03-1230_RBF CONSUTLING_Personal Services Agreement0 0
PERSONAL SERVICES AGREEMENT
THIS AGREEMENT is made and entered into this day of Dom�003,
by and between the City of San Juan Capistrano (hereinafter referred to as the "City")
and RBF CONSULTING, (hereinafter referred to as "Consultant").
RECITALS:
WHEREAS, City desires to retain the services of Consultant regarding the City's
proposal to provide structural engineering review services for the Terminal Reservoir
No. 2 Replacement Project; 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 no later than June 5, 2004.
Section 3. Compensation.
3.1 Amount.
Total compensation for the scope of services for this Project shall be for a lump
sum of Fourteen Thousand dollars ($14,000) as set forth in Exhibit "A," attached and
incorporated herein by reference.
3.2 Rate Schedule.
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The services shall be billed to the City as 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.
Notwithstanding the payment terms outlined in Exhibit "A", 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.
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. Consultant shall
complete the Scope of Services as set forth in the schedule included in Exhibit "A",
attached and incorporated herein by reference.
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.
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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 resulting from 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 policylpolicies 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: Paul Young
RBF Consulting
14725 Alton Parkway
Irvine, CA 92618-2027
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.
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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.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
ATTEST:
ji. kl---
R. Monahan, City Clerk
APPROVED AS TO FORM:
John R. Maw, City Attorney
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CITY OF SAN JUAN CAPISTRANO
By: &�
City Manag
CONSULTANT
By: /� e4"
RBF Consulti
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. .
CONSULTING
December 3, 2003
Mr. Peter Salgado, P.E.
Associate Engineer
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
10-102896
Subject: Proposal for Structural Plan Checking and Constructibility Review, Terminal Reservoir
No. 2 Replacement Project.
Dear Peter:
RBF Consulting is pleased to submit this proposal to provide the City with the structural plan checking and
constructibility review of construction documents for the Terminal Reservoir No. 2 Replacement Project. As
outlined below RBF has extensive pre -stressed concrete reservoir design experience and looks forward to
providing the City a quality, timely review of the reservoir plans specifications.
Project Understanding:
This proposal is to provide the City with structural plan checking services for the proposed Terminal Reservoir
No. 2 Replacement Project. The scope includes review of the plans, specifications and structural calculations
for the pre -stressed concrete reservoir.
The new partially buried reservoir, Terminal Reservoir No. 2, will be constructed at the northerly end of the site,
partially overlapping the abandoned Terminal Reservoir No. 1. Construction of the new 6 MG reservoir will
require removal of Reservoir No. 1 and temporary cut slopes and slope stabilization measures to create
adequate work area for construction of the reservoir.
Project Review Methodology:
The goal of the review process is to assure the replacement reservoir design is in compliance with current
design codes in addition to being constructible, cost effective and functional. RBF Consulting will accomplish
this through a systematic approach to the review, which raises any significant concerns early in the design
process, prior to any significant final design efforts. Our approach will review critical documents and information
at the appropriate time in the design process as follows:
PLANNING 0 DESIGN ■ CONSTRUCTION
14725 Alton Parkway, Irvine, CA 925162027 m P.O. Boz 57057, Irvine, CA 926197057 ■ 949.472.3505 • Fax 949472.8373
Offices located throughout Caldomia, Arizona & Nevada ■ w ,RBF.
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50% Construction Document Review- The 50% submittal should include complete unchecked structural plans
and submittal of the Final Geotechnical Report. This review will look at the format and completeness of the
structural plans and proposed details for constructibility.
90% Construction Document Review — This will be a detailed review of the final structural calculations, plans
and specifications for conformance to the design criteria and review of the cost estimate unit prices. The 90%
submittal should be a complete submittal, ready for bid. Comments will be returned to the City in an organized
outline format and marked on the documents returned to the City.
Fina( Back Check of the Construction Documents - This will be performed to ensure all review comments have
been implemented or adequately addressed.
Qualifications:
RBF has extensive experience in the analysis and design of concrete reservoirs, both above and below grade,
including conventionally reinforced and circular pre -stressed reservoirs. RBF has recent design experience on
over 20 reinforced concrete reservoirs including the following:
- Las Flores Reservoir (Two 10 MG Prestressed Reservoirs, SMWD)
- Date Street Reservoir (10 MG Prestressed Reservoir, RCWD)
- Northwood Reservoir (Two 5 MG Pre -stressed Reservoirs, IRWD)
- Hilltop Reservoir (1.2 MG Pre -stressed Reservoir, City of Signal Hill)
- South County Reservoir (3 MG Pre -stressed Reservoir, SMWD)
- North Reservoir (2.5 MG Prestressed Reservoir, LBCWD)
We encourage you to contact the following references regarding our structural reservoir design capabilities:
Mr. Steve Malloy
Principal Engineer
Irvine Ranch Water District
(949)453-5570
Mr. Dan Ferrons
Chief Engineer
Santa Margarita Water District
(949) 459-6590
The Structural Design Review will be lead by Mr. Sal Sheikh, P.E., with 27 years of structural engineering
experience, focused primarily in the area of water resource structures. His experience includes the design of
above grade and below grade reinforced concrete reservoirs, both pre -stressed and conventionally reinforced,
steel reservoirs, pump stations, lift stations, and wastewater treatment facilities. Mr. Sheikh was either the
design engineer of record or performed the quality control review on each of the pre -stressed concrete
reservoirs listed above. Mr. Sheik also has extensive experience in the preparation of specifications foi
concrete reservoir construction, including specifications for over 20 concrete reservoirs.
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Schedule:
We will complete the reviews in the time frame summarized below. Please notify us two weeks prior to any
submittals. This will allow us to property schedule staff availability for each of the review phases.
- 50% CD Review 2 weeks
- 90% CD Review 3 weeks
- Back Check Review 1 week
Scope and Fee:
RBF will perform the design review services outlined in the attached Exhibit "A" for a total fee of $14,000 as
outlined in the attached Exhibit "B"
RBF has the qualifications and resources to perform the requested design review of the Terminal Reservoir No.
2 Replacement within the scheduled time frames proposed by the City. Should you have any questions or need
additional information please contact me at (949) 855-3641.
We look forward to the opportunity to work with you on this project.
Sincerely,
gyp,,• ,
el
Paul R. Young, S.E.
Vice President
Structural Engineering
PC: Larry Gallery, RBF
Jermone Ruddins, RBF
Accounting, RBF
Enclosures:
Exhibit "A" Scope of Services
Exhibit "B" Compensation
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EXHIBIT "A"
SCOPE OF SERVICES
The Client (City of San Juan Capistrano) and Consultant (RBF Consulting) for a mutual consideration
hereinafter set forth agree as follows:
The Consultant agrees to perform the following services:
Task 1 50% Construction Document Review
This task is based upon receiving complete structural plans presenting the reservoir layout and
construction details of the prestressed concrete reservoir. This review will focus on
completeness of the plans and proposed construction details from a constructibility aspect.
Particular attention will be given to joint locations, spacing and details; water stop details; wall
and slab opening locations and details; footing types and details; reinforcing congestion and
details with respect to concrete placement and vibration; and concrete placement sequence.
RBF will prepare a memorandum summarizing the review comments.
Task 90% Construction Document Review
This task is based upon receipt of structure plans, calculations, specifications and cost
estimate complete and ready for bidding. RBF will initially review the submittal package to
determine that 50% review comments have been addressed and the submittal package is
complete and ready for review. RBF will then perform a detailed review of the structural
calculations for conformance to the established design criteria; review of the plans for
completeness, clarity and constructibility; review of the structural special provisions; and review
of the cost estimate unit prices. The review will include the reservoir design and the attachment
and details for ladders, outlet piping and other appurtenances. RBF will prepare a
memorandum summarizing the review comments.
Task 3 Final Back Check of Construction Documents
RBF will perform a final review of the bid package to confirm that all comments
have been adequately addressed. The cost of multiple reviews for 90% review
comments not adequately addressed is not included in the scope of this
proposal.
Exclusions;
Review of incomplete submittal packages or multiple reviews for comments that are not adequately
addressed.
Structural review of temporary tie -back retaining walls
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EXHIBIT "B"
Client agrees to compensate Consultant for such services as follows:
The Consultant will perform the services outlined in the Scope of Work and shall invoice the
Client monthly on a percent complete basis, not to exceed the total lump sum fee shown below
without prior authorization, plus the direct costs of reimbursable expenses.
Task Descriotion
Fe&
1 50% Construction Document Review
2,800
2 90% Construction Document Review
8,700
3 Final Back Check of Construction Documents
2.400
TOTAL PROFESSIONAL FEE
$13,900
Estimated Reimbursable Expenses
100
TOTAL FEE (LUMP SUM)
$14,000
FR6-m:
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CITY CLERK'S DEPARTMENT - ACTION REMINDER
Peter Salgado, Senior Civil Engineer
Mitzi Ortiz, Deputy City Clerk
SITUATION:
DATE: February 15, 2005
On December 30, 2003, the City of San Juan Capistrano entered into a Personal Services
Agreement with RBF Consulting to provide engineering review services for the Terminal
Reservoir No. 2 Replacement Project.
ACTION REQUESTED:
Agreement states services provided shall be completed no later than June 5, 2004.
On May 3, 2004, agreement extended to December 2, 2004.
On November 3, 2004, agreement extended to January 2, 2005.
On December 21, 2004, agreement extended to February 1, 2005.
On January 17, 2005, agreement extended to March 1, 2005.
Please notify the City Clerk's office if agreement has been completed or if there is a need to
extend the time period.
ACTION TO BE TAKEN:
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION:
DATE SIGNED: 0—//ca/�4
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
Tickler Date: 05/03104 11/01/04 12115/04 01/17/05 02/15/05
Deadline Date: 06/05/04 12/02/04 01/02105 02/01/05 03/01/05
(600.30/rbO
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CITY CLERK'S DEPARTMENT - ACTION REMINDER
Peter Salgado, Senior Civil Engineer
01i Mitzi Ortiz, Deputy City Clerk DATE: January 17, 2005
` SITUATION:
On December 30, 2003, the City of San Juan Capistrano entered into a Personal Services
Agreement with RBF Consulting to provide engineering review services for the Terminal
Reservoir No. 2 Replacement Project.
ACTION REQUESTED:
Agreement states services provided shall be completed no later than June 5, 2004.
On May 3, 2004, agreement extended to December 2, 2004.
On November 3, 2004, agreement extended to January 2, 2005.
On December 21, 2004, agreement extended to February 1, 2005.
Please notify the City Clerk's office if agreement has been completed or if there is a need to
extend the time period.
ACTION TO BE TAKEN: i�e7t;P-yJ
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION:
DATE SIGNED: ///9'
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
Tickler Date: 05/03/04 11/01/04 12/15/04 01/17/05
Deadline Date: 06/05/04 12/02/04 01/02/05 02/01/05
cc: Department Head
(600.30/rbo
ACORD CERTIFICATODF LIABILITY INSURANCO OP ID DATE (MMIDD VYYY1
RBFCO-1 06/27/05
PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATIO
United Captive Ins.
17151 Newhope St.,
Fountain Valley CA
Phone:714-708-4370
Brokers
Ste 211
92708
Fax:714-701toGEIVED
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE NAIC9
INSURED
RBF consulting, Inc.
14725 Alton Parkway
Irvine CA 92718
JOL P bt O
CITY CLERK
INSURER A[ U.S. Fidelity and Guaranty o.
NSURER B.
INSURER C.
INSURER D:
UNSURER E:
COVERAGES
GENERAL LIABILITY
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE EFFECTIVE
POLICY EXPIRATION
DATE MWDDN—EXPIRATION
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $
PREMISES Ea occuranca $
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE D OCCUR
MED EXP (Any one person) S
PERSONAL S ADV INJURY E
GENERALAGGREGATE $
GEN'L AGGREGATE LIMITAPPLIES PER:
PRODUCTS - COMP/OP AGO S
POLICY PE0. LOC
AUTOMOBILE
LIABILITY
ANYAUTO
COMBINED SINGLE LIMB $
(Ea accident)
BODILY INJURY E
(Per person)
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY accident) E
(Per accMent)
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE S
(Per accident)
GARAGE LIABILITY
AUTO ONLY- EA ACCIDENT S
OTHER THAN EAACC $
ANYAUTO
AUTO ONLY AGO $
EXCESSIUMBRELLALIABILITY
EACH OCCURRENCE E
AGGREGATE $
OCCUR D CLAIMS MADE
$
DEDUCTIBLE
$
RETENTION $
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
D123WO0118
07/01/05
07/01/06
XTORY UMTS GER
E.L. EACH ACCIDENT $1000000
__—
EDISEASE- EA EMPLOYE E1000000
R/MEMBER EXCLUDED?
ifye.
Syes, tleSP`Z0 Untler
SPECIAL PROVISIONS below
EL.DISEASE- POLICY LIMIT $1000000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
*10 days notice of cancellation for non-payment of premium.
CERTIFICATE HOLDER CANCELLATION
CITYSJC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of San Jaun Capistrano IMPOSE NO OBLIGATION OR LIABILITY OFANY KIND UPON THE INSURER, ITS AGENTS OR
Dir. Admin. Services
32400 Paseo Adelante REPRESENTATIVES.
San Juan Capistrano CA 92675 AUTHORIZED REPRESENTAT
Mark Barrie
ACORD 25 12001/081 ®ACORD CORPORATI N 1
L llentrf: AIIIIIII, AEWLIVNbUL
ACORD. CERTIFIC OF LIABILITY INSU 11/291
NCE MIDD YY)
11/29/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO
Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P. O. Box 10550 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Santa Ana, CA 92711-0550,
714 427-6810 INSURERS AFFORDING COVERAGE
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
INSURED
RBF Consulting
PO Box 57057
Irvine, CA 92619-7057SURER
INSURER A:
Travelers Property Casualty Co of Am
INSURER B:
Hartford Fire Ins. Co.
INSURERc:
Fireman's Fund Insurance CO.
D
Underwriters at Llovd's of London
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.
INSRrypE
LT
OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE fMMMDtM
POLICY EXPIRATION
DATE (MMITID"I
LIMITS
A
I GENERAL LIABILITY
P630SOOD409204
11/30/04
11/30/05
EACH OCCURRENCE
$1000000
FIRE DAMAGE (My one fire)
$1009000
X ,COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
INDP. CONTRACTORS
MED EXP(Anyooe person)
$5000
PERSONAL $ ADV w.IueY
a1000000
X_iCONTRACTUAL__ ,__
INCLUDED
GENERALAGGREGATE
$2 000 000
X 1BFPCXCU
GEN'L AGGREGATE LIM ITAPPLIES PER:
PRODUCTS-COMP/OP AGO
_
x2,000,000
POLICY X PEO- CT XJ LOC
- _-
B
AUTOMOBILE LIABILITY
X ANY AUTO
57UENTLO126
11/30/04
11/30/05
COMBINED SINGLE LIMIT
(Ea aooidenl)
$1,060,060
BODILY INJURY
(Par person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
-
BODILY INJURY
(Per accident)
$
X HI R ED AUTOS
X NON -OWNED AUTOS
i
PROPERTY DAMAGE
(Per acct J)
$
-
LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
�GARAGE
� ANY AUTO
$
AUTO ONLY'. AGG
C
EXCESS LIABILITY
XSM00086597721
11/30/04
11/30/05
EACH OCCURRENCE
$1 O O00 900
_ X OCCUR - J CLAIMS MADE
Professional Llab.
AGGREGATE
x10,000, 000
_
$
is Excluded
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
WCSTATU-7--To—TIL
EMPLOYERS' LIABILITY
EL EACH ACCIDENT
$
E.L. DISEASE -EA EMPL OVEE
$
E.L. DISEASE-POLICYUMIT
$
D
OTHER Professional
P1049400
11/30/04
111/30/05
$1,000,000 per claim
lability
$2,000,000 annl aggr.
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECML PROVISIONS
General Liability policy excludes claims arising out of the performance of professional
services
All Operations as performed by the named insured.
City of San Juan Capistrano is Additional Insured as respects to General
(See Attached Descriptions)
City of San Juan Capistrano
Att: city Clerk's Office
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
SHOULD ANYOF THE MOW DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL AAR5A$DAXiP MAIL 30__ DAYS WRITTEN
NOTICE TO TH E CERTIFICATE H OLD ER NAM ED TO TH E LEFT, BKK5AL W)DrjjAAAAMNAX
ACORD 25-S (7/97)1 Of 2 #M115917 - I -° .. —1 —W r.1-`1-1FBG o ACORD CORPQF*LTION 1988
DE IPTIONS (Continued from P'�e 1)
Liability.
AMS 25.3 (07197) 2 of 2 #M715917
0 0
POLICYNUMBER: P630500D409204 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES or
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of San Juan Capistrano
Att: city Clerk's Office
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.)
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 work" for that insured by or for you.
CG 20 10 11 85
AC RD CERTIFIC OF LIABILITY INSURA DP ID DATE(107/VYY)
RBFCO-1 07 07 04
PRODUCER THIS CERTIFICATE SUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
United Captive Ins. Brokers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
17151 Newhope St., Ste 211 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fountain Valley CA 92708
Phone: 714-708-4370 Fax:714-708-2300 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A. U.S. Fidelity and Guaranty do.
INSURER B:
RBF Consulting
14725 Alton Parkway
Irvine CA 92718
LaT4Y=I:T_TVT*9
INSURER C:
INSURER D:
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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
.UK
LTR
W.
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLIGYEFFECT7VE
DATE MM/DD/YY
POLICYIE)(PIRATION
DATE MWDD
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $
PREMISES Ee ocotoence $
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ❑ OCCUR
MED EXP (Any one Person) $
PERSONAL B ADV INJURY f
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG f
POLICY EjE LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT S
(Ea waJent)
BODILYrPw INJURY S
(Per person)
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY S
(Par acatlenU
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE f
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT S
OTHER THAN EA ACC S
ANYAUTO
--
AUTO ONLY: AGO f
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE f
OCCUR CLAIMS MADE
AGGREGATE f
f
f
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
X TORY LIMITS ER
A
EMPLOYERIETOR/PAR
ANY PROPRIETOR/
D123W00096
07/01/04
07/01/05
E.L. EACH ACCIDENT $1000000
E.L. DISEASE - EA EMPLOYEE f lOOOOOO
OFFICER/MEMBER EXCLUDED'!
EXCLUDED?
K yes, tl L oftePRO ISIO
SPECIAL PROVISIONS DaIow
E.L. DISEASE -POLICY LIMIT I f1000O00
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLE$ I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
*10 days notice of cancellation for non-payment of premium.
CERTIFICATE HOLDER CANCELLATION
City of San Jaun Capistrano
Dir. Admin. Services
32400 Paseo Adelante
San Juan Capistrano CA 92675
CITYSJC I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAMOI
DATE THEREOF, WE ISSUING INSURER WILL EMAIL *30 DAYSWRIITEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SWILL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
n
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 FAX
www.sanjuancapistrano.org
June 2, 2004
IA(AAIAAItFA
• tsremsxn � I961
1776
Robert Bein, William Frost & Associates
14725 Alton Parkway
Irvine, CA 92618-2069x
MEMBERS OF THE CITY COUNCIL
SAMALLEVATO
DIANE L. BATHGATE
`MIATT HART
JOE SOTO
DAVID M. SWERDLIN
RE: Compliance with Insurance Requirements — Plan Check Services/Corrosion
Protection Agreements
The following insurance documents are due to expire:
J Workers Compensation Certificate 07/01/2004
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 324001faseo Adelanto, San Juan Capistrano, CA 92675 by the above
expilAtion dates,..;if have any questions, please contact me at (949) 443-6309
cc: Dawn Schanded, Administrative Assistant
San Juan Capistrano: Preserving the Past to Enhance the Future
ClienA55
•RBFCONSUI
ACORD,N CERTIFICATE OF LIABILITY
INSURANCE
DATE12/221030n r1
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dealey, Renton & Associates
P. O. Box 10550
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Santa Ana, CA 92711.0550
POLICY EXPIRp TIONLTR
714 427.6810
INSURERS AFFORDING COVERAGE
INSURED
RBF Consulting
PO Box 57057
INSURER A: Travelers Indemnity Co. of Illinois
INSURER B: Hartford Fire Ins. Co.
INSURER c: Fireman's Fund Insurance Co.
Irvine, CA 92619-7057
—'-------� _- --� --- ---"
WSURER D: Underwriters at Lloyd's London
NSURER E:
X COMMERCIAL GENERAL LIABILITY
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRp TIONLTR
LIMn$
A
GENERALUABILITY
P63050OD409203
11/30/03
11/30/04
EACH OCCURRENCE $1060000
FIRE DAMAGE (My one firs) $1000000
X COMMERCIAL GENERAL LIABILITY
cLAIMSMADE QX OCCUR
INDP.CONTRACTORS
MED EXP (AM .pereml $5000
PERSONAL&ADVIWURY_ $1,000,000
X CONTRACTUAL
INCLUDED.
X BFPD, XCU, OCP
GENERAL AGGREGATE s2 006 000
GENL AGGREGATE LIM IT APPLIES PER:
PRODUCTS-COMP/OPAGG 12000000
POLICY X PRo- X LOC
JFCT
B
AUTOMOBILE
X
LIABILITY
ANY AUTO
57UENTLO126
11/30/03
11/30/04
COMBINED SINGLE LIMIT $1,000,000
(Ee acmdenO
BODILY INJURY $
(Per P°�i
j ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY $
(Par accident)dandent)
i
X
X
HIRED AUTOS
I
NON -OWNED AUTOS
PROPERTY DAMAGE $
(Per...*M)
GAMGE LIABILITY
AUTO ONLY -EA ACCIDENT $
OTHER THAN EAACC i
ANY AUTO
7
AUTO ONLY: AGG $
C
EXCESS LIABILITY
XSM00097333165
11/30/03
11/30/04
EACHOCCURRENCE $10.000,000
X OCCUR CLAIMS MADE
AGGREGATE $10,000,000
PROFESSIONAL
$
DEDUCTIBLE
LIABILITY IS
RETENTION $
EXCLUDED.
$
WORKERS COMPENSATION AND
WC STATU. OTK
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
E.L. DISEASE -EA EMPLOYEE S
E.L. DISEASE -POLICY UNIT $
D
OTHER Professional
P1039400
11/30/03
11/30/04
$1,000,000 Per Claim
Liability
$2,000,000 Annl Aggr.
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIFXCLU51GN3 ADDED BY ENDORSEMENTISPECIAL PROVISIONS
General Liability policy excludes claims arising out of the performance of professional
services.
All Operations as performed by the named insured.
(See Attached Descriptions)
City of San Juan Capistrano
Aft: city Clerk's Office
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
ACORD 25S (7197)1 of 2 #M81822
SHOULD ANYOF THE ABDVE DESCRIBED POLICIES SECANCELLED BEFORETHE EMRAT'AN
DATE THEREOF, THE ISSUING INSURER WILL XM014BNPRXTp MAIL30_DAYSWRITTEN
NOMCETOTHE CERTIFICATE HOLDERNAMED TO THE LEFT,
9 0
El
POLICYNUMBER: P630500D409203 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES or
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Name of Person or Organization:
City of San Juan Capistrano
Att: city Clerk's Office
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.)
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 work" for that insured by or for you.
CG 20 10 11 85
0
32AOO PASEO ADEI-ANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 (FAX)
IFIVIr.sanjuoncapis)rano. org
October 12, 2003
Javan � •
!`�Y`�r lemromN
• �tmuuro I 1961
1776
Robert Bein, William Frost & Associates
14725 Alton Parkway
Irvine, CA 92618-2069x
MEMBERS OF THE CITY COUNCIL
DIANE L. BATHGATE
JOHN S. GELFF
MATT HART
JOESOTO
OINM M. SWEROLIN
INTERIM CITY MANAGER
PAMELAGIBSON
RE: Compliance with Insurance Requirements - Plan Check Services/Corrosion
Protection Agreements
The following insurance documents are due to expire:
✓ General Liability Certificate 11/30/03 -
✓ General Liability Endorsement Form naming the City of San Juan
Capistrano as additional insured.
✓ Automobile Liability Certificate 11/30/03 "t—
✓ Professional Liability Certificate 11/30/03 �(�
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, j
Meg ona an
Ci Clerk
cc: William M. Huber, Engineering and Building Director
Dawn Schanded, Administrative Assistant
San Juan Capistrano: Preserving the Past to Enhance the Future
Maria Guevara
From: Maria Guevara
Sent: Monday, December 08, 2003 4:24 PM
To: Dawn Schanderl
Subject: Robert Bein, William Frost & Assoc. (Plan Check/Corrosion Protection)
Hi my friend,
We received all of their insurance with the exception of the endorsement
form.
I feel like Chinese food.
Thanks,
Maria
Client#: 6255
RBFCONSUI
ACORD. CERTIFICATE OF LIABILITY
INSURANCE
1DATE (M212212122/wooml
03
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dealey, Renton & Associates
P. O. Box 10550
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Santa Ana, CA 92711-0550
POLICY EXPIRATION
DATE M/DDNY
714 427.6810
INSURERS AFFORDING COVERAGE
INSURED
INSURER A: Travelers Indemnity Co. of Illinois
RBF Consulting
PO Box 57057
Irvine, CA 92619 -7057
INSURER B: Hartford Fire Ins. CO.
INSURER C: Fireman's Fund Insurance Co.
- at `clo
INSURER D: Underwriters at Lloyd's Londoinn
INSURER E:
FIRE DAMAGE(Anyone fi®)
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.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
O T M 0
POLICY EXPIRATION
DATE M/DDNY
LIMITS
A
GENERAL LIABILITY
P63050OD409203
11/30/03
11/30/04
EACH OCCURRENCE
$1000000_
FIRE DAMAGE(Anyone fi®)
$1,000,000
X COMMERCIAL GENERAL LIABILITY
CI -AIMS MADElil OCCUR
INDP. CONTRACTORS
MED EXP(Arr, one person)
$5,000
PERSONAL _&ADV INJURY
$1 000,000
X CONTRACTUAL
INCLUDED.
_
X BFPD XCU, OCP
GENERALAGGREGATE
s2,000,000
GEN'L AGGREGATE LIM ITAPPUES PER:
PRODUCTS-COMP/OPAGG
$2000000
POLICY X PROT X LOC
B
AUTOMOBILE
X
LIABILITY
ANY AUTO
57UENTLO126
11/30/03
11/30/04
COMBINED SINGLE LIMIT
(Ea acddent)
$1,0001000
BODILY INJURY
(Per persw )
$
j ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accitlent)
$
X
X
I HIRED AUTOS
I NON-0WNEO AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE
LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGO
C
EXCESS LIABILITY
XSM00097333165
11/30/03
11/30/04
EACH OCCURRENCE
$10,000,000
AXI OCCUR ❑ CLAIMS MADE
AGGREGATE
$10,000,000
_
PROFESSIONAL
-_
$
s i
DEDUCTIBLE
LIABILITY IS
RETENTION $
EXCLUDED.
$
WORKERS COMPENSATION AND
WC STATU- OTH-
EMPLOYERS' UASILITY
E.L. EACH ACCIDENT
S
E.L. DISEASE -EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
$
D
OTHER Professional
P1039400
11/30/03
11/30/04
$1,000,000 Per Claim
lability
$2,000,000 Annl Aggr.
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLEV/ CLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
General Liability policy excludes claims arising out of the performance of professional
services.
All Operations as performed by the named insured.
(See Attached Descriptions)
City of San Juan Capistrano
Att: city Clerk's Office
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
SHOULD ANYOFTHEABOVEDESCRIBED POLICIESSECANCELLED BEFORETHEEXPIRAnON
DATE THEREOF, THE ISSUING INSURER WILL XXRMMXTP MAIL 30_ DAYSWRITTEN
NOTICETOTHE CERRFICATE HOLDERNAMED TOTHE LEFT, aX35AL =AARVMjkMU
ACORD 25S (7197)1 of 2 #M81822 V-
- - -- „ —' '' ",-�TMP1 0 ACORD CORPOR/)TIqFN 1988
0 9
DESCRIPTIONS (Continued from Page 1)
City of San Juan Capistrano is Additional Insured as respects to General
Liability.
AMS 25.3 (07197) 2 of 2 W81822
POLICYNUMBER: P63050OD409203 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES or
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of San Juan Capistrano
Att: city Clerk's Office
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.)
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 work" for that insured by or for you.
CG 20 10 11 85
0
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 (FAX)
svwsv.sanjuancapistrano. org
October 12, 2003
Robert Bein, William Frost & Associates
14725 Alton Parkway
Irvine, CA 92618-2069x
RE: Compliance with Insurance Requirements -
The following insurance documents are due to expire:
✓ General Liability Certificate 11/30/03 - 04-11
MEMBERS OF THE CITY COUNCIL
DIANE L. BATHGATE
JOHN S. GELFF
MATT HART
JOE SOTO
DAVID M. SWERDLIN
INTERIM CITY MANAGER
PAMELAGISSON
✓ General Liability Endorsement Form naming the City of San Juan
Capistrano as additional insured.
✓ Automobile Liability Certificate 11/30/03 oe—
✓ Professional Liability Certificate 11/30/03 i6 -&J
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, j ^
V �
Meg
ona an
Cit Clerk
cc: William M. Huber, Engineering and Building Director
Dawn Schanderl, Administrative Assistant
San Juan Capistrano: Preserving the Past to Enhance the Future
0 •
Maria Guevara
From:
Maria Guevara
Sent:
Monday, December 08, 2003 4:24 PM
To:
Dawn Schanderl
Subject:
Robert Bein, William Frost & Assoc. (Plan Check/Corrosion Protection)
Hi my friend,
We received all of their insurance with the exception of the endorsement
form.
1 feel like Chinese food.
Thanks,
Maria
1
0 f
CITY CLERK'S DEPARTMENT - ACTION REMINDER
Peter Salgado, Associate Engineer
P4V;<
FFR4MM: Mitzi Ortiz, Deputy City Clerk DATE: May 3, 2004
SITUATION:
On December 30, 2003, the City of San Juan Capistrano entered into a Personal Services
Agreement with RBF Consulting to provide engineering review services for the Terminal
Reservoir No. 2 Replacement Project.
ACTION REQUESTED:
Agreement states services provided shall be completed no later than June 5, 2004.
Please notify the City Clerk's office if agreement has been completed or if there is a need to
extend the time period.
ACTION TO BE TAKEN: ¢�ofrp, / �� / - ��' �° �y12, D�
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION:
DATE SIGNED: 47 3 lo
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
Tickler Date: 05/03/04
Deadline Date: 06/05/04
cc: Department Head
(600.30/rbo
r
32400 PASEO AOELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 (FAX)
www. sanjuancapistrano. org
January 5, 2004
Paul Young
RBF Consulting
14725 Alton Parkway
Irvine, CA 92618-2027
Dear Mr. Young:
3/•�'_ IINIIIIIIfH
• nunuw 1961
1776
MEMBERS OF THE CITY COUNCIL
DIANE L. BATHGATE
JOHN S. GELFF
MATT HART
JOESOTO
DAVID M. SWERDLIN
INTERIM CITY MANAGER
PAMELA GIBSON
A fully executed, original Personal Services Agreement related to providing engineering
review services for the Terminal Reservoir No. 2 replacement project is enclosed.
Thank you for forwarding current evidence of insurance as required by the agreement.
Please keep in mind that this documentation must be maintained current with our office,
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, Peter Salgado, Associate Engineer (949) 443-6366.
Yours truly,
Mon an, CMC
Clerk
Agreement
cc: Peter Salgado, Associate Engineer
Amy Amirani, Public Works Director
San Juan Capistrano: Preserving the Past to Enhance the Future