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03-0228_DIVE/CORR, INC._Personal Services AgreementPERSONAL SERVICES AGREEMENT THIS AGREEMENT is made and entered into this `day ofJ5bkU 003, by and between the City of San Juan Capistrano (hereinafter referred to as the "City') and Dive/Corr, Inc. (hereinafter referred to as "Consultant"). RECITALS: WHEREAS, City desires to retain the services of Consultant regarding the City's proposal to provide Underwater Inspection of the Cook's Reservoir, located at 25702 Calle Ricardo, San Juan Capistrano, California. WHEREAS, Consultant is qualified by virtue of experience, training, education and expertise to accomplish such services. NOW, THEREFORE, City and Consultant mutually agree as follows: Section 1. Scope of Work. The scope of work to be performed by Consultant shall consist of those tasks as set forth in Exhibit "A," attached and incorporated herein by reference. Consultant warrants that all of its services shall be performed in a competent, professional and satisfactory manner and in accordance with the prevalent standards of its profession. Section 2. Term. This Agreement shall commence on the effective date of this Agreement and services required hereunder shall be completed by no later than 180 calendar days from the effective date of the agreement. Section 3. Compensation. 3.1 Amount. Total compensation for the scope of services for this Project shall not exceed One Thousand Five Hundred dollars ($1,500), as set forth in Exhibit "A," attached and incorporated herein by reference. 1 W/Eng/Misc/Cooks_overflow/Cooks dive Inspection PSA.doc W 3.2 Rate Schedule. The services shall be billed to the City at the hourly rate set forth in Exhibit "A," attached and incorporated herein by reference. Included within the compensation are all the Consultant's ordinary office and overhead expenses incurred by it, its agents and employees, including meetings with the City representatives and incidental costs to perform the stipulated services. Submittals shall be in accordance with Consultant's proposal. 3.3 Method of Payment. Consultant shall submit monthly invoices based on total services which have been satisfactorily completed and specifying a percentage of projected completion for approval by the City. The City will pay monthly progress payments based on approved invoices in accordance with this Section. For extra work not part of this Agreement, a written authorization from City is required prior to Consultant undertaking any extra work. 3.4 Records of Expenses. Consultant shall keep complete and accurate records of all costs and expenses incidental to services covered by this Agreement. These records will be made available at reasonable times to City. Section 4. Independent Contractor. It is agreed that Consultant shall act and be an independent contractor and not an agent or employee of City, and shall obtain no rights to any benefits which accrue to City's employees. Section 5. Limitations Upon Subcontracting and Assignment. The experience, knowledge, capability and reputation of Consultant, its principals and employees were a substantial inducement for City to enter into this Agreement. Consultant shall not contract with any other entity to perform the services required without written approval of the City. This Agreement may not be assigned, voluntarily or by operation of law, without the prior written approval of the City. If Consultant is permitted to subcontract any part of this Agreement by City, Consultant shall be responsible to City for the acts and omissions of its subcontractor as it is for persons directly employed. Nothing contained in this Agreement shall create any contractual relationships between any subcontractor and City. All persons engaged in the work will be considered employees of Consultant. City will deal directly with and will make all payments to Consultant. 2 W/Eng/isc/Cooks_OverflowlCooks give Inspection PSA.doc Section 6. Changes to Scope of Work. In the event of a change in the Scope of Work provided for in the contract documents as requested by the City, the Parties hereto shall execute an addendum to this Agreement setting forth with particularity all terms of the new agreement, including but not limited to any additional Consultant's fees. Section 7. Familiarity with Work and Construction Site. By executing this Agreement, Consultant warrants that: (`I) it has investigated the work to be performed; (2) it has investigated the proposed construction site, including the location of all utilities, and is aware of all conditions there; and (3) it understands the facilities, difficulties and restrictions of the work under this Agreement. Should Consultant discover any latent or unknown conditions materially differing from those inherent in the work or as represented by City, it shall immediately inform City of this and shall not proceed with further work under this Agreement until written instructions are received from the City. Section 8. Time of Essence. Time is of the essence in the performance of this Agreement. Section 9. Compliance with Law. Consultant shall comply with all applicable laws, ordinances, codes and regulations of federal, state and local government. Section 10. Conflicts of Interest. Consultant covenants that it presently has no interest and shall not acquire any interest, direct or indirect, which would conflict in any manner or degree with the performance of the services contemplated by this Agreement. No person raving such interest shall be employed by or associated with Consultant. Section 11. Copies of Work Product. At the completion of the contract period, Consultant shall have delivered to City at least one (1) copy of any final reports and architectural drawings containing Consultant's findings, conclusions, and recommendations with any support documentation. All reports submitted to the City shall be in reproducible format. All services to be rendered hereunder shall be subject to the direction and approval of the City. 3 W/Eng/Misc/Cooks_Ovorflow/Cooks Clive Inspection PSA.doc Section 12. 4wnershi of Documents. All reports, information, data and exhibits prepared or assembled by Consultant in connection with the performance of its services pursuant to this Agreement are confidential to the extent permitted by law, and Consultant agrees that they shall not be made available to any individual or organization without prior written consent of the City. All such reports, information, data, and exhibits shall be the property of the City and shall be delivered to the City upon demand without additional costs or expense to the City. The City acknowledges such documents are instruments of Consultant's professional services. Section 13. Indemnity. Consultant agrees to protect, defend and hold harmless City, its elected and appointed officials and employees from any and all claims, liabilities, expenses or damages of any nature, including attorneys' fees, for injury or death of any person or damage to property or interference with use of property and for errors and omissions committed by Consultant arising out of or in connection with the work, operation or activities of Consultant, its agents, employees and subcontractors in carrying out its obligations under this Agreement. Section 14. Insurance. Insurance required herein shall be provided by Admitted Insurers in good standing with the State of California and having a minimum Best's Guide Rating of A- Class VI I or better. 14.1 Comprehensive General Liability. Throughout the term of this Agreement, Consultant shall maintain in full force and effect Comprehensive General Liability coverage in the following minimum amounts: $500,000 property damage, $500,000 injury to one person/any one occurrence/not limited to contractual period; $1,000,000 injury to more than one person/any one occurrence/not limited to contractual period. 4 w/Eng/Misc/Cooks„„,overflow/Cooks Dive inspection PSA.doc 14.2 Comprehensive Automobile Liability. Throughout the term of this Agreement, Consultant shall maintain in full force and effect Comprehensive Automobile Liability coverage, including owned, hired and non - owned vehicles in the following minimum amounts: $500,000 property damage; $500,000 injury to one person/any one occurrence/not limited to contractual period; $1,000,000 injury to more than one person/any one occurrence/not limited to contractual period 14.3 Worker's Compensation. If Consultant intends to employ employees to perform services under this Agreement, Consultant shall obtain and maintain, during the term of this Agreement, Worker's Compensation Employer's Liability Insurance in the statutory amount as required by state law. 14.4 Proof of Insurance Requirements/Endorsement. Prior to beginning any work under this Agreement, Consultant shall submit the insurance certificates, including the deductible or self -retention amount, and an additional insured endorsement to the Consultant's general liability and umbrella liability policies to the City Clerk's office for certification that the insurance requirements of this Agreement have been satisfied. 14.5 Not Applicable 14.6 Notice of Cancellation/Termination of Insurance. The above policy/policies shall not terminate, nor shall they be cancelled, nor the coverages reduced, until after thirty (30) days' written notice is given to City, except that ten (10) days` notice shall be given if there is a cancellation due to failure to pay a premium. 5 WIEnglMisc/Cooks_overflow/Cooks Dive Inspection PSA.doc 14.7 Terms of Compensation. Consultant shall not receive any compensation until all insurance provisions have been satisfied. 14.5 Notice to Proceed. Consultant shall not proceed with any work under this Agreement until the City has issued a written "Notice to Proceed" verifying that Consultant has complied with all insurance requirements of this Agreement. Section 15. Termination. City and Consultant shall have the right to terminate this Agreement without cause by giving thirty (30) days' advance written notice of termination to the other party In addition, this Agreement may be terminated for cause by providing ten (10) days' notice to the other party of a material breach of contract. If the other party does not cure the breach of contract, then the agreement may be terminated subsequent to the ten (10) day cure period. Section 16. Notice. All notices shall be personally delivered or mailed to the below listed addresses, or to such other addresses as may be designated by written notice. These addresses shall be used for delivery of service of process: To City: City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Attn. Public Works Director To Consultant: Dive/Corr, Inc. P.O. Box 30427 Long Beach, CA 90853 Section 17. Attorneys' Fees. If any action at law or in equity is necessary to enforce or interpret the terms of this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees, costs and necessary disbursements in addition to any other relief to which he may be entitled. 6 WIEng/Misc/Cooks_Overflow/Cooks Dive Inspection PSA.doc Section 18. Dispute Resolution. In the event of a dispute arising between the parties regarding performance or interpretation of this Agreement, the dispute shall be resolved by binding arbitration under the auspices of the Judicial Arbitration and Mediation Service ("JAMS") Section 19. Entire Agreement. This Agreement constitutes the entire understanding and agreement between the parties and supersedes all previous negotiations between them pertaining to the subject matter thereof. IN WITNESS WHEREOF, the parties hereto have executed this Agreement. ITT OF A' /. -.. CONSULTANT By: ve1C r, Inc. ATTEST: Margaret R: Monahan, City Cleric APPROVED A,$ TO FORM: John R. Shpw, City Attorney 7 W/EnglMisc/Cooks_Overflow/Cooks Give Inspection PSA.doc TI TA h, City Manager 32400 PASEO ALDELANTO SAN JUAN CAPISTRANO CA 92575� IREERVLI!##Q £SELL#ISM#D (7�� MEMBERS OF THE CITY COUNCIL (949) 493-1171 (949) 493-1053 (FAX) 1776 DIANE LBATHGAiE • JOHN S. GELFF viviv.sanjuancapistrano.ori WYATT OESOHART JO£SO • � TD DAVID M. SWERDLIN February CITY MANAGER February 25, 2003 GEORGESCARBOROUGH Dive/Corr, Inc. PO Box 30427 Long Beach, CA 90853 Dear Sir or Madam: A Personal Services Agreement related to underwater inspection of the Cook's Reservoir is in the process of being executed and will be issued upon receipt of required documentation related to contract terms under Section 14. Insurance. Work may not begin under the agreement until the agreement is issued. Insurance evidence may be faxed to (949) 493-1053, followed by original signed documents. I have enclosed copies of pages 4 through 6 of the agreement for your reference in supplying this documentation. If you have questions specific to the contact, please contact the project manager, Peter Salgado, Associate Engineer (949) 443-6366. If you have questions regarding the forms of insurance needed, please contact Dawn Schanderl, Deputy City Clerk (949) 443-6310. Thank you, Meg onaha , CMC City rk (949) 44 - enclosure: as noted cc: Peter Salgado, Associate Engineer A y Amirani, Public Works Director awn Schanderl, Deputy City Clerk DRUG USE is San Juan Capistrano: Preserving the Past to Enhance the Future Section 12. OWners ip of Documents. All reports, information, data and exhibits prepared or assembled by Consultant in connection with the performance of its services pursuant to this Agreement are confidential to the extent permitted by law, and Consultant agrees that they shall not be made available to any individual or organization without prior written consent of the City. All such reports, information, data, and exhibits shall be the property of the City and shall be delivered to the City upon demand without additional costs or expense to the City. The City acknowledges such documents are instruments of Consultant's professional services. Section 13. indemnity_. Consultant agrees to protect, defend and hold harmless City, its elected and appointed officials and employees from any and all claims, liabilities, expenses or damages of any nature, including attorneys' fees, for injury or death of any person or damage to property or interference with use of property and for errors and omissions committed by Consultant arising out of or in connection with the work, operation or activities of Consultant, its agents, employees and subcontractors in carrying out its obligations under this Agreement. Section 14, Insurance. Insurance required herein shall be provided by Admitted Insurers in good standing with the State of California and having a minimum Best's Guide Rating of A- Class VII or better. 14.1 Comprehensive General Liability. Throughout the term of this Agreement, Consultant shall maintain in full force and effect Comprehensive General Liability coverage in the following minimum amounts: $500,000 property damage, $500,000 injury to one person/any one occurrence/not limited to contractual period; $1,000,000 injury to more than one person/any one occurrence/not limited to contractual period. 4 W/Eng/Misc/Cooks_Overflow/Cooks dive Inspection PSA.doc 14.2 Comprehensive Automobile Liability. �/ Throughout the term of this Agreement, Consultant shall maintain in full force and effect Comprehensive Automobile Liability coverage, including owned, hired and non - owned vehicles in the following minimum amounts: $500,000 property damage; $500,000 injury to one person/any one occurrence/not limited to contractual period; $1,000,000 injury to more than one person/any one occurrence/not limited to contractual period 14.3 Worker's Compensation. If Consultant intends to employ employees to perform services under this Agreement, Consultant shall obtain and maintain, during the term of this Agreement, Worker's Compensation Employer's Liability Insurance in the statutory amount as required by state law. 114.4 Proof of Insurance Requirements/Endorsement. Prior to beginning any work under this Agreement, Consultant shall submit the insurance certificates, including the deductible or self -retention amount, and an additional insured endorsement to the Consultant's general liability and umbrella liability policies to the City Clerk's office for certification that the insurance requirements of this Agreement have been satisfied. 14.5 Not Applicable 14.6 Notice of CancellationlTermination of Insurance. The above policy/policies shall not terminate, nor shall they be cancelled, nor the coverages reduced, until after thirty (30) days' written notice is given to City, except that ten (10) days' notice shall be given if there is a cancellation due to failure to pay a premium. 5 W/Eng/Misc/Cooks_overfiow/Cooks Dive Inspection PSA.doc 14.7 Terms of Compensation. Consultant shall not receive any compensation until all insurance provisions have been satisfied. 14.8 Notice to Proceed. Consultant shall not proceed with any work under this Agreement until the City has issued a written "Notice to Proceed" verifying that Consultant has complied with all insurance requirements of this Agreement. Section 15. Termination. City and Consultant shall have the right to terminate this Agreement without cause by giving thirty (30) days' advance written notice of termination to the other party In addition, this Agreement may be terminated for cause by providing ten (10) days' notice to the other party of a material breach of contract. If the other party does not cure the breach of contract, then the agreement may be terminated subsequent to the ten (10) day cure period. Section 16. Notice. All notices shall be personally delivered or mailed to the below listed addresses, or to such other addresses as may be designated by written notice. These addresses shall be used for delivery of service of process: To City: City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Attn: Public Works Director To Consultant: Dive/Corr, Inc. P.Q. Box 30427 Long Beach, CA 90853 Section 17. Attorneys' Fees. If any action at law or in equity is necessary to enforce or interpret the terms of this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees, costs and necessary disbursements in addition to any other relief to which he may be entitled. 6 MEnglMisc/Cooks_Overflow/Cooks hive Inspection PSA.doc NDIVE / CORR51 ■ Industrial Photography & Inspection Services P. O. BOX 30427 •LONG BEACH, CA 90853 . ©FF(CE (562) 434-8287 - FAX (562) 438-7151 CITY OF SAN JUAN CAPISTRANO DATE` 01/29/03 32400 PASEO ADELANTO JOB #: QUOTE SAIN JUAN CAPISTRANO, CA 92675 0310 ATTN: MR. PETER SALGADO PAGE 'I OF 1. QUOTE FOR THE UNDERWATER INSPECTION OF ONE 1) CONCRETE WATER STORAGE RESERVOIR RESERVOIR NAME: COOK PROPC? ED SCOPE OF WORK TO HE AS FOLLOWS 1} Fully examine the reservoir for signs of leakage; 2) Photograph with color video as needed; 3) Once leakage areas are identified, patch all Leak indications to identify if all suspect ,sites have been found; 4) Photograph with color video as needed; DIVE C0RR 1NC TO PROVIDE: 1) One primary diver* 2) One safety diver; 3) A decontamination procedure and 4) All diving equipment, diving to 5) Color video cameras and lights; 6) All film and NSF approved patch 7) All jobsite travel; 8) Office report time; 9 ) Experience in .over 2,500+ water materials; be performed with dry suits; supplies; tank inspections CITY OF SAN JUAN CAPISTRANO TO PROVIDE I) All keys necessary to access the site and the roof hatches; 2) High water levels at the time of inspection to allow a thorough leak evaluation. A total of I day is estimated to complete the field work The tank does not have to be removed from service during the inspection TOTAL PROJEC-T SINCERELY CTOR $1500 . 00 CITY CLERK'S DEPARTMENT - ACTION REMINDER f,t#V-, X'o Peter Salgado, Associate Engineer P M. Maria Guevara, Secretary f DATE: August ;2003 SITUATION: On February 28, 2003, the City of San Juan Capistrano entered into a Personal Services Agreement with Dive/Corr, Inc. to provide Underwater Inspection of the Cook's Reservoir, located at 25702 Calle Ricardo, San Juan Capistrano. ACTION REQUESTED: Said Agreement states services shall be completed by August 27, 2003. Please notify our office if agreement has been completed or will be extended. ACTION TO BE TAKEN: DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN: SIGNATURE OF OFFICIAL TAKING ACTION: DATE SIGNED: Tickler Date: 08/09/03 Deadline Date: 08/27/03 CC. Department Head (600.30/dlvecorr) ***FOR CITY CLERK'S DEPARTMENT USE ONLY"*` D� 11-24-2003 10:07AM FROM MARINERS"SAN13IECO 61922GS410 P1. 2 DATE A v • D-. CERTIFI K OFLIABILITY IN St7k ._ 1 7/14/2003 RROOf1C6R M3r3Tl�r'S General Insurance Group THIS CERTIFICATE IS ISSUI5V:AS'A MATTER OF INFORMATION San Diego, CA 92] 06 ONLY AND CONFERS NO RIGHTS UPON TH3= CERTIFICATE Su>ncoast General In,surAanca Agoncy, Inc. HOLDER, THIS CERTIFICATE DOES. NOT AMEND, EXTEND OR PO sox 31057, tagvna Hills, CA 92654 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1619? 226-a 551 INSURERS AFFORDING COVERAGE IN Ru RED _, -._...-.--..._T_.__.---._._...._.__,.,_.,,......._.— Diva/Cors Inc INSURER A' New Marine and #general •Yn....__.........._.._...._—_ ..._. _...,._..., aurah❑® pan Gross INSURER B: -- -- PO Sox 30427 INSURER G' ~ Long Boesch, CX 90853 1N9URER0: 1!NSURER E: CC)VFRAr.FS THF_ NCSI.ICIE'S OFA INISURANCF. LISTED AEi OW HAVE BEEN ISgLJEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTNIIT+#STANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH REVECT 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 COND3 TIONS OF SUCH POLICIES. AGGREGATE LIMITSSHOWN MAY HA B REDUCED BY PAID CLAIMS. 1N5i>,�-..-»..._......_...-.----- TYPE OF IN5URAItCB �oLEN .—.-....'ICY NUMBERry-� FgUCYEFFECI'IVE wOLICrE7Sl'E#tATIpN —.... LIMITS GE—NERM. i. RILOY 6AGH OCCUIZREMCE 1 2,000,000 A COM1MERCIALGENCRAL LIAD - 6/2003 7/16/2004 21383ML703 7/3 R� raArwu,G� ono We). S 50,000 CLAIMS MACE PCUR MEDEKPIAn nne oarWr)} > 5 000 1EnOINAL&ADV INJURY y2,000,000 cCNCRkL AGGREGRTE 2 , 000, 000 GGN L ,tGG4tE4J 1E_ L M T nPAL{ES F'ER. I PRODUCTS � CCMNOP AG € 2,000,000 AUTOM061L9 WA211.7y COMBINED SINGLE LIWT ..' ANY AUT0 � jEd aQCiden I ALL OWNED ALTOS f 90INLY INJURY $ } SCMEbULIrU AUiUw I {Pmfperw rt1 .. ] NiRED AUTOS 7 BOOILY INJURY $ NON-OWN60AVTos IPa mccidgni) �..._ _ ........---.----.- PROPERTY DAMAGE (Paracctpenti I � pAaAdE I.sAa141'fY AI)TOONLY- EA ACCIDENT S { ANY AUTO _ rJ'€hf:gt THAN _SA AGC S ( f a Aff'OC}NLY! AGG S • Y., € EXC•ES5 L4AeI �iTY EAC K OCCURREN�C S ' I OCCL)R CLAIMS MACS _ ] ACrfjRE;'iSTE S TION AN F?...I<.$, EY LOYERS' 0AMOry i E �. EAC ACCT 0 NT .,.L ,.._.., ... :... _.. , _,. [E [( E.L. DISEASE - 6A IrMPLOYE S . ., I i E.L. DISEASE • POLICY LIMB 5 DINER i I I OESCMPTION OFOPERATIOMSILOCATIONSNEHICLESIFX"USI®NS ADDED BY ENDORBEMRid7f8PEC+AI. PROVISIONS Certificate holder is hereby named as an additiOnal Lnsuxed as reSpeCtS the operations and act>jva,tiaa of, or on behalf of, the named i.nlIured 'parfqrmed under agreement wa-th the City of San .Tuan Capistrano L;eK4 F1UAI t MQLUV K / `. ADDMONAL lNSVR>ED; LN5VRER 4.ETTtfu I Ivan City of San Juan Capps t.rAno $HOULO ANY OF THE ABOVE DESCFt49;D POLICIES OF CA,NCFLLEo®FFORF n4rL 6KNRATSON City Clarks Office DATE -THEREOF, T14F 133VING I"SVRER WILL kN99AVAR TO MAILy30 DAYS WRITYEN j NOTICD TO THE CLRTPfCATE HOLDER NAMED TO THE LEFT, OUT FAILURE TO DD 50 3HAI_L 32400 Pisa@o j delanto - IM9039 NO QGOIZATIC9I OR LIAD1071' OF ANY MIND UPON THE INSURER, IIS AO£NT9 OR Sail .Tuan Capistrano, CA 92675 REPRESENTATIVES. I AUTkDRIjE9,?fE?RE5EN7f�fIVEIf —A P+P90l19F 0 r7lall1 `114/ r 11-24-2002 1 B: 0SAM FROM MAR I NERS"SAND IEGC 61922GG4 1 0 ENDORSEMENT # 31 Effective February 6, 2003, it is hereby understood and agreed that the following is incivded as an Additional Assured hereunder as respects operations of the Named Assured, as their interest may appear.- City ppear: City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA . Q2675 Attached to and forming part of policy number PMM0_.213B3ML702................... of the NEIN YORK MARINE AND GENERAL INSURANCE COMPANY ...................... ........issued to Date: February l 1.., 2003 AUTHORIZED REPRESENTATIVE �POL* 213,93ML702 Itacific Mufugi gring Office In R. 2 Aug -18-03 04:28P DIVE/TORR 5524?R7151. P.02 7-28-2003 9 : 01 AM M LIAR I (VERS " SAIL:) I EUU DA'I'S �ACOR CERTIFICATE OF LIABILITY 1N_, E,I 1/l4/2CQ3 PRODaCIR Mariner' m General Tn3arance Group THE$ C RTIF11GA !~ 13 1a5 ED AS A MATTER OF I[NRORMAMN „ San Di4go, EA 92105 ONLYA{ 0 CONFERS Iv RIGHTS UPONTHE CERTIFICATE Suneoast General lnsuranes Agmncy, Inc. HOLDER (� THIS`ERTIfIC T 6,VE ODES NOT AIt1ENtl, EXTEND OR V0 bon 31651, Laguna Hills, CA 92654 ALTER THE CRAGE A FORDED BY THE POLICIES BEI OW. (619)226-8661 )iIpUiRER5 AFFOROINGCOVERAGE INSVRFD Dive/Corr, Inc INSURER r. ! Yoc ,.Karina and GOT%oral Insurance Dan Gross PO Sox 30427 Long Beach, CA 90853�— Ih61.RF0.f; phut©n2cc _-.- ThE POLICIES OF INSURANCE LISTED a9LOW NAVE BEEN f3SUE0 To YKE INSURED NAMED 40OV6 00 7HE POLI PEFUOD iNDICATEO. NOTWlTISS'CANOtNG ANY REautiEMENf "IERM OR CONDITION OF ANY CONTRACT OR OTHER DOCLUENT WI* RESPO� TO WME 3 THIS CERTIF1CATE MAY BF ISSUED OR MAY PERTAIN, THE INSVIRANCF AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO A( HE TERMS EXCLUS€ONS AND CONDITIONS OF SUCH I POUCIMAGGREGATE LIMITS SHOWN MAYnAVEBEEN REDUOP-D9YPAIDCUUMS. 9 IwBAI TYP£OC INBVRAMCG >•OLICY NUMBER DATE IMMUN1191 I+GLKY 3�'�-'C POC+G�! PM4TIDN' i __LI41TS .:,. _$ O%c1�c�uC3i€RiEhnxy=a GEi ERA;L 42,000,000 0 A rOUMERZU^_GENE€AI.L-AEI�rh 22393M703 7/6/2043. 7/562004°tERCErO I ' CC I CU'-An8l�cfzrYaA s. 5,000 's2 000, v00 IOVAL 4 ACV INjQk - ( �tRAL.aiftEG�7E a 2,000,000M CENL&V'•.-WGATJ 01,#Y APPOt ,S PjWI 1 i POLICY ` "3. LSC I: _RCEkJC • CO�+'+b� a4G 0 2 • OQO,_A00 AVTOMOSI�E UAftITY iiI I r1NY AUTO.-- .- � '� NED s'lw'L� '-k Wr � t 3 ! [ �SCIFCLI@CAUTO5 001L-4 IN3URY i HAF0 AUTOS — l 1 LY NIU ( aawamY x g NON•OWNFA nt{llifi GARAGE LIASIL Y i ANI AVT1) I•'I a THER 1HAN (. ALTO CNLY: EiCE35 L";LITY_ .... rM CCCURRENCC _ ...cCv+F [OCCUA CIAIMS VAOE '. -,�:[' [ *! .. .._._ R57 hMON f ' S wC S.ATu i a7x• ; WORKER6 0C*PEMSATION AND ....�I 9MAL.OYEAV LIAaVTY , , i - € £ L. DISEASE, EA EVPeL e 3 E L OFSEASC PO"Y I.IWr . f OiNER OESCRiAfIpN OF PROVISO" E' Cartif3Ckkta holder iv heroby np'Nagd ae .an additional insy)�'rci ea(;'` redpe t.3 the operations and activitiab of, or on behalf of, the named insured "rfo�'-Id I]"r rag cementt, with the City of San Juan Capistrano --- CERTIFICATE HOLDER /N AMMIQKAL WSLIREa' pwau tiksETTeR GAHGtt.(J4 Ij L1M r: yy City of San Tuan Capi*traRo SHOULD ANY 60 TkG A410. 9 DESCRWI POLICIES HE CANCEIIED 89FOAE 1*t EXFIPAr'ON city clerks O£fiCa DA's TMERHQ►, TNG 0 €NSURSR WILL 2110EAVDA TO IAAx 30 PAvg WRiiTEN Ij �J M*M* 70 71i� CCP Tlalt�{ E NOLD0 AUEn ro Tua Lam. (&UT FAACURE TO 0a 30 3RALL 32400 ra*eP Adelan<.0 IMPOSE 90 OjSCK;A:w ' YK LIA4R+TY F ANY KNO UPON TNI (NSU0.EA, 7TS AASNT1 OR; Caa'1n Juan Capistrano, CA 92615 itEPRS,iBNT E9. .'I{ AVTHo W ESONT_ E el- AC6RQ 25-9 (7197) Q) ACORD CORPORATION 1988 32400 PASEo ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 (FAX) July 22, 2003 Dive/Corr, Inc. P.Q. Box 30427 Long Beach, California 90853 ° �ssRRusRlo 1776 • 1 R RiRRRM J S I MEMBERS OF THE CITY COUNCIL DANE L BATHGATE JOHN S. GELFF WYATT HART ° JGESOTO DAVID M. SWERDLIN C€TY MANAGER GEORGESCA@BOROUGH RE: Compliance with lnsurance„Requirements - Underwater Inspection of the Cook's Reservoir The following insurance documents have expired: General Liability Certificate 7/16/2003V V, , 11 General Liability Endorsement naming the City of San Juan Capistrano as additional insured. Please submit updated documentation to the City of San Juan Capistrano, attention City Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675 by August 1, 2003. If you have any questions, please contact me at (949) 443-6310. Sincerely, A&M avw Dawn Schanderl Deputy City Clerk cc: Peter Salgado, Associate Engineer Kathleen Springer, Management Analyst �s San Juan Capistrano: Preserving the Past to Enhance the Future �au� u�� 77 SG C DER COPY _, P.O. BOX 807, SAN FRAN.CISCO',CA 94142-0807 COMPENSATION INSURANCEFUND � r CERTIFICATE OF WORKERS' COIVIPENSATI0IIC INSURANCE ISSUE DATE: 04-01-2003 GROUP: POLICY NUMBER: 0802834-2003 CERTIFICATE ID: 420 CERTIFICATE EXPIRES: 44-01.-2004 04-01-2003/04-01-2004 CITV. OF SAN JOAN CAPISTRANO SG ATTN PETER SOLGADO 32100 PASEO ADELANTO SAN:JUAN CAP I STRANOCA 92675 This is to certify .that we have issued a valid Workers' Compensation insurance policy in a form approved by the Caiifgrroa insurance Commissioner Lu the empo.yer rrarrred 156101P] fol' the policy perinu. 00l.cated. This pahcy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer. We will also give you. 30 days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend: or alter the coverage afforded by the polities listed herein. Notwithstanding any `requirement, term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded: by the policies described Herein is subject to alt the terms, exclusions and conditions of such policies. AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,0W00 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04-01-2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER DIVE/CORK; INC PO. BOX 30427 LONG BEACR CA 90853 LEGAL NAME 8 02/?,0/2003 11:04 7149684963 EOWLER PAGE 02 CERTIFICATE OF INSURANCE STATE fAKM TIH sa th ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois ® STATE FAR'dl GENERAL INSURANCE COMPANY, Bloomington, Illinois inj urvs4v0dkwing policyholder for the coverages indicated below; " of policyholder Dan Groan DILA Qive/Corri Inc Address of policyholder 230 Syracuse Walk Long Beach CA 9080.3-50.31 Location of operations Description of operations The policies listed below have been issued to the policyholder For the policy periods shown. The insurance described in these policies is A d't` f fl, ,& ollcies The limits of liability shown mav have been reduced b any Paid claims, subject to all the terms exclusions an can I ions o 0 PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCEPOLICY Effaetive Date Ex iration Hate at beoinning of p2lig eftd Comprehensive BODILY INJURY AND Business Liability PROPERTY DAMAGE This insurance includes; ❑ Products - Completed Operations ❑ Contractual Llability ❑ Underground Hazard Coverage Each Occurrence $ ❑ Personal Injury ❑ Advertising Injury General Aggregate $ ❑ Explosion Hazard Coverage Products - Completed ❑ Collapse Hazard Coverage Operations Aggregate $ ❑ General Aggregate Limit applies to each project El ❑ POLICY PERIODBoI�ILY INJURY ANDPROPERTY DAMAGE EXCESS LIABILITY Effective nate Expiration Date (Combined Single Limit) 75 R4 2045 4 [Z Umbrella Each Occurrence $ ❑Other 03./04/03 01/04/04 Ag9rargate $ 1000 000, Part 1 STATUTORY Part 2 BODILY INJURY Workers' Com pen saFon and Employers Liability Each Accident $ Disease Each Employee $ m (disease - P91ic Limit $ POLICY PERIODT LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date Exiraiion Da tat beginning of policy period) 166-49.78-75G 1998 Dodge van 02/07./02 08/01 03 100/300 Name and Address of Certificate Holder CITY OF SAN JUAN CAPISTRANO ATTN:PETER SOLGADO 32400 PASEO AILANTO SAN JUAN CAPTSRTRANO,CA 92675 if any of the desCribed policies aro Canceled before its expiration date, State Farrn will try to mail a written notice to the certificate holder 3 0 days before cancellation. If, however, we fail to mail such notice, no obligation or liability will be Imposed on State Farm or its agents or representatives. signature of Authorized Representative Title 558-884 a 2-8r3 Pr[Mad In U. &A. Dato COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLCY PERIOD INDICATED. NOTWITHSTANDING THE POLICIES OF INSURANCE 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 S AGGREGATE LIMITS SHOWNN MAY MAY HAVE BEEN REDUCED BY PAID CLAIMS �.�__ - POLICY EFFECTIVE IPOLICY EXPIRATION LIMITS 'NSRT TYPE OF INSURANCE I POLICY NUMBER !. DAT M IDDI D T MIDDI 2, 000 000 GENE RAL LIABILITY AICOMh�±cRCiA!_CNEr'2t.L-1:,flILi;Y-351'ff.'71;2 ,. EACH OCCURRENCE e ..W....,.._ ___ - _-I 7/16,!20E�2 [ 7/6/2(iOS LFIREDANW.GErAr3yo�eEire) g .70,000 .-"--_-- CLAIMS MADE OCCUR _.......... ... MED EXP [Any one person)— 5- ... 000 I ---I 'I 2,000000 ! PERSONAL &ADV INJURY .[, 5 GENFRALAC�REGATE x2,000,000-'- --_. 2 , 000 j I PRODUCTS-COMPlOP AGG 5 000 CEN'LAGGREGATE L; MITAPPLIE5 PER: i- E Pf20- POLICY LOC AUTOMOBILE LIABILITY i -, ... .. ',, OW-B,NED SINGLE LIMET I $ _.. .... ' Ea ecc[deni} ANY AUTO..... Ai L OWNED-ALITCS - - - 900ILY INJURY - - $ (Per Person) SCHEDULEDAUTOS ! H(RED AUTOS F' INJJRY�,B�ODILY NCN-OVVNFD AUTOS ccident) .,.:._.---_ .._._....{ PROPERTY DAMAGE S III accident] - 3• AUTO ONLY - EA ACCIDENT _ 5 `I i GARAGE LIABILITY EA ACC 5 ANY AUTOOTHIER THAN AUTO ONLY: AGG S LITY 3 ��SS I EACH OCCi1RRENCE 5 I AGGREGATE x OCCUR ( CLAIMS MADE _ .- -- i DEDUCTIBLE 1 RETENTION 5 5 ' I WORKERS COMPENSATION AND ' - WC STATE- I GTI+ ;—.L!Qky LIMITS_ I_, > ER �_ ......._... , EMPLOYERS' L€ABILITY E.L. EACH ACCIDENT a I � E DISEASE - EA EMP:,OVErj S E.L. DISEASE - PO ICY LI MIT S OTHER I I I 7 i DESCRIPTION OF OPERATION SILOCATION SIv5H ICLESIEXC L U SION 3 ADDED BY ENDORSEMENTISPECIAL PROVISIONS 3 Certificate is issued as proof of insurance as it pertains tothe business operations [of the named insured I I CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION Cit of San Juan Capistrano SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION . DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MA€L3-0 DAYS VlR€TTEN I Peter Soigado I NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL I 32400 Paseo Adea.anto IMPOSE NO DELIGATION OR LIABILITY OF ANY KIND 'UPON THE INSURER, ITS AGENTS OF San Juan Capistrano, CA 92675 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE/ - ACORD 25 S {7f97} ............. A© ACORD CORPORATION 1988 02/08/2003 11:08 FAX STATE COMP INSURANCE L6001/001 SMATE P.Q. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION INSUFtANICE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE FEBRUARY 10, 2003 0602034 - 02 Pt3L[CY NUMBER! 4-1-03 CERTIFICATE EXPIRES: CITY OF SAN JUAN CAPISTRANO ATTN PETER SOLOADO 32400 PASEO ADELANTO SAN JUAN CAPISTRANG CA 92675 L This is to certify that we have issued a valid Workers' Compensation insurance poi(cy in a form approved by the California _ insurance Commissioner to the employer named below for the pot y {period indicated_ This policy is not subject to cancellation by the Fund except upon ft days' advance written notice to the employer. 30 We will also give you AkN days' advance notice shouid this poiicy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance poiicy and does not amend, extend or alter the coverage afforded by the policies listed herein': Notwithstanding any requirement, term, or condition of any contract or Esther document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the idescribed herein is subject to all the terms, exclusions and conditions of such policies. AUTHORIZED REPRES NTATWE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT 42065 ENTITLED CERTIFICATE H€ILDERS'NOTICE EFFECTIVE 04/01/02 I5 ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER r-- DIVE/CORR INC P 0 BOX 30427 LOO BEACH CA 94853 L sCiF7C32621REV.5A1j . 2-26-2003 S:29AM FROM MARINERS"SANDIEGO 6192266410 ��W ENDORSEMENT # 31 Effective February 6, 2003, it is hereby understood and agreed that the following is included as on Additional /fissured hereunder as respects operations of the Named Assured, as their interest may appear; City of Son .duan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA, 92675 ,ALL OTHER TERMS AND CONDITIONS REMAINING UNCHANGED. Attached to and forming part of policy number PMMO,..21383ML702................... of the NEW YORK MARINE AND GENERAL INSURANCE COMPANY...............................issued to DAN GROSS dba: DIVE/CORR, INC. — ................................................................... Date: February 11, 2003 /l�le�—w-i AUTHORIZED REPRESENTATIVE POL— 21383ML702 1 1 Pacific Mutual Marine Office, Inc. Dive/Corr, Inc. PO Box 30427 Long Beach, CA 90853 Dear Sir or Madam: A Persona[ Services Agreement related to underwater inspection of the Cook's Reservoir is in the process of being executed and will be issued upon receipt of required documentation related to contract terms under Section 14. Insurance. Work may not begin under the agreement until the agreement is issued. Insurance evidence may be faxed to (949) 493-1053, followed by original signed documents. I have enclosed copies of pages 4 through 6 of the agreement for your reference in supplying this documentation. If you have questions specific to the contact, please contact the project manager, Peter Salgado, Associate Engineer (949) 443-6366. If you have questions regarding the forms of insurance needed, please contact Dawn Schanderl, Deputy City Clerk (949) 443-6310. Thank you, Meg onaha , CMC City Chtvrk (949) 44 - enclosure: as noted cc: Peter Salgado, Associate Engineer Amy Amirani, Public Works Director Dawn Schanderl, Deputy City Clerk �rt+uG uss Is San Juan Capistrano: Preserving the Past to Enhance the Future 32400 PASEO ADELANTO IMRRIR11R7ER SAN JUAN CAPISTRANO, CA 92675 � � ES1RRLiiLER ��5� MEMBERS OF THE CITY COUNCIL (949) 493-1171 DIANE L BATHGATE (949} 493-1053 (FAX)1776 • Y JOHN S. GELFF vviviv. sanjuancapisirano. org WYATT HART • " JOESOTO DAVID M. SWERDLIN February 25, 2003 CITYMANAGERORGESCARBOROUGH Dive/Corr, Inc. PO Box 30427 Long Beach, CA 90853 Dear Sir or Madam: A Persona[ Services Agreement related to underwater inspection of the Cook's Reservoir is in the process of being executed and will be issued upon receipt of required documentation related to contract terms under Section 14. Insurance. Work may not begin under the agreement until the agreement is issued. Insurance evidence may be faxed to (949) 493-1053, followed by original signed documents. I have enclosed copies of pages 4 through 6 of the agreement for your reference in supplying this documentation. If you have questions specific to the contact, please contact the project manager, Peter Salgado, Associate Engineer (949) 443-6366. If you have questions regarding the forms of insurance needed, please contact Dawn Schanderl, Deputy City Clerk (949) 443-6310. Thank you, Meg onaha , CMC City Chtvrk (949) 44 - enclosure: as noted cc: Peter Salgado, Associate Engineer Amy Amirani, Public Works Director Dawn Schanderl, Deputy City Clerk �rt+uG uss Is San Juan Capistrano: Preserving the Past to Enhance the Future