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00-0404_SILVERADO SENER LIVING, INC._Lic & Reciprocal Acs & Parking Agr r Recorded in Official Records, county of Orange RECORDING REQUESTED BY AND Gary Granville, clerk-Recorder WHEN RECORDED MAIL TO: 1111111111111111111111111114111111111127.00 City Clerk 118 4 Al2 8000019817111:26am 04118100 City of San Juan Capistrano 0.00 0.00 0.00 0.00 21.00 0.00 0.00 0.00 32400 Paseo Adelanto San Juan Capistrano, CA 92675 LICENSE AND RECIPROCAL ACCESS AND PARKING AGREEMENT } (Assessor's Parcel #s 121-050-21 and 121-070-08, County of Orange) This License and Reciprocal Access and Parking Agreement is entered into this 4th day of April, 2000, by and between the City of San Juan Capistrano (hereinafter"City") and Silverado Senior Living, Inc., a California corporation (hereinafter"Developer'). RECITALS: WHEREAS, Developer has obtained a rezoning approval (RZ 98-03) from City to construct a 38,000 square-foot Care Facility at the location of Junipero Serra Road and Camino Capistrano, San Juan Capistrano, on certain real property depicted on the site plan, attached as Exhibit "A", and incorporated herein by reference; and WHEREAS, a portion of the Care Facility project consisting of an access and parking area as further depicted on Exhibit "A" is owned in fee title by City; and WHEREAS, RZ 98-03 contains a condition of approval requiring that the Developer enter into a reciprocal access and parking agreement with City; and WHEREAS, City and Developer agree that Developer shall construct certain access roadway and parking improvements as shown on Exhibit "A" on City's real property; and WHEREAS, the subject City-owned property shall be reciprocally utilized for City parking to access City-owned open space lands and for Developer's access and parking needs; NOW, THEREFORE, BE IT MUTUALLY RESOLVED BETWEEN DEVELOPER AND CITY AS FOLLOWS: Section 1. Grant of License. City hereby grants to Developer a license for the purpose of allowing Developer to construct, at Developer's sole expense, certain access roadway and parking improvements c:\myfi1es\si1verado\1icense.agr -1- 12/27199 on City-owned land, as more particularly set forth in Exhibit "A." The improvements shall be constructed in strict accordance with applicable City Municipal Code standards. Section 2. Reciprocal Access and Parking Rights/Additional Developer Obligations A. Reciprocal Parking Rights. City and Developer shall be equally entitled to utilize the subject improvements for access and parking purposes as further delineated in Exhibit "A" with respect to the City- owned land. B. Additional Developer Obligations. (1) Construction of Access Driveway. Developer's project will result in a ten- foot elevation difference between its site and the adjoining City open space land. Prior to issuance of a certificate of occupancy for the project, the developer shall complete, to the satisfaction of the City Engineer, an access driveway, as depicted on Exhibit "A," "Site Plan" to the northerly property and all facility improvements necessary to serve the development in accordance with the approved plan and approved exceptions. (ii) Grading. Prior to issuance of a building permit, the developer shall submit to the City Engineer and Building Official, for their review and approval, a Precise Grading Plan prepared by a registered civil engineer. These plans shall show the limits of grading, drainage, sewer, water, driveways and street improvements. The extent of the topography shall be extended enough to determine the drainage impacts to adjacent properties. The elevations shall correspond with the Orange County benchmark datum. All drainage must be properly conveyed to the street or a City-approved drainage facility. The driveway which serves as an access to the northerly City-owned vacant property shall be designed as a permanent ramp, not to exceed a Fifteen Percent (15%) grade, with proper structural fill and pavement section. Section 3. Term of Agreement. This Agreement shall remain in full force and effect until mutually rescinded by the parties. Section 4. Developer's Maintenance Obligations During the term of this Agreement, Developer, or its successors-in-interest, shall be solely responsible for maintaining the improvements depicted on Exhibit "A" in a first class condition. Section 5. Agreement Runs With the Land. This Agreement shall run with the land and bind all Developer's successors and assigns. c:\myfiles\silverado\Iicense.agr -2- 12/27/99 Section 6. Indemnity. (a) Developer shall indemnify and save City, its elected and appointed officials, and employees, harmless from and against all claims, demands, loss or liability of any kind which City may sustain or incur arising out of Developer's performance of its rights and obligations under this Agreement. (b) City shall indemnify and save Developer harmless from and against all claims, demands, loss or liability of any kind which Developer may sustain or incur arising out of City's performance of its rights or obligations under this Agreement. Section 7. Insurance. During the term of this Agreement, Developer shall obtain and maintain a general liability insurance policy, naming the City as an additional insured, in an amount of at least one million dollars ($1,000,000) combined single limit and in a form acceptable to the City Attorney. Section 8. Notices. Any notices required to be given under this Agreement shall be sent first-class mail to: City: George Scarborough, City Manager City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Developer: Loren B. Shook, President/CEO Silverado Senior Living 11 Mareblu, Suite 200 Aliso Viejo, CA 92656 Section 10. 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. c:\rnyfiles\silverado\Iicense.agr -3- 12/27/99 IN WITNESS WHEREOF, the Parties hereto have executed this Agreement. CITY OF SAN JUAN CAPISTRANO, a municipal c rporation By: 71 ollene mpbell, ayor ATTEST: By: Cheryl Joh n, eity Clerk APPROVED AS TO FORM: By: John R. Shaw, Ciq A116rney SILVERADO NIOR LIVING, INC. By: Loren B. Shook, President/CEO cAmyflesW1verado\1icense.agr -4- 12J27199 EXHIBIT "A" u z SITEPLAN J ' ( LEGEND PROPERTY LINE l PROP. PROPOSED R.W ROW RIGHT—OF—WAY (E) EXISTING APN ASSESSORS PARCEL NUMBER LIMIT OF `�\ \ i GRADING , = :\ SEE SHEET 2 FOR RECIPROCAL PARKING AND ACCESS AREA DETAIL. RAMP TO i ADJACENT CITY �..�` _ PROPERTY \ —`CAAd�IVO CAP I STRAND___. `\ Y4 pROp - -- - " i / 000 0 -� o o 0 I cn� APN 121-070-08 / /• ' / '' d z / •'• / CJG ,/••' // / u- 1 " = 100' •�• � PAGE 1 cApISRAN� f! sf EXHIBIT A RECIPROCAL ACCESS & PARKING DETAIL DENOTES AREA OF RECIPROCAL ACCESS AND PARKING AGREEMENT i m 0 I 0 h O 0 Z I Of 04 Q V CL z U 4 Q �N I O 0 V) O O Z a U Q ill 50' v PAGE 2 AMERI C } STATE OF CALIFORNIA }ss. COUNTY OF ORANGE } On March 22, 2000 before me, Jon G. Ervin personally appeared LOREN A. SHOOK (president/CEO of Silverado Senior Living, Inc. ) , personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s) or the entit upon behalf of which the person(s) acted, executed the instrument. WITNESS m and official seal. Signatur ERVIN Ccmrid—don #1200015 Cm '• Notary Public - California to Orange County My Comm.Explies Jan.23,2003 )This area for official notarial seal) Title of Document LICENSE AND RECIPROCAL ACCESS AND PARKING AGREEMENT Date of Document April 4, 2000 No. of Pages SIX ( . ) Other signatures not acknowledged Collene Campbell , Cheryl Johnson, John Shaw 3008 941 iGenerai First American Title In5'Jranee Company 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 April 4. 2000 , before me, Dawn M. Schanderl Deputy City Clerk, personally appeared - - - Collene Campbell - - - , personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her 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. • Deputy City Clerk OPTIONAL Capacity Claimed by Signer Description of Attached Document Municipal Corporate Officer Mayor License and Reciprocal Access and Title Parking Agreement Title or Type of Document Signer is Representing City of San Juan Capistrano Six Number of Pages April 4. 2000 Date of Document Loren Shook Signer(s) Other Than Named Above Y ��. `� .mxenn '; ;6 lilt I ��l `f j Fah``- ,.�... CORD CERTIFICA OF LIABILITY INSU NCFI LSE01 0CSR A4 DATE(MM DD/10 0508/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lockton insurance Brokers, Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 725 S. Figueroa St. , 35th Fl. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Los Angeles CA 90017 Phone: 213-689-0065 Fax:213-689-0550 INSURERS AFFORDING COVERAGE INSURED INSURER A: Lloyds of London INSURER B: :ii lverado Senior Living, Inc. INSURER C: Encinitas 335 Saxony Road INSURER D: Encinitas CA 92024 INSURER E: 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. INSR TYPE OF INSURANCE POLICY NUMBER DAPOLICY E M /EFFECTIVE DATEVMW D N LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY UP02US38$5002 03/31/02 03/01/03 FIRE DAMAGE(Anyone Fire) $ 50,000 X CLAIMS MADE a OCCUR MED EXP(Any one person) $EXClud@d X Retro Date:4/3/01 PERSONAL SADV INJURY $ IT1C1U ed X Pro£. Liability GENERAL AGGREGATE 83,00(),0()0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Included POLICY F7 PRO-ECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (PeraccidenU GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGO $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION g $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY TORY LIMITS ER E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLO E.L.DISEASE-POLICY LIMiij$ OTHER M N o M DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS TV .� Certificate Holder are named as Additional Insured as respects General an m C2 Liability Coverage only for the project at 30311 Camino Capistrano, San ni Capistrano *10 Day Notice of Cancellation for non-payment of premium. CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER:_ CANCELLATION SANLTUI5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of San Juan Capistrano Sr DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYSWRITTEN Capistrano Valley Water NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL District IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 32400 Paseo Adelanto San Juan Captistrano CA 92676 REPRESENTATIVES. AUTH RIZ R PR§GENTATIVE !AM—� ACORD 25S(7/97) ©ACORD CORPORATION 1988 _JJL. 30. 2002- 9 : 52AM — -LOGON- ` — • N0. 568 P. 2 ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION It is understood and agreed that Section II -WHO IS AN INSURED 2. is amended to include as an"Insured"the person or organization shown below as an 'Insured" but only with respect to liability arising out of your operations or premises owned by or rented to you. Name of Person or Organization: City of San Capistrano & Capistrano Valley Water District as respects to the following location: San Juan Capistrano 30311 Camino Capistrano San Juan Capistrano, CA 92675 All other terms remain unchanged. Attached to and forming part of No. UP02US38B5002 of Underwriters hereon. Effective: March 31, 2002 On behalf of Underwriters U.S. RiskUn/ derwriters, Inc. Insured: Silverado Senior Living Id,Gf$6/ 16 By ROD"C. Coss cwvaww/CEO (Authorized Representative) HC 413 Ed 0600 • �,, Jac* • 32400 IFASEO ADELANTO �,(� MEMBERS OF THE CITY COUNCIL SAN JUAN CAPISTRANO, CA 92675 �% 111A111,,,, DIANE L.BATHGATE (949) 493-1171 13Tlmlln IB61 JOHN SN GEL FRBELL (949) 493-1053 (FAX) 1776 WATT HART www.sanjuancapistrano.org • • DAVID M.SWERDLIN • CITY MANAGER GEORGE SCARBOROUGH April 14, 2002 Silverado Senior Living 11 Mareblu, suite 200 Aliso Viejo, California 92656 RE: Compliance with Insurance Requirements - Water Facilities Agreement/Utility Undergrounding Agreement/License Agreement The following insurance documents have expired: General Liability Certificate 4/3/2002 Y General Liability Endorsement naming the City of San Juan Capistrano as / well as the Capistrano Valley Water District as additional insureds. Y Other Information: Please name the City of San Juan Capistrano and the Capistrano Valley Water District as certificate holder 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 April 19, 2Q02.. If you have any questions, please contact me at (949) 443-6310. j Sincerely, Dawn M. Schanderl " r Deputy City Clerk cc: Craig Harris Kathleen Springer DRUG USE IS San Juan Capistrano: Preserving the Past to Enhance the Future AL. 30. 2002 9: 51AM LOON • N0. 568 P. 1 LOCKFOU Insurance and Risk Management Specialists FAX TRANSMITTAL Lockton Insurance Brokers, Inc. License#0714705 Date: 7/30/02 Total Pages Sent: 2 (Including Cover Sheet) To: Craig Harris From: Nichelle Nakano Company: City of San Juan Capistrano Phone: 213-689-0583 FAX: 949-493-3955 Phone: 949-487-4305 Fax: 213-689-0586 Re: Silverado Senior Living Copy of Additional Insured Endorsement NOTICE OF CONFIDENTIALITY: The documents accompanybig this telephone transmission facsimile are confidential, legally privileged and the oxelusive properly of the stridor The transmitted infamvtion is intended exclusively for the use of the individual or entity to whom the documents should be delivered. If you are not the intended recipient, you are hereby notified that any disclosure,copying distribution or action taken iu reliance on the contents of this telephuna transmission is strictly prohibited. If you have received this telephone transmission in error,please notify the sender immediately by telephone or amnge,for the return of ale w3mmilted dacurrimts. Message: Dear Mr, Harris: Attached please find a copy of the additional insured endorsement for the City of San Juan Capistrano. Should you have any questions or concerns, please do not hesitate in contacting our office. Sincerely, Nichelle Nakano Account Manager 4 LOCKTON IN5tJMME 13"UPS,INC. 725 S.Figueroa Street,35th Floor/Las Angeles,CA 90017 (213)689-0065/FAX:(213)6890550 SEP-13-2001 10;34 Marsh 8 McLennan I.A 213 346 5927 P.02/02 CERTIFICATE NUMUR LOS-000182247-00 FRODUCIR 7110 CERTIFICATE 13 ISSUED AS A MATTER 01 INFORMATION ONLY AND CONFERS Marsh Risk& Insurance Servicef NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE Licii No.0437153 - POLICY.THIS CERnFICA711 DOES NOT AMEND.EXTEND OR ALTER THE COVERAGE 777 South Figueroa Street AFFORDED BY THE POLICIER DESCRIBED HEREIN, Los Angeles,CA 90017 COMPANIES AFFORDING COVERAGE Attn:Barbara Roessler 213-348-5237 COMPANY 509643-00/01 A Lexington Insurance Company INSURED COMPANY SILVERADO SENIOR LIVING 9 American Home Assurance Company 27121 Celle Arroyo,Suite 2220 ')AnaL TA I T- Son Juan Capistrano,Ca.92675 COMPANY C COMPANY D J:1 77 THIS %It CERTIFY THAT POLICIES Of INSUPLAblict DESCRIBED HEREIN HAVE ISSIN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED NOTW17HSTANDINO ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIT14 RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED aY PAID CLAIMS. Go TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION UNITSLTR DA7E(MMMi DATE(MAI A GENERAL LIABILITY 6790102 04/03/01 W03/02 GENERAL AGGREGATE $ 3,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGO $ 3,000,ODO CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ 1,0D0,000 L OWNERS 6 CONTRACTOR*3 PROT EACH OCCURRENE $ 1,000.00 FIRE DAMAGE JAny one Pre) $ 50,000 MED ESP(MY oft Ohi $ 5,000 8 AUTOMOBILE LIABILITY CA6549609 09101/01 D9101102 COMBINED SINGLE LIMIT 1,000,000 7 ANY AUTO ALL OWNED ALTOS BODILY INJURY $ SCHEOULCOAUTOS (per wai X HIRED AUTOS 5001LY INJUPIT' $ NON-OWNED AUTOS IlAor walarril PROPERTY DAMAGE GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANYAUTO OTHER THAN AUTO ONLY AGGREGATE EX CEM LIABILITY EACY40CCURAIi UMBRELLA FORM AGGREGATE orwpRIHAN UMBRELLA FORM $ MPE A LIT i won""0 ON AND WC67111065 09101101 09101102 x I ToOLI'M'1% ER O EMPLOYERS EL EACH ACCIDENT $ 1,000,0 D THE PROPRIETOR/ X. INCL CL OISrJrSEPOLICY LIMB $ 1,000,DOD PARTRIERSIEXECUTIVE - OFFICERS ARE EL DISEASE-EAC'4 EMPLOYCE1 1,000000 .'i MORIPTION OF OPeRAnONWLOCAT70N3fVEMICLE61SPECIAL ITEMS JUMITS MAYBE BUBIECTTOOEDUC BLf30R RETENTIONS) Certificate holders aro named Additional Insured as respects General Liability Coverage for project 0 30311 Camino Capistrano,San Juan Capistrano. z. !""WMIRIM �w- i—q'IM aIy I - 'g� -'-4z.4 SHOULD ANY of THE PO4IC490 DESCRIBED HEREN BE CANCELLIED bdPORM THE 94IRATION OATS THER1101, THE INSURER AFFORi COVIERACS VMU.ENDEAVOR TO MAIL,3Q DATE YNATTIEN Hi TO ME Clly of San Juan Capistrano& CERTIFICATE HOLOM KAMUIP MERCK,60 FAILURE TO Hi OUCH NOTICE 61ri IMPOSE NO MCATIM OR Capistrano Valley Water District 32400 Paseo Adelanto LIABILITY OF ANY AND UPON THE INSURER AIPOROON5 ICIA!MIC.115 AGCNTS OR PV EMATNES. San Juan Capistrano,Ca.92676 MARSH USA INC. BY: Wendell L.Barnet TOTPL P.02 DEC-27-2001 17: 10 OF-770 (NAM)VO.28 1M 026 0012 P.02i02 • ENDORSEMENT #9 • This endorsement, effective 12:01 AM: April 3, 2001 forms a part of policy number: 6790102 Issued to: SILVERADO SENIOR UVING, INC by_ LEXINGTON INSURANCE COMPANY ADDITIONAL INSUREDS ENDORSEMENT The Policy is amended as follows: Section II. WHO IS AN INSURED of the HEALTHCARE PROFESSIONAL LIABILITY COVERAGE PART is amended by adding the following: Section Il. WHO IS AN INSURED of the HEALTHCARE GENERAL LIABILITY COVERAGE PART is amended by adding the following: CITY OF SAN JUAN CAPISTRANO & CAPISTRANO VALLEY WATER DISTRICT 32400PASEA ADELANTO SAN JUAN CAPISTRANO, CA 92676 The coverage afforded by this endorsement is limited to the additional insured's legal liability arising out of the COC project for San Juan Capistrano. All other terms, conditions and exclusions of the Policy remain unchanged. Authorized Representative 74769 (12/99) .1rnn ac mTor v n7- TOTAL P.02 DEC-27-2001 17:09 .UF-770 (NAM)U0.28 1M 028 0012 P.01i02 Facsimile Marsh USA Risk&Insurance Services • 777 South Figueroa Street Transmittal Los Angeles, CA 90048 sheet Phone:213/346-5237 Fax-213/346-5927 Caliloinin Licensc No.0437153 MARSH An MARC Company Date: December 27, 2001 Pages,with cover: 2 To: Craig Harris Fax: 949/493-3955 Company: City of San Juan Capistrano From: Barbara A. Roessler Subject: Silverado Senior Living,Inc Craig: At long last here is the endorsement adding the City& the Water District as additional insured's to Silverado's liability policy. We apology for the delay. Please let us know if you have any questions. Thank you, �l rl ��1 u Y V[A The information contained in this facsinule message is confidential,nmv be privileged,and is intended for Use ate ofthe individual or entity named above. !f yon. the render of flus message, are not the intended recipient, the agent, or employee responsible for delivering this transnvxvion to the intended recipient,you are eepi essly prohibited frau copying, disseminating, distributing,ar in om,other way using any of the it formation containedin this facsimile message. Documrnr_ 1aP-13-2001 10:34 eirsh 8 McLennan • 213 346 5927 P,01i02 r Facsimile Marsh USA Risk g Insurance Services 777 S.Figueroa Street Transmittal I,os Angeles,Ca,90017-5822 Sheet Phone:213 346 5231 Fmr.213 346 5927 CaRfornia License No.0437153 MARSH An MMC Company Date: September 13,2001 Pages,with cover: 2 To: Mr. Craig Harris Fax: 949 493 3955 Company: City of San Juan Capistrano From: Lillian J Klein Subject: Certificate of Insurance Dear Craig: Here is the Certificate of Insurance for Silverado Senior Living. The original was mailed yesterday, Sincerely, Lilly Klein i I I i The information contained in this facsimile message is confidential,may be privileged,and is Intendedfor the use of the individual or entity named above. Ifyou,the reader of this message, arc not the intended recipicnr.the agent, or employee "sponsible for delivering this transmission to the intended rrcipieni.ynu am espresslyprohibired from copying, disseminating, distributing. or in any other way using any ofthe information contained in thisfacsimile me.magr. o.wme.a I � ' 1 Q: �Tt-�Ll✓�h� t3Mo99 � C�?A+� Ncvvu=o 32400 RASED ADELANTO i� MEMBERS DIA EL ITHGATE CIL SAN JUAN CAPISTRANO,CA 92675 • IMIIMNIH JOHN S.GELFF (949) 493-1171 fSTO USM 1961 JOHN GREINER (949)493-1053 (FAX) 1776 WYATT HART www.sanjuancapistrano.org •� • DAM M. SWERDUN CIN MANAGER GEORGE SCARBOROUGH August 21, 2001 I Silverado Senior Living 'Reee 11 Mareblu, Suite 200a— Aliso Viejo, California 92656 RE: Compliance with Insurance Requirements - Improvement and Reimbursement Agreement for Water Facilities The following insurance documents are due to expire: General Liability Endorsement naming the City of San Juan Capistrano and the Capistrano Valley Water District as additional insureds. Automobile Liability Certificate 9/1/01 Workers Compensation Certificate /1/01 The City of San Juan Capistrano as well as the Capistrano Valley Water District must be listed as certificate holders. 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, /Cad)-n7n Dawn M. Schanderl Deputy City Clerk cc: Craig Harris K. Springer DRUM use is San Juan Capistrano: Preserving the Past to Enhance the Future • fA i�'Sft:i,'a�M�lr�..lt 3� ��� CERTIFICATE NUMBER .t ;.'...::. ,.+v.. LOS-000182247-00 . ..,. ... . . 1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Marsh Risk&Insurance Services NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE License-No.0437153 POLICY.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE 777 South Figueroa Street AFFORDED BY THE POLICIES DESCRIBED HEREIN. 'Los Angeles, Roessler 90017 COMPANIES AFFORDING COVERAGE Attn:Barbara Roessler 213-346-5237 COMPANY 09643---00/01 A Lexington Insurance Company INSURED COMPANY SILVERADO SENIOR LIVING B N/A 27121 Calle Arroyo,Suite 2220 San Juan Capistrano,Ca. 92675 COMPANY C COMPANY y�D _,i.trllaFi�.., THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE POLICYEXPIRATION LIMITS LTR DATE(MM/DOM') DATE(MM/DD/YY) A GENERAL LIABILITY 6790102 04/03/01 04/03/02 GENERAL AGGREGATE $ 3.000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGO $ 3,000,000 CLAIMS MADE 111 OCCUR PERSONAL&ADV INJURY $ 1,000,000 OWNERS&CONTRACTORS PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Any one fire) $ 50.000 MED EXP(My one Carson $ 5,060 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY. EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ OR Rb COMP1,115ATIUN AND I IMF. - EMPLOYERS'LIABIUTY TORY LIMITS ER _'�i1,9 EL EACH ACCIDENT $ THE PROPRIETOR/ INCL EL DISEASEPOLICYLIMIT $ PARTNERS/EXECUTIVE OFFICERS ARE EXCL EL DISEASE-EACH EMPLOYEE $ OTHER t/7 T A_ 7 C h DESCRIPTION OF OPERATIONS(LOCATIONSNEHICLES/SPECUL ITEMS(LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS) rn Certificate holders are named Additonal Insured as respects General Liability Coverage for project @ 30311 Camino Capistrano,San Juan Capistrano. B . s%Vu"1. [ i:< :5 SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE TH®IRADON DATE THEREOF. THE INSURER AFFORDING COVERAGE L 1. ENDEAVCR TO MAIL.__in DAYS WRITTEN NOTICE TO THE City of San Juan Capistrano& CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Capistrano Valley Water District 32400 Paseo Adelanto LIABILITY OF ANY KIND UPON THE INSURER AFFORDINGCOVERAGE ITS AGENTS OR REPRESENTATIVES. San Juan Capistrano,Ca. 92676 MARSH USA INC. eY: Wendell L. Earner n m'.i..• ,1:.� 5t; 9 c 'diA i J d :•..._9 `:9at MAk9A USA { i l CERTIFICATE NUMBER LOS-000182247-00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Marsh Risk&Insurance Services NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE License No.0437153 POLICY.TNIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE 777 South Figueroa Street RECEIVED AFFORDED BY THE POLICIES DESCRIBED HEREIN. Los Angeles,CA 90017 Attn.Barbara Roessler 2113r 6-5x37 5,r py t Q I COMPANIES AFFORDING COVERAGE a f` L 11� COMPANY 09643---00101 A Lexington Insurance Company INSURED L T T C L COMPANY SILVERADO SENIOR LIVING C.` I% d IT B N/A 27121 Calle Arroyo,Suite 22261 Ci ;dr7 San Juan Capistrano,Ca,W6M IJ I,aLdJ COMPANY C COMPANY D OOVERAWS' ."`.. THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE(MWDDMO DATE IMMMDIYr) LIMITS A GENERAL LIABILITY 6790102 04103101 04103/02 GENERAL AGGREGATE $ 3,000,000 X COMMERCIAL GENERALUAWLITY PRODUCTS-COMP/OP AGG $ 3,000,000 _ CLAIMS MADE I_] OCCUR PERSONAL B ADV INJURY $ 1,000,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 —_—_—_--_ FIRE DAMAGE(My One in) $ 50,000 MED EXP(Ary one wsDF $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _ 1 ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS {Far Terson) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per amclenp PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY a.. _ EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLAFORM AGGREGATE IS OTHER THAN UMBRELLA FORM $ �IIERS CD0PENSAT11 EMPLOYERS`LIABIUTY TORY LIMITS ER o`l;d, T' :• ' EL EACH ACCIDENT IS THE PROPRIETOR! INCL EL DISEASE-POLICY LIMIT $ PARTNERSPEXECUTIVE OFFICERS ARE. EXCL I EL OISEASE-EACH EMPLOYEE $ OTHER PESCRIP71ON OF OPERATIONS/IACATONSNEHICLES/SPECIAL ITEMS(LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS) Certificate holders are named Additonal Insured as respects General Liability Coverage for project @ 30311 Camino Capistrano, San Juan Capistrano. I..t `',''� :, ..:. ,.. : ::. ,a wt SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL_3Q DAYS INNOTEN NOTICE TO THE ity of San Juan Capistrano& CERTIFICATE HOLDER NAMED HEREIN.BUT FAILURE TO MAIL SUCH NOTICE SHALL NAPOSE NG OBLIGATION OR apistrano Valley Water District 2400 Paseo Adelanto LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES. an Juan Capistrano,Ca.92676 M USAIN BY: liI'M :il� v:i. �}yNss "'gagA,' : ti SCI — 0011F RECEIVED MR 23 3 04 PM '01 Additional Insured Section 2 Endorsement CITY c L F N K DFP,A,RIM,-NT In consideration of the premium charged, it is hereby understood and agreed that thlaib®IowAgAptioned policy the "folic amended in the following P Y� Y"1 �is B Particulars: JUAN Coverage under Section 2 (Business Liability Coverage) of Division I of the below numbered policy is extended to the additional insured designated below. CITY OF SAN JUAN CAPISTRANO & CAPISTRANO VALLEY WATER DISTRICT 32400 PASEA ADELANTO SAN JUAN CAPISTRANO, CALIFORNIA 92676 Designated Additional Insured The coverage afforded by this endorsement is limited to the additional insureds legal liability arising out of the COC project for San Juan Capistrano. This extension of coverage does not apply to the additional Insured's liability arising wholly or partly out of its own negligence or that of Its agents or employees. This endorsement is attached to the Policy indicated below and is effective on the date stated herein, 12:01 a.m. standard time at the address shown in Item 2 of the declarations insert. All other terms and conditions remain unchanged. Policy No. Effective Date of Endorsement Expiration Date of Endorsement Endorsement No. 11171,0005020 9/01/2000 9/01/2001 14 Issued To Additional Premium Return Premium SILVERADO SENIOR LIVING INC f.00 $.00 SCPIE Indemnity Company By President— HPI 604-CA (9/97) CERTIFICATE NUMBIi0. .. _. _ .. .. LOS0 001822470 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Marsh{tisk&Insurance Services NO RIGHTS UPON THE CERTIFCATE HOLDER OTTER THAN THOSE PROVIDED IN THE License No.0437153 POLICY.Ti18 CERTIFCATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE 777 South Figueroa Street AFFORDED BY THE POUGES DESCRIBED HEREIN. Los Angeles,CA 90017 COMPANIES AFFORDING COVERAGE COMPANY 09643--00/01 A SCPIE Indemnity Company INSURED COMPANY SILVERADO SENIOR LIVING B American Home Assurance Company 11 Mareblu Suite 200 Aliso Viejo,Ca.92656 COMPANY C COMPANY D 1111111MMINININVAMM THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTV41THSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. F OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POIJCY EXPIRATION LIMITS DATE(MMIOD/YY) DATE(MMIDDIYY) LITY HPL0005020 04/03/00 04/03/01 GENERAL AGGREGATE $ 5,000,000 IAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 5,000,000 MSMADE X OCCUR PERSONAL S ADV INJURY $ 8 CONTRACTOR'S PROT EACH OCCURRENCE $ S,000,OOO FIRE DAMAGE Any one fire) $ MED EXP An ane areon $ ABILITY CA6331680 09/01/00 09/01/01 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ H ANY AUTO OTHER THAN AUTO ONLY: IT _ EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE Is UMBRELLAFORM AGGREGATE Is OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND 09/01/00 09/01/01 X TORYLIMIT- Eft B EMPLOYERS'UABIUTY WC6331681 �x EL EACH ACCIDENT $ 1,000 DOO THE PROPRIETOR/ X INCL EL DISEASE-POLICY LIMIT $(� 1,000,000 PARTNERS/EXECUTIVE OFFICERS ARE EXCL EL DISEASE-EACH,EMPLOYEE $ 1,000,000 N z"a w rn a < n _Tyres m DESCRIPTION OF OPERATIONS/LOOATIONSA EHICLES/SPECIAL ITEMS(LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS) —..n Certificate holders are named Additonal Insured as respects General Liability Coverage for project @ 30311Tom'„i CIE W o Camino Capistrano,San Juan Capistrano. z S O CRAfi 'I"..I,gi it i.Ii 11°I rS I I1 II i i t :Tu $'.- .. .. L ,.. qr .. r ., _. _ ......n.... .. . .. . . SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 3 DAYS MITTEN NOTICE TO THE Qty Of San Juan Capistrano& = CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Capistrano Valley Water District 32400 Paseo Adelanto LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES. San Juan Capistrano,Ca.92676 MARSH USA INC. BY: MAR-01-2001 09:04 Marsh & McLennan 213 346 5927 P.02iO3 Additional Insured Section 2 Endorsement In consideration of the pmmh=charged,it is hereby understood and agreed that the below captioned Policy(the'Policy')is amended in the following particulars: Coverage under Section 2 (Business Liability Coverage) of Division I of the below numbered policy Is extended to the additional Insured designated below. CITY OF SAN JUAN CAPISTRANO At CAP15TRANO VALLEY WATER DISTRICT 32400 PASEA ADELANTO SAN JUAN CAPISTRANO, CALIFORNIA 92676 Designated AddltJonal -Insured - The coverage afforded by this endorsement Is limited to the additional Insured's legal liability arising out of the COC project Tor Sen Juan Capistrano. This extension of coverage does not apply to the additional Insured's ON liability arising wholly or partly out of Its own negligence or th" of Its agents or employees, z--m— tri C1 CO M a < A �u`mz ess c z J A This cndorsazuent is attacher)to the Policy indicated below and is effective on the date stated herein, 12:01 a.m.standard time at the address shown in Item 2 of the declarations insert. All other terms and conditions remain unchanged. Policy No. Effmilve Date of Endormumint Rxpiradon Data of Enduraemeat Endorsanmt No. HPL)005020 9/01/2000 9(01(2001 14 Is To Additional Premium Return PnmhM SILVERAM SENIOR LKING INC S.00 $A SCPIE Indemnity Company By Preddena HPL-604-CA (9/97) ttlarsh Riefr& 1nsTlTarfCa.SIviDe^ ERTIFIATE Q IRislJI3AF" " C�FzLficata# PRODUCER • THIS CERTIFICATE I ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER Marsh Risk & Insurance Services RE THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT 777 South Figueroa Street , EXTEND OR ALTER THE COVERAGE AFFORDED BY THE Los Angeles, CA 90017-5811 B POLICIES LISTED HEREIN. L OMPANIES AFFORDING COVERAGE INSURED --c-ITU ttbw A SCPIE Indemnity D[P4 TRENT Silverado Senior Living CITY ,yUpfrRRA B 11 Mareblu Suite 200 JUAN CA.r( pRT{q 'C Aliso Viejo CA 92656 COMPANY C LETTER COMPANY D rr+.�y♦♦,�L��yy C�+!d LETTER 4V MITAriiaa ,'; THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -r CO POLICY EFFECTIVE POLICY EXPIRATION LTR TYPEOFINSURANCE POLICY NUMNER GATE IMMIOUIYYI ORTEIMMIOOEYY) LIMITS A GENERAL LIABILITY HPL0005020 42100 413101 GENERAL AGGREGATE S 5,000,000 x COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGG t 5,000,000 ElCLAIMS MADE OCCUR. PERSONAL&AOV INJURY f 5,000,000 OWNER'S CONTRACTOR'S PROT, EACH OCCURRENCE f 5.000,000 FIRE DAMAGE(anyonefire) f MEDEKPENSECC,,ane Nereanl i AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per Person) f ALL OWNED AUTOS BODILY INJURY(PO,accident) f SCHEDULED AUTOS PROPERTY DAMAGE E HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY AN TO ONLY EA ACCIDENT E ANY AUTO OTHER THAN AUTO ONLY EACH ACCIDENT f AGGREGATE 5 EXCESS LIABILITY EACH OCCURRENCE 3 UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM WORKERS'COMPENSATION AND STATUTORY LIMITS ' EMPLOYERS LIABILITY EACH ACCIDENT f DISEASE POLICY LIMIT f DISEASE-EACH EMPLOYEE f OTHER DESCRIPTION OF OPERAnONSILOCATIONSKlilCLESISPECIAL ITEMS Re: Location of Jumper Serra Road ad Camino Capistrano.San Juan Capistrano City of San Juan Capistrano is added as additional insured as respects referenced location CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES LISTED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE INSURER City of San Juan Capistrano AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER 32400 Paseo Adelanto NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE-H LL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES,OR THE ISSUER OF THIS CERTIFICATE. San Juan Capistrano CA 92675 Attn: George Scarborough J&HBY: MARSH&MCLENNAN,INCORPORATED MMI 1 (81951 VALID AS OF: 6116100 Dated: 04/19/01 CA62295 RECEIVED I 111111111111111111 1111 APR 2O 2 is PM '01 7114 7389 6621 0042 1839 CALIFORNIA PRELIMINARY NOTICE IE , ,,;.1N iT c; '4n;accordance with sections 3097 and 3098, California Civil Code This iiL'Yi t4 LIW,,'This is not a reflection on the integrity of any contractor or subcontractor 1 -You are hereby notified that Reputed Owner FIRE CALL INC CITY OF SAN JUAN CAPISTRANO 15744 CALIFORNIA AVE 32400 PASEO ADELANTO PARAMOUNT CA 90723 SAN JUAN CAPISTRANO CA 92675 2-Has furnished or will furnish labor, services,equipment,or materials of the following general description: FIRE ALARM SERVICES Reputed Construction Lender or Lessee FUNDED BY: 3-An estimate of the total price of the HEALTH CARE REIT INC labor,services,equipment,or materials furnished or to be furnished is: ONE SEAGATE#1500 TOLEDO OH 43603 $63,260.00 4-The building,structure or other work of Reputed General Contractor improvement is located at: FIRE CALL INC SSL-SJC-007/SILVERADO 15744 CALIFORNIA AVE SENIOR LIVING/SAN JUAN CA PARAMOUNT CA 90723 PISTRANO INC/30291/30311 CAMINO CAPISTRANO/SAN JUAN CAPISTRANO CA 92675 UNKNOWN 5-The name of the person or firm who contracted A.D.C. for the purchase of such labor,services, equipment or material is: NOTICE TO PROPERTY OWNER CENTERPOINT DEV INC 22865 LAKE FOREST DR IF BILLS ARE NOT PAID IN FULL FOR THE LABOR, LAKE FOREST CA 92630 SERVICES, EQUIPMENT,OR MATERIALS FURNISHED 6-Name and address of Trust Funds to which OR TO BE FURNISHED,A MECHIANICV LIEN LEADING Supplemental Fringe Benefits are payable TO THE LOSS,THROUGH COURT FORECLOSURE (if applicable): PROCEEDINGS,OF ALL OR PART OF YOUR PROPERTY BEING SO IMPROVED MAY BE PLACED AGAINST THE PROPERTY EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL. YOU MAY WISH TO PROTECT YOURSELF AGAINST THIS CONSEQUENCE BY 7-Jobsite is Federal Public Work Title 40 USC (1)REQUIRING YOUR CONTRACTOR TO FURNISH A Sec.270A-210E. RELEASE SIGNED BY THE PERSON OR FIRM GIVING Contract# YOU THIS NOTICE BEFORE MAKING FINAL PAYMENT Bond Co: TO YOUR CONTRACTOR OR(2)ANY OTHER METHOD OR DEVICE THAT IS APPROPRIATE UNDER THE CIRCUMSTANCES. Signed 1. e Authorized Agent construction Notice Services,Inc. 1.8003665660 32400 PAS EO ADE LANTO MEMBERS OF THE CITY COUNCIL SAN JUAN CAPISTRANO, CA 92675 COLLEGE CAMPBELL JOHN GREIGER (949) 493-1 171 ummlru GIL JO HART (949) 493-1053 (FAX) Is1776 1961 GIL ID M. 1776 ogwo M.$WEROLIN CIN MANAGER GEORGE SCARBOROUGH April 11, 2000 Mr. Loren B. Shook, President Silverado Senior Living, Inc. 11 Mareblu, Suite 200 Aliso Viejo, California 92656 Re: License and Reciprocal Access and Parking Agreement Dear Mr. Shook: At their meeting of April 4, 2000, the City Council of the City of San Juan Capistrano took action to approve a License and Reciprocal Access and Parking Agreement with Silverado Senior Living to provide for a joint access driveway aligned with the intersection of Camino Capistrano and Junipero Serra and parking improvements to be jointly used by the development and the public using the City's open space. A fully-executed copy of the Agreement is enclosed for your files. A copy has been forwarded to the Orange County Recorder's Office. Please feel free to contact the Planning Director, Tom Tomlinson, at 443-6323 if you have any questions. Very truly yours, l�QZy� Cheryl Johnson City Clerk Enclosure cc: Planning Director (with enclosure) onus us¢ n San Juan Capistrano: Preserving the Past to Enhance the Future 4. RECEIVE AND FILE CASH BALANCES BY FUND FOR JANUARY AND FEBRUARY, 2000 (330.50) The City Treasurer's Report of Cash Fund Balances for the months of January and February, 2000, was ordered received and filed. 5. RECEIVE AND FILE INVESTMENTS AS OF FEBRUARY 29 2000 (350.30) The City Treasurer's Report of Investments as of February 29, 2000, was ordered received and filed. 6. APPROVAL OF CONTINUED CITY PARTICIPATION IN THE COUNTY'S MORTGAGE CREDIT CERTIFICATE PROGRAM FOR FIRST-TIME HOMEBUYERS (600.50) As set forth in the Report dated April 4, 2000, from the Planning Director, the following Resolution was adopted authorizing the City to continue to participate in the Mortgage Credit Certificate Program with the County of Orange to assist first-time homebuyers: RESOLUTION NO. 00-4-4-1, PARTICIPATION IN MORTGAGE CREDIT CERTIFICATE PROGRAM -A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN JUAN CAPISTRANO, CALIFORNIA, AUTHORIZING CONTINUED PARTICIPATION IN THE MORTGAGE CREDIT CERTIFICATE PROGRAM WITH THE COUNTY OF ORANGE FOR FIRST-TIME HOME BUYERS (COUNTY OF ORANGE) 7. APPROVAL OF CONSTRUCTION LICENSE AGREEMENT-SAN JUAN MESA VERDE HOMEOWNERS ASSOCIATION -LA NOVIA/LA RONDA DRAIN (CIP NO. 129) (600.30) As set forth in the Report dated April 4, 200, from the Engineering and Building Director, the Construction License Agreement with the San Juan Mesa Verde Homeowners Association for a catch basin construction project on the west side curb line of La Novia Avenue immediately upstream of the intersection with Paseo La Ronda, was approved to allow the portion of the project on private property to proceed. The Mayor and City Clerk were authorized to sign the Agreement. The License Agreement will be effective for the period ending with the filing of a Notice of Completion or December 31, 2001, whichever is sooner. �8. APPROVAL OF LICENSE AGREEMENT FOR JOINT USE OF ACCESS DRIVEWAY AND PARKING IMPROVEMENTS AT THE INTERSECTION OF CAMINO CAPISTRANO AND JUNIPERO SERRA ROAD (SILVERADO SENIOR LIVING, INC.) (60Q.30) As set forth in the Report dated April 4, 2000, from the Planning Director, the License Agreement with Silverado Senior Living, Inc.,was approved, providing for reciprocal use of the access driveway and parking improvements. City Council Minutes -3- 4/4100 AGENDA ITEM April 4, 2000 TO: George Scarborough, City Manager FROM: Thomas Tomlinson, Planning Director SUBJECT: Consideration of License Agreement for joint use of Access Driveway and Parking Improvements at the Intersection of Camino Capistrano and Junipero Serra Road (Silverado Senior Living, Inc.) RECOMMENDATION By Motion, approve the attached License Agreement for the reciprocal access driveway and parking agreement between Silverado Senior Living, Inc., and the City of San Juan Capistrano. A. APPLICANT/PROPERTY OWNERS Silverado Senior Living, Inc. City of San Juan Capistrano 11 Mareblu, Suite 200 32400 Paseo Adelanto Aliso Viejo, California 92656 San Juan Capistrano, California 92675 B. SUMMARY AND RECOMMENDATION - The City Council, in taking action to approve Rezone 98-03 and the associated development plans for an assisted care facility by Silverado Senior Living, placed a condition of approval for the execution of a reciprocal driveway access and parking agreement that would serve the project site and also provide access to a portion of the City's northern open space lands. Said agreement is to require the developer to construct the joint access driveway aligned with the intersection of Camino Capistrano and Junipero Serra and parking improvements that could be used by both the development and the public using the City's open space (Exhibit "A" of the agreement). In response to the condition of approval, the City has prepared the attached draft License Agreement that establishes reciprocal use of a joint access driveway and parking area. Staff recommends that the City Council approve the License Agreement. C. BACKGROUND - In developing the site plan for the senior living facility, staff explored the alignment of a joint access driveway that could be designed to be integrated into the signalized intersection at Camino Capistrano and Junipero Serra that would serve both the project site and provide improved access to a portion of FOR CITY COUNCIL AGEN A .: DI9 • AGENDA ITEM -2- April 4, 2000 the City's northern open space lands. The City's parcel is located on the northwest corner of the subject intersection, between Camino Capistrano and Trabuco Creek. The useable portion of the property is located approximately ten feet below the street grade of Camino Capistrano. This joint access drive which includes portions of both properties is to be constructed by the developer providing improved access that benefits both parcels at a signal controlled intersection. The developer in return for the use of the City's property associated with the alignment of the driveway will be required to construct the improvements along with improved parking spaces. Both of these improvements will be available for reciprocal use. Benefit to the City for use of this property is the creation of an improved access driveway to the open space parcel and reciprocal use of improved parking spaces. If the agreement was not executed, the City would at some future time have to install an improved access drive and parking improvements to serve this isolated parcel from the remainder of the City open space holdings (separated by Trabuco Creek). As was noted during the initial approval hearings, the parking that is being improved as part of this agreement was not necessary to meet the parking requirements of the Municipal Code to serve the senior facility. PUBLIC NOTIFICATION None required. The applicant has been provided a copy of this agenda item. COMMUNITY REDEVELOPMENT AGENCY The development of the Silverado Senior Living facility is located within the Central Project Area of the Community Redevelopment Agency and improvements associated with the development will result in increment funds being generated to the Agency. Silverado Senior Living, Inc., has not requested any financial assistance from the Agency. FINANCIAL CONSIDERATIONS The costs of the full improvements for the joint access driveway and parking spaces are the responsibility of Silverado Senior Living, Inc. OTHER COMMISSION REVIEW AND RECOMMENDATIONS The Planning Commission has previously recommended approval of the development plans and condition of approval for a joint access and parking arrangement with the City. ALTERNATE ACTIONS 1. Approve the attached License Agreement. AGENDA ITEM -3- April 4, 2000 (Alternate Actions Continued) 2. Approve the attached License Agreement with modifications. 3. Continue the item and request additional information. RECOMMENDATION By Motion, approve the attached License Agreement for the reciprocal access driveway and parking agreement between Silverado Senior Living, Inc., and the City of San Juan Capistrano. Respectfully submitted, Thomas Tomlinson Planning Director Attachments: 1. License and Reciprocal Access and Parking Agreement 2. Location Map C:\OFFICE\W P W IN\W PDOCS\CURRENTP\RZ\RE9903.AGR � RE EXHIBIT "A" SITEPLAN LEGEND ..�•'� I FE PROPERTY LINE l PROP. PROPOSED R.W ROW RIGHT-OF-WAY (E) EXISTING APN ASSESSORS PARCEL NUMBER LIMIT OFT ` GRADING f SEE SHEET 2 FOR RECIPROCAL PARKING AND ACCESS AREA DETAIL. RAMP TO � ADJACENT CITY \�\ 1 ,.,�_ CAM�NO CAPISmkKo�.-! PROPERTY ` �\` / 38 000 r W Z , �• 0 IL Lo v APN 121 -070-08 z a va, 100' PAGE 1 ,soh � '` .. r�•� �� `• • i • / ♦♦.♦,/♦�._•` < \.�`�,� r•.r.r,V.a►.�I •�.. .0 `moi.,_ �'��i� 111Y!/10 i, 1'' ♦ ♦♦♦ aaaafUa/aaY Y //f//I//y/Y/1O ♦ a♦ ♦ aaaa ♦♦♦♦♦ 133 Y!/!Y/IY1 aaaa/Y.laaaaaaa A�% ZFF �* n %!• A . m 4 y '^ ttu3q CD 1 "d z 1 �� �•0 �,,dMw► C� I 32400 PASEO ADELANTO MEMBERS OF THE CITY COUNCIL JOHN SAN JUAN CAPISTRANO,CA 92675 COLLENE CAMPBELL WYA (949) 493-1 171 ' n(IARIAf1A N GREINER MART (949)493-1053 (FAX) fSMIl11Xf1 1961 GIL JONES 1776 DAVID M.SWERDLIN CRY MANAGER � GEORGE SCARBOROUGH Clerk-Recorder's Office County of Orange P. O. Box 238 CONFORMED COPY Santa Ana, California 92701 Not Compared with Original Re: License and Reciprocal Access and Parking_Agreement Gentlemen: The following document is enclosed for recordation: License and Reciprocal Access and Parking Agreement with Silverado Senior Living A check in the amount of$28.00 is included to cover recording and conformed copy fees. When placed of record, please return said document to this office. Please stamp Document Number and date of recording on this letter and return it, as the conformed copy, to this office in the enclosed, stamped, self-addressed envelope at your earliest convenience. Thank you for your cooperation. Very truly yours, Cheryl Johnson Recorded in Official Records, county of Orange City Clerk Gary Granville, Clerk-Recorder Enclosure IIIIIIIIIIiiIN 11111 IN 11111111111111111111111111111127.00 2000019817111:26am 04118100 118 4 Al2 8 0.00 0.00 0.00 0.00 21.00 0.00 0.00 0.00 DRUG USE Ri San Juan Capistrano: Preserving the Past to Enhance the Future