04-0408_HAMILTON ELKINS, INC._Personal Services AgreementPERSONAL SERVICES AGREEMENT
IS AGREEMENT is made and entered into this '1day of
2004, by and between the City of San Juan Capistrano (hereinafter
reqrred to a
ss the "City") and Hamilton Elkins, Inc., (hereinafter referred to as
"Consultant").
RECITALS:
WHEREAS, City desires to retain the services of Consultant regarding the City's
proposal to provide a Public Works Inspector; 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.
This Agreement shall commence on the effective date of this Agreement and
services required hereunder shall be completed by no later April 2, 2005.
Section 3. Compensation.
3.1 Amount.
Total compensation for the scope of services for this Project shall not exceed
Fourteen Thousand dollars ($14,000), as set forth in Exhibit "A," attached and
incorporated herein by reference.
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3.2 Rate Schedule.
The services shall be billed to the City at the hourly rate set forth in Exhibit "A,"
attached and incorporated herein by reference. Included within the compensation are
all the Consultant's ordinary office and overhead expenses incurred by 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.
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Section 6. Changes to Scope of Work.
0
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.
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
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9
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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.
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 valid for a minimum of one year, or term of
contract, whichever is longer, and it 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;
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$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.
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 to the City Clerk's office 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 Clerk of the Board's office 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 cancelled, 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.
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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' 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: Public Works Director
To Consultant: Hamilton Elkins, Inc.
8711 EI Manor Avenue
Los Angeles, CA 90045
Attn: Brian L. Elkins
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.
9
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.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
CITY OF SAN JUAN CAPISTRANO
By:
David F. Adams, City Manager
CONSULTANT
By. • •
ATTEST:
R. Monahan, City Clerk
APPROVED AS TO FORM:
John R. Slhaw, City Attorney
W:\ENG\MSTRFRM\AGMT\PERSONALSERVICESAGREEMENT HAMILTON&ELKINS.DOC
0
HAMILTON
0
ELKINS
CONSULTING ENGINEERS
February 10, 2004
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan, Capistrano 92675
871 1 EL MANOR AVENUE • Los ANGELES, CA 90045
P 310.429.0900 F 310.910.4506
Attention: Mr. Eric Joseph, Water Operation Manager
Subject: On -Call Construction Inspection Services
Dear Mr. Joseph:
COMPANY INFORMATION
Proposal No. PO4-1004
For your information, Hamilton Elkins, Inc. is an engineering consulting firm recently founded
by Mr. David Hamilton, P.E. and Mr. Brian Elkins, both formerly of Associated Soils
Engineering, Inc. (ASE). Mr. Mathew Steele, Assistant Construction Inspector, is also
employed by our firm and will perform the services mentioned in the preceding proposal
under our supervision and professional review. The engineering team previously proposed
under ASE letterhead consisted entirely of Mr. Elkins and Mr. Steele, therefore project
integrity, scope, and services will remain the same.
Hamilton Elkins, Inc. will provide exemplary services. Our company will be 1) sensitive and
responsive to directions from The City of San Juan Capistrano's Project Engineer, 2) honest,
forthright, and clear in billing and invoicing to The City of San Juan Capistrano, and 3)
dependable with respect to the execution of all project tasks.
In accordance with your request, Hamilton Elkins, Inc. is pleased to submit this proposal of
costs to provide a public works inspector/project manager to work with the City of San Juan
Capistrano on various projects as directed.
EXHIBIT "A"
PROJECT DESCRIPTION
To provide a public works inspector/project manager to work with the City of San Juan
Capistrano on various projects as directed.
SCOPE OF WORK
We understand that the scope of services is to provide a Public Works Inspector/Project
Manager responsible for all final inspection at a rate of $82.50 per hour. At a minimum, our
Public Works Inspector/Project Manager will be on-site on an as -needed basis and when not
necessary an assistant Inspector will be provided at a reduced rate of $70.00 per hour, to
record all construction activities and to be available to the contractor at all times during the
course of the project. The Project inspector's assistant will perform field compaction testing
services as needed and perform sampling of materials for laboratory testing as required
during construction. If necessary, Hamilton Elkins, Inc. will provide testing services for soil
subgrade, base material, concrete and asphalt paving.
SCHEDULE
Hamilton Elkins, Inc. will commence our services, immediately, with your authorization to
proceed. If the proposal fees, terms, and conditions meet with your approval, please issue a
written contract referencing this proposal.
We look forward to providing professional services to you on your current Public Works
project and any forthcoming Public Works Projects. If you have any questions or require
additional information, please contact the undersigned.
Respectfully submitted
HAMILTON ELKINS, INC.
.1--)
/�_ialn LElkins DCavidstruction Manager Principal Engineer
Distribution: Ms. Amy Amirani, Director
Mr. Craig Harris, Assistant Engineer
% S I(DS
SFCQNO R�
CITY CLERK'S DEPARTMENT - ACTION REMINDER Qvi
TO: Craig Harris, Assistant Engineer
FROM: Mitzi Ortiz, Deputy City Clerk DATE: March 1, 2005
SITUATION:
On April 8, 2004, the City of San Juan Capistrano entered into a Personal Services
Agreement with Hamilton Elkins, Inc. to provide a Public Works Inspector.
ACTION REQUESTED:
Said Agreement states services shall be completed by April 2, 2005.
Please notify our office if agreement has been completed or will be extended.
ACTION TO BE TAKEN:
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION: d
DATE SIGNED: _l__[ C J /!J 6
Tickler Date: 03/01/05
Deadline Date: 04/02/05
cc: Department Head
(600.30/hamilton elkins)
"'FOR CITY CLERK'S DEPARTMENT USE ONLY"'
APR 1 5 2CCb
PUBLIC'+f ` S
JAN -26-2005 P.01
02:16
PM
David Hamilton
Pax]
949.493.3955
Posen
2, Including cover
390 AHAPCLA AV[Nu[ 'JSILTG 9, TORHANni, CA 90501
P 31 0.61 0.21 90 F 3 1 0.6 1 B.2 191
HAMILTON
& Associates
D
To:
Mr. Craig Hams
Prom:
David Hamilton
Pax]
949.493.3955
Posen
2, Including cover
Phone
Dela
1/26/05
Re] Insurance Cert CC]
❑ Urgent ❑ Per Revlew ❑ Please Comment ❑ Pleaee Reply ❑ Please Recycle
Comments.,
Craig,
Here is an updated copy of our Insurance.
Thanks, Dave
JAN -26-2005 02:16 PM - P.02
,lar? 28 05 11143a ve Dwight STRTEFRRM 5876680 p,2
Is CERTIFICATE OF INSURANCE
This certifies that ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
❑ STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario
❑ STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida
❑ STATE FARM LLOYDS, Della%, Texas
Insunrs the following Policyholder for the coverages Indicated below:
Policyholder Hamilton L Aasoeiateo, Inc.
Address of policyholder 390 Amapola Ave Suits 9 Torrance, Ch 90501
Location of operations
Description of operations
The policies listed below have been issued to the policyholder for the policy periods shown. The Inaurance described In these Policies ie
subject 10 all the teens exclusions, and conditions of those policies. The limits of Ilabllity shown may have been reduced by any paid claims.
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
If any of the described poiclet are canceled before
Rs expiration date, State Fenn will try to mail a written
notice to the certificate holder 30 days before
Name and Address of Certificate Holder cancellation. If however, we fall to mail such notice,
no obligation or liability will be Imposed on State
CITY OF SAN JOAN CAPISTRANO Farm or its agents or representatives.
ATTN, CRA10 HARRIS
32400 PA$EO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
95"044,4 11.124002 Prexea h U.S.A.
Signature of Authorized Representative
Aa00T 01/26/05
Tlae Data
Agenrx Cede Stamp
AFO Code ?411
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER
TYPE OF INSURANCE
Effective Dab expiration Dab
(at beginning of policy period)
Comprehensive
BODILY INJURY AND
92-XY-2410.5 G
_.. ..-........-
_ Business UabllltY os/1o/2004 j 05/07/2005
........-.. _....
PROPERTY DAMAGE
Thte Insurance in 06111%
... .................
® Products - Completed Operations
® Contractual Liability
❑ Underground Hazard Coverage
Each Occurrence S 2, 000, DDO
❑ Personal In(ury
❑ Advertising In)ury
General Aggregate S 4,000,000
Q Explosion Hazard Coverage
❑ Collapse Hazard Coverage
Products- Completed S 4 , 000, 000
❑ MEDICAL PAYMENTS
Operations Aggregate
POLICY PERIOD
BODILY INJURY AND PROPERTY DAMAGE
EXCESS LIABILITY
Effective Date Explirsdan Dab
(Combined Simple Limit)
4E PS 0000033750
® Umbrella
Each Occurrence $ 1, 000, 000
IM other
02/01/02 07/01/06
Aggregate $2,000,000
Part t STATUTORY
Pan 2 BODILY INJURY
92 Xy 47484 F
Workers Compensation
01/29/05 01/79/06
and Employer% Liability
Each Accident $ ACT Lose SUET
Disease - Each Employee$
Disease - Policy Limit $
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER TYPE OF INSURANCE
Effective Date EiMirall1w Data
(at beginning of policy period)
103 5414 -All -75 Commercial Auto
01/11/2005 07/11/7005
1.000,000 Single Limit LSab
104 2563-725-75 Emp Non owned
12/25/2004 06/25/2005
1,000,000 Single Limit Liab
117 5451-726-75 Commercial AUto
17/76/2005 06/29/7005
1,000,000 Single Limit Limb
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT
OF INSURANCE AND NEITHER
AFFIRMATIVELY NOR NEGATIVELY
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
If any of the described poiclet are canceled before
Rs expiration date, State Fenn will try to mail a written
notice to the certificate holder 30 days before
Name and Address of Certificate Holder cancellation. If however, we fall to mail such notice,
no obligation or liability will be Imposed on State
CITY OF SAN JOAN CAPISTRANO Farm or its agents or representatives.
ATTN, CRA10 HARRIS
32400 PA$EO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
95"044,4 11.124002 Prexea h U.S.A.
Signature of Authorized Representative
Aa00T 01/26/05
Tlae Data
Agenrx Cede Stamp
AFO Code ?411
0
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 FAx
www. sanjuancapistrano. 0 f
January 14, 2005
Hamilton Elkins, Inc.
8711 EI Manor Avenue
Los Angeles, CA 90045
ps
MEMBERS OF THE CITY COUNCIL
RE: Compliance with Insurance Requirements — Public works inspector
The following insurance document is due to expire:
✓ Professional Liability Certificate 2/1/2005
SAM ALLEVATO
DIANE L. BATHGATE
WYATT HART
JOE SOTO
DAVID M. SWERDLIN
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 32499 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
expjrMion date.,lf tqu have any questions, please contact me at (949) 443-6309.
.o
cc: Michelle Perea, Administrative Assistant
San Juan Capistrano: Preserving the Past to Enhance the Future
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493,1171
(949) 4931053 FAX
www.sanjuancapistrano.org
January 6, 2005
Hamilton Elkins, Inc.
8711 EI Manor Avenue
Los Angeles, CA 90045
0
RE: Compliance with Insurance Requirements — Public works inspector
The following insurance document is due to expire:
✓ Workers Compensation Certificate 1/29/2005
i OF THE CITY COUNCIL
SAM ALLEVATO
DIANE L. BATHGATE
WYATT HART
JOE SOTO
DAVID M. SWERDLIN
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk'§ office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
expiion date. Ifou have any questions, please contact me at (949) 443-6309.
Adminisjfative Secretary
cc: Michelle Perea, Administrative Assistant
San Juan Capistrano: Preserving the Past to Enhance the Future
' Mar, 05 04 02:35p St•e Dwight STRTEFRRM 5676680 p.1
CERTIFICATE OF INSURANCE
This certifies that ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
❑ STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario
❑ STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida
❑ STATE FARM LLOYDS, Dallas, Texas
insures the following policyholder for the coverages indicated below:
Name of policyholder HAMILTON ELKINS, INC.
Address of policyholder 8711 EL MANOR AVE, LOS ANGELES, CA 90045-3706
Location of operations
Description of operations
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid
claims.
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
If any of the described policies are canceled before
ADDITIONAL INSURED: Its expiration date, State Farm will try to mail a
clTz of SAN JUAN CAPISTRANO written notice to the certificate holder 10 days before
ATTN: MR. CRAIG HARRIS Cancellation. If however, WB fail to mall such notice,
32400 PASEO ADELANTO no ob" r liability will be imposed on State
SAN JUAN CAPISTRANO, ca 92675 F r i or itsa s or�epr sentatives�— � 7
Agent's
AFO Code 8230
568-M s.3 04-19ea Prktad in USA
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER
TYPE OF INSURANCE
Effective Date Expiration Date
(at beginning of policy period)
92 -W4 -0706-2q
Comprehensive 1 05/10/2004 05/02/2005
BODILY INJURY AND
...
Business Liability
.. .............. -------------'---------
PROPERTY DAMAGE
..........................
This insurance includes:
® Products - Completed Operations
® Contractual Liability
-
❑ Underground Hazard Coverage
Each Occurrence s 2,000,000.00
❑ Personal Injury
❑ Advertising Injury
General Aggregate $ 4, 000, 000.00
❑ Explosion Hazard Coverage
❑ Collapse Hazard Coverage
Products - Completed $
❑
Operations Aggregate
POLICY PERIOD- -
BODILY INJURY AND PROPERTY DAMAGE
EXCESS LIABILITY
Effective Date Expiration Date
(Combined Single Limit)
4E PS 0000033750
Umbrella
Each Occurrence $ 1, 000, 000.00
® Other PROF. LIAS.
02/01/04 02/01/05
Aggregate $2,000,000-00
Part 1 STATUTORY
Part 2 BODILY INJURY
92 XY47484F
Workers'COmpensation
01/29/04 01/29/05
and Employers Liability
Each Accident $ ACT LOSS SUST
Disease Each Employee $
Disease - Policy Limit $
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER
TYPE OF INSURANCE
Effective Date Expiration Date
(at beginning of policy period)
089 5090 D17 75A
COMMERCIAL AUTO
01/26/2004 06/26/2004
51,000,000.00 SINGLE LIMIT
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
If any of the described policies are canceled before
ADDITIONAL INSURED: Its expiration date, State Farm will try to mail a
clTz of SAN JUAN CAPISTRANO written notice to the certificate holder 10 days before
ATTN: MR. CRAIG HARRIS Cancellation. If however, WB fail to mall such notice,
32400 PASEO ADELANTO no ob" r liability will be imposed on State
SAN JUAN CAPISTRANO, ca 92675 F r i or itsa s or�epr sentatives�— � 7
Agent's
AFO Code 8230
568-M s.3 04-19ea Prktad in USA
Mar 05 04 02:35p SWe Dwight STRTEFRRM 56OP76GBQ
CERTIFICATE OF INSURANCE
This certifies that ®
STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
❑
STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
❑
STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario
❑
STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida
❑
STATE FARM LLOYDS, Dallas, Texas
insures the following policyholder
for the coverages indicated below:
Name of policyholder
Address of policyholder
Location Of operations
Description of operations
HAMILTON ELKINS, INC.
6711 EL MANOR AVE, LOS ANGELES, CA 90045-3706
P.1
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid
claims,
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
If any of the described policies are canceled before
ADDITIONAL INSURED: its expiration date, State Farm will try to mail a
CITY OF SAN JUAN CAPISTAANO written notice to the certificate holder 10 days before
CITY: MR. CRAIG HARRIS cancellation. If however, we fail to mail such notice,
32400 MR.PASC AIG HARRIS
ANTO too r liability will be imposed on State
SAN JUAN CAPISTRANO, Ca 92675 r Osage s or repr entatives.
epreaentWA
GENT 3/5/2004
Title Date
Agent's Code Stamp
AFO C8O
558494 a.3 04-ING Printed in USA.
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER
TYPE OF INSURANCE
Effective Date ; Expiration Date
(at beginning of policy period)
92 -W4 -0706-2g
Comprehensive 05/10/2004 05/02/2005
BODILY INJURY AND
Business Liability _ _ _
----------------'-
PROPERTY DAMAGE
----"-"'--...-'-' ..........................'-"•'----
This insurance includes:
® Products -Co m pl eted Operations
® Contractual Liability
❑ Underground Hazard Coverage
Each Occurrence s 2, 000, 000.00
❑ Personal Injury
❑ Advertising Injury
General Aggregate E 4, 000, 000.00
❑ Explosion Hazard Coverage
❑ Collapse Hazard Coverage
Products - Completed s
❑
Operations Aggregate
POLICY PERIOD
BODILY INJURY AND PROPERTY DAMAGE
EXCESS LIABILITY
Effective Date ; Expiration Date
(Combined Single Limit)
4E Ps 0000033750
® Umbrella
Each Occurrence s 1, 000, 000.00
® Other PROF. LIAR.
02/01/04 02/01/05
Aggregate S 2, OD 0, 000. 00
Part 1 STATUTORY
Part 2 BODILY INJURY
92 XY47484F
Workers' Compensation
01/29/04 01/29/05
and Employers Liability
Each Accident $ ACT LOSS SUST
Disease Each Employee $
Disease - Policy Limit $
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER
TYPE OF INSURANCE
Effective Date ; Expiration Date
(at beginning of policy period)
069 5090 D17 75A
COMMERCIAL AUTO
01/26/2004 06/26/2004
51,000,000.00 SINGLE LIMIT
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
If any of the described policies are canceled before
ADDITIONAL INSURED: its expiration date, State Farm will try to mail a
CITY OF SAN JUAN CAPISTAANO written notice to the certificate holder 10 days before
CITY: MR. CRAIG HARRIS cancellation. If however, we fail to mail such notice,
32400 MR.PASC AIG HARRIS
ANTO too r liability will be imposed on State
SAN JUAN CAPISTRANO, Ca 92675 r Osage s or repr entatives.
epreaentWA
GENT 3/5/2004
Title Date
Agent's Code Stamp
AFO C8O
558494 a.3 04-ING Printed in USA.
STi TE FARM
�\Y
INSURANCE
State Farm
Specialty Products
CERTIFICATE OF INSURANCE
ISSUE DATE: April 27, 2004
Producer
THIS CERTIFICATE IS ISSUED AS A MATTER OF
STEVEN H DWIGHT
INFORMATION ONLY AND CONFERS NO RIGHTS UPON
STEVEN H DWIGHT STATE FARM AGENCY
THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
4625 E ANAHEIM STREET
NOT AMEND, EXTEND OR ALTER THE COVERAGE
LONG BEACH, CA 90804-3122
AFFORDED BY THE POLICIES BELOW.
INSURER AFFORDING COVERAGE
Producer Code #: 758230
STATE FARM FIRE AND CASUALTY COMPANY
Insured
BLOOMINGTON, IL
HAMILTON ELKINS, INC
8711 EL MANOR AVENUE
LOS ANGELES, CA 90045
COVERAGES
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 POLICY(IES) DESCRIBED HEREIN IS SUBJECT TO
ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY
PAID CLAIMS.
POLICY NUMBER
POLICY EFFECTIVE DATE
POLICY EXPIRATION DATE
PS 0000000337500
January 29,
2004
January 29, 2005
TYPE OF INSURANCE
LIMIT OF LIABILITY
ARCHITECTS & ENGINEERS PROFESSIONAL LIAB
$1, 000, 000. o0 Limit of Liability Each Claim
$1, 000, 000. o 0 Total Limit of Liability
CERTIFICATE HOLDER
CANCELLATION
CITY OF SAN JUAN CAPISTRANO
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
ATTN: MR. CRAIG HARRIS
CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
32400 PASEO ADELANTO
THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30
SAN JUAN CAPISTRANO, CA 92675
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE
SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIN
UPON THE INSURER, ITS AGENTS OR REPRESENT IV S.
AUTPORIZED REPRES ATIVE
CERT(Rev4) (01/01)
May 05 04 07:25a SteDwight STRTEFARM 5625680 P.2
aa0s COIWRCIAL FAd ®001
SH POIICy NO. 92-W -0706-2 EFFECTIVE APRIL 13 2004 FE0493
(S9r)
ADDITIONAL INSURED ENDORSEMENT
Controlling Interest
Polity No.: 92-144-0706-2
NamedInsured: HAM::LTON RLRINS INC
Name of Person or Or)anization: CITY OF SAN JUAN CAPISTEANO
C/O CRATO HARRIS
32400 PASEO ADELANTO
SAN MOAN CAPISTRANO CA 92675
WHO IS AN INSLRED, under SECTION II
DESIGNATION OF INSURED, is amended to inClude
as an insured the p(rson Or organization shown
above, but only with res 7eot to their liability arising out
of
1. their financial cont of of you; or
2. Premises they awn, maintain or control while you
lease or occupy those premises.
This insurance does not apply to structural alterations,
new construction or demolition operations performed
by or for that person or organization.
FENOs
(5191) PMtEdln U.S.A
•
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493.1171
(949) 493-1053 FAX
www.sanjuancapistrano.org
May 5, 2004
Brian L. Elkins
Hamilton Elkins, Inc.
8711 EI Manor Avenue
Los Angeles, CA 90045
Dear Sir or Madam:
i
(r'�yj IAUAPIIIiFI
EST AILISHED I I96I
1776
MEMBERS OF THE CRY COUNCIL
SAM ALLEVATO
DIANE L. BATHGATE
WYATT HART
JOE SOTO
DAVID M. SWERDLIN
An original, executed Personal Services Agreement related to providing a Public Works
Inspector is enclosed for your records.
Thank you for maintaining your insurance documentation current with our office. Please
keep in mind it must remain current, or all work under this agreement must stop and all
payments for services rendered will be withheld, until these documents are brought
current.
You may proceed with work under this agreement in coordination with the Project
Manager, Craig Harris, Assistant Engineer (949) 487-4305.
Thank you,
Nan. CMC
cc: —Craig Harris, Assistant Engineer
Amy Amirani, Public Works Director
San Juan Capistrano: Preserving the Past to Enhance the Future
C
32400 PASEO ADEI—ANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 FAX
ww tsanjuancapistrano.oi
April 8, 2004
Brian L. Elkins
Hamilton Elkins, Inc.
8711 EI Manor Avenue
Los Angeles, CA 90045
Dear Sir or Madam:
J`m(0 RvoR RTE
�
1776
Is1961 i 1776 "
MEMBERS OF THE CITY COUNCIL
SAM ALLEVATO
DIANE L. BATHOATE
WYATT HART
JOE SOTO
DAVID M. SWERDLIN
A Personal Services Agreement related to providing a Public Works Inspector is in the
process of being executed. It will be issued upon receipt of required documentation
related to contract terms under Section 14. Insurance. Specifically, we have not
received the required additional insured endorsement to your general liability and
umbrella liability policies — which is to name the City of San Juan Capistrano as
Additional Insured. This must be a separate endorsement form.
I have enclosed a copy of this requirement. Insurance evidence may be faxed to (949)
493-1053 — ATTENTION CITY CLERK -- followed by original signed documents. I have
enclosed a copy of the agreement terms for your reference in supplying this
documentation.
If you have questions specific to the contact, please contact the project manager, Craig
Harris, Assistant Engineer (949) 487-4305. Please call Maria Guevara, Secretary, (949)
443-6310 if you have questions regarding the forms of insurance needed.
Thank you,
v _
Me ona an, CMC
Cit Clerk
cc: Craig Harris, Assistant Engineer
Amy Amirani, Public Works Director
San Juan Capistrano: Preserving the Past to Enhance the Future
0 0
$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.
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 to the City Clerk's office 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 Clerk of the Board's office 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 cancelled, 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.
•
Maria Guevara
From: Craig Harris
Sent: Thursday, April 08, 2004 12:21 PM
E�
To: Maria Guevara
Subject: RE: Insurance
�(Ple `�u�B+Se�,ewf
Hi Maria, _
The agent said they will fax this back today. �lie
Craig L. Harris k(�Cf4 L p
-----Original Message-----
From: Maria Guevara _ IU
Sent: Thursday, April 08, 2004 11:39 AM
To: Craig Harris
Subject: Insurance
Hi Craig,
For the new agreement with Hamilton Elkins, Inc. we need the endorsement form naming the City
as an additional insured and their professional liability.
Maria Guevara, Secretary
City of San Juan Capistrano
City Clerk Division V IA
(949) 443-6309 10U V"`�
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