,rF.Nr10N MEAEMPLI,)YFE E}WORNERB COMPONSATION AND w", DABRJtt ATU CTH.EEgL NI'ANY 1OFFICERIMEMOER PPOPRIFTOWPARTNFnIF•JCCCUr,vE CIDENT • FA EMPLOYEE tII EXCLUDE01 NNMf5 D]AOIpe ISmor IOSPf;CIAI. PROMBIONB UNIM• POUCY UMR t OTHER PER CLAIM 1,000,000 C PROFEBSXO14AL LIAR. PHSDO97991 7/24/2004 7/24/2005 AGOREOATE 1,000,000 CLAIMS MADE ONLY DEDUCTIBLE 2,500 DESCRIPTION OF OPERATIOBB I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SMCIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED_ CITY OV BAN JUAN CAPISTRANO 32400 PASCO ADELANOT BAN JUAN CAPISTRANO, CA 92675 ATTN, CITY CLEAR SHOULD M OF TME ANOVE DESCKIBED POLICIES BE CANCSUAD BEPORF THE EXNRA MIN DATE THBIIEOP, 111E MIRING IReUR IR "LL ENDEAVOR TO N1AI130 DAIS WNTFEN NONCE TO THE CERTflCATE HOLDER NANIED 10 TALI LFII, BUT FAR.DR6 TD DO EO SHALL AIPOSE NO OSUGATION DIN WBNJTY OF AMY KIND UPON THE MEURNR, RE ADEPTS OR AUTNOI@ED REPWIGN LEANN SSLOAU J MCPHERSON GEE 3713 Alamo t. 2"d Floor Simi Valley, CA 93063 Phone: (805) 578-3883 Fax: (805) 582-6191 18055826191 Ta: City of San Juan Capistrano Fax: 949-493-1053 Attn: Mania Guevara From: Pages: Date: 10/22 '04 08:35 • NO.378 01/02 Shelley 2 w/cover 10/22/04 Re: Accelerated Imaging Professional Liability Maria, Please see the attached Certificate of Insurance showing the General Liability, Auto and Professional Liability as per your request. A copy has been sent to the insured as well. Please feel free to call me if you have any questions. Best Regards, Shelley Brazelton (shelley@blueskyins.com) Commercial Department Cc, Accelerated Imaging (Ani (949-472-4780) MCPHERSON GEE 18055826191 10/21 104 14:57 NO.365 02/02 A& PORCy NUMber. 690-139BW704 Ift DBtO Entered: 4/24/2004 AC -0 -RD, CERTIFICATEF LIABILITY INSURANC MTF mmDTYYYI 10/221/200,1/2004 PRODUCER BLUE SKYTHIS 3713 ALAND STREET 2ND FLOOR SINI VALLEY CA 93063 LICENSE N OD94590 (005)578-3003 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL N INSURED ACCELERATED IMAGING SERVICES 103 N. POINTEINSUR'RC LILRR AORC6T, CA 92630 INSURER A.TRhVZLERS PROPERTY CASUALTY YMITI INSURER 9PROPREBBIVE INSURFRD INSURER E' CETVCDA!]DC THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIAITS SHOWN MAY RAVE BEEN REDUCED BY PAID CLAMS. INBR ADO' YPSIJtlmwmocrl— POU"MUUMER POLJLT lPPEC POLICY EXNRATNNU YMITI EACH OCOJRnF•NCE ,T 1.000,000 GENERAL UARILRY A X COMNERCIALGENERALIJANLITY jp� J CLIMB MAr?E I/J OCCUR 680-1398M704 4/24/2004 4!24/2005 15pEoou�lnml ME0EXP(ASwopmw2 s $ 5,000 PERSONN.6ADVIN,MRY 51,000.000 OFNFRAt AGGREGATE 1$3,000,000 CFVL AGGREGATE UWT APPLIES PER PRODUCTS-CONAX)P AGG 92,000,000 POIJCY P - LOC B X AUTOMINT" LM04ITY ANY AUTO 0-16-49-664-1 5/1/2004 5/1/2005 COMBINED SINGLE LIMB (EG --J6") 51,000,000 BODILY INJURY (PS,PYK") 5100,000 AU. OMNED AITO8 SCI¢IAILEDAUTOS BODILY INJURY (Pa ovjd M) 5300,000 BRED AUTOS NON-0WNF.0 AUTOS PROPERTYOAMAOF (Pa APJGOI'4 550,000 OARAD[LIABILTR AUrO ONLY - EA ACCIDENT E OSIER THAN EAACC 5 ANYAUTO 5 AUTO ONLY, AGG $RCII$SR1gARUAUANNTY OCCUR InJ CWM8 MADE EACHOCCURRENCE 9 AGGREGATE 5 E S OEDUCT191.E RETENTION F5 MORNEIM COMPRMEATRNJ AND ETALOYER$' UABET' NCSTATU OTH iBD-iIMITS J ElFACHACCIDENT 5 ANY PnOPNETORIP IFVE .TFCUTI f.L. OIBEABE-FA EMPLOYEE f OFFILPiUMDHBFA FJTCIARX-IAIOEDT r yw a ISIO BI+F.dIAAI. rPR OV1510 GMa„ EL DISEASE -POLICY LNAn f OTNlR DESCRIPTION OF OPERATION$ I LOCATORS I WHICLEB I EXCLUSION$ ADDED BY ENCONSEN IDIT I DPECIA-PRCNBRNM CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED, CITY OD BAN JOAN CAPISTRANO 32400 PASCO ADELANOT BAN JOAN CAPISTRANO, CA 92675 ATM, CITY CT.BRR WOUND ANY OF THE ADOW DEBCRREED EOLICI!! NE CARCSLLED NlPORE THE EXPIRATION DATE MENEM, THR MIMING WEAKER MILL ERDL" TO MAIL 3Q DAYS WWTTEN ROTIC! TO THE CENTIRCAT! NOL AMED TO THE LEFT, WTEAIWRR TO DD MT 9HAUJ TMIDBE NO OSLI" DIU ON ITv OT AMY KIND, UPON THE MOUREN. ITS AOIMR on AF ArMa"Amlpo yl �:• ' MCPHERSON GEE 18055826191 10121 104 14:57 NO.365 01102 4 • 3713 Alamo Street. 2nd Floor Simi Valley, CA 93083 B Phone: (805) 578-3883 Fax: (805)582-8191 =eip 70: ACCELERATED IMAGING, INC From: Le Ann Fax: (949) 472-2780 Pages: Attn:ANI Date: 10/21/04 Re: CITY OF SAN JUAN CC: CITY OF SAN JUAN CAPISTRANO CAPISTRANO / ATTN: MARIA GUEVARA (949) 493-1053 0 Urgent 0 For Review 0 Please Comment X Please Reply 0 Comments., Hi Ani, Please see IJ -).e attached certificate of insurance naming the "City of San Juan Capistrano" as an additional insured. Travelers Ins. Co, supposable sent it to them, directly on 5/4/04. I am also faxing this to them. Thank you, Le Ann �CQRD- CERTIFICAN OF LIABILITY INSURATCE DATE (MM/DD/YY) 5/6/2009 PRODUCER BLUE SKY INSURANCE AGENCY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 3713 ALAMO ST 2ND FLOOR AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS SIMI VALLEY, CA 93063 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE (888) 661-3938 COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE XV843 700 INSURED ANI MIRZIAN, DEA: INSURER A: Travelers Property Casualty Company Of America INSURER B: N/a ACCELERATED IMAGING SERVICES INSURER C: N/a 103 N POINTE DR INSURER D: N/a LAKE FOREST, CA 92630 INSURER E: N/a COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. HR LTR TYPE OF INSURANCE POUCY NUMBER POUCYEFFECTIVE DATE(MMIDD1M POLICY EXPIRATION DATE(MMIDDNY) UMTS GENERALUABIUTY 680-1398W704-04 04/24/2004 04/24/2005 EACH OCCURRENCE $ 1,000,000 FIREDAMAGEIAq.ft) $ 300,000 A GENERAL LIABILITY TCOMMEROAL MADE ERIOCCUR VcnaP ) $ 5 000 dADVPLLRY $ 1,000,000 4GENERALAGGREGATE $ 2,000,000 -C08IOPAGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: JECT X POUCY PRO LOC AUTOMOBILE UASIUTY 680-139BW704-04 04/24/2004 04/24/200$ COMBINED SINGLE LIMIT A ANY AUTO (Ea accident) $ 1,000,000 BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) $ BODILY INJURY X HIREDAUTOS X NON -OWNED AUTOS (Per acd nU $ PROPERTY DAMAGE _ (Per accident) $ AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC $ qGAUGEDABIUTY ANY AUTO AUTO ONLY: AGO $ EXCESS LNSRDY EACH OCCURRENCE OCCUR FICIAIMSMADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND YLIVIT oE nIT R TORSIAER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ E.L. DISEASE - PAEAPLOYEE $ E.L. DISEASE - POLICY LIMIT Is OTHER $ $ $ DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS ADDED AS AN ADDITIONAL INSURED, DURING THE POLICY PERIOD, AS PER CG 20 10, BUT ONLY AS RESPECTS TO WORK PERFORMED BY THE INSURED. CERTIFICATE HOLDER I X I ADDITIONAL INSURED' INSURER LETTER: A CANCELLATION CITY OF SAN JUAN CAPISTRANO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10DAYS 32400 PASEO ADELANTO WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO SAN JUAN CAPISTRANO, CA 92675 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUFHORQED REPRESENTATIVE ACORD 26S (7197) 0ACORD CORPORATIO 7988 ACORD 25S (7/97) MAY 14 2004 13:35 FR • POLICY NUMBER: 1 -680 -1398N704 -TIL -04 5098357061 TO 994931053 P. 02102 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 03-11-04 THIS ENDORSEMENT CHANGES THE POLICY- PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following! COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANTO SAN JUAN CAPISTRANO CA 92675 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II — Who Is An Insured is amended to such work, on the project (other than ser - include as an insured the person or organization vice, maintenance or repairs) to be per - shown in the Schedule, but only with respect to formed by or on behalf of the additional liability arising out of your ongoing operations per- insured(s) at the site of the covered op - formed for that insured erations has been completed; or B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to 'bodily in- jury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with CG 20 10 10 01 (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ® ISO Properties Inc., 2000 Page 1 of 1 ** TOTAL PAGE.02 ** MAY 14 2004 13:35 FR 0 M-avelers Traveler Service Curter P.O. Box 1515 Spokane, WA 992101515 Fax 5099357061 TO 09494931053 P.01i02 Phone: 18881661.3938 Fax. 18771 662.6091 Hours: 5:00 AM - 5.00 PM PST Mon. -Fn. hR�ylservlcecenter .trovaleik„com To: Maria From: I Amanda Fax: 949-493-1053 Pages: 2 pages including cover Phone: Date: 5/14/04 Re: Attn: []Urgent ❑ For Review ❑ Please Comment El Please Reply ❑ Please Recycle • Comments: Reg. No.: 506589240161531 4 City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA, 92675 (949) 493-1171 Fax: (949) 493-1053 FAX TRANSMISSION COVER SHEET Date: To:(( Fax. ffoS-) Sender: YOU SHOULD RECEIVE PAGE(S), INCLUDING THIS COVER SHEET. IF YOU DO NOT RECEIVE ALL THE PAGES, PLEASE CALL (949) r/1 1z641 -57v Cfe�0-77,1�C'zic yyf3 - I0-5 3 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493.1171 (949) 493-1053 FAX www sanjuancap istrano. org March 2. 2004 Accelerated Imaging Services 103 North Pointe Lake Forest, CA 92630 Jtwo (✓/✓J/�� 1MORRORRIIA � FSIR ell SRfO � I96i 1776 RE: Compliance with Insurance Requirements — Imaging Services The following insurance documents are due to expire: ✓ General Liability Certificate 04/24/2004 MEMBERS OF THE CITY COUNCIL CITY MANAGER DIANE L. BATHGATE JOHN S. GELFF WYATT HART JOE SOTO DAVID M. SWERDLIN DAVE ADAMS ✓ General Liability Endorsement Form naming the City of San Juan Capistrano as additional insured. ✓ Automobile Liability Certificate 05/01/2004 Please submit updated documentation to the City of San Juan Capistrano, attention City Paseo Adelanto, San Juan Capistrano, CA 92675 by the above )u have any questions, please contact me at (949) 443-6309. cc: Dawn M. Schanderl, Administrative Assistant San Juan Capistrano: Preserving the Past to Enhance the Future • Policy Number: 680-1398W704 • Date Entered: 4/24/2004 ACORD„tl CERTIFICATE OF LIABILITY INSURANCE DATE IM2 YYYYI 4/a6//zoos PRODUCER BLUE SKY INSURANCE AGENCY 3713 ALAMO STREET 2ND FLOOR SIMI VALLEY CA 93063 LICENSE # OD94590 (805)578-3883 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED ACCELERATED IMAGING SERVICES 103 N. POINTE LAKE FOREST, CA 92630 INSURER A TRAVELERS PROPERTY CASUALTY INSURER B: PROGRESSIVE INSURER C: INSURER D. INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IMR ADO' TRDATE POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 * �/ X COMMERCIAL GENERAL LIABILITY 6-139BW 80704 4/24/2004 4/24 2005 / DAMA GETO RENTED PREMISES Ea mwrence $ CLAIMS MADE IN OCCUR MED EXP (My one person) $ 5,000 PERSONAL B ADV INJURY 51,000,000 GENERAL AGGREGATE $ 2.000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2.000,000 POLICY 7PRO- LOC B \/ X AUTOMOBILE LUMMUTY ANY AUTO 0-16-49-664-1 5/1/2004 5/1/2005 COMBINED SINGLE LIMIT $1,000,000 (Ea amdent) BODILY INJURY (Per person) 8100,000 ALL OWNED AUTOS SCHEDULED Auros BODILY INJURY 300,000 HIRED AUTOS NON-0WNED AUTOS (Per accident) $ PROPERTY DAMAGE $ 50,000 (Per amtlant) GARAGE LIABILITY AUTOONLY- EAACCIDENT $ OTHER THAN EAACC $ ANY AUTO AUTO ONLY'. AGG $ ESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 17 CLAIMS MADE AGGREGATE $ E $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND TA'CSTAMITTU- OTH- R E. L EACH ACCIDENT $ EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE EL DISEASE EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yea, desdnbe under SPECIAL PROVISIONS below E. L. DISEASE -POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED: CITY OF SAN JUAN CAPISTRANO 32400 PASEO AOSLANOT SAN JUAN CAPISTRANO, CA 92675 ATTN: CITY CLERK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO AWL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION O&IJAII IUTY 00 -Ng KIND UPON,7fi11NSURER, ITS AGENTS OR t MCPHERSON GEE 18055826191 10/16 '03 11:49 NO -564 02/02 _ Policy Number: A Date Entered, 10/16/2003 ACORDTm CERTIFICATE OF LIABILITY INSURANCE DATE MWWYYYYI 10/16/2003 PRODOcgrt Whilip McPherson Inainriance Agency, Inc - 37" ALANO STREET, 2ND FLOOR SJ UT VALLEY, CA 93063 LICENSE NUMBER: 0650735 (8051582-6188 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, INSURERS AFFORDING COVERAGE NAIL 0 INSURED ACCELERATED IMAGINU 103 N. POINTE, DRIVE LASE FOREST, CA 92630 PGLIGY EXERTION LIM17a INSURER A. FARMERS INBORJNCE INSURER B I INSURER INRURERp- 1 NRURERE. COVF_RAGFS THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM 09 CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE_ MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. KRA0&17POLICY IWOSE NO OBLIGATION OR LIABILITY OR ANY MIND UPON THE INSURAM ITS RENTS OR p POLICY NUMBER EFFECTIVE PGLIGY EXERTION LIM17a GENERA. IJARIJTY EACH OCCURiENCFA 1 COMMERCIAL GENERAI-I-ABILITYS ICIAIMSMADB F71OCCUR M --ED EXP o9n S PERSONAI, A ADV WJURY E _ OENERALAOGREGATP, S GEM.AOGRECJRE LIMIT APIAJFY PM PRODUCTS -COMROP AGO S POLICY LOO AUTOMOBILE I-IAN.ITY ANY AL'10 COMBINED SINGLE LIMB (E"n •ctlEeM) $ BODII V INJURY (Pe,P wN ALL OWM?D AUTOS RCIIFODUD AUTUG 4 HIRED MAGE NON -OWNED AUTOG BODILY INJURY (R•r•°°IC•m) 1 PROPERTY DAMAGE (Per nAildenl) S GARADE LIABILITY AUTO ONLY-FAACCXN;NT S — OTHPR THAN EA ACC ANYAUTO S S AUTO ONLY AGO BXCESRA1MBg5LU1LIABII,ITY FAGM OCCURRENCE S AGGREGATE y OCCUR ❑ CIAMS MADE S y DFDUCTIRF S RETENTION S A WORI@RS COMPENSATION ANO RMMOT'ER0 LUBILITY ANY PR0rYIIETORIPARTNET2X¢CTI F !f0921-35-55 10/28/2003 10/2@/2009 G UTATU• OTH- Or EL. EACH ACCIDENT S ,00 OFyAeeEWW OFRCf:RIL(MBFR F.,TGI U0Ep9 EL.DISFj.OE-EAC-MPI.OYEE S�'•00 ,000 9naer EPF_CIALPROMMONSW. EL DIYEASE•POIJCYUMR , 00 1,000,0015,— S OTHER OTHER DPSCRPTION OF OPERATIONS/ LOCATIONS / VEMCLES/ BXCUISIONS ADDED BY FNOORSETEM /SPECIAL PROVIYXINS CITY OF RAN JOAN CAAIBTRANO ATTN: CITY CLIIAILIR OPPICE @MOULD ANY OF THE ABOVE DESCRIBED POLICIFB BE CANCEILPD BFrDRE THE FApiEwriON DATE TRLRFDF• YW ISSUNO INSURER MLL ENDEAVOR TO AWL 3 0 DAYS WRITTEN NOTICE TO THE CBRTIFICATE MOLDER NAMED TO THP LETT, BUT FAILURE TO DO YO SMALL 32400 8ASEC AnOTnANTO IWOSE NO OBLIGATION OR LIABILITY OR ANY MIND UPON THE INSURAM ITS RENTS OR BAN MAN' CAPISTRANO, CA 92075 REPRESENTATIVES, AUTHORIIED REPRESENTATIVE ACORp 25 (2007/08) ®ACORD CORPORATION 199E MCPHERSON GEE 18055826191 3713 Alamo Street 2nd Floor Simi Valley, CA 93063 Phone: (805) 582-5188 Fax: (805) 582-6191 License #0650725 I =M7,,tv" 10/16 '03 11 0 49 NO.564 01/02 To. City of San Juan Capistrano From: Stacey Fleming Fax: 949-493-1053 Page: 2 Attn: City Clerk's Office Date: 10/16/03 Re: Accelerated Imaging Services CC: ❑ Urgent ❑ For Review D Please Comment X Please Replyli Please Recycle • Comments: Per your request, please fund the attached renewal Certificate of Insurance. If you should have any question, please feel free to contact our office. 32400 PASEO AOELANTO SAN JUAN CAPISTRANO, CA 92575 (949) 493-1171 (949) 493-1053 (FAX) Ivlvly. sanjuancapis)rano. org October 2003 Accelerated Imaging Services 103 North Pointe Lake Forest, CA 92630 MEMBERS OF THE CITY COUNCIL DIANE L SATHGATE JOHN S. GELFF MATT HART JOESOTO DAVID M. SWERDLIN INTERIM CITY MANAGER PAMELAGIBSON RE: Compliance with Insurance Compliance with Insurance Requirements — Imaging City documents— Imaging of City documents The following insurance document is due to expire: ✓ Workers Compensation Certificate 10/28/2003 Please submit updated documentation to the City of San Juan Capistrano, attention City Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above expiration dates. If you have any questions, please contact me at (949) 443-6308. Sincerely, Meg nah n City Jerk cc: William M. Huber, Engineering and Building Director Dawn Schanded, Administrative Assistant San Juan Capistrano: Preserving the Past to Enhance the Future Policy Number: SRX BELOW Date Entered: 6/25/2003 ACORDr DATE(WWDDIYYYI7 CERTIFICA*OF LIABILITY INSURA 8/28/2003 PRODUCER BLUE SKY INSURANCE AGENCY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 3713 ALAMO STREET 2ND FLOOR ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SIMI VALLEY CA 93063 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR LICENSE # OD94590'\f LTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (805)578-3883 vv �� INSU S AFFORDING COVERAGE NAIC # INSURED ACCELERATED IMAGING SERVICES - INSURANCE 1003 SEP INSURERB:TRAVELRRS FARMERS INSURANCE GROUP OF COMPANIES 103 N. POINTEURER .PHILADELPHIA INDEMNITY INSURANCE COMP UTY 4/24/2003 LAKE FOREST, CA 92630 °c 21 C) (Ail CQ`. SAN JUF INSURER E: nnVFRARFR THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR UX) -L 9 OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION l.Rff3 GENERAL LIABILITY EACH OCCURRENCE 1.000,000 5 A �/ /� COMMERCIAL GENERAL LIABIUTV CLAIMS MADE ®OCCUR I-680-139819704 4/24/2003 4(24{2004 pREMI a (300,000 MED EXP (Any one parson) 55,000 PERSONAL S ADV INJURY 51,000,000 GENERAL AGGREGATE 5 2.000, 000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP,OPAGG f 2.000,000 17 POLICY RO- LOC P1FCT AUTOMOBILE LOABILNY COMBINED SINGLE LIMB C ANY AUTO 0-16-49-664-1 5/1/2003 5/1/2004 51,000,000 (EB Bary) BODILY INJURY (Per Pmon) f 100,000 ALL ONMED AUTOS SCHEDULEDAUTOS BODILY INJURY 5300,000 (Pere dw,l) HIRED AUTOS NONOWNED AUTOS PROPERTY DAMAGE 550,000 (Per=iden0 GARAGE LIABILITY AUTO ONLY - EAACCIDENT f OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGO S EXCESS/UMBRELLA I-MBRUTY EACH OCCURRENCE $ OCCUR FICLNMS MADE AGGREGATE f f f DEDUCTIBLE E RETENTION $ WORKERS COMPENSATION AND VA:STAIQRY IT OTH- B EMPLOYERS' LIABBITYr ANY PROPRIETOR/PARTNER, IFCUTNE 0921-35-55-02 10/28/2002 10/28/2003 E.L EACH ACCIDENT S 0 0 . 00 E.L. DISEASE - FAEMPLOYEE S OFFICERIMEMBER EXCLUDED'/ rcyas, Oesaiw uriCx SPECIAL PROVISIONS W. EL. DISEASE - POLICY LIMIT S A OTHERBUSINESS PER.PROP. I -680-1398N704 4/29/2003 4/24/2004 $200,000 D PROFESSIONAL LIAR. PHSD061147 7/24/2003 7/24/2004 EACH CLAIM $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED NAMED AS AN ADDITIONAL INSURED: CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA. 92675 CITY OF SAN JOAN CAPISTRANO 32400 PASEO ADELANTO SAN JOAN CAPISTRANO, CA. 92675 ATTN: CHERYL JOHNSON — CITY CLERX ACORD 25 (2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURE��THE TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDERFL'BIIJLFMCDRE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY E INSUR Iji AGENTS OR AUTHORRED REPRESENTATIVE Mary Mcpheraon / Pnlicv NUmhnr RRR BRAnM ITatn Fntcrcd- R/iR/inn CERTIFIC OF LIABILITY INSU E °"'�'"""°°Y"Y"' ACORD >r al2a1aoo3 PRODUCER BEM SKY INSUMMICE AGENCY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 3713 ALAMO STREET 2ND FLOOR ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SIMI VALLEY CA 93063 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR LICENSE It OD94590 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (805)578-3883 INSURERS AFFORDING COVERAGE NAIC # INSURED ACCELERATED IMAGING SERVICES INSURER A. TRAVELERS INSURANCE INSURER B. FARMERS INSURANCE GROUP OF COMPANIES 103 N. POINTE INSURER C,PHILADSLPHIA INDEMNITY INSURANCE COMP LAY LAKE FOREST, CA 92630INSURER D' 1 INSURER E: OVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWL It= TYPE OF INSURANCETE POLICY NUMBER POLX:Y EFFECTIVE POLICY EXPIRATION IMMODADD LINTS THE LEFT, B /I TO DO 80 ?HALL GENERAL LIABILITY ND I E WSUR AGENTS OR REPRESENTATIVES. EACH OCCURRENCE §1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ®OCCUR I-680-139BW704 4/24/2003 4/24/2004 -NiMAA T Ra �i Dnce f 300,000 PREMISES MED EXP (My "parson) $5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2.000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPrOP AGO $2.000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT C ANY AUTO 0-16-49-664-1 5/1/2003 5/1/2004 $11000,000 (Ea i=a N) BODILY INJURY ALL OWNED AUTOS SCHEDULEDAUTOS (PW pamm) $100,000 BODILY INJURY HIRED AUTOS NON -OWNED AUTOS $300,000 (Per accidan0 PROPERTY DAMAGE 350,000 (Pwam mtl) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT f OTHER THAN EAACC $ ANY AUTO AUTO ONLY'. AGO $ EXCESSIUMBRELLA UA9NTY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE $ f f DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATIM- 0TH. RY LIMITS FR B EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE N0921-35-55-02 10/28/2002 10/28/2003 E.L.EACHACCIDENT f 11000,000 E.L. DISEASE-EAHEMPLOYEE S OFFICERWEMBER EXCLUDED? If yyeeee ee.mm uM SPECIAL PROVISIONS beim E.L. DISEASE - POLICY LIMIT i f A oTIIERBUSINESS PER.PROP. I -680-1398W704 4/24/2003 4/24/2004 $200,000 D PROFESSIONAL LIAB. YRSD061147 7/24/2003 7/24/2004 EACH CLAIM $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED NAMED AS AN ADDITIONAL INSURED: CITY OF SAN JUAN CAPISTRANO 32400 PASSO ADELANTO SAN JUAN CAPISTRANO, CA. 92675 CITY OF SAN JUAN CAPISTRANO 32400 PASSO ADSLANTO SAN JUAN CAPISTRANO, CA. 92675 ATTN, CHERYL JOHNSON - CITY CLERK CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 30 DATE THEREOF, THE ISSUING INSURER WILL FAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER THE LEFT, B /I TO DO 80 ?HALL IMPOSE NO OBLIGATION OR LWBILITY ND I E WSUR AGENTS OR REPRESENTATIVES. AUTHORMED REPRESENTATIVE Mary Mapheraon, G my zD (ZUUTIUD) V 7 -'O ACORD CgWORATION 1988 r MCPHERSON GEE 3713 Alamo t. 2nd Floor Simi Valley, CA 93063 Phone: (805) 578-3883 Fax: (805) 582-6191 18055826191 06/10 '03 14:59 NO.010 01/03 To: City of San Juan. Fax: 949-493-1053 Attn: ,.Till Thomas Ito Accelerated Imaging From: Shelley for Phil Page: 3 Date: 6/10/03 Jill, Please see the attached Certificate of Liability and Additional Insured Endorsement for your review. Please feel free to call me if you have any further questions. Thank You, Best Regards, 5helley Brazelton (shelley@blueskyins.com) MCPHERSON GEE 18055826191 06/10 '03 15:00 NO.010 02/03 Policy Number: I-680-1:1481f7C4 Data Entered: 4/24/2003 ACORD,N CERTIFICATE OF LIAB_IL_ ITN' INSURANCEATE(MWOD M) 6/6/2003 PRODUCER —BLTWSKY INSURANCE AGENCY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 3713 ALAMO STRZXT 2ND FLOOR ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SIMI VALLEY CA 93063 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR LICENSE M OCS3043 _ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (805)570-3883 INSURERS AFFORDING COVERAGE MAIC N INSURED ACCELERATED IMAGING SERVICES INSURER A TRAVELLERS-IN3IIRANCK�—� 103 N. POINTE INSURER G:PHOORS✓STV$ LARK FOREST, CA 92630 INSURER 1) COVERAGES 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, THF INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBIEGT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_ AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID POLICY NUMBER CLAIMS YEEFECTNE NLIGYfiXPIRADON LI61TYliMI1JMOH477Y3� LIMITS INER 0 TYPEOPMOUBME GENERAL LIABILIn' _ __ LAGHLICGHRRENF _DAMADEM $1,000,000 $300,000 A �/ X GOMMF_ROW GENERAL I_IAnILIn' 1-680-139BW704 WWF 4/24/2003 1:4/24/2004 Pa I e �zel CLAIMS MME IN OCCUR MED EXP(MyaR mYMRI f 5'000 -- $1,000,60 1, 00,GENERAL _ y PERSONAL&AOVINJURY GENERAL AGGREGATE $2,000,000 PRDDUCTS-COMPOPAGG GEN'L AGGREGATE LIMIT APPLIFB PER (2,000,000 POLICY PRO .. _ COMBINED SINGLE I W 3/1/2003 5/1/2004 C AOTOMOBILE LABILITY ANY aJTo 0-16-49-664-1 $1,000,000 $100,000 I ALL OWNEDAUTOS SOHEDOLEDAUTOS BOdLYINJURY _ / (PRr Pelson) f 300,000 HIRED AUTOS Non-DNnMeO Auros V e00II.Y INJURY � $50,000 PROPERTY OAMAUF (Per eackbMJ OARAOI LIABILITY --- AUTO ONLY-EAACCIDENT $— 3 ANY AUTO M11ERTMAN EAPOC — y ` AUTO ONLY AZU `y 1.— EACH OCCURRENCE EXCESSIBMRRELLAI LIIIBMJTY $ OCCUR CIAIM6 MADE AGGREGATE __ 9 f f DEDUCTIBIr_ ! RETENTION $ _Tlg 1M17S OTH- 10/28/20021 10/28/2003 El EAGMACCIDENT H INORHPARCONRENBATIONAND'V ImPLOYERs. LIABILITY ANY PROPRIETORIPARTNEREXIECUTNE N0921-35-55-02 f ' y OFFICER/MEMBER F=LIJDFDT LL DISEASE - FAEMFLOYEE )W rIL P IXleel BPFC8W I-PROY18 5 EL d9FA4E •POIJGY I.PAR 6 A orBPRHUSINESS I -680-1390N704 4/24/2003 4/24/2004 $200,000 PERSONAL PROPERTY - DESCRIPTION OF OPERATNJNS f LOCA1gM6IYEHICLES I EXCWEIOMS ADDER BY ENGORGEMENT I9PECl/1L PROYISIONR CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED NAMED AS AN ADDITIONAL INSURED: CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANT0 SAN JUAN CAPTRTRANO, CA. 92675 CERTIFICATE HOLDER CITY OF BAN ,TUAN CAPISTRANO 32400 PASEO ADKLANTO SAN JOAN CAPISTRANO, CA. 92675 ATTN, CHERYL JOXN8ON - CITY CLERK CANCELLATION CMOULD ANY OF THE AeUNP DIESCRISFO POLICIES HE CANCELLED BEFORE THIN EXPIRATION GATE THEREOF, THE ISSURr0 INSURER YALE ENDEAVOR TO MAIL 330 OAVB WRITTEN NOTICE TO THE CEenncw E HOLDER NAMED TO THE E5F T, DBT FAILURE TO 00 80 SHALL BIPOBF NO ODLIOATIDN OR LIABILITY OF ANY KIND UPON TRE INSURER IIs AGENTS OR MYRON= NEYREBEIITATNE Nary Ncpher®on-i'LiQhr�rjcA.4�cr»._ ACORD MCPHERSON GEE 18055826191 POLICY NUMBER: I -680 -139M"04 -TIL -03 06/10 '03 15:00 NO.010 03/03 • COMMERCIAL GENERAL LIABILITY ISSUE DATE: 03-25-03 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY_ ADDITIONAL INSURED --OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement mods ins insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: CITY OF $Alf JUAN CALPTSTWO 32400 aAOm AWMAMO SAN JOAN WISTRANO Ch 92675 (If no entry appears above, information required to complete this endorsement will be shown In the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an Insured the person or organization shown in the Schedule but only with respect to liability arising out of your ongoing operations perforated for that insured. CG 2010 10 93 Copyright. Insurance Services Office. Inc.. 1992 Page 1 of 1 *. Tn rol On= GIG ww 0 0 Dawn Schanderl To: Jill Thomas Subject: Accelerated Imaging Services I transferred a call from Accerlerated to you this am. I told the women to talk to you about the invoicing which she said was submitted prior to the insurance expiring. I wanted to see a copy of invoice as we may be able to release that particular check. Do you have a copy? )Le �p ,YU BILL TO: CITY OF SAN JUAN CAPISTRANO 32400 Paseo Adelanto San Juan Capistrano, CA 92675 ATTENTION: ACCOUNTS PAYABLE PLEASE REMIT PAYMENT TO: • 103 North Pointe Drive Lake Forest, CA 92630 Ph: 949.472.2777 - Fax: 949.472.2780 SHIP TO: INVOICE DATE INVOICE NI 1/13/2003 2003110 CITY OF SAN JUAN CAPISTRANO 32400 Paseo Adelanto San Juan Capistrano, CA 92675 ATTENTION: JILL THOMAS P.O. NUMBER TERMS DUE DATE REP SHIP DATE SHIP VIA -- -- ---- 17681 --- QUANTITY Net 7 1/2112003 JRA --------'--------- 1/14/2003 Vendor ITEM CODE DESCRIPTION RATE AMOUNT 1120 26,230 Scanning - Turn -Key 0.075 1,967.: ENGINEERING TRACT FILES Boxes: SJCETF02122 - SJCETF02135 CD: 10E 1150 273 Scanning - Oversized Documents i 0.991 270.: ENGINEERING TRACT FILES - MAPS CD:10E 1120 4,684 Scanning - Turn -Key 0.075 351.: BUILDING PERMITS Boxes: SJCBP02095 - SICBPO2096 CD: 48 1150 813 Scanning - Oversized Documents 0.991 804.E BUILDING PERMITS - MAPS Rolled Plans: SJCRP02098 - SJCRP02120 CD: 48 12 Boxes of Original Documents Returned. 0 Boxes: SJCETF02122 - SJCEFT02135, SJCBP02095 - SJCBP02096 1150 900 Scanning - Oversized Documents -0.99 -891.( CREDIT DUE ON INVOICE NO. 2002295 Sales Tax - 7.75% 7.75% 193 - - --- Thank Youi For Your Business. TOTAL $2,696 Lwww. infiin iteimagingsystems. com Dawn Schanderl To: Dottie Shaw Subject: Infinite Imaging Infinite Imaging that now goes by the name of Accelerated Imaging Services submitted an invoice dated 1/13/2003 - just before they were added to the nonpay list for expired insurance. The amount of the invoice $2,696 and change (the change part cut off by Jill's copying of invoice). If you have a check in that amount it can be released. However any additional cut checks must be held. They will still be on the nonpay. Please let me know - I will be out the rest of the afternoon from 1:45 on. Boy, this is never easy is it? Anyway I want to thank you for all of your help - I really appreciate it. Dawn Policy Number: I -680-1398W704 Date Entered: 2/11/2003 ACORD-. CERTIFICAT OF LIABILITY INSURA E 3�IMMIDD3"" PRODUCER U E 3713 ALAMO STREET 2ND FLOOR SIMI VALLEY CA 93063 LICENSE # OC83043 (805)578-3883 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED ACCELERATED IMAGING SERVICES 103 N. POINTE LAKE FOREST, CA 92630 INSURER ATRAVELERS INSURANCE INSURER 8: INSURER INSURER D INSURER E: CflVFRArFR THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADVIL h§m TYPE OF INSURANCEPOLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DANA ENTED 300,000 occED PREMISES Ea $ A �/ X COMMERCIALGENERALUABILITY I -680-1398W704 4/24/2002 4/24/2003 5 000 CLAIMS MADE � OCCUR MED EXP (Any one person) $ • PERSONAL S ADV INJURY $1,000,000 GENERAL AGGREGATE $2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOPAGG $2'000.000 1 POLICY 17 PROIpCTLOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea aWden0 $ BODILY INJURY ALL OWNED AUTOS SCHEDULEDAUTOS (Per parson) $ BODILY INJURY HIREDAUTOS NON -OWNED AUTOS (Per amdent) $ PROPERTY DAMAGE E (Per awdentQ GARAGE LIABILITY AUTO ONLY - EAACCIDENT $ OTHER THAN EA ACC E ANY AUTO AUTO ONLY: AGG E EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION E WORKERS COMPENSATION ANDWC STATU- OTH- RYR EMPLOYERS'LMBIDTY ANY PROPRIETORIPARTNERIEXECUTIVE E. L. EACH ACCIDENT E E. L. DIS E -EAE YEE S OFRCERIMEMBER EXCLUDED+ If yes, describe under ZZ SPECIAL PROVISIONS below E.L. DISBRSE-POUCtT&IT E A OTHERBUSINESS I-680-139BW704 4/24/2002 4/24/2003 Gc"J 0,000 PERSONAL PROPERTY s D`!a rn_ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS r CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED v � NAMED AS AN ADDITIONAL INSURED: CITY OF SAN JUAN CAPISTRANO I.A! 32400 PASEO ADELANTO ,gyp t SAN TUAN CAPISTRANO, CA. 92675 ' CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA. 92675 ATTN: CHERYL JOHNSON - CITY CLERK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MNL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Mary Mcpherson Co7cCHU:7 47416T:1:101:FAtCiT; i{:7:7:1 1� r/ -7-C4 lJi(,& • DS To: Our Valued Customers and Vendors From: Jordan R. Angst Date: 2/3/2003 Re: Name Change, Billing and Correspondence Information Effective January 20, 2003, we are proud to announce the merger of Accelerated Imaging, Inc. and Infinite Imaging Systems, Inc.. The name may have changed, but faces have not, plus a few new ones have been added. Along with our current quality suite of document imaging products and services, we will now offer a full -line of outsource data entry services. Please make a note of the following changes for all billing and correspondence information: ACCELERATED IMAGING, INC. 103 North Pointe Drive Lake Forest, CA 92630 Phone: 949.472.2777 Fax: 949.472.2780 www.aimaging.com We appreciate your patronage and are very excited about this merger. If you have any questions in regards to the above changes, please contact: Accelerated trr Accelerated Im Regards, Jordan R. Anast .2777 Ext. 221 � 2777 Ext. 231 0 303 '-J_ 103 North Paint. Lake Forest, CA 92630 Phan.: 949.472.2777 Fax: 949.472.2790 www,ei�iro.. DgvyK-Schanderl To: Shane Moss Subject: Infinite Imaging System FYI: I have not received the updated insurance for Infinite and have placed them on the non -pay list. "Official" notification goes to Bill and Michelle but thought you should know. Also did you happen to locate the letter changing their name back to Infinite? I really do need a copy for file inorder to change over the agreement. Thanks I 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 (FAX) Ivwlv.sanjuancapisirano. org January 22, 2003 Infinite Imaging System 103 N. Pointe Lake Forest, California 92630 C MEMBERS OF THE CITY COUNCIL DIANE L BATHGATE i JOHNS.GELFF MATT HART JOESOTO DAVID M. SWERDLIN / CITYMANAGER l GEORGESCARBOROUGH RE: Compliance with Insurance Requirements - Imaging of City documents The following insurance documents have expired: V General Liability Certificate 1/21/2003 �^ V General Liability Endorsement naming the City of San Juan Capistrano as additional insured. I Automobile Liability Certificate 1/21/2003 V Professional Liability Certificate 1/21/2003 V Workers Compensation Certificate 1/21/2003 Please submit updated documentation to the City of San Juan Capistrano, attention City Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675 by January 31, 2003. If you have any questions, please contact me at (949) 443-6310. Sincerely, Dawn Schanderl Deputy City Clerk cc: William Huber, Director of Engineering & Building Michelle Noreillie, Administrative Assistant DRUG USE IS San Juan Capistrano: Preserving the Past to Enhance the Future MEMORANDUM TO: Memo to File FROM: Maria Guevara, Secretary DATE: September 18, 2003 SUBJECT: Accelerated Imaging Services As of May 2001, Infinite Imaging Systems name changed to HS&A Imaging, Inc. Infinite Imaging System file was closed -out (transfer date 2003) and re -opened as HS&A Imaging Inc. As of September 2003, HS&A Imaging, Inc. name changed to Accelerated Imaging Services. HS&A Imaging, Inc. was closed -out (transfer date 2005) and re -opened as Accelerated Imaging Services.