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03-0929_CHAMBERS GROUP, INC_Personal Services AgreementPERSONAL SERVICES AGREEMENT M-L�- THIS AGREEMENT is made and entered into this � day of r 03, by and between the City of San Juan Capistrano (hereinafter re rred to as the "City") and Chambers Group. Inc., (hereinafter referred to as "Consultant"). RECITALS: WHEREAS, City desires to retain the services of Consultant regarding the City's proposal to provide environmental monitoring services for the SC -04 Terminal Pipeline 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 by January 31, 2005. Section 3. Compensation. 3.1 Amount. Total compensation for the scope of services for this Project shall not exceed Fourteen Thousand Nine Hundred Fifty dollars ($14,950), as set forth in Exhibit "A," attached and incorporated herein by reference. 1 SD 5 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 S. Limitations Upon Subcontracting and Assignment. 2 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. 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 B. 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. 3 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. 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. 4 0 0 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. 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. 5 0 0 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. 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 9 To Consultant: Chambers Group, Inc. 17671 Cowan Avenue, Suite 100 Irvine, CA 92614 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. 7 IN WITNESS WHEREOF, the parties hereto have executed this Agreement. ATTEST: R. Monahan, City Clerk APPROVED AS TO FORM: John R. Shaw, Attorney [3 CITY OF SAN JUAN CAPISTRANO By:-�—�_ Pamela Gibson Interim City Manager CONSUL ANT By: Chambers Group, Inc. 0 @Chambers Grou s Environmental Services Blotogical Resources Cultural Resources 0 August 25, 2003 (03-300) Mr. Peter Salgado LAUG 2 2003 City of San Juan Capistrano Public Works Pf1BUCW 32400 Paseo Adelanto ORBS San Juan Capistrano, California 92675 Subject: Proposal for Revegetation Monitoring Program for the SC -04 Pipeline Dear Peter: Chambers Group, Inc., is pleased to offer you our restoration monitoring services for the Coastal Sage Scrub (CSS) take associated with the construction of the SC -04 Pipeline Project. Chambers Group performed the environmental monitoring services for the construction of the SC -04 Pipeline and is very familiar with the scope for the revegetation program. Revegetation Area Per the "Final Report Summarizing Biological Monitoring Activities" for the SC -04 Pipeline Project, there are two areas of CSS take that require revegetation. Per recent conversations between the Wildlife Agencies and the City, the 0.24 acre unauthorized take adjacent to La Fatal Avenue and the 1.18 acres permitted take will both be subject to the same revegetation success criteria and one year monitoring program as specked in the June 13, 2001 4(d) permit. The total acreage subject to the revegetation program is estimated at 1.42 acres in the two locations identified above. The "Erosion Control/Revegetation Program" letter dated July 8, 2002 generally outlines the revegetation program for the disturbed CSS take areas. The City will contract separately with a general contractor/landscape contractor for the restoration installation, one-year erosion control program, and the one-year revegetation site maintenance. Revegetation Monitoring Services Chambers Group will perform the revegetation monitoring services required for the revegetation program. These services include: ➢ Monitoring of site preparation activities; ➢ Preparation of an Installation Summary letter report within six weeks of installation completion; ➢ Monitoring of plant establishment activities; Monitoring of one-year maintenance activities including education regarding desirable and undesirable plant materials; ➢ Twelve monthly inspections, qualitative surveys, and progress reports (two copies each to the General Contractor and the City) to assess site conditions including five surveys (March — July) evaluating wildlife species use; ➢ Monitoring of the federally threatened coastal California gnatcatcher between March and July; ➢ Coordination with Landscape Contract regarding appropriate reseeding measures in the event of widespread low germination and pest control; it "115T A. Corporate Headquarters Inland Empire Los Angeles www.chambersgroupina.com 17671 Cowan Avenue, Suite 100 302 Brookside Avenue 350 South Grand Avenue Suite 3920A Irvine. CA 92614 Redlands, CA 92373 Los Angeles, CS 9007 1949126i-5414 19091335-7068 (21 31 613-1 450 Certified Small Business Fax (94 91 26 1-8950 Fax (9091 335-6318 ,°ax 1213] 613-1465 Certified Disabled Veteran Business Enterprise ICVBE) F Mr. Peter Salgado August 25, 2003 Page 2 0 03-300 ➢ Coordinating with the General Contractor/Landscape Contractor regarding site status; ➢ Attending up to two onsite meetings during installation procedures; ➢ Consulting with and obtain approval from the General Contractor concerning implementation plan revisions; ➢ Notify the General Contractor prior to the initiation of any and all stages of plan implementation; ➢ Providing a federally permitted gnatcatcher biologist holding a valid 10(a)(1)(a) recovery permit for monitoring between March and July; and Assessing one-year site performance and preparation of a Final Status Report (two copies each to the General Contractor and the City). At the discretion of the Biological Monitor, the 12 -month maintenance period may be extended if there is insufficient erosion control, poor seed mix performance, or inadequate control of week species due to improper maintenance. Monitoring any extension of the maintenance period is not part of this scope and will require a contract addendum with the City of San Juan Capistrano. The above scope also does not include focused surveys for the federally threatened coastal California gnatcatcher. Schedule It is anticipated that the revegetation installation would occur between October 1 and November 30 depending upon weather conditions. The monitoring effort would be a 12 -month period from the initiation of revegetation program. We recommend an on-site meeting with the Landscape Contract in early October to identify the reseeding areas and installation procedures. The Landscape Contractor should also determine the availability of the approved seed mix (Seed Mix No. 1 — CSS species) for October reseeding efforts as soon as possible. Cost The cost to complete the above scope of work is a fixed fee of $14,950.00. Assumptions ➢ Chambers Group has reviewed the City of San Juan Capistrano Personal Services Agreement and agrees to use this consultant agreement. ➢ The proposal is based on hourly labor rates and material cost markups for Chambers Group provided in our 2003 Schedule of Fees. Any agreed upon out -of -scope costs and additional work will be based on the Schedule of Fees. ➢ Chambers Group, Inc. complies with IWO-4-2001 (AB -60), Eight Hour Day Restoration and Work Place Flexibility Act of 1999. Our standard workday is eight hours, and when estimating our project costs we assume that there will be no overtime required. However, from time to time we are required by the client or by other circumstances beyond our control to work more than eight hours. "We will pass along all costs which we are required to pay as a matter of law on a time and material basis. Chambers Group assumes that, by receipt of notice to proceed, full access to the property will be provided by the Client, including keys to locked gates and advance notice to existing property tenants of our right of entry. Should Chambers Group biologists be denied access to the property at the time prearranged for the field surveys, the additional costs incurred by Chambers Group will be billed separately to the Client on a time -and -materials basis. (Rhambers Group' L Mr. Peter Salgado August 25, 2003 Page 3 03-300 ➢ Cost and schedule estimates are based on our best judgment of the requirements known at the time of the proposal and can be influenced favorably or adversely by Client needs and other circumstances. Chambers Group will endeavor to perform the services and accomplish the objectives within the estimated costs and schedule; however, if the scope of work or schedule changes, Chambers Group reserves the right to revise costs accordingly. ➢ Chambers Group will use and rely upon the aerial photos, topographic maps, and any other documentation provided by the Client as correct. We will use these maps and photos to serve as a base for determination of acreage. ➢ Additional copies of the documents will be billed at $.15 per page for text and $2.00 per page for photographs, plus staff time. ➢ It Is assumed by Chambers Group that the Client will reimburse Chambers Group for all costs, internal and external, including legal or other contractually related issue fees that are the result of any challenges to the document. These costs are not included in the estimate. ➢ Change orders will be issued and signed by the Client and Chambers Group before starting additional work not provided for in the original proposal. If the Client's authorized representative is not available for a signature; the additional out -of -scope work will not commence until the change order is signed. ➢ No verbal promises or changes to any part of this proposal will be honored by Chambers Group unless documented in writing and signed with authorized signatures from the Client and Chambers Group. ➢ This cost estimate is valid for a period of 60 days from the date of this proposal. Beyond 60 days, Chambers Group reserves the right to reevaluate the estimated costs. ➢ If the original scope of work is interrupted due to no fault of Chambers Group, the contract shall be considered complete and the client will be billed for work performed up to the time of cancellation. The invoice shall become due and payable immediately upon presentation of the invoice. ➢ Except as expressly provided to the contrary in the client's contract, Chambers Group's terms and conditions presented with this proposal for services, which are incorporated herein by this reference, shall apply. ➢ Chambers Group shall not be held responsible for work delays or cancellations caused by strikes, accidents, acts of God, delays imposed by the Client, or other delays beyond the control of Chambers Group. Chambers Group reserves the right to pass through actual costs resulting from any such delays, including demobilization and remobilization costs. ➢ The cost for invoicing presented in this proposal is for issuing invoices in our standard format. Any requests for special invoicing requirements such as a change in format, inclusion of backup or other requirements will be billed as an approved augment to the contract on a Time -and -Materials basis. ➢ If the project is reactivated, Chambers Group reserves the right to charge remobilization costs and charge the cost of the remainder of the project due to material changes in billing rates. ➢ This proposal was prepared by Chambers Group solely for your internal use in evaluating Chambers Group's business proposal and deciding whether or not to contract with Chambers Group to perform the services described in this proposal. Chambers Group considers the pricing and other business (Rhambers Group° 0 Mr. Peter Salgado August 25, 2003 Page 4 03-300 information the property of Chambers Group. This proposal and the information contained herein shall not be used for any purpose other than as specifically stated above and shall not be disclosed to any other party without Chambers Group's written consent. Chambers Group 2003 Schedule of Fees StaffTltle,' Rate PROF 1 $28.00 - 39.00 PROF II 40.00 - 43.00 PROF III 44,00 - 48.00 PROF IV 49.00 - 58.00 PROF V 59.00 - 63.00 PROF VI 64.00 - 68.00 PROF VII 69.00 - 73.00 PROF VIII 74.00 - 78.00 PROF IX 79.00 - 92.00 PROF X 93.00 - 110.00 PROF XI Rates available upon request PROF XII Rates available upon request PROF XIII Rates available upon request Other.Direct'Costs Internal Costs Faxes $0225 per page 'Mise. Supplies Cost plus 15% Equipment Rental Cost plus 15% " '." Photographs/Film-: - Cost "plus 15% Computer Usage- 15.00 per hour GIs Usage 30.00 per hour " "Mileage 0.41,per mile Company Vehicle Usage " 35:00 - 50.00 per day Photocopies (internal) 0.15 per page Color copies 8 x 11. (Internal) 1.00 per copy Color copies 11 x 17 (Internal) 2.00 per copy Outside Printing Cost plus 15% External Costs All external costs are computed on the basis of actual "costs plus a fee of 15%. The costs include but are not limited to shipping charges, printing and reproduction, special tees, permits, and subcontracts. chambers Group, 0 Mr. Peter Salgado August 25, 2003 Page 5 03-300 Thank you for the opportunity to provide this proposal to you. We look forward to working with you on this project. Your contact for contract issues and revegetation monitoring services is Sue Lamoureux, Vice President and Director of Environmental Services. Please call us at (949) 261-5414 if you have any questions or comments regarding this proposal. Sincerely, CHAMBERS GROUP, INC. Susan D. Lamourel Vice President Director of Environmental Services Chambers Group® • Mr. Peter Salgado August 25, 2003 Page 6 Attachment A — Task Breakdown" 0 Task 1 — Installation Support/Meetings/Summary Report $ 2,450 Task 2 — Maintenance Monitoring/Support/Reporting $ 11,000 Task 3 — Final Report Total 1,500 $ 14,950 'Each task is an estimate, not an exact price for each task. The total fixed fee is $14,950. 03-300 -A ORD. CER,TIFICAT F LIABILITY INSURA E oiii3/2 s' PRODUCER (949)833-7126 FAX ( 33-7127 Insurance Office of America, Inc. DBA IDA Insurance Services One Park Plaza, Suite 600 Irvine, CA 92614 THIS CERTIFICATE ISIRMED 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 # msuREo Chambers Group Inc. 17671 Cowan Avenue, Suite 100 Irvine, CA 92614 INSURER A. National Fire Ins. of Hartford INSURER B: Hartford Insurance INSURER C: Continental Casualty Co. INSURER D: NSURER E: 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 DD' rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY TCP2079851160 06/01/2005 06/01/2006 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S 1,000,000 CLAIMS MADE O OCCUR MED EXP (Any one person) $ S'00 A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000, GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,00 POLICY PRO- LOC JECT B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 57UECTM6614 I--� LI5 06/01/2005 —_- __ rl 11 _._._- U I� 1 4 t0D 06/01/2006 COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 BODILY INJURY (Per person) $ X X BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY PIiBLIC WORKS AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG S ANVAUTO _ _,.,_..._. —_ EXCESWUMBRELLA LIABILITY CUP207984991 06/01/2005 06/01/2006 EACH OCCURRENCE $ 4,000,000 X OCCUR CLAIMS MADE AGGREGATE $ A $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND N.'C STATU- OTM- £MPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ C ioessional Liability MCA254087693 11/30/2004 11/30/2005 $1,000,000 per claim $2,000,000 aggregate DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS eneral Liability: City of San Juan Capistrano is an additional insured per the attached Endorsement. ten (10) day notice will be given for non-payment of premium. City of San Juan Capistrano Attn: Peter Salgado 32400 Paseo Adelanto SJC, CA 92675 ACORD 25 (2001108) 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY AUTHORIZED REPRESENTATIVE IN ©ACORD CORPORAT)bN 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) • • G -17957-G99 CNA (Ed. 10/01) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C.1.OF THIS ENDORSEMENT FOR THESE DUTIES. ALSO, THIS ENDORSEMENT CHANGES THE CONTRACTUAL LIABILITY COVERAGE WITH RESPECTS TO THE "BODILY INJURY" OR "PROPERTY DAMAGE" ARISING OUT OF THE "PRODUCTS -COMPLETED OPERATIONS HAZARD." SEE PARAGRAPH B.3. OF THIS ENDORSEMENT FOR THIS COVERAGE CHANGE. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S SCHEDULED AND BLANKET ADDITIONAL INSURED ENDORSEMENT WITH LIMITED PRODUCTS - COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Designated Project: (Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.) A. WHO IS AN INSURED (Section II) is amended to written contract or written agreement or in the include as an insured any person or organization, Declarations of this policy, whichever is less. including any person or organization shown in the These Limits of Insurance are inclusive of, and schedule above, (called additional insured) whom not in addition to, the Limits of Insurance shown you are required to add as an additional insured on in the Declarations. this policy under a written contract or written 3. The coverage provided to the additional insured agreement; but the written contract or written by this endorsement and paragraph f. of the agreement must be: definition of "insured contract" under 1. Currently in effect or becoming effective during DEFINITIONS (Section V) do not apply to the term of this policy; and "bodily injury' or "property damage" arising out of the "products -completed operations hazard" 2. Executed prior to the "bodily injury," "property unless required by the written contract or written damage," or "personal and advertising injury." agreement. When coverage does apply to B. The insurance provided to the additional insured is "bodily injury' or "property damage" arising out limited as follows: of the "products -completed operations hazard" such coverage will not apply beyond: 1. That person or organization is an additional insured solely for liability due to your negligence a. The period of time required by the written and specifically resulting from "your work" for contract or written agreement; or the additional insured which is the subject of the b. 5 years from the completion of "your work" written contract or written agreement. No on the project which is the subject of the coverage applies to liability resulting from the written contract or written agreement, sole negligence of the additional insured. whichever is less. 2. The Limits of Insurance applicable to the additional insured are those specified in the 4. The insurance provided to the additional insured does not apply to "bodily injury," "property (J -17957-G99 Page 1 of 2 i Ed. 10/01) • damage," or "personal and advertising injury' arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, or inspection activities performed as part of any related architectural or engineering activities. C. As respects the coverage provided under this endorsement, SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS are amended as follows: The following is added to the Duties In The Event of Occurrence, Offense, Claim or Suit Condition: e. An additional insured under this endorsement will as soon as practicable: (1) Give written notice of an occurrence or an offense to us which may result in a claim or "suit" under this insurance; (2) Tender the defense and indemnity of any claim or "suit" to us for a loss we cover under this Coverage Part; (3) Tender the defense and indemnity of any claim or "suit" to any other insurer which also has insurance for a loss we cover under this Coverage Part; and (4) Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. f. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or "suit" from the additional insured. 2. Paragraph 4.b. of the Other Insurance Condition is deleted and replaced with the following: G -17957-G99 (Ed. 10/01) • G -17957-G99 (Ed. 10/01) 4. Other Insurance b. Excess Insurance This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing to the additional insured's own coverage. This insurance is excess over any other insurance to which the additional insured has been added as an additional insured by endorsement. When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured against any "suit" if any other insurer has a duty to defend the additional insured against that "suit." If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self- insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. Page 2 of 2 • 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493.1171 (949) 493.1053 FAX www sanjuancapistrano. org June 13, 2005 The Chambers Group 17671 Cowan Ave., Suite 100 Irvine, CA 92614 MEMBERS Of THE CITY COUNCIL SAM ALLEVATO DIANE SATHGATE WYATT HART JOE SOTO DAVID M. SWERDLIN RE: Compliance with Insurance Requirements - Environmental Monitoring Services for the SC -04 Terminal Pipeline Project The following insurance documents are due to expire:/ ✓ General Liability Certificate 06/25/2005 ✓ General Liability Endorsement Form naming th City of San Juan Capistrano as additional insured. ✓ Automobile Liability Certificate 06/25/2005/ 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 epiration date If you have any questions, please contact me at (949) 443-6309. Administrofive Secretary cc: Michelle Perea, Administrative Assistant Peter Salgado, Associate Engineer San Juan Capistrano: Preserving the Past to Enhance the Future Lam.) Printed on recycled Daper • • OHOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-13-2005 GROUP: POLICY NUMBER: 803550-2005 CERTIFICATE ID: 240 CERTIFICATE EXPIRES: 01-01-2006 01-01-2005/01-01-2006 CITY OF SAN JUAN CAPISTRANO ATT CITY CLEARS OFFICE 32400 PASEO ADELANTO SAN JUAN CAPISTRANO CA 92675 This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. yAhl- AUTHORIZED REPRESENTATIVE PRESIDENT V EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - M. D. CHAMBERS, COB - EXCLUDED. ENDORSEMENT #1600 - SHERMAN SMITH, PRES EXCLUDED. ENDORSEMENT #1600 - JACQUIE GREENE, TRES - EXCLUDED. ENDORSEMENT #1600 - NOEL DAVIS, VP - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2004 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER CHAMBERS GROUP, INC 17671 COWAN STE 100 IRVINE CA 92614 SCIF 10262E Adept Nis ce,dG,ate only if you see a faint watem,aM that Made 'OFFICIAL STATE FUND DOCUMENT' b1csTG� RIN:01-13-2005 PAGE 1 OF 1 0 32400 PASEO ADEL.ANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 4931053 FAx www.sanjuancapistrano.org December 16, 2004 The Chambers Group 17671 Cowan Ave., Suite 100 Irvine, CA 92614 dam, IAFIA AAIAIFI F$IABIISBFI 1961 1776 MEMBERS OF THE CITY COUNCIL SAM ALLEVATO DOWEL SATHGATE WYATT HART JOE SOTO DAVID M. SWERDLIN RE: Compliance with Insurance Requirements — Environmental Monitoring Services for the SC -04 Terminal Pipeline Project The following insurance document is due to expire: ✓ Workers Compensation Certificate 1/1/2005 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 expira I n date. If y9q have any questions, please contact me at (949) 443-6309. cc: Michelle Perea, Administrative Assistant San Juan Capistrano: Preserving the Past to Enhance the Future 0 0 AC RD 07TE(MMM CERTIFICATE OF LIABILITY INSURANCE DATE0/04 YV) PRODUCER 1-949-729-0777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Professional Practice Ineur r er I '`� - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE V f l HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2249 west Coast Highway ~ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 Newport Beach, CA 92663 INSURERS AFFORDING COVERAGE INSURED — INiSURER A. TRANSPORTATION INSURANCE COMPANY Chambers Group, Inc. - --- - — INSURERS: HARTFORD FIRE INSURANCE COMPANY 17671 Cowen Ave., Suite 100 _-- INSURERQTRANSPORTATION INSURANCE CO. PUBLIC WORKS INSURER D. Continental Casual Company Irvine, CA 92614 I INCI IHCP F 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. I T..I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE immminN, POLICY EXPIRATION LIMITS C IFGENERAL LIABILITY 2077875736 06/01/04 06/01/05 EACH OCCURRENCE $1,000,000 —__ _ �� COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 1,000,00F0 � MED EIP(Anyone person) $ 10,000 _ OCCUR F�7 CLAIMS MADE PERSONAL S ADV INJURY $1,000,000 X Contractural Liability) GENERAL AGGREGATE $2,000,000 I—GEN 'L AGGREGATE LIMIT APPLIES PER: PRODUCTB- COMP/OPAGG $2,000,000 POLICY FXI PRO LOG E AUTOMOBILE LIABILITY 72UECUMS379 06/01/04 06/01/05 COMBINED SINGLE LIMIT $1,000.000 �X�gNY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ $ X,NON-OWNED AUTOS (Per accident) _ PROPERTY DAMAGE $ (Per accitlenp GA RAGE LIABILITY AUTO ONLY, EA ACCIDENT ANY AUTO OTHER THAN EAACCC$ AUTO ONLY. AGG $ A EXCESS LIABILITY 2077875736 06/01/04 1 06/01/05 EACH OCCURRENCE $5.000.000 OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 $ FDEDUCTIBLE g RETENTION $ WORKERS COMPENSATION AND ATU OTH- WRYI EMPLOYERS' LIABILITY IMI- T E L. EACH ACCIDENT___ 'E. L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ OTHER D jProfessional Liability EEA254087693 11/30/03 11/30/04 Per Claim 1,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERPTIONSILOCAUONWEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ALL OPERATIONS OF NAME INSURED. GENERAL LIABILITY: CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED PER ATTACHED ENDORSEMENT. City of San Juan Capistrano Attn: Michelle Pere& 32400 Paseo Adelanto San Juan Capistrano, CA 92675 coralim SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL EMIIXJrd'd Y4 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, WJr);1 I1BIRXNDDl60 SHALL XpWp6Y6179X19DIiNIKfOTA'gYOINKNX1C6Tpp7f%pIONXIC11571XLY)q[9UgF]yCXEMYK117S1ItR AUTHORIZED REPRESENTATIVE USA / I. m ACORD V14VG] Powered ByCertificatesNownl 0 0 CNA (Ed.0 /99) (Ed. 09/99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NONCONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS ACCOUNT PACKAGE POLICY BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESS ACCOUNT PACKAGE POLICY BUSINESSOWNERS COMMON POLICY CONDITIONS A. WHO IS AN INSURED (Section C. of the This insurance does not apply to 'bodily Businessowners Liability Coverage Form) is injury," 'property damage' or "personal and amended to include as an insured any person or advertising injury" arising out of operations organization (called additional insured) described in performed for the state or municipality. paragraphs 2.a. through 2.g. below whom you are b. An Y persons organizations with a required to add as an additional insured on this re q es controlling interest in you but only with policy under: respect to their liability arising out of: 1. A written contract or agreement; or 1 ()Their financial control of you; or 2. An oral contract or agreement where a (2) Premises they own, maintain or control certificate of insurance showing that person or while you lease or occupy these organization as an additional insured has been premises. issued; but This insurance does not apply to structural the written or oral contract or agreement must be: alterations, new construction and demolition 1. Currently in effect or becoming effective during operations performed by or for such the term of this policy; or additional insured. 2. Executed prior to the 'bodily injury," 'property c. A manager or lessor of premises but only damage" or 'personal injury and advertising with respect to liability arising out of the injury," but ownership, maintenance or use of that Only the following persons or organizations are specific part of the premises leased to you additional insureds under this endorsement and and subject to the following additional coverage provided to such additional insureds is exclusions: limited as provided herein: This insurance does not apply to: a. A state or political subdivision subject to the (1) Any `occurrence" which takes place following provisions: after you cease to be a tenant in that (1) This insurance applies only with respect premises; or to the following hazards for which the (2) Structural alterations, new construction state or political subdivision has issued or demolition operations performed by a permit in connection with premises or on behalf of such additional insured. you own, rent, or control and to which d. A mortgagee, assignee or receiver but only this insurance applies: with respect to their liability as mortgagee, (a) The existence, maintenance, repair, assignee, or receiver and arising out of the construction, erection, or removal of ownership, maintenance, or use of a advertising signs, awnings, premises by you. canopies, cellar entrances, coal This insurance does not apply to structural holes, driveways, manholes, alterations, new construction or demolition marquees, hoistaway openings, operations performed by or for such sidewalk vaults, street banners, or additional insured. decorations and similar exposures; or e. An owner or other interest from whom land (b) The construction, erection, or has been leased by you but only with respect to liability arising out of the removal of elevators; or ownership, maintenance or use of that (c) The ownership, maintenance, or specific part of the land leased to you and use of any elevators covered by subject to the following additional this insurance. exclusions: (2) This insurance applies only with respect This insurance does not apply to: to operations performed by you or on (1) Any 'occurrence" which takes place your behalf for which the state or after you cease to lease that land; or political subdivision has issued a permit. G -134844-A Page 1 of 2 (Ed. 09/99) 0 (2) Structural alterations, new construction B. or demolition operations performed by or on behalf of such additional insured. If. A co-owner of a premises co -owned by you and covered under this insurance but only with respect to the co-owners liability as co- owner of such premises. g. Any person or organization from whom you lease equipment. Such person or organization is insured only with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply: (1) To any "occurrence" which takes place after the equipment lease expires; or (2) To "bodily injury' or "property damage" arising out of the sole negligence of such additional insured. Any insurance provided to an additional insured designated under paragraphs a. through g. above does not apply to "bodily injury" or "property damage" included within the "products -completed operations hazard". NAMED INSURED: CHAMBERS GROUP INC. POLICY NO: 2077875736 ADDITIONAL INSURED: G -134844-A (Ed. 09199) 0 G -134844-A (Ed. 09t99) As respects the coverage provided under this endorsement, Section H. OTHER INSURANCE, of the Businessowners Common Policy Conditions is deleted and replaced with the following: H. Other Insurance 1. If there is other insurance covering the same loss or damage, we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance (except as indicated in 2. below), whether you can collect on it or not. But we will not pay more than the applicable Limit of Insurance. 2. This insurance is excess over: G.ny other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a contract or agreement specifically requires that this insurance be either primary or primary and noncontributing. Where required by contract or agreement, we will consider any other insurance maintained by the additional insured for injury or damage covered by this endorsement to be excess and noncontributing with this insurance. 3. When this insurance is excess, we will have no duty under Business Account Package Policy Liability Coverage to defend any claim or "suit" that any other insurer has a duty to defend. I f n o other i nsurer defends, we will undertake to do so; but we will be entitled to the insured's rights against all those other insurers. Page 2 of 2 Professional Practice Insurance Brokers, Inc. 2244 Nest Coast Highway Suite 200 Newport Beach, CA 92663 USA �1LCL�: j� AIL& USA /�' w U/'"'• �� �" rtificatesNow. 0 D EEE WE AUG 4 200 D 4 PUBLIC WORKS If you have questions regarding the content of this document, please contact the Producer/Agent listed on the certificate of insurance or the Insured listed on the notice of cancellation/reinstatement. To find out how you can send and receive all of your certificates of insurance either by email, high speed fax or standard mail, call ConfirmNet toll-free at 877.669.8600, email customercare®confirnnet.com, or visit our website at www.cwnfirmnet.con The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information. Powered BYCerti/icatesNowm a ACORD,,, CERTIFICATE OF LIABILITY INSURA E 07/30/04 DATE(M04MY) PRODUCER 1-949-729-0777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Professional Practice Insurance Brokers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE POLICY EFFECTIVE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2244 Nest Coast Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 06/01/04 Newport Beach, CA 92663 INSURERS AFFORDING COVERAGE INSURED Chambers Group, Inc. INSURER A: TRANSPORTATION INSURANCE COMPANY INSURERS HARTFORD PIRS INSVRANCB COMPANY 17671 Cowan AVe., Suite 100 INSURER C: TRANSPORTATION INSURANCE CO. INSURER D: Continental Casual Company Irvine, CA 92614 INSURER E: 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 EXPIRATION LNAYfB C GENERAL LIABILITY 2077875736 06/01/04 06/01/05 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Any one fire) $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE I X I OCCUR MED EXP (Any one parson) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 X Contractural Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X I PRO -LOC JFCT B AUTOMOBILE X LIABILITY ANY AUTO 72UECUMS379 06/01/04 06/01/05 (Ea accident) LIMIT $1,000,000 BODILY INJURY $ (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Par accident) X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EAACC $ ANY AUTO AUTO ONLY: AGG $ A EXCESS LIABILITY 2077875736 06/01/04 06/01/05 EACH OCCURRENCE $ 5,000,000 —71 OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WCSTATU- OTH- I LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE$ E.L. DISEASE - POLICY LIMIT $ OTHER D Professional Liability BEA254087693 11/30/03 11/30/04 Per Claim 11000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONSAOCATIONSNEHICLESIEXCLUSKBIS ADDED BY ENOORSEMENTISPECIAL PROVISIONS ALL OPERATIONS OF NAME INSURED. GENERAL LIABILITY: CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED PBR ATTACHED ENDORSEMENT. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of San Juan Capistrano DATE THEREOF, THE ISSUING INSURER WILL ElffiNKNIRC114 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KXXXXMICI 0DDM0 SHALL Attn: Michelle Perea 32400 Paseo Adelanto XYIE[17X7vNfIBtiNwBOE%IPilNX9R�7MCi6R XD=XKI]DCXXXXXXXXXXXXXXXXXXXXIIXXXXXXXXXXXXXXXXXXXXXXX San Juan Capistrano, CA 92675 USA AUTHORIZED REPRESENTATIVE ACORD 25-S!7/971 coralim [a ACORD CORPORATION T SEE 2014023 Powered ByCeTti/icetesNowTM • • G-134844-ACNA (Ed. 09/99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NONCONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS ACCOUNT PACKAGE POLICY BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESS ACCOUNT PACKAGE POLICY BUSINESSOWNERS COMMON POLICY CONDITIONS A. WHO IS AN INSURED (Section C. of the This insurance does not apply to "bodily Businessowners Liability Coverage Form) is injury," "property damage" or "personal and amended to include as an insured any person or advertising injury" arising out of operations organization (called additional insured) described in performed for the state or municipality. paragraphs 2.a. through 2.g. below whom you are b. Any persons or organizations with a required to add as an additional insured on this controlling interest in you but only with policy under: respect to their liability arising out of: 1. A written contract or agreement; or (1) Their financial control of you; or 2. An oral contract or agreement where a (2) Premises they own, maintain or control certificate of insurance showing that person or while you lease or occupy these organization as an additional insured has been premises. issued; but This insurance does not apply to structural the written or oral contract or agreement must be: alterations, new construction and demolition 1. Currently in effect or becoming effective during operations performed by or for such the term of this policy; or additional insured. 2. Executed prior to the "bodily injury," "property c. A manager or lessor of premises but only damage" or "personal injury and advertising with respect to liability arising out of the injury," but ownership, maintenance or use of that Only the following persons or organizations are specific part of the premises leased to you additional insureds under this endorsement and and subject to the following additional coverage provided to such additional insureds is exclusions: limited as provided herein: This insurance does not apply to: a. A state or political subdivision subject to the (1) Any 'occurrence" which takes place following provisions: after you cease to be a tenant in that (1) This insurance applies only with respect premises; or to the following hazards for which the (2) Structural alterations, new construction state or political subdivision has issued or demolition operations performed by a permit in connection with premises or on behalf of such additional insured. you own, rent, or control and to which d. A mortgagee, assignee or receiver but only this insurance applies. with respect to their liability as mortgagee, (a) The existence, maintenance, repair, assignee, or receiver and arising out of the construction, erection, or removal of ownership, maintenance, or use of a advertising signs, awnings, premises by you. canopies, cellar entrances, coal This insurance does not apply to structural holes, driveways, manholes, alterations, new construction or demolition marquees, hoistaway openings, operations performed by or for such sidewalk vaults, street banners, or additional insured. decorations and similar exposures; e. An owner or other interest from whom land or has been leased by you but only with (b) The construction, erection, or respect to liability arising out of the removal of elevators; or ownership, maintenance or use of that (c) The ownership, maintenance, or specific part of the land leased to you and use of any elevators covered by subject to the following additional this insurance. exclusions: (2) This insurance applies only with respect This insurance does not apply to: to operations performed by you or on (1) Any "occurrence" which takes place your behalf for which the state or after you cease to lease that land; or political subdivision has issued a permit. G -134844-A Page 1 of 2 (Ed. 09/99) (2) Structural alterations, new construction B. or demolition operations performed by or on behalf of such additional insured. f. A co-owner of a premises co -owned by you and covered under this insurance but only with respect to the co-owners liability as co- owner of such premises. g. Any person or organization from whom you lease equipment. Such person or organization is insured only with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply: (1) To any "occurrence" which takes place after the equipment lease expires; or (2) To "bodily injury" or "property damage" arising out of the sole negligence of such additional insured. Any insurance provided to an additional insured designated under paragraphs a. through g. above does not apply to "bodily injury' or "property damage" included within the "products -completed operations hazard". NAMED INSURED: CHAMBERS GROUP INC. POLICY NO: 2077875736 ADDITIONAL INSURED: G-134844-A (Ed. 09/99) • G-134844-A (Ed. 09/99) As respects the coverage provided under this endorsement, Section H. OTHER INSURANCE, of the Businessowners Common Policy Conditions is deleted and replaced with the following: H. Other Insurance 1. If there is other insurance covering the same loss or damage, we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance (except as indicated in 2. below), whether you can collect on it or not. But we will not pay more than the applicable Limit of Insurance. 2. This insurance is excess over: Any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a contract or agreement specifically requires that this insurance be either primary or primary and noncontributing. Where required by contract or agreement, we will consider any other insurance maintained by the additional insured for injury or damage covered by this endorsement to be excess and noncontributing with this insurance. 3. When this insurance is excess, we will have no duty under Business Account Package Policy Liability Coverage to defend any claim or "suit" that any other insurer has a duty to defend. If no other insurer defends, we will undertake to do so; but we will be entitled to the insured's rights against all those other insurers. Page 2of2 0 32400 PASEO ADEL NTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 FAX www.sanjuancapistrano.org May 10, 2004 The Chambers Group 17671 Cowan Ave., Suite 100 Irvine, CA 92614 dwa,� IA(RAlRARIf1 AslnnusnnR IA61 1776 MEMBERS OF THE CITY COUNCIL SAM ALLEVATO DIANE L. BATHOATE WYATT HART JOE SOTO DAVID M. SWEROLN RE: Compliance with Insurance Requirements - Environmental Monitoring Services for the SC -04 Terminal Pipeline Project The following insurance documents are due to expire: ✓ General Liability Certificate 06/01/2004 ✓ General Liability Endorsement Form naming the City of San Juan Capistrano as additional insured. ✓ Automobile Liability Certificate 06/01/2004 Please submit updated documentation to the City of San Juan Capistrano, attention City Clerk's office, 32400 Po Adelanto, San Juan Capistrano, CA 92675 by the above exp"tion dates. L�Dyo ave any questions, please contact me at (949) 443-6309. Secretary cc: Michelle Perea, Administrative Assistant Peter Salgado, Associate Engineer San Juan Capistrano: Preserving the Past to Enhance the Future Agency Name and Address: Professional Practice Insurance Brokers, Inc. 2030 Main Street, Suite 350 Irvine, CA 92614-7248 Insureds Name and Ad Chambers Group, Inc. 17671 Cowan Avenue, Suite 100 Irvine, CA 92614 Pq u Certificate of Insurance 1 of 1 NM88241 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON ZWro FICATE HOLDER. THIS CERTIFICATE DOES 8 I`6T D, EXTEND OR ALTER THE COVERAGE DEC 2 a A. B. C. D. ._?IIl W04- _ E. CERTIFY THAT POLICIES OF INSURANCE LISTED BFLOW HAVE BEEN ISSUED TO THE IN REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH Fire Insurance Co. tal Casualty Company ,MED ABOVE FOR THE POLICY PERIOE TO WHICH THIS CERTIFICATE MAY BE TYPE OF INSURANCE POLICY NUMBER EFF.DATE EXP.DATE POLICY LIMITS A GENERAL LIABILITY 2077875736 06/01/04 06/01/05 $2,000,000 X❑ Commercial General Liability $1,000,000 Each Occurrence: $1,000,000 Fire Ding. (any one fire): ❑ Claims Made Combined Single Limit: $1,000,000 Bodily Injury/person: $0 ® Occurrence $0 Property Damage: $0 Each Occurrence: ❑ Owner's and Contractors Aggregate: $5,000,000 Statutory Limits Protective Disease/Policy Limit: Disease/Employee: Per Claim $1,000,000 Aggregate $ AUTO LIABILITY 72UECUM5379 06/01104 06701/05 ❑X Any Automobile ❑ All Owned Autos ❑ Scheduled Autos X❑ Hired Autos X❑ Non -owned Autos ❑ Garage Liability El— A EXCESS LIABILITY 2077875736 06/01/04 06/01/05 ❑X Umbrella Form ❑ Other than Umbrella Form WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY C PROFESSIONAL EEA254087693 11/30/04 11/30/05 LIABILITY' General Aggregate: $2,000.000 Products-Com/Ops WITHIN THE POLICY FOR ALL OPERATIONS OF THE INSURED. Aggregate: $2,000,000 Personal and Adv. Injury: $1,000,000 Each Occurrence: $1,000,000 Fire Ding. (any one fire): $1,000,000 Combined Single Limit: $1,000,000 Bodily Injury/person: $0 Bodily Injury/accident: $0 Property Damage: $0 Each Occurrence: $5,000,000 Aggregate: $5,000,000 Statutory Limits Each Accident: Disease/Policy Limit: Disease/Employee: Per Claim $1,000,000 Aggregate $2,000,000 $0 Description of Operations/LocationsNehicles/Restrictions/Special items: GENEI:AL LIABILITY: CITY OF SAN JUAN CAPISTRANO IS NAMED ADDITIONAL INSURED PER ATTACHED ENDORSEMENT. 'VU,Htan at Annranafa limits of liahility not lase than nirrI shnwn Certificate Holder: THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY FOR ALL OPERATIONS OF THE INSURED. City Of San Juan Capistrano CANCELLATION: Attn: Peter Salgado SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY, ITS AGENTS OR REPRESENTATIVES WILL MAIL 30 32400 Paseo Adelanto DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, EXCEPT IN San Juan Capistrano, CA 92675 THE EVENT OF CANCELLATION FOR NON-PAYMENT OF PREMIUM IN WHICH CASE 10 DAYS NOTICE WILL BE GIVEN. Authorized Representative'. 12/221D4 cc G -134844-A Page 1 of 2 (Ed. 09/99) CNA (-134844-) (Ed. 09/99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NONCONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS ACCOUNT PACKAGE POLICY BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESS ACCOUNT PACKAGE POLICY BUSINESSOWNERS COMMON POLICY CONDITIONS A. WHO IS AN INSURED (Section C. of the This insurance does not apply to "bodily Businessowners Liability Coverage Form) is injury," "property damage" or "personal and amended to include as an insured any person or advertising injury" arising out of operations organization (called additional insured) described in performed for the state or municipality. paragraphs 2.a. through 2.g. below whom you are b. Any persons or organizations with a required to add as an additional insured on this _ controlling interest in you but only with policy under. _> r1i ° 1`°- "" respect to their liability arising out of: 1. A written contractor agreement; orr — `� _ ` (1) Their financial control of you; or 2. An oral contract or agreement -4&re a certificate of insurance showingthiihp ion LO�� P QED 8 (;)-Premises the own, maintain or control y 2 while you lease or occupy these organization as an additional insur be�e4t4r -` premises. µh8s issued; but ` This insurance does not apply structural the written or oral contract or agreement ust . WORKS p�g�IC d alterations, new construction and demolition 1. Currently in effect or becoming effec've durl� operations performed by or for such the term of this policy, or additional insured. 2. Executed prior to the "bodily injury," "property c. A manager or lessor of premises but only damage' or "personal injury and advertising with respect to liability arising out of the injury," but ownership, maintenance or use of that Only the following persons or organizations are specific part of the premises leased to you additional insureds under this endorsement and and subject to the following additional coverage provided to such additional insureds is exclusions: limited as provided herein: This insurance does not apply to: a. A state or political subdivision subject to the (1) Any "occurrence' which takes place following provisions: after you cease to be a tenant in that (1) This insurance applies only with respect premises, or to the following hazards for which the (2) Structural alterations, new construction state or political subdivision has issued or demolition operations performed by a permit in connection with premises or on behalf of such additional insured. you own, rent, or control and to which d. A mortgagee, assignee or receiver but only this insurance applies: with respect to their liability as mortgagee, (a) The existence, maintenance, repair, assignee, or receiver and arising out of the construction, erection, or removal of ownership, maintenance, or use of a advertising signs, awnings, premises by you. canopies, cellar entrances, coal This insurance does not apply to structural holes, driveways, manholes, alterations, new construction or demolition marquees, hoistaway openings, operations performed by or for such sidewalk vaults, street banners, or additional insured. decorations and similar exposures; e. An owner or other Interest from whom land or has been leased by you but only with (b) The construction, erection, or respect to liability arising out of the removal of elevators; or ownership, maintenance or use of that (c) The ownership, maintenance, or specific part of the land leased to you and use of any elevators covered by subject to the following additional this insurance. exclusions: (2) This insurance applies only with respect This insurance does not apply to: to operations performed by you or on (1) Any "occurrence' which takes place your behalf for which the state or after you cease to lease that land; or political subdivision has issued a permit. G -134844-A Page 1 of 2 (Ed. 09/99) (2) Structural alterations, new construction B. or demolition operations performed by or on behalf of such additional insured. f. A co-owner of a premises co -owned by you and covered under this insurance but only with respect to the co-owners liability as co- owner of such premises. g. Any person or organization from whom you lease equipment. Such person or organization is insured only with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply: (1) To any "occurrence' which takes place after the equipment lease expires; or (2) To "bodily injury' or "property damage' arising out of the sole negligence of such additional insured. Any insurance provided to an additional insured designated under paragraphs a. through g. above does not apply to "bodily injury" or "property damage' included within the ,,products -completed operations hazard". NAMED INSURED: CHAMBERS GROUP INC. POLICY NO: 2077875736 ADDITIONAL INSURED: CITY OF SAN JUAN CAPISTRANO G -134844-A (Ed. 09/99) • G -134844-A (Ed. 09/99) As respects the coverage provided under this endorsement, Section H. OTHER INSURANCE, of the Businessowners Common Policy Conditions is deleted and replaced with the following: H. Other Insurance 1. If there is other insurance covering the same loss or damage, we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance (except as indicated in 2. below), whether you can collect on it or not. But we will not pay more than the applicable Limit of Insurance. 2. This insurance is excess over: Any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a contract or agreement specifically requires that this insurance be either primary or primary and noncontributing. Where required by contract or agreement, we will consider any other insurance maintained by the additional insured for injury or damage covered by this endorsement to be excess and noncontributing with this insurance. 3. When this insurance is excess, we will have no duty under Business Account Package Policy Liability Coverage to defend any claim or "suit" that any other insurer has a duty to defend. If no other insurer defends, we will undertake to do so; but we will be entitled to the insured's rights against all those other insurers. ` PUBUG WORKS Page 2 of 2 E 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 FAX www.sanjuancapistrano.org November 22, 2004 The Chambers Group 17671 Cowan Ave., Suite 100 Irvine, CA 92614 0 MEMBERS OF THE CITY COUNCIL SAM ALLEVATO DIANE L. BATHGATE WYATT HART JOE SOTO DAVID M. SWERDLIN RE: Compliance with Insurance Requirements — Environmental Monitoring Services for the SC -04 Terminal Pipeline Project The following insurance document is due to expire: ✓ Professional Liability Certificate 11/30/2004 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 expAtion date. Jfi you have any questions, please contact me at (949) 443-6309. T cc: Michelle Perea, Administrative Assistant 112 San Juan Capistrano: Preserving the Past to Enhance the Future a 4h CORD. CERTIFICATE OF LIABILITY INSURA CE 0DAT271k0DDY7 1/27/04 PRODUCER 1-949-729-0777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Professional Practice Insurance Brokers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE POLICY NUMBER HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2244 Neat Coast Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 GENERAL LIABILITY Newport Beach, CA 92663 INSURERS AFFORDING COVERAGE INSURED Chambers Group, Inc. INSURER A:Unitsd States Fidelity S Guaranty Company INSURER B: United States Fidelity and Guaranty Company 17671 Cowen Ave., Suite 100 INSURER C: Continental Casual Company INSURER D: Irvine, CA 92614 NSURER E: PERSONAL 4 ADV INJURY $ 1,000,000 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 EXPIRATION DATE (MMM)DNYI LIMITS B GENERAL LIABILITY BX01554135 06/01/03 06/01/04 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE IK OCCUR MED EXP (Any onePerson) $ 10, 000 PERSONAL 4 ADV INJURY $ 1,000,000 X Contractural Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 POLICY X1 PRO LOC A AUTOMOBILE X LIABILITY ANY AUTO BA01577642 06/01/03 06/01/04 COMBINED SINGLE LIMIT $ 1, 000,000 (Ea accident) BODILY INJURY $ (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGO $ E%CESS LIABILITY EACH OCCURRENCE $ OCCUR F-1 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND jWC STATU- OTH- DRY LIM TS EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER C Professional Liability EEA254087693 11/30/03 11/30/04 Per Claim 1,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESfEXCLUSIONS ADDED BY ENOORSEMENT/SPECIAL PROVISIONS Certificate holder is named as additional insured per endorsement attached. All operations of the named insured. of San Juan Capistrano : Nichelle Perea 3 Paseo Adelanto SHOULD ANY OF THE ABOVE DATE THEREOF, THE ISSUING INSURER WILL EWWWORW MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BOOp00®IKX60 SHALL R San Juan Capistrano, CA 92675 I AUTHORIZED REPRESENTATIVE USA Pow4Ted ByCertiNcatesNown` ARCHITECTS AND EANEERS PROGRAM ENDORS&ENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURED: CHAMBERS GROUP INC. POLICY NUMBER: BINDER405926 POLICY PERIOD: 06/01/03 — 06/01/04 ADDITIONAL INSURED: This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY Additional Insured: The following is added to paragraph 2. of Section II. — WHO IS AN INSURED: i. If you are required to add another person or organization as an insured under this policy by a written work contract or agreement which is i n e ffect d uring t he policy period and a certificate of insurance has been issued listing that person or organization as an Additional Insured, that person or organization is an insured. Such person or organization is referred to in this Coverage Part as an Additional Insured. The following paragraph is added to Section I - COVERAGE: E. Additional Insured Exclusions 1. 1 n addition to the other exclusions applicable to COVERAGES A., B. and C., the insurance provided to an Additional Insured does not apply to: a. "Property damage" to: 1) Property owned, occupied or used by the Additional Insured; 2) Property rented, leased or loaned to, in the care, custody or control of, of over which physical control is being exercised for any purpose by the Additional Insured; or 3) "Your work" performed for the Additional Insured. UNITED STATES FIDELITY & GUARANTY COMPANY b. "Bodily injury", "property damage", "personal injury", or "advertising injury" which is not caused in whole or in part by the negligent acts or omissions of anyone directly or indirectly employed by a Named Insured or for whose acts a Named Insured may be liable. The following additional provision applies: SECTION IV.5 Other Insurance is replaced by the following: 5. Other Insurance The insurance afforded by this Coverage Part is primary insurance and we will not seek contribution from any other insurance available to the insured unless the other insurance is provided by a contractor. Then we will share with that other insurance by the method described below. If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. Countersigned by Authorized RepT sentative CL/BF 21 8104 01 Abbreviated Printed in U.S.A. 4 • Professional Practice Insurance Brokers, Inc. 2244 west Coast Highway Suite 200 Newport Beach, CA 92663 USA City of San Juan Capistrano Attn: Michelle Peres, 32400 Paseo Adelanto San Juan Capistrano, CA 92675 USA This document was brought to you by Carti£icateallow. i., F F B 2 2004 ! I PUBLIC WBRKS If you have questions regarding the content of this document, please contact the Producer/Agent listed on the certificate of insurance or the Insured listed on the notice of cancellation/reinstatement. To find out how you can send and receive all of your certificates of insurance either by email, high speed fax or standard mail, call ConfirmNet toll-free at 877.669.8600, email customercere@confirmnet.com, or visit our website at www.confirmnet.com The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information. P4wmed ByCertificatesNow- CERTHOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-29-2004 CITY OF SAN JUAN CAPISTRANO ATTN MICHELLE PEREA 324 PASEO ADELANTO SAN JUAN CAPISTRANO CA 92675 i1 h _i l! F EP Cuv'i PU6LIC WORKS GROUP: --POLICY NUMBER: 803550-2004 CERTIFICATE ID: lel -CERTIFICATE EXPIRES: 01-01-2005 01-01-2004/01-01-2005 This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance 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. AUTHORIZED REPRESENTATIVE Al� e. f9' PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - M. D. CHAMBERS, COB - EXCLUDED. ENDORSEMENT #1600 - SHERMAN SMITH, PRES - EXCLUDED. ENDORSEMENT #1600 - JACQUIE GREENE, TRES - EXCLUDED. ENDORSEMENT #1600 - NOEL DAVIS, VP - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2004 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER CHAMBERS GROUP, INC 17671 COWAN STE 100 IRVINE CA 92614 SCIF 10282E Accept Nis cariMate only 0 you see afaint watermark that mods'OFFICIAL STATE FUND DOCUMENT' PEW.SGJ RINTED: 01-29-20W PAGE 1 OF 1 Maria G From: Michelle Perea 'U )e Sent: Tuesday, December 02, 2003 3:45 PM To: Maria Guevara I Subject: RE: Chamber Group, Inc - SC -04 Environmental Monitoring J Hi Maria, I just received the updated insurance today on the professional liability, but it does not have workers' comp. I will see about getting that, and I will forward you what I got today. Thanks! -----Original Message ----- From: Maria Guevara Sent: Tuesday, December 02, 2003 3:44 PM To: Michelle Perea Cc: Peter Salgado Subject: Chamber Group, Inc - SC -04 Environmental Mani riIzllil Hi Michelle, Their professional liability expired on 11/3 Iter on October 12, 2003. Now the' or ers comp is due to expire on 1/1 4.1 will not be sending them a letter, si en ing insurance. Thanks for your help. Maria 1 L Maria Guevara From: Maria Guevara Sent: Tuesday, December 02, 2003 3:44 PM To: Michelle Perea Cc: Peter Salgado Subject: Chamber Group, Inc - SC -04 Environmental Monitoring Hi Michelle, Their professional liability expired on 11/30/03. We sent out a letter on October 12, 2003. Now their workers comp is due to expire on 1/1/04. 1 will not be sending them a letter, since we are already pending insurance. Thanks for your help. Maria 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949)493-1053 (FAX) (VII, Iv sonjuancapisirano. org October 12, 2003 The Chambers Group 17671 Cowan Ave., Suite 100 Irvine, CA 92614 Muneuno " m uuw � 1961 1776 MEMBERS OF THE CITY COUNCIL DIANE L. BATHGATE JOHN S. GELFF MATT HART JOESOTO DAVID M. SWERDLIN INTERIM CITY MANAGER PAMEIAGIBSON RE: Compliance with Insurance Requirements — Environmental Monitoring Services for the SC -04 Terminal Pipeline Proiect The following insurance document is due to expire: ✓ 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 date. If you have any questions, please contact me at (949) 443-6308. Sincerely, Meg on han City Clerk cc: Peter Salgado, Associate Engineer Kathleen Springer, Management Analyst I San Juan Capistrano: Preserving the Past to Enhance the Future °Y° ACDR . CERTIFICATE OF LIABILITY INSURANCE . 11/as/D3 PRODUCER 1-549-729-0777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Professional Practice Insurance Brokers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2244 West Coast Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 Newport Beach, CA 92663 INSURERS AFFORDING COVERAGE Chambers Group, Inc. 17671 Cowan Ave., Suite 100 Irvine, CA 92614 _ I COVERAGES INsuRERe: United States Fidelity and Guaranty Company INSURER C. Continental Casual Company INSURER D. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TH E INSURED TANDI NG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCU LED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS POLICY 06/ 000 INSR TYPE OF INSURANCE POLICYNUMBER H GENEMLLIABILRY 8X01554135 X COMMERCIAL GENERAL LIABILITY 000 CLAIMS MADE OCCUR X 'Contractural Liability 000 000 GEN1 AGGREGATE UMITAPPLIES PER: 000 POLICY X PRO- 1-1 LOC Ofi/0 A AUTOMOBILE LIABILRY BA01577642 X ANV AUTO 000 ALL OWNEDAUTOS SCHEDULED AUTOS X HIRED AUTOS X NON-OWNEDAUTOS PROPERTY DAMAGE $ (Pe, actltlant) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESS UABILFTY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND WC STAID- OTH- TORY UMII EMPLOYERS' LIABLITY EL. EACH ACCIDENT b E.L. DISEABE-EA EMPLOYEE E E.L. DISEASE -POLICY LIMIT $ OTHER C Professional Liability 8EA254087fi93 11/30/03 11/30/04 Per Claim 11000,000 Aggregate 2,000,000 DESCRIPTION OF OPEMTONSILOCATIONS/WHICLESIEXCWSIONS ADDED BY ENOORSEMENTISPECIAL PROVISIONS Certificate holder is named as additional insured per endorsement attached. All operations of the named insured. City of San Juan Capistrano named as additional insured. Job SC -04 Environmental Monitoring lsl City of San Juan Capistrano Attn: Public Works Director 32400 Paseo Adelanto San Juan Capistrano, CA 92675 USA 25.S (7197) coralim SHOULD ANY OF THE ASWE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIMnow DATE THEREOF, THE ISSUING INSURER WILL. IXMX1QWi WMAIL 30 DAYS WRITTEN NOTICE TO THE CERTFICATE HOLDER NAMED TO THE LEFT, AUf7fieIXIRA7fK76L5750 SHALL XR97b11H77�O[pDDNCgYiTAi%i61A[MY70F9011)SHIfNmilO'rSg7727D8mlIp0FXKSIDCXMIBCiR AUTHORIZED REPRESENTATNE Powered ByCeAifiea tesND W 14 ARCHITECTS AND ENIINEERS PROGRAM ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURED: CHAMBERS GROUP INC. POLICY NUMBER: BINDER405926 POLICY PERIOD: 06/01/03 — 06/01/04 ADDITIONAL. INSCRED: This endorsement modifies insurance provided under the following: BIISINF.SSOWNERS POLICY Additional Insured: The following is added to paragraph 2. of Section II. - WHO IS AN PJSURF.D: i. If you are required to add another person or organization as an insured under this policy by a written work contract or agreement which is in effect during the policy period and a certificate of insurance has been issued listing that person o r o rganization a s a n Additional Insured, that person or organization is an insured. Such person or organization is referred to in this Coverage Part as an Additional Insured. The following paragraph is added to Section I — COVERAGE: E. Additional Insured Exclusions 1. I n addition to the other exclusions applicable to COVERAGES A., B. and C., the insurance provided to an Additional Insured does not apply to: a. "Property damage" to: t) Property owned, occupied or rued by the Additional Insured: 2) Property rented, leased or loaned to, in the care, custody or control of, of over which physical control is being exercised for any purpose by the Additional Insured, or 3) "Your work" perfonned fou the Additional Insured. UNITED STATES FIDELITY & GUARANTY COMPANY IL "Bodily injury", "property damage", "personal injury", or "advertising injury" which is not caused in whole or in part by the negligent acts or ornisstons of anyone directly or indirectly employed by a Named Insured or for whose acts a Named Insured may be liable. The following additional provision applies: SECTION IV.5 Other Insurance is replaced by the following: 5. Other Insurance The insurance afforded by this Coverage Part is primary insurance and we will not seek contribution from any other insurance available to the insured unless the other insurance is provided by a contractor. Then we will share with that other insurance by the method described below. If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all Insurers. 4�/( 7 Countersigned by Authorizedd R+eprsentative CLBF 21 81 0401 Abbreviated Printed in U.S.A. C MA TM City of San Juan Capistrano Attn: Attn: Public Works Director Fwc 1-949-493-1053 FROM:Chambara Group, Inc. Phone: 1-949-261-5414 Professional Practice Insurance Brokers, Inc. Phone: 1-949-729-0777 Subject This document was brought to you by CertificateeNow. If you have questions regarding the content of this document, please contact the Producer/Agent listed on the certificate of insurance or the Insured listed on the notice of cancellation/reinstatement. To find out how you can send and receive all of your certificates of insurance either by email, high speed fax or standard mail, call ConfirmNet toll-free at 877.669.8600, email customercare®confirmnet.com, or visit our website at w .confirmnst.cam The data included in this notice and in the attached document is confidential to ConfirmNet and the party responsible for bringing you this information. Pov "' ByCeriificai"No.- 0 ACORD,„ CERTIFICATE OF LIABILITY INSURANCE DATE`M09/18/03MIDDIYY) PRODUCER 1-949-729-0777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Professional Practice Insurance Brokers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE POLICY NUMBER HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2244 West Coast Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 Binder405926 06/01/03 Newport Beach, CA 92663 INSURERS AFFORDING COVERAGE INSURED Chambers Group, Inc. INSURERA.St Paul -United States Fidelity & Guaranty (INSURER B: St Paul -United States Fidelity and Guaranty 17671 Cowan Ave., Suite 100 INSURER C. Lloyd's of London INSURERD: Irvine, CA 92614 INSURER E'. 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. (NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION IATELIMBS B GENERAL LIABILITY Binder405926 06/01/03 06/01/04 EACH OCCURRENCE$1,000,000 FIRE DAMAGE (Aryone fire) $ 1,0001000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one OBrsoN 10,000 CLAIMS MADE OCCUR U X Contractural Liability j�$ PERSONAL &ADV INJURY 1.000,000 yl$ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGO $ 2,000,000 ( POLICY! X PRO- JFCT E] LOC I A AUTOMOBILE LIABILITYBinder405924 X ANY AUTO 06/01/03 06/01/04 COMBINED SINGLE UMIT $1,000,000 (Ea accident) BODILY I $ 0n (Pa {wrs.r) CI ALL OWNED AUTOS SCHEDULED AUTOS IIS, X1 ! HIRED AUTOS X X NON -OWNED AUTOS BODILY INJURY :$ (Per dr.ld.Ml — PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY. AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY _ WC STATW OTH- E.L. EACH ACCIDENT $ E.L DREASE EA EMPLOYE $ _ E.L. DISEASE - POLICY LIMIT I $ OTHER -------- C Professional Liability ARP159 11/30/02 11/30/03 Per Claim 11000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCWSIONS ADDED BY ENDORSEMENTISPECUIL PROVISIONS Certificate holder is named as additional insured per endorsement attached. All operations of the named insured. City of San Juan Capistrano named as additional insured. Job SC -04 Environmental Monitoring City of San Juan Capistrano Attn: Public Works Director 32400 Paseo Adelanto San Juan Capistrano, CA 92675 USA ACORD 25-S (7/97) JMGCGL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 6WifYWMWX MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, dEK*XK;MMO X"O SHALL XO($PiLM70ffi7OMDCxPC10iCPA%YE6MKMX7OI+Y73Xdm017YXfCAlO:074%%a[SBiiFkitCSA1CYK18CiIR AUTHORRED REPRESENTATIVE Powered ByC.,Wficates;iIII SEP -23-2003 TUE 0411 PM 0 ers Group �ry FAX NO 9W18950 "w �An t1 S— S`155 .Inc. �!� rN-, POLICYHOLDER COPY P, 02 STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142.0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 09-19-2003 GROUP: POLICY NUMBER: 803550-2003 CERTIFICATE ID: 170 CERTIFICATE EXPIRES. 01-01-2004 01-01.2003/D1-01-2004 CITY OF SAN JUAN C'APISTRANO ATTR PUBLIC WORKS .DIRECTOR 22400 PASEO ADELANTO SAN JUAN CAPISTRANO CA 92675 This is to certify that we have issued a valid Worker's Compensation Insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy pedod Indicated. This policy Is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give youi30 days advance notice should this policy be cancelled rprior 'to its normal expiration. This certificate of insurance is not an insurance policy and does not emend, extend or altar the coverage afforded by the policies listed herein: Notwithstanding any requirement, term or condition oheny contract or other document with respect to which this'certilicate of insurance 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. AIITNCRIZEO REPRFLFMATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS! $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - M. D. CHAMBERS COB - EXCLUDED., ENDORSEMENT #1600 - SHERMAN SMITH PRES - EXCLUDED. ENDORSEMENT 91600 - JACQUIE GREENE TRES - EXCLUDED. ENDORSEMENT #1600 - NOEL DAVIS VP - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER CHAMBERS GROUP, INC 17671 COWAN STE 100 IRVINE CA 92614 Ilf PPRRINNTTEfD osaa.x00J SClp 102029 Aempnnll atlifcale Ply If Y. fpinl wwnmerk that mol °OFFICW. STATE rUNp pOCJNBNT^ PAGE l OF 09/18/03 ConfirinNet —> 194931053 • ARCHITECTS AND ENGINEERS PROGRAM ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURED: CHAMBERS GROUP INC. POLICY NUMBER: BIN DER405926 POLICY PERIOD: 06/01/03 — 06/01/04 ADDITIONAL INSt 1(kL): This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY Additional Insured: "Che fallowing is added to paragraph 2. of Section II. — WHO IS AN INSURED: i. If you are required to add another person or ot'=anization as an insured under this policy by a written work contract or agrcmnent which is i n e ffect d Luing t he Policy period and a certificate of insurance has been issued listing that person o r o rganization a s a n Additional Insured, that person or organization is an insured. Such person or organization is referred to in this Coverage Part as an Additional Insured. The following paragraph is added to Section I - COVERAGF.: E. Additional Insured Exclusions 1. 1 n addition to the other exclusions applicable to COVERAGES A.. B. and C., the insurance provided to an Additional Insured does not apply to: a. "Property damage" to: 1) Property owned. occupied or used by the Additional Insured: 2) Property rented, leased or loaned to, in the care, custody or control of', of over which physical control is being exercised for any purpose by the Additional Insured: or 3) "Your work' perforated for the Additional Insured. Pg 3 UNITED STATES FIDELITY & GUARANTY COMPANY b. 'Bodily injury", "property damage", "personal injury", or "advertising injury" which is not caused in whole or in part by the negligent acts or onussions of anyone directly or indirectly employed by a Named Insured or for whose acts a Named Insured may be liable. The following additional provision applies: SECTION IV.5 Other Insurance is replaced by the following: S. Other Insurance The insurance afforded by this Coverage Part is primary insurance and we will not seek contribution from any other insurance available to the insured unless the other insurance is provided by a contractor. Then we will share with that other insurance by the method described below. If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. Countersigned by Authorized Repr sentative CI.BF 21 81 04 01 Abbreviated printed in U.S.A. r 32400 PASEO ADELANTO SAN -JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 (FAX) ivivw.sonjuancapisirano. org September 29, 2003 Chambers Group, Inc. 17671 Cowan Avenue, Ste 100 Irvine, CA 92614 Dear Sir or Madam: �&Wft [sumu[1 I 1961 1776 MEMBERS OF THE CITY COUNCIL DIANE L. BATHGATE JOHN S. GELFF MATT HART JOESOTO DAVID M. SWERDLIN INTERIM CITY MANAGER PAMELAGIBSON A fully executed, original Personal Services Agreement related to environmental monitoring services for the SC -04 Terminal Pipeline 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. Please coordinate your work under this agreement in coordination with the Project Manager, Peter Salgado, Associate Engineer (949) 443-6366. Yours truly, an, CMC cc: Peter Salgado, Associate Engineer Amy Amirani, Public Works Director Finance San Juan Capistrano: Preserving the Past to Enhance the Future 0 0 CITY CLERK'S DEPARTMENT - ACTION REMINDER Peter Salgado, Senior Civil Engineer Fq�dM: Christy Swanson, Secretary DATE: June 1, 2006 SITUATION: On September 29, 2003, the City of San Juan Capistrano entered into a Personal Services Agreement with Chambers Group, Inc. to provide environmental monitoring services for the SC -04 Terminal Pipeline Project. ACTION REQUESTED: Said Agreement states services shall be completed by January 31, 2005. On January 17, 2005, said agreement extended to June 30, 2005. On June 2, 2005, said agreement extended to December 31, 2005. On December 2, 2005, said agreement extended to June 29, 2006. Please notify our office if agreement has been completed or will be extended. ACTION TO BE TAKEN: tae y� �r �Nl�LEl� DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN: SIGNATURE OF OFFICIAL TAKING ACTION: DATE SIGNED: 6 z�''�! "'FOR CITY CLERK'S DEPARTMENT USE ONLY'"' Tickler Date: 01/15/05 06/01/05 12/01/05 06/01/06 Deadline Date: 01/31/05 06/30/05 12/31/05 06/29/06 d -y (600.301chambers) oo 9 CITY CLERK'S DEPARTMENT - ACTION REMINDER Peter Salgado, Senior Civil Engineer F Mitzi Ortiz, Deputy City Clerk SITUATION: DATE: December 2, 2005 On September 29, 2003, the City of San Juan Capistrano entered into a Personal Services Agreement with Chambers Group, Inc. to provide environmental monitoring services for the SC -04 Terminal Pipeline Project. ACTION REQUESTED: Said Agreement states services shall be completed by January 31, 2005. On January 17, 2005, said agreement extended to June 30, 2005. On June 2, 2005, said agreement extended to December 31, 2005. Please notify our office if agreement has been completed or will be extended. ACTION TO BE TAKEN: 4y7&4-)�2 `0 C-."- S DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN: SIGNATURE OF OFFICIAL TAKING ACTION: DATE SIGNED: Tickler Date: 01/15/05 Deadline Date: 01/31/05 (600.301chambers) ***FOR CITY CLERK'S DEPARTMENT USE ONLY*** 06/01/05 12/01/05 06/30/05 12/31/05 r� L-A �y0: Peter Salgado, Senior Civil Engineer FR Mitzi Ortiz, Deputy City Clerk 1 SITUATION: DD - ACTION REMINDER JUN 1 2005 Pukic WORKS DATE: June 1. 2005 On September 29, 2003, the City of San Juan Capistrano entered into a Personal Services Agreement with Chambers Group, Inc. to provide environmental monitoring services for the SC -04 Terminal Pipeline Project. ACTION REQUESTED: Said Agreement states services shall be completed by January 31, 2005. On January 17, 2005, said agreement extended to June 30, 2005. Please notify our office if agreement has been completed or will be extended. ACTION TO BE TAKEN: cGvy1p7VW r 3 / 2v DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN: SIGNATURE OF OFFICIAL TAKING ACTION: DATE SIGNED: Tickler Date: 01/15/05 Deadline Date: 01/31/05 cc: Department Head (600.301chambers) ***FOR CITY CLERK'S DEPARTMENT USE ONLY*** 06/01/05 06/30/05 r� 0 CITY CLERK'S DEPARTMENT - ACTION REMINDER Peter Salgado, Senior Civil Engineer F�41M: Mitzi Ortiz, Deputy City Clerk DATE: January 17, 2005 SITUATION: On September 29, 2003, the City of San Juan Capistrano entered into a Personal Services Agreement with Chambers Group, Inc. to provide environmental monitoring services for the SC -04 Terminal Pipeline Project. ACTION REQUESTED: Said Agreement states services shall be completed by January 31, 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: ***FOR CITY CLERK'S DEPARTMENT USE ONLY*** Tickler Date: 01/15/05 Deadline Date: 01/31/05 cc: Department Head (600.301chambers) .A L