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11-1017_WALTER ENTERPRISES_Personal Services AgreementPERSONAL SERVICES AGREEMENT THIS AGREEMENT is made, entered into, and shall become effective this day of October 2011, by and between the City of San Juan Capistrano (hereinafter referred to as the "City") and Waiter Enterprises (hereinafter referred to as the "Consultant"). RECITALS: WHEREAS, City desires to retain the services of Consultant regarding the City's proposal to obtain archaeological investigations to support CEQA and the project design for the Blas Aguilar Adobe project (CIP No. 07403); and WHEREAS, Consultant is qualified by virtue of experience, training, education and expertise to accomplish such services. NOW, THEREFORE, City and Consultant mutually agree as follows: Section 1. Scope of Work. The scope of work to be performed by the Consultant shall consist of those tasks as set forth in Exhibit' A," attached and incorporated herein by reference. To the extent that there are any conflicts between the provisions described in Exhibit "A" and those provisions contained within this Agreement, the provisions in this Agreement shall control. Section 2. Term. This Agreement shall commence on the effective date and shall terminate, and all services required hereunder shall be completed, no later than June 30, 2012, Section 3. Compensation. 3.1 Amount. Total compensation for the services hereunder shall not exceed $11,100 (Eleven thousand one hundred dollars) as set forth in Exhibit "A," attached and incorporated herein by reference. 3.2 Method of Payment. Subject to Section 3.1, Consultant shall submit monthly invoices based on total services which have been satisfactorily completed for such monthly period. Invoices shall be addressed as provided for in Section 10 below. The City will pay monthly progress payments based on approved invoices in accordance with this Section. 3.3 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 the City. Section 4. Independent Contractor. It is agreed that Consultant shall act and be an independent contractor and not an agent or employee of the City, and shall obtain no rights to any benefits which accrue to Agency's employees. Section 5. Limitations Upon Subcontracting and Assi nment. The experience, knowledge, capability and reputation of Consultant, its principals and employees were a substantial inducement for the 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 the 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. Section 6. Changes to Scope of Work. For extra work not part of this Agreement, a written authorization from City is required prior to Consultant undertaking any extra 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/or Construction Site. By executing this Agreement, Consultant warrants that: (1) it has investigated the work to be performed; (2) if applicable, it has investigated the work site(s), and is aware of all conditions there; and (3) it understands the facilities, difficulties and restrictions of the work to be performed 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 the 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; E -Verify. 9.1. Compliance with Law. Consultant shall comply with all applicable laws, ordinances, codes and regulations of federal, state and local government. 9.2. E -Verify. If Consultant is not already enrolled in the U.S. Department of Homeland Security's E -Verify program, Consultant shall enroll in the E -Verify program within fifteen days of the effective date of this Agreement to verify the employment authorization of new employees assigned to perform work hereunder. Consultant shall verify employment authorization within three days of hiring a new employee to perform work under this Agreement. Information pertaining to the E -Verify program can be found at hftp://www.uscis.go , or access the registration page at htt s://e-veri . uscis, ov/enroll/. Consultant shall certify its registration with E -Verify and provide its registration number within sixteen days of the effective date of this Agreement. Failure to provide certification will result in withholding payment until full compliance is demonstrated. Section 10. Conflicts of Interest. Consultant covenants that it presently has no interest and shall not acquire any interest, direct or indirect, which would conflict in any manner or degree with the performance of the services contemplated by this Agreement. No person having such interest shall be employed by or associated with Consultant. Section 11. Copies of Work Product. At the completion of the work, Consultant shall have delivered to City at least one (1) copy of any final reports and/or notes or drawings containing Consultant's findings, conclusions, and recommendations with any supporting documentation. All reports submitted to the City shall be in reproducible format, or in the format otherwise approved by the City in writing. Section 12. Ownership of Documents. All reports, information, data and exhibits prepared or assembled by Consultant in connection with the performance of its services pursuant to this Agreement are confidential to the extent permitted by law, and Consultant agrees that they shall not be made available to any individual or organization without prior written consent of the City. All such reports, information, data, and exhibits shall be the property of the City and shall be delivered to the City upon demand without additional costs or expense to the City. The City acknowledges such documents are instruments of Consultant's professional services. k? Section 13. Indemnity. To the fullest extent permitted by law, Consultant agrees to protect, defend, and hold harmless the City and its elective and appointive boards, officers, agents, 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 damages of any nature, including interference with use of property, arising out of, or in any way connected with the negligence, recklessness and/or intentional wrongful conduct of Consultant, Consultant's agents, officers, employees,. subcontractors, or independent contractors hired by Consultant in the performance of the Agreement. The only exception to Consultant's responsibility to protect, defend, and hold harmless the City, is due. to the negligence, recklessness and/or wrongful conduct of the City, or any of its elective or appointive boards, officers, agents, or employees. This hold harmless agreement shall apply to all liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by Consultant. Section 14. Insurance. 4n or before beginning any of the services or work called for by any term of this Agreement, Consultant, at its own cost and expense, shall carry, maintain for the duration of the agreement, and provide proof thereof that is acceptable to the City, the insurance specified below with insurers and under forms of insurance satisfactory in all respects to the City. Consultant shall not allow any subcontractor to commence work on any subcontract until all insurance required of the Consultant has also been obtained for the subcontractor. Insurance required herein shall be provided by 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 an amount not less than one million dollars per occurrence ($1,000,000.00), combined single limit coverage for risks associated with the work contemplated by this agreement. 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 agreement or the general aggregate limit shall be at least twice the required occurrence limit. 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 - 0 owned vehicles in an amount not less than one million dollars per occurrence ($1,000,000.00). 14.3 Workers' Compensation. If Consultant intends to employ employees to perform services under this Agreement, Consultant shall obtain and maintain, during the term of this Agreement, Workers' 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 naming City, its officers, employees, agents, and volunteers as additional insured as respects each of the following: Liability arising out of activities performed by or on behalf of Consultant, including the insured's general supervision of Consultant; products and completed operations of Consultant; premises owned, occupied or used by Consultant; or automobiles owned, leased, hired, or borrowed by Consultant. The coverage shall contain no special limitations on the scope of protection afforded City, Its officers, employees, agents, or volunteers. 14.5 Notice of Cancellation/Termination of Insurance. The above policy/policies shall not terminate, nor shall they be cancelled, nor the coverages reduced, until after thirty (30) days' written notice is given to City, except that ten (10) days' notice shall be given if there is a cancellation due to failure to pay a premium. 14.5 Terms of Compensation. Consultant shall not receive any compensation until all insurance provisions have been satisfied. 14.7 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 shall have the right to terminate this Agreement without cause by giving thirty (30) days' advance written notice of termination to Consultant. 5 In addition, this Agreement may be terminated by any party 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: Teri Delcamp To Consultant: Stephen Van Wormer Walter Enterprises 238 Second Avenue Chula Vista, CA 91910 Section 17. Attorneys' Fees. If any action at law or in equity is necessary to enforce or interpret the terms of this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees, costs and necessary disbursements in addition to any other relief to which he may be entitled. Section 18. Dispute Resolution. In the event of a dispute arising between the parties regarding performance or interpretation of this Agreement, the dispute shall be resolved by binding arbitration under the auspices of the Judicial Arbitration and Mediation Service ("JAMS"). 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. [SIGNATURE PAGE FOLLOWS] [:9 IN WITNESS WHEREOF, the parties hereto have executed this Agreement, Uff w W.-Irrelyj i .-D T 1412ImLm�j O SaKeoai, City Attorney J- CITY OF SAN JU CAPISTRANO By City M g ren P. Brunt, City' Manager 7 EXHIBIT A WALTER ENTERPRISES 238 Second Avenue, Chula Vista, CA 91910 (619) 426 5109 FROM: Walter Enterprises August 23, 2011 238 Second Avenue Chula Vista, CA 91910 TO: Teri Delcamp Historic Preservation Manager City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 The following scope of work has been prepared to achieve three goals: (1) locate remains of the horno that existed on the south side of the Blas Aguilar Adobe, (2) locate the well .that existed in the courtyard on the south side of the Blas Aguilar Adobe, and (3) locate the four major foundation corners of the Casa Tejada as well as the intersection of the central interior dividing wall and exterior courtyard wall. TASK 1: LOOK FOR THE HORNO. Base on photographs and maps the center of the previously existing horno should be against the south wall of the Blas Aguilar adobe at a point 10 feet west of the southwest corner. A 2 to 3 foot wide trench, centered on this point and extending south for a length of 10 feet will be laid out and excavated to see what evidence remains of the horno. Time: Field Supervisor 8 hours Field Crew 16 hours TASK 2: LOOK FOR AND UNCOVER THE WELL Based on photographs and maps the well was located approximately 12.5 feet south of the west doorway on the south wall of the Blas Aguliar Adobe. A 3 foot wide and 10 foot long trench will be centered on this point and laid out and excavated in a north -south orientation to find remains of the top of the well. It is assumed that the top of the well should lie within 3 feet of the current ground surface. When the well is found the top surface area and any existing treatments will be exposed, Excavation into the well to examine construction techniques will not exceed three feet or beyond a safe distance (5 feet below surface). Time: Field Supervisor 16 hours Field Crew 32 hour TASK 3: LOOK FOR AND UNCOVER THE SURFACE OF THE FOUNDATION CORNERS OF THE CASA TEJADA AND THE COURT YARD AND INTERIOR DIVIDING WALLS. Based on previous excavations the northwest corner of the foundations of the Casa Tejada should lie 25 feet to the south of the southeast corner of the Blas Aguilar Adobe. 238 Second Avenue, Chula Vista, CA 91910 (619) 426 5109 A point 25 feet south of the southeast corner of the Blas Aguilar will be marked on the ground. A 1 foot wide, 6 foot long, north -south oriented trench will be excavated approximately 6 feet to the east of this point in order to cross cut and find the north wall foundation alignment of the Casa Tejada. Once the foundation stones are encountered a small narrow 6 inch wide tracing trench will be excavated along the north side of the foundation alignment to locate the northwest corner. A unit approximately three feet square will be excavated to expose the complete foundation surface at the corner alignment. The excavation of the tracing trench should also encounter the footing of the courtyard wall of Hacienda Aguilar if a foundation for this wall exists. A unit approximately 3 foot square will also be excavated to expose the surface of the foundation at the juncture of the Casa Tejada and courtyard wall alignment. Based on plans by Yorba and Roberts of the Casa Tejada before it was demolished, measurements will be taken from the northwest foundation corner to plot the locations of the remaining three corners of the Casa Tejada. A similar combination of narrow trenches, tracing trenches, and units will be used to locate and expose the surfaces of the foundations at these corners. The same methodology will be used to attempt to locate remains of the main central interior dividing wall of the Casa Tejada as shown on the Roberts and Yorba plans. All corners and wall intersections will be recorded by GPS. Time: Field Supervisor 16 hours Crew 32 hours ARTIFACT ANALYSIS AND REPORT WRITING. Artifact analysis will consist of washing, sorting, identification and cataloging all artifacts recovered. Artifacts will be identified by activity, material, item, type, and any relevant identification marks or patterns. Items will be quantified by estimated minimum number and weight. They will be tagged and placed in appropriate containers. All containers and materials will be of archival quality. A report will be written describing the field work, architectural remains, and artifacts. Tlme: Artifact Analysis 40 hours Report Preparation 40 hours DELIVERABLES. Artifact Catalog Report Artifacts cataloged to archival standards. WALTER ENTERPRISES 238 Second Avenue, Chula Vista, CA 91910 (619) 426 5149 BUDGET Task Field Crew Supervisor Artifact Analysis Report 7 days perdeum @ $100.00 per day Rate Hours Total $50 80 $4,000.00 $60 40 $2,400.00 $50 40 $2,000.00 $50 40 $2,000.00 $700.00 TOTAL $11,100.00 Oct 07 11 10:51a S. "Alter/S. VanWormer 619-"26-5109 D.,CERTIFICATE 4F INSURAW"IE' p.2 SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW, This certifies that: ® STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois ❑ STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois ❑ STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS of Dallas, Texas ❑ STATE FARM INDEMNITY COMPANY of Bloomington, Illinois, or STATE FARM GUARANTY INSURANCE COMPANY of Bloomington. Illinois has coverage in farce for the following Named Insured as shown below: NAMED INSURED: WALTER ENTERPRISES ADDRESS OF NAMED INSURED: 238 SEC:ONI) AVE, CHULA VISTA, CA 91410 POLICY NUMBER 064 9194 -R22 -55A EFFECTIVE GATEOF POLICY 8-22-2011 DESCRIPTION OF 2001 FORD RANGER IFTYRIOD51PB6438-7 i VEHICLE (including VIII) LIABILITY COVERAGE ® YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO LIMITS OF LIABILITY a. Bodily Injury Each Person 110001000 i Each Accident 11000,000 b, Property Damage Each Accident 1, 0n0, 000 c. Bodily InTury & Property Damage Single Limit Each Accident PHYSICAL DAMAGE COVERAGES ® YES ❑ NO ❑ YES ❑ NO ❑ YES [:1 NO ❑ YES ❑ NO a_ Ca�rehensive $ 100 Deductible $ Deductible $ Deductible $_ Deductible ® YES ❑ NO ❑ YES I] NO ❑ YES ❑ NO ❑ YES ❑ NO b. Collision $ 5oo Deductible $ Deductible $ Deductible $ Deductible EMPLOYERS NON -OWNED CAR LIABILITY COVERAGE ❑ YES ❑ NO ❑ YES []NO ❑ YES ❑ NO ❑ YES ❑ NO HIRCOED AG LIABILITY COVERAGE ❑ YES ❑ NO ❑ YES ❑ NO ❑YES ❑ N(� ❑ YES []NO FLEET - COVERAGE FOR W ALL OWNED AND LICENSED MOTOR VEHICLES 10YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO Agent's Asst 55-8051 9/30/201ICerti Title Agent's Name and Address of Certificate Holder Name and Address of A ent I Certificate holder is additional ii1sured ~"-- HISTORIC PRESERVATION MANAGER CI'T'Y OF SAN JUAN CAPISTRANO Ray Bello, Agent Lic. # 0455530 :rare rnrcn SAN 313 PASEQ ASTRANTO O, 5464 Baltimore Drive, Suite C SAN ,�crAt� c�.P1sTRAt�o, CA !32>a75 La Mesa, CA 91942-2074 1l'fSVeXlito Bus 619 462 5700 ray.bello,bugn@statefarm.com INTERNAL STATE FARM USE ONLY: O Request permanent Certificate of Insurance for liability coverage 122429.3 Rev. 07-26 -2005 0 Request Certificate Holier to be added as an Additional Insured. Oct 07 11 1O.51a S.,"1�lter?S. VanWormer 619-426-5109 p.3 STATE FARM INSURANCE, RAS' BE,LLO TRIC 4 0455530 Aute -Life -Health -Home and Business 'Ffli RE BRIM-- Ray raytello. cam LA MESA, CA 91942. PHONE: (61.9) 452-5700 FAX (619) 462-3527 October 04, 2011 SUSAN WALTER 238 2ND AVE CHOLA VISTA, CA 91910-2927 Oct 07 11 10:51a S. '`altar/S. VanWormer 619,A26-5109 p.1 WALTER ENTERPRISES 238 Second Avenue, Chula Vista, CA 91910 (619) 426 5109 To: Ayako Rauterkas Teri Delcamp Fx: 949.202.5469 -Qct.10 11 02:23p S.--ilter/S. VanWormer 619-126-5109 P. 1 ACORD CERTIFICATE OF LIABILITY INSURANCE �� PRtsc€ucEtt THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ©1t]3Ul�T i3ESSEI.BARTII, INC. P.Q. BOX 880267 ONLY AND .CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. SAN DIEGO, CA 92168 INSURERS AFFORDING COVERAGE ' NAIC# tNsuRED SUSAN W'AL'TER NStis?ERA: T3ATj�iXEfi 7t3C (.Ct_ % BLISS A CT F7llitlid , -- B. DBA: WALTER ENTERPRISESINSURER -�—� -- -- INsuRFRC: 238 2ND AVENUE II NSURER➢ �_ INSURER E: CHULA VISTA, CA 91910 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PFRIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TF -RM 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 CONorrIoNS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NIUMSER POL 115 EECTWE € PAL3,CC, Y E,7CPtReI'Sil�N .� _... .............. _ _ _....__.. MWI)ONX) DA LIMIT IS A. GENERAL LIAHILrYY ( I FACHOOCUARI=RICE is 1,000,000 A.I COMMERC€ALGIEwuI.I.1ABILrTY €i 1QQ Q(j PROM€srsfrmaccvsaxelS__,! O 1 cLAUISMADI X:occL€R? NN1537349/5/11 9/5/12 MEDEX AAW—Persay !s 5,000 i 1 PEASoNSLBADVIUPJRY � 5 EXCLUDED 11000,000 EGENL ACGRE—CATE LIMIT APPLIES Pf PRODUCTS-COMPIOPAGG ; s EXCLUDED _ E POLICY j r RC3 LOC AUTOMO5KXLW8iL," j f ANY AUTO COMBINED S1NGI.EL"Ar., ALt„OW,14WALSTOS BODSL,Y INJURY _I , 5CHEpUl.EOALTTt7S j tPs> iyPei s I HIREBAUTOS BC?E73LY IN,T%1HY � NON -O WNEC AU 08 I (per accioem) 5 RHOPERTY DAMAGE § _ GARAGE UABILrrY I f � AUrOONLY -EAACCII ENT,---' s ANY AUTO -I ..-...._. 'OTHER ThihN .,RAACC S E A JTOONLY: AGG S j ECC0�BAELLA LIABILMY l EACH OCCURRENCE $ OCCUR J " CLAIMS MAOE DEDUC7151 E i FETEWWN $ i � t 5 i 1 WORI4ESPm-L[ LIABILITY FJdPLOYERS LIABILrTY W C BTATU- :OTH- ANY PROPRtET0R/PARTN2W;) SCUT€VE€ ANY E.LL. EACHAWDENT_ 5 _ OFFICCF3!}7IFMaf-REXGLUDEO? Lfl15EASE-ER EMPLOYEE" $ under Idesentv 3PECIAL PROVISIONS befow I ELMEASE-POLICYLIMIr S j OTHER € I I { DESCRIPTION OF OPERATIONS1LOCAnotmivr"pCL.> EXGLUSIONSADDED BY ENDOASEMEWISPe IAL PROVISION$ ITS OFFICERS, EMPLOYEES, AGENTS AND VOLUNtTEERS." CERTIF'ICA1`E HOLDER ADDED AS ADDITIONAL INSURED. vn,krwc�..a_e: rfvtr --a.v awca.t, v,ra�rv�.s, xvrk 1YEJj,draG).trurlFil SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION `CITY OF SAKI JUAN CAPISTRANO DATE THEREOF, THE tSsuNG MURE1 MLL IrNDEAVOR TO M1mt30 GAYS PIRruEN .32400 PASEO ADELAN O NOTICE TO THE CEMVICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DD 50 SHALL SAN JUAN CAPISTRANO, CA 92675 WOSE NO OBLIGATION OR LIAML€TY OF ANY KIND UPON THE B#SUREki, R's AGEnm OR ASTM: TERI DELCAW REPREs TIVES. HISTORIC PRESERVATION MANAGER AUTOOkpp ACORD2SC {fir ACORD CORPORATION t 9RR I]ct 10 11 03:14P GHIINC 619 291 2822 X5.2 POLICY NUMBER: 91INZ53-134 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY AND NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s): CITY OF SAN JUAN CAPISTRANO, ITS OFFICERS, EMPLOYEES„ AGENTS AND VOLUNTEERS 21400 PASEO A©E'-ANTO SAN JUAN CAPISTRANO, CA 32675 Location(s) of Covered Operations_ Description of Work Performed for the Additional Insured: A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organizations) shown in the Schedule, but only with respect to liability for "bodily injury" 'property damage" or "personal and advertising injury" caused, in whole or in part. by: 1. Your acts or omissions, or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured at the locations) designated in the Schedule, but only for occurrences of coverages not otherwise excluded in the policy to which this endorsement applies. B. With respect to the insurance afforded to the additional insured, the following additional exclusions apply: This Insurance does not apply to "bodily injury" or "property damage" occurring after. 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured at the location of the covered operations has been completed; or 2. That portion of 'your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. G. The following is added to 4.a. of Other Insurance of Section IV - Commercial General Liability Conditions: If required in a written contract, your policy is primary and noncontributory in the event of an occurrence caused, in whole or in part, by your acts or omissions, or the acts or omissions of those acting on your behalf that occurs while performing ongoing operations for the additional insured at the locations) designated in the: Schedule. All other terms and conditions of this policy remain unchanged. L803 {06)07) #ncludes c;opyriented material of Insurance Services Ofh:e, Ina., with its permission, g� J CQr� EIRTIFI A►TI- ®F LI ILIT'Y INS�URAN E DATE (MM1001YYYY) 10/3/11 gn PRODUCER CORDON ESSELBARTII, INC. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX. 880267 A AFFORDED BY THE POLICIES BELOW. __ POLICY EFFECTIVE [ POLICY EXPIRATION-�� !NSR ADS' �W-....__,_,,....,..._, ] SAN DIEGO, CA 92168 LIMITS INSURERS AFFORDING COVERAGE NAIL # INSURED SUSAN WALTER IN -1�-�- t2Lj2-_AW..- . - " DAMAGErbRNo PREMISES fEaoecurence DBA: WALTER ENTERPRISES 238 2ND AVENUE CHULA VISTA, CA 91910 I INSURER B: wsuRERc - �`R g r;` €MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY INSURER E: I 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. __ POLICY EFFECTIVE [ POLICY EXPIRATION-�� !NSR ADS' �W-....__,_,,....,..._, ] POLICY NUMBER LTi3 M R Y £LANCE DATE MMIDDIYY € DATE MM/DD/YY LIMITS A' GENERAL LIABILITY [. EACH OCCURRENCE $ 1,000,000 ALIABILITY COMMERCIALI GENERAL DAMAGErbRNo PREMISES fEaoecurence $ 100,000 CLAIMS MADEiOCCUR NN153734 9/5/11 9/5/12 €MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY 5 EXCLUDED I GENERAL AGGREGATE $ 1,000,000 j GEN'LAGGREGATEUMiTAPPLIESPER: $ EXCLUDED PRO- _PRODUCTS-COMPIOPAGG f _ POLICY 0 ( '- LOC E AUTOMOBILE LIABILITY I r COMBINED SINGLE LIM#T $ ANYAUTO E fEaaaadent) ! ALL OWNED AUTOS '� � BODILY INJURY v E SCHEDULEDAUT05 (Per person) i HIRED AUTOS BODILY INJURY $' € I NON�OWNED AUTOS.,..._.-_..._.......-_..... (Per accident) ......W.r...__.,_...._.,_. i [ PROPERTY DAMAGE €$ i (Per accident) GAR AGE LIABILITY AUTO ONLY -EA ACCIDENT 1 $ I ANY AUTD OTHER THAN EA AGC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY ! EACH OCCURRENCE $ W, u$ tm j I I. OCCUR CLAIMS MADE ! AGGAEGATE I ! $ DEDUCTIBLE € i ..................W.,_._.......,_ .._._....._.,. -...........-...,w................ RETENTION $ $ WC STATU- OTH- WORKERS COMPENSATION AND I-,,,, `:,,,,,TORY LIMITS ER EMPLOYERS' LIABILITY E,L. EACH ACCIDENT S ANY PROPRIETOR/PARTNER/EXEOUTWE i OFFICER/MEMBER EXCLUDED?E.L.DISEAS iE - EA EMPLOYEE= $ If yyes, describe under SPECiALPROVISIONS below j _ 1 E.L. DISEASE-POLICYUMIT I$ OTHER ] I € l DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS ITS OFFICERS, EMPLOYEES, AGENTS AND VOLUNTEERS.,, CERTIFICATE HOLDER ADDED AS ADDITIONAL INSURED. L;hK l IHL;A l t HL)LUt€i I AIVE.C€..L.A I IUM -- E v Lni z vii LvvLvr baa ri1 iv a "CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 ATTN: TERI DELCAMP HISTORIC PRESERVATION MANAGER 25 !20011081 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAI 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ©ACORD CORPORATION 1988 Oct 17 11 10.16a S. 'alter/S. VanWcrmer 619 '26-5109 WORKERS' COMPENSATION OECLARATION I hereby a irm, under penalty of perjury under the laws of the State of California, as follows (ini ial one): V 11 I certify that while performing the services required by my agreement with the City of San Juan Capistrano or the San Juan Capistrano Community Redevelopment Agency, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California. I agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall immediately comply with the provisions of Section 3700. I have and will maintain workers' compensation insurance as required by Section 3700 of the Labor Code, while serving as an Independent Contractor providing leisure services/programs for the City of San Juan Capistrano. My workers' compensation insurance carrier and policy number are: Carrier Policy No. (Original to follow) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided by Section 3700 of the Labor Code, while serving as an Independent contractor providing leisure services/programs for the City of San duan Capistrano. Failure to secure Workers' Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cast of compensation and damages as provided for in Section 3706 of the Labor Code, interest, and attorney fees. Name of Declarant:5/4e Business Name: Executed this r day of California. Signature: V 1.a� �u �r � I ._.. A (City), p.3 Oct 17 11 10:15a S. `alter/S. VanWormer 618-A26-5109 p.1 WALTER ENTERPRISES 238 Second Avenue, Chula Vista, CA 91910 (619) 426 5109 For: Avaho Rauterlcns Development Services Ph. 949.443.6325 Fx: 949.202.5469 And Teri Delcamp Historic Preservation Manager City of San. Juan Capistrano 32400 Pasco A.delanto San Tuan Capistrano, CA 92675 P: 949-443-63313 Dept. Pax; 949-661-5451 Christy Jakll From: Christy Jaki Sent: Friday, October 14, 2011 11:11 AM To: Teri Delcamp Cc: Ayako Rauterkus Subject: Agreements (Walter Enterprises & IS Architecture) Hi Teri, Please provide the follow for final execution of your contracts; Walter Enterprises o Workers' Compensation o E -verify (need by 16 days from the execution date) IS Architecture o Automobile Liability (expired 9/1/11) o Professional Liability (expired 10/8/11) o FYI — Professional Liability expires on 11/1/11 Let me know if you have any questions. Thanks! Cl-irist� RAI Deputy City Clerk City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 (949) 443-6310 1 (949) 493-1053 fax Today's Date: Transmittal Routing (Check All That Apply) City Attorney City Manager City Clerk CONTRACT TRANSMITTAL CIP No. (if any): 7 Project Manager's Last Name: Phone Extension: ,) Council or CRA Meeting Date (if applicable): APPROVING AUTHORITY: (Check One) ® Mayor J CRA Chair 4 City Manager Provide (1) executed original contract for each signing party, including the City. If the agreement is to be recorded — only (1) original will be recorded with certified copies going to other parties. Please provide the mailing address of any party to receive an agreement — unless the mailing address is included within the body of the agreement: I Name s) Street Cit St OTHER INSTRUCTIONS: is 'rs a PSA J i qC&)J�Py m tv4&, ok n -(A., a c%r. e�', Form Date: 01-2004 D - 7 f 32400 PAGrO AOr.LANTO SAN JUAN CARSTRANO, CA 92-675 (949) 493-1171 �949) 493-1058 PAX fin Stephen Van Wormer Walter Enterprises 238'Second Avenue Chula Vista, CA 91910 NOTOWORRUM FROG, Christy Jakl, Deputy City Clerk (949) 443-6310 kVAISErd Or'T"L UTY MONQt, &WkLEVATO LAURAM'.I.-SE LAORYKRAMER DF-r4'KRr-'P1r- jm'J TAY[�oR RE: Personal Services Agreement — Archaeological I . nvestigations to.: Support C EQA and the Project Design for B[as Aguilar Adobe Project (01P 07403) Thank you for providing docu,mentat. - ion confirming compliance: WRh the ter.rns of the agreement related to insurance. Please keep in mind this documentation must remain current with our office urine the term of this agreement, If you have q00%tions related to insurance requlmments,. please call me at (949) 443-6310. If you have. questions concerning the agreement, please contact Teri Delcamp, Historic Preservation Manager at (949) 443-6339. An original 'agreement is enclosed for your records. Cc- Teri Delcamp, Historic Preservation Manager: saft Jim Ca Ovran.:o: the .Future 0 printed O'l 10% aKrdrd var'tse Chris Jak! From: Christy Jakl Sent: Monday, October 17, 2011 4:30 PM To: Teri Delcamp Cc: Ayako Rauterkus Subject: RE: Agreements (Walter Enterprises) Attachments: 11-1017 Walter Enterprises PSA.pdf Hello, Attached is the executed agreement with Walter Enterprises. Thanks!! Christi JAI 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: Teri Delcamp Sent: Monday, October 17, 2011 11:59 AM To: Christy Jakl Cc: Ayako Rauterkus Subject: RE: Agreements (Walter Enterprises) Thank you Christy! Teri From: Christy Jaki Sent: Monday, October 17, 2011 11:54 AM To: Ayako Rauterkus Cc: Teri Delcamp Subject: RE: Agreements (Walter Enterprises) Awesome! They are good to start work! I'll process the agreement today, Thanks! Christi JW Deputy City Clerk City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 (949)443-6310 i (949)493-1053 fax From: Ayako Rauterkus Sent: Monday, October 17, 2011 10:29 AM To: Christy Jakl Cc: Teri Delcamp Subject: RE: Agreements (Walter Enterprises) Hi Christy: Here are the declaration forms from Walter Enterprises. Thankyou! Ay,kh,o Rauterkus Developmen.t Services Ph: 949.443.6325 Fx. 949.202.5469 arauterkus@sapjRjajintra c�.or�