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11-0215_OPEN SPACE FOUNDATION, SJC_SIte Access License
SITE ACCESS LICENSE This Site Access License ("License") is granted as of the 15�hday of February, 2011 to the San Juan Capistrano Open Space Foundation ("Licensee") by the City of San Juan Capistrano, a municipal corporation ("Owner"). Whereas, Licensee proposes to provide volunteer services to the Owner for the benefit of the community on Owner's property located at the Northwest Open Space, Phase 2 area as depicted on plans approved by the City and at 2C Ranch as depicted on plans approved by the City (the "Property") consisting of constructing trail-related improvements consistent with a City-issued building permit. Whereas, City supports the community services provided by Licensee. NOW, THEREFORE, in exchange for Licensee's promises stated herein, the Owner grants this License subject to the following terms and conditions: 1. Grant of License. The Owner hereby grants to Licensee, its contractors, and their employees, volunteers and agents, a non-exclusive revocable temporary license and permission to enter upon the Property for the purpose stated above. Except as specifically set forth in this Section 1, Licensee shall not use or enter upon any portion of the Property for any other purpose without the prior written consent of the Owner. Licensee's use of the Property pursuant to the license granted herein shall not interfere with the Owner's use of the Property. 2. Condition of Premises. Licensee understands and acknowledges that Licensee (a) has inspected the Property and accepts to enter upon the Property in its "AS IS" condition with full knowledge of the physical condition thereof, (b) the Property may contain hazardous conditions which may present danger and/or risks to the persons and property, and (c) Owner, its officials, employees, representatives and agents, have not made representation or warranty, express or implied, as to the condition of the Property, the suitability of the Property for any purpose. 3. Insurance. Licensee shall, at its sole cost and expense, procure and maintain in effect throughout the term of this License, maintain in full force and effect Comprehensive General Liability coverage in an amount not less than one million dollars per occurrence ($1,000,000.00), combined single limit coverage for risks associated with the access and activities contemplated by this License. If a Commercial General Liability Insurance form or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to the work to be performed under this License or the general aggregate limit shall be at least twice the required occurrence limit. Prior to accessing the Property under this License, Licensee shall submit the insurance certificates, including the deductible or self-retention amount, and an additional insured endorsement naming City, its officers, employees, agents, and volunteers as additional insureds as respects each of the following: Liability arising out of activities performed by or on behalf of Licensee, including the insured's general supervision of Licensee; 1 751034.1 products and completed operations of Licensee; or automobiles owned, leased, hired, or borrowed by Licensee. The coverage shall contain no special limitations on the scope of protection afforded City, its officers, employees, or agents. 4. Indemnification, Licensee shall indemnify, defend (with counsel acceptable to Owner), protect and hold harmless Owner and its directors, officers, employees, shareholders, members, partners, lenders, agents, representatives, contractors and each of their respective successors and assigns and Owner's affiliates and members (collectively, "Owner's Parties") from and against any and all claims, demands, judgments, actions, damages, losses, penalties, liabilities, costs and expenses (including, without limitation, attorneys' fees and court costs), whether based on personal injury, property damage, negligence, nuisance, trespass, or pollution, arising at any time during or after the Term as a result (directly or indirectly) of or in connection with Licensee's access or use of Owner's Property pursuant to this License, or the conduct of Licensee's activity, work or things done, permitted or suffered by Licensee in or about Owner's Property pursuant to this License, except to the extent caused by Owner's negligence or willful misconduct. The obligations of Licensee under this Section 4 shall survive the expiration or earlier termination of this License. 5. Termination. Notwithstanding the provisions of Section 1, above, this License may be terminated by Owner "at will" and for no cause. No termination hereof shall release Licensee or its respective successors or assigns from any liability or obligation hereunder, whether of indemnity or otherwise, resulting from any acts, omissions, or events occurring prior to the effective date of such termination. 6. Surrender. Upon expiration or earlier termination of this License, Licensee shall remove all Licensee's personal property. Except for the improvements or work identified in this License, Licensee shall clean, repair and restore Owner's Property to the same condition as existed prior to Licensee's entry thereon. 7. Term. This License shall expire on October 15, 2011. San Juan Capistrano Open Space Foundation By:--= � � Print name: 8lzlro r, T;t�x Title: Pz6st,l r r APPROVED BY: City of San Juan Capistrano By: Joe Tait City Manager APPROVED AS ow' 'o !1FORM751034.1 KJ, 2 Christy Jakl From: Christy Jakl Sent: Thursday, February 24, 20119:03 AM To: 'bgates@cox.net' Cc: Bill Ramsey; Ayako Rauterkus Subject: RE: Open Space Foundation Site Access License Good Morning, A fully signed original copy of the License Access Agreement is available for you to pick up. Please be aware as part of the agreement, a General Liability Certificate needs to be filed with our office with a minimum coverage of $1,000,000. Please let me know if you have any questions. Kindest Regards, Christi Jakl Deputy City Clerk City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 (949) 443-6310 1 (949) 493-1053 fax From: Ayako Rauterkus Sent: Wednesday, February 23, 2011 10:40 AM To: 'bgates@cox.net' Cc: Bill Ramsey; Christy Jakl Subject: Open Space Foundation Site Access License Mr. Gates: Attached please find the site access license for the North West Open Space that was approved at the City Council meeting on 2/15. Please print out 2 copies and sign/or have an authorized party sign on both copies in blue ink, send them back directly to my attention. If you would like to come in and sign here at the City Hall, please let me know so I can prepare the documents for the signatures. Should you have any questions, please contact me. Thank you, Ayako Rauterkus Development Services Ph: 949.443.6325 Fx: 949.202.5469 arauterkus@sanjuancapistrano.org From: Christy Jakl Sent: Tuesday, February 22, 20115:27 PM To: 'bgates@cox.net' 1 Cc: Bill Ramsey; Ayako Rauterkus Subject: Open Space Foundation Access License Agreement Good Evening Mr. Gates, I'm working with the project manager Bill Ramsey, Principal Planner to have the Open Space Foundation's Access License Agreement executed as soon as possible. Please let me know if you have any questions or concerns. Have a nice evening! Christi Jakl Deputy City Clerk City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 (949) 443-6310 1 (949) 493-1053 fax 2 *q0 _30 1700. l v�7 USz)•`�� 2/15/2011 AGENDA REPORT G3a TO: Joe Tait, City Manage FROM: Grant Taylor, Development Services Director SUBJECT: Consideration of Approval of Preliminary Improvement Plans, Funding of Waterline Improvements to 2C Ranch, Granting a Permit Fee Waiver and Approving a Site Access License for the San Juan Capistrano Open Space Foundation's Construction of Trail-Related Improvements on a Portion of the 2C Ranch Property and Trail Staging Area Improvements on the Northwest Open Space. RECOMMENDATION: By motion: that City Council: • approve the Open Space Foundation's preliminary improvement plans for interim trail-related improvements on a portion of the 2C Ranch and the Northwest Open Space; and, • approve funding of waterline improvements to 2C Ranch not to exceed a maximum of$25,500; and, • grant a Permit Fee Waiver to the Open Space Foundation for the processing of any required grading and building permits related to the proposed interim trail improvements; and, • grant a Site Access License to Open Space Foundation to allow access to construct proposed improvements. SITUATION Last Fall, City Council considered proposed conceptual plans submitted by the Open Space Foundation for the construction of trail-related improvements to the southern portion of the 2C Ranch and to the Northwest Open Space (see Attachment 1, Open Space Foundation Conceptual Plans). The Foundation's objective is to improve public accessibility to the City's open space lands through these improvements. The Foundation is now prepared to move forward with the proposed projects and requires City Council action on the improvement plans, a permit fee waiver, a site access license, and City funding of 2C Ranch waterline improvements. Staff recommends that City Council approve the Open Space Foundation's preliminary improvement plans for interim trail-related improvements on a portion of the 2C Ranch and the Northwest Open Space; grant a Permit Fee Waiver to the Open Space Foundation for the processing of any required grading and building permits related to the proposed interim trail improvements; and grant a Site Access License to Open Space Foundation to allow access to construct proposed improvements. Agenda Report • • Page 2 February 15, 2011 BACKGROUND At the October 19, 2010 meeting, City Council considered proposed conceptual site plans and improvement plans submitted by the San Juan Capistrano Open Space Foundation to construct interim trail-related improvements on the southern portion of the 2C Ranch Property and a multi-use trail staging area on the Northwest Open Space Phase 2 Area (see Attachment 2, City Council October 19, 2010 Minutes). At that time, the Foundation requested that the City pay the cost of waterline improvements to the 2C Ranch property. City Council continued consideration of the proposal, referred the conceptual project plans to the former Park, Recreation & Equestrian Commission for review and recommendation, and requested staff to prepare cost estimates for the 2C Ranch waterline improvement. The Parks Commission review and favorably commented on the Foundation's proposed improvements at their November 15, 2010 meeting (see Attachment 3, Park, Recreation & Equestrian Commission November 15, 2010 Minutes). STAFF ANALYSIS The proposed conceptual improvement plans have been reviewed by staff and the Park, Recreation & Equestrian Commission. Staff found that the proposed interim improvements to 2C Ranch would be substantially consistent with the City Council's prior designation of that property as appropriate for equestrian-related use. Also, the accessory nature of the Foundation's proposed improvements would not conflict with the design of future potential equestrian improvements including a potential multi-use trail staging area. Similarly, the proposed multi-use trail staging area for the Northwest Open Space, Phase 2 planning area would be situated within an area that has been tentatively designated for equestrian use and can be designed and constructed so as to be integrated into the future Phase 2 master plan design. Utilities Department has determined that the proposed 2C Ranch watering trough and hose bib could be adequately supplied by a 2-inch, schedule-80, polyvinyl chloride (PVC) waterline. Trenching would be accomplished using a "Ditch Witch" or similar type of mechanical trenching equipment. Based on two potential alignments from the existing High West side reservoirs to the project site, Utilities Department estimates 1,700 linear feet (LF) of pipe would be needed with a total cost of $25,500 including pressure reducer (if needed), risers, connections, etc. The Foundation has requested a permit fee waiver for required building permits related to the proposed improvements. A building permit will be required for all fencing, gates, waterline improvements and galvanized pipe hitching posts. Staff estimates the cost/value of the proposed improvements to the Northwest Open Space at approximately $7,650 and to the 2C Ranch at about $30,650, including waterline improvements. The total cost of permit fees for these improvements is estimated to be $2,681. Because the Open Space Foundation is a 501(c)(3) non-profit organization and the proposal consists of constructing improvements to City open space for the benefit of i - � < a. -x,* Horse watering trough (Diamond Match Co. replica)with hose bib. t Three (3) picnic benches (general location) Hitching post (30 feet length (3-inch galvanized pipe). Y� i p Memorial to 2C x�,„;; Ranch site. � 7 Proposed potable waterline extension improvements (by City) CA pr e M R 2C Ranch City of San Juan Capistrano Proposed improvements by the Open Space Foundation scale: V=60 feet Page 1 ATTACHMENT 1 R e x w � .y 9 i '4d•h-;.k a.� gI '..4 lk It r • r t �.r. t� ;4rEY•Y. } C 5 `s " T�� ' n , E7 -,A L s. J, A (D lap - lu� ll;/77--"Z CONSTRUCTION PLAN & DETAILS • "TONY FORSTER MEMORIAL" LOW ENTRY PILASTERS SC HISTORICAL SOC I M SAN XAN CMISIRAM CAlJl0RN1A • G2. DEVELOPMENT SERVICES a. DISCUSSION OF PROPOSALS BY THE OPEN SPACE FOUNDATION TO CONSTRUCT TRAIL-RELATED IMPROVEMENTS ON A PORTION OF THE 2C RANCH PROPERTY AND CONSTRUCT A MULTI-USE STAGING AREA ON THE NORTHWEST OPEN SPACE (700.10) Council Member Nielsen recused himself due to sitting in the Open Space Foundation Board. William Ramsey, Principal Planner, provided a staff report and responded to questions. Public Comments: • Brad Gates, Open Space Foundation, provided information related to their proposed improvements, and asked that the City install the water supply line and provide water for the horse trough; and responded questions from the City Council. Mayor Uso, asked the possibility of allowing an interested Boy Scout to install the water trough, as an eagle scout project. • Diane Carter, American Horse Products owner, spoke regarding the importance of a staging area, and having adequate room for different size trailers to turn and park. • Gail Zukow, Parks, Recreation and Equestrian Commission; requested that the item be presented to the Parks, Recreation and Equestrian Commission. • Adam Maywhort, City resident, spoke regarding importance to consider adequate space for the staging area during the designing process, and have with proper signage that restricts certain area for equestrian parking. • Renee Ritchie, Open Space Committee Member, stated that a lot of time was spent in researching the staging area. Council Comments: • Felt that the City should look into making improvements in their open space in order for the public to enjoy; and partner with private organizations in hopes of receiving funding opportunities. • Felt that the project is fantastic, but preference in having the City's cost before making a final decision. • Need to be clear that the staging area will have a separate horse trailers area from single vehicles (general purpose); supported the item going to the Parks, Recreation & Equestrian Commission for their input. • Council Direction to forward the item to the Parks, Recreation and Equestrian Commission for their review, and bring it back to the City Council with the costs of extending an existing potable waterline to the location of the proposed watering trough. 10 10/19/2010 ATTACHMENT • Parks, Recreation, and Equestrian Commission Minutes November 15, 2010 Page 2 ADMINISTRATIVE ITEMS 1. CONSIDERATION OF PROPOSALS BY THE OPEN SPACE FOUNDATION TO CONSTRUCT TRAIL RELATED IMPROVEMENTS ON A PORTION OF THE 2C RANCH PROPERTY AND CONSTRUCT A MULTI-USE TRAIL STAGING AREA ON THE NORTHWEST OPEN SPACE Bill Ramsey, Principal Planner, Development Services, presented a brief synopsis of the report, and introduced Mr. Tom Ostensen, member of the Open Space Committee, Open Space Foundation and Historical Society. Mr. Ostensen explained that the City Council sent this item back to the Commission for their consideration. He explained the background of the report. The foundation is proposing to install: • horse watering trough • 3 picnic benches • 3" galvanized pipe hitching post • river rock-faced monument with bronze plaque Vice Chairperson Hart inquired about a water line extension. Mr. Ostensen does not see it being a big expense, but it does need to be handled by Development Services. Commissioner Hanna likes the concept very much and hopes the City agrees to it. Commissioner Byrnes was concerned about the railroad; Mr. Ostensen assured her there is not affected by the site. Chairperson Zukow asked about Department of Fish and Game and Mr. Ostensen said staff is in discussion with them; however, it has been curtailed by other processes. Chairperson Zukow asked about an easement and getting access through Alipaz. Mr. Ramsey replied that staff's position is that occasional access is preferred, but public access could be problematic. Chairperson Zukow asked about the trough and Mr. Ostensen assured her the design has a plug, float mechanism, vandal proof cover and the 4H Rangers will do monthly maintenance. Mr. Ostensen oriented the Commission regarding the proposed construction area at the lower level of the Northwest Open Space for a multi-use trail staging area. This project will include: • ASAP to open/close gates to area to whatever hours the City deems appropriate; or perhaps the Sheriffs Department • fencing to prohibit off road vehicles (City) • use the existing road (may need City to enhance road) • installed signage (City) • multi-use parking (City) • water trough (working well site) (Foundation) • hitching posts(Foundation) Chairperson Zukow asked if this is temporary. Mr. Ostensen explained this plan is an interim solution to use this Open Space in the near future. Mr. Ramsey added that Proposition 84 was not granted to the City, and explained the plans the City proposed Page 1 ATTACHMENT 3 Parks, Recreation, and Equestrian Commission Minutes November 15, 2010 Page 3 for Open Space are still viable by pursuing other avenues of funding. Commissioner Hanna commented that this land has been left fallow for so long, she is very enthusiastic about this plan; however, she would suggest 2 acres set aside for a staging area is not enough and does not leave enough room for expansion. Commissioner Byrnes believes it should be a community project and brought together by community volunteers. The Commission gives full support to this project. 2. STATUS UPDATE REGARDING THE FORTHCOMING PLAYGROUND EQUIPMENT FOR THE KINDERGARTEN READINESS PROGRAM AT THE LACOUAGUE BUILDING AT THE OLD FIRE STATION COMPLEX Steven A. Apple, Deputy City Manager, explained the report and added that the parents of participants of the recently relocated Kindergarten Readiness program have requested a playground to compliment the program. The report has identified two zones as potential playground areas and that this is the purpose of the item to receive feedback regarding the preferred area. Vice Chairperson Hart suggested the audience members are given the opportunity for comments/questions. Jennifer Pointer, 31442 La Matanza, San Juan Capistrano, stated that she preferred Area 1 and requested that the playground be open to the public, not just Kindergarten Readiness. Andrea Ewell, 23 Via Conocido, San Clemente, inquired as to the timeline of putting in the playground and chooses Area 1. Debi Kellermann, 31452 Paseo Caliz, prefers Area 1 and concurs there is too much traffic and children in Area 2. Ms. Kellermann also stated that not having a playground is a deterrent to potential participants. Amanda Earnest, 37 Calle Akelia, San Clemente, agrees that Area 1 is clearly safer and more convenient for students. She wants to expedite the building of the playground. Susan Waiter, Recreation Coordinator and coordinator for the Kindergarten Readiness program, commented that she believes the new facility works better; however, the lack of the playground is a impairment to the program. Commissioner Hanna feels that Area 1 is the best choice, except for relocation of the ADA parking. Steven A. Apple, Deputy City Manager, explained there may be an opportunity to return some additional parking in another area. Cynthia Alexander, Community Services Manager, explained that there are no longer renters using the Lacouague Building, all previous renters have been transferred to the Nydegger Building, and so the Kindergarten Readiness program is the only occupant of the Lacouague Building. Commissioner Byrnes inquired if Area 1 takes up the whole parking lot. Steven A. Apple, Deputy City Manager, stated the area is approximately 1800 sq. ft. Vice Chairperson Hart Inquired about the design regarding parking spaces, ADA consideration, what funding is available and construction costs. Mr. Apple stated that the parking situation is to be decided at a later date and that the cost for the playground is estimated at $42,000. Cynthia Alexander, Community Services Manager, reported that the funds to be used for the playground were designated originally from the Park Fund for upgrades for playground equipment. Vice Chairperson Hart and Matt Gaffney (American Legion) met at the site of the Old Page 2 32400 PAS@O AOE'LANTO MEMBERS OF THE CnY COUNCIL SAN JUAN CAPISTRANO,CA 92675 SAM ALLEVATO (949)4931171 ,; KIK011111 LAURAFREESE (949)48,3-1053 FAX t (SIUMN(i THOM"W.HRISAR www,.4anyuanca1*11'ano.otX 1776 MMM NIELSEN • • UR LOIOREs USO NOTIFICATION OF MEETING OF POTENTIAL INTEREST OF THE SAN JUAN CAPISTRANO CITY COUNCIL The City Council of San Juan Capistrano will meet at 6:00 p.m. on Tuesday, February 15, 2011, in the City Council Chamber in City Hall, to consider; "Consideration of Approval of Preliminary Improvement Plans, Funding of Waterline Improvements to 2C Ranch, Granting a Permit Fee Waiver and Approving a Site Access License for the San Juan Capistrano Open Space Foundation's Construction of Trail Related Improvements on a Portion of the 2C Ranch Property and Trail Staging Area Improvements on the Northwest Open Space" — Item No. G3a. If you have specific thoughts or concerns regarding this item, you are encouraged to participate in this decision making process. You can communicate with the City Council through correspondence addressed to the Council and/or by attending the meeting and speaking to the Council during the public meeting. Correspondence related to this item must be received at the City Clerk's office by 5:00 p.m. on Monday, February 14, 2011, to allow time for the Council to consider its content. If you would like to speak at the meeting, please complete a yellow "Request to Speak" form found inside the entrance to the Council Chamber. This form is turned in at the staff table, just in front of the Council dais. You will be called to speak by the Mayor when the item is considered. You have received this notice at the request of the City staff member William A. Ramsey, AICP, Principal Planner. You may contact that staff member at (949) 443-6334 with any questions. The agenda, including agenda reports, is available to you on our web site: www.sanivancapistrano.org. If you would like to subscribe to receive a notice when agendas are posted to the web site, please make that request by sending an e-mail to: cityclerk aC)sanivancapistrano.or4. Maria Morris, CMC City Clerk cc: Tom Ostensen; Brad Gates San Juan Capistrano: Preserving the Past to Enhance the Futuro a►coRv' CERTIFIATE OF LIABILITY INSU&CE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOE$,NOT,CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HQLD�H. - IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policiesmay require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MATT GAFFNEY _ _ NAME: _ MATT GAFFNEY INSURANCE PHAAjONE a—: 949-493-4407 ac No: 949-368-6248 32302 CAMINO CAPISTRANO E-MAIL __ - -- - -L-- - .. aooREss SUITE 212 NAZC SAN JUAN CAPISTRANO CA 92675 INSURERIS)AFFORDING COVERAGE A INSURER A.PENN STAR _INSURANCE COMPANY_ INSURED INSURERB SAN JUAN CAPISTRANO OPEN SPACE FOUNDATION INSURERC: INSURER D: 31601 AVENIDA LOS CERRITOS #250 INSURER E: SAN JUAN CAPISTRANO CA 92675 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSRTYPE OF INSURANCE L �-POLICY EFF POLICY EXP -i LTR POLICY NUMBER (MMID0/YYYY1 UNWDLIMITS GENERAL LIABILITY EACHOCCURRENCE E 1,000,000 CPS5034112 03/07/2011 03/07/2012-DAMA R N E COMMERCIAL GENERAL LIABILITY REMISES(Ea occurrence PE lOO,000 CLAIMS-MADE OCCUR IttI MED EXP(Any one person) E 5'000 A ( PERSONAL B ADV INJURY 1,0001000 GENERAL AGGREGATE S _ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: _PRODUCTS-COMPIOPAGG2.000,000 JECT POLICY II— r PRO LOC . AUTOMOBILE LIABILITY r COMBINED SINGLE LIMIT Ea accident _ $ ANY AUTO BODILY INJURY(Per Person) E ALL ONMED SCHEDULED AUTOS _ AUTOS BODILY INJURY(Per..den[) $ NON OMED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) E UMBRELLA LIAR OCCUR EACH OCCURRENCE $ _ CE33 LMB_ -iLAIMS-MADE AGGREGATE _ E-_ - DEO RETENTIONS $ WORKERS COMPENSATION V,C STATU- OTH- AND EMPLOYERS'LIABILITY YIN _ER_'— MyPROPRIETORIPARTNER/EXECUTIVE Ein NH) _.L.EACH ACCIDENT $ OyFRCER/MEMBER EXCLUDED? NIA - - -- (Mand L DISEASE-1A LOYE $ DE SORPTION OF OPERATIONS below �E L.DISEASE-POLICY LIMIT $ t! es describe under - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Addi lona)Rennadra Schedule,If more space Is rt ulred) CERTIFICATE HOLDER CANCELLATION CITY OF SAN JUAN CAPISTRANO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 32400 PASEO ADELANTO AU 7EPRESENTAT ZtSAN JUAN CAPISTRANO CA 92675 ©1988-2010 ACORD COR PO . All reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. I POLICY CHANCES Policy Change Number 1 POLICY NUMBER POUCYCHANGES COMPANY EFFECTIVE CPS5034112 - 03/25/2011 PENN-STAR NAMED INSURED AUTHORIZED REPRESENTATIVE 02470 San Juan Capistrano Open Space Foundation Partners Specialty Group 2450 Colorado Avenue,Suite 200E Santa Monica,CA 90404 COVERAGE PARTS AFFECTED Commercial General Liability CHANGES In consideration of the premium charged below,4 is hereby agreed that Additional Insured-State or Political Subdivisions -Permits,form CG2012(07/98),is endorsed to coverages as per attached. it ADDT'L PREMIUM $60.00 RET PREMIUM STATE TAX .$1.50 FEE $0.13 4 - Date 04/01/2011 Initials rmb rized Representdive Signature IL 12 01 1186 Copyright,Insurance Services Office,Inc., 1983 Copyright,ISO Commercial Risk Services,Inc.,1983 --A INSURED a COMMERCIAL GENERAL LIABILITY CG 20 12 07 98 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS This andorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Political Subdivision: 1. City Of San Juan Capistrano 2. 3. 4. (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endotsemem) Section II - Who is An Insured is amended to 2. This insurance does not apply to: include as an insured any state or political subdivision shown in the Schedule, subject to the following a. "Bodily injury; "property damage" or"personal provisions: and advertising injury'arising out of operations performed for the state or municipality;or 1.This insurance applies only with respect to oper- ations performed by you or on your behalf for b. "Bodily injury' or 'property damage" included which the state-or political subdivision has issued a within the "products-completed operations permit. hazard". CG 20 12 0798 Copyright, Insurance Services Office,Inc., 1997 Page 1 of t INSURED