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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 • 0 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 0 0 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