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03-0618_OC TRANSPORTATION AUTHORITY_Agreement Amd No. 8I AMENDMENT NO. 8 TO 2 AGREEMENT NO. C-8-0196 3 BETWEEN 4 ORANGE COUNTY TRANSPORTATION AUTHORITY 5 AND 6 THE CITY OF SAN JUAN CAPISTRANO 7 THIS AMENDMENT NO. 8 is made and entered into this A ay of)'�, 2003 by 8 and between the Orange County Transportation Authority ("AUTHORITY') and the City of San Juan 9 Capistrano ("CITY'). 10 WITNESSETH: 11 WHEREAS, by Agreement No. C-8-0196 dated July 1, 1998, as last changed by Amendment 12 No. 7 dated May 13, 2002, AUTHORITY and CITY entered into a Contract for CITY to purchase 13 transportation services from AUTHORITY for the purposes of providing a means for seniors to 14 participate in the Area Agency on Aging (AAA) senior nutritional program; and 15 WHEREAS, both parties have agreed to extend this Agreement for up to six (6) months or until 16 the start date of CITY's Senior Mobility Program, to continue senior transportation services; and 17 WHEREAS, CITY agrees to pay AUTHORITY $10.75 per Vehicle Service Hour at an amount 18 not to exceed of $3,011.65; and 19 WHEREAS, this amendment is contingent and solely based upon execution of Agreement C-0- 20 0502 between the Area Agency on Aging (AAA) and the AUTHORITY; and 21 WHEREAS, AUTHORITY desires to adjust the CITY's Scope of Work to reflect CITY's 22 budgeted amount for the period July 1, 2003 through December 31, 2003 and revise the estimated 23 number of trips; 24 NOW THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that 25 Agreement No. C-8-0196 is hereby amended in the following particulars only: 26 Page 1 of 3 L:\Camm\CLERICAL\WORDPROG AGREEViMENDWM880196.DOC.doc P 4 • AMENDMENT NO. 8 AGREEMENT NO. C-8-0196 1 1. Amend ARTICLE S. TERM OF AGREEMENT, Page 4 of 6, line 3, as last changed by 2 Amendment No. 6, in its entirety and in lieu thereof insert the following: 3 ARTICLE 4. TERM OF AGREEMENT 4 This Agreement shall commence July 1, 1998, and shall continue in full 5 force and effect through December 31, 2003, unless earlier terminated or extended 6 as provided in this Agreement. 7 2. Amend ARTICLE 9. PAYMENT, Page 4 of 6, as last changed by Amendment 8 No. 7, to delete paragraph "A" in its entirety and in lieu thereof insert the following: 9 A. For services provided by AUTHORITY for the period July 1, 2003 10 through December 31, 2003 CITY shall pay AUTHORITY the 11 amount of Ten Dollars and Seventy -Five Cents ($10.75) per Vehicle 12 Service Hour at an amount not -to -exceed Three Thousand Eleven 13 Dollars and Sixty -Five Cents ($3,011.65). 14 3. Amend Exhibit A "Scope of Work", as last changed by Amendment 15 No. 6, to delete paragraph 11 in its entirety and in lieu thereof insert the following: 16 11. The CITY has budgeted $3,011.65 for the period July 1, 2003 17 through December 31, 2003. The service provided to the center(s) 18 shall not exceed this amount. The estimated number of trips for all 19 centers from July 1, 2003 through December 31, 2003 is 1,342. The 20 AUTHORITY does not guarantee that all budgeted trips will be 21 provided. 22 / 23 / 24 ! 25 / 26 / Page 2 of 3 L:\Camm\CLERICAL\WORDPROCWGREEW MENDW M860196.DOC.doc f 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 . • AMENDMENT NO.8 AGREEMENT NO. C-8-0196 The balance of said Agreement remains unchanged. Upon execution by both parties, this Amendment No. 8 shall be made effective July 1, 2003 IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 8 to Agreement No. C-8-0196 to be exe uted on the date first above written. THE Cl O JU N CAPISTRANO ORANGE COUNTY TRANSPORTATION AUTHORITY By By UAMl GeorgScarbo ugh Arthur T. Leahy City Manager Chief Executive Officer APP ES T M: By ohn R. Shaw City Attorney APPRED AS TO FORM: By Kennard R. Smart, Jr. General Counsel APPROVED: By Richard A. Teichert Director Transit Operations Date Page 3 of 3 L:\Camm\CLERICAL\W ORDPROCWGREE\AMEND\AM880196.DOC.doc OCTA U AMENDMENT NO. 7 TO AGREEMENT NO. C-8-0196 3 BETWEEN 4 ORANGE COUNTY TRANSPORTATION AUTHORITY 5 AND 6 THE CITY OF SAN JUAN CAPISTRANO 7 THIS AMENDMENT NO. 7 is made and entered into this day of 2002 by 8 and between the Orange County Transportation Authority ("AUTHORITY") and the City of San Juan 9 Capistrano ("CITY"). 10 WITNESSETH: 11 WHEREAS, by Agreement No. C-8-0196 dated July 1, 1998, as last changed by Amendment No. 12 6 dated May 14, 2001, AUTHORITY and CITY entered into a Contract for CITY to purchase 13 transportation services from AUTHORITY for the purposes of providing a means for seniors to participate 14 in the Area Agency on Aging (AAA) senior nutritional program; and 15 WHEREAS, both parties have agreed to extend this Agreement for up to twelve months or until 16 the start date of CITY's Senior Mobility Program, to continue senior transportation services; and 17 WHEREAS, CITY agrees to pay AUTHORITY $10.42 per Vehicle Service Hour at an amount not 18 to exceed of $5,861.25; and 19 WHEREAS, AUTHORITY desires to adjust the CITY's Scope of Work to reflect CITY's budgeted 20 amount for the period July 1, 2002 through June 30, 2003 and revise the estimated number of trips; 21 NOW THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that 22 Agreement No. C-8-0196 is hereby amended in the following particulars only: 23 1. Delete ARTICLE 8. TERM OF AGREEMENT, Page 4 of 6, as last changed by 24 Amendment No. 6, in its entirety and in lieu thereof insert the following: 25 26 ter 1 N580196 DO Page 1 of 3 . • AMENDMENT NO. 7 AGREEMENT NO. C-8-0196 1 ARTICLE 8. TERM OF AGREEMENT 2 This Agreement shall commence July 1, 1998 and shall continue in full force and effect 3 through June 30, 2003, unless earlier terminated or extended as provided in this Agreement a 2. Amend ARTICLE 9. PAYMENT, Page 4 of 6, as last changed by Amendment No. 6, to 5 make the following changes: 6 A. Page 4 of 6, paragraph 1, as last changed by Amendment No. 6, at end add "For 7 services provided by AUTHORITY for the period July 1, 2002 through June 30, S 2003 CITY shall pay AUTHORITY the amount of Ten Dollars and Forty -Two Cents 9 ($10.42) per Vehicle Service Hour at an amount not -to -exceed Five Thousand, 10 Eight Hundred, Sixty -One Dollars, and Twenty -Five Cents ($5,861.25). 11 g Page 4 of 6, paragraph 2, as last changed by Amendment No. 6, to delete this 12 paragraph in its entirety and in lieu thereof insert the following: 13 "AUTHORITY shall submit monthly invoices to CITY for payment pursuant to this 14 Agreement within 30 days after the close of each month. Failure of CITY to pay 15 AUTHORITY amount due under this contract within 30 days from date of invoice 16 shall entitle AUTHORITY to, in addition to any other legal remedies available to 17 AUTHORITY, suspend or diminish its performance under this Agreement if it so 1s elects. 19 2. Amend Exhibit A "Scope of Work", as last changed by Amendment No. 7, paragraph 11, 20 to delete in its entirety and in lieu thereof insert the following: 21 11. The CITY has budgeted $5,861.25 for the period July 1, 2002 through June 30, 2003. 22 The service provided to the center(s) shall not exceed this amount. The estimated 23 number of trips for all centers from July 1, 2002 through June 30, 2003 is 2,683. The 24 AUTHORITY does not guarantee that all budgeted trips will be provided. 25 26 Mer AL1580196 DO Page 2 of 3 M OCTA aoARD C=DIRECTORS Mrnael warn Chan -an Tooc Scizer . ce-Chairman an,,lrc E—wn a,ecl,r L Calz J6Pi(Or _d.ddnn LpJY Director �'p lreP^?n � ""'wr Pu.lo .,1101 W Siva „eetor Cl+ar.es V Smrtn D✓Pero' Tno.Tas w wi,son Dlrec[or Susan Withrow Dvecror C� rcna P Coao -0Ilemale ShweV McCracxen Alternate G(egorvT wmrerponom Auernate Cnoy ouon Govemors Ex-0Poclo Memner • July 30, 2001 Karen Crocker CITY OF SAN JUAN CAPISTRANO 32400 Paseo Adelanto San Juan Capistrano, CA 92675 L.7 SUBJECT: AMENDMENT 6 TO AGREEMENT C-8-0196 Dear Ms. Crocker: Enclosed for your records is a original copy of the above -referenced subject. If you have any questions, please feel free to call me at 714/560-5576. Sincerely, �' Kjl�� Denise L. Kadlec Contracts Administration and Materials Management Office Specialist III Enclosure Orange County Transportation Authority 550 South Main Street/P. O. Box 14184 /Orange /California 92863-1584 r (714) 560 -OCTA (6282) A KDP:CF 1 AMENDMENT NO. 5 TO 2 AGREEMENT NO. C-8-0196 3 BETWEEN 4 ORANGE COUNTY TRANSPORTATION AUTHORITY s AND 6 THE CITY OF SAN JUAN CAPISTRANO 7 THIS AMENDMENT NO. 5 is made and entered into this �2-4_sday o : , 2000 s by and between the Orange County Transportation Authority ("AUTHORITY") ang"' of San 9 Juan Capistrano ("CITY"). 10 WITNESSETH: 11 WHEREAS, by Agreement No. C-8-0196 dated July 1, 1998, as last changed by Amendment 12 No. 4 dated June 21, 2000, AUTHORITY and CITY entered into a Contract for CITY to purchase 13 transportation services from AUTHORITY for the purposes of providing a means for seniors to 14 participate in the Area Agency on Aging (AAA) senior nutritional program; and is WHEREAS, both parties have agreed to extend this agreement for twelve months to 16 continue senior transportation services. 17 NOW THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that is Agreement No. C-8-0196 is hereby amended in the following particulars only: 19 1. Amend ARTICLE 8. TERM OF AGREEMENT, Page 4 of 6, line 7 to delete "June 30, 20 2000" and in lieu thereof insert "June 30, 2001." 21 2. Amend ARTICLE 9. PAYMENT, to make the following changes: 22 A. Page 4 of 6,paragraph 2, end of line 21, to add "For services provided by 23 AUTHORITY for the period July 1, 2000 through June 30, 2001 CITY shall pay AUTHORITY the 24 amount of Nine Dollars and Eighty cents ($9.80) per Vehicle Service Hour at an amount not -to - 25 exceed Five Thousand Fifteen Dollars and Eighty -Eight Cents ($5,515.88)." 26 1 Page 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 KDP:CP 0 t AMENDMENT NO. 5 AGREEMENT NO. C-8-0196 The balance of said Agreement remains unchanged. Upon execution by both parties, this Amendment No. 5 shall be made effective. IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 5 to Agreement No. C-8-0196 to be executed on the date first above written. THE CITY OF SAN JUAN CAPISTRANO ORANGE COUNTY TRANSPORTATION AUTHORITY By Name Title APPROVED AS TO FORM: Attorney By CoreyCrea y Sectie gerPPr APPROVED AS TO FORM: By — Kennard R. Smart, r. General Counsel Page 2 of 2 1 AMENDMENT NO. 4 TO 2 AGREEMENT NO. C-8-0196 3 BETWEEN 4 ORANGE COUNTY TRANSPORTATION AUTHORITY 5 AND 6 THE CITY OF SAN JUAN CAPISTRANO 7 THIS AMENDMENT NO. 4 is made and entered into this o2. is day of _7SWyxC , 2000 8 by and between the Orange County Transportation Authority ("AUTHORITY") and the City of San 9 Juan Capistrano ("CITY"). 10 WITNESSETH: 11 WHEREAS, by Agreement No. C-8-0196 dated July 1, 1998, as last changed by Amendment 12 No. 3 dated January 11, 2000, AUTHORITY and CITY entered into a Contract for CITY to purchase 13 transportation services from AUTHORITY for the purposes of providing a means for seniors to 14 participate in the Area Agency on Aging (AAA) senior nutritional program; and 15 WHEREAS, both parties have agreed to increase the number of trips allocated through the 16 AAA nutrition transportation program by 270 trips at an increase in the maximum payment obligation 17 of $496.80. 18 NOW THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that 19 Agreement No. C-8-0196 is hereby amended in the following particulars only: 20 1. Amend ARTICLE 9. PAYMENT, Page 4 of 6, paragraph 1, to delete in its entirety 21 and in lieu thereof insert the following: 22 For services provided by AUTHORITY under this Agreement, CITY shall pay 23 AUTHORITY the amount of Two Dollars and Four Cents ($2.04) per passenger trip 24 through October 31, 1999. For services provided by AUTHORITY under this 25 Agreement for the period November 1, 1999 through June 30, 2000, CITY shall pay 26 AUTHORITY the amount of One Dollar and Eighty -Four Cents ($1.84) per passenger Page 1 of 3 Page 2 of 3 • • AMENDMENT NO. 4 AGREEMENT NO. C-8-0196 1 trip, which conforms to Authority's service standard up to but not to exceed the 2 amount of Twelve Thousand Two Hundred Eighty -Four Dollars, Ninety -Six Cents 3 ($12,284.96), which would be the amount equivalent to the provision of the maximum 4 number of passenger trips from September 1, 1998 through June 30, 2000. The 5 AUTHORITY's standard service is curb -to -curb service. Should the agency or center 6 request door-to-door service, there will be and additional charge of eighty cents 7 ($0.80) at each end of a one way trip utilizing premium service. Agencies or centers 8 must provide to AUTHORITY a written list of those passengers who may receive 9 premium service. 10 2. Amend Exhibit A "Scope of Work," Page 2 of 2, paragraph 11 delete in its entirety and in lieu thereof insert 11 12 the following: The CITY has budgeted $4,071.92 for the period November 1, 1999 through June 30, 13 2000. The service provided to the center(s) shall not exceed this amount. The 14 estimated number of trips for all centers from November 1, 1999 through June 30, 15 1999 is 2,213. The AUTHORITY does not guarantee that all budgeted trips will be 16 provided. If Agencies or centers hold seating for passengers who are not using the 17 service due to vacation, extended illness, etc. the CITY agrees to pay $1.84 for the 18 unused trip. 19 20 / 21 22 ! 23 24 25 / 26 Page 2 of 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 0 AMENDMENT NO. 4 AGREEMENT NO. C-8-0196 The balance of said Agreement remains unchanged. This Amendment No. 4 shall be made effective upon execution by both parties. IN WITNESS WHEREOF, the parties hereto have caused this Amendment No.4 to Agreement No. C-8-0196 to be executed on the date first above written. THE CITY OF SAN JUAN CAPISTRANO ORANGE COUNTY TRANSPORTATION AUTHORITY By Corey Cr ey Section Manage — Procurement APPR VED AS TO FORM: By Kennard R. Smart, Jr General Counsel Page 3 of 3 r 0 1 AMENDMENT NO. 3 TO 2 AGREEMENT NO. C-8-0196 3 BETWEEN 4 ORANGE COUNTY TRANSPORTATION AUTHORITY 5 AND 6 THE CITY Of SAN JUAN CAPISTRANO 2C3=Vr__b 7 THIS AMENDMENT NO. 3 is made and entered into this qday of`=;5,4999—G.. a by and between the Orange County Transportation Authority ("AUTHORITY') and the City of San v Juan Capistrano ("CITY'). 10 WITNESSETH: 11 WHEREAS, by Agreement No. C-8-0196 dated July 1, 1998, as last changed by Amendment 12 No. 2 dated July 7, 1999, AUTHORITY and CITY entered into a Contract for CITY to purchase 13 transportation services from AUTHORITY for the purposes of providing a means for seniors to 14 participate in the Area Agency on Aging (AAA) senior nutritional program; and 15 WHEREAS, both parties have agreed to extend this Agreement for eight months to continue 16 senior transportation services; 17 NOW THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that 18 Agreement No. C-8-0196 is hereby amended in the following particulars only: 19 1. Amend ARTICLE 8. TERM OF AGREEMENT, Page 4 of 6, to delete in its entirety 20 and in lieu thereof insert the following: 21 ARTICLE 8. TERM OF AGREEMENT 22 The term of this Agreement shall be twenty-two (22) months, commencing September 23 1, 1998 and expiring at the end of business or 5:00 p.m., whichever occurs last on June 30, 2000. 24 25 26 Page 1 of 4 1 2 3 a s 6 7 8 9 10 11 12 13 14 1s 16 17 18 19 20 21 22 23 24 25 26 Cl • AMENDMENT NO. 3 AGREEMENT NO. C-8-0196 2. Amend ARTICLE 9. PAYMENT, to make the following changes: A. Page 4 of 6, paragraph 1, to delete in its entirety and in lieu thereof insert the following: following: For services provided by AUTHORITY under this Agreement, CITY shall pay AUTHORITY the amount of Two Dollars and Four Cents ($2.04) per passenger trip through October 31, 1999. For services provided by AUTHORITY under this Agreement for the period November 1, 1999 through June 30, 2000, CITY shall pay AUTHORITY the amount of One Dollar and Eighty -Four Cents ($1.84) per passenger trip, which conforms to Authority's service standard up to but not to exceed the amount of Eleven Thousand Seven Hundred Eighty -Eight Dollars and Sixteen Cents ($11,788.16), which would be the amount equivalent to the provision of the maximum number of passenger trips from September 1, 1998 through June 30, 2000. The AUTHORITY's standard service is curb -to -curb service. Should the agency or center request door-to-door service, there will be and additional charge of eighty cents ($0.80) at each end of a one way trip utilizing premium service. Agencies or centers must provide to AUTHORITY a written list of those passengers who may receive premium service. B. Page 4 of 6, paragraph 2, to delete in its entirety and in lieu thereof insert the AUTHORITY shall submit quarterly invoices to CITY for payment pursuant to this Agreement within 30 days after the close of each of the following periods: for period July 1, 1998 through September 30, 1998; for the period October 1, 1998 through December 31, 1998; for the period January 1, 1999 through March 31, 199; for the period April 1, 1999 through June 30, 1999; for the period July 1, 1999 through October 31, 1999; for the period November 1, 1999 through December 31, 1999; for the period January 1, 2000 through MDOC Page 2 of 4 1 2 3 4 5 6 7 s 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2s 26 3. following: the following: 11 • AMENDMENT NO. 3 AGREEMENT NO. C-8-0196 March 31, 2000 and for the period April 1, 2000 through June 30, 2000. The AUTHORITY does not agree that all budgeted trips will be provided. Failure of CITY to pay AUTHORITY amount due under this contract within 30 days from date of invoice shall entitle AUTHORITY to, in addition to any other legal remedies available to AUTHORITY, suspend or diminish its performance under this Agreement if it so elects. If any portion of the invoice is disputed by CITY, CITY agrees to identify disputed amount and pay AUTHORITY all remaining undisputed costs. All disputed costs shall be resolved within 30 days and shall be included as part of the subsequent month's payment to AUTHORITY. Amend Exhibit A "Scope of Work," as follows: A. Page 1 of 2, paragraph 9, to delete in its entirety and in lieu thereof insert the 9. The AUTHORITY requires all passengers be ready for the transportation vehicle at the scheduled pick up time. The drivers shall wait only five minutes after the scheduled time. If the passenger is not ready within this time, the driver must proceed to the next location and the passenger will be recorded as a "No Show". The CITY will be billed for all "No Shows" at the rate of $2.04 each through October 31, 1999. For the period November 1, 1999 through June 30, 2000 the CITY will be billed for all "No Shows" at the rate of $1.84 each. B. Page 2 of 2, paragraph 11 delete in its entirety and in lieu thereof insert 11. The CITY has budgeted $3,575.12 for the period November 1, 1999 through June 30, 2000. The service provided to the center(s) shall not exceed this amount. The estimated number of trips for all centers from November 1, Page 3 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 • AMENDMENT NO. 3 AGREEMENT NO. C-8-0196 1999 through June 30, 1999 is 1,943. The AUTHORITY does not guarantee that all budgeted trips will be provided. If Agencies or centers hold seating for passengers who are not using the service due to vacation, extended illness, etc. the CITY agrees to pay $1.84 for the unused trip. The balance of said Agreement remains unchanged. Upon execution by both parties, this Amendment No. 3 shall be made effective November 1, 1999. IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 3 to Agreement No. C-8-0196 to be executed on the date first above written. THE CITY OF SAN JUAN CAPISTRANO ORANGE COUNTY TRANSPORTATION AUTHORITY By Corey Cr asey S n anager— rement APPVD AS TO FORM: By d� Ke nard R. Smart, J . General Counsel Page 4 of 4 =4r .i AMENDMENT NO.2 TO 2 AGREEMENT NO. C-8-0196 3 BETWEEN 4 ORANGE COUNTY TRANSPORTATION AUTHORITY s AND 6 THE CITY OF SAN JUAN CAPISTRANO 7 THIS AMENDMENT NO. 2 is made and entered into this =day of 1999 8 by and between the Orange County Transportation Authority ("AUTHORITY") an of San 9 Juan Capistrano ("CITY"). 10 WITNESSETH: tt WHEREAS, by Agreement No. C-8-0196 dated July 1, 1998, as changed by Amendment 12 No. 1 dated September 1, 1998, AUTHORITY and CITY entered into a Contract for CITY to 13 purchase transportation services from AUTHORITY for the purposes of providing a means for 14 seniors to participate in the Area Agency on Aging (AAA) senior nutritional program; and 15 I WHEREAS, both parties have agreed to extend this Agreement for four months to continue 16 senior transportation services; I/ NOW THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that 18 I Agreement No. C-8-0196 is hereby amended in the following particulars only: 19 1. Page 1 of 6, line 9, to delete "31421 La Matanza Street' and in lieu thereof insert 20 "32400 Paseo Adelanto." 21 2. Amend ARTICLE 8. TERM OF AGREEMENT, Page 4 of 6, to delete in its entirety 22 and in lieu thereof insert the following: 23 ARTICLE 8. TERM OF AGREEMENT 24 The term of this Agreement shall be fourteen (14) months, commencing September 1, 25 1 1998 and expiring at the end of business or 5:00 p.m., whichever occurs last on October 31, 1999 26 sn Page 1 of 3 i 2 3 a s 6 7 s 9' 10 11 12 13 14 15 16 17 is 19 20 21 22 23 24 2s 26 . • AGREEMENT NO. C-8-0196 3. Amend ARTICLE 9. PAYMENT, to make the following changes: A. Page 4 of 6, lines 11 and 12, as changed by Amendment No. 1, to delete "Five Thousand, Nine Hundred Eighty -Four Dollars ($5,984.00)" as the not to exceed amount and in lieu thereof insert "Eight Thousand, Two Hundred Thirteen Dollars and Four Cents ($8,213.04)." B. Page 4 of 6, line 22, to add "and for the period July 1, 1999 through October 31, 1999." 4. Amend ARTICLE 11. NOTICES Page 5 of 6 line 18, to delete "31421 La Matanza Street" and in lieu thereof insert "32400 Paseo Adelanto." Page 5 of 6, line 21, to delete "Linda Evans" and in lieu thereof insert "Karen Crocker." Page 5 of 6, line 22, to delete (714) 443-6357" and in lieu thereof insert "(949) 443-6389:' 5. Amend Exhibit A "Scope of Work," as follows: A. Page 1 of 2, paragraph 1, delete in its entirety and in lieu thereof insert the following: 1. The AUTHORITY, through CONTRACTOR, shall provide special agency transportation service to the following senior centers for the purpose of community meals and related activities: San Juan Capistrano Senior Center, 25925 Camino del Avion, San Juan Capistranso AUTHORITY shall provide services to individuals designated by CITY per AUTHORITY's contract with Area Agency on Aging. B. Page i of 2, paragraph 3, to delete "ARTICLE 12" and in lieu thereof insert "ARTICLE 10:" C. Page 2 of 2, paragraph 10, to delete "(714) 741-3235" and in lieu thereof insert "(949) 552-7760." Page 2 of 3 1 D. 2 following: 3 4 s 6 7 8 9 10 11 "quarterly." 12 1311 "560-5709." 14 15 16 17 18 19 20 21 22 23 24 25 26 KPEALE:SA AMENDMENT NO.2 AGREEMENT NO. C-8-0196 Page 2 of 2, paragraph 11 delete in its entirety and in lieu thereof insert the 11. The CITY has budgeted $8,213.04 through October 31, 1999. The service provided to the center(s) shall not exceed this amount. The estimated number of trips for all cities from September 1, 1998 through October 31, 1999 is 4,026. The AUTHORITY does not guarantee that all trips budgeted for will be provided. If Agencies or CITIES hold seating for passengers who are not using the service due to vacation, extended illness, etc. the CITY agrees to pay $2.04 for the unused trip. E. Page 2 of 2, paragraph 12, to delete "monthly" and in lieu thereof insert F. Page 2 of 2, paragraph 13, to delete "636-7433" and in lieu thereof insert The balance of said Agreement remains unchanged. Upon execution by both parties, this Amendment No. 2 shall be made effective July 1, 1999. IN WITNESS WHEREOF, the parties hereto have caused this Amendment No.2 to Agreement No. C-8-0196 to be executed on the date first above written. THE CJ,TY QF SAKI JUAN CAPISTRANO ORANGE COUNTY TRANSPORTATION AUTHORITY Corey Creas Sectioal nager— urement APPR ED AS TO FORM: E /2 0 Kennard R. Smart, Jr. General Counsel Page 3 of 3 0 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 EAx www. sanjuancapfstrano. org TRANSMITTAL TO: Pia Veesapen Orange County Transportation Authority PO Box 14184 Orange, CA 92863-1584 FROM: Meg Monahan, MMC — City Clerk (949) 443-6308 MEMBERS OF THE CITY COUNCIL SAMALLEVATO THOMAS W. HRIBAR MARK NIELSEN JOE SOTO DR. LONDRES USO RE: Amendment No. 13 to Agreement No. C-8-0196 purchasing transportation services providing a means for seniors to participate in the Area Agency on Aging senior nutritional program (2) original, executed agreements are enclosed for approval. Following approval and Execution by OCTA, please return (1) executed original to my attention. Thank you, CC: Karen Crocker, Community Services Director San Juan Capistrano: Preserving the Past to Enhance the Future 0 Printed on 100% recycled paper I AMENDMENT NO. 13 TO 2 AGREEMENT NO. C-8-0196 3 BETWEEN 4 ORANGE COUNTY TRANSPORTATION AUTHORITY 5 AND 6 THE CITY OF SAN JUAN CAPISTRANO 7 THIS AMENDMENT NO. 13 is made and entered into this day of , 8 2007 by and between the Orange County Transportation Authority ("AUTHORITY") and the City of San 9 Juan Capistrano ("CITY"). 10 WITNESSETH: 11 WHEREAS, by Agreement No. C-8-0196 dated July 1, 1998, as last changed by Amendment 12 No. 12 dated April 10, 2006, AUTHORITY and CITY entered into a contract for CITY to purchase 13 transportation services from AUTHORITY for the purposes of providing a means for seniors to 14 participate in the Area Agency on Aging (AAA) senior nutritional program; and 15 WHEREAS, both parties have agreed to extend this Agreement for up to twelve (12) months or 16 until the start date of CITY's Senior Mobility Program, to continue senior transportation services; and 17 WHEREAS, CITY agrees to pay AUTHORITY $9.31 per Vehicle Service Hour at an amount not 18 to exceed $6,982.50; and 19 WHEREAS, this amendment is contingent and solely based upon execution of Agreement 20 C-4-0348 between the Area Agency on Aging (AAA) and the AUTHORITY; and 21 WHEREAS, AUTHORITY desires to adjust the CITY's Scope of Work to reflect CITY's 22 budgeted amount for the period July 1, 2007 through June 30, 2008 and revise the estimated number of 23 trips; 24 NOW THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that 25 Agreement No. C-8-0196 is hereby amended in the following particulars only: 26 / LACamm%C LERICAL\CLERICAL\WORDPROCAGREEWMEND\am1380196.do Page 1 of 3 . • AMENDMENT NO. 13 TO AGREEMENT NO. C-8-0196 1 1. Amend ARTICLE 8. TERM OF AGREEMENT, Page 4 of 6, as last changed by 2 Amendment No. 12, in its entirety and in lieu thereof insert the following: 3 "This Agreement shall commence July 1, 1998, and shall continue in full force and effect 4 through June 30, 2008, unless earlier terminated or extended as provided in this Agreement." 5 2. Amend ARTICLE 9. PAYMENT, Page 4 of 6, as last changed by Amendment No. 12, 6 to delete paragraph A in its entirety and in lieu thereof insert the following: 7 "A. For services provided by AUTHORITY for the period July 1, 2007 8 through June 30, 2008, CITY shall pay AUTHORITY the amount. of Nine 9 Dollars and Thirty-One Cents ($9.31) per Vehicle Service Hour at an 10 amount not-to-exceed Six Thousand, Nine Hundred Eighty-Two Dollars 11 and Fifty Cents ($6,982.50)." 12 3. Amend Exhibit A "Scone of Work", as last changed by Amendment No. 12, to delete 13 paragraph 11 in its entirety and in lieu thereof insert the following: 14 "11. The CITY has budgeted $6,982.50 for the period July 1, 2007 through 15 June 30, 2008. The service provided to the center(s) shall not exceed 16 this amount. The estimated number of trips for all centers from July 1, 17 2007 through June 30, 2008 is 2,683. The AUTHORITY does not 18 guarantee that all budgeted trips will be provided." 19 / 20 / 21 / 22 / 23 / 24 / 25 / 26 / L',\Camm\CLERICAL\CLERICAL\WORDPROCAGREEIAMEND\aml380196.dm Page 2 of 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 a The balance of said Agreement remains unchanged. • AMENDMENT NO. 13 TO AGREEMENT NO. C-8-0196 Upon execution by both parties, this Amendment No. 13 shall be made effective July 1, 2007. IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 13 to Agreement No. C-8-0196 to be executed on the date first above written. THE CITY OF SAN JUAN CAPISTRANO ORANGE COUNTY TRANSPORTATION AUTHORITY By EJPvr 9�. �� I U4� By Dave Adams Arthur T. Leahy City Manager Chief Executive Officer APPROV D AS TO FORM: APPRO D AS TO FORM: By l By John R. 3 aw Kennard R. Smart, Jr. City Attorney General Counsel ATTEST: APPROVED: �( By �) q� � " L L Efeth McCormick Acting General Manager, Transit Date: � 2f- LZA-�� R. MONAHAN, CITY CLERK L:\Camm\CLERICAL\CLERICAL\WORDPROC\AGREEAMEND\am I380196.dx Page 3 of 3 MEMORANDUM TO: Karen Crocker, Community Services Manager FROM: Dawn Schanderl, Deputy City Clerk d/pt j - DATE: April 28, 2000 SUBJECT: Update 1. The CapiOLo (rc� 41ficate of insurance is being reviewed by John Shaw. 2. 1 received the original Little League certificate and endorsement. It's fine. 3. Amendment 1 to the OCTA agreement you sent to me is blank. I am hoping you have a signed copy in your files you could forward to me. Amendment 2 is fine. Thanks again for all your help. I it 0 1 AMENDMENT NO. 1 TO 2 AGREEMENT NO. C-8-0196 3 BETWEEN 4 ORANGE COUNTY TRANSPORTATION AUTHORITY S AND 6 THE CITY OF SAN JUAN CAPISTRANO 7 THIS AMENDMENT NO. 1 is made and entered into this day of , 1998 8 by and between the Orange County Transportation Authority ("AUTHORITY") and the City of San 9 Juan Capistrano ("CITY"). 10 WITNESSETH: 11 WHEREAS, by Agreement No. C-8-0196 dated July 1, 1998, AUTHORITY and CITY entered 12 into a Contract for CITY to purchase transportation services from AUTHORITY for the purposes of 13 providing a means for seniors to participate in the Area Agency on Aging (AAA) senior nutritional 14 program; and is WHEREAS, both parties have agreed to amend this Agreement to allow for several program 16 changes as stipulated below; 17 NOW THEREFORE, it is mutually understood and agreed by AUTHORITY and CITY that 18 Agreement No. C-8-0196 is hereby amended in the following particulars only: 19 1. Amend ARTICLE 8. TERM OF AGREEMENT Page 4 of 6, line 6 to delete 20 "July 1, 1998" as the effective date of this Agreement and in lieu thereof insert "September 1, 1998." 21 2. Amend ARTICLE 9. PAYMENT, to make the following changes: 22 A. Page 4 of 6, lines 11 and 12, to delete "Six Thousand Six Hundred Forty -Five 23 Dollars ($6,645.00)" as the not to exceed amount and in lieu thereof insert "Five 24 Thousand Nine Hundred Eighty -Four ($5,984.00)." 25 26 Page 1 of 2 MEMORANDUM TO: FROM: DATE: SUBJECT: Status: 0 Karen Crocker, Community Services Manager Dawn Schanderl, Deputy City Clerk February 1, 2000 Insurance/Agreement Updates 1. ✓ Capistrano Girls Softball - Use of Concession Stand at Cook Park Cordova - Have not received the general liability certificate and endorsement form. 2. San Juan Capistrano Little League - Use of Concession Stand at San Jan Capistrano Sports Park - Have not received the general liability certificate and endorsement form. .. 3. ✓ OCTA - Senior Transportation Services - I do not have Amendments 1 and 2. Also, in the file I have a general liability and auto liability certificate with Laidlaw Transit. So i need to have a workers' comp certificate re-i>3sued! naming the City as certificate holder. The one you sent over with amendment 3 namLLes-- the OCTA. Thanks. ✓ 0.` gym' WaJ� b d^erk `� 51 1 0J-9� �4,�o, 4auv.\.) 1 2 3 4 5 6 7 s 9 10 11 12 13 14 15 16 17 1s 19 20 21 22 23 24 25 26 RP Mu000 - i AGREEMENT NO. B-0196 BETWEEN i THE ORANGE COUNTY TRANSPORTATION AUTHORITY AND THE CITY OF SAN JUAN CAPISTRANO THIS AGREEMENT, made and entered into this _qday of 4 , e,&, _ 1998, by and between the Orange County Transportation Authority 550 South Maim; Street, P.O. Box 14184, Orange, California 92863-1584, a public corporation of the State of California (hereinafter referred to 3a.5Loo Paseo 4dehwto as "AUTHORITY") and the City of San Juan Capistrano, 31421 La o7atanZa StFe9t San Juan Capistrano, California 92675 (hereinafter referred to as "CITY"). WITNESSETH: WHEREAS, AUTHORITY has been retained by the Area agency on Aging (AAA) to provide countywide transportation of seniors to nutritional sites funded by AAA; WHEREAS, CITY is a participant in the AAA senior nutritional program and desirous of obtaining transportation service from AUTHORITY for the purpose of providing a means for seniors to participate in the program; NOW THEREFORE, in consideration of the respective and mutual covenants and promises hereinafter contained hereof, the parties hereto agree as follows: ARTICLE 1. COMPLETE AGREEMENT This Agreement fully expresses all understanding of the parties concerning all maters covered and shall constitute the total Agreement. No prior written or oral provisions or understandings between the parties shall have any force or affect. No addition to or alteration of the terms of this Agreement shall be valid unless made in writing and formally adopted in the same manner as this Agreement. 9 Page 1 of 6 AGREEMENT 8-0196 1 ARTICLE 2. RESPONSIBILITY 2 AUTHORITY, through an Agreement with a SUBCONTRACTOR of its choosing, assumes all 3 responsibility as appropriate for the operation, scheduling and maintenance of any vehicles, which 4 are to be operated in the performance of this Agreement. 5 AUTHORITY and/or SUBCONTRACTOR shall obtain and maintain all licenses, registrations 6 and accreditations governing its operation, which are necessary to perform the obligations under this 7 Agreement. 8 ARTICLE 3. INSURANCE 9 AUTHORITY shall ensure that SUBCONTRACTOR obtain at its sole cost and file with CITY, 10 prior to exercising any right or performing any obligation pursuant to this Agreement and maintain for 11 the period covered by the Agreement, the following insurance, which shall be full -coverage 12 insurance not subject to self-insurance conditions: 13 (1) Commercial General Liability insurance with a least One Million Dollars 14 ($1,000,000.00) per occurrence; and 15 (2) Comprehensive Automobile Liability insurance of combined single limit Primary Bodily 16 injury and Primary Property Damage in an amount not less than Two Million dollars ($2,000,000.00) 17 per occurrence. 1s (3) Workers' compensation insurance with limits established and required by the State of 19 California. 20 Each policy of the insurance required in subsections (1) and (2) shall name CITY as an 21 additional insured with respect to performance hereunder. Should any of the above-described 22 policies be canceled before the expiration date thereof, the issuing company will endeavor to mail 30 23 day written notice to the certificate holder named. 24 / 25 / 26 �e Page 2 of 6 AGREEMENT 8-0196 1 ARTICLE 4. REQUIRED LICENSES & CERTIFICATES 2 AUTHORITY, through its agreement with the SUBCONTRACTOR, shall employ only 3 qualified drivers to operate any vehicles In performance of this Agreement. Prior to employment, 4 SUBCONTRACTOR shall review the records maintained and made available by the Department of 5 Motor Vehicles regarding each of said drivers. Each of said drivers shall possess and maintain any 6 licenses or certificates required by law and necessary for their individual performances on behalf of 7 SUBCONTRACTOR under this Agreement. 8 ARTICLE 5. FEDERAL, STATE AND LOCAL LAWS 9 Notwithstanding any other provision of this Agreement, AUTHORITY and CITY agree to 10 comply with all applicable federal, state and local laws and regulations. 11 ARTICLE 6. INDEMNIFICATION 12 A. AUTHORITY shall indemnify, defend and save harmless CITY, its officers, directors, 13 employees and agents from and against any and all claims (including attorney's fees and 14 reasonable expenses for litigation or settlement) for any loss or damages for bodily injuries, 15 including death or loss of, damage to or loss of use of property caused by the negligent acts, 16 omissions or willful misconduct by AUTHORITY, its officers, directors, employees, agents, 17 subcontractors or suppliers in connection with or arising out of the performance of this Agreement. 18 B. CITY shall indemnify, defend and save harmless AUTHORITY, its officers, directors, 19 employees and agents from and against any and all claims (including attorney's fees and 20 reasonable expenses for litigation or settlement) for any loss or damages for bodily injuries, 21 including death or loss of, damage to or loss of use of property caused by the negligent acts, 22 omissions or willful misconduct by CITY, its officers, directors, employees, agents, subcontractors or 23 suppliers in connection with or arising out of the performance of this Agreement. 24 / zs 26 L 1CAMM\CLEMAL\AGREE G80196 II Page 3 of 6 1 2 3 4 s 6 7 8 9 10 11 12 13 14 15 16 17 18 19' 20 21 22 23 24 25 26 RRy ua a ,ce L \CAMM\CLEF 0 9 AGREEMENT 8-0196 ARTICLE 7. DELIVERY LOCATIONS) Passengers shall be picked up, transported and delivered from and to such locations and at such times as are described in EXHIBIT A — "STATEMENT OF SERVICES"- attached hereto and by this reference incorporated herein. ARTICLE 8. TERM OF AGREEMENT The term of this Agreement shall be one (1) year, commencing July 1, 1998, and expiring at the end of business or 5:00 p.m., whichever occurs last on June 30, 1999. ARTICLE 9. PAYMENT For services provided by AUTHORITY under this Agreement, CITY, shall pay AUTHORITY the amount of Two Dollars and Four Cents ($2.04) per passenger trip, which conforms to AUTHORITY'S service standard up to but not to exceed the amount of Six Thousand Six Hundred Forty -Five Dollars ($6,645.00), which would be the amount equivalent to the provision of the maximum number of passenger trips specified in EXHIBIT A — STATEMENT OF SERVICES. The AUTHORITY'S standard service is curb -to -curb service. Should the agency or CITY request door- to-door service, there will be an additional charge of eighty cents (.80¢) at each end of a one way trip utilizing premium service. Agencies or CITIES must provide to AUTHORITY a written list of those passengers who may receive premium service. AUTHORITY shall submit quarterly invoices to CITY for payment pursuant to this Agreement within 30 days after the close of each of the following periods: for period July, 1, 1998, through September 30, 1998; for the period October 1, 1998, through December 31, 1998; for the period January 1, 1999, through March 31, 1999, and for the period April 1, 1999, through June 30, 1999. Failure of CITY to pay AUTHORITY amount due under this contract within 30 days from date of invoice shall entitle AUTHORITY to, in addition to any other legal remedies available to AUTHORITY, suspend or diminish its performance under this Agreement if it so elects. Page 4 of 6 AGREEMENT 8-0196 1 ARTICLE 10. AVAILABILITY OF FUNDS 2 A. It is mutually understood between the parties that this Agreement may have been 3 written before ascertaining the availability of congressional or legislative appropriation of funds, for 4 the mutual benefit of both parties in order to avoid program and fiscal delays which would occur if 5 the Agreement were executed after that determination was made. 6 B. This Agreement is valid and enforceable only if the AUTHORITY has entered into a 7 service provider Agreement with the County of Orange Area Agency on Aging (AAA). It is mutually 8 agreed that if the AAA and the AUTHORITY do not enter into an Agreement, this Agreement shall 9 be amended to reflect a reduction in funds or service levels or may be terminated. 10 C. In the event that insufficient funds are appropriated, this Agreement may be canceled 11 at any time by either party, by giving thirty (30) days written notice to the other party. 12 ARTICLE 11. NOTICES 13 All notices pertaining to this Agreement, and any communications from the parties may be 14 made by delivery of said notices in person or by depositing said notices in the U.S. Mail, registered 15 or certified mail, return receipt requested, postage prepaid and addressed as follows: 16 To CITY: To AUTHORITY: 17 City of San Juan Capistrano Orange County Transportation Authority 18 31421 La Matanza Street 550 South Main Street 19 San Juan Capistrano, CA 92675 P.O. Box 14184 20 wren Croci(e - Orange, CA 92863-1584 n ATTENTION:ATTENTION: Rebecca Potter 22 Procurement Administrator C q4 9) 'f'f 3 9 23 (714) 560-5619 24 25 26 Page 5 of 6 1 2 3 4 51 6 7 s 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 0 i AGREEMENT 8-0196 ARTICLE 12. TERMINATION Any of the parties may cancel this Agreement by giving thirty (30) days written notice of said cancellation to the other party. In the event of termination or cancellation for any reason, CITY shall pay AUTHORITY for services rendered up to the effective date of such termination. CITY shall be liable for any and all reasonable costs incurred by AUTHORITY as a result of such cancellation. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date first above written. CITY OF SAN JUAN CAPISTRANO M City Attorney ORANGEZaills By Li a TRANSPORTATION AUTHORITY C Yk4,&� =tive officer TO FORM: Kennard R. Smart, General Counsel Page 6 of 6 s s AGREEMENT NO. C-8-0196 EXHIBIT A STATEMENT OF SERVICES FOR CITY OF SEAL BEACH SENIOR TRANSPORTATION 1. The AUTHORITY, through SUBCONTRACTOR, shall provide special agency transportation service to the following senior centers for the purpose of community meals and related activities: North Seal Beach Senior Center, 333 Saint Cloud Drive, Seal Beach 2. Service shall commence on July 1, 1998 when a contract is executed between the AUTHORITY and the contracting CITY. Contracts not executed within thirty (30) days after the effective date shall result in an interruption of service. 3. The AUTHORITY, or its SUBCONTRACTOR, upon approval and direction by the AUTHORITY, shall schedule and operate a vehicle or vehicles Monday through Friday within the hours mutually agreed upon by the Authority and the senior center. The service level will be determined according to the provisions stated in ARTICLE 12, "Availability of Funds", found in Agreement No. C-8-0196. 4. The AUTHORITY at its discretion shall assign vehicles it deems necessary for this transportation. The model and configuration of the vehicle may vary from time to time. The vehicles are not for the sole purpose of the senior transportation and there may be ACCESS rides booked on the routes. 5. The CONTRACTOR, upon approval and direction of the AUTHORITY, shall assign any equipment it feels appropriate for the needs of the client and reserves the right to reassign both equipment and drivers as needs may occur either for the passengers or for AUTHORITY scheduling. 6. The AUTHORITY or its CONTRACTOR, upon approval and direction of AUTHORITY, shall deny transportation to any passengers who may pose a danger to themselves, other passengers or the drivers or who may require special handing beyond the scope of the driver's responsibility and/or training. 7. All rides provided shall be on a space available basis. Geographic considerations may affect the AUTHORITY's ability to schedule riders. 8. Passengers using transportation services under this Agreement are subject to all policies and procedures applicable to AUTHORITY paratransit services. 9. The AUTHORITY requires that all passengers be ready for the transportation vehicle at the scheduled pick up time. The drivers shall wait only five minutes after the scheduled time. If the passenger is not ready within this time the driver must proceed to the next location and the passenger will be recorded as a "No Show". The CITY will be billed for all "No Shows" at the rate of $2.04 each. RP'yourtype.dr L'.\CAMM\Clerical\WOMprpo GREE 980187a Page 1 of 2 m OCTA 0 June 18, 2003 Mr. George Scarborough City Manager City of San Juan Capistrano 25925 Camino Real Avion San Juan Capistrano, CA 92675 Dear Mr. Scarborough: 0 Attached for your records is a fully executed copy of Amendment No. 8 for Agreement No. C-8-0196. If I can be of any further assistance, please do not hesitate to contact me. Sincerely, Janiece Teegarden Senior Procurement Administrator Contracts Administration and Material Management JUN 2003 Xi /J Orange County Transportation Authonty 550 South Main Street / P.O. Box 14184 / Orange / California 92863-1584 / (714) 560 -OCTA (6282) M OCTA 0 0 BOARD OF DIRECTORS Laurann Cook June 27, 2000 Chair MWara Vice -Char Saah L Catr George Scarborough Director CITY OF SAN JUAN CAPISTRANO chnthi i P Coad 32400 Paseo Adelanto Director San Juan Capistrano, CA 92675 Tam Daly Dirccror Tim Keenan Director SUBJECT: AMENDMENT 4 TO AGREEMENT C-8-0196 M'g,rel Police Director James W. Direectorctor Dear Mr Scarborough: Todd Sever Director TPemasW Wilson Enclosed for your records is a original copy of the above -referenced subject. If you have Director any questions, please feel free to call me at 714/560-5576. Susan Withrow Director Mike McManus Sincerely, Governor's Ex Officio Member "- Arthur C Bmwn ho jw�' Alternate Cnaries V Smith Denise L. Kadlec A"e'nale Contracts Administration T Wraierbotlom and Materials Management ARcrnate Office Specialist III Enclosure �/� e0VY1 Jeltil�..�S , Orange County Transportation Authority 550 South Main Street / P.O. Box 14184 / Orange /California 92863-1584 / (714) 560 -OCTA (6282) EPP i2 121:18 CERTIF dCTN CHI'IM TE''F LIABILITY In MIMS INTERNATIONAL, LTD. 901 DULANBY VALLEY RD # 610 TOWSON PID 21204 ?hone:410-296-1500 Fax:410-296-1741 LAIDLAW TRANSIT SERVICES INC. 16251 CONSTRUCTION CIRCLE WAY IRVINE, CA 92606 COVERAGES INSURER D: 71-1 5513 57q'-:' P. 82. 0.4 -W!Ar PID p� DATE IMM JW ISSUED AS A MATTER OF INFORMATIOI FERS NO RIGHTS UPON THE CERTIFICATE :ERTIFICATE DOES NOT AMEND, EXTEND OR TERAGE AFFORDED BY THE POLICIES BELOV INSURERS AFFORDING COVERAGE FIC1\N HOME -ASSURANCE CO THE POUCIES OF IHSURANI:E LISTED BELOW HAVE BEEN ISSUED TO THE N45URW NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NO7WRNSFAHDVW ANY REQUIREMENT. TERMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TMS CERTwICATE 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 POMES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLANS. INSPI LTR TYPE OP INSURANCE POLICY NIMMaER A LIMITS amalluu. LIABILITY 6ACH OCCURRENCE S 5, 500, 00 A X CIMIKRCULGENTdRALLUNLRY TMMa737811 09/01/01 09/01/04 FIREOMAAGSyM mewftj S 1, 000, 00 IaAIMB MADE ®OCCUR A1�E�LAMAI�PilAAAt s 50,00 PERSON S ADV INJURY S 5,000.00 GENERAL AGGREGATE S 10, GOO, 000 GHYL AGGREGATE APPLIES POL PRODUCTS• COWIOP AGO S 5,000,00 pLpW�T 17 POLICY JECT X Lor A AUTOMOME X IYBRf1Y ANY AUTO PS=5273484 09/01/01 09/01/04 COMBINED SINGLE LIMIT Ta.uaaanq a 5,000,00 BODILYINJURYS (Pe, Parsm) X X ALL oWNEO AUTOS SCHEDULED AUTOS Bomy INJURY Twbmde ) S X X HREDAUTOS NON-0IYNTfl Autos PROPERTYCAMAGE (Prealdenll ' S ' OAAAOE LLABINTT ATO ONLY. EA ACCIDENT S OTHERTHAN EA ACC S ANY AUTO AUTO ONLY: AGG a QC=3 LIABILITY OCCUR ❑ CIAIIMS MADE FACH OCCUPMENCE S AGGREGATE S E DEDUCTIBLE S -� RETENTION S 9 WORMIS COWENS LTWM AND TORY UWTS 8 D�U°BAm 2MNC4066004 09/01/01 09/01/D4 E1.EACH ACCIDENT S 5,000,001 SL DmAm. W GYRO F 5,000,004 E.L DMASE-POLICY LWT I s 5,000,00( OESCIII/ITIOM OTHER Oe aPERAmauaATTeuuK..rs.A..eI_Ire..e.ee.n II,. Woe�.�.,.er,... *•PLEASE REFER TO TEE ATTA(M= RlIDORSEM MS FOR IIQFORMATION REA=nM CIS 923 ADDITIONAL INSURED ?ROVISIONS** HOLDER ORANGE COUNTY TRANSIT ARTS_ COJOWNITY TRANSIT SERVICES ATTNT EATSY ?ESL P.O. BOX 14184, 550 S. MAIN ST ORANGS, CA 92863-1584 ORANGI7 I DMOUAOANYOFTMABOWDEWPMWPOUMWCANCM-MBEFORETTEE M'nOI DAT{TNERIOF,THERLLRNSPWJPZRMALLS"DSA11ORY0AIR, -J-L-/AY3wwrrw NOTICE TO THE CERTIFICATE HOLDER NAM® TO THE LEFT, BUT FAILU STO 00 SO SHAT L 11WOBE NO OBUOATION OR LMDERY OF AMYIWD UPON THE INSURER ITS YOENTS OR arra ��ltu i ; i POLICY NUMBER: RMGLI737511 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY PART. SCHEDULE Name of Person or Organization - The following cities are named as additional insureds: Santa Ana Garden Grove Anaheim Brea Buena Park Costs Mesa Cypress Fullerton Huntington Beach La Hambra Los Alamitos Orange Sael Beach Mission Viejo San Juan Capistrano San Clemente Stanton Tustin Westminster Also named as additional insured are: The Jewish Senior Center and Orange County Transit Authority (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 11) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. L ;!oi2xizefd Representative CG 20 26 1195 Copyright, Insurance Service Qffice, Inc., 1984 h 0i -W02 12: is OCTA CANM 714 i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ENDORSEMENT #1 This endorsement, effective 12:01 A.M. September 1, 2001 forms a part of Policy No. RMCAS273484 issued to LAR)LAW TRANSIT, INC. by American Home Assurance Co. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section 11- Liability Coverage, A - Coverage, 1 - Who Is An Insured, is amended to add: d. Any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of your operations or premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: 1. The coverage and/or limits of this policy, or_ 2. The coverage and/or limits required by said contract or agreement Authorized Representative 61713 (12194) TOTAL P.04 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949)493-1171 (949)493-1053(FAX) March 16, 1999 Daves Transportation Service 26111 Antonio Parkway Rancho Santa Margarita, CA 92688 0 (000. 5o O►�C,i,r� CD Tr�rvsporf�+-ion �/q-� A 1_�1-4 .\o r c. b� Sen / � MEMBERS OFTHE CITYCOUNCIL COLLENE CAMPBELL 1'f'N JOHN GREINER WYATT HART GILJONES DAVID M. SWERDLIN CITY MANAGER GEORGE SCARBOROUGH Re: Renewal of Workers' Compensation Certificate of Insurance (Senior Transportation Services Gentlemen: The Workers' Compensation Certificate of Insurance, regarding the above -referenced service, expired December 31, 1998. In accordance with your agreement, the insurance certificate needs to be renewed for an additional period of one year. Please forward an updated certificate to the City of San Juan Capistrano, attention City Clerk's office, by March 30, 1999. If you have any questions, please contact me at (949) 443-6310. Thank you for your cooperation. Very truly yours, Dawn M. Schanderl \ Deputy City Clerk cc: Cheryl Johnson, City Clerk Rebecca Potter, OCTA San Juan Capistrano: Preserving the Past to Enhance the Future TE 001 YY) -,!A_ o CERTIFI TE OF LIABILITY IN RANC�PID MJ DA10/26/9 RCAT-1 10/26/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MIMS INTERNATIONAL, LTD. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 901. DU-LANEY VALLEY RD # 610 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TOWSON MD 21204 Phone: 410-296-1500 Fax:410-296-1741 INSURERS AFFORDING COVERAGE INSURED INSURERA: NATIONAL UNION FIRE INS. CO. _ INSURER B: LAIDLAW TRANSIT SERVICES, INC. INSURER C: 14736 SAND CANYON AVENUE INSURER D: ' IRVINE, CA 92618 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 LTR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDM' DATE MM/CY DD RAT1ON LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR RMGL6122027 09/01/98 09/01/01 EACH OCCURRENCE S 5,500,000 FIRE DAMAGE (Any one Pre) $1,000,000 MED EXP (Any one person) S 50,000 PERSONAL L ADV INJURY S 5,500,000 GENERAL AGGREGATE S 10, 000, 000 GENL AGGREGATE LIMIT APPLIES PER: 17 POLICY JEST X LOC PRODUCTS -COMPIOP AGO 55,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS RMCA3209209 09/01/98 09/01/01 COMBINED SINGLE LIMIT (Ea accident) $5,000,000 X X X X BODILY INJURY (Per Person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident)- -- $ GARAGE LIABILITY ANYAUTOOTHER AUTO ONLY - EA ACCIDENT $ THAN EA ACC AUTO ONLY: AGG S S EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE $ AGGREGATE S IS S S B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY RMWC3471447 01/01/99 09/01/01 WC STA I TORY LIMITS I ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT S OTHER DESCRIPTION OF OPERHTIONSILOCATIONSNEHICLE&EXCLUSIONS ADDED BY ENDORSEMENLSPECIAL PROVISIONS **PLEASE REFER TO THE ATTACHED ENDORSEMENTS FOR INFORMATION REGARDING ADDITIONAL INSURED PROVISIONS** CERTIFICATE HOLDER Y I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION ORANGI7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ORANGE COUNTY TRANSIT AUTH. EXPIRATION DATE THEREOF, THE ISSUING INSURERWILL ENDEAVOR TO MAIL COMMUNITY TRANSIT SERVICES 30 DAYS WRITTEN NOTICE TO THE C TIFIC TE HOLDER NAMED TO THE ATTN: KATHY PEEL LEFT, BUT FAILURE TO DO SO SHALL RARE NO ^ BLIGATION OR LIABILITY OF/ P.O. BOX 14184, 550 S. BLAIN ST / ORANGE, CA 92865-15$4 ANY KIND UPON THE-INBURER, ITS AG2`ITS4. REPRES NTA VES.7 /,y I .i. ACORD POLICY NUMBER: RMGL6122026 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY PART. SCHEDULE Name of Person or Organization - The following cities are named as additional insureds: Santa Ana Garden Grove Anaheim Brea Buena Park Costa Mesa Cypress Fullerton Huntington Beach La Hambra Los Alamitos Orange Sael Beach Mission Viejo San Juan Capistrano San Clemente Stanton Tustin Westminster Also named as additional insured are: The Jewish Senior Center and Orange County Transit Authority (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 11) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. CG 20 26 11 85 Copyright, Insurance Service Office, Inc., 1984 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ENDORSEMENT#1 This endorsement, effective 12:01 A.M. September 1, 1998 forms a part of Policy No. issued to LAIDLAW TRANSIT, INC. by National Union Fire Insurance Company of Pittsburgh, PA. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provider[ under the following: BUSINESS AUTO COVERAGE FORM Section II - Liability Coverage, A - Coverage, 1 - Who Is An Insured, is amended to add: d. Any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of your operations or premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: The coverage and/or limits of this policy, or. 2. The coverage and/or limits required by said contract or agreement. Authorized Rep esentative 61713 (12/94) BOARD OF DIRECTORS Thomas W. Wilson Chairman Laurann Cook Vice -Chairman Sarah L. Catz Director Cynthia P. Coad Director Tom Daly Director Tim Keenan Director Miguel Pulido Director James W Silva Director Todd Spitzer Director Michael Ward Director Susan Withrow Director January 11, 2000 Ms. Karen Crocker City of San Juan Capistrano 25925 Camino del Avion San Juan Capistrano, CA 92675 Subject: Amendment No. 3 to Agreement C-8-0196 Dear Ms. Crocker: Enclosed for your records is a copy of the subject contract amendment. If you have any questions, please contact the undersigned at (714) 560-5609. Sincerely, Kathy Peale Procurement Administrator Ken Nelson Governor's Enclosure Ex-Olhcio Member Arthur C. Brown Alternate Charles V Smrth Alternate Gregory T. Winterbottom Alternate Orange County Transportation Authority 550 South Main Street / P.O. Box 14184 / Orange / California 92863-1584 / (714) 560 -OCTA (6282) ACORD CERTIFICAV OF LIABILITY INSUFONCE GSR MD DAM(MM/DDNY) RACAT-4 12/03/98 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MIMS INTERNATIONAL, LTD, HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 901 DULANEY VALLEY RD # 610 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE TOWSON MD 21204 COMPANY T A NATIONAL UNION FIRE INS. �CO. F M. HUSCEMI Ph ... an. No. 410-296-1500 F.sNe.41 -296-1741 wsuRED LAIDLAW TRANSIT SERVICES, INC. VAN TRAN OF TUSCON, INC./ DAVE TRANSPORTATION SERVICES, INC./DAVE MANAGEMENT, INC. COMPANY ^ l/..I' COMPANY C 26111 Antonio Parkway Rancho Santa Margarita CA 92688 COMPANY D �- COVERAGES ZZ m THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF NSUMNCE POLICY NUMBER POLICYEFFECTIVE DATE (MM/DD/YY) POLICYEXPIRAT10N DATE IMM/DDNY) LIMITS GENERAL MBILITY GENERAL AGGREGATE 810,000,000 A X COMMERCIAL GENERAL LIABILITY RMGL6122026 09/01/98 09/01/01 PRODUCTS - COMPIOPAGO 55,000,000 CLAIMS MADE 51 OCCUR PERSONAL &ADV INJURY 8 5,000,000 EACH OCCURRENCE 85,000,000 OWNER'S& CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) 81,000,000 MED EXP IAny one parson) *50,000 A AUTOMOBILE X LIABILRY ANY AUTO RMCA3209209 09/01/98 09/01/01 COMBINED SINGLE LIMIT *51000,000 X X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY 8 (Par person) BODILY INJURY 8 (Per accident) X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE 8 GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT S AGGREGATE 8 EXCESS MBILRY EACH OCCURRENCE 8 AGGREGATE 6 UMBRELLA FORM 8 OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I WC STATU- OTH- TORY LIMITS R ELEACH ACCIDENT b THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE EL DISEASE - POLICY LIMIT 8 EL DISEASE - EA EMPLOYEE 8 OFFICERS ARE: EXCL OTHER A PHYSICAL DAMAGE RMCA3209209 09/01/98 09/01/01 $10,000 DED COMP $10,000 DED COLL. DESCRIPTION OF OPERATIONS/LOCATKHRUVEHICIES/SPECIAL REM& THE CITY OF SAN JUAN CAPISTRANO, ITS OFFICERS, AGENTS AND EMPLOYEES ARE LISTED AS ADDITIONAL INSURED AS RESPECT TO THE OPERATIONS OF THE NAMED INSURED ONLY. CERTIFICATE HOLDER CANCELLATION SANJUA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPwATION DATE THEREOF, THE ISSUNG COMPANY INEGUM TO MAIL CITY OF SAN JUAN CAPISTRANO 30 DAYS NOTICE TO TIE CERTIFICATE HOLDER NAMED TO THE LEFT, RECORDS COORDINATOR ATTENTION: DAWN SCHANDERL 32400 PASEO ADELANTO,CITY HALL SAN JUAN CAPISTRANO, CA 92675 Aur D s ATIVE PELI AGORD 25-S 41195) VA: OR CORPORATION 1988 POLICY NUMBER: RMGL6122026 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY PART. SCHEDULE Name of Person or Organization: THE CITY OF SAN JUAN CAPISTRANO ITS OFFICERS, 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 as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. CG 20 26 1185 Copyright, Insurance Service Office, Inc., 1984 • 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ENDORSEMENT # 1 This endorsement, effective 12:01 A.M. September 1, 1998 forms a part of Policy No. RMCA3209209 issued to Laidlaw Transit Services, Inc. , VAN TRAN OF TUSCON, INC./DAVE TRANSPORTATION SERVICES, INC./DAVE MANAGEMENT, INC. by National Union Fire Insurance Company of Pittsburgh, PA. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section II - Liability Coverage, A - Coverage, 1 - Who Is An Insured, is amended to add: d. Any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of your operations or premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: The coverage and/or limits of this policy, or. The coverage and/or limits required by said contract or agreement. 61713 (12/94) DEC -B4-1998 Sl�zb � ACURDN fT' i �s� aN,.De9 m �• X91 #' 12/03 TH16 CEIMICATE IS ISSUED AS A I4ATT9I OF NAORMATWN ONLY AND CONFERS NO NIGHTS UPON THE CIPTVICA7E HIHS IRTERNATIONAL. LSD- "OLDER. THIS CEMIFICATE DOLS NOT AMBID. MOW OR 901 DOLAYBY VALLEY RD S 610 ALTER THE COVERAGE AFPONDED BY THE POLIC105 BELOW. TOWSON 1® 21204 COMPANIES AMOROMIR OOVEFAFNE PiLXCIA Y. EIISCHIIZ cD"""""Y ..Ba 410-296-1500 fta% 4T0-196-1741 _ A NATIONAL ONIOR PION IRS_ CO- _,- aNau1E0 .GNP.«. LAIDLAN SRMSIT SSRVICIS, IHC. a VAN TRAM OF TITSCON, INC./ — — — DAVX TRAYSPORTATZIOR SERVZCNS, COMPANY IRC./DAVM WJMGE11WNT, INC- O — — 26111 Antonio Parkvmy COMPANY Rancho Santa Margarita CA 92698 D .r _ M ._. _ _................ ..........,– THIS E TO CN7ITIFY THAT MF POLICIES OF MSURaNC4 LISTED BELOW HAVE OEar RsflEil TO THF INS!lRED xANEO AFOVE 11,08 THE POLN:Y Ptl110D INDICATED. NOTWITHSTANDING ANY REOVIRERIFRT, TM OR CONDITION OF ANY CONTRACT OR 074FR DOCUMENT WITH RESPECT TO WHICH THIS CFMIFICATF NAY BE NIFUED OR MAY PERTAIN. FHF INSURANCE AFFORDED BY TNF POLICIES DESCRIBED HEREIN IS 9LOJECT TO ALL THE TERNS. EIICLUVONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAV NAV% OFDI M6OUCU) BY PAO CUINS. _ uY1 TVR OF FIWMIICE roucr NllMabl roIICY ENECTNE IPOucr ilfWUTOM A —_ IWft WWOPMR PAn UNNGx'A A J CLAMS MACK OWNEF'1 L CONTa ANY AUTO Aulty I RMOILS122026 occult RMCA3209209 ILMI NILLA FORM OTHER THAN UNIG ELLA FOWA wommim fIIPNFNFATNR AND dNtOVIAF &^OWN T.ErAFIPltONU[TDiNuTM Wra OfR(cm AAF "o. OTNIN A PHYSICAL DAMn61s RMC; 09/01/99I AINDINDM[ IIIIIARV PRaoum-CummupaGe 151000,000 X 4NYAUTO IYAPONaLAAOV I/UYRY s5 000.000 X ALL. OWNED AVM ][ SCNmW[D AUTO$ FATE DAAgCt N.....a.! I • 14_000, 000 X HUED Aum OND fxr lAnr pr Pa..Pr 450, 000 ]( NONIOWNEO AUTO4 ANY AUTO Aulty I RMOILS122026 occult RMCA3209209 ILMI NILLA FORM OTHER THAN UNIG ELLA FOWA wommim fIIPNFNFATNR AND dNtOVIAF &^OWN T.ErAFIPltONU[TDiNuTM Wra OfR(cm AAF "o. OTNIN A PHYSICAL DAMn61s RMC; 09/01/99I 09/01/01 PRaoum-CummupaGe 151000,000 _ AOOIIE9wTT N IYAPONaLAAOV I/UYRY s5 000.000 EACH OCCuTps A S, 000.000 _ FATE DAAgCt N.....a.! I • 14_000, 000 OND fxr lAnr pr Pa..Pr 450, 000 09/01/98 09/01/01 cawlNLoaDIeuamm NS,000,000 7.4m, EA C.Vv rFL S ADDILr yElultr I I (01/99 09/01/01 W r..w II T. BDDLLY M,IUNY I I IIp .arJsal 4ltpPERT'r DAMAGE N �— AyTO ONLY -LA ACCOEIIT ,. ..v OTHER THAN wuTO OIAY:'""' ..._ ;..r GG af:CIOFMN C THE CIT)r OF sm S ARE LZS IDASAADDITZO ZMSVNED AS R 6FZCTPT0�RT8I! OF TICKS f TTEESEX]EEOi;D CITY OIF SAIL Jum CAPZS'PNARO ACCOn08 CODRDZIFATOR ATT%XTI0x: DAMN $I=wIIDERL 32400 PA=O AnZAIiTO,CITY HALL SAH JUAR CAPZSTRARO, CA 92675 SANJIIA3 ZINNIA MY OP M MO -F DM%NFD POYCN3 ae CANCRIED NINOIE M aNP1AATwm PATP TNIFFOF. M asume Co&~ jmjjv� 16 MAL 30 oNp1 YDTI� re M GBITNKIITE IIPIDaN NAIIp fo TIE uDwF. DEC -03-1998 12:33 4107961741 q7z f ' FAON ocCwRENa f _ _ AOOIIE9wTT N WC STATW NUL iE mew ACCpENT I n Or. a ro,wr uMm 4 7.4m, EA C.Vv rFL S (01/99 09/01/01 S10,000 DSD COKE $10,000 DBD COLL. THE CIT)r OF sm S ARE LZS IDASAADDITZO ZMSVNED AS R 6FZCTPT0�RT8I! OF TICKS f TTEESEX]EEOi;D CITY OIF SAIL Jum CAPZS'PNARO ACCOn08 CODRDZIFATOR ATT%XTI0x: DAMN $I=wIIDERL 32400 PA=O AnZAIiTO,CITY HALL SAH JUAR CAPZSTRARO, CA 92675 SANJIIA3 ZINNIA MY OP M MO -F DM%NFD POYCN3 ae CANCRIED NINOIE M aNP1AATwm PATP TNIFFOF. M asume Co&~ jmjjv� 16 MAL 30 oNp1 YDTI� re M GBITNKIITE IIPIDaN NAIIp fo TIE uDwF. DEC -03-1998 12:33 4107961741 q7z DEC -04-1998 POLICY NUMBER: RMCYL6122026 COMMERCIAL GENERAL LIABIIJTY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ 1T CAREFULLY - ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY PART. SCHEDULE Name of Person or Organization: THE CITY OF SAN JUAN CAPISTRANO ITS OFFICERS, 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 Il) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. CG 20 26 11 85 DEC -03-1998 12=33 Copytigbt, Insurance Service Qfftce, Inc., 1984 4102961741 9?% P 0- PFC-04-199A 11 27 nCTA MMM 4& - 9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ENDORSEMENT#1 This endorsement, effective 12:01 A.M. September 1, 1998 forms a part of Policy No. RMCA3209209 issucd to Laidlaw Transit Services, Inc., VAN IRAN OF T USCON, INC/DAVH TRANSPORTATION SERVICES, INCJDAVE MANAGEMENT, INC. by National Union Fire Insurance Company of Pittsburgh, PA. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following. $USINMSS AUTO COVERAGE FORM Section II - Liability Coverage, A - Coverage, 1 - Who Is An Insured, is amended to add.- Any dd: Any person or organization to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to famish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of your operations or premises owned by or rented to you. However, the insurance provided will not exceed the lesser Of. 2. 61713 (17/94) The coverage and/or limits of this polioy, or_ The covetago andlor limas required by Said contract or ngrocuxsrt_ nct _n,:_•. m.+ T O MI 11.04 DEC -04-1999 11:2r, O1 i A CAMM 714 579: F'. N7 104 Orange County . Main Sc, P:O. Box 14184, Orange, CA 9?863-1584 Transportation Authority To: Dawn Schanderl City of Sen Juan Capistrano Phone: _ Fax phone: 949-493-1053 _! CC: Date: 12_499 Number of pages including cover sheet: 4 From: Rebecca Potter Orange County Transportation Authority Phone_ ,7141560_5619 Fax phone: _ 714/560-5792 REMARKS: ® Urgent (1 For your review [j Reply ASAP [ 1 Please comment REGARDING: Certificate of Insurance from Laidaw Transit Services, Inc - see attached. facsimile TRANSMITTAL t0: Rebecca Potter fax #: (714)560-5792 re: Copy of Certificate of Insurance and endorsement date: December 1, 1998 pages: 3, including cover sheet. From the desk of.. Dawn M. Schanderl Deputy City Clerk City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 (949)443-6310 Fax: (949) 493-1053 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949)493-1171 (949) 493-1053 (FAX) November 9, 1998 Ms. Rebecca Potter, Procurement Administrator Orange County Transportation Authority 550 South Main Street Orange, California 92863-1584 MEMBERS OF THE CITY COUNCIL COLLENE CAMPBELL JOHN GREINER MATT HART GILJONES DAVID M. SWERDLIN CITY MANAGER Re: General Liability, Automobile Liability and General Liability Endorsement Form (Senior Transportation Services - C95040/Dave Transportation Services) Dear Ms. Potter: The copy of the General Liability and Automobile Liability Certificate of Insurance I received per your letter of October 8, 1998 will need to be reissued to name the City of San Juan Capistrano as certificate holder. In addition, I have not received the General Liability Endorsement form naming the City of San Juan Capistrano as an Additional Insured. I would appreciate it if the above requested documents could be mailed right away. If there are any questions please call meat (949) 443-6310. Thank you for your assistance. Very truly yours, 1 I a, (' X�� C a -.t t.wl Dawn M. Schanderl Deputy City Clerk cc: Cheryl Johnson, City Clerk Karen Crocker, Community Services Manager Daves Transportation Service City Attorney DRUG USE IS AS SE San Juan Capistrano: Preserving the Past to Enhance the Future 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 (FAX) October 5, 1998 Daves Transportation Service 26111 Antonio Parkway Rancho Santa Margarita, CA 92688 MEMBERS OF THE CRY COUNCIL COLLENE CAMPBELL JOHN GREINER WYATT HART GILJONES DAVID M. SWERDLIN CITY MANAGER GEORGE SCARBOROUGH Re: Renewal of General Liability and Automobile Liability Certificates of Insurance (Senior Transportation Services) Gentlemen: The General Liability and Automobile Liability Certificates of Insurance, regarding the above - referenced service, expired on September 1, 1998. In accordance with our agreement with the Orange County Transportation Authority, the insurance certificates need to be renewed for an additional period of one year. The agreement requires a general liability endorsement form naming the City of San Juan Capistrano as an additional insured. I have included a City approved endorsement form to submit to your insurance company; however, your insurance company may provide their own endorsement form. Please forward the updated certificates and the endorsement form to the City, attention City Clerk's office, by October 16, 1998. If you have any questions, please contact me at (949) 443-6310. Thank you for your cooperation. V,(erry/� truly yours, Dawn M. Schanderl Deputy City Clerk Enclosure cc: -`Cheryl Johnson, City Clerk Karen Crocker, Community Services Manager Rebecca Potter, County of Orange DRUG USE IS ..I E San Juan Capistrano: Preserving the Past to Enhance the Future RECEiVED OCTA OCT j3 . ;t. p BOARD OF DIRECTORS Sarah L. Catz October 8, 1998 �. Chairman �DQi� �• Thomas W. Wilson Vice -Chairman City Clerk's Office Laurann Cook City of San Juan Capistrano Director 32400 Paseo Adelanto Tom Daly San Juan Capistrano, CA 92675 Director Miguel Director To Whom It May Concern: Charles Smith Director Attached is the current Certificate of Insurance regarding Agreement No. C-8- Todd Spitzer 0196 for providing senior transpiration services. Director a William G. Steiner I have requested a copy of the certificate and th%eadorsement to be Sent tcj Director you directly from MIMS International, LTD. Robert P Wahlstrom Director If you have any questions, please contact me directly at 714/560-5619. Michael Were Director Sin c ely, Susan Withrow Director Mike McManus Governors Ex-Officio Member Rebecca Potter Arthur Brown Procurement Administrator Alternate Contracts Administration and Materials Management James W Silva Alternate Enclosure Gregory T Winterbottom Alternate Orange County Transportation Authority 550 South Main Street/P. O. Box 14184/Orange/California 92863-1584/(714)560-OCTA(6282) VQR_o CERTIFICi4E OF LIABILITY INS NCECSR 008/12 /9 'ZtACAT-4 08/12/98 PRO1IUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER ICATE MIMS INTERNATIONAL, LTD. 901 DULANEY VALLEY RD # 610 HOLDER. THIS CERTIFICATE DOES NOT AMEND, WTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING OOVERAM TOWSON MD 21204 COMPANY'S A NATIONAL UNION EIRE INS. m FELICIA M. BUSCEMI Phone No. 410-296-1500 FaXNo.410-296-1741 INSURED LAIDLAW TRANSIT SERVICES, INC. VAN TRAM OF TUSCON, INC./ �,� DAVE TRANSPORTATION SERVICES INC. /DAVE MANAGEMENT, INC. COMPANY IS '°- - COMPANY --- C ca COMPANY D 26111 Antonio Parkway Rancho Santa Margarita CA 92688 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 POLICY NUMBER POLICYEFFECTIVE DATE(MMIOD/YY) POLICY EXPIRATION DATE IMMIDDIYYI LIMITS GENERAL LIABILITY GENERAL AGGREGATE $10,000,000 A X COMMERCIAL GENERALIJABUJ7Y RMGL6122026 09/01/98 09/01/01 PRODUCTS -COMPIOPADD S 5 000 000 CLAIMS MADE O OCCUR PERSONAL B ADV INJURY $ 5,000,000 EACH OCCURRENCE $ 5,000,000 OWNER'S B CONTRACTOR'S PROT FIRE DAMAGE(Any one Bre) $ 11000,000 MED EXP (Any one person) S 50,000 A AUTOMOBILE X LIABILITY ANY AUTO RMCA3209209 09/01/98 09/01/01 COMBINED SINGLE LIMIT $5,000,000 X X BODILY INJURY $ (Parperson) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per accident) X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT S AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE S AGGREGATE S UMBRELLA FORM j 1 OTHER THAN UMBRELLA FORM. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTH- X WC TORY T RV LIMIT E EL EACH ACCIDENT $5,000,000 A THE PROPRIETOR/ X INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL RMWC3471447 09/01/98 09/01/01 EL DISEASE - POLICY LIMIT 55,000,000 EL DISEASE. EA EMPLOYEE $5,000,000 OTHER A PHYSICAL DAMAGE RMCA3209209 09/01/98 09/01/01 $10,000 DED COMP $10,000 DED COLL DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS RE: THE ORANGE COUNTY TRANSIT DISTRICT ITS OFFICERS DIRECTORS EMPLOYEES ANDAGENTS ARE LISTED AS ADDITIONAL INS6RED AS RESPECTS TO THE 6PERATIONS OF THENAMED INSURED ONLY. CERTIFICATE HOLDER CANCELLATION ORANGI7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ORANGE COUNTY TRANSIT DISTRICT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. BOX 14184 OF ANY PON THE COMPANY, ITS ADEN R REPRESENTATIVES. AUTHO D WRESENTATIVE ORANGE, CA 92613 a FELM. BUSC I/L ACORD 25-S (1195) PORATION 1111 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 (FAX) October 5, 1998 Daves Transportation Service 26111 Antonio Parkway Rancho Santa Margarita, CA 92688 MEMBERS OF THE CITY COUNCIL COLLENE CAMPBELL JOHN GREINER WYATT HART GILJONES DAVID M. SWEROLIN CITY MANAGER GEORGESCARBOROUGH Re: Renewal of General Liability and Automobile Liability Certificates of Insurance (Senior Transportation Services) Gentlemen: The General Liability and Automobile Liability Certificates of Insurance, regarding the above - referenced service, expired on September 1, 1998. In accordance with our agreement with the Orange County Transportation Authority, the insurance certificates need to be renewed for an additional period of one year. The agreement requires a general liability endorsement form naming the City of San Juan Capistrano as an additional insured. I have included a City approved endorsement form to submit to your insurance company; however, your insurance company may provide their own endorsement form. Please forward the updated certificates and the endorsement form to the City, attention City Clerk's office, by October 16, 1998. If you have any questions, please contact me at (949) 443-6310. Thank you for your cooperation. Very truly yours, Dawn M. Schanderl Deputy City Clerk Enclosure cc: Cheryl Johnson, City Clerk Karen Crocker, Community Services Manager Rebecca Potter, County of Orange DRUG USE Is AB San Juan Capistrano: Preserving the Past to Enhance the Future AGORP. GFRTIFICA-0 OF LIABILITY AND �MIMS INTERNATIONAL, L'.('D. HOLDE ;301 DULANEY VALLEY R_' # 610 ALTER TOWSON I43J :.1204 g COMPANY MAR:. '._ZAIRE GOFF Ph.n. qac 4LO-2961500 A _ _-N.._410_-296-1741 INSURED :)AVE MANAGEMENT, LNC../VAN TRAM COMPANY B )F TUSCON, INC.:SuNTRAN. INC./ COMPANY DAVE TRANSPORATION SERVICES, -NC. C ::6111 ANTONIO PAF:EWAY COMPANY RANCHO SANTA MARGARITA CA 92688 D DATE (MMMM-Y) AFFORDED BY THE NATIONAL UNION FIRE INS. CO. `COVERAGES 'i- S S I C CERT IFY THAT THE POL IC E' Of INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD N111KAiC0 NOTIMTHSTANDINGANYRFOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS (:F R L �F ICA FE MAY BE ISSUED OR MA r PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS. E? :I JSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IYPE OF INSURANCE _----- POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS Ta DATE(MMMMM DATE(MMMMM -. GENERA! LIABILITY- GENERAL AGGREGATE A �: :oMMFRCIAL GENERAL LABL 11 RMGLI135380 11/01/97 09/01/98 PRODUCTS -COMPADP AGG ;INNS MADE �OC.L+-', PERSONAL a ADV INJURY P'S & CONTRACTOR'S PI I EACH OCCURRENCE AUTOMOBILE LIABILITY A F: ANY AU rr oll.. IVME J AUTOS g 3:I -E DOLED AUTOS a W J AU I05 ,, N OWN I:D AUTOS - GAP.AGELIABRITY _- "I u, -C - _-P (tiiESS LIABII.ITy -- Ail 14EI L+ FORM - • R D IAN UMSRELLA FCF "PIKERS COMPENSATION AND $'AL' OYL9S ;ABILITY III '11;1'RI1 TORI I P.'.F4'NIEP PFX1 CUTIVE - t QTR£R PPYSICAL DAMAGE RMCA1439391 1 11/01/97 I 09/01/98 I COMBINED SINGLE LIMIT ND OR BELOW. $ 5,000,000 % 5,000,000 $ 1,000,000 $ 50,000 $5,000,000 BODILY INJURY $ (Pr Pw ) BODILY INJURY $ (Par ActlEi,nl) PROPERTYDAMAGE S AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE $ EACH OCCURRENCE $ AGGREGATE S S OTOT RYTL'MI- OER- EL EACH ACCIDENT S EL DISEASE -POLICY LIMIT S EL DISEASE - EA EMPLOYEE S RMC -N1439391 11/01/97 09/01/98 $10,000 CONP DED. $10,000 COLL DED. �ESCRIPT ION OF OPERATIONSILOCATW vYVF.HCLEWSPECIAL ITEMS SLE: THE CITY OF SAN -DAN CAPISTRANO, ITS OFFICERS AGENTS AND EMPLOYEES ARELISTED AS ADDITIONAL INSUREDS AS RESPECTS TO TkE OPERA+IONS OF THE NAMED INSURED ONLY. E17T F"GATE HOLDER CITY OF SAN N N CAPISTRANO RECORDS COORC:.:JATOR ATTN: PAWN SCHANDERL 32400 PASEO :,1):31,ANTO, CITY HALL SAN TUAN CAP". �'^RANO, CA 92675 SANJDA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL 91111318110101imm MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, MARY CLAIRE GOFF ANNORD. CERTIFICA OF INSURANCE DATE(MM/DD/YY) + 12/24/97 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER Averbeck Company 3270 Inland Empire Blvd #100 p ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ontario, CA 91764 COMPANIES AFFORDING COVERAGE COMPANY AAr onaut Insurance Company INSURED The Dave Company Inc., COMPANY B Laidlaw/Crawford 1240 East Diehl Road #100 coMPauv C Naperville, IL 60563 COMPANY D CMRAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 00 LTR TYPE OF INSURANCE POLICYNUMBER POLICYEFFECTIVE DATE(MM/DD/YY) LICYEXPIRATION DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERA -AGGREGATE $ PRODUCTS-COMP/OP AGO $ OMMEgCIAL GENERAL LIABILI CLAIMS MADE ❑ OCCUR PERSONAL B ADV INJURY $ EACH OCCURRENCE $ _ WNER'S6 CONTRACTOq'S PRO FIRE DAMAGE (Any one Ike) $ MED EXP(Any one person) $ AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT $ BODILY INJURY $ (Per parson) ALL 0WNEI AUTOS SCHEDULED AUTOS BODILY INJURY (Peraccitlent) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ OAR AGE LIABILITY AUTO ONLY-EAACCIDENT S ANY AUTO OTHER THAN AUTO ONLY: EACH ACCI DE NT S _ AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE _ 5 OTHERTHAN U MSRELLAFORM $ A WORKERS COMPENSATION ANO WC62593115589 12/31/97 12/31/98 X STATUTORY LIMITS EMPLOYERS LIABILITY EACH ACCIDENT SZ 000 000 THE PROPRIETOR/ INCL' PARTNERS/EXECUTIVE OFFICERSARE: EXCL DISEASE -POLICY LIMIT Sl 000 000 ' DISEASE -EACH EMPLOYEE Sl 000 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Name Printed on DEC Page: The Dave Company, Inc. (See Attached Schedule.) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BEOANCELL Q4EFORE THE City of San Juan Capistrano EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILLENDEAVORTOAAIL Attn.: Linda Evans O Y`iODAYS WRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAOI6DTOYHELEFT, 32400 Paseo Adelanto/ City Hall San Juan Capistrano, CA 92675 B UT FAI LURE TO MAI L SUCH NOTICE SHALL IMPOSE NO OH LIGATION OR L119 I LITY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPR NTAlWES, AUTHORIZED EPRESENTATIVE - 0 Maria Guevara From: Karen Crocker Sent: Monday, August 11, 2003 12:31 PM To: Maria Guevara Subject: RE: OCTA Amendment I should! I will send it over. -----Original Message ----- From: Maria Guevara Sent: Friday, August 08, 2003 8:55 AM To: Karen Crocker Subject: OCTA Amendment Hi Karen, We received Amendment No. 8 to agreement C-8-0196, but we are missing Amendment No. 7. Do you have a copy in your records? Thanks for your help, 8 F 2 P.