02-1117_NOBEL SYSTEMS_Action Reminder0 0
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Eric Bauman, Water Engineering Manager
FROM: Christy Swanson, Administrative Secretary
SITUATION:
I t iz ;F NCn cE
SECOND
DATE:
On December 17, 2002, the City of San Juan Capistrano entered into
Agreement with Nobel Systems to provide. GIS system support.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2003.
REQUEST
� ��C)2)
May 15, 2008
�t 41t2D�t_
Personal Services
-eLLr+ I -kb quegst
On June 16, 2003, agreement extended (180) days or by December 27, 2003.
On December 4, 2004, agreement extended (180) days or by June 24, 2004.
On June 8, 2004, agreement extended (180) days or by December 21, 2004.
On December 7, 2004, agreement extended {180) days or by June 18, 2005.
On May 16, 2005, agreement extended (365 days or by June 18, 2006.
On May 18, 2006, agreement extended (365 days)
On May 18, 2007, agreement extended (365 days)
Please notify our office if agreement has been completed or will be extended.
ACTION TO BE TAKE
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION:
DATE SIGNED: O��• Z �
'FOR CITY CLERK'S DEPARTMENT USE ONLY***
Tickler Date: 06110103
12101103
Deadline Date: 06130103
12127103
05115106
05115107
06118106
06 18107
CC.' Department Head
06101104 12101104 05/16/05
06124104 12121104 06118105
05115108
06118108
4l2lC9
(600.301nobel) /
V
fitzsr Na�c�
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Eric Bauman, Water Engineering Manager
FROM: Christy Swanson, Administrative Secretary DATE: May 15, 2008
SITUATION:
On December 17, 2002, the City of San Juan Capistrano entered into a Personal Services
Agreement with Nobel Systems to provide GIS system support.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2003.
On June 16, 2003, agreement extended (180) days or by December 27, 2003.
On December 4, 2004, agreement extended (180) days or by June 24, 2004.
On June 8, 2004, agreement extended (180) days or by December 21, 2004.
On December 7, 2004, agreement extended (180) days or by June 18, 2005.
On May 16, 2005, agreement extended (365 days or by June 18, 2006.
On May 18, 2006, agreement extended (365 days)
On May 18, 2007, agreement extended (365 days)
Please notify our office if agreement has been completed or will be extended.
ACTION TO BE TAKEN:
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN
SIGNATURE OF OFFICIAL TAKING ACTION:
DATE SIGNED: 6�. 02-. 2L69
***FOR CITY CLERK'S DEPARTMENT USE ONLY`**
Tickler Date: 06/10/03
12/01/03
Deadline Date: 06/30/03
12/27/03
05/15/06
05/15/07
06/18/06
06/18/07
cc: Department Head
(600.30/nobel)
06/01/04 12/01/04 05/16/05
06/24/04 12/21/04 06/18/05
05/15/08
06/18/08
0
•
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Eric Bauman, Water Engineering Manager
FROM: Christy Swanson, Administrative Secretary DATE:
SITUATION:
May 15, 2007
On December 17, 2002, the City of San Juan Capistrano entered into a Personal Services
Agreement with Nobel Systems to provide GIS system support.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2003.
On June 16, 2003, agreement extended (180) days or by December 27, 2003.
On December 4, 2004, agreement extended (180) days or by June 24, 2004.
On June 8, 2004, agreement extended (180) days or by December 21, 2004.
On December 7, 2004, agreement extended (180) days or by June 18, 2005.
On May 16, 2005, agreement extended (365 days or by June 18, 2006.
On May 18, 2006, agreement extended (365 days)
Please notify our office if agreement has been completed or will be extended.
ACTION TO BE TAKEN:
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION:
DATE SIGNED: O�Vg017
-
Tickler Date: 06/10/03
Deadline Date: 06/30/03
05/15/06
06/18/06
• cc: Department Head
(600.30/nobel)
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
12/01/03 06/01/04
12127/03 06/24/04
05/15/07
06/18/06
12101/04 05/16/05
12/21/04 06/18/05
0 40
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Eric Bauman, Water Engineering Manager
FROM: DATE: May 15, 2006
SITUATION:
On December 17, 2002, the City of San Juan Capistrano entered into a Personal Services
Agreement with Nobel Systems to provide GIS system support.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2003.
On June 16, 2003, agreement extended (180) days or by December 27, 2003.
On December 4, 2004, agreement extended (180) days or by June 24, 2004.
On June 8, 2004, agreement extended (180) days or by December 21, 2004.
On December 7, 2004, agreement extended (180) days or by June 18, 2005.
On May 16, 2005, agreement extended (365 days or by June 18, 2006.
Please notify our office if agreement has been completed or will be extended.
/TgL*7Li%77=&jF1:/4:A
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION: /
DATE SIGNED:
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
Tickler Date: 06/10/03 12/01/03 06/01/04 12/01/04 05/16/05
Deadline Date: 06/30/03 12/27/03 06/24/04 12/21/04 06/18/05
05/15/06
06/18/06
cc: Department Head
(600.30/nobel)
n
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Eric Bauman, Water Engineering Manager
DATE: May 16, 2005
SITUATION:
On December 17, 2002, the City of San Juan Capistrano entered into a Personal Services
Agreement with Nobel Systems to provide GIS system support.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2003.
On June 16, 2003, agreement extended (180) days or by December 27, 2003.
On December 4, 2004, agreement extended (180) days or by June 24, 2004.
On June 8, 2004, agreement extended (180) days or by December 21, 2004.
On December 7, 2004, agreement extended (180) days or by June 18, 2005.
Please notify our office if agreement has been completed or will be extended.
ACTION TO BE TAKEN:
F–
MAY 1 6 2005
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN: i
-—
PUB� c&Y:$
SIGNATURE OF OFFICIAL TAKING ACTION
DATE SIGNED: Vj r �o�
Tickler Date: 06/10/03
Deadline Date: 06/30/03
cc: Department Head
(600.30/nobel)
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
12/01/03 06/01/04 12/01/04 05116/05
12/27/03 06/24/04 12/21/04 06/18/05
0 0
PERSONAL SERVICES AGREEMENT
THIS AGREEMENT is made and entered into this d day of D E�002,
by and between the City of San Juan Capistrano (hereinafter referred to as the "City")
and Nobel Systems, (hereinafter referred to as "Consultant").
RECITALS:
WHEREAS, City desires to retain the services of Consultant to provide GIS
system support; and
WHEREAS, Consultant is qualified by virtue of experience, training, education
and expertise to accomplish such services.
NOW, THEREFORE, City and Consultant mutually agree as follows:
Section 1. Scope of Work.
The scope of work to be performed by Consultant shall consist of those tasks as
set forth in Exhibit'A," attached and incorporated herein by reference.
Consultant warrants that all of its services shall be performed in a competent,
professional and satisfactory manner and in accordance with the prevalent standards of
its profession.
Section 2. Term.
This Agreement shall commence on the effective date of this Agreement and
services required hereunder shall be completed by no later than June 30, 2003.
Section 3. Compensation.
3.1 Amount.
Total compensation for the scope of services for this Project shall not
exceed three thousand five hundred dollars ($3,500), as set forth in Exhibit "A,"
attached and incorporated herein by reference.
1
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3.2 Rate Schedule.
The services shall be billed to the City at the hourly rate set forth in Exhibit
'A," attached and incorporated herein by reference. Included within the compensation
are all the Consultant's ordinary office and overhead expenses incurred by it, its agents
and employees, including meetings with the City representatives and incidental costs to
perform the stipulated services. Submittals shall be in accordance with Consultant's
proposal.
3.3 Method of Payment.
Consultant shall submit monthly invoices based on total services, which
have been satisfactorily completed and specifying a percentage of projected completion
for approval by the City. The City will pay monthly progress payments based on
approved invoices in accordance with this Section.
For extra work not part of this Agreement, a written authorization from City
is required prior to Consultant undertaking any extra work.
3.4 Records of Expenses.
Consultant shall keep complete and accurate records of all costs and
expenses incidental to services covered by this Agreement. These records will be
made available at reasonable times to City.
Section 4. Independent Contractor.
It is agreed that Consultant shall act and be an independent contractor and not
an agent or employee of City, and shall obtain no rights to any benefits which accrue to
City's employees.
Section 5. Limitations Upon Subcontracting and Assignment.
The experience, knowledge, capability and reputation of Consultant, its principals
and employees were a substantial inducement for City to enter into this Agreement.
Consultant shall not contract with any other entity to perform the services required
without written approval of the City. This Agreement may not be assigned, voluntarily or
by operation of law, without the prior written approval of the City. If Consultant is
permitted to subcontract any part of this Agreement by City, Consultant shall be
responsible to City for the acts and omissions of its subcontractor as it is for persons
directly employed. Nothing contained in this Agreement shall create any contractual
relationships between any subcontractor and City. All persons engaged in the work will
be considered employees of Consultant. City will deal directly with and will make all
FA
payments to Consultant.
Section 6. Changes to Scope of Work.
In the event of a change in the Scope of Work provided for in the contract
documents as requested by the City, the Parties hereto shall execute an addendum to
this Agreement setting forth with particularity all terms of the new agreement, including
but not limited to any additional Consultant's fees.
Section 7. Familiarity with Work and Construction Site.
By executing this Agreement, Consultant warrants that: (1) it has investigated
the work to be performed; (2) it has investigated the proposed construction site,
including the location of all utilities, and is aware of all conditions there; and (3) it
understands the facilities, difficulties and restrictions of the work under this Agreement.
Should Consultant discover any latent or unknown conditions materially differing from
those inherent in the work or as represented by City, it shall immediately inform City of
this and shall not proceed with further work under this Agreement until written
instructions are received from the City.
Section 8. Time of Essence.
Time is of the essence in the performance of this Agreement.
Section 9. Compliance with Law.
Consultant shall comply with all applicable laws, ordinances, codes and
regulations of federal, state and local government.
Section 10. Conflicts of Interest.
Consultant covenants that it presently has no interest and shall not acquire any
interest, direct or indirect, which would conflict in any manner or degree with the
performance of the services contemplated by this Agreement. No person having such
interest shall be employed by or associated with Consultant.
Section 11. Copies of Work Product.
At the completion of the contract period, Consultant shall have delivered to City
at least one (1) copy of any final reports and architectural drawings containing
3
0 0
Consultant's findings, conclusions, and recommendations with any support
documentation. All reports submitted to the City shall be in reproducible format.
All services to be rendered hereunder shall be subject to the direction and
approval of the City.
Section 12. Ownership of Documents.
All reports, information, data and exhibits prepared or assembled by Consultant
in connection with the performance of its services pursuant to this Agreement are
confidential to the extent permitted by law, and Consultant agrees that they shall not be
made available to any individual or organization without prior written consent of the City.
All such reports, information, data, and exhibits shall be the property of the City and
shall be delivered to the City upon demand without additional costs or expense to the
City. The City acknowledges such documents are instruments of Consultant's
professional services.
Section 13. Indemnity.
Consultant agrees to protect, defend and hold harmless City, its elected and
appointed officials and employees from any and all claims, liabilities, expenses or
damages of any nature, including attorneys' fees, for injury or death of any person or
damage to property or interference with use of property and for errors and omissions
committed by Consultant arising out of or in connection with the work, operation or
activities of Consultant, its agents, employees and subcontractors in carrying out its
obligations under this Agreement.
Section 14. Insurance.
Insurance required herein shall be provided by Admitted Insurers in good
standing with the State of California and having a minimum Best's Guide Rating of A -
Class VII or better.
14.1 Not Applicable
14.2 Comprehensive Automobile Liability.
Throughout the term of this Agreement, Consultant shall maintain in full
force and effect Comprehensive Automobile Liability coverage, including owned, hired
and non -owned vehicles in the following minimum amounts:
$500,000 property damage;
0
0
0
$500,000 injury to one person/any one occurrence/not limited to
contractual period;
$1,000,000 injury to more than one person/any one occurrence/not limited
to contractual period
14.3 Worker's Compensation.
If Consultant intends to employ employees to perform services under this
Agreement, Consultant shall obtain and maintain, during the term of this Agreement,
Worker's Compensation Employer's Liability Insurance in the statutory amount as
required by state law.
14.4 Proof of Insurance Requirements/Endorsement.
Prior to beginning any work under this Agreement, Consultant shall submit
the insurance certificates, including the deductible or self -retention amount, and an
additional insured endorsement to the Consultant's general liability and umbrella liability
policies to the City Clerk's office for certification that the insurance requirements of this
Agreement have been satisfied.
14.5 Not Applicable
14.6 Notice of Cancellation/Termination of Insurance.
The above policy/policies shall not terminate, nor shall they be cancelled,
nor the coverages reduced, until after thirty (30) days' written notice is given to City,
except that ten (10) days' notice shall be given if there is a cancellation due to failure to
pay a premium.
14.7 Terms of Compensation.
Consultant shall not receive any compensation until all insurance
provisions have been satisfied.
14.8 Notice to Proceed.
Consultant shall not proceed with any work under this Agreement until the
City has issued a written "Notice to Proceed" verifying that Consultant has complied
with all insurance requirements of this Agreement.
Section 15. Termination.
City and Consultant shall have the right to terminate this Agreement without
cause by giving thirty (30) days' advance written notice of termination to the other party
In addition, this Agreement may be terminated for cause by providing ten (10)
days' notice to the other party of a material breach of contract. If the other party does
not cure the breach of contract, then the agreement may be terminated subsequent to
the ten (10) day cure period.
Section 16. Notice.
All notices shall be personally delivered or mailed to the below listed addresses,
or to such other addresses as may be designated by written notice. These addresses
shall be used for delivery of service of process:
To City: City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
Attn: Public Works Director
To Consultant: Nobel Systems
194 S. Del Rosa Dr., Ste. G
San Bernardino, CA 92408
Attn: Michael Samuel, President
Section 17. Attorneys' Fees.
If any action at law or in equity is necessary to enforce or interpret the terms of
this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees, costs
and necessary disbursements in addition to any other relief to which he may be entitled.
Section 18. Dispute Resolution.
In the event of a dispute arising between the parties regarding performance or
interpretation of this Agreement, the dispute shall be resolved by binding arbitration
under the auspices of the Judicial Arbitration and Mediation Service ("JAMS").
A
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Section 19. Entire Agreement.
This Agreement constitutes the entire understanding and agreement between the
parties and supersedes all previous negotiations between them pertaining to the subject
matter thereof.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
ATTEST:
M r ret R. Monahan, City Clerk
APPROVED AS TO FORM:
John R. Saw, City Attorney
CITY OFj�AN JUALI CAPISTRANO j
�y /) /
A
CONSULTANT
7
Nobel Systems
h, City Manager
6 N ' BEL
SYSTEMS
October 11, 2002
Mr. Eric P. Bauman
Public Works Department
City of San Juan Capistrano
34000 Paseo Adelanto
San Juan Capistrano, CA 92675
Subject: Proposal for consulting services
Dear Mr. Bauman,
•194 S. Del Rosa Dr., Ste. G
San Bernardino, CA 92408
Phone: 909382-0160
Fax: 909382-0163
msamueloiobel eystems.com
www.nobel systems.com
Please find below our proposal to provide the City of San Juan Capistrano for consulting
services per your request
Consulting Services — Nobel Systems proposes to provide Srinivas Suryanarayanaiah to
support the City's GIS efforts on-site for about 3 visits of about 8 hours during this fiscal
year. Srinivas will visit the City at City's request, and it is requested that a week's
advance notice be given.
Cost: We will bill Srinivas' services at $120 per hour plus travel costs of $50 per day.
Budget: $3,500.
Best n
'•�
Michael Samuel
President
EXHIBIT "A"
' CER1r1w Ire OF LIABILITY IN NCE
ACC?RL7®
DATE IMM/DD YYYY)
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
07/15/2005
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Farnan and Associates
1695 Mesa Verde Ave., Suite #130
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Ventura, CA 93003
IUN
ATE (MM/DD Y)
(805)644-4546
INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURER A'. Truck Insurance Exchange
Nobel Systems, Inc.
1845 Business Dr., Suite #130
San Bernardino, CA 92408
(909)382-0160
INSURER B Farmers Insurance Exchange
INSURER C. Mid -Century Insurance Exchange
INSURERD: United States Liability Insurance
NSURERE
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NARLTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE (MM/ I
IUN
ATE (MM/DD Y)
LIMITS
A
GENERAL LIABILITY
601708560
01/29/2005
01/29/2006
EACH OCCURRENCE $ 1,007050
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
_ffA N O 100,000
PREMISES Ea ocwurence $
MED EXP (Any one person) $ 2,000,000
PERSONAL B ADV INJURY $ 2,000,000
GENERAL AGGREGATE $ 1,000,000
GENIE AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMPIOP AGG $
POLICY PROJECT LOC
B
AUTOMOBILE LIABILITY
ANY AUTO
141784295
11/10/2004
11/10/2005
COMBINED SINGLE LIMIT $ 1,000,000
Ea accident)
�/ ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY $
(Per person)
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY $
(Par accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY
N/A
AUTO ONLY - EA ACCIDENT $
OTHER EA ACC $
ANY AUTO
AUTO ONLVN
AGG $
D
EXCESSIUMBRELLA LIABILITY
Proffesional Liability
11/10/2004
11/10/2005
EACH OCCURRENCE $ 1,000,000
✓ OCCUR CLAIMS MADE
CE001003538
AGGREGATE $ 1,000,000
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS• LIABILITY
A09228014
04/26/2005
04/26/2006
7/ TWO LIMITS ER
E L EACH ACCIDENT $ 1,000,000
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? NO
If yes, describe under
EL DISEASEEAEMPLOYEE $ 000,000
EL.DISEASE - POLICY LIMIT $ 1,000,000
SPECIALLPROVISIONS below
B OTHER Special form including theft. Bpp limits @
Business Personal Property $100,600. $250 We applies....
Policy # 60170-85-60, 1 deducta
Certificate holder is named as additional insured.
TE
City of San Juan Capistrano
Attn: Maria Guevara
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, TN!E)ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
I HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 FAX
www.sanjuancapistrano.org
April 5, 2005
RIO AAOAATEI
'
EST AILISAEA 1961
1776
Nobel Systems
Attn: Michael Samuel, President
194 S. Del Rosa Drive, Ste G
San Bernardino, CA 92408
•
MEMBERS OF THE CITY COUNCIL
SAM ALLEVATO
DIANE BATHGATE
MATT HART
JOE SOTO
DAVIO M. SWERDUN
RE: Compliance with Insurance Requirements — GIS System Support
The following insurance document is due to expire:
✓ Workers Compensation Certificate 0426/2005
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
expirqop date. I tyogflave any questions, please contact me at (949) 443-6309.
Secretary
cc: Michelle Perea, Administrative Assistant
Eric Bauman, Water Engineer Manager
San Juan Capistrano: Preserving the Past to Enhance the Future
CO pnntod on reo, Uee pacer
4 lot
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Eric Bauman, Water Engineering Manager
FROM: Mitzi Ortiz, Deputy City Clerk DATE: December 1, 2004
SITUATION:
On December 17, 2002, the City of San Juan Capistrano entered into a Personal Services
Agreement with Nobel Systems to provide GIS system support.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2003.
On June 16, 2003, agreement extended (180) days or by December 27, 2003.
On December 4, 2004, agreement extended (180) days or by June 24, 2004.
On June 8, 2004, agreement extended (180) days or by December 21, 2004.
Please notify our office if agreement has been completed or will be extended.
ACTION TO BE TAKEN:
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION:
DATE SIGNED:
"'FOR CITY CLERK'S DEPARTMENT USE ONLY"'
Tickler Date: 06/10/03 12/01/03 06/01/04 12/01/04
Deadline Date: 06/30/03 12/27/03 06124/04 12121/04
cc: Department Head
(600.30/nobel)
%011 I %'L=rNr% J M=r,^r% I IYIGIY I - N l' I IVIY RCIYI/IY
TO: Eric Bauman, Water Engineering Manager
FROM: Mitzi Ortiz, Deputy City Clerk DATE: June 1, 2004
SITUATION:
Cca
JUN II - 20042004 Jf
P1 'JG VAiRHs
On December 17, 2002, the City of San Juan Capistrano entered into a Personal Services
Agreement with Nobel Systems to provide GIS system support.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2003.
On June 16, 2003, agreement extended (180) days or by December 27, 2003.
On December 4, 2004, agreement extended (180) days or by June 24, 2004.
Please notify our office if agreement has been completed or will be extended.
ACTION TO BE TAKEN:
Cx -le /7c/ l�U q�jl
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION:
c�
DATE SIGNED: O/f�pg�G Y
Tickler Date: 06/10/03
Deadline Date: 06/30/03
cc: Department Head
(600.30/nobel)
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
12/01/03 06/01/04
12/27/03 06/24/04
J'Y
DATE IMM 00 YY)
(�y���,�rr��yi�y'GAYR�A�NEA����
AC
YrME,R��
11/12/2009
PRODUCER 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
Farnan & Associates ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 3935 COMPANIES AFFORDING COVERAGE
Ventura, CA 93006 COMPANY
805-644-4546 A Truck Insurance Exchange
INSURED
COMPANY
Nobel Systems, Inc.
B Farmers Insurance Exchange
COMPANY
1845 Business Center Dr.,Ste. 130
C Mid-Century Insurance Exchange
San Bernadino, CA 92408
COMPANY
909-382-0160
D United States Liabilit Insurance
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
FOLICY NUMBER
POIJCY IrFFECTIVE
DATEDAMIDDNIT
POLICYE%MMTM
DATE PAM XVM
MIIITS
431INERAL
LMBLSTY
BODILY BNJURY DOC $1000000
COMPREHENSIVE FORM
X
BODILY INJURY AGG 5 2 0 0 0 0 0 0
X
PREMSES/OPERATIONS
PROPERTY DAMAGE OCC $1000000
UNDERGROUND
EXPLOSION& COLLAPSE HAZARD
PROPERTY DAMAGE AGO $ 2 0 0 0 0 0 0
BI 6 PD COMBINED OCC $
A
X
PRODUCT$AWMPLETED OPER
CONTRACTUAL
601108560
01/29/04
01/29/05
a&PDcGMSNEDAGG s
PERSONAL INJURY AGG $
WDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
Med Pay 5,000
PERSONAL IWURY
AUTOMONLE
UABILNY
BODLYNJURY
$
X
ANY AUTO
(P°'PAen)
IURY
X
ALL OWNED AUTOS qn ePae)
X.
ALLOWNEDAUTOS
(P.ODILY ) $
(Other than Pnwte Paee w)
B
X
HIREDAUTOS
141784295
11/10/04
11/10/05
PROPERTY DAMAGE $
X
NONAWNEDAUTOS
BODILY R11URY A
GARAGE LIABILITY
PROPERTY
COMBINED DAMAGE $1,000,000
EACEM LIABILITY
EACH OCCURRENCE $1,000,000
D
UMBRELLA FORM
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11/10/04
11/10/05
AGGREGATE $1,000,000
X OTHER THANUMBRELLAFORM
CE001003538
$
Y'OCONPBIBATIOtI AND
TOTYTLMTS ER
EL EACH ACCAeNr $1000000
EMP
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THE TOR/TNE �.
A09228014
04/26/04
04/26/05
EL DISEASE -POLICY LIMIT $1000000
PARTNE
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EL DISEASE - EA EMPLOYEE $1000000
CHER Business Personal
Property Policy
#60170-85-60,
Special
form including
theft. BPP Limit
@ $100,600. $250
deductable
applies.
B
DESCRIPTION OF OPEIAAONBILOCATNLIWENICLGBISPEOAL ITEMS
Certificate holder is named as additional insured.
�E)4p ryiN� l�fl 114!'$ F�dlYl Y#k II 4'V !_U?
p
?I., 1 k F LiRle'Pd R''>l'ylA. ly 1 i 3�',As4{ fffi `j, 'L�IfV A�S�FIi IIQII .I�{I 154
Nrrl tgl€ vww,lrw
i�l
i`fi i1+< _
BNOULD ANY OF TME ABOVE DEBCRIE 1O 115 BE CANCELLED BEFOIIE TNG
EXPIRATM DATE THEREOF, TIIE ISSUIM OpAPANY ANLL ENDEAVOR TO MAIL
City of San Juan Capistrano
30DAYS wRrtTBI NDITLTe TO THE CERTNRJITE NOLoe1 NAMm TO TIE LEFT.
Attn: City Clerk's Office
BUT FALUM TO MAL tNNil NOTICE SHALL UPDOE ND pMJOA71011 W U AIIN ITY
32400 Paseo Adelanto
OF ANY N UPC, TIIE COMINIY, Irs AOBITB ON MMLMTA
SanJuanCapistrano, CA 92675
AREDR�M T
n�^, r I,Te! ' x j4n .. M.,..,
1
4%% •
32400 PASEO ADtLANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493.1171
(949) 493-1053 FAx
m4wsanyuancapivrano. olg
November 4, 2004
Nobel Systems
Attn: Michael Samuel, President
194 S. Del Rosa Drive, Ste G
San Bernardino, CA 92408
�VAN* •
F
(r/J,py 10(FFPoFRfF
[f1ABlIf9E0 1' 1161
1776
MEMBERS OF THE CITY COUNCIL
RE: Compliance with Insurance Requirements — GIS System Support
The following insurance document is due to expire:
J Automobile Liability Certificate 11/10/2004
SAM ALLEVATO
DIANE L. BATHDATE
WYATT HART
JOE SOTO
DAVID M. SWERDLIN
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 3400 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
expiration date. you have any questions, please contact me at (949) 443-6309.
Secretary
cc: Michelle Perea, Administrative Assistant
San Juan Capistrano: Preserving the Past to Enhance the Future
0 a
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Eric Bauman, Senior Engineer
FROM: Maria Guevara, Secretary DATE: June 10, 2003
SITUATION:
On December 17, 2002, the City of San Juan Capistrano entered into a Personal Services
Agreement with Nobel Systems to provide GIS system support.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2003.
Please notify our office if agreement has been completed or will be extended.
ACTION TO BE TAKEN:
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION:
DATE SIGNED:
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
Tickler Date: 06/10/03
Deadline Date: 06/30/03
cc: Department Head
(6oa 30,1nobel)
PPnM ' TNqI IPi:INCF*C;PPUICFS ANIL FAX NO. :8056449433 M41MW2 2004 04:52PM P2
"Su
TM CERTIFICATE IS ISBUEP AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4CEICA'C1
"OLDER. TM CERTIFICATE DOES NOT AMEND, EXTEND OR
COVERAGE
Farnan & Associates ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.C. Box 3935 COMPANIES AFFORDING COVERAGE
Ventura, CA 93006 cooANY
805-614-4546 Truck Insurance Exchange
NBUINED
Nobel Systems, Tric.
Farmers Insurance Evchanqe
1845 Business Center Dr., #130
C Mid -Century Insurance Evchange
San Bernadino, CA 92408
COWANY
2-0160
United States LiabilW
7-�
,,,kn %h,
THIS 13 TO CERTIFY THAT THE POLICIES 01: INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERM
INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE SS1JEI.) 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
"ITpummm
I Mrs P"Mm"
U1111ITS
SOOPLYINAW=
11000000
X
COMPREHENSIVE FORM
EDGILY IKIURY AGO
12000000
-X
PREWwsT FnAnoIqs
EXPLOSION A COLLAPSE HAZARD
�AIDWAOEC;C
%3.000000
PROPERTY PAWkG0 AGO
%2000000
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SIAPOCO~OOCC
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CONTRACTUAL
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01/29/04
01/29/05
w&PDcoI
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MRSONALINARYAGO
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Med Pay
5"000
PFRAONAL AIJURY
AUTOMOBILE
X
LIABILITY
ANY AUTO
NOMY *UUNY
LPW
Xx
X
AIL OWNED ADIOS (Pl�N—)
ALL OWNED AUTOS
(Orw (M P'�
BODILY *4JUPY
(PW ... W")
S
B
X
HIRIIDAU7�
141'Y@4295
11110/03
11110104
X
X
VDN9WWEO AUTOS
PROPERTY DAMAGE
5
GARAGE UAKITY
SOGILY I"" A
PROPERTY DAMAGE
COMBINED
OXGUS
L INLITY
—1,000,000
fACHOCCURRENCE
000 000
D
UMMELLAFORM
Professional Liab.
11/10/03
11/10/04
AGGREGATE
-Li-,
11-10-00,-000
X
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CE001003538
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1IMPLIN10101V LIMI&M
--UORV LMT% P
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92
$1000000
F3
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THE PROPPwTO0v RLL
OFFICERS ARE X IXCL
A09228014
04/26/03
04/26/05
EL DRSEASE POLICY LIMIT
$1000000
EL OISEA&E EA EMPLOYEE
91000000
OTHER
Certificate holdor is named as additional insured.
�11 EN 777-Ti14::
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MORD
UM A10 THE A111OVII! IMSCIVINIS) MULES W CAIKIILLED BEFORE TIM
A"'O'
City of San Juan Capistrano
231nurldl . TTM IYMIIO cOMEANT WK.I. 1101011AMOR Tb MNL
attention City Cli-rck's office
30 NOIEi TO TTM cawnFrATI NOlDB11 "ARM TO THE UwT.
32400 Paseo AdelantO,
VEIT MIAMWI!= NWA -L wo" NO OIRLINIATIO111 OR LIMINLITY
San Juan Capistrano, CA 92675
OF ITS AaNNVB CIE 11011'"10110MATIMINI.
(949)443-6:109
I.
"Vlj
".1w, yyIll 10'soppawwwwN
FROM :INSURANCE*SERVICES • FAX NO. :8056449433
1695 Mesa Verde Ave., Sults 130,
Ventura, California 93003
6054444546 FAX 805-644 9433
farnan@,pacbell.net
F0 -TAIA,
To fyi�tif j�"-
0 12 2004 04:51PM PS
Few
ejc
Fnu i Y� `�/3l 53 .asm a -
F1sNu o.d, 3 -/d ox/
ai J11, r2z( cc'
a commomre
01k'6fAlc- it4
32400 PASEO AOELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493.1053 FAX
www.sanjuancapistrano.org
March 2, 2004
Nobel Systems
Attn: Michael Samuel, President
194 S. Del Rosa Drive, Ste G
San Bernardino, CA 92408
\0 6�
I]
MEMBERS OF THE CITY COUNCIL
CITY MANAGER
RE: Compliance with Insurance Requirements — GIS System Support
The following insurance document is due to expire:
✓ Workers Compensation Certificate 0426/2004
DIANE L. BATHGATE
JOHN S. GELFF
MATT HART
JOE SOTO
DAVID M. SWERDLIN
DAVEADAMS
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 324,09 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
e"tio lat,pj.You have any questions, please contact me at (949) 443-6309.
cc: Michelle Perea, Administrative Assistant
Eric Bauman, Water Engineer Manager
San Juan Capistrano: Preserving the Past to Enhance the Future
ti
R BEL
SYSTEMS
October 24, 2003
Meg Monahan
City Clerk
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
184'6 BUSINESS CENTER DR., STE, 130
SAN BERNARDINO, CA 92408
PHONE: 9096904611
FAX: 9096905612
MSAMUELBNOBEL 4STSTEMS.COM
WW W.NOBEL9TSTEMS.COM
I am attaching the updated certificate of insurance as requested.
Sincerely,
Michael Samuel
President
DATE IM )
AS./O DTM � TY"
if W bi
10/21/20/2003
PRODUCER THIS CERTIFICATE SUED AS A MATTER OF INFORMATION
' ONLY AND CONFE S NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Farnan & Associates ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. 0. Box 3935 RECEIVE COMPANIES AFFORDING COVERAGE
Ventura, CA 93006 COMPANY
805-644-4546 A Truck Insurance Exchange
IMIIM 1003 OCT 21 P 4:
F2B""Y
Nobel Systems, Inc.
Farmers Insurance Evchan e
COMPANY
C Mid-Centur Insurance Evchan e
p ?� Ci L "r�>„p
1845 Business Centeg4�88AA�iiP�Sft(,
NO
COMPANY
San Bernadino, CA 924(j
909-382-0160
D United States Liabilit Insurance
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.
ro
LTR
TE OPSU
YP MRNCAE
POLICY NUMBER
POl SIFWEGTIYE
DATE IMMMDIYYI
POLIDYEXPMATIDN
DATEIMMODIM
LIMITS
BIDIERA.
LIAMLm
BODILY INJURY OCC $1000000
X
COMPREHENSIVE FORM
BODILY INJURY AGO $2000000
X
PREMISES/OPERATIONS
PROPERTY DAMAGE OCC $1000000
UNDERGROUND
EXPLOSION E COLLAPSE HAZARD
PROPERTY DAMAGE AGG $ 2 0 0 0 O O O
SIAPOCOMBINEDOOC $
A
X
PRODUCT comm.ETEo OPER
CONTRACTUAL
601708560
01/29/03
01/29/04
BISPDCOMBINED AGG $
PERSONAL INJURY AGG $
INDEPENDENT COWRACTORS
BROAD FORM PROPERTY DAMAGE
Med Pa
PERSONAL INJURY
AUTOMOBILE
UASIL"
"LY INJURY $
X
ANY AUTO
(Par Osrsan)
X
ALL OWNED AUTOS Tr're Pass)
BODILY INJURY
BODILYINJU
X
ALL OWNED AUTOS
(OIMr tMn Prim. Pas "r)
$
B
X
HIRED AUTOS
141784295
11/10/03
11/10/04
X
NON-0WNED AUTOS
PROPERTY DAMAGE $
GARAGE LIABILITY
BODILY NLURY A
PROPERTY COMBINED $1,000,000
EXCE88 LIAMIm
EACH OCCURRENCE $1,000,000
D
UMBRELLA FORM
Professional Liab.
11/10/03
11/10/04
AGGREGATE $1, 000 000
X OTHER THAN UMBRELLA FORM
CE001003536
$
Mgpl�AS WRpEN311TNN1 AND
TORSdR�°
57
LIA&IJTY
El EACH AOCIpENT $1000000
B
THE PROPRIETOR/ INDL
A09228014
09/26/03
04/26/04
ELgSEASE- POIX.WLIMrt $1000000
PARTNERSIEXECUTNE
OFFICERS ARE X EXCL
EL DISEASE - EA EMPLOYEE 1$1000000
DTHE" Business Personal
Property Policy
#6017
-85-60,
Special form including
theft. BPP Limit
@ $100,600. $250
deductabi
applies
B
DESCRIPTION OF OPEMTMN&LOCATIONSfflEH CLEWSPECUIL ITEMS
Certificate holder is named as additional insured.
'_Ir.r.I.Ph+ I w.VT��'Ikl�u�Ft4x:.,,.,
vwl.«�a�lrex+�I�.�f�;Il�uaellu.I='�`.�.�'�'+,�,�Exl�'�'�'I�'II �•.�
_..,r.. _... ..vrurlr�a�lul4,',.�'�'�cn .
.,..�.
SHOULD ANY OF THE ABOVE DESCRIBED POLIOIES SE CANCELLED BFPDIIE THE
EXPIRAT DATE THEREOF, THE ISSUIND COMPANY WILL ERMWIR TO AWL
City of San Juan Capistrano
30 QAYBwm,TENNDTMTNECEIMN TENDLD NANWTOT UI!FT.
32400 Paseo Adelanto
BUT FAtLIp1E TO M1AL atJal NoncE aNAu IMPOSE NO aauDATlax aR MABE.ITT'
San Juan Capistrano, CA 92675
of ARr IOND UPON THE COMPANY, ITS AGENTS M REPRSSBfTAT .
Attn: City Clerk's Office
"�D(�p� U"SMAMIE
u,",r.IPll.. ,. .. ..�.i,W4:G'
I+�n n, i �y�--s-r'-rr r I
�if !o Ii 17� Ir I M �n'� hrn ,.,,:I:r+-
it A(.xORD"„ "T - �!1� II�i�'I I. III 'I'l 10/21/ 0031f
1,1:1.1 .' L,''.i N' ,, ,Gil..:. I�.,.v,.,f�,.�4TdTf
MODUCRA
lCATIE IS E ) AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER- THIS CERTWIWLT'-c DOES NOT AMEND, EXTEND OR
Farnan & Associates
ALTER THE COVERAGE AF;ORDED BM' THE: POLICIES BELOW.
P.U. BOX 3935
COMPANIES AFFORDING COVERAGE
Ventura, CA 93006
COMPANY
805-644-4546A
Truck InsuraTlce Exchancle
— -
COMPANY
Nobel. Systems, Inc,.
B Farmers InsuT ance Evchan e
,
COMPANY
1845 Business Center Dr.,Ste. 130 C Mid-Century ',nsuram.e Evchanqe
San Bernadino, CA 92408
COMPANY
909-3B2-0160
United State Liabzr-it
i Insurance
United
_..D ,.'�'', i, ii-I IIT, WI
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA AED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION
Of ANY CONTRACT OR OTHER DOCUMENT WITH RE'3PECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HeI FIN 18 SUBJECT To ALL THE TERM$,
EXCLUSIONS AND CONDITIONS Or SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
"mmIMMIAANCe y
POLICY MUIwM1
DAMEQ"
m E-n
IJNPTB
QUISRAL
LLABNTY
I ODILY INJURY 011C 110 00 0 00
IDOILYMLIURYAIO 12000000
X
L'OMPREHENBIVE FORM
X
PR ENSESIOPERATIONB
PROPERTY OAMAQE ME: *1000000
IADPERTYDAMAGE AGO *2000000
UNDERGROUND
EXPLOSION A COUAPDE HAZARD
IIAPDCOMNNEDOCC,,. *
A
x
PRODUCISIOPMWETE00PER
,_.
II&POCOMBINEDAep_ 4
CONTRACTUAL
601708560
01/29/03
01/29/09
IeNSONN.wuf:r App S
INDEPENDENT CONTRACTORS
MROAD rorm PROPeRTY DMMOE
`led Pay_ _5 000
_
PERSONAL INJURY
ALRV*gMLM
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ALLOWNEDAUTOSJRWWF..
IODA.Y INJURY
X
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(Ol xMAS Pfl O PH,~)
141784295
11/10/03
11/10/04
�IROPexrroAMlmE 1
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— _ _
GARAGE UMNLITY
I OdLY NJURY A
INrnApE 110,0901000
TPcew6lMwXITY
!ACNffiGINREfICE S1,000,000
DUMBHE"PORM
Professional Liab.
11/10/03
11/10/04
%oo ATE �� *1,000 000
HX OTHERTHANUMBREUJIFORM
CE001003538
Wowl"10~111EIATIGNANO
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04/26/03
04/26/04
L PGI LIM 100_0000
PANTNERSA'XEDUTIVE
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[L -EAI!MPLOTEE 1.000000
DTR■N Business P
raonal Property Policy
#6017
-85-60,DeiE�1,
_
�Drm eluding
theft_ NPP Limit
0 $100,600_ 5250
eductabl
applies_
1;9 m
z IV
0
DBBCIOPrIpN Or wlMTIDxBAODATxNW VN11CliNNM:MI ITNMw
Certificate holder is named as additional insured_
........
MIOWM ANY w Tl6 AmD Dew xMED POW:INN BB CANCwum BBIOAN TNN
NXPNMTION MT1 TMLI . THU MIGIM COMPANY MALL MUkAMOR TO /MIL
City Of San Juan Capistrano
3.1)_DAor.T,.IND,IOem xacwT.�TIIxmMNAImTDTN.L.sT,
32400 Paseo Adelanto
NR ARLU E TO MAIL BI*ul KORO NYAL IMIGmc No 0BLN3 nm OR Lkw m
San Juan Capistrano, CA 92675
M ANY NNID MAON TRP eor ABY, " A wr* .w NePNcraTAlrNEs-
Attn City Clerk's office
;�'],•TP�
4141��1fiV4�1'lllC<l khhhll l'11+!9t'1611:Ih rR11!I'hl .a:;.. 1, .`::.;.`'�►j
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32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 (FAX)
Avtvtv.sanjuancapis(rano. org
1�1
October, 2003
IAIIAI111111
• BunnlB 1 1961
1776
Nobel Systems
Attn: Michael Samuel, President
194 S. Del Rosa Drive, Ste G
San Bernardino, CA 92408
MEMBERS OF THE CITY COUNCIL
DIANE L. BATHGATE
JOHN S. GELFF
MATT HART
JOESOTO
DAVID M. SWERDLIN
INTERIM CITY MANAGER
RE: Compliance with Insurance Requirements — GIS System Support
The following insurance document is due to expire:
✓ Automobile Liability Certificate 11/10/03 \�� (�
`X' o\v
PAMELAGIBSON
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
expiration date. If you have any questions, please contact me at (949) 443-6308.
Sincerely,
Uric Bauman, Water Engineer Manager
Kathleen Springer, Management Analyst 1
San Juan Capistrano: Preserving the Past to Enhance the Future
DATE(MMIDDIM
ACORD CERTIFICATE$' LIABILITY
INaUR/#W
TM 04/28/2003.
PRODUCER 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
Farnan & Associates ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 3935 COMPANIES AFFORDING COVERAGE
Ventura, CA 93006 COMPANY
805-644-4546 A Truck Insurance Exchange
INSURED
/4
COMPANY
Nobel Systems, Inc. v(15 �y/
B Farmers Insurance Evchan e
COMPANY
d'u�� U
1845 Business Dr. Suite 130
C Mid -Century Insurance Evchan e
San Bernadino, CA 92408
COMPANY
909-382-0160
D United States Liabilit Insurance
ii::7 .. 3:« -.:
a� 5y "OK
1 nk
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 M INSURANCE
POLICY NUMBER
LIMna
GENERAL
LAMLITY
BODILY INJURY OCC $1000000
X
COMPREHENSIVE FORM
BODILY INJURY AGG $ 2 0 0 0 0 0 0
X
PREMISES O ERATIONS
PROPERTY DAMAGE OCC $1000000
UNDERGROUND
EXPLOSION a COLLAPSE HPZARD
PROPERTY DAI"E AGG $2000000
MaPDCOLBINEDOCC $
A
X
PRODUCTSCOMPLEfED OPER
CCN7ACTUAL
601708560
01/29/03
01/29/04
Ma PDcoMMNEOAGG S
PERSONAL INJURY AGO $
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
Med Pay 5,000
PERSONAL INJURY
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LABILITY
BODILY WJlB2V $
X
ANY Aero
(Per PN,;aA)
X
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BODILY INJURY
X
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(Other than Pr a PiI.N.r)
(Per ecc t) $
B
X
HIRED AUTOS
141784295
11/10/02
11/10/03
PROPERTY DAMAGE $
X
NON -OWNED AUTOS
GARAGE LUIBAITY
BODILY INJURY a
PROPERTY COMBINED DAMAGE 1,000,000
EXCESS
LABILITY
EACH OCCURRENCE $1,000,000
D
UMBREUAFORM
Professional Liab.
11/10/02
11/10/03
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x
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CE001003538
$
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A09228019
09/26/02
09/26/09
EL DISEASE - POLICY LMT $1000000
NR
PARTNERSIEXECUTIVE
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#601.7
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0 $100,600. $250
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NZ
Certificate holder is named as additional insured. A M
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33,
vv
I
SHOULD ANY M THE ABOVE DESCRIBED POLICIEA BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE IBWILL ENDEAVOR COMPANY WENDEAVOR TO /MIL
City of San Juan Capistrano
.30 OA"WMTT Wn=Mro C�TEHOLOMILUM MTNEL .
32400 Paseo Adelanto
BUT FABlRIE M MAIL MICA NOTICE BALL HPOIE NO OBUOATION OR LIABILITY
San Juan Capistrano, CA 92675
M ANY IGND UPON THE COMPANY, ITS AGENTS OR REPREBMTTATIVEB.
Attn: City Clerk's Office
AUT RED REPR rAr
Fax. (949)993 1053,�h�_
12✓r`,3"`ii','�,I rtik'A.."..s#2'sschF;s`I§.s,R,l
ACORDCERTI■ ICA OF LIA 11NISUR AW, DATE (M YY)
iLI 1
10/21// 2003
PRODUCER THIS CERTIFICATE XSSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Farnan 6 Associates ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 3935 COMPANIES AFFORDING COVERAGE
Ventura, CA 93006 RECEIVED COMPANY
805-644-4546 A Truck Insurance Exchange
NauRED
Nobel Systems, Z(�IXT 24 P 12- L,. O
COMPANY
B Farmers Insurance Evchan e
COMPANY
C Mid-CenturyInsurance Evchan e
1845 Business Cen&J>{rl'Da)e..'�1 30
'�§�"II
�AN
D United States Liab*l Insurance
San Pernadino,SAa%j SS II
909-382-0160
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OP INSURANCE
FOI.NY NUMBER
POLICYEFFECTNE
DNTE(MMIODIYYI
POLICY EJIPIRATINI
DATE (Mumoff )
LR$ITS
OEMIRIIL
UI UTY
BCDEY NJURY OCC
$1000000
X
COMPREHENSNE FORM
BODILY INJURY ADD
$2000000
X
PREMISESMPERATIONS
PROPERTY DAMAGE OCC
$1000000
UNDERGROUND
COLLAPSE HAZARD
PROPERTY DAMAGE AGO
$2000000
BI d PD COMBINED COC
$
A
X
PRODUCTSrDmPFTED OPER
CONTRACTUAL
601708560
01/29/03
01/29/09
1 BIa PDoOMENED AGG
$
INJURY AGO
$
NDEPmDENT CONTRACTORSPERSONAL
Med Pay
5,000
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
AUrOMDBY.Eu
X
LJT+
MY AUTO
BODILY NJURY
OWPOB°">
$ ,
X
X
ALL OWNED AUTOS (Pr Pass)
ALL OWNED AUTOS
(Other Men Private Pesaenper)
DDDILYINJURY
(Per ecNCerS)
$
PROPERTY DAMAGE
$
B
X
X
HIRED AUTOS
NON -OWNED AUTOS
141784295
11/10/03
11/10/04
BODILY NJU2Y a
GARAGE LNBRJTY
PROPERTY
COMBINED DAMAGE
$1,000,000
EXCESSLMBILTY
EACH OCCURRENCE
$1,000,000
DUMBRELLA
FORM
Professional Liab.
11/10/03
11/10/04
AGGREGATE
$1, 000, 000
X OTHER THANUMBREUAFORM
CE001003538
$
WORKM COMRlMTM AND
EL EACH ACCIDENT
$1000000
STAFLOYEHY UABRJTY
B
THE PROPRIETOR/ NCL
PARTNERS/EXECUTNE
OFFICERS ARE: X E(CL
A09228014
04/26/03
04/26/04
EL DISEASE - POU UNIT
$1000000
I EL DISEASE - EA EMPLOYEE
$1000000
OTHER Business Personal
Property Pol'cy
#6017)-85-e60,
pecial form including
theft. BPP Limit
@ $100,600. $250
eductabl
applis
B
DESCRIPTWII OF OFEMTIONaILOCATMNSAMH ala IAL R0I$
Certificate holder is named as additional insured.
yN�rl {' Tq Ai 'I{M e 441F14QFl Ilei 11 fl4W^1
1 fl I Il $ YIYI� �N R TY�I ry1i a" Ilu i� ($ 1k 9R
,t cd5 i�.uT t' I11-1 {b" II�, ri
SHOULD AMY OF THE ABOVE OERGtlSm FOLIC" BE CANCFl1m BEFORE THE
EXPIRATION DATE THEREOF, THE ISIKMG DOMFANY WILL ENDEAVOR TO MRM.
City of San Juan Capistrano
30 MY*WWn*N NDn=To TIE CMTPN;ATE HOLDER NAMED To THE LEFT.
32400 Paseo Adelanto
BUT FA{AIE TO MAB. SUCH NOT WE S WOSE W DBLEATNIN OR LJABEITY
San Juan Capistrano, CA 92675
OF ANY NND o THE OOMMNY, " AGEUTS oR REFRESWAWAM
Attn: City Clerk's office
AATR�
�—
i•a,ar"Y�u�i��'1:�?C��xa''��`I,t`7ri,L�liti
0
NOBEL
SYSTEM S
December 10, 2002
Michelle Perea
City of San Ju pistrano
34000 P Adelanto
S an Capistrano, CA 92675
�f
j n 194 S. DEL ROSA DR., STE. G
SAN BERNARDINO, CA 92408
PHONE: 909.382-0160
FAx: 909.382-0163
MSAMUEL@NOBEL-SYSTEMS.COM
W W W.NOBELSYSTEMS.COM
I am enclosing the original Insurance Certificate
Sincerely n
'
Michael Samuel
President
�--
ACIORD,„ CSPPRTi INSU DATE IMMNOW
ICAlWP LIABILF .12/06/2002
PRODUCER 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
Farnan & Associates ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 3935 COMPANIES AFFORDING COVERAGE
Ventura, CA 93006 COMPANY
805-644-4546 A Truck Insurance Exchange
IxwREO
COMPANY
Nobel Systems, Inc.
B Farmers Insurance Evchan e
COMPANY
194 S. Del Rosa Dr., Suite G
C Mid -Century Insurance Evchan e
San Bernadine, CA 92408
COMPANY
909-382-0160
D United States Liabilit Insurance
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWTTHSTANDING 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
LTR
TYPE of NISIARANCE
POLICY NIRMFR
POLICY EFFBDTNE
DATEIMBMOOVVY)
PO "PtRATION
DAiE(1MVDDIYYI
LIMITS
LNBIEIAL
LIABILITY
BODILY INJURY DCC $1000000
COMPREHENSIVE FORM
X
BODILY INJURY AGO $ 2 0 0 0 0 0 0
X
PREMISESIOPERATIONS
PROPERTY DAMADE OCC $1000000
UNDERGROUND
EXPLOSION a COLLAPSE HAZARD
PROPERTYDAM&GEAGG 12000000
BISPD COMSBIED OCC 1
A
x
PRODwYs/COMPL.ETED OPER
CONTRACTUAL
601708560
01/29/02
01/29/03
BI&MOOMBmPDAGG IS
PERSONAL INJURY AGO S
INDEPENDENT OONTRACTORS
BROAD FORM PROPERTY DAMAGE
✓
Med Pay 5,000
PERSONAL INJURY
AUTOMOBILE
UM AU y
ANYAUTO
BODILY INJURY 1
@br Paraon)
X
X
ALL OWNED AUTOS(PrtvAle Paas)
ALL OWNED AUTOS
(Other then PrivNe PosaenSAo
BO ) 1
(Per,xcidam)
X
PROPERTY DAMAGE i
B
X
X
HIRED AUTOS
NON-0WNED AUTOS
141784295
11/10/01
11/10/03
BODILY INJURY a
PROPERTY
CODAMAGE
11, 000 000
GARAGE LIABILITY
` /
v
EXCESS UABILRY
EACH OCCURRENCE $1,000,000
DUMBRELLA
FORM
Professional Liab.
11/10/01
11/10/03
AGGREGATE $1,000,000
X OTHER THAN UMBRELLA FORM
CE001003538
i
1
YIDANERS COMPENSATIDf1 AND
BAPI.WERB' LUBILNTY
S A - OTH- sI ;t t
TORYLMTS ER
_
EL EACH ACCIDENT 11000000
B
THE PROPRIETOR/ ECL
PARTNERSIEXECUTIVE
OFFICERS ARE: EXCL
A09228014
04/26/02
04/26/03
EL DISEASE -POLICY LSAT 11000000
EL DISEASE - EA EMPLOYEE $1000000
--[Xl
OTHER Business Personal
Property Policy
#6017)-85-60,
Special form including
theft. BPP Limit
@ $100,600. $250
eductabl
applies
B
I
I
I
I
i
DESCRIPTION OF OPERATONSM1OCATONSNEHICLESASPECULL ITEMS
Certificate holder is named as additional insured.
SHOULD ANY OF THE ABOVE OESCRWED POLICIEi BE CANCELLED BEFORE THE
City of San Juan Capistrano
EXPIRATION DATE THEREOF, THE ISSUING AUL
COMPANY WILL ENDEAVOR TO M
32400 Paseo Adelanto
3— GAYS WRITTEI NOTICE TO THE CE TVIICATE HOLDER NAMED TO THE LEFT.
San Juan Capistrano, CA 92675
BUT FAILURE TO MAIL SUCII NOTICE SIMLL NMGBE NO GnJOATKN OR IJABILNY
Attn: Michelle Perea
OF ANY ICIPID UPON THE COMPANY, ITS AGENTS GR RATRBlETTATIVES.
Fax #949-493-3955
"DTHOFF." REr'"ESE"F""
Coo . s.....s ...
FASIERS INSURANCE GR(&
Truck Insurance Exchange
POLICY NUMBER: 60170-85-60
INSURED; Nobel Systems, Inc.
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART A
SCHEDULE
Name of Person or Organization:
City of San Juan Capistrano and its officials, agents and employees.
(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 work for that insured by or
for you.
PRIMARY INSURANCE: It is agreed that such insurance as is afforded by this policy for the benefit of
the persons or organizations as listed above shall be primary Insurance as respects any claim, loss or
liability arising directly or indirectly from the insured's operations, and any other insurance or self
insurance maintained by such persons or organizations shall be non-contributory with the insurance
provided hereunder.
CG 20 10 11/85 Copyright, Insurance Services Offices, Inc. 1984
FROM INSURANCE*SERV I CES FAX NO.
++ 805644943�3L �y j� JIr�r r 28 2003 10: 27AM P1
aDNaTnTrrv..,� ..1 1 Ai,hd1 .'1-IW.'T�wfL1"t,�W,,,� I,�lll�i,.l MATTER
^m:<r,!.;rt�nmvz^�znrr'
i
1. 1
' I �ATE(MMIOdY1'1
ACOR671 ,'II 11 04/26/2003
xoo'F3SUI-D ASA OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
+ - HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Farnan & Associates ALTER_ THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 3935 COMPANIESAFFORDINGCOVERAGE
Ventura, CA 93006 cawiwr
805-644-4546 A Truck Insurance Exchange
MwR®
Quenu
Nobel, Systems, Inc.
B Farmers Insurance Cvchan�
� � T
LvvANr
1845 Business Dr, Suite 130
San Bernadino, CA 92408
�_c Mid -Century Insurance Evchange._
CO1PA`1Y
909-382-0160
D United States Lia Insurance
I u
l
THIS IS TO CERTIFY THAT THE POLICIES
OF INSURANCE LISTED BELOW HAVE
BFI -N ISSUED
"
,'t rp 1 n �� ..
..I
TO THE INSURI'O NAMED
h u 1 1i171
-:r.�1 p11 ��,
ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY
RCOUIREMENT, TERM OR CONOTTION
OF ANY CONTRACT
OR OTHER COCUMENT
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 CONDITION: OF
SUCH POLICIES. LIMITS SHOWN MAY HAVE
BEEN REDUCED
roucr vFecTIIRra
MiE RArmvrl
BY PAID CLAIMS
cY rnFMenON
DALE RIMANWO
LIMD'e
CO
LTR
TYPiSINRIRMMOE
PDLICYIRIYEII
91000000
III MJURY AGO
12000000
X
COMPREHENSIVE FORM
X
PREMISVWI RATIDN6
PROPERTY C M r DCC
S1.000000
UNDERGROUND
UNUR ION b COLLAPSE HIVIWO
PROPERTY DAMAGE AOO
i Z 0 D 0 U OO
_
NbPD caAMm ED ace
s
A
X
PROpiCTBICOMPLETED OPE(,
CONTRACTUAL
601708560
01/29/03
01/29/04
EMAPO coPe1RED ADD
$
PERSONAL INJURY n[',a
S- ---_
INOPPMWNT CONTRACTOR'S
kiHOAO FORM PROPERTY [MMAOE
Med Payr '--
`5♦ OOO '
PERSONAL INJURY
IWTOPPCNL6
UARIUTT
MYAUTO
._.
DDDDY wImr
G
X
X
X
ALL NPOAUTOG(Nr Pow)
AIJI
(OILIIeOr IM�n PMmin Pner^n0^�1
HODILY INJURY
(Ps acclJem)
S
B
X�HIREOAUTOF
191784295
11/10/02
11/10/03
X
NON- ENURED eIlTOG
fROPEAT pAMAaE
$
OIVIAOE UPDRRY
eOPR.Y MJURYb —_
.'a ro aE
EACH OCCURRENCE
_
1,000,000
S1-, 000,000
ESCPJM
LMRRRY ._`
n
UipRELLAFORM
Pl.ofeSsla] Liab.
11/10/02
11/10/(13
_
MJ,JREoATE _
31,000rOOO_
X
OTHlRTHMlUMDREUAPEWA
CF;00100353On8
y
WO COMPDNMTMKMDTpRYTLNNTS
nwLarRRr Luarrr
_
- —
r_LEJNaIACLTOENT
'f IfCfI J I_, f('. 4
-
x1000000
13
THE PR IETOIV Incl
PARTNeRS'ExECUTNE
A09220014
04/26/02
04/26/G4
El. EASE-PDUCYLIMIT
$1000000
_
-II NSEAGE-EA EMPLOYEE S1-000000
pedal form including
OFPIOERD ARE. X r_XcL
_
#6017
-BS -60,
OTHOR Business Personal
Property Pol'cy
BPP Limit
@ .5100,600. $2-1)0
eductabl
applies_
,,(theft_
Certificate holder is named as additional insured.
City of Sari Juan Capistrano
32400 Paseo Ade-lanto
San Juan Capistrano, CA 92615
Attn: City Clerk's Office
,Fax: t949)45i3-1053
' """�uI�;PNovla ' I 1.^'''la ;6lillir.Pryl'Ih'+SII`I,I'h4�'k111;1119IDIII'Il'IiH9VhhVd9V.�1#!IIIIGN"
ANOULD ANY OF TNF AAI GMUNED POUT Ni GANCELLRO BEFORE TNN
MPIIDITMI MTi THIEREOP. 'INE INWWO COMPANY WILL 6N"AVOR TO AMIE,
JUL— DAYR WIRnfl1 NOTrA To TN! OER iricli 6 NOLDet NAMEO TO TNe LSF,
N RMUMI TO ATAR 1KI NOTICIE IMLL N VI NO OINURATION OR LAMILITV
DE ANY KIND UPM( TTIR COMPANY. OR ASSME11 OM Rs*IMacNYATI eft
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 (FAX)
tviviv sanjuancapistrano, org
April 18, 2003
Nobel Systems
Attention: Mr. Michael Samuel
194 S. EI Rosa Drive, Suite G
San Bernardino, CA 92408
0
MEMBERS OF THE CITY COUNCIL
DIANE L BATHGATE
JOHN S. GELFF
MATT HART
JOESOTO
DAVID M. SWERDLIN
CITY MANAGER
GEORGE SCARBOROUGH
RE: Compliance with Insurance Requirements - GIS System Support
The following insurance documents are due to expire:
V Workers Compensation Certificate 4/26/2003
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
expiration dates. If you have any questions, please contact me at (949) 443-6310.
Sincerely,
Daw�chand��
Deputy City Clerk
cc: Kathleen Springer
Eric Bauman
OR- -30
n
San Juan Capistrano: Preserving the Past to Enhance the Future
•1���61RD.H CER"1`���+^'?F L#AiA�'i��EE�i� 1z"io6/ ooz
PRODUCER 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
Farnan Sr Associates ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.D. Box 3935 COMPANIES AFFORDING COVERAGE
Ventura, CA 93006 COMPANY
805-644-4546 A Truck Insurance Exchange
INSURED
COMPANY
Nobel Systems, Inc.
B Farmers Insurance Evchan e
COWANY
194 S. Del Rosa Dr., Suite G
C Mid -Century Insurance Evchan e
San Bernadino, CA 92408
COMPANY
909-382-0160
D United States Liabi Insurance
v
-Lei=,- ., {., viz i xLTHIS 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.
COTYPEWINICIRMCE
LTR
POLICY NUYEER
POLICYEFFECTNE
DATE (Namo YY)
POLICYEXPIMTKKi
DATE PULMOMY)
UMRS
GNNEIAL
LIABBIrr
BODILY INJURY OCC $1000000
N
COMPREHENSIVE FORM
BODILY INJURY AGG S 2 0 0 0 0 O O
X
PREMISES/OPERATIONS
PROPERTY DAMAGE OCC $1000000
ND
EXPPLLOSION 8 COLLAPSE R12ARD
PROPERTY DAMAGE AGG f 2 0 0 0 D O O
818 PD COMBINED OCC $
A
X
PRODUCTS2CMALEfED OPER
CONTRAOTUU
601708560
01/29/02
01/29/03
BIaPDCOMBINEDAGO $
PERSONALBNJURYAGG $
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
Med Pay 5,000
PERSONAL INJURY
AUTOMOBILE
X
LIABILITY
ANY AUTO
BODILY INJURY $
T. �)
X
X
ALL OWNED AUTOS (Privet. Pass)
ALL OWNED AUTOS
(011ier than PrrvOe Pass q
BODILY INJURY $
(Per accitlerrt)
PROPERTY DAMAGE $
B
X
X
HIRED AUTOS
NON-OWNEDAUTOS
141784295
11/10/01
11/10/03
GARAGE LABILITY
BODILY INJURY 8
PROPERTY
COMBINED AGE $1,000,000
EXCEBB ANILITY
EACH OCCURRENCE $1,000,000
DRUMBRELLA
FORM
Professional Liab.
11/10/01
11/10/03
AGGREGATE $l, 000, 000
OTHER THAN UMBRELLA FORM
CEO01003538
$
wmam COMP��TNN NIU
W STATU- O
TORYLMTB ER
EL EACH ACCIDENT $10000004
EMPLOYERS' LABILITY
B
THE PROPRIETOR/ INCL
PARTNERSAEXECUTNE
OFFICERS ARE: X EXCL
A09228014
04/26/02
04/26/03
ELIISEASE-POLICYLIIT $1000000
ELDI E -EA ENFUOYEE $1000000
OTHER Business Personal
Property Pot
cy #6017
-85-60,
pedral jpcluding
B
theft. BPP Limit
@ $100,600. $250
eductabl
applies
C- m iTl
c� n
rn_
DESCNYTIOH OF OPRiuTloxsA.ocArlGNSevEIxcLEamPIB;uL+TeNBS -
- O <
(11
Certificate holder is named as additional insured. = N
z
- �
.-A,' Lni
u, �'��t J 5 tn5n v5 itLs
�»
f {1+' i �i {{. 'vl y
....... J .wl... , 3l.'•"i 8'Ni CiFk�'t�a' 3 'F 4w$�.xiu
��. —
SHOULD ANY W THE ABOVE DESCRIEED POLIGHS BE CANCELLED BEFORE THE
City of San Juan Capistrano
EXINRATICIL DATE THEREOF, THE ISSUING COMPNNY WILL ENDFMVOR TO MNL
32400 Paseo Ade T a n t o
30 DwYS wmmTPn NoncE ro THE ceRTwrwTE NaLDeL NAM® To TNB LEFT,
San Juan Capistrano, CA 92675
BUT FAILURE TO MNL BUNCH NONCE MAU SIPOSE NO wLB1ATIDN OR LIABILITY
Attn: Michelle Perea
OF AMY HND UPON THE COININANY, ITS AGENTS oR RI3RESENTwTNES.
Fax 949-4 93 3955
AUTHORREP,RESETTNE
ACG?RW:► , ,.
...:.., :;JR At hs�;,t19B14
.4
FAVIERS INSURANCE GRA
Truck Insurance Exchange
POLICY NUMBER: 60170-85-60
INSURED: Nobel Systems, Inc.
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART A
SCHEDULE
Name of Person or Organization:
City of San Juan Capistrano and its officials, agents and employees.
(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 work for that insured by or
for you.
PRIMARY INSURANCE: It is agreed that such insurance as is afforded by this policy for the benefit of
the persons or organizations as listed above shall be primary Insurance as respects any claim, loss or
liability arising directly or indirectly from the insured's operations, and any other insurance or self
insurance maintained by such persons or organizations shall be non-contributory with the insurance
provided hereunder.
CG 20 10 11/85
Copyright, Insurance Services Offices, Inc. 1984
i
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 (FAX)
lviv Iv. sanjuancapistrano. org
December 17, 2002
/�� , IIIf1A111�0
uuuum 1961
1776
Nobel Systems
194 S. Del Rosa Drive, Ste G
San Bernardino, CA 92408
Attention: Michael Samuel, President
Dear Mr. Samuel:
MEMBERS THE CITYCOUNCIL
DIANE l BATHGATE
GOL NE CAMPBELL
JOHNS. GEUT
WYAlT HART
DAVID M. SWERDUN
CITY MANAGER
GEORGESCARBOROUGH
Please find enclosed an original, fully executed, Personal Services Agreement related
to providing GIS system support.
We have on file current evidence of insurance and bonding as required by the
agreement. Please keep in mind that this documentation must be maintained current
with our office, or all work under this agreement must stop and all payments for services
rendered will be withheld, until these documents are brought current.
You may proceed with work under this agreement in coordination with the Project
Manager, Eric Bauman, Water Engineer Manager (949) 487-4312, who can also assist
you with any questions regarding the agreement.
Yours truly,
MegM an, CMC
City erk
cc: Eric Bauman, Water Engineer Manager
Amy Amirani, Public Works Director
San Juan Capistrano: Preserving the Past to Enhance the Future