1998-0707_MALASPINA HOMEOWNERS ASSN_LICENSE AGREEMENT +�g 5. 2004 10 28AM No, 0097 P.
27362 Calk Arroyo San Juan Capistrano,CA 92675
Phone.(949)487-613t Fe>< 487-8152 Robco Insurance
Lic 90750612 Services
Fax
To: Irene Marcote/Eng &Building DeptFrorn: Bonnie Ayersman Ext 210
Fan: 949-493-1053 Pages:4( including cover)
Phone: Date: 815104
Ra: Malaspina HOA CC: Robert Foresman/Property Man
949-858-0505
0 t/rgent 0 For Review ❑Please Comment ❑Please Reply 0 Please Recycle
Following please find the additional Insured certificate for the above captioned you
have requested.
The original will be mail`edd..,,
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER Or INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ROBCO INSURANCE SERVICES HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
License#0750612 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
27362 Calle Arroyo COMPANIES AFFORDING COVERAGE
San Juan Capistrano, CA 92675 COMPANY
A PHILADELPHIA INDEMNITY CO
INSURED COMPANY
MALASPINA HOMEOWNERS ASSOC. B GREAT AMERICAN INS,CO.
Malaspina Homeowners Assoc. COMPANY
26902 Pasco CarderO C
San Juan Capistrano,CA 92675 COMPANY
BJA D
COVIftRAjgS
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 POUCYGFFECTTVE P0UCyExTHRAT(Of4 LIMIT3
LTR RATE(M"DNYI D&TE(MMMMyn
A GENERAL LIABILITY PHPK073427 02417/04 02/17/05 GENERAL AGGREGATE 6 2,0001000
X COMMERCIAL GENERAL UABILITY PRODUCTS-COMPIOP AGG S 2,000l000
—1 CLAIMS MADE FRI OCCUR PERSONALS ADV INJURY s LWO.W
OWNERS&CONTRACTOP'SPROY EACH OCCURRENCE 1 1,000,000
FIRE OAN&AGE Any ono fire) 6 100.000
MED ExIs(Any one Colson) $ S'W
A AUTOMOBILE LIABILITY PHPK073427 02(17/04 02/17/05 COMBINED SINGLE LIMIT S 1,00,000
ANY AUTO
ALL OW WO AUTOS BC1DfLY INJURY
SCHEDULED AUTOS (P.,Pomon)
MIRED AUTOS BODILY INJURY $
NON OWNED AUTOS (P.,ace,09N)
PROPERTY DAMAGE %
GARAGE LIABILITY AUTO ONLY EA ACCIDENT S
ANY AUTO OTHER THAN AUTO ONLY
EACH ACCIDENT S
AGGREGATE $
A UCESBUAIRUTY PHUSS027698 02/17104 02q1/0S EACH OCCURRENCE S 3,000,000
UMBRELLA FORM AGGREGATE S 3,ONOW
OTHER THAN UMBRELLA FORM i$
WORKERS COMPENSATION AND I T&Il,Al.yi ITI
IS" ER
EMPLOYERS.IUABRUITY E4EACtACCIOGNT $
THE PROPRIETOR INCL EL DISEASE POLICY LIMIT $
PARTNEAS'EXECUTivE
OFFICERSAkE EXCL. RL DISEASE-EA EMPLOYEE 1 5
A OTHER
PROPERTY COVERAGE PHPK073427 02117104 07./17/0S $50,000 AGREED VALUEMKLT
COMMON AREA ONLY COV.$1,000 DEDUCTIBLE
DESCRIMM Of OPERAT1,43NIVIUCCATIONSAfENCLESISPIECKL ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE:USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
...........
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!04T.(OCATtIH DE. ul.
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED WMAE THE
CITY OF SAN JUAN CAPISTRANO EXPIRATION DATE THEREOP, THE ISSUM COMPANY 11011 11IM110 TO MAIL
OFFICE OF THE CITY CLERK 'JO--DAYS"ITTEM NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE US",
32400 PASEO ADELANTO BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OSUIGAYON OR LIABILITY
SAN JUAN CAPISTRANO,CA 92675 OF ANY KIND UPON THE COMPANY, ITS AGENTS ON REPRESENTATIVES,
AUTHORIZED REPREAMENTA
j
Aug 5 200410: 28AV No 0097—P.
001058 8JA
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES-(Continued):
co POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS
B DIRECTORS AND EPP5667268 02/III04 02/111051,000,000 LIMIT
OFFICERS LIABILITY 11,000 DEDUCTIBLE
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS-(Continued):
PROPERTY MANAGER IS INCLUDED AS NAMED INSURED ON COMMON AREA ONLY
PROPERTY MANAGER IS ADDITIONAL INSURED ON D&O LIABILITY
UMBRELLA IS EXCESS OVER COMMON AREA LIABILITY AND D&O LIABILITY
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Aig. F 2004 10: 280 No. 0097 P, 4
POLICY NUMBER: PHPK073427 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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
OFFICE OF THE CITY CLERK
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE: USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
(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 ll) is amended to include as an insured the person or organization shown in
the Schedule, but only with respect to liability arising out of your operations or premises owned by or
rented to you.
CG 20 26 11 85 Copyright, Insurance Service Office, Inc., 1984
32400 PASEO ADELANTO v / ® A MEMBERS OF THE CITY COUNCIL
SAN JUAN CAPISTRANO,CA 92675 SAM ALLEVATO
(949)493-1171 InneeOnAe[I DIANE L.BATHGATE
(949)493-1053 FAX
MOWNH 1961 WYATT HART
w wsanjuancapistrano.org 1776 JOE SOTO
• • DAVID M.SWERDLIN
July 23, 2004
Malaspina Homeowner's Association
26902 Paseo Cardero
San Juan Capistrano, CA 92675
Attention: Homeowner's Association Board
Regarding: Compliance with Insurance Requirements for the Purpose of Construction
and Maintaining Facilities in the Public Right-of-Way (Tract 9184).
SECOND NOTICE
In conjunction with the installation of a private entry gate on the public portion of Malaspina
Road, the Malaspina Homeowner Association was granted the use of the public right-of-
way to place a call box and related appurtenances. A license agreement was entered into
between the Malaspina Homeowner's Association and the City of San Juan Capistrano
City. It has come to my attention that the insurance certificate and endorsement form,
required by the license agreement, expired and a new one has not been submitted to the
City.
The conditions of the agreement states that the Homeowner's Association would maintain
in full force, during the term of the agreement, comprehensive general liability insurance
and the City named as additional insured on the policy. The insurance certificate and
endorsement is to be provided to the City proving that said insurance coverage is in place.
The policy is to be kept current and on file in the City Clerk's office.
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675. If you have any
questions, please contact Irene Marcote at 949 443-6352.
S' ely,
Irene Marcote
Engineering Technician
Engineering and Building Department
cc: Dawn Schanderl, Engineering & Building Department
Maria Guevara, City Clerks Office
San Juan Capistrano: Preserving the Past to Enhance the Future
h
V
A!r MEMBERS OF THE CITY COUNCIL
J' DIANE . TE
JOHN S..GELFF GELFF
WYATT HART
JOE
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675 1> II ��IIDAVIDD MM.SWEROLIN
M.
(949) 493-1171 DIIBBIB 1961
1776
(949) 493-1053 (FAX) INTERIM CITY MANAGER
ivlvw sanjuancapistrano.org � PAMELA GIBBON
C
January 6, 2004
Malaspina Homeowners Association
P \n
26902 Paseo Cardero
San Juan Capistrano, CA 92675 `v1�
RE: Compliance with Insurance Requirements — Use of Portion of the Public Right-of-
Way for the purpose of constructing and maintaining a call box and related
apputenances.
The following insurance document is due to expire:
✓ General Liability Certificate 02/11/2004
✓ General Liability Endorsement Form naming the City of San Juan
Capistrano as additional insured.
Please submit updated documentation to the City of San Juan Capistrano, attention City
A
e, 32400 P eo Adelanto, San Juan Capistrano, CA 92675 by the above
at If h ve any questions, please contact me at (949) 443-6309.
ar
Secretary
cc: Dawn M. Schanderl, Administrative Assistant
Irene Marcote, Engineering Technician
San Juan Capistrano: Preserving the Past to Enhance the Future
32400 PASEO ADEIANTO i i Fate A MEMBERS OF THE CITY COUNCIL
SAN JUAN CAPISTRANO,CA 92675 /// ILLS' SAM ALLEVATO
(948)483-1171 InuA MR TED DIANE L.BATHGATE
(949)493-1053 FAX • FSAAIIISYFI IBBI WYATT HART
www.sanjuancapistrano.org 1776 JOE SO 1`0
• • DAVID M.SWERDLIN
June 19, 2004
Malaspina Homeowner's Association
26902 Paseo Cardero
San Juan Capistrano, CA 92675
Attention: Homeowner's Association Board
Regarding: Compliance with Insurance Requirements for the Purpose of Construction
and Maintaining Facilities in the Public Right-of-Way (Tract 9184).
In conjunction with the installation of a private entry gate on the public portion of Malaspina
Road, the Malaspina Homeowner Association was granted the use of the public right-of-
way to place a call box and related appurtenances. A license agreement was entered into
between the Malaspina Homeowner's Association and the City of San Juan Capistrano
City. It has come to my attention that the insurance certificate and endorsement form,
required by the license agreement, expired and a new one has not been submitted to the
City.
The conditions of the agreement states that the Homeowner's Association would maintain
in full force, during the term of the agreement, comprehensive general liability insurance
and the City named as additional insured on the policy. The insurance certificate and
endorsement is to be provided to the City proving that said insurance coverage is in place.
The policy is to be kept current and on file in the City Clerk's office.
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675. If you have any
questions, please contact Irene Marcote at 949 443-6352.
Sincerely,
Irene Marcote
Engineering Technician
Engineering and Building Department
cc: Dawn Schanderl, Engineering & Building Department
vlGaria Guevara, City Clerks Office
San Juan Capistrano: Preserving the Past to Enhance the Future
L
4
4
Recorded in the County of Orange, California
Gary L. Granville, Clerk/Recorder
IIi111111111111111111111111111111111111111111111111111111111 fill 24.00
19980491675 10:21am 07/30/98
RECORDING REQUESTED BY: 005 19006577 19 04
City of San Juan Capistrano Al2 7 6.00 18.00 0.00 0.00 0.00 0.00
AND WHEN RECORDED RETURN TO:
City of San Juan Capistrano
Office of the City Clerk
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
it
Reference: Malaspina/Tract 9184
P
LICENSE AGREEMENT(MALASPINA)
Assessor's Parcel No. 650-061-02
THIS LICENSE AGREEMENT(the"Agreement")is made this 7t day of.�,, 1999, by
and between the CITY OF SAN JUAN CAPISTRANO,hereinafter referred to as "Licensor" and the
MALASPINA HOMEOWNERS ASSOCIATION, hereinafter referred to as "Licensee".
WHEREAS, at their meeting of May 19, 1998, the City Council approved an application to
establish a gate-guarded neighborhood at the Malaspina Development, Tract 9184, and approved,
in concept, a gated entry at Malaspina Road.
WHEREAS,the Malaspina Homeowner's Association proposes to place a part of their entry
gate improvements in a portion of the public right-of-way,
NOW THEREFORE BE IT RESOLVED, Licensor and Licensee agree as follows:
1. Grant of License
Licensor hereby grants to Licensee a license right to use a portion of the public right-
of-way for the purpose of constructing additional asphalt street section and concrete
curb, and constructing and maintaining a phone service island, electrical conduit, and
street striping(the "Improvements"), at the eastern terminus of the public portion of
Malaspina Road, located within the City of San Juan Capistrano, and more
particularly described in Exhibit "A", attached hereto. Licensee will place the
Improvements, under the direction of the Licensor's Director of Engineering and
Building, in the public street. The Improvements are shown on Exhibit "B", attached
hereto.
-1-
2. Hold Harmless,
Licensee agrees to save and defend the Licensor and its elected and appointed
officials, harmless from and against any and all injuries to and deaths of persons and
injuries to property or other interests and all claims, demands, costs, loss, damage,
and liability, arising out of the performance of Licensee's rights and obligations under
this Agreement.
Licensee shall maintain in full force during the term of this agreement a policy of
comprehensive general liability or commercial general liability insurance in which the
limits ofliability shall not be less than One Million Dollars($1,000,000.00). Licensor
shall be named as additional insured on such policy and an endorsement shall be
provided to Licensor proving that said insurance coverage is in place.
3. Respon�y of Licensee to Maintain. Repair. Remove and/or Relocate the
Improvements.
Licensee has requested and Licensor, by execution of this Agreement, allows the
Licensee, at Licensee's sole expense, to construct and maintain the Improvements in
the public portion of Malaspina Road, for the benefit of Tract 9184.
Licensee acknowledges that Malaspina Road from Rancho Viejo Road to its easterly
terminus at Tract 9184 is a public street that has existing Licensor, the Water District
of the City of San Juan Capistrano, public utility and other agency facilities. As
needed, all facility owners have the right to lay, construct, reconstruct, remove and
replace, renew, inspect, maintain, repair, improve and relocate their facilities in
Malaspina Road right-of-way that may require repair to, removal of, and/or relocation
of the Improvements. All costs to repair, remove and/or relocate the Improvements
occasioned by the above shall be home by the Licensee.
Before the issuance of construction permits, any of the Improvements in conflict with
existing utility facilities or systems shall be redesigned, or utilities shall be relocated,
subject to the approval of the specific agency/utility company, at the expense of the
Licensee.
Licensee further acknowledges if, during construction and/or maintenance of the
Improvements by the Licensee, any of the facility owner's equipment is damaged, the
costs to repair and/or replace said equipment shall be borne by the Licensee.
The Licensor reserves the right to terminate this Agreement immediately if the
Licensee fails to maintain the Improvements in the public street right-of-way to the
point that the Licensor believes this placement to be detrimental to the public health,
safety and welfare.
-2-
4. Successors in Interest.
This Agreement shall inure to and be binding on the heirs, successors, executors,
administrators, and assignees of the Licensee.
5. Attorneys'Fees
If any legal action or proceeding arising out of or relating to this Agreement is
brought by either party to this Agreement, the prevailing party shall be entitled to
receive from the other party, in addition to any other relief that may be granted, the
reasonable attorneys' fees, costs, and expenses incurred in the action or proceeding
by the prevailing party.
6 Term.
This Agreement shall continue in full force and effect, subject to paragraph 4, unless
terminated by the Licensee or Licensor upon ninety(90) days written notice; or, shall
be terminated on ten(10) days notice if Licensee fails to adhere to any conditions of
this Agreement.
DATED his 11�'- day of v/ 1998, at San Juan Capistrano.
ATTEST: CITY OF S AN CAPIS RANO:
By
titi 7 — _– 1 Jones, Mayor
Cheryl Jo o , City Clerk
APPROVED AS TO FORM: MALASPINA HOMEOWNERS
ASSOCIATION:
John Shaw, City Attorney A �
BY:
Robert Foresman, Secretary-Treasurer
-3-
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California I
County of 0qw-61 ss.
/� I
On �_ E / , before me, C U TE /yz h1gy
Data Name and Title of Officer(e.g.,'Jam Doe,Notary Public")
personally appeared /—
Name(s)of Signer(s)
proved to me on the basis of satisfactory
evidence
to be the person(&)- whose nam 1s
a subscribed to the with' instrument and
DEE WHITE acknowledged to me t he hefthey executed
COMM. #1172005 the same in i uthorized
'+ NOTARY PUBLIC•CALiFORNiA capacity(ies}, and that by hi it
ORANGE COUNTY si natur n the instrument the erso r
My Comm.Ezp.feb.1,20"u2 9 e(s}e p n{s},-o
the entity upon behalf of which the person(sj---
acted, executed the instrument.
WITNESS my hand and official seal.
Place Notary Seal Above j
Signature of Notary Public
OPTIONAL
Though the information below is not required by law,it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Docunpt
Title or Type of Document:
Document Date: & fig Number of Pages:
I
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name:El � �T � N
rp dual C�r � Top or thumb Here
� Corporate` orate Officer—Title(s):
❑ Partner—❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing: /»lel <f�/Nf� 1CY)2�XL7/l� S
t�ST�lfjT/Z�✓rV
01997 National Notary Association•9350 De Soto Ave.,PO.Boz 2402•Chatsworth,CA 91313-2402 Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827
PUBLIC AGENCY FORM OF ACKNOWLEDGEMENT
State of California )
County of Orange ) ss.
City of San Juan Capistrano )
(Gov't Code 40814 & Civil Code 1181)
On July 7, 1998 , before me, Cheryl Johnson , City Clerk, personally
appeared ---Gil Jones - - - ,personally known to me
to be the person whose name is subscribed to the within instrument and acknowledged to me that
he executed the same in his authorized capacity, and that by his signature on the instrument the
person, or the entity upon behalf of which the person acted, executed the instrument.
(SEAL)
WITNESS my hand and official seal.
c
City Clerk
OPTIONAL
Capacity Claimed by Signer Description of Attached Document
Municipal Corporate Officer
Mayor License Agreement/Malaspina NOA
Title Title or Type of Document
Signer is Representing Three
City of San Juan Capistrano Number of Pages
July7, 1998
Date of Document
Malaspina HOA
Signer(s)Other Than Named Above
LICENSE AGREEMENT
THE LAND REFERRED TO IN THIS AGREEMENT IS SITUATED IN THE STATE OF
CALIFORNIA, COUNTY OF ORANGE, CITY OF SAN JUAN CAPISTRANO, AND IS
FURTHER DESCRIBED AS:
PORTION OF MALASPINA ROAD IN THE PUBLIC RIGHT-OF-WAY, AT THE BOUNDARY
OF TRACT 9184, AND ALSO KNOWN AS LOT "E" OF TRACT 12954 (GRANT DEED
DATED MAY 2, 1997).
EXHIBIT "A"
a-
/ 40
/` 40
\v NEW COX.
\�
?RIGHT-OF-WAY LINE CURB
llooe : \� AUTOMATIC SWING GATES
/' LANE DIVISION ELEMENT
i
PAINTED STOP BAR ,
/ GUEST/SERVICE / O.C.F.A. APPROVED
PRONE ISLAND EMERGENCY OVERRIDE KEY
a
\` UNLET, .�
Go
IN
v`
NEW CONC. CURB \Z. \\,``
MpLBSP'N ROAD /_
IC} v \
�PUBL
EXISTING ENTR]( WALL •�; :, � °
AND PILLAR (TYP. BOTH \.•i�\ T
SIDES OF ROAD)
EXISTING CONCRETE CtD2B
d�
Di
PRIVATE ENTRY GATE IMPROVEMnS
IN THE PUBLIC RIGHT-OF-WAY
ICAI.ts �� a 2o" AvMovxo mY,
°ATz.-ti-25-q-7 EXHIBIT "B"
-aRDD07/17/2003
Y'
r; M
AC
�/17 Y OwO3
PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION
ROBCO INSURANCE SERVICES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
License#0750612 RECEIVE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
27362 Calle Arroyo COMPANIES AFFORDING COVERAGE
San Juan Capistrano,CA 92675 COMPANY
IN] JUL 19 A A ne A NEW HAMPSHIRE INSURANCE CO.
7 INSU COMPANY
ZALASPINA HOMEOWNERS t�SOCCIT Y CLERK B KEMPER INSURANCE COMPANY
Malaspina Homeowners Assoc.I N JUAN CAPI AOOMPANY
26902 Pasco Cardero
San Juan Capistrano, CA 92675 COMPANY
I JEH D
777 777771"t1h , 1,,, , � " �''' I
COVERAGES Wlih ,
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 POUCY NUMBER POLICY POLICY EXPIRATION LIMITS
LTR DATE(MMMDVY)
A GENERAL LIABILITY CDO1967497 02111103 02/11/04 GENERAL AGGREGATE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO $ 2,000,000
CLAIMSMADEFX70CCUR PERSONAL&ADV INJURY $ 11000,000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 11ONO 1000
FIRE DAMAGE(Any we fire) $ 50.000
MED EXP(Any onePerson) $ 5.000
A AUTOMOBILE LIABILITY
ANY AUTO CDO1967497 02/11/03 02/11/04 COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY $
X NON-OWNED AUTOS (Perawident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY
EACH ACCIDENT $
H AGGREGATE $
A EXCESS LIABILITY UL0793931 02/11/03 02/11/04 EACH OCCURRENCE $ 3,0002000
AlUMBRELLA FORM AGGREGATE -- $ 3,000,000
OTHER THAN UMBRELLA FORM . OT $
WORKERS COMPENSATION AND TOCRYLUIT-S I- EFj
EMPLOYERS'LIABILMY
EL EACH ACCIDENT $
THE PROPRIETORd INCL EL DISEASE-POLICY LIMIT $
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $
A OTHER
PROPERTY COVERAGE CDO1967497 02tI1103 02111104 $10,000 ALL RISK REPL
COMMON AREA ONLY COST$1,000 DED 90% COIN
DESCRIPTION OF OPERATIONSLOCATIONSNENCLEWSPECLIAL ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE:USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
...... j1M1P1qjjj T7777—
X l'oft 'JoAtollf "!'96400N 4#16wivi
SHOULD MY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF SAN JUAN CAPISTRANO EXPIRATION DATE HEREOF,
THE ISSUING COMPANY WILL ENDEAVOR TO MAL
OFFICE OF THE CITY CLERK 30 DAYS IN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
SAN JUAN CAPISTRANO,CA 92675 F MIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LABILITY
32400 PASEO ADELANTO BUT Fa UR
"I
OF MY 'lie UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZE I E ENTAME 9,5,0
FIR III
M�- G , 4,1W=1
ACORD,25-S(11,11,0, QN1988
1le 0_0.INI Plli
4 - i s ti 1 I
(dontinUatlOnS i,(. irr .'rti'':n. ru�lr
001058 JEH
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES -(Continued):
CO POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS
B DIRECTORS AND 3DY005361 02/11/01 02/11/04 $1,000,000 LIMIT
OFFICERS LIABILITY $1,000 DEDUCTIBLE
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS-(Continued):
PROPERTY MANAGER IS INCLUDED AS NAMED INSURED ON COMMON AREA ONLY
PROPERTY MANAGER IS ADDITIONAL INSURED ON D&O
UMBRELLA IS EXCESS OVER COMMON AREA LIABILITY AND D&O
POLICY NUMBER: CDO1967497 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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
OFFICE OF THE CITY CLERK
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
,
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE: USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in
the Schedule, but only with respect to liability arising out of your operations or premises owned by or
rented to you.
CG 20 26 11 85 Copyright, Insurance Service Office, Inc., 1984
AC_
ORD �1 � _
�I "�`:Ti 1 Iil i �(� !t'Ij,� ,i ti'j�' DATE wndY
, 07/17/2003
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ROBCO INSURANCE SERVICES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
License#0750612 DER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Liven Calle 0612Arroyo R E C E I R THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
San Juan Capistrano,CA 92675 c0
&A U I�p�N,�
1003 JUL 19 5 NEW HAMPSHIRE INSURANCE CO.
INSURED
ANY
MALASPINA HOMEOWNERS ASSOC. CITY CLERK BKEMPER INSURANCE COMPANY
Malaspina Homeowners Assoc. SAN JUAN CAPqtgAu
26902 Paseo Cardero C
San Juan Capistrano,CA 92675
COMPANY
JEH D
COVERAGES ;IIInIi.Ild" .,It'i11 Ini > IIIff1�r n,;ini .IC:{i,i, lu,.i4. .. ...
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,
COPOUCYEFFECTIVE POUCYEXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMMD/YY) DATE(MMIDD/YY) LIMITS
A GENERAL LIABILITY CDO1967497 02/11103 02111104 GENERAL AGGREGATE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO $ 2000000
CLAIMS MADEFil OCCUR PERSONAL B ADV INJURY $ 1000000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1000 000
FIRE DAMAGE(Any me fire) $ 50,000
MED EXP(Any one person) $ 5,000
A AUTOMOBILE UABILITY
ANY AUTO CDO1967497 02/11/03 02/11/04 COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Par person)
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGELIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
A EXCESS LIABILITY UL0793931 02/11/03 02/11/04 EACH OCCURRENCE $ 3,000,000
X UMBRELLA FORM AGGREGATE $ 3, 00,000
OTHER THAN UMBRELLA FORM TRH $
WORKERS COMPENSATION AND WC IT E
EMPLOYERS'LIABILITY T LIMIT
EL EACH ACCIDENT $
THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $
PARTNERS/EXECUTIVE
OFFICERS ARE: R EXCL I I EL DISEASE-EA EMPLOYEE $
A OTHER
PROPERTY COVERAGE CD01967497 02/11/03 02/1U04 $10,000 ALL RISK REPL
COMMON AREA ONLY COST$1,000 DED 90%a COIN
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES,SPECIAL ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE: USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CAL OX AND RELATED APPURTENANCES.
CER ICXTE,HQLPER ., , "t1, I ",,,,. „ r . , ..:
.an ax' , C. "fit... 4 ':..'` i1 YiiGrS�6u�` W `Rt4iPre�rilum
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF SAN JUAN CAPISTRANO EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
OFFICE OF THE CITY CLERK 30 DAYaTHE
OTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
32400 PASEO ADELANTO BUT FAIL UCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
SAN JUAN CAPISTRANO,CA 92675
OF ANY KI COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED R ATIVE
ACOF�t125�
i. (1,RA)
' Ci�F!ltftlUcltl011$ • I:I i� la{.: ii�l,. . is' > ; I ..
001058 JEH
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES -(Continued):
CO POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS
B DIRECTORS AND 3DY005361 02/11/01 02/11/04 $1,000,000 LIMIT
OFFICERS LIABILITY $1,000 DEDUCTIBLE
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS- (Continued):
PROPERTY MANAGER IS INCLUDED AS NAMED INSURED ON COMMON AREA ONLY
PROPERTY MANAGER IS ADDITIONAL INSURED ON D&O
UMBRELLA IS EXCESS OVER COMMON AREA LIABILITY AND D&O
i (i��iP61 'dg1GGI�Ct iW iSNi 11 i it r'flt�i 1 Yi �"'.{� i III;q kik iii P7.5i�S�tii i 4i- �il�al{'t't i i.tiL i�i,,m 3bd,, . .
POLICY NUMBER: CDO1967497 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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
OFFICE OF THE CITY CLERK
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE: USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in
the Schedule, but only with respect to liability arising out of your operations or premises owned by or
rented to you.
CG 20 26 11 85 Copyright, Insurance Service Office, Inc., 1984
� A �A
32400 PASEO ADELANTO
11[OA161110
SAN JUAN CAPISTRAND, CA 92675 (�I61O I 1961 MEMBERS OF THE CITY COUNCIL
(949) 493-1171 1776 - DIANE BATHGATE
(949) 493-1053 (FAX) .JOHN S.GELFF
1V1V11'.sant#an Capistrano.org WYATT HART
O
AVID M
DAVID M.SWERDLIN
JRGESCARSOROUGH
June 16, 2003
Malaspina Homeowner's Association
26902 Paseo Cardero 01
San Juan Capistrano, CA 92675
Attention: Elgin Chalayan, President
Regarding: Compliance with Insurance truction
and Maintaining Facilities ii
In conjunction with the installation of a . .-jd, the
Malaspina Homeowner Association was gi „1 LI1e public right-of-way to place
a call box and related appurtenances. A license agreement was entered into between the
Malaspina Homeowner's Association and the City of San Juan Capistrano City. It has
come to my attention that the insurance indorsement form, required by the license
agreement, expired and a new one has not been submitted to the City.
The conditions of the agreement states that the Homeowner's Association would maintain
in full force, during the term of the agreement, comprehensive general liability insurance
and the City named as additional insured on the policy. The insurance certificate and
endorsement is to be provided to the City proving that said insurance coverage is in place.
The policy is to be kept current and on file in the City Clerk's office.
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675. If you have any
questions, please contact Dawn Schanderl, Deputy City Clerk, at 949 443-6310.
t4e'y'
Marcote
Engineering Technician
Engineering and Building Department
cc: Dawn Schanderl, Deputy City Cleric
apemaVnalaspuvn�mgbzeimwarice DR116 VSE
IS
San Juan Capistrano: Preserving the Past to Enhance the Future
r'
. �„a
32400 PASEO ADELANTO I/ iXXAX
SAN JUAN CAPISTRANO, CA 92675 •
(949) 493-1177 /tpppSXIX IA61 MEMBERS OF THE CITYCODNLIL
(949) 493-1053 (FAX) 1776 DIANE L DATHGATE
O JOHN S.GELFF
tCly w.SQYIJ t(QNCQP IS(1'Qtt O.OYg MATTHART
• ° JOE BOTO
DAVID M.SWERDLIN
CRY MANAGER
GEORGESCARBOROUGH
February 18, 2003
iYialaspina Homeowners Association
26802 Paseo Cardero
San Juan Capistrano, California 92675
RE: Compliance with Insurance Requirements - Use of Portion of the Public Right-of
Way for the purpose of constructing and maintaining a call box and related
appurtenances. ^A
The following insurance documents expired:
General Liability Certificate 2/11/2003
V General Liability Endorsement naming the City of San Juan Capistrano as
additional insured.
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 February 26,
2003. If you have any questions, please contact me at (949) 443-6310.
n Sincerely', 9� } ��J
`I 4 L I X
L Schanderl
Deputy City Clerk
cc: William Huber, Director of Engineering & Building
Irene Marcote, Engineering Technician
®RUG USE
IS
San Juan Capistrano: nese vine :2e aSi to Enhance ripe Future
/ NMI";
>
...n: ....: A.• .., .nf:
3 3 WM/DD/YY)
a . T
y
n
r�
is < /r: 0
1�>3: � /' . . .. :.;, 3/07/2003
,a�..a
✓,'ai,waavxc:a,3c'/e�e 9
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ROBCO INSURANCE SERVICES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
License#0750612 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
27362 Calle Arroyo COMPANIES AFFORDING COVERAGE
San Juan Capistrano, CA 92675
COMPANY
A NEW HAMPSHIRE INSURANCE CO.
INSURED COMPANY
MALASPINA HOMEOWNERS ASSOC. a KEMPER INSURANCE COMPANY
Malaspina Homeowners Assoc.
26902 Paseo Cardero COMPANY
C
San Juan Capistrano,CA 92675
COMPANY
LLP D
°si$� a;l'r�ra ,,.. ' afi.'/'$ 3 r`r.sg v , eiai fo�i5
"my: , .,P�'i.�',kcG.t.�k�`.:.P/.:.4r2.�:<�ui'.S/acro'�� .r'�uua"�l.�r' ar.4.fr�L.rpu'�.
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 UMRS
LTR DATE(MMOD/YY) DATE(MM/DD/YY)
A GENERALLIABILMY GENERAL AGGREGATE $ _ 2,000.000
CD01896034 02/11/01 02/11/04
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGG $ 2000000
CLAIMS MADE Fx_�OCCUR PERSONALS ADV INJURY_ S _ 1,000,000 _
OWNER'S S CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE(Artywe fire) $ __50,000
MED EXP(A w Pelson) i S 5.000
A AUTOMOBILE LIABILITY
ANY AUTO CD01896034 02/11/01 02/11/04 COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per Pe,son) $
X HIRED AUTOS BODILY INJURY
X NONOWNEDAUTOS (PeramderO $
PROPERTY DAMAGE $
I
AGE LIABILITY AUTOONLY EAACCIDENT S
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $ `
AGGREGATE $
B MEXCESS LIABILITY 7SGI33629 02/11/01 02/11/04 EACH OCCURRENCE $ 3 000 000
UMBRELLA FORM AGGREGATE $ 3,000,000 _
OTHER THAN UMBRELLA FORM $
YORKERS COMPENSATION AND RYI M - OTH
W� .. .a..
EMPLOYERS'LIABILITY I
EL EACH AO ENT $
THE PROPRIETORI INCL EL 6ISEASB5*OUCY Ury $
PARTNERS/EXECUTIVE -----OFFICERS ARE. EXO_ ELDISEA MPLO E $
A OTHER D'—
PROPERTY COVERAGE CDO1896034 02/11/01 02/11/04 S10,00aA4 RISA RE10
COMMON AREA ONLY COSTVM0 De 90%FMIN
r-
'9 rT I
DESCRIPTION OFOPEMTONS/LOCATIDNSIVENICLES/SPECIAL ITEMS SIS rn
RE:USE OF PORTION OF THE PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF n
CONSTRUCTING AND MAINTAINING A CALL BOX AND RELATED APPURTENANCES z W
PROPERTY MANAGER IS INCLUDED AS NAMED INSURED ON COMMON AREA ONLY La
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY FO SAN JUAN CAPISTRANO EXPIRATON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MNL
ATTN: CITY CLERK'S OFFICE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
32400 PASEO ADELANTO BUT FAILUR L SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
SAN JUAN CAPISTRANO,CA 92675
OF ON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
fAUT E NT VE
. . $ o ,=70/r1'�+;i .r..'`:�.':.Y: Ri.' �."r'yry 3:.�r'ra,.::.t)••::r..,r:,../ 7.>: /r v 'SrTri.'G.^; vi Vii,. ::::?a�;rir..:iii-vv.,r,:
.t''�,'�' cfiv. r.. .i$✓3'r.. /§'$t�.r,�!^j` r r.�e/IE.S�3:/r:':.. rI/.,.$Tri!!':i:,.',� :,:
NEE
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES- (Continued):
CO POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPEOF INSURANCE POLICY NUMBER DATE DATE LIMITS
B DIRECTORS AND 3DY005361 02/11/01 02/11/04 $1000,000 LIMIT
OFFICERS LIABILITY $1:000 DEDUCTIBLE
............ ...... ................ ............................................ ....................... ....................
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS -(Continued):
PROPERTY MANAGER IS ADDITIONAL INSURED ON D&O
UMBRELLA IS EXCESS OVER COMMON AREA LIABILITY AND D&O
g
• ,, Joao •
32400 PASED ADELANTO 1ptl ApppR1
SAN JUAN CAPISTRANO, CA 92675
(848) 493.1171 R1110f111 �96� MEMBERS OF THECIVCOUNCIL
(949) 493-1053 (FAX) 1776 DIANE I.GELBATFF TE
MATTJOHN ART
IVII'U'.SgNJQQYICq�J(S(YgtlO.OYg MATT HART
• • JOESOTO
DAVID M.SWERDLIN
CITY MANAGER
GEORGESCARWROUGM
February 18, 2003
Malaspina Homeowners Association
26802 Paseo Cardero
San Juan Capistrano, California 92675
RE: Compliance with Insurance Requirements - Use of Portion of the Public Right-of
Way for the purpose of constructing and maintaining a call box and related
appurtenances.
The following insurance documents expired:
l
V General Liability Certificate 2/11/2003( i
General Liability Endorsement naming the City of San Juan Capistrano as
additional insured.
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 February 26,
2003. If you have any questions, please contact me at (949) 443-6310.
Sincerely,
Schanderl
Deputy City Clerk
cc: William Huber, Director of Engineering & Building
Irene Marcote, Engineering Technician
aauc use
is
San Juan Capistrano: Preserving the Past to Enhance the Future
03/07/03 11: 10 NO-765 UO2
�\/�i�A/� •
NEW .:N Ii'li�ti: 'i. 03/07/2003
i.A ". 'A,�
iROR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ROHCO INSURANCE SERVICES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
' Lieeme#0750612 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
27362 Calle Arroyo ALTER THE COVERAGE AFFORDED BY THF POLICIES BELOW.
3o COMPANIES AFFORDING COVERAGE
Salt Juan Captsfruno, CA 92675
T COMPANY
A NEW HAMPSHIRE INSURANCE CO.
NSUNEp COMPANY --
MALASPINA HOMEOWNERS ASSOC. 0 KEMPER INSURANCE COMPANY
Malaspina Homeowners Assoc.
26902 Palm Cardero COMPANY \ �( 1 pU C s�o (�C D!�
San Juan Capistrano,CA 92675 D YV/I1f1�4/ 1 1U/ ---
COMPANY ` ,, 1
/�)�y��q I LLP D -yV -
X.Ebd«+l :iL ... ......THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THF INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMFNT 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,
IXCI USIONI3 AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
DO TYPE OF INSMMNCF POLICY NUMBER POL{CYETFECTIVE POUCYEAFMATOUN UNITS
LTA OATS DWAJOMPI DATP IMMNOMYI
A OFNERALuANAm CDO1896034 02!11!01 02111/04 GENEquADGHmATE _ s 0000 0,
X OOAAIERCUL GENERAL LIABILITY PRODUCTS COMPOP AGO i 1808,800
CLAIMS WIDE ®OCCUR PERSONAL L ADV INJURY S 3-QOy,QQQ
`
OWNER'66 CONTgACTOR'BPROT IaDH a(Y:URRENCE 7 1.88�8II,8n181811_
FIRE DAMAGE ono LNl $ _$Q,�OQ_ _
�—f
MED EYPA aw XIMWO Is 1000
A AUTDMOONLlL ANLL TY COMBINED DINGLE LIMIT 6 ],000,QQQ
ANY AUTO CDO1896034 02/11/01 'I 02/11/04
ALL OWNED AUTOS BODILY INJURY
SCHFDULFDAUTOG (PA,mr,m) i
X HIREDAUTO6 BODILYINJURY
X MONOWNLDAUTOS (PA,.WoHl i
PROPERTY DAMAGE S
GARAGE LADNRY AUTO ONLY.LA ACCIDENT S
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT 3
AOOREGATE 6
R EXCESS UABNmF 750133629 02/11/01 011104 EACH OCCURRENCE 6 3 000 888
X UMBRELLA FORM AODREOATE 6 3,000,000
OTHER THAN UMRRPUA FORM i
WORMERS COMPENSATION AMD BTA
EMPLOYERS'LMBLITY EL EACH ACCIDENT S, ,
THE PROPRIETOR,
INCL " EL DIBEASE.POLICY LIMIT i
PARTNERSIEXEC{ITNF
OFFICERS ARE: EXCL EL DISEASE-EA UAPIDYEE S
A OTHER
PROPERTY COVERAGE CD01896034 02/11/01 02111/04 $10.000 ALL RISK REM
COMMON AREA ONLY COST$1,000 DED gc%COIN
GESCRIPDDN OF OPERATIOMNLOCATIOMLVEHICLP66 PECIAL ITEMS
RE:USE OF PORTION OF THE PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF
CONSTRUCTING AND MAINTAINING A CALL BOX AND RELATED APPURTENANCES
PROPERTY MANAGER IS INCLUDED AS NAMED INSURED ON COMMON AREA ONLY
wie53R4eAaaul+« b1„s,,.MYI,aw' •.>,Awx.TA�..I...�.�,::,,.,..«,.': .. .i:.�.'.;�� i dYS ;, , f0 RR• �1�- � ..� � �I
SIIOUTD ANY OF THE ABOVE DESCRIBED POU:IES SE CANCELLED BEFORE THE
CITY FO SAN JUAN CAPI9MANO ENPWATIOM DATE TIIERPOF. THE USUMJ0 COMPANY WILL ENDEAVOR TO MNL
ATM:CITY CLERKS OFFICE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
32ADO PASEO ADELANTO BUT FA6.0 L SUCH NOTICE BNALL IMPOSE NO ORUGATAM OR LIABILRY
SAN JUAN CAPISTRANO,CA 92675
OF N TME COMPANY. ITS AGENTS OR AEPAES[NUTINCS.
AU 6 Ni E
�.v......r r+rue,wa,�+mnm'mann,wwwmm:MYlw9xltpMS��YM. .i :f}:TeHTM�RYN :,9Tl.Y,I,.T,ATT.IT.iK:IA'S}u'"..A:CwTwT. YM�I�L��S•�it^XiIK}'.
N0.365 UO3
r
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES - (Continued):
CO POLICY EFFECTIVE POLICY WIRATION
LTR TYPEDF?F4MJRAA'LE POLICY HUMBER DATE CAW IIMRe
B DIRECTORS AND 3DY065361 02/11/01 02/11/04 $[.006.600 LIMIT
OFFICERS LIABILITY $1,000 DEDUCTIBLE
1
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL.ITEMS-(Continued):
PROPERTY MANAGER IS ADDITIONAL INSURED ON D&O
UMBRELLA IS EXCESS OVER COMMON AREA LIABILITY AND D&O
ri
i
i
�7
i'
_
i-
i-
x
f.
L
03r07iO3 11: 18 N0.365 D01
32400 PA5L0 AneuwNTO
// Re to
SAN JuwN C1Ap154X4N0, GA 92675 TA., ,11111 1 r,6r MfNOCR30F TME cI*r COURCa
(949) 493-1171 rrrc
(949) 493.1053 (FAX) JOHNS
LYE
RR GELFF
Irlru gpnj vernCnpisu'unu O/S MATT MART
i JOE SOip
OAV
O4Vi0 IN Sw[ROUN
CINMANAGER
GEORGE SCARROROUGN
February 18, 2003
Malasptha—Fi eowners ssoc(a (onj T— �,
26802 Paseo Cardero J
San Juan Capistrano, California 92675
RE: Compliance with Insurance Reguirements - Use of Portion of the Public Right-of
Way for the purpose of constructing and maintaining a call box and related
appurtenances.
The following insurance documents expired: 1
General Liability Certificate 211112003
Y General Liability Endorsement naming the City of San Juan Capistrano as
additional insured.
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 February 26,
2003. If you have any questions, please contact me at (949) 443-6310.
n Sincerely,
`Il�aw��der�LQ/�i
Deputy City Clerk
CC William Huber, Director of Engineering & Building
Irene Marcote, Engineering Technician
aluo usE
a
rhe- Future
DAM(M
041187020"Oly)
MINI f.
PRODUCER RROEIVED THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ROBCO INSURANCE SERVIICTS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
License#0750612 APR ZU 2 16 PN '0 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
27362 Calle Arroyo COMPANIES AFFORDING COVERAGE
San Juan Capistrano, CA 926757,11 Y CL; RK COMPANY
DEPAR 1 piENT A NEW HAMPSHIRE INSURANCE CO.
C.;;y OF 160i —
INSURED JUANI If, Sfl)lh' ) COMPANY
MALASPINA HOMEOWNERS 'SS66. B KEMPER INSURANCE COMPANY
Malaspina Homeowners Assoc. COMPANY
26902 Pasco Cardero C
San Juan Capistrano,CA 92675 COMPANY
LLP
pg gg
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.
00 TYPE OF INSURANE POLICY NUMBER
COPOLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MMMONY) DATE(MM/DD/YY)
A GENERAL LIABILITY CD01896034 02/11/01 02/11/02 GENERAL AGGREGATE $ 2,000,000
COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP ADS $ 2,000,000
CLAIMS MADE rx]OCCUR PERSONAL&ADV INJURY 3 1,000,000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE one fim) $ 50,000
MED EXP(AM one M=10 $ 5,900
A AUTOMOBILE LIABILITY
ANY AUTO CDO1896034 (12/11/01 02/11/02 COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Pe,P .)
-y HIRED AUTOS BODILY INJURY
NON-OWNEDAUTOS (Pe,..idallft)
PROPERTY DAMAGE $
GAR[X--
AGE LIABILITY AUTO ONLY�EA ACCIDENT It
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT S
AGGREGATE S
B EXCESS LIABILITY BINDER#1058 62/11/01 02/11/02 EACH OCCURRENCE $ 3,000,000
EACH
UMBRELLAFORM AGGREGATE $ 3,000,000
OTHER THAN UMBRELLA FORM i i $
FT
H
WC
WORKERS COMPENSATION AND —7TORSTATU 7YLIMITS 7 -R
EMPLOYERS'LIABILITY EL EACH ACCIDENT S
THE PROPRIETOR/ INCL EL DISEASE.POLICY LIMIT $
PARTNERS/EXECUTIVE
_OFFICERS ARE EXCL EL DISEASE-EA EMPLOYEE $
B OTHER
DIRECTORS AND BINDER#1058 (1:2/11/01 02111/02 $1,000,000 LIMIT
OFFICERS LIABILITY $1.000 DEDUCTIBLE
DESCRIPTION OF OPEMTIONSILOCAnONSfVEHICLEMPECLAL ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE:USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF SAN JUAN CAPlS`rRAN0 EXPIRATION DATE ERE F. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
'
OFFICE OF THE CITY CLERK 30 DAYS OTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
32400 PASEO ADELANTO BUT FAILUR O 0 SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
SAN JUAN CAPISIRANO,CA 92675 OF MY IND P4 THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
THORIZED EP ATI
P,grgm a-
N:1
MOWN"
16
v v:?
M1 4�
,G>
.a..
..d.d...
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ig:r.,r`?ha.aS,r•.,'ho;'iyi,.'..n.$.<�v. e q �4 $"3...,�r ' � a?a � �✓�o� � o i
d '' .n R 3✓ i,.3§''%d', h,% s3'y; 3t$a '/dii..,g3g'..:.fiz+v: .'' +f(f d s 3 3 f> : 3 a
001058 LLP
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES - (Continued):
(p POLICY EFFECTIVE POLICY EXPIRATION
lTR TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS
A PROPERTY COVERAGE CDO1896034 02/11/01 02/11/02 $10,000 ALL RISK REPL
COMMON AREA ONLY COST$1,000 DED 90% COIN
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS- (Continued):
UMBRELLA IS EXCESS OVER COMMON AREA LIABILP7& D&O LIABILITY
4i
lI
POLICY NUMBER: CDO1896034 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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
OFFICE OF THE CITY CLERK
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO,CA 92675
,
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE: USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in
the Schedule, but only with respect to liability arising out of your operations or premises owned by or
rented to you. 1,
{
CG 20 26 11 85 Copyright, Insurance Service Office, Inc., 1984
AOL
DATE(M )
04/06/2000
PRooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ROBCO INSURANCE SERVICES ONLY AND ERS NO RIGHTS UPON THE CERTIFICATE
License#0750612 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE RAGE AFFORDED BY THE POLICIES BELOW.
27362 Calie Arroyo COMPANIES AFFORDING COVERAGE
San Juan Capistrano, CA 9267.5 COMPANv
A RELIANCE INSURANCE COMPAWY
INSURED COMPANY
MALASPINA HOMEOWNERS ASSOC. B CHUBB/FEDERALIN C2
CO
Malaspina Homeowners Assoc. MPANY f"
26902 Pasco Cardero C C"� 01
San Juan Capistrano, CA 92675 rn
�COMPANY
DDC; D 41111 in
.. ........
........
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE ICY PERIOD
INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT4=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 PAIL)CLAIMS.
COOLICY EFFECTIVE ICY EXPIRATION
TYPE OF INSURANCE POLICY DATE(MM/OD/VY) TE(MM/DD/Y LIMITS
LTR DITlyvr FPOILI Y)
A GENERAL LIABILITY JK2846021 02/11/98 02/11/03
GENERAL AGGREGATE i$ 2.000.000
1
MMERCiAL GENERAL LIABILITY PRODUCTS-COMPiOP AGG _$ 1000 000
CLAIMS MADE OOCCUR PERSONAL&ADViNJURY S 1 000-000
OWNER'S&CONTRACTOR'S PROT' EACH OCCURRENCE
—
—txocow $ 1�000 000
I MED EXP(Any one Person) $ 5,000
A AUTOMOBILE LIABILITY
ANY AU70 JK2846021 02111198 02111103 COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS BODILY INJURY S
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY $
X NON OWNED AUTOS (P
OWNED
PROPERTY DAMAGE S
GARAGE LIA81UTY
ALTO ONLY EA ACCIDENT
ANY AUTO P, THFR THAN AUTO ONLY
EACHACCIDENT $F
AGGREGATE 9
B EXCESS LIABILITY 79412900 02/11/98 02111101 EACH OCCURRENCE S
X :
UMBRELLAPORM AGGREGATE S .3,000,000
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND WC
EMPLOYERS'LIABILITY Toa
EL EACH ACCIDENT $
THE PROPRIETOR INCL EL DISEASE-POLICY POLICY LIMIT 1 $
PA NERS)FXECLITIVE I ---- - — — , ---- —
OF ICERSARE EXCL EL DISEASE EA EMPLOYEEi $
B OTHER
DIRECTORS AND 81152746 07/15/99 07/15/00 $1,000,000 LIMIT
OFFICERS LIABILITY $1,000 DEDUCTIBLE:
DESCRIPTK)PI OF OPERATIONS(LOCATIONSIYEHICLESISPECIAL ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE: USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
Rf *.60* 0".
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF SAN JUAN CAPISTRANO EXPIRATION DATE THEREOF, THE I LING COMPANY WILL ENDEAVOR TO MAIL
OFFICEOF THE CITY CLERK 30 DAYS WRITTEN NOTICE TCERTIFICATE HOLDER NAMED TO THE LEFT,
32400 PASEO ADELANTO BUT FAILURE ALL IMPOSE NO OBLIGATION OR LIABILITY
SAN JUAN CAPISTRANO,CA 92675
Of ANY K MY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACatiq 25 8 t?85} �;x
E.. .......
............... .......
IFICATTE:i!:
TT
001058 DDC
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES - (Continued):
CO POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS
A PROPERTY COVERAGE JK2846021 02/11/98 02/11/03
$10,000 ALL RISK,REPL
COMMON AREA ONLY COST,$1,000 DED 90% COIN
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS - (Continued):
UMBRELLA IS EXCESS OVER COMMON AREA LIABILITY & D&O LIABILITY
Y M • • Y
POLICY NUMBER. JK2846021 COMMERCIAL GENERAL LIABILITY '
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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
OFFICE OF THE CITY CLERK
32400PASEO ADELANTO
SAN JUAN CAPISTRANO,CA 92675
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE: USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in
the Schedule, but only with respect to liability arising out of your operations or premises owned by or
rented to you.
CG 20 26 11 85 Copyright, Insurance Service Office, Inc., 1984
Dawn Schanderl
From Irene Marcote
Sent: Thursday, April 06, 2000 10:55 AM
To: Dawn Schanderl
Subject: RE: Malaspina HOA
I call the Association representative and he was going to check on it and get back to me.
I just called again (thanks for reminding me) and should get an answer to you soon.
thanks . . .im
-----Original Message-----
From: Dawn Schanderl
Sent: Thursday,April 06, 2000 9:02 AM
To: Irene Marcote
Subject: Malaspina HOA
Any luck with the insurance?
I
I
A AOA DATE WWDWYY)
U2/lU/99
PROOLVER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ROBCO INSURANCE SERVICES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
License#0750612 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
27362 Calle Arroyo COMPANIES AFFORDING COVERAG TI
San Juan Capistrano,CA 92675 COMPANY
A RELIANCE INSURANCE COMPANX
INSURED COMPANY
m
MALASPINA HOMEOWNERS ASSOC. B CHUBB/FEDERAL INS.CO. Iv
Malaspina Homeowners Assoc. COMPANY
26902 Paseo Cardero C
San Juan Capistrano,CA 92675 Z:COMPANY
mono JEH D ki
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 EFFECTNE POLICY EXPIRATION UNITS
LTR DATE(MIUDDIM DATE DIMND/YY)
A OENERALLIAmLm GENERALAGGRErATE d 00
JK2846021 02/11/98 02/11/00
J( COMMERgA1 GENERAL LIABILITY PRODUCTS-COMPlDP AGO $ 1.000,000
aAIMS MADE ®OCCUR PERSONAL&ADV INJURY $ 1,000,000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE S 1.000,000
RRE DAMAGE "Am) $ 50,000
MED EXP arm wroW ! 5,000
A AUTOMOBILE LMUIIIURY
ANY AUTO JK2846021 02/11/98 02/11/00 COMBINED SINGLE LIMIT d 11000,000
ALL OWNGDAUTOS BODILY INJURY
SCHEDULED AUTOS (Per PPmon) S
X HIRED AUTOS BODILY INJURY
X NON-aWNEDAUTOS (Per=W"
PROPERTY DAMAGE S
GARAGE I.NBKRY AUTO ONLY-EA ACCIDENT S
ANY AUTO OTHER THAN AUTO ONLY: '$6?EP;$`$6�.'."a. .�a?y
EACH ACCIDENT $
AGGREGATE S
B imuOSSUABLITY 79412900 O?Jll/98 01J11/00 EACH OCCURRENCE d 3,000,000
X UMBRELLA FORM AGGREGATE S 3,000,000
OTHER THAN UMBREUA FORM d
WORKERSCOMPENMTIOMANDWCSTLIM
ATU- OTH-
EYPLOYERrLNBLITY
EL EACH ACCIDENT d
THE PROPRIETORU INCL ELDIBEASE-PCUCYUMIT $
PARTNERSID(ECUTNE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE I S
B DE
IRECTORS AND 81152746 07/15/89 07/15/99 $1,000,000 LIMIT
OFFICERS LIABILITY $1000 DEDUCTIBLE
DESCRIPTION OFOPERATONMACATION&NEHICLENSPECML ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE:USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
SHOULD ANY OF THE MOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CI Y OF SAN JUAN CAPISTRANO EXPSIATON DATE THE ISWNIG COMPANY NpJ ENDEAVOR TO MAIL
OFFICE OF THE CITY CLERK 3GL
32400 PASEO ADELANTO �LIL DAYS TOE TO THE CFATFICATE HOLDER HAYED TO THE LEFT,
SAN JUAN CAPISIRANO,CA 92675 elrr FAILURE SUCH NOME SHALL RTPOSE NO OBLIGATION oR UABI ITY
OF MY K THE COMPANY ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED NTATIVE
001058 JEH
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES-(Continued):
CO POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPEOFINSURANCE POLICY NUMBER DATE DATE LIMITS
A PROPERTY COVERAGE JK28"021 02/11/98 02/11/00 $10,000 ALL RISK,REPL
COMMON AREA ONLY COST,$1,000 DED 90% COIN
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS-(Continued):
UMBRELLA IS EXCESS OVER COMMON AREA LIABILITY&D&O LIABILITY
• 32400 PASEO ADELANYO I � Q Q MEMBERS OF THE CITY COUNCIL
SAN JUAN CAPISTRANO,CA 92675 LK.,1 LWl JONGECAMPBELL
OHN REINER
(949)493-1171 �j ....unir WATT HART
(949)493-1053(FAX) ' muuuu 1961 GILJONES
1776 DAVID M.SWERDLIN
CITY MANAGER
GEORGE SCARBOROUGH
January 18, 1999 '
Malaspina Homeowners Association
26902 Paseo Cardero
San Juan Capistrano, California 92675
Re: Renewal of General Liability Certificate of Insurance (License Agreement-Use of Portion
of the Public Right-of-Way for the Purpose of Constructing and Maintaining a Call Box and
Related Appurtenances)
Gentlemen:
The General LiabilityCertificate of Insurance regarding the above-referenced License Agreement,
S 6 6 >
is due to expire on February 11, 1999. In accordance with your agreement,the insurance certificate
needs to be renewed for an additional period of one year. The agreement requires a general liability
endorsement to naming the City of San Juan Capistrano as an additional insured. I have included
a City approved endorsement form to submit to your insurance company; however,your insurance
company may provide their own endorsement form.
Please forward the updated certificate and the endorsement form to the City, attention City Clerk's
office, by February 11, 1999.
If you have any questions, please contact me at(949) 443-6310.
Thank you for your cooperation.
Very truly yours,
IXSP. �
Dawn M. Schanderl
Deputy City Clerk
Enclosure
cc: Cheryl Johnson, City Clerk
Irene Marcote, Engineering Technician
DRUG USE
is
pB
San Juan Capistrano: Preserving the Past to Enhance the Future
ISSUE DATE IMMIDDNY)
07/02/98
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
ROBCO INSURANCE SERVICES DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
License#0750612 POLICIES BELOW,
27362 Calle Arroyo COMPANIES AFFORDING COVERAGE
San Juan Capistrano,CA 92675
COMPANY A RELIANCE INSURANCE COMPANY
LETTER
INSURED L
CETTEROmPEmR ` B CHUBWFEDERAL INS.CO. r
COMPANY G.
MALASPINA HOMEOWNERS ASSOC. LETTER rn
Malaspina Homeowners Assoc.
26902 Paseo Cardero COMPANYn o
D f m
San Juan Capistrano,CA 92675
COMPANY E
JEH 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, NOIWITHSTANDING 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.
C R TYPE OF NSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MAIDDYY) DATE(MMOY"
GENERAL UABILIP/ GENERAL AGGREGATE S 2,000,000
J( COMMERCIAL GENERAL LIABILITY PRODUCTS OOMPIOP AGO. $ 1,000,000
A CLAIMSMADEFX�OCCUR. JK2846021 02/11/98 07/11/99 PERSONAL sADV.INJURY a 1,000,000
OWNER'S &CONTRACTORS PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE WW"fln) $ 50,000
MED.EXPENSE Wry oro pww $ 5,000
AUTOMOBILE LABILITY
LIMITED SINGLE $ 1,000,000
ANY AUTO
ALL OWNED AUTOS BODILY INJURY $
A SCHEDULED AUTOS JK2846021 02/11/98 02/11/99 Pwpe o
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS (Perms klw* $
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILDY EACH OCCURRENCE i 3,000,000
B X UMBRELLA 79412900 02/11/98 02/11/99 AGGREGATE t 3,000,000
OTHER THAN UMBRELLA FORM .:`..<<'r.7.:$g. ¢?.:d:..:�+t
:.'OP.IQR'S CC.L'PI'i l.^iATID;I STATUTORY LIMITSp.F:;':5``:6¢,".',ym'g.f$' .ki;`?
EACH ACCIDENT $ c
AND
DISEASE—POLICY LIMIT S
EMPLOYERS' LUINLITY DISEASE—EACH EMPLOYEE $
OTHER
B DIRECTORS AND 81152746 07/15/89 07/15/99 $1,000,000 LIMIT
OFFICERS LIABBdTY $1000 DEDUCTIBLE
DESCRIPTION OF OPSRATIONSA.00ATIONSIVETNCLE&SPECIAL ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE:USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF SAN JUAN CAPISTRANO EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
OFFICE OF THE CITY CLERK MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
32400 PASEO ADELANTO LEFT, BUT FAILU TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
SAN JUAN CAPISTRANO,CA., 92675 LIABILITY OF NO UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AU7140RI2m ATVE
001058
1W
001058 JEH
INSURED: MALASPINA HOMEOWNERS ASSOC.
OTHER COVERAGES,(Continued):
CO
POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE DATE LlMrrB
A PROPERTY COVERAGE JK2946021 02/11/98 02/11/99 $10,000 ALL RISK,REPL
COMMON AREA ONLY COST,$1,000 BED 90%COIN
DESCRIPTION OF OPERATIONS/LOCATIONStVEHICLESISPECIAL ITEMS-(Continued):
UMBRELLA IS EXCESS OVER COMMON AREA LIABILITY&D&O LIABILITY
J 1 • •
POLICY NUMBER: JK2846021 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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
OFFICE OF THE CITY CLERK
32400PASEO ADELANTO
SAN JUAN CAPISTRANO,CA.,92675
CERTIFICATE HOLDER IS ADDITIONAL INSURED RE: USE OF PORTION OF THE
PUBLIC RIGHT-OF-WAY FOR THE PURPOSE OF CONSTRUCTING AND MAINTAINING A
CALL BOX AND RELATED APPURTENANCES.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in
the Schedule, but only with respect to liability arising out of your operations or premises owned by or
rented to you.
CG 20 2611 85 Copyright, Insurance Service Office, Inc., 1984
8. APPROVAL OF LICENSE AGREEMENT FOR IMPROVEMENTS IN THE
PUBLIC RIGHT-OF-WAY RELATING TO ENTRY GATE ON MALASPINA
ROAD(TRACT 9184,MALASPINA HOMEOWNERS ASSOCIATION)(600.30)
As set forth in the Report dated July 7, 1998 from the Director of Engineering and Building,
the Mayor and City Clerk were authorized to execute the License Agreement between the
Malaspina Homeowners Association and the City for installation of an entry gate and related
facilities on the public portion of Malaspina Road. The City Clerk was authorized to forward
the Agreement to the Orange County Recorder for Recordation.
XAAL OF AGREEMENT FOR SLOPE DISPLACEMENT WARRANTY
-TRACTS 13866 AND 13437(TAYLOR WOODROW HOMES AND
GTON SAN JUAN HILLS L.P. 600.30h in the Report dated July 7, 1998 from the Director of Engineering and Building,
ent Establishing Slope Displacement Warranty Program" for Tracts 13866 and
roved and the City Clerk was authorized to forward the Agreement to the
unty ecorder for recordation.
OF DESI SERVICES CONTRACT SAN JUAN CAPISTRANO
TRAFFIC MODEL A TIN-FOUST ASSOCIATES INC. CIP NO. 127
6�)
As set forth in the Report dated Jul 1998 from the Director of Engineering and Building,
the Agreement to develop the San Juan apistrano Traffic Model was approved with Austin-
Foust Associates, Inc. in the amount of 600.
11. APPROVAL OF AMENDED FINAL MAP SUBDIVISION IMPROVEMENT
AGREEMENT TRACT 14379 PEPPERW D ESTATES SAN JUAN
ENCLAVE. LLC) (600.30)
Asset forth in the Report dated July 7, 1998 from the Direc r of Engineering and Building,
the Amended Final Map and Subdivision Improvemen Agreement, Tract 14379,
Pepperwood Estates was approved and the City Engineer and Ci Clerk were authorized to
execute the Amended Final Map. The Mayor and City Clerk were thorized to execute the
Amended Subdivision Improvement Agreement and accept the co sponding securities.
The City Clerk was directed to forward the Amended Map and Am ded Subdivision
Improvement Agreement to the County Recorder for recordation.
12. ADOPTION OF RESOLUTION SETTING A DATE AND TIME FOR A PU IC
HEARING REGARDING SALE OF A PORTION OF THE HELICOPTER HI
PARK SITE (WITT) (670.70)
As set forth in the Report dated July 7, 1998 from the Director of Engineering and Buil g,
the following Resolution setting a Public Hearing for August 4, 1998,regarding the propos
City Council Minutes -5- 7/7/98
AGENDA ITEM July 7, 1998
TO: George Scarborough, City Manager
FROM: William M. Huber, Director of Engineering&Building
SUBJECT: Consideration of License Agreement for Improvements in the Public Right-of-way
Relating to Entry Gate on Malaspina Road (Tract 9184, Malaspina Homeowners
Association)
RECOMMENDATION
By motion, authorize the Mayor and City Clerk to execute the License Agreement between the
Malaspina Homeowners Association and the City, and authorize the City Clerk to forward the
Agreement to the Orange County Recorder for Recordation.
STUATION
A. Applicant - Malaspina Homeowner's Association
Mr. Robert Foresman -HOA Representative
26902 Paseo Cardero
San Juan Capistrano
B. Summary and Recommendation
The License Agreement is to implement the conceptual entry gate design approved by the City
Council at their meeting of May 19, 1998. Improvements include constructing a call box island and
related facilities and extending the existing turn-around at the easterly terminus of the public portion
of Malaspina Road. See Exhibit "A". Staff has reviewed the entry design plans and believes the
placement,use and maintenance of the private improvements in the public right-of-way is appropriate
with the execution of the License agreement and recommends the City Council authorize the Mayor
and City Clerk to execute the License Agreement.
-I-
FOR CITY COUNCIL AC_.
C. Background
Tract 9184 is a well-defined neighborhood taking access off Malaspina Road, a public street up the
tract boundary. East of the tract boundary, Malaspina Road is private. See Exhibit "B". At the City
Council meeting of May 19, 1998, the Malaspina Homeowner's Association presented, for City
Council consideration, their application for a gate-guarded neighborhood. The City Council approved
their application and approved the conceptual design for the entry gate on Malaspina Road.
To provide a proper turn-around radius before the entry gates, considerable reconstruction of existing
slopes on either side of the private portion of Malaspina would have to be completed. It has been
determined that a license agreement between the Malaspina Homeowner's Association and the City
to place part of the entry gate improvements (specifically the call box island) in the public portion of
Malaspina Road is appropriate and will not affect the health, safety and welfare of the public. The
Licensee shall be required to obtain all necessary construction and encroachment permits before
installation of improvements. The License Agreement includes a comprehensive indemnification
section that holds the City harmless during the construction of the improvements and provides for
ongoing maintenance of the call box island and related facilities in the public right-of-way.
This License Agreement also retains the City's and all public utilities' rights to access and maintain
their infrastructure and facilities located beneath said private improvements. The burden of any
repairs and maintenance to the private improvements is placed on the homeowners' association of
Tract 9184 as Successor in Interest to the License Agreement.
FINANCIAL CONSIDERATIONS
All recording costs will be paid by the Applicant. A deposit was submitted to the Engineering
Division to defray the processing costs.
NOTIFICATION
The Malaspina Homeowner's Association and all property owners in Tract 9184.
ALTERNATE ACTIONS
1. By motion, authorize the Mayor and City Clerk to execute said Agreement and authorize the
City Clerk to forward the Agreement to the Orange County Recorder for Recordation.
2. Do not authorize the Mayor and City Clerk to execute said Agreement.
3. Refer to Staff for additional information.
-2-
• s
RECOMMENDATION
By motion, authorize the Mayor and City Clerk to execute the License Agreement between the
Malaspina Homeowners Association and the City, and authorize the City Clerk to forward the
Agreement to the Orange County Recorder for Recordation.
Respectfully Submitted: Prepared By: _
1 A
William M. Huber Irene Marcote,
Director of Engineering and Building Project Manager
Attachments:
I. Exhibit "A" Private Improvements in Public Right-of-way
Exhibit °B" Location Map
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NEW CONC.
RIGHT_OF—WAY I SI E� CURB / \\ . \; AUTOMATIC SWING GATES
/' / / ��• LANE DIVISION ELEMENT
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PHONE ISLAND EMERGENCY OVERRIDE KEY
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NEW CONC. CURBA;low
EXISTING ENTRY WALL
AND PILLAR (TYP. BOTH \,;•��\
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PRIVATE ENTRY GATE IIIPROVEMENTS
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LOT 12
MALASPINA DEVELOPMENT
SAN JUAN CAPISTRANO
EXHIBIT "B"
• awl" •
32400 PASEO ADELANTO (j A MEMBERS OF THE CITY COUNCIL
[� (pO CAMPBELL
SAN JUAN CAPISTRANO, CA 92675 V , JOHNGR R
(949)493-1171 WYATT HART
(949)493-1053 (FAX) imulvu IA61 GILJONES
1776 DAVID M.SWERDUN
• ` • CITY MANAGER
" GEORGE SCARBOROUGH
July 9, 1998
Mr. Robert Foresman
26902 Paseo Cardero
San Juan Capistrano, California 92675
Re: License Agreement to Guard Gate Installation
Dear Mr. Foresman:
At their meeting of July 7, 1998, the City Council of the City of San Juan Capistrano
approved the License Agreement with the Malaspina Homeowners Association to provide
for the installation of an entry gate and related facilities on the public portion of Malaspina
Road.
The agreement has been forwarded to the Orange County Recorder's Office. A fully-
executed copy is enclosed for your files.
Please feel free to contact Irene Marcote, Project Manager, at 443-6352 if you have any
questions.
Very truly yours,
Cheryl Johnson
City Clerk
Enclosure
cc: Engineering and Building Director (with enclosure)
Irene Marcote (with enclosure)
DRUG USE
IS
AB
San Juan Capistrano: Preserving the Past to Enhance the Future
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32400 PASEO ADELANTO ® ri 1 (� MEMBERS OF THE CITY COUNCIL
SAN JLJAN CAPISTRANO,CA 92675 IL[l� OLLENECAMPBELL
JOHNR
HART
(949)493-1171 (j � Intorrorrno WYATT HART
(94 9)493-1053 (FAX) unuuur 1961 GILJONES
1776 DAVID M.SWERDLIN
CITY MANAGER
/ GEORGE SCARBOROUGH
July 20, 1998 'o�-'/�/
Cindy Vial(, Unit Supervisor
Clerk-Recorder's Office
County of Orange
P. O. Box 238
Santa Ana, California 92701
Re: License Agreement for Entry Gate Purposes (Malaspina)
Dear Ms. Viall:
By letter dated July 8, 1998, 1 forwarded the enclosed License Agreement for recording.
It was returned with a statement there was no provision to record the document. In March,
1998, a document with almost the exact same wording and for the same purpose was
recorded as Document No. 19980125259, recorded on March 5, 1998. 1 spoke with Ron
Cowley on July 20, 1998, who ultimately suggested your review of the document.
I have enclosed a duplicate copy of this letter. If you determine the document is
recordable, please stamp the Document Number and date of recording on the letter and
return it to this office in the enclosed, stamped, self-addressed envelope at your earliest
convenience. If the document is not recordable, I would appreciate a suggestion as to how
to "fix it."
Thank you for your cooperation. I can be reached at 949-443-6308 if you have any
questions.
Very truly yours,
Cheryl Jo son
City Clerk Recorded in the County of Orange, California
Gary L. Granville, Clerk/Recorder
Enclosure 24.00
19980491675 10:21am 07/30/98
005 19006577 19 04
Al2 7 6.00 18.00 0.00 0.00 0.00 0.00
IMBUSE
San Juan Capistrano: Preserving the Past to Enhance the Future