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1994-0701_O C TRANSPORTATION AUTHORITY_AgreementAGREEMENT NO. C-94-797 1 AGREEMENT 2 THIS AGREEMENT, is entered effective July 1, 1994, by and between the City of 3 San Juan Capistrano ("PURCHASER") and the Orange County Transportation Authority, a 4 public corporation of the state of California ("AUTHORITY"). 5 WHEREAS, AUTHORITY is experienced in the transportation of seniors, and persons 6 with disabilities, and 7 WHEREAS AUTHORITY is a provider of mass transportation services to meet the 8 special needs of the elderly and persons with disabilities; and 9 WHEREAS, AUTHORITY has entered into Agreement No. C-92-386 with a third party 10 contractor ("CONTRACTOR") to provide transportation services for the elderly pursuant 11 to the Older Americans Act of 1965, as amended; and 12 WHEREAS, AUTHORITY reimburses CONTRACTOR through Agreement No. C-92-386 with 13 funds pursuant to Article 4.5 of the Transportation Development Act of 1972 among 14 other funds to support transportation services in the county; and 15 WHEREAS, PURCHASER is desirous of purchasing "Social Services" transportation 16 service from AUTHORITY. 17 NOW THEREFORE, in consideration of the respective and mutual covenants and 18 promises hereinafter contained and made, and subject to all the terms and conditions 19 hereof, the parties hereto agree as follows: 20 1. AUTHORITY, through its Agreement with CONTRACTOR, assumes all responsibility 21 for the operation, scheduling and maintenance of any vehicles which are to be 22 operated in the performance of this Agreement and cost thereof except to the 23 extent this Agreement provides otherwise. 24 2. AUTHORITY and/or CONTRACTOR, shall obtain and maintain all licenses, 25 registrations and accreditations from agencies governing its operation, which 26 are necessary for AUTHORITY to perform its obligations under this Agreement. DP:BY SANJUAN. AGG Page 1 of 6 AGREEMENT NO. C-94-797 1 3. AUTHORITY shall ensure that CONTRACTOR obtain at its sole cost and file with 2 PURCHASER, prior to exercising any right or performing any obligation pursuant 3 to this Agreement and maintain for the period covered by the Agreement, the 4 following insurance, which shall be full-coverage insurance not subject to s self-insurance conditions- 6 (1) Comprehensive General Liability insurance with at least One Million 7 Dollars ($1,000,000.00) per occurrence; and s (2) Comprehensive Automobile Liability insurance of combined single 9 limit Primary Bodily Injury and Primary Property Damage in an amount not less 10 than Two Million Dollars ($2,000,000.00) per occurrence. 11 (3) Workers' Compensation insurance with limits established and 12 required by the State of California. 13 Should any of the above described policies be canceled before the expiration 14 date thereof, the issuing company will endeavor to mail 30 day written notice 15 to the certificate holder named. 16 4. AUTHORITY, through its agreement with the CONTRACTOR, shall employ only 17 qualified drivers to operate any vehicles in performance of this Agreement. 18 Prior to employment, CONTRACTOR shall review the records maintained and made 19 available by the Department of Motor Vehicles regarding each of said drivers. 20 Each of said drivers shall possess and maintain any licenses or certificates 21 required by law and necessary for their individual performances on behalf of 22 CONTRACTOR under this Agreement. AUTHORITY, through its agreement with 23 CONTRACTOR shall be solely responsible for the supervision of said drivers in 24 the performance of their duties. 25 5. Notwithstanding any other provision of this Agreement, AUTHORITY and PURCHASER 26 agree to comply with all applicable federal, state and local laws and DP:ev SAN.IUAN.AG4 Page 2 of 6 AGREEMENT N0. C-94-797 1 regulations. 2 6. AUTHORITY shall ensure that CONTRACTOR establishes, maintains, and preserves 3 records which include and substantiate costs of all labor and materials related 4 to the performance of this Agreement and documentation which substantiates 5 CONTRACTOR's performance of transportation services pursuant to this Agreement. 6 AUTHORITY, through its agreement with CONTRACTOR shall make all of the above 7 records available, upon reasonable prior notice, to PURCHASER during regular 8 business hours. 9 7. AUTHORITY shall indemnify, defend and save harmless PURCHASER, its officers, 10 directors, employees and agents from and against any and all claims (including 11 attorney's fees and reasonable expenses for litigation or settlement) for any 12 loss or damages for bodily injuries, including death or loss of, damage to or 13 loss of use of property caused by the negligent acts, omissions or willful 14 misconduct by AUTHORITY, its officers, directors, employees, agents, 15 subcontractors or suppliers in connection with or arising out of the 16 performance of this Agreement. 17 8. PURCHASER shall indemnify, defend and save harmless AUTHORITY, its officers, 18 directors, employees and agents from and against any and all claims (including 19 attorney's fees and reasonable expenses for litigation or settlement) for any 20 loss or damages for bodily injuries, including death or loss of, damage to or 21 loss of use of property caused by the negligent acts, omissions or willful 22 misconduct by PURCHASER, its officers, directors, employees, agents 23 subcontractors or suppliers in connection with or arising out of the 24 performance of this Agreement. 25 9. CONTRACTOR shall pick up, transport and deliver such passengers at and to such 26 locations and at such times as are described in EXHIBIT A - STATEMENT OF NP M SANJUAN.AG9 Page 3 of 6 AGREEMENT N0. C-94-797 1 SERVICES - attached hereto and by this reference incorporated herein. 2 10. For services provided by AUTHORITY under this Agreement, PURCHASER shall pay 3 AUTHORITY the amount of One Dollar and Twenty-Four Cents ($1.24) per passenger 4 trip up to but not to exceed the amount of Five Thousand, Six Hundred Dollars 5 ($5,600.00), which shall be PURCHASER's total contribution under this 6 Agreement. AUTHORITY shall submit quarterly invoices to PURCHASER for payment 7 pursuant to this Agreement at the close of each of the following periods: for 8 the period July 1, 1994, through September 30, 1994; for the period 9 October 1, 1994, through December 31, 1994; for the period January 1, 1995 10 through March 31, 1995; and for the period April 1, 1995, through June 30, 1t 1995. Failure of PURCHASER to pay AUTHORITY amount due under this contract 12 within 60 days from date of invoice shall entitle AUTHORITY to, in addition to 13 any other legal remedies available to AUTHORITY, suspend or diminish its 14 performance under this Agreement if it so elects. 15 11. All notices pertaining to this Agreement, and any communications from the 16 parties may be made by delivery of said notices in person or by depositing said 17 notices in the U.S. Mail, registered or certified mail, return, receipt 18 requested, postage prepaid and addressed as follows: 19 To AUTHORITY: 20 Orange County Transportation Authority 21 550 South Main Street 22 P.O. Box 14184 23 Orange, CA 92613-1584 24 Attention: Contracts Administrator 25 / 26 / ON BY SAND AN.AG4 Page 4 of 6 AGREEMENT NO. C-94-797 1 To PURCHASER: 2 City of San Juan Capistrano 3 32400 Paseo Adelanto/City Hall 4 San Juan Capistrano, CA 92675 5 Attention: Dawn Schanderl, Records Coordinator 6 12. Any of the parties may cancel this Agreement by giving thirty (30) days written 7 notice of said cancellation to the other party hereto. In the event of 8 termination or cancellation for any reason, AUTHORITY shall return to PURCHASER 9 any money or other property allocable to the post termination/cancellation 10 period. 11 13. The terms of this Agreement shall be one (1) year, or that portion of a year 12 commencing July 1, 1994, and expiring at the end of business or 5:00 p.m. 13 whichever occurs last on June 30, 1995. 14 14. This document fully expresses all understandings of the parties concerning all is matters covered and shall constitute the total Agreement. No prior written or 16 oral provisions or understanding, between the parties shall have any force or 17 affect. No addition to or alteration of the terms of this Agreement shall be 18 valid unless made in writing and formally adopted in the same manner as this 19 Agreement. 20 / 21 / 22 / 23 / 24 / 25 / 26 / GP:Bw SANJUAN. AGO Page 5 of 6 11 2 3 4 5i 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 ovav SANJUAN.AG4 0 0 AGREEMENT NO. C-94-797 IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date first above written. B; M ORANGE C NTY TRRA-NSPlO,RTATION AUTHORITY BygOa 4 f _�' �(/�L� ftelieExecutive Officer By L-'V� - Kennard R. Smart, Ji. General Counsel Page 6 of 6 EXHIBIT A 1. The AUTHORITY, through its agreement with a third party CONTRACTOR, 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. The AUTHORITY 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. The AUTHORITY 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 Capaistrano Senior Center 31421 La Matanza San Juan Capistrano, CA 92675 5. The AUTHORITY, through its CONTRACTOR, may, at its discretion, deny transportation to passengers who may pose a danger to themselves, other passengers or the drivers. 0 10 6. All rides provided by the AUTHORITY through its CONTRACTOR shall be on a space available basis. Geographic considerations may affect the AUTHORITY's ability to schedule riders. Further, site managers should be aware that the number of individuals assigned to a given route may affect service quality and route integrity. 7. The AUTHORITY, through its CONTRACTOR, requires that passengers be ready at the agreed pick-up time. The CONTRACTOR's drivers shall wait only five minutes after the scheduled pick-up time. Passengers who need to cancel scheduled rides, must do so at least one hour prior to scheduled pick-up times. Additionally, a "No Show" policy provides for removal from the service of passengers who do not comply with this policy. 8. "Will Call" passengers must notify the CONTRACTOR by 0730 of the morning they wish to ride. DRBY SANJUAN.AG4 PRODUCER Averbeck Company 3380Shelby St. Ontario, CA 91764 INSURED Dave Transportation Services, Inc. 201 E. Sandpointe, Ste. #800 Santa Ana, CA 92707 ONLY AND CONFERS NO RIGHTS UPOI HOLDER. THIS CERTIFICATE DOES NOT COMPANY AGreat States Ins. Co. COMPANY BGreat American COMPANY COMPANY / D �/ c 12 EXTEND OR 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. (LTR TYPE OF INSURANCE I POLICYNUMBER POLICY EFFECTIVE( OATE(MM/DDJYYj POLICY EXPIRATION GATE(MM(00/hYj LIMITS AUTO ONLY -EA ACCIDENT $ GENERAL LIABILITY OMMERCIAL GENERAL UASiLM CLAIMSMADE❑ OCCUR WNER'S& CONTRACTOR'S PROT AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM GENERAL AGGREGATE S PRODUCTS-COMP/OPAGG $ EACH OCCURRENCE $ PERSONAL&ADV INJURY S EACHOCCURRENCE $ FIRE DAMAGE (Any one fire) $ DMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS SINGLE LIMIT PROPERTY DAMAGE B OTHER Blanket MAC789173601 12/31/94 12/31/95 $100,000 Limit. mployee $1,000 Deductible. ishonesty DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Verification of Insurance. *10 Day Notice of Cancellation applies for Non Payment of Premium. City of San Juan Capistrano Attn. Linda Evans 32400 Paseo Adelanto/ City Hall San Juan Capistrano, CA 92675 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATETHEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ". _� 0 PAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUTFAILURE4"AILSUC NOTIC A CMFI\POaENOOBLIGATIONORLIABILITY AUTHORIZED GARAGE LIABILRY ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN AUTO ON LV. :....... _. _..::.<::.. _........,,..::.:: EACH ACCIDENT S AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM _-6-1-7-0-1-T9-5 EACH OCCURRENCE $ AGGREGATE $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I� THE PROPRIETOR/ IAIINCL PARTNERS/EXECUTIVE __ _ _ GWN10071295 -0-1-7-0-1-T9-6 STATUTORVLIM ITS EACH ACCIDENT el OOO OOO d DISEASE -POLICY LIMIT $1 000 000 I - — — — — — — B OTHER Blanket MAC789173601 12/31/94 12/31/95 $100,000 Limit. mployee $1,000 Deductible. ishonesty DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Verification of Insurance. *10 Day Notice of Cancellation applies for Non Payment of Premium. City of San Juan Capistrano Attn. Linda Evans 32400 Paseo Adelanto/ City Hall San Juan Capistrano, CA 92675 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATETHEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ". _� 0 PAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUTFAILURE4"AILSUC NOTIC A CMFI\POaENOOBLIGATIONORLIABILITY AUTHORIZED December 8, 1994 Orange County Transportation Authority Attention: Contract Administrator 550 South Main Street Orange, California 92613-1584 Dear Gentlemen: MEMBERS OF THE CITY COUNCL COLLENE CAMPBELL GARY L HAUSDORFER OIL JONES CAROLYN NASH JEFF VASOUEZ CITY MANAGER GEORGE SCARBOROUGH • The Workers' Compensation Certificate of Insurance, regarding the above -referenced service, is due to expire on January 1, 1995. In accordance with your agreement, the insurance certificate needs to be renewed for an additional period of one year. Please forward an updated certificate to the City of San Juan Capistrano, attention City Clerk's office, by January 6, 1995. If you have any questions, please contact me at (714) 443-6310. Thank you for your cooperation. {vLVery�tr�)�ully yours, ( / `d,�, a�� Dawn M. Schanderl Deputy City Clerk cc: Cheryl Johnson, City Clerk Linda Evans, Community Services Supervisor 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 • (714) 493.1171 Acke p. CERTIFICA OF INSURANCE ISSUE DATE (MM/DDIVV) 1101 94 PRODUCER HIS CERTIFICATE IS ISSUED AS A MATTE OF INF RMATI N ONLY AND " CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE k RODES—ROPER—LOVE INS. AGENCY, INC. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P. O. BOX 700 POLICIES BELOW. MELBOURNE, FL 32902-0700 COMPANIES AFFORDING COVERAGE i ONV LETTEROMPAA NATIONAL UNION FIRE INS CO OF PITTSBURGH PA LETTERNY B GENERAL STAR NATIONAL / OXBRIDGE INSURED DAVE MANAGEMENT, INC. COMPANY LETTER C 4 DAVE TRANSPORTATION SERVICES, INC. f VAN TRAN OF TUCSON, INC. TTER"Y D DAVE FLEET MANAGEMENT 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 j IINDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS SI CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, I 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 LIMITS DATE (MM/DDIVY) DATE (MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 5,000,000 A XCOMMERCIAL GENERAL LIABILITY MLG2367703 11/01/94 11/01/95 PRODUCTS-COMP/OP AGG. 35,000,000 CLAIMS MADE X OCCUR. PERSONAL & ADV. INJURY $5,000,000 OWNER'S& CONTRACTOR'S PROT. EACH OCCURRENCE $ 5,000,000 FIRE DAMAGE (Any one (ire) IS 50,000 MED. EXPENSE (Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 29500,000 A X ANY AUTO M[A2042028 11/01/94 11/01/95 ALL OWNED AUTOS { BODILY INJURY $ , SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON OWNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $2,500,000 UMBRELLA FORM AGGREGATE $ B X OTHER THAN UMBRELLA FORM NXG322881 06/01/94 11/01/95 f WORKER'S COMPENSATION STATUTORY LIMITS AND EACH ACCIDENT IS DISEASE—POLICY LIMIT $ EMPLOYERS' LIABILITY � DISEASE—EACH EMPLOYEE $ OTHER fr A PHYSICAL DAMAGE MLA2042028 11/01/94 11/01/95 $10,000. DID. COMP. $10,000. DED. @91.L. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CITY OF SAN JUAN CAPISTRANO, ITS OFFICERS, AGENTS AND EMPLOYEES ARE SHOWN AS ADDITIONAL INSUREDS AS RESPECTS TO THE _ OPERATIONS OF THE NAMED INSURED ONLY CERTIFICATE HOLDER CANCELLATION m SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BEI ANCEWLED BEFORE THE CITY OF SAN JUAN CAPISTRANO EXPIRATION DATE THEREOF, THE ISSUING COMPANY WI��I ATTN: DAWN SCHANDERL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE RECORDS COORDINATOR LEFT, 32400 PASEO ADELANTO CITY HALL xau�xw tiaarr�acaraatacDadcal�awMNrs xo�NaxaDiaxxxgs�cazau�esx SAN JUAN CAPISTRANO, CA 92675 AUTHORIZED REP ENTATIVE ` ACORD 25-S (7190) CACORD CORPORATION 1990 0 0 ADDITIONAL INSURED ENDORSEMENT Attached to and forming a part of the Certificate of Insurance dated 11/01/94 Policy: $NXG322881 Issued to: CITY OF SAN JUAN CAPISTRANO ITS OFFICERS, AGENTS & EMPLOYEES The Certificate Holder named above is shown as an Additional insured as respects to the operations of the named insured only to the extent of liability assumed by the Named Insured under the contract between the Certificate Holder and the Named Insured pursuant to which this certificate is issued, subject to the policy terms and conditions. g /'-/� �(- Richard P. Ldiie, Jr. Authorized Representative General Star National CITY OF SAN JUAN CAPISTRANO j ATTN: DAWN SCHANDERL RECORDS COORDINATOR 32400 PASEO ADELANTO CITY HALL SAN JUAN CAPISTRANO, CA 92675 ACORD 26-S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL ___3_0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, i AU RIZED REPRES NTATIVE m,ernRn mwonoennu conn I CERTIFICA OF INSURANCE ISSUE DATE (MM/DD/VY 1/27/94 I PRODUCER r THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE K, DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE RODES-ROPER-LOVE INSURANCE AGENCY, INC. POLICIES BELOW. P. 0. BOX 700 COMPANIES AFFORDING COVERAGE f MELBOURNE, FL 32902-0700 COMPANY LETTER A NATIONAL UNION FIRE INS. CO. OF PITTSBURGH PA COMPANY B 1 INSURED LETTER COMPANY C DAVE MANAGEMENT, INC. LETTER DAVE TRANSPORTATION SERVICES, INC. COMPANY D VAN IRAN OF TUCSON, INC. LETTER DAVE FLEET MANAGEMENT COMPANY E LETER 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. " ICO TYPE OF INSURANCE POLICY NUMBER {LTR POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE (MMIDDIYY) DATE (MMIDDIYY) GENERAL LIABILITY GENERAL AGGREGATE $ 5,000,000 A X COMMERCIAL GENERAL LIABILITY MLG5244555 02/01/94 02/01/95 PRODUCTS-COMPIOP AGG. $ 5,000,000 CLAIMS MADE 'OCCUR. PERSONAL& ADV. INJURY $ 5'000'000 OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ 5,000,000 FIRE DAMAGE (Any one fire) $ 50,000 MED. EXPENSE (Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE I LIMIT $ 2,500,000 1 A X ANY AUTO MLA2038662 02/01/94 02/01/95 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $ j EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS i AND EACH ACCIDENT $ DISEASE—POLICY LIMIT $ EMPLOYERS' LIABILITY FDISEASE—EACH EMPLOYEE $ OTHER I i A PHYSICAL DAMAGE MLA2038662 02/01/94 02/01/95 $1,0000. DDID: 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CITY OF SAN JUAN CAPISTRANO, ITS OFFICERS, AGENTS AND EMPLOYEES ARE j SHOWN AS ADDITIONAL INSUREDS AS RESPECTS TO THE L OPERATIONS OF THE NAMED INSURED ONLY CITY OF SAN JUAN CAPISTRANO j ATTN: DAWN SCHANDERL RECORDS COORDINATOR 32400 PASEO ADELANTO CITY HALL SAN JUAN CAPISTRANO, CA 92675 ACORD 26-S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL ___3_0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, i AU RIZED REPRES NTATIVE m,ernRn mwonoennu conn I • . ... .... ..... . ... .. .. ... . . ....... ISSUE DATE(MM/DD/YY) No . .... 712/30/93 PRODUCER Averbeck,Company 3380 Shelby St. 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. Ontario, CA 91764 COMPANIES AFFORDING COVERAGE COMPANY A Great States Ins. Co. LETTER COMPANY LETTER INSURED Dave Transportation Services, Inc. 201 E. Sandpointe, Ste. #800 COMPANY C LETTER COMPANY D LETTER Santa Ana, CA 92707 COMPANY E LETTER . . . . .. . . .. . ... . . . .... THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED 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. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTH TYPE OF INSURANCE IPDUCYNUMEIER POLICY EFFECTIVE DATE(MM/DD/YY) POLICY EXPIRATION DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE 5 PRODUCTS-COMP/OPAGO. COMMERCIAL GENERAL LlAaILM =�LAIMS MADE =OCCUR. PERSONAL &ADV. INJURY EACH OCCURRENCE DWNERS & CONTRACTOR'S PROT. FIRE DAMAGE(Anyone fire) $ MED.S(PENSE (Any one mrwn) S AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE $ LIMIT BODILY INJURY S (Por person) ALL OWNED AUTOS SCHEDULED AUTOS BODILYINJURY $ (PerwcIdent) HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM STATUTORYLIMITS EACH ACCIDENT Sl 000 000 OTHER THAN UM BRELLA FOR M AWORKER'S COMPENSATION AND EMPLOYERS' LIABILITY GWR10052794 O1 O1 94 I 17 -- T7 6 9— 5 DISEASE -POLICY LIMIT $1,000,000 DISEASE -EACH EMPLOYEE $1,000,000 OTHER — = DESrRlPnONOFOPERATIONS/LOGATIONS/VEHICLES/SPECIALITEMS Verification of Insurance. *10 Day Notice of Cancellation applies for Non Payment of Premium. ......... . . l........ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO City of San Juan Capistrano MAIL * 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Attn. Linda Evans LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGA-noN OR 32400 Paseo Adelanto/ City Hall LIABILITY OF ANY WIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. San Juan Capistrano, CA 92675 AUTHORIZED REPRESENTATIVE CM A _ Ab AgIRL A91h RINVU CE IS ATE (MMIDD/VY) 3-15-93 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Sedgwicik James of Ga,, Inc. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE Suite 500, South Mower POLICIES BELOW. 3333 PeachtT'ee Rd. NE COMPANIES AFFORDING COVERAGE Atlanta, Georgia 30326 COMPANY A LETTER National UTIion Fire Iris. Co. COMPANY B INSURED LETTER DAVE Transportation Services, Inc COMPANY 201 East Sandpointe #800 LETTER C Santa Ana, CA 92 707 COMPANY D LETTER 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 POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/DD/VY) DATE (MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO. $ CLAIMS MADE OCCUR. PERSONAL & ADV. INJURY $ OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) if j MED. EXPENSE (Any one pereon) $ IIi AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT $ ALL OWNED AUT OS j BODILY INJURY Ii SCHEDULED AUTOS (Per person) $ i HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY C LM 308 5924 5/01/92 5/01/94 EACH OCCURRENCE $2 500000 I UMBRELLA FORM AGGREGATE $2500000 X OTHER THAN UMBRELLA FORM 7 ,500,000 WORKER'S COMPENSATION STATUTORY LIMITS Q EACH ACCIDENT $ fk ANO DISEASE—POLICY LIMIT $ EMPLOYERS' LIABILITY DISEASE—EACH EMPLOYEE $ OTHER i I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS �3ee Attached Endorsement CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL -S 61111W 16R 441 CITY OF SAN JUAN CAP I STRANO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE DAWN SCHANDERL—RECORDS COORD. LEFT, 32400 PASEO ADELANTO/CITY HALL SAN JUAN CAPISTRANO, CA. 9267) AUTHORIZED EP NTAT E - ��O/ 6 ADM 26$ (7/90) ®ACORD CORPORATION 1990 , I g ADDITIONAL iVSURED ENDORSEMENT Attaching to and forming a part of the certificate of insurance dated: 3-15-93 =ssued to: City of San Juan Capistrano its Officers, Agents and Employees =`.e above Certificate Holder is added as an Additional Insured to the extent of ::ability assumed by the Named Insured under the Contract between the Certilicafe Holder and the Named Insured pursuant to which this Certificate is issued; however the Certificate Solder shall not be included as an Additional insured to the extent of their willful misconduct. Michael G. Crandall authorized Representative