1989-0701_O C CONSOLIDATED TRANS SERVICE_Agreement0 City C0
AGREEMENT
THIS AGREEMENT, is entered into, in duplicate, effective July 1, 1989, by
and between the City of San Juan Capistrano, hereinafter referred to as
"PURCHASER," and the ORANGE COUNTY CTSA, a California nonprofit
public benefit corporation, hereinafter referred to as OCCTSA.
WHEREAS, OCCTSA is experienced in the transportation of seniors, and
persons with disabilities, and
WHEREAS, pursuant to 49 USC S1612 and California Government Code
1403, CTSA, under contract with the California Department of Transportation,
is a provider of mass transportation services to meet the special needs of elderly
and handicapped persons; and
WHEREAS OCCTSA has entered into an Agreement with the County of
Orange which requires OCCTSA to provide transportation services for the elderly
pursuant to the Older Americans Act of 1965, as amended; and
WHEREAS, OCCTSA, pursuant to Section 15975 of the California
Government Code has been designated ORANGE COUNTY CONSOLIDATED
TRANSPORTATION SERVICE AGENCY (OCCTSA) by the Orange County
Transportation Commission and haq been allocated Article 4.5 of the
Transportation Development Act of 1972 funds; and
WHEREAS, PURCHASER is desirous of purchasing "Social Services"
transportation service from OCCTSA as a consolidated transportation agency
(OCCTSA) which pursuant to the OCCTSA mission statement, seeks to provide
for the transportation needs of clients of social service agencies in an effective
cost efficient manner.
NOW THEREFORE, in consideration of the respective and mutual covenants
and promises hereinafter contained and made, and subject to all the terms and
conditions hereof, the parties hereto agree as follows:
I
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1. OCCTSA assumes all responsibility for the operation, scheduling,
maintenance, and cost thereof of any vehicles which are to be
operated in the performance of this Agreement except to the extent
this Agreement provides otherwise.
2. OCCTSA shall obtain and maintain all licenses, registrations, and
accreditations from agencies governing its operation, which are
necessary for OCCTSA to perform its obligations under this
Agreement.
3. OCCTSA shall obtain at its sole cost and file with PURCHASER,
prior to exercising any right or performing any obligation pursuant to
this Agreement and maintain for the period covered by this
Agreement, a policy of policies of general and auto liability insurance
and a certificate of such insurances, naming PURCHASER, its
officers, agents, and employees, as insured or additional insured,
which provides coverage not less than that provided in the form of a
general and auto liability insurance policies for any and all claims
and suits for damages or injuries to persons or property resulting from
or arising out of operation of vehicles by OCCTSA, its officers,
agents, or employees. OCCTSA shall carry general liability insurance
of One Million Dollars ($1,000,000) per occurrence and auto insurance
of combined single limit bodily injury and property damage in the
amount of Five Million Dollars ($5,000,000) per occurrence. Should
any of the above described policies be cancelled before the expiration
date thereof, the issuing company will endeavor to mail 30 days
written notice to the certificate holder named.
4. Before OCCTSA shall employ any person or persons in the
performance of this contract, OCCTSA shall procure a policy of
2
Workers' Compensation Insurance as required by the provisions of
Section 3700 of the California Labor Code; and OCCTSA shall furnish
to PURCHASER a Certificate of Insurance showing that the aforesaid
insurance is in full force and effect during the entire term of this
Agreement.
5. OCCTSA shall employ only qualified drivers to operate any vehicles
in performance of this Agreement. Prior to employment, OCCTSA
shall review each of said drivers' Department of Motor Vehicles
record. Each of said drivers shall possess and maintain any licenses or
certificates required by law and necessary for their individual
performances on behalf of OCCTSA under this Agreement. OCCTSA
shall be solely responsible for the supervision of said drivers in the
performance of their duties.
6. Notwithstanding any other provision of this Agreement, OCCTSA and
PURCHASER agree to comply with all applicable federal, state and
local laws and regulations.
7. OCCTSA agrees to establish, maintain and preserve records which
include and substantiate costs of all labor and materials related to the
performance of this Agreement, and documentation which
substantiates OCCTSA performance of transportation services
pursuant to this Agreement. OCCTSA shall keep such records for a
period of three (3) years after expiration of this Agreement (unless
Section 6 hereof requires a longer period). OCCTSA shall make all of
the above records available, upon reasonable notice, to PURCHASER
during regular business hours.
8. NEITHER party shall assign or transfer any interest in this
Agreement, without prior written consent of the other party,
3
provided, however, that claims for money due or to become due from
the other party on account of this Agreement may be assigned to a
bank, trust company or other financial institution, or to a trustee in
bankruptcy without said written consent.
9. OCCTSA shall hold PURCHASER harmless from and against any and
all liability, loss, damage, claims, suits, costs and expenses, including
reasonable attorney's fees, regardless of the merit or outcome of any
such claim or suit, claimed or arising from any negligent or wrongful
act or omission of OCCTSA, its officers, employees, agents or
subcontractors in the performance of this Agreement.
10. PURCHASER shall hold OCCTSA harmless from and against any and
all liability, loss, damage, claims, suits, costs and expenses, including
reasonable attorney's fees, regardless of the merit or outcome of any
such claim or suit, claimed or arising from any negligent or wrongful
act or omission of PURCHASER, its officers, employees, agents or
subcontractors in the performance of this Agreement.
11. OCCTSA shall pick up, transport and deliver such passengers at and
to such locations, and at such times as are described in EXHIBIT A -
STATEMENT OF SERVICES - attached hereto and by this reference
incorporated herein.
12. Cash payments from PURCHASER to OCCTSA constitute part of the
performance of this Agreement, PURCHASER shall pay OCCTSA
such amounts as follows: Four Thousand, Three Hundred and Eighty-
seven Dollars ($4,387.00). Failure of PURCHASER to pay OCCTSA
amounts due under this contract within 60 days of such amounts
becoming due shall entitle OCCTSA to, in addition to any other legal
remedies available to OCCTSA, suspend or diminish its performance
4
9 0
under this Agreement if it so elects.
13. Cash payment in the total amount of $4,387.00 are to be paid to
OCCTSA by PURCHASER as part of the performance of this
Agreement.
14. OCCTSA Executive Director is authorized to receive any and all
notices pertaining to this Agreement.
Any communications from PURCHASER to OCCTSA may be made by
mailing the same, postage prepaid, to the Executive Director of
OCCTSA, to the following Address:
Orange County CTSA
1000 E. Santa Ana Blvd., Suite 300
Santa Ana, California 92701
15. Any communications from OCCTSA to PURCHASER may be made by
mailing the same, postage prepaid, to the following address:
City of San Juan Capistrano
31421 La Matanza
San Juan Capistrano, CA 92675
16. Either of the parties hereto may cancel this Agreement by giving sixty
(60) days written notice of said cancellation to the other party hereto.
In the event of termination or cancellation for any reason OCCTSA
shall return to PURCHASER all sums of money or other property
allocable to the post termination/cancellation period.
17. The terms of this Agreement shall be one (1) year, or that portion of a
5
0 9
year commencing July 1, 1989 and expiring at the end of business or
5:00 PM whichever occurs last on June 30, 1990.
18. This document fully expresses all understandings of the parties
concerning all matters covered and shall constitute the total
Agreement. No addition to or alteration of the terms of this
Agreement shall be valid unless made in writing and formally adopted
in the same manner as this Agreement.
6
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement on
the respective dates as set forth below:
ORANGE COUNTY CONSOLIDATED TRANSPORTATION SERVICE
AGENCY
Executed on February 16 198L at Santa Ana California
By
Typtd/Name: James D. Bolton
Title: Chairman of the Board of Directors
Executed on February 16 1989 , at Santa Ana
California
By
Typed Name: Gregory T. Winterbottom
Title: Executive Director
(PURCHASER)
Executed on J
By
Typed Na Gary L.
19 89, at
Title Mayor
ATTEST: APPROVED AS TO FORM:
i
XUte on 119 at
By
Typed Name
Title
7
California
0 0
EXHIBIT A
1. Orange County Consolidated Transportation Service Agency (OCCTSA) shall
schedule and operate a vehicle or vehicles Monday through Friday within the
present hours of service provided to the identified site or sites in Item 4.
Additional service within budgetary constraints may be available outside the
regular service hours.
2. OCCTSA may, at its discretion, utilize the assigned vehicle or vehicles for
any purpose it deems necessary at any time when senior passengers are not
being transported.
3. OCCTSA shall assign any equipment it feels appropriate for the needs of the
client type and reserve the right to reassign both equipment and driver as
needs change.
4. Service shall be provided to the following site or sites located at:
San Juan Capistrano Nutrition,
31421 La Mantanza,
San Juan Capistrano, CA 92675
8
AGENDA ITEM June 20, 1989
TO: Stephen B. Julian, City Manager
FROM: Thomas L. Baker, Director of Community Services
SUBJECT: Award of Contract for Dial -A -Van Services (Orange County
Consolidated Transportation Service Agency)
SITUATION:
Since April 1, 1983, the City has contracted services to operate a Dial -A -Van
transportation service for both senior citizens and our handicapped population.
The Orange County Consolidated Transportation Service Agency (OCCTSA), is the
agency that the City has contracted to provide this service. The OCCTSA is
under contract with the California Department of Transportation, a provider of
mass transportation services to meet the special needs of the elderly and
handicapped persons. Most Orange County cities contract with OCCTSA for their
transportation services.
The service is well received by our senior citizens. This van provides free
transportation for seniors and the disabled to attend the Nutrition Program at
the Old Fire Station Recreation Complex. The service is available Monday
through Friday. Every Friday, seniors who have ridden the van to the Nutrition
Program may also use the van to go grocery shopping within the City. It is
estimated that the yearly ridership of the van is approximately 5,000 persons.
Staff is seeking approval to renew the contract with OCCTSA for the 1989-1990
fiscal year. A copy of the contract is attached for your review.
NOTIFICATION:
Executive Director
Orange County CTSA
1000 E. Santa Ana Blvd., Suite 300
Santa Ana. CA 92701
COMMISSION/BOARD REVIEW. RECOMMENDATION:
The Parks and Recreation Commission reviewed this item at their meeting of
April 17, 1989, and forwarded a recommendation of approval to City Council.
FINANCIAL CONSIDERATIONS:
The term of the contract with OCCTSA is from July 1, 1989 - June 30, 1990. The
financial support from the City which will be needed is $4,387. This amount has
been included in the Community Services Department's submittal for the 1989-1990
fiscal year budget and is approximately $200 less than the amount approved by
the City Council in last year's budget.
The OCCTSA will be responsible for the operation, scheduling and maintenance of
the van, and the salary of the van driver. The OCCTSA must maintain all
licenses, registrations and accreditations from agencies governing its operation
and maintain policies of liability insurance naming the City and its officers,
agents and employees as additionally insured.
FOR CITY COUNCIL AGENDA
T GZ-
Agenda Item -2- June 20, 1989
ALTERNATE ACTIONS:
1. Approve the agreement with Orange County Consolidated Transportation
Service Agency (OCCTSA) for Dial -A -Van transportation service for the
City's senior citizen and handicapped population for July 1, 1989 -June 30,
1990, and, pending the approval of the 1989-1990 fiscal year budget,
approve $4,387 of cash payment for this program; authorize the Mayor and
City Clerk to sign the agreement.
2. Do not approve the agreement with Orange County Consolidated
Transportation Service Agency (OCCTSA) for the Dial -A -Van transportation
service for the City's senior citizen and handicapped population for
July 1, 1989 -June 30, 1990, and do not approve $4,387 of cash payment for
this program.
3. Direct staff to provide further information.
RECOMMENDATION:
By motion, approve the agreement with Orange County Consolidated Transportation
Service Agency (OCCTSA) for the Dial -A -Van transportation service for the City's
senior citizen and handicapped population for July 1, 1989 -June 30, 1990, and,
pending the approval of the 1989-1990 fiscal year budget, approve $4,387 cash
payment for this program; authorize the Mayor and City Clerk to sign the
agreement.
Respectfully submitted,
Thomas L. Baker
TLB: LE: eg
Attachment
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Tom Baker, Director of Community Services
FROM: City Clerk DATE: May 5, 1990
SITUATION:
At their meeting of June 20, 1989, the City Council approved the Agreement with the
Orange County Consolidated Transportation Service Agency for Dial -A -Van
transportation service for the City's senior citizen and handicapped population. Said
Agreement is effective July 1, 1989, through June 30, 1990.
ACTION REQUESTED:
Please advise of status of the Agreement and whether or not the Agreement needs to be
scheduled for the Agenda to extend the time period/new Agreement.
ACTION TO BE TAKEN: J-Inewal of },IIS oc�reernenf has been
Ie&�o be inched on 4a y-Ltr)f,- iq agenda of 4 fie Ci JL� Cou-n6-Q.
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
0
SIGNATURE OF OFFICIAL TAKING ACTION: [�+
DATE SIGNED: 5 - `% • 90
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
Tickler Date: 5/5/89 5/5/90
Deadline Date: 6/30/89 6/30/90
cc: City Attorney 514116
Assistant City Manager 1— 4
(600.30)
• 0
ACOR
SSUE DATE (NW/DDM')
10/17/69
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATI N ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
Curtis Day & Company
AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGES
50 Fremont St., Suite #300
Son Francisco,
COMPANY A
LETTER nice a Insurance Company
CA 94105
COMPANY B
LETTER
415-543-3140
INSURED
Orange County Consolidated
Transportation Service Agency
COMPANY C
LETTER
COMPANY D
LETTER
1000 E. Santa Ana Blvd. 3rd FI
Santa Ana
COMPANY E
LETTER
CA 92701
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORT E
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.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (NM/DDMI)
ALL LIMITS IN THOUSANDS
GENERAL
LIABILITY
GENERAL AGGREGATE Is
COMMERCIAL GENERAL LIABIUTY
PRODUCTS-COMP/OPS AGGREGATE $
CLAIMS MADE FlOCCURRENCE
PERSONAL 8 ADVERTISING INJURY $
OWNER'S 8 CONTRACTORS PROTECTIVE
EACH OCCURRENCE $
FIRE DAMAGE (ANY ONE FIRE) $
MEDICAL EXPENSE UNI ONE PERSON $
AUTOMOBILE
LIABILITY
ANY AUTO
CSL
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY
(PERRY
HIRED AUTOSINJURLY
NON -OWNED AUTOS
Wawl
Y
IPER
GARAGE LIABILITY
OEWL
PROPERTY
DAMAGE
EXCESS LIABILITY
EACH
OCCURRENCE AGGREGATE
$ $
OTHER THAN UMBRELLA FORM
WORKERS'
STATUTORY'
COMPENSATION
$ 100GEACH ACCIDENTI
A
EMPLOYEANDLIABILITY
UCA021606
7/01/89
7/01/90
1000DISEASE-POLICY LIMIT
$ 100DDISEASE-EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY
City of San Juan Capistrano
WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
Attn: Sheri F o r tmu e I I e r
CERTIFICATE HOLDER, NAMED TO THE LEFT, BUT FAILURE TO MAIL
Community Services Supervisor
31421 La Matanza
Juan Capistrano, CA 92675
SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY
KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES.
AUT}10K1ZE/1--�)D REPRESENTATIVE
iaSan
154928000
Dear Certificate Holder:®' 3o
We are pleased to provide the att ned Certificate(s) of Insuranc. You may find that
this Certificate(s) does not comply with all of the terms and conditions of your contract
due to the insurance carrier's restrictions under their policy forTp.r If you should have
any questions, please feel free to contact the undersig ed.
Curtis Day & Co.
50 Fremont St., 1300 Mary S. Hatley, ccount Exec ive
San Francisco, CA 94105 (415) 543-3140
CDC 005p 8/89
ACORD 0 SWE DATE WWOW"
9/22/89
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
F1
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
Cur t i s Day & Company
AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGES
50 Fremont S t . , Suite #300
San Francisco,CA 94105
COMPANYA Ins. Co. of the State of PA
415-543-3140
LETTER
1
COMPANY B
LETTER
INSURED �.
Orange County Consolidated
COMPANY
C
Transportation Serv. Agency
LETTER
COMPANY
D
1000 E. Santa Ana Blvd. 3rd FI
Santa Ana,
LETTER
COMPANY pp
CA 92701 ATTN.: CAROL SAAVEDRA
(THIS CANCELS AND SUPERSEDES CERTIFIC
T�TYAEVTOUSLY ISSUED 6/29/89.)
THIS IS TO C RTIV THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISS ED TO THE INSURED NAMED ABOVE FOR THE
POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, 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,
CO
OR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE InM, MM)
POLICY EXPIRATION
DATE MWIDDI"
ALL LIMITS IN THOUSANDS
GENERAL LIABILITY
GENERAL AGGREGATE _
COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OPS AGGREGATE $
CLAIMS MADE F-1 OCCURRENCE
PERSONAL & ADVERTISING INJURY $
OWNER'S 8 CONTRACTORS PROTECTIVE
EACH OCCURRENCE $
FIRE DAMAGE MANY ONE FIRE) $
MEDICAL EXPENSE ]AW ONE PERSON] $
AUTOMOBILE
LIABILITY
ANY AUTO
CSL
ALL OWNED AUTOS
IBOJDIILLYY,
SCHEDULED AUTOS
]PER
HIRED AUTOS
INJURY
NON -OWNED AUTOS
IPER
ACCUOULL
GARAGE LIABILITY
PROPERTY
DAMADE
EXCESS LIABILITY
tALH AGGREGATE
OCCURRENCE
S $
OTHER THAN UMBRELLA FORM
WORKERS'
STATUTORY
COMPENSATION
S 1EACH ACCIDENT)
AND
EMPLOYERS' LIABILITY
DISEAS -POLICY LIMIT)
$ ]DISEASE -EACH EMPLOYEE)
OTHER
A
S AUTO LIABILITY
7892355
7/01/89
7/01/90
3000K XS $2000K
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS
THE BELOW NAMED CERTIFICATE HOLDER, ITS OFFICERS, AGENTS AND EMPLOYEES ARE
EREBY INCLUDED AS ADDITIONAL INSUREDS.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY
City of San Juan Capistrano
WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
A t t n: Sheri F o r t m u e l l e r
CERTIFICATE HOLDER, NAMED TO THE LEFT, BUT FAILURE TO MAIL
Community Services Supervisor
SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY
3142 1 L a Ma t a nza
KIND U HE COMPANY ITS AGENTS OR REPRESENTATIVES.
AUTHORIZE REP E NTATIVE
San Juan Capistrano, CA 92675
�� 154928000
Dear Certificate Holder: 6 3
We are pleased to provide the at :hed Certi,ficat9(s) of Insuranc. You may find that
this Certificate(s) does not comply with all of the terms and conditions of your contract
due to the insurance carrier's restrictions under their policy form. If you should have
any questions, please feel free to contact the and@rs ed.
Curtis Day & Co.
50 Fremont St., #300- Mary S. Harley,count Exec ve
San Francisco, CA 94105 (415) 543-3140
CDC 005p 8/89
RTIFICATE OF INSURANCE 08/03/89
This certificate is issued s a matter of information ly and confers no rights
upon the _ertificate holder. This certificate does not amend, extend or alter
the cuverge afforded by the policies listed below.
PRODUCER 11 C Letter A NATIONAL UNION FIRE INS. CO
0 C/O BLACK/WHITE & ASSOCIATES
GENERAL INSURANCE AGENCY M Letter B
P. 0. BOX 6010 P
MISSION VIEJO CA 92690-4010 A Letter C
INSURED N
I Letter D
ORANGE COUNTY C.T.S.A. E
1000 E. Santa Ana Blvd,3rd fl. S Letter E
Santa Ana CA 92701
This is to certify that policies of insurance listed below have been issued to
the insured named above for the policy period indicated. Notwithstanding any
requirement, term or condition of any contract or other document with respect
to which this certificate may be issued or may pertain, the insurance afforded
by the policies described herein is subject to all the terms, exclusions and
conditions of such policies. Limits shown may have been reduced by paid claims.
-------------------.----- :-------;=-COVERAGES---------------------_--_—__—_—_—__�
Co Type of Policy # Policy Policy All Limits
Ltr Insurance Effective Expiration in Thousands
---- GENERAL LIABILITY ___________________________________
A (X) Commercial GL NLP5251611 07/01/89 07/01/90
( ) ( )Claims Made
(X)Occurrence
( ) Owners & Contr
(X) $500 DED BI/PD
---- AUTOMOBILE LIABILITY
( ) Any Auto
( ) All Owned
( ) Scheduled
( ) Hired
( ) Non—Owned
( ) Garage Liab
Gnl Aggregate $2,000
Prd—CompOp Agg $2,000
Pers & Adv Inj $1,000
Each Occur $1,000
Fire Damage $50
Medical Exp
CSL
B.I./Person
S.I./Accident
P.D.
„___ EXCESS LIABILITY ---------- __--------------- _______----------- ____.._______________
( ) Umbrella Form Each Occur Aggregate
( ) O.T. Umbrella
_--- WORKERS COMPENSATION --------- —-------- --------------- - ---------- _—__----__
W.C. STATUTORY
Employers Liab. Each Accident
Disease/Pol
Disease/Emp
____ OTHER ------ ___________--------- _______________________----------
-----------
__________
DESCRIPTION OF Operations/Locations/Vehicles/Restrictions/Special Items
EFFECTIVE 7/1/89 CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER
FORM CG2026 ATTACHED.
X10 DAYS NOTICE FOR NON PAYMENT OF PREMIUM
CANCELLATION: Should any of the above described policies be cancelled
before the expiration date thereof, the issuing company will
mail ■30 days written notice to the certificate holder named below
NAME and ADDRESS of CERTIFICATE HOLDER
CITY OF SAN JUAN CAPISTRANO
314 LA MATANZA
SAN JUAN CAPISTRANO, CA. 92674 "�f 61t4/
025 ATT:SHERI FORTMUELLER u orize Repres atm
Cl 2(
POLICY NUMBER: *NLP5251611 EXPIRES 7/1/90 (t 1-8:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 26 11 85
ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
CITY OF SAN JUAN CAPISTRANO
314 LA MATANZA
SAN JUAN CAPISTRANO, CA 92675
ATTN: SHERI FORTMUELLER
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
WHO IS AN INSURED (Section II) isamended to includeasan insured the person ororganization shown in the Schedule
as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you.
ORANGE COUNTY CONSOLIDATED TRANSPORTATION SERVICE AGENCY
T, Cfl
8/3/89 MLP
A1:011n` CERTIFICA
PROIFUCEA
CODE
Cur l 1 i3 Li.:a'y to IC;omrsa ny
San F'Y <nnc i S.c or CA 94105
415....54:3--3140
SUB -CODE
INSURANCE . ISSUE DATE (MM/DD/YY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
COMPANIES AFFORDING COVERAGE
COMPANY
LETTER A P.I.C. (a Y I!sl( sharing pool.)
INSURED
Orange County Consolidated Transportation
Serv. Agency
1000 E. Santa Ana Blvd. 3rd Fl
Santa Ana, CA 92701
COMPANY Y1 B
LETTER s.. Y . 'iErCl 1.Ti'lfE•7"nrYl I U71i81. Ins.
COMPANY
LETTER C StoTie Wa 1. 1. Surp £lis Lines
COMPANY
LETTER D L..l.ey19=s Of I ... ondon
COMPANY E
LETTER
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
ALL LIMITS IN THOUSANDS
GENERAL LIABILITY
GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OPS AGGREGATE $
CLAIMS MADE OCCUR.
PERSONAL & ADVERTISING INJURY $
OWNER'S 8 CONTRACTOR'S PROT.
EACH OCCURRENCE $
FIRE DAMAGE (Any one fire) $
MEDICAL EXPENSE (Any one person) S
AUTOMOBILE LIABILITY
COMBINED
A X ANY AUTO 2
7/0'1/89 7/07./90
LIMTLE $ 100
ALL OWNED AUTOS
BODILY
INJURY $
SCHEDULED AUTOS
(Per person)
X HIRED AUTOS
BODILY
X
NJURY $
NON -OWNED AUTOS
(Per accident)
GARAGE LIABILITY
PROPERTY
DAMAGE $
EXCESS LIABILITY
EACH AGGREGATE
B X13400300
7/01/£39 7/07./90
OCCURRENCE
$ 100$
X OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
STATUTORY
$ (EACH ACCIDENT)
AND
$ (DISEASE—POLICY LIMIT)
EMPLOYERS' LIABILITY
$ (DISEASE—EACH EMPLO)
OTHER
C; XG AUTO I...IADIL_:I:TY 5000607£:3
7/01/£.39 7/07./90
<(,BOOK X£:, $20OK
D AU'10 F AYSIi: A1... DAM. Nil) C10.1.:1-
7/01/£39 7101/90
m-.11 C£mp & CCJI._
C XS AUTO LIABILITY 58006079
7/01/89 7/01/90
$1000K XS $IOOOK
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
THE CERTIFICATED HOLDER NAMED BELOW, ITS OFFICERS, AGENTS AND EMPLOYEES ARE HEREBY NAMED AS
ADDITIONAL INSURED.
CERTIFICATE HOLDER CANCELLATION
City of San Juan Capistrano
Attn: Sheri Fortmueller
Community Services Supervisor
31421 La Matanza
San Juan Capistrano, CA 92675
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILLXN9H Xid(X9=
MAIL AID DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, i@ARiFiFi4741iL43IlRXLX1[9411{Ni4iQVi4Ckii3C4s•XI}(17{44C]fS4}O@R�7F%&NX]B
1549 ?£3000
CACORD CORPORATION 1988
Achamp. CERTiFICA
PRC9UCER
Curtis Day L. Company
50 Fremont St., Suite x300
San Francisco,CA 94105
415-543-3140
CODE SUB -CODE
'NVURANCE qw ISSUE DATE (MM/DD/YY)
,V 6/29/39
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
Ins. Co. of the State Of PA
COMPANY B
INSURED LETTER
Orange County Conso L idated COMPANY `.
Transportation Serv. Agency LETTER
1000 E. Santa Ana RLvd. 3rd FL COMPANTTER Y
Santa Ana,
CA 92701 COMPANY E
LETTER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS
LTR DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR.
OWNER'S & CONTRACTOR'S PROT.
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
GENERAL AGGREGATE $
PRODUCTS-COMP/OPS AGGREGATE $
PERSONAL & ADVERTISING INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Any one fire) $
MEDICAL EXPENSE (Any one person) $
COMBINED
SINGLE $
LIMIT
BODILY
NJURY $
Per person)
BODILY
INJURY $
(Per .00d.rit)
PROPERTY $
DAMAGE
EACH AGGREGATE
OCCURRENCE
STATUTORY
$ (EACH ACCIDENT)
$ (DISEASE—POLICY LIMIT)
$ (DISEASE—EACH EMPLOI
OTHER
XS AUTO LIABILITY 47881835 '7/01/88 7/01/69 $3000K XS $2000K
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(RESTRICTIONS(SPECIAL ITEMS
THE BELOW NAMED CERTIFICATE HOLDER, ITS OFFICERS, AGENTS AND EMPLOYEES" ARE
HOLDER
City of San Juan Capistrano
Attn. Sheri FortmueLLer
Community Services Supervisor
314'>'1 La Matanza
San Juan Capistrano, CA 92675
ACORD 25-S
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL -.Q DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANYK�AtS'OPQN THE COMPANYh S AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESE ATI _ _/
a
0
June 23, 1989
Executive Director
Orange County CTSA
1000 East Santa Ana Boulevard, Suite 300
Santa Ana, California 92701
Re: Dial -A -Van Services
Dear Sir:
MEMBERS OF THE CITY COUNCIL
ANTHONY L. BLAND
LAWRENCE F. BUCHHEIM
KENNETH E. FRIESS
GARY L. HAUSDORFER
PHILLIP R. SCHWARTZE
CITY MANAGER
STEPHEN B JULIAN
At their regular meeting held June 20, 1989, the City Council of the City of San
Juan Capistrano approved the agreement with the Orange County Consolidated
Transportation Service Agency for Dial -A -Van services for both senior citizens
and handicapped residents in San Juan Capistrano at $4,387. The agreement will
be effective for the period of July 1, 1989, through June 30, 1990.
Enclosed for your files is a fully -executed copy of the agreement. It is my
understanding that the required insurance will be forwarded to my office by
approximately July 1st. If you need any further information, please let me know.
Very truly yours,
i
Mary Ann H over, CMC
City Clerk
MAH/cj
Enclosure
cc: Director of Community Services
32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 • (714) 493.1171
Dear Certificate Holder:
We are pleased to provide the attached Certificate(s) of Insurance. You may find that
this.Certificate(s) does not comply with all of the terms and conditions of your contract
due to the insurance carrier's restrictions under their policy form. If you should have
any questions, please feel free to contact the undersigned.
Curtis Day & Co. F} �,'J,L ,-
50 Fremont St. #300 Susan Heil, Assistant Account Bx cutive
San Francisco, CA 94105 (415) 543-3140
CDC 005p 11/85