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1987-0929_VAN DELL & ASSOCIATES, INC._Consulting Services Agreement
Agency Copy" ti AGREEMENT FOR CONSULTING SERVICES THIS AGREEMENT is made and entered into this 29th day of September 19 87 by and between the SAN JUAN CAPISTRANO COMMUNITYDEVELOPMENT �3n AGENCY, hereinafter referred to as "AGENCY" and Van Dell Associates, Inc., hereinafter referred to as "CONSULTANT'. WITNESSETH : WHEREAS, AGENCY requires consulting services for the project described as follows: design precise alignments for Ortega Highway, El Camino Real, and Forster Street WHEREAS, CONSULTANT represents he/they is duly qualified to provide said service. NOW, THEREFORE, AGENCY and CONSULTANT, for the consideration hereinafter named, agree as follows: SECTION 1. GENERAL The considerations of work on the project shall be governed by the conditions contained herein. In general, the tasks delineated herein are to be performed with mini- mum direction and assistance from AGENCY. All work performed by CONSULTANT, however, shall be subject to review and approval of the Director of Public Works or his of the Director of Public Works or his designee at all timesat all times. SECTION 2. SCOPE OF TASKS BY CONSULTANT Subject to the terms and conditions of this agreement, CONSULTANT shall per- form the tasks as set forth in Exhibit A, attached and incorporated herein by reference. During the performance of the above tasks, CONSULTANT shall have access to existing data in AGENCY files and AGENCY shall provide copies of any such data CONSULTANT requests at no cost to CONSULTANT. SECTION 3. TIME OF BEGINNING AND COMPLETION OF SERVICES The services provided under this Agreement shall begin upon execution of this Agreement by all parties. The services provided under this Agreement shall be completed within 9 weeks of written notice to proceed. SECTION 4. PAYMENT FOR CONSULTANT'S SERVICES Payment under this Agreement shall be in accordance with Exhibit B, attached hereto and made a part hereof. Three (3) copies of itemized bills, clearly indicating the period for which the billing is made, and including dates on which expenses (except costs for reproduction) were incurred, and individuals' hourly rates and tasks performed, including time spent on each task, shall be submitted to: City of San Juan Capistrano, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675. SECTION 5. COVENANT AGAINST CONTINGENT FEES CONSULTANT warrants that he has not employed or retained any company or person, other than a bona fide employee working for CONSULTANT, to solicit or secure this Agreement, that he has not paid or agreed to pay any company or person, other than a bona fide employee, any fee, commission, percentage, brokerage fee, gift or any other consideration, contingent upon or resulting from the award or making of this Agree- ment. For breach or violation of this warranty, AGENCY shall have the right to annul this Agreement without liability, or, at its sole discretion, to deduct from the Agreement price or consideration, or otherwise recover the full amount of such fee, commission, percentage, brokerage fee, gift or contingent fee. SECTION 6. EXPENSES CONSULTANT acknowledges AGENCY is under no obligation to compensate consultant for services rendered or expenses accrued under this Agreement in excess of the maximum compensation specified in Section 4. SECTION 7. OWNERSHIP OF DOCUMENTS All tracings, plans, specifications, maps or other documents prepared or obtained under the terms of this Agreement shall be delivered to, and become the property of the AGENCY, and basic survey notes and sketches, charts, computations and other data prepared or obtained under this Agreement, shall be made available upon request, to AGENCY without restriction or limitation on their use. SECTION 8. NON-DISCLOSURE The designs, plans, reports, investigation, materials and documents prepared or acquired by CONSULTANT pursuant to this Agreement (including any duplicate copies kept by CONSULTANT) shall not be shown to any other public or private person or entity, except as authorized by AGENCY. CONSULTANT shall not disclose to any other public or private person or entity any information regarding the activities of AGENCY, except as authorized by AGENCY. SECTION 9. CONFLICT OF INTEREST For the duration of this Agreement, CONSULTANT shall not act as consultant or perform services of any kind for any person or entity in regard to the project area without the prior written consent of AGENCY. 2 SECTION 10. CHANGES IN SCOPE OF CONSULTANT'S SERVICES No additional fee shall be paid by AGENCY for additional consulting services not included in this Agreement without the written approval of AGENCY prior to undertaking such work. In the event of suspension of project by AGENCY, CONSULTANT shall have the right to renegotiate fees if delay is greater than six (6) months. SECTION 11. TERMINATION AGENCY may, without cause, terminate the Agreement at any time prior to completion by CONSULTANT of any of the services required hereunder. Notice of Termination of this Agreement shall be given in writing to CONSULTANT, and shall be sufficient to complete when same is deposited in the U.S. Mails, First Class postage prepaid. In the event this Agreement is terminated by AGENCY, CONSULTANT shall be paid the value of services performed by him pursuant to this Agreement prior to the date of termination thereof, such value to be the total to which he shall have become entitled, as determined by the Director of Public Works, less the amount of any payments previously made, but in no event exceeding the maximum contract amount stated in SECTION 4. SECTION 12. DISPUTES Unless otherwise specified herein, any dispute over a question of fact arising under this Agreement, which cannot be resolved by agreement between the parties, may be, by mutual consent of the parties, submitted to a "Board of Arbitration" consisting of three (3) arbitrators having expertise relating to this contract subject matter, one of whom shall be selected by each of the parties, and the third by the two members selected by the parties. Each of the parties shall pay the member selected by it, and the compensation of the third member shall be paid equally by the parties. The parties shall be bound by the decision of the Board of Arbitration. SECTION 13. NO ASSIGNMENTS Neither any part nor all of this Agreement may be assigned or subcontracted, except as otherwise specifically provided herein, or to which AGENCY, in its sole discretion, consents to in advance thereof in writing. Any assignment or subcontracting in violation of this provision shall be void. SECTION 14. ENDORSEMENT ON PLANS, ETC. CONSULTANT shall endorse all plans, data and other documentation submitted to AGENCY pursuant to this Agreement. SECTION 15. CORRECTION OF WORK The performance of services by CONSULTANT shall not relieve CONSULTANT from any obligation to correct any incomplete, inaccurate or defective work at no further cost to AGENCY, when such inaccuracies are due to the negligence of CONSULTANT, provided such work has not been accepted in writing by AGENCY. 3 SECTION 16. MAINTENANCE OF RECORDS CONSULTANT and is subcontractors shall maintain all books, documents, papers, employee time sheets, accounting records and other evidence pertaining to costs incurred and shall make such materials available at their respective offices at all reasonable times during the contract period and for three (3) years from the date of final payment under this Agreement, for inspection by AGENCY and copies thereof shall be furnished, if requested. SECTION 17. INDEPENDENT CONTRACTOR At all times during the term of this Agreement, CONSULTANT shall be an independent contractor and shall not be an employee of AGENCY. AGENCY shall have the right to control CONSULTANT only insofar as the results of CONSULTANT'S services rendered pursuant to this Agreement; however, AGENCY shall not have the right to control the means by which CONSULTANT accomplishes services rendered pursuant to this Agreement. SECTION 18. LICENSES, PERMITS, ETC. CONSULTANT represents and warrants to AGENCY that he has all licenses, permits, qualifications and approvals of whatever nature that are legally required to practice his profession. CONSULTANT represents and warrants to AGENCY that CONSULTANT shall, at his sole cost and expense, keep in effect at all times during the term of this Agreement, any license, permit or approval which is legally required for CONSULTANT to practice his profession. SECTION 19. CONSULTANT'S INSURANCE CONSULTANT shall obtain and maintain during the life of this Agreement all of the following insurance coverages: A. Comprehensive general liability, including premises-operations, products/completed operations, broad form property damage, and blanket contractual liability, and each of the following except as may be stricken out by CONSULTANT'S Project Manager: explosion and collapse hazard, underground hazard, independent contractors, personal injury; and B. Automobile liability, including owned, hired, and non-owned vehicles, except as may be stricken out by AGENCY'S Project Manager. C CONSULTANT shall obtain and maintain, during the life of the Agreement and for three (3) years after completion of the work hereunder, a policy of professional errors and omissions liability insurance with policy limits of not less than $500,000, combined single limits, per occurrence. D. Workers' Compensation Insurance in statutory amount. All of the endorsements which are required above shall be obtained for the policy of Workers' Compensation Insurance. 4 Endorsements shall be obtained for the policies providing the above insurance for the following three provisions: 1. Additional Insureds: "The SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY and the City of San Juan Capistrano, its elected and appointed boards, officers, agents, and employees are additional insureds with respect to this subject project and contract with AGENCY." 2. Notice: "Said policy shall not terminate, nor shall it be canceled, nor the coverage reduced, until thirty (30) days after written notice is given to AGENCY." 3. Primary Coverage: "The policy and coverage afforded to the COMMUNITY REDEVELOPMENT AGENCY and the City of San Juan Capistrano and its elected and appointed boards, officers, agents, and employees shall be primary insurance and not contributing with any other insurance maintained by AGENCY." The policy limits shall have minimum coverages per occurrence as follows: $ 500,000 - Property Damage; $ 500,000 - Injury to One Person/Any One Occurrence; and $1,000,000 - Injury to More Than One Person/Any One Occurrence CONSULTANT shall provide to AGENCY certificates of insurance showing the insurance coverages described in the paragraphs above, in a form and content approved by AGENCY, prior to beginning work under this Agreement. SECTION 20. LIABILITY Notwithstanding any other provision contained in this Agreement, CONSULTANT shall be responsible for all injuries to persons and for all damage to real or personal property of AGENCY or others, caused by or resulting from the wrongful act or negligent acts errors or omissions of itself, its employees, or its agents during the progress of, or connected with, the rendition of services hereunder. CONSULTANT shall defend and hold harmless and indemnify AGENCY, and all officers and employees of each public agency from all costs and claims for damages to real or personal property, or personal injury to any third party, resulting from the negligence of itself, its employees, or its agents, arising out of CONSULTANT'S performance or work under this Agreement. 5 SECTION 21. COMPLIANCE WITH LAWS During the performance of this Agreement, CONSULTANT agrees as follows: A. CONSULTANT will not discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin. CONSULTANT will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. B. CONSULTANT will, in all solicitations of advertisements for employees placed by or on behalf of CONSULTANT, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex or national origin. C. CONSULTANT will perform the services herein contemplated in compliance with the Federal and California laws concerning minimum hours and wages (Davis-Bacon Act, 40 U.S.C. 267a et seq. and California Labor Code, Sections 1171 et seq.), occupational health and safety (29 U.S.C. 651 et seq. and California Labor Code, Sections 6300 et seq.), fair employment practices (29 U.S.C. 201 et seq. and California Labor Code, Sections 1410 et seq.), Workers' Compensation Insurance and Safety in Employment (Divisions 4 and 5 of the California Labor Code) and all amendments thereto, and all similar State or Federal laws to the extent they are applicable. D. CONSULTANT will cause the foregoing provisions to be inserted in all subcontracts for any work covered by this Agreement so that such provisions will be binding upon each subcontractor, provided that the foregoing provisions shall not apply to contracts or subcontracts for standard commercial supplies or raw materials. SECTION 22. CONSULTANT NOT AN AGENT Except as AGENCY may specify in writing, CONSULTANT shall have no authority, expressed or implied, to act on behalf of AGENCY in any capacity whatsoever as an agent. CONSULTANT shall have no authority, expressed or implied, pursuant to this Agreement to bind AGENCY to any obligation whatsoever. SECTION 23. PERSONNEL CONSULTANT agrees to assign the following person/persons to perform the tasks set forth in this Agreement: M. Robert Lewis Ronald J. Jonas Kevin McHugh CONSULTANT shall not unilaterally alter the assignment of the above personnel without the authorization of the Director of Public Works. 6 AGENCY shall have the unrestricted right to order the removal of any person/persons assigned by CONSULTANT by giving oral or written notice to CONSULTANT to such effect. SECTION 24. NOTICES Notices to the parties, unless otherwise requested in writing shall be sent to AGENCY at: San Juan Capistrano Community Redevelopment Agency 32400 Paseo Adelanto San Juan Capistrano, CA 92675 and CONSULTANT at: Mr. M. Robert Lewis, Project Manager & A Van Dell. Associates, Inc. 17801 Cartwright Road Irvine, CA 92714 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first hereinabove written. CONS/ULTANT �l2 By: P'a6; SAIV AN C PISTRANO COMMUNI ED ELO E AGENCY By: PH N B. J I�— EXECUTIVE DIRECTOR APPROVED S TO FORM: ATTEST: -TOH1 R. SHAW, CITY ATTORNEY MARY OVER AGENCY SECRETARY 7 • EXHIBIT "A" SCOPE OF WORK ITEM 1: FIELD SURVEY AND MAPPING Van Dell and Associates proposes to complete a topographic field survey of existing centerline and property line monuments, important structural improvements, and centerline profiles of existing roadways at areas joining existing roadways. Existing information, including improvement plans, records of survey and other maps of record, will be researched to determine monumentation before the field survey begins. The data collected, including field survey notes will be reduced for computer entry into a geographical database. The computer database will be used in other tasks for precise horizontal and vertical control. A Record of Survey Map will be prepared and recorded on said field survey. ITEM 2: PRECISE ALIGNMENT Utilizing aerial and field data, Van Dell proposes to provide the City of San Juan Capistrano with precise alignments at 1"=20 ' scale of the subject project area. This item is to be based upon a traffic study currently being prepared by the City of San Juan Capistrano. We propose to accomplish this phase of the work, using the following tasks : a. Information Review - Review the City and Development Team plans for the area. Specifically identify the concepts of public streets, parking areas, and vehicular and pedestrian access locations . The concept plan provided with the RFP, indicates the use of parking and building access areas within the proposed public street areas . Review the City street design criteria, including street widths, design speeds, signalization concepts, etc. Review available traffic volume data for existing and proposed development conditions within the greater project area. b. Concept Plan Development - Within the constraints of the development plans and the City criteria, prepare a 1"-40 ' scale concept striping plan. This plan would reflect traffic movements within the subject project area, including lane widths, turning pockets, and access conditions and restrictions . The traffic studies, as provided by the City and/or Development Team, will provide the data utilized in the concept striping plan. The concept striping plan will focus on traffic flow requirements and geometric design considerations. This plan would be reviewed by the City and discussed with the Development Team. -1- C. Preliminary Alignment Plan - Utilizing the computer geographic database compiled from aerial and field surveys, prepare a preliminary 1"=20 ' scale precise alignment plan. The alignments will provide a traffic circulation system, capable of efficiently moving the traffic throughout the subject project area. The following key areas of concern have been identified: * Traffic Circulation - lane requirements and widths and configurations as detailed in the concept striping plan. Utilization of traffic signals and signing to assist in the efficient flow of traffic. * Parking Areas - efficient access and impacts on traffic circulation. Flexibility to modify needs as development changes. * Building Clearances - provide maximum clearances, as applicable. * Utility Relocations - the available development plan indicates that the existing street corridors will remain open for continued use as utility corridors. Utility concerns for expansion or relocation of the facilities will be identified. * Drainage - the provision of adequate grades to permit site drainage and street drainage to existing storm drain systems. Consideration of the future extension of drainage systems due to new street patterns . * Property Severance - minimize, as practicable, the acquisition of property line bearings and locations, where practicable. The preliminary alignment plan will be reviewed and approved by the City and discussed with the Development Team. d. Final Precise Alignment - Following review of the preliminary alignment plan, the precise alignment will be calculated. The 1"=20 ' scale plan will include the street centerline, proposed rights of way, and existing property lines. The plan will show key building, utility, and drainage impact areas . The precise alignment submittal will include a report indicating the results of the preliminary alignment plan investigation and the impact on properties affected. ITEM 3: RIGHT OF WAY DOCUMENTS Van Dell and Associates proposes to prepare complete right of way documents including legal description and sketch. Preliminary title reports will be obtained by the City for use in the development of the documents. All processing of documents to obtain or abandon/vacate rights of way or easements will be done by the City. No property value appraisals nor negotiations for property will be provided. -2- M The number of parcels requiring right-of-way documents cannot be identified at this time, therefore a cost estimate is given in Exhibit H for the base work for right-of-way acquisition, in addition to a cost per parcel, as required. Due to the age of the property in question, retracement of property lines may require additional field survey work and boundary analysis. Should this be the case, the City would be notified and a revised scope of services would be identified and negotiated at that time. For your budgeting purposes it is estimated at this time that 20 parcels will be affected. ITEM 4: PROJECT COORDINATION In addition to coordination efforts within each major task, Van Dell proposes to provide attendance at two meetings with the City for general project coordination of the precise alignment and two meetings for general coordination of the right of way documents. -3- • EXHIBIT "B" • FEE SCHEDULE s The following is a estimated breakdown of fees corresponding to the Scope of Work as explained in the Request For Proposal revision dated July 9 , 1987 and our contact with the City of San Juan Capistrano discussing the project. Hours: Rate: Cost: I. Field Survey and Mapping: a. Research record information 3 $ 95 $ 285 b. Survey centerlines & property lines ( 3-man survey crew) 18 180 3 , 240 C. Field not reduction, cal- culations & analysis 8 64 512 . d. Record of Survey Map 1. Drafting 8 42 336 2 . Processing 4 64 256 3 . Analysis 2 95 190 Subtotal $ 4,819 II. Precise Alignments: a. Information Review 8 53 424 8 85 680 b. Concept Plan Development 1 . Review Traffic Data 16 74 1, 184 2 . Striping Plan Layout 12 53 636 3 . Plan Review 6 85 510 4 . Revision to Plan ( 1) 8 53 424 C. Preliminary Alignment Plan 1. Property Line Data 10 53 530 2. Preliminary Centerline 32 74 2, 368 3 . Utility Coordination 8 53 424 4 . Drainage Considerations 20 74 1,480 5 . Plan Review 8 85 680 6 . Revision to Plan ( 2) 24 74 1, 776 d. Final Precise Alignment 1. Final Alignment Plan 16 74 1, 184 2 . Final Alignment Report 16 85 1, 360 3 . Final Plan Review 4 85 340 4 . Reproduction 700 Subtotal $14,700 III.Right of Way Acquisition a. Title Report Analysis 4 95 380 b. Calculations & Analysis 4 95 380 C. Legal Descriptions 4 95 380 d. Exhibits 8 42 336 e. Right-of-Way documents (estimate 20 @ $246/parcel) 4 , 920 Subtotal $ 6,396 IV. Project Coordination a. For Precise Alignments 4 95 380 b. For Right of Way Acquisition 4 95 380 Subtotal $ 760 TOTAL (not to exceed) $26,675 SEPTEMBER 29, 1987 ADJOURNED REGULAR MEETING OF THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY BOARD OF DIRECTORS The Adjourned Regular 'Meeting of the Board of Directors of the San Juan Capistrano Community Redevelopment Agency was called to order by Chairman Hausdorfer at 8:07 p.m., in the City Council Chamber. ROLL CALL PRESENT: Gary L. Hausdorfer, Chairman Kenneth E. Friess, Vice Chairman Anthony L. Bland, Director Lawrence F. Buchheim, Director Phillip R. Schwartze, Director ABSENT: None STAFF PRESENT: Stephen B. Julian, Executive Director; Thomas G. !Merrell, Deputy Director; Mary Ann Hanover, .Agency Secretary; Glenn Southard, Assistant City Manager; John R. Shaw, City Attorney; William D. Murphy, Director of Public Works; Thomas L. Baker, Director of Community Services; Cheryl Johnson, Recording Secretary. MINUTES Regular Meeting of September 15, 1987: It was moved by Director Schwartze, seconded by Director Friess, that the Minutes of the Regular Meeting of September 15, 1987, be approved as submitted. The motion carried by the following vote: AYES: Directors Schwartze, Friess, Bland, Buchheim, and Chairman Hausdorfer NOES: None ABSENT: None BOARD ACTIONS 1. APPROVAL OF WARRANTS (300.30) It was moved by Director Schwartze, seconded by Director Buchheim, and unanimously carried to approve the List of Demands dated September 10, 1987, Warrant Nos. 619-632, in the total amount of $8,182.16. 2. CONSULTANT SELECTION - REDEVELOPMENT SERVICES (PERSONNEL) (600.40) Written Communications: (Ij Report dated September 29, 1987, from the Deputy Director, advising that a recommendation would be made regarding a request to submit proposals for general redevelopment services while two Agency Staff members are on leave. -1- 9/29/87 (2) Additional Report dated September 29, 1987, from the Deputy Director, recommending selection of The Synthesis Group to provide general redevelopment consultant services from October, 1987, to April, 1988. Selection of Synthesis Group: It was moved by Director Buchheim, seconded by Director Bland and carried with Director Schwartze abstaining, to authorize the Executive Director to execute a contract with The Synthesis Group for general redevelopment services in an amount not to exceed $35,000. A budget transfer of $10,000 from the .Administrative and Overhead account to the Specialized Services account was approved. 3. CONSULTANT AGREEMENT - PRECISE ALIGNMENT DESIGN OF ORTEGA HIGHWAY EL CAMINO REAL AND FORSTER STREET VAN DELL AND ASSOCIATES 600.40 < Written Communications: Report dated September 29, 1987, from the Director of Public Works, requesting approval of an agreement for development of the precise alignments of Ortega Highway, El Camino Real, and Forster Street to coordinate with development of the Historic Town Center. Cost for the service was estimated at $26,675. Funds were available in the Capistrano Improvement Account 26-6900-4720-001. Approval of Consultant Agreement: It was moved by Director Schwartze, seconded by Director Buchheim and unanimously carried to approve to .Agreement for Consulting Services with Van Dell and Associates, Inc., of Irvine, at a cost not to exceed $26,675, to design precise alignments for Ortega Highway, EI Camino Real, and Forster Street. The Executive Director and Agency Secretary were authorized to execute the agreement on behalf of the Agency. 4. RELOCATION SETTLEMENT - TEXACO SERVICE STATION LOCATED AT 26874 ORTEGA HIGHWAY CHUA 400.20 Written Communications: Report dated September 29, 1987, from the Deputy Director, advising that realignment of Ortega Highway as part of the Historic Town Center project would require relocation of Han Chua, owner/occupant of the Texaco Service Station.. The report advised that an agreement had been reached to relocate Mr. Chua to the Chevron station at 26988 Ortega Highway. Escrow had been opened contingent upon the Agency's approval of the relocation settlement and the Church's acceptance of the Agency's offer for purchase of the Texaco property. The settlement amounted to $101,350; funds were available in the Capital Improvements Account 26-6213-4720-Cl 7, Approval of Relocation Settlement: It was moved by Director Schwartze, seconded by Director Friess and unanimously carried to approve the full relocation settlement in the amount of $101,350 for Mr. Han Chua. -2- 9/29/87 0 AGENDA ITEM September 29, 1987 TO: Stephen B. Julian, Executive Director FROM: W. D. Murphy, Director of Public Works SUBJECT: Consultant Agreement - Precise Alignment Design of Ortega Highway, El Camino Real, and Forster Street (Van Dell & Associates) SITUATION Staff is requesting that a Consultant Services Agreement be approved with Van Dell & Associates for developing the precise alignments of Ortega Highway, EI Camino Real, and Forster Street. The City/Agency is presently processing the Historic Town Center Development and these alignments are necessary for the proposed development plans and actual road designs. The Oliver McMillan/Collins Development Team of San Diego has been selected as the Developer of the area (see Figure 1) which will include a 125-room hotel and 75,000 square feet of retail. These alignments must coordinate with the development plans and will be constructed as part of the development. In response to the attached Request for Proposals, proposals were submitted by eight firms. All firms indicated a high degree of capability to perform the work required. Three of the firms submitted excellent proposals and the compensation requested by them was within 10 percent of each other. Van Dell & Associates was chosen on the basis of their superior scope of work, their experience with this type of work, and their experience with other agencies. Copies of the submitted proposals are available for review in the Public Works Department. NOTIFICATION Mr. M. Robert Lewis, P.E., Van Dell & Associates; and Mr. Dean Oliver, Oliver/McMillan/Collins COMMISSION/BOARD REVIEW, RECOMMENDATIONS Not applicable FINANCIAL CONSIDERATIONS The cost for consultant services for precise alignment designs is estimated not-to-exceed $26,675. Funds are available in FY 87-88 CRA Capital Improvement Account #26-6900- 4720-COI totaling $150,000 for the street design projects in the downtown area. These consultant services will provide the alignments to be used for the actual design. Actual construction is scheduled in subsequent Fiscal Year Capital Improvement Programs. 1 'Agenda Item • • Page 2 September 29, 1987 ALTERNATE ACTIONS 1. Approve the agreement. 2. Do not approve the agreement. 3. Request further information from Staff. RECOMMENDATION By motion, approve the Consultant Agreement for precise alignment design of Ortega Highway, El Camino Real, and Forster Street. Respectfully submitted, �, V\, n"",e W. D. Murphy Attachments WDM/TGS:kjs INFINUE IMAGING SYSTEMS 23011 Moulton Parkway, Suite #E-8 Laguna Hills, California 92653 (714) 472-2777 �tti l � 0 '1 Juft MEMRERS OF THE CITY COUNC+'. ANLAND THONY L-FOB OBUC" • •� KENNETH FAl ESS IM KENNETH E. FWIESS 196h GARY L. HAUSOORFER rII76 PHILLIP R. SCHWARTZE 0 • CITU MANAGER STEPHEN 6 JULIAN September 30, 1987 Mr. M. Robert Lewis, Project Manager Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, CA 92714 Re: Notice to Proceed with Consultant Services - Precise Alignment of Ortega Highway, El Camino Real and Forster Street Dear Mr. Lewis: At the City Council meeting of September 29, 1987, the Agreement for the subject services was approved. In accordance with the Agreement Section 3, you are hereby given "Notice to Proceed". I am looking forward to having you work with the City/Agency. The City/Agency Project Manager, Mr. Brian Perry and myself will be available for a meeting, at your convenience, to resolve project direction issues. Very truly yours, Theodore G. Simon City Engineer TGS:kjs cc: Stephen B. Julian W.D. Murphy Mary Ann Hanover, City Clerk Nancy Erickson Brian Perry M 6ro-z1.0a" CITY CLERK'S DEPARTMENT - ACTION REMINDER TO: Brian Perry, Senior Civil Engineer FROM: Dawn Schanderl, Deputy City Clerk DATE: December 1, 1992 SITUATION: Status on the Vandell & Associates agreement for Ortega Highway Realignment CIP No 129. Are they working? ACTION REQUESTED: ACTIOt4 TO Bqr-t 607E (AKEN: n&-t�p- DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN: c SIGNATURE OF OFFICIAL TAKING ACTION: DATE SIGNED: ***FOR CITY CLERK'S DEPARTMENT USE ONLY*** Tickler Date: 10/01/92 12/01/92 Deadline Date: 1Ia shi s- I on kola �e� vl�u'1�2,rrc� (600.40/Vandell/Insurance needed when work begins) JJ 9a i C , IBBUE DATE 1f/O/8S/yy) .. Vim=4 PRODUCER 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 ALTER THE COVERAGE AFFORDED BY THE `AKASAKA ORTIZ A VARELA INS. POLICIES BELOW. PROFESSIONAL LIABILITY DIV. .._._._....... ....._..... ..........._,.... ......_.......... . . ............ 333 CITY BLVD, WEST, SUITE 100 COMPANIES AFFORDING COVERAGE ORANGE CA 92668 � R Y A TIO Insurance Company COMPANY B Northbrook Ins. Company ...... ....... LETTER INSURED .......... ......_........ ......_._....... .................. .. .......... . . ....... ............... Van Dell and Associates, Inc. LETTER COMPANY C St. Paul Fire A Marine 17801 Cartwright Road .. ........-.... ....,....._...._ ...._............ COMPANY D Design Prof. Ins. Co. Irvine CA 92714.0000 LETTER . ......._._._. .._..._......... ... ............ ._........_...... .. ......._.. .. ........... ..............._. COMPANY E LETTER 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 SUBIECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ............._............._..........._............_._........._.,........._.......-..._.............................................--._......................._............_........._.....:............._,........................._.........._...........................-..... 00 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE -.POLICY EXPIRATION LIMITS LTR: - DATE (MMIDDIM DATE(MMrDDA'Y) . ...i....... ... ....... ......._...... .... '........._ .......... . ............ . ....._._.... ..-....._...... ........ ........................................................... .... .. .......... C ._GENERAL LIABILITY RP0664S452 10127195 10127/96 GENERAL AGGREGATE f 2000000 X COMMERCIAL GENERAL LIABILITY _ - PRODUCTS-COMPAOP AGO. sx 2009000 f CLAIMS MADE X OCCUR. '., PERSONAL x AW.IILAIR7 {f 1999060 OWNERS 6 CONTRACTORS MOT. EACH OCCURRENCE f 1000990 :...............--.......-....................... ....._.........._.................. FIRE DAMAGE(Any one fire) :S 1000000 MEG:EXPENSE(Ary ane person).s 61100 B ,AUTOMOBILE LLIBLRY CA0796128 10/27/95 , 10127/96 COMBINED SINGLE ,f 1000000 X ANY AUTO .LIMB .._.......... .........._. f.. ........ ..._.... .... ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS :(Per person) :................................................::..................................... :....x...HIRED AUTOS BODILY INJURY :f X NCWOWNED AUTOS i(Por eaitlenq .. .................................. ........-............_....... ...... ......... GARAGE LIABILITY i.._.,... PROPERTY DAMAGE :x .............. .................._._........_...._........_............... -.................._........_...................... _........._........._.;............._..................;......................................._.......'......._.........._.................... EXCESS LLIBLITY EACH OCCURRENCE :x UMBRELLA FORM : AGGREGATE f OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION X STATUTORY LNRS ........ AAND 00228007 09101195 09/01196 EACH ACCIDENT s ; DISEASE-POLICY LIMIT f 1000000 i EMPLOYERS LIABILITY :........_.................... ................ i DISEASE-EACH EMPLOYEE S 1000000 OTHER A *Professional Liability PL700032A1 06115195 06115196 Per Claim 1000000 :Annual Aggregate 1000000 DESCRIPTION OF OPERATXNISADCATIDNSNEHIC EW-PECML ITEMS **EXCEPT 10-DAY NOTICE FOR NONPAYMENT OF PREMIUM. FOR PROFESSIONAL LIABILITY COVERAGE, THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR ALL COVERED CLAIMS PRESENTED WITHIN THE POLICY PERIOD. THE LIMIT WILL BE REDUCED BY PAYMENTS F� INDEMNITY AND EXPENSE. t 'Y l�):LR A,IA F,MMfF!� % .Y. .:.:i ? '..Y :F1lMIl e .::. ..... ... :..• tot.vw ; SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANG D BEFORE" >: EXPIRATION DATE THEREOF, THE ISSUING COMPANY WIQ,_9FTDFRAVOF� rn ?. MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE' ER ED THE CRY OF SAN JUAN CAPISTRANO -- LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE„ PBUG"ON 32400 PASEO ADELANTO s; SAN JUAN CAPISTRANISA 9267E LIABILITY OF ANY KIND UPON C PANV, ITS AGEIPTS (56REPRlTATIVES. ,AUTHORIZED REPRESENT7A S GRADIAS i: ` .x_ . ;:.E. 53 NOTICE Effective October 27, 1995, Van Dell and Associates, Inc. asked us to handle their insurance. While the change involved replacement of some policies with new carriers, the limits of liability carried by the firm remain unchanged. Accordingly, a new certificate of insurance is attached. Kindly destroy any previously issued certificates as they are null and void. You might also receive cancellation notice from previous insurance carriers. Please be assured that coverage continues with no lapse as noted on the certificates. We appreciate your patience and should you have any questions, please feel free to contact Cindy Phillips at 714/704-7349. Thank you. 0 z N „ m s 1V m v, 0 m CO fJi ................ ...... ....... ....... INS, ISSUE DATE (MM/DDlM u 00/19195 ... ... .. PRODUCER 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 ALTER THE COVERAGE AFFORDED BY THE CROWELLINSURAMCE AGENCY POLICIES BELOW. A DIVISION OF AOV 43 CORPORATE PARK, SUITE 200 COMPANIES AFFORDING COVERAGE IRVINE CA 92714 COMPANY A Design Professionals In*. LETTER GDmPANY B INSURED LETTER COMPANY Van Dell and Associates, Inc. LETTER C 17801 Cartwright Road COMPANY D IRVINE CA 92714-0000 LETTER COMPANY E LETTER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ...............- .................. ....... ....... ............................ CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DAM (MM/DDn DAM(MMA)DNY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPADP AGO. s ....................... ................................ ........... CLAMS MADE OCCUR. PERSONAL&ADV.INJURY OWNERS&CONTRACTORS MOT. EACH OCCURRENCE FIRE DAMAGE(My ane file) $ MED.EXPENSE(Any m,per").$ .......... .......- .........— ........ ......... ...... ............... ..........—... ........ .............................. AUTOMOBILE LLAB� COMBINED SINGLE LIMIT ANY AUTO .......--l-11.1-1-.1-1........ 4C ......-.......... ALL OWNED AUTOS GODLY INJURY SCHEDULED AUTOS (Per parson) TV HIRED AUTOS BODILY INJURY (Peg acddqo r TTI NON-OWNED AUTOS ............. -�. .......... GARAGE LIABILITY PROPERTY DAWOtg,Z m Sa ........ .......... ........ . y. LA rn ........ .. .............. . ......... .............. ................-............... ................. . . ....... EXCESS LIASAM —i UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS AND EACH ACCIDENT 0 SEASE-POLICY LIMIT EMPLOYERS'LIABILITY .......... ........................... DISEASE-EACH EMPLOYEE OTHER A PROFESSIONAL LIABILITY* PL700032.01 06115195 06115196 PER CLAIM AND 1000000 ANNUAL AGGREGATE DESCRIPTON OF OPERATION&LOCATIONSNEHICLESSPECIAL rrEMS "EXCEPT 10-DAY NOTICE FOR NONPAYMENT OF PREMIUM. FOR PROFESSIONAL LIABILITY COVERAGE, THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR ALL COVERED CLAIMS PRESENTED WITHIN THE POLICY PERIOD. THE LIMIT WILL BE REDUCED BY PAYMENTS FOR INDEMNITY AND EXPENSE. n 0 X. P4.9.0.*11,000"ll.WIN -�I.. :I 1,�. 0........... ........ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECELLED BEFORE TH CAN FOR E EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO CITY OF SAM JUAN CAPISTRANO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE �-X. LEFT, BUT FAILURE TO MAIL SUCH NOTICE $HALL IMPOSE NO OBLIGATION OR 32400 PASEO ADELAmTO LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. SAM JUAN CAPISTRANGIA 92675 1 Rt:FHM—�D REPRESENTATIVE Gradles AWN ..... ........ ..... ......... CS3 CITY CLERK'S DEPARTMENT - ACTION REMINDER TO: Brian Perry, Senior Civil Engineer FROM: Dawn Schanderl, Deputy City Clerk DATE: October 1, 1992 SITUATION: Status on the Vandell & Associates agreement for Ortega Highway Realignment CIP No 129. Are they working? ACTION REQUESTED: ACTIONT TAKEN- NA - , P" ; ( I �gQ2i DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN: SIGNATURE OF OFFICIAL TAKING ACTION: DATE SIGNED: (0/2 QZ ***FOR CITY CLERK'S DEPARTMENT USE ONLY*** Tickler Date: 10/01/92 Deadline Date: (600.40/Vandell/Insurance needed when work begins) ol/ /q2. (�2- f MEMORANDUM i TO: Brian Perry, Senior Civil Engineer FROM: Theodore G. Simon, City Eng*w +,. SUBJECT: Ortega Highway Realignment (CII' Q. 129�:(i According to the March 5, 1991 City Council action on the GIP. was to complete the Record of Survey and prealfe elignmowl!* years. The revised budget for FY 90-91 was $1;4000. ,1 Projects were agreed to be performed based on cash flow av&114bj been no other direction given to date, the agreement for they4txbjeei!$� Dell and Associates and the CRA should not be terminated. y r TG S:ssg , cc: William M. Huber 4 < Cassandra Walker 'T c4 f477 ri J; P . 1 1 ra M res CITY CLERK'S DEPARTMENT - ACTION REMINDER TO: Director of Public Works �/ FROM: City Clerk DATE: November 1, 1987 SITUATION: At a regular meeting of the Community Redevelopment Agency on September 20, 1987, the Board of Directors entered into an Agreement with Van Dell and Associates, Inc. to provided Consultant Services in regards to the design precise alignments for Ortega Highway, El Camino Real, and Forester Street. ACTION REQUESTED: Said agreement states that the work shall be completed within 9 weeks of the Notice to Proceed. This is a reminder that the due date is December 1, 1987. ACTION TO BE TAKEN: Z4 ?17 Lt,4/ proal DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN: 1/e7, Z47 / 98 2 SIGNATURE OF OFFICIAL TAKING ACTION: DATE SIGNED: /O ***FOR CITY CLERK'S DEPARTMENT USE ONLY*** 3(( 8C9a_ * W .O ., . .. Tickler Date: It/l/87 Deadline Date: 12/1/87V �1.1 V) -, Lv cc: City Attorney (J ) Assistant City Manager Ac/ mo. VAN ■TI4 V■ wsup t& / �{1A, ISSUE DATE(MM/DD/YY) y �+ Y6/20/94 PRODUCER The Crowell Insurance Agency CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 9 y DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P. O. Box 19501 POLICIES BELOW. _ 43 Corporate Park, Suite 200 COMPANIES AFFORDING COVERAGE Irvine, CA 92713-9501 COTTEMPANYR A LE COMPANY B INSURED LETTER COMPALETTER `. Van Dell and Associates, Inc. 17801 Cartwright Road COMPANY LETTER D Irvine CA 42714 COMPANY E LETTER Desian Professionals Ins, Co. COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ ~� COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/CP AGG. $ CLAIMS MADE OCCUR. PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MEO.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY *For professional liability coverage, COMBINED SINGLE $ ANY AUTO the aggregate limit is the total in— LIMIT ALL OWNED AUTOS surance available for all covered Claims BODILY INJURY SCHEDULED AUTOS presented within the policy period. (Per person) $ HIRED AUTOS The limit will be reduced by payments BODILY INJURY $ NON-OWNED AUTOS of indemnity and expense. (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT $ AND DISEASE-POLICY LIMN $ EMPLOYERS'LIABILITY DISEASE-EACH EMPLOYEE $ E OTHER PL700032 6/15/94 6/15/95 +PROFESSIONAL $1, 000, 000 EACH LIABILITY CLAIM DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS �- #eTEN DAYS NOTICE IN THE EVENT OF NONPAYMENT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO CITY OF SAN JUAN CAPISTRANO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR SAN JUAN CAPISTRANO, CA 92675 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZ REPRESENTATIVE C. L n! ACORD 25-S(9150) ©ACORD CORPORATION 1990 4— 12 Crowell Ins. Agency 4. T E, s D it rz IT 4 c-r c pe n r o'-I�, --n x IF,is i :t 1(11 J E, F e A f tint I--. I � b 9 1 4� O7 Tic 0 i6J7, U i bck; -lqq 3 0 f4 S W T d 41 ry S 9 C Ot! it' it'I 11 T Aj T V!- 3 : 1 OT -EDITOO 2Y,,-!, q T r qA D 14AIJL L IAP 'll- v T D ,'.TWAJ- 3CA 0--T3A9 'iFONVE: UWART219A,, AAklu WA2 f7tr, r f r AI:011b. CERTIFICAG OF INSURANCE 0 ISSUE DATE (�$9 PR&UCEil 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 ALTER THE COVERAGE AFFORDED BY THE ASSOCIATION ADMINISTRATORS POLICIES BELOW. & CONSULTANTS INC COMPANIES AFFORDING COVERAGE P 0 BOX 19570 IRVINE CA 92713 COMPANY LETTER A COMPANY B '. . _... LETTER INSURED COMPANY fv C VAN DELL AND ASSOCIATES LETTER + n 17801 CARTWRIGHT C°OMPA Y D , IRVINE CA 92714 LEGION INSURANCE CO., J COMPLETTEANRY E COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS 7p DATE(MM/DDM') DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGG. f CLAIMS MADE OCCUR. PERSONAL 6 ADV.INJURY $ OWNER'S A CONTRACTOR'S PROT. EACH OCCURRENCE S FIRE DAMAGE(Any"bre) S .. MED.EXPENSE(Any aa.W ) $ AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Par person) S HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per eoeitlenq $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS MABILRY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION WC2002867 9/01/93 9/01/94 X STATUTORY LIMITS AND EACH ACCIDENT $1, 000, 000 DISEASE--POLICY LIMIT Sl r 000 r 000 EMPLOYERS'LIABILITYDISEASE--POLICY EMPLOYEE $1, 000, 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEWCLES/SPECIAL ITEMS SEE ATTACHED ENDORSEMENTS PAYMENT,A 10 DAY NOTICE WILL BE GIVEN CERTIFICATE HOLDER" - - - CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL �pIbFIL>AQAs�'@T MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE CITY OF SAN JUAN CAPISTRANO LEFT, 32400 PASEO ADELANTO SAN JUAN CAPIST CA 92675 Au 1 4FRT5( d FOR �A`AAy'&C Y ACORD 25-S (7190) V OACORD CORPORATION 1990 • 86 f 07 (Ed. 1-88) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY POLICY INFORMATION PAGE ENDORSEMENT The following item(s) X Insured's Name _ Item 3 .A. States Policy Number _ Item 3 .B. Limits _ Effective Date _ Item 3 .C. States Expiration Date _ Item 3 . D. Endorsement Numbers Insured's Mailing Address _ Item 4 . Class, Rate, Other Experience Modification _ Interim Adjustment of Premium Producer's Name _ Carrier Servicing Office Change in Workplace of Insured _ Interstate/Intrastate Risk Insured's Legal Status I . D. Number Carrier Number X The Following Added as Additional Insured for Work Performed By The Named Insured: CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY & ITS ELECTED & APPOINTED BOARDS , OFFICERS, AGENTS & EMPLOYEES 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CALIFORNIA 92675 All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy. ) ENDORSEMENT EFFECTIVE 09/01/93 POLICY NO. WC2002867 INSURED: VAN DELL AND ASSOCIATES LEGION INSURANCE COMPANY ENDORSEMENT NO. N/A AA&C:Y ISSUE: 8/18/93 O'h#uV 0A) 0)&0&,v J CHERYL ANN BODEN For AA&C Authorized Representative _. f LEGION INSURANCE COMPANY Named Insured: VAN DELL AND ASSOCIATES Pol . # WC2002867 This endorsement forms a part of the policy as numbered above, issued by LEGION INSURANCE COMPANY designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 09/01/93 Effective hour is the same as stated in the Declarations of the policy. PRIMARY CLAUSE ENDORSEMENT It is agreed that such insurance as is afforded by this policy for the benefit of CITY OF SAN JUAN CAPISTRANO, 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CA 92675 shall be primary insurance, but only as respects any claim, loss or liability arising out of the operations of the Named Insured(s) and any insurance maintained by the above shall/. I: obe non-contributing. X AA&C:Y ISSUE: 8/18/93 � 1)'o,C ock) eb'AI CHERYL ANN BODEN for AA&C Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B • PROFESSIAL LIABILITY ARCHITEC ENG; Sjs FRS _"For All the Commitments You Make° INSURED: Van Dell and Associates, Inc. Policy AAE 00-431-24-68 MEMORANDUM OF INSURANCE ARCHITECTS AND ENGINEERS PROFESSIONAL LIABILITY This memorandum is issued Addressee: as a matter of information only and confers no rights City of San Juan Capistrano upon the holder. By its Attn: Mr. Theodore G. Simon, City Eng. issuance the Company does 32400 Paseo Adelanto not alter, change, modify San Juan Capistrano, CA 92657 or extend the provisions of said policy and does not waive any of its rights thereunder . Name and Address of Insured: Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, CA 92714 Policy Period: 05/18/93 to 05/18/94 $ 1, 000 , 000 Per Claim limit of liability (including claim expenses) $ 1, 000, 000 Aggregate limit of liability (including claim expenses) In the event of the cancellation of the Insurance as shown herein, the Continental Casualty Company or its authorized representative will provide thirty (30 ) days prior written notice to the party to whom this certificate is addressed at the address stated herein . The mailing of such notice shall be sufficient proof of notice. The above named insured has in force, on the date indicated below, a policy of professional liability insurance issued by the Continental Casualty Company with a limit of liability of not less than the amount indicated above. Dated at: San Francisco, California Date : 06/28/93 VICTOR 0. SCHINNERER & CO. BY: Authorized Representative 1-41249-A • PROFESSIONAL .BILITY CIVAARCHITECTSIEN�NEERS r For AH the Commitments You Make INSURED: Van Dell and Associates, Inc . Policy AAE-00-431-24-68 Effective 05/18/93 Endorsement Number 12 ENDORSEMENT It is agreed that this policy will not be cancelled until thirty (30) days prior written notice is given to : City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 City of Irvine Attn : Public Works Department One Civic Center Plaza Irvine, CA 92714 City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92657 All other provisions of this policy remain unchanged. Counter : gne y AutVfiVed Representative 83-118 BROKER (Ed . 08/83 ) CERTIFIC/SE OF INSURANCE ` = "�"�°"'� '"'M'0/ A�:A�1. I 9/10/92 92 PRODUCER 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 ALTER THE COVERAGE AFFORDED BY TIME ASSOCIATION ADMINISTRATORS POLICIES BELOW. & CONSULTANTS INC COMPANIES AFFORDING COVERAGE P O BOX 19570 IRVINE CA 92713 COMPANY / A LETTER "f COMPANY B _n INSURED LETTER 7 p COMPANY r' < LETTER C .. J1 r1 "J VAN DELL AND ASSOCIATES COMPANY D LETTER - 17801 CARTWRIGHT LEGION INSURANCE CO IRVINE CA 92714 COMPANY T� LETTER E COVERAGES THIS 15 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. CO DAMAG POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF NSURANCE POLICY NUMBER DATE(MMMONY) DATE(MMA)DNY) LENTS OENFJ7AL UABSITY BODILY INJURY O= i COMPREHENSIVE FORM BODILY INJURY AGG. f 1PI1RE�M�pISCONE�SOPERATIONS PROPERTY E OCC. EXi PLOSIt COLLAPSE HAZARD PROPERTY DAMAGE AGG. i PRODUCTS/COMPLETED OPER. BI i PD COMBINED OCC. B CONTRACTUAL BI 8 PD COMBINED AGG. i INDEPENDENT CONTRACTORS PERSONAL INJURY AGG. B BROAD FORM PROPERTY DAMAGE PERSONAL INJURY AUTOMOBILE LIABYJTY BODILY INJURY i ANY AUTO IPM wl") ALL OWNED AUTOS(P& put) BODILY INJURY ALL OWNED AUTOS ( W) 0owIPM soddwd) i HIRED AUTOS PROPERTY DAMAGE i NON-OWNED AUTOS GARAGE LIABILITY BODILY INJURY S PROPERTY DAMAGE i COMBINED EXCESS LUU3ILJTY EACH OCCURRENCE i UMBRELLA FORM AGGREGATE i OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION WC1-002867 9/01/92 9/01/93 X JTORY LIMIT$ EACH ACCK)ENT it 000 000 AND DISEASE-POLICY LIMIT it 000,000 EMPLOYERS'LIABKJTY DISEASE-EACH EMPLOYEE it 000,000 OTHER DESORPTION OF OPERATIONNIOCAMONS/VENICLESAMCW.ITEMS ALL ENGINEERING OPERATIONS IN THE EVENT OF CANCELLAT.ICN! FOR NON- PAYMENT, A 10 DAY NOTICE WILL BE GIVEN CERTIFICATE HOLDER - - - CANCELLATION - - - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SAN JUAN EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL `ENDEA0SR%-T0 CAPISTRANO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT, B T '0815,Ij0k.JOBOQAf?lQLll" SAN JUAN CAP CA 92675 p AUTHOR D REPRESENTA7NE ,, CJ ` // 0W ACORD 25 (7/90) - - ® ORD CORPORATION 1990 86 00 07 (Ed. 1-88) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY POLICY INFORMATION PAGE ENDORSEMENT The following item (s) X_ Insured' s Name _ Item 3. A. States _ Policy Number _ Item 3. B. Limits _ Effective Date _ Item 3. C. States _ Expiration Date _ Item 3 . D. Endorsement Numbers Insured ' s Mailing Address _ Item 4. Class, Rate, Other _ Experience Modification _ Interim Adjustment of Premium _ Producer ' s Name _ Carrier Servicing Office _ Change in Workplace of Insured _ Interstate/Intrastate Risk Insured' s Legal Status I . D. Number _ Carrier Number X The Following Added as Additional Insured for Work Performed By The Named Insured: CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS AND EMPLOYEES 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy. ) ENDORSEMENT EFFECTIVE SEPTEMBER 1, 1992 POLICY NO. WC1-002867 INSURED VAN DELL AND ASSOCIATES, INC. LEGION INSURANCE COMPANY ENDORSEMENT NO. N/A (.CJ AA&C: CJW ISSUE: 9/10/92 _ CJ WEB99RLEY for AA&C Authorized Representative LEGION INSURANCE COMPANY Named Insured: VAN DELL AND ASSOCIATES, INC. Pol WC1-002867 This endorsement forms a part of the policy as numbered above, issued by LEGION INSURANCE COMPANY designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/01/92 Effective hour is the same as stated in the Declarations of the policy. PRIMARY CLAUSE ENDORSEMENT It is agreed that such insurance as is afforded by this policy for the benefit of CITY OF SAN JUAN CAPISTRANO shall be primary insurance, but only as respects any claim, loss or liability arising out of the operations of the Named Insureds ) and any insurance maintained by the above shall a non-contri uting.� AA&C CJW ISSUE: 9/10/928bf 12 QX/Jr�/Jft CJ WEBatRLEY for AA&C Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B IMMUDoml 6/13/89 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ASSOCIATION ADMINISTRATORS DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 8 CONSULTANTS INC ------ P 0 BOX 19570 COMPANIES AFFORDING COVERAGE IRVINE CA 92713 COMPANY LETTER A COMPANY INSURED : LETTER B VAN DELL AND ASSOCIATES COMPANY 17801 CAkTldkIGHT LETTER— C IRVINE CA 92714 ETTTERCOMPA"YD COMPANY CONTINENTAL CASUALTY LETTER E 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 REOUIHEMENT,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. DO TYPE OF INSURANCE POLICY NUMBER vOLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS LTR DATE IMM/DDYY) DATE(MM/DD/YY) EACH AGGREGATE _ OOCURENCE GENERAL LIABILITY III BODILY COMPREHENSIVE FORM IWURY PREMISES,OPERATIONS li PROPERTY UNDERGROUND DAMAGE EXPLOSION 6 COLLAPSE HAZARD PRODUCTS'COMPLETEO OPERATIONS OONTRAGTUAL BI BPD COMBINED INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY IIS PERSONAL INJURY AUTOMOBILE LIABILITY IN= (PER PERSON) BODILY ANY AUTO INJURY (PER ALL OWNED AUTOS ACCIDENT) I HIRED AUTOS PROPERTY DAMAG NON-OWNED AUTOS I DAMAGE GARAGE LIABILITY COMB) '. COMBINED EXCESS LIABILITY UMBRELLA FORM BI b COMBINED OTHER THAN UMBRELLA FORM I _ STATUTORY WORKERS'COMPENSATION EACH ACCIDENTI AND EMPLOYERS'LIABILITY li DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) OTHER AAE1312468 5/18/89 5/18/90 LI 1 ,000 DESCRIPTIONOFOPERATIONS/LOCA TIONS/VEHICLES/SPECIAL ITEMS —� *PROFESSIONAL LIABILITY LIMIT PER CLAIM AND POLICY AGGREGATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY FMR. THEODORE G SIMON CITY ENG WILLE NDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO Y OF SAN JUAN CAPISTRANO THECE RT I FICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON 00 F`ABEO ADELANTOTH. A Y, ITS AGENTSORR ESENTATIVES JUAN CAPISTRANO CA 92675 RUTH R E T ERALL GRADIA FOR AABC D RECEIVED , FAY 19 10 33 4H185 MEMORANDUM CITY CLERK DEPARTMENT C{TY 3F SAN JUAN C'F'STRANA May 17, 1989 MEMO TO: FIRMS IN POSSESSION OF CERTIFICATES OF PROFESSIONAL LIABILITY INSURANCE FROM: SHERALL GRADIAS SUBJECT: VAN DELL AND ASSOCIATES, INC. CONTINENTAL CASUALTY COMPANY POLICY NO. AAE4312468 As you are no doubt aware, the certificate of insurance evidencing the referenced policy and issued to your firm will expire on May 18, 1989. At this time, we are in the midst of the renewal process and will not have negotiations completed prior to expiration. Please be assured that CNA has extended coverage under the above policy until June 1, 1989 at which time a decision should be reached and a new certificate issued to you. Again, I must reiterate that coverage will not lapse on May 18, 1989. If you have any questions at all , please do not hesitate to contact me at 714/833-0673. 7), t V Shera11 Gradias /s CC: Van Dell and Associates, Inc. ASSOCIATION ADMINISTRATORS & CONSULTANTS, INC. 19000 MacArthur Blvd.•Suite 500•Irvine,CA 92715•Mailing address:P.O.Box 19570•Irvine,CA 92713 In Alaska,Calitornia and Hawaii telephone 71418330673•All other stales 8001854-0491•FAX 71417521588 Y • I L;SUE DATE(M'VODNY) ` • 4/26/89 v f ® t PR�IDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND COnFERS NO RIGHTS UPON 'HE CERTIFICATE HOLDER.THIS CERTIFICA"E DOES NOT A AEND, EXTEND OR ALTE I THE COVEF IE AFFORDED BY THE POLNAES BELOW. ASSOCIATION ADMINISTRATORS & CONSULTANTS INC COI'APANIES AFFORDING COVERAGE 19000 MacArthur B1 #500 Irvine, California 92715 CCMPANY A COMMERCIAL UNION LE TER k ry CC.MPANvCOMMERCIAL UNION INS JRED LE ETER B -. VAN DELL AND ASSOCIATES INC COMPANYC COMMERCIAL UNION rj DOLE ITER 17801 Cartwright Road Irvine, California 92714 CCMPANY p HARTFORD ACCIDENT & M NITFICO LE ITER 141- COMPANY CCMPANY E GO LE ITER PHIS IS TO CERTIFY THAT POLICIES OF:INSURANCE LISTED BELOW HAVE BEEN ISSUED TO'I HE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY,:ONTRACT OR OTH ER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY HE ISSUED OR MAY PERTAIN,THE INSIJRANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDI- PIONS OF SUCH POLICIES. CO POLICY ERECIVE POLICI EXPIRATION LIABILITY LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER DATE IMM Odyn DAT;(MMDGNY) 7 EACH AGGREGATE _ OCCURRENCE GENERAL LIABILITY BODILY A X COMPREHENSIVE FORM IN..URY $ $ PREMUNDEIRGBO�D TIONS FALB96105 4/01/89 4/01/90 PROPEY RT EXPLOSION&COLLAPSE HAZARD DAMAGE $ $ PRODUCTSICOMPLETED OPERATIONS X CONTRACTUAL BI&RD $ 500 $ 500 X INDEPENDENT CONTRACTORS X BROAD FORM PROPERTY DAMAGE $500 X PERSONAL INJURY PERSONAL INJURY AUTOMOBILE LIABILITY BODILY INA BY X ANY AUTO CAAA09354 4/01/89 /Ol/89 4/01/90 (PER PERSON) $ X ALL OWNED AUTOS(PRIV. PASS,) BDOuv X ALL OWNED AUTOS OTHER THAN) Ak nIm0EM1 $ 4", J PRIV. PASS (PER X HIRED AUTOS v } PROPERTY 7. $ X NON-OWNED AUTOS DAMAGE $ M`; f GARAGE LIABILITY BI s PD ` Ia COMBINED $500 t: t�"P`�,' EXCESS LIABILITY X UMBRELLA FORM Being Issued 4/01/89 4/01/90 81&RINED $5,000 $5,000 OTHER THAN UMBRELLA FORM STATUTORY ? ^ (- WORKERS'COMPENSATION 72WJCI4619W 9/01/88 9/01/895 $ 1 006EACH ACCIDENT) AND EMPLOYERS' LIABILITY $ 1 00(§ ISEASE-POLICY LIMIT) _ Yt, $ 1 00(JDISEASE-EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONSILOCATIONEiNEHICLES/SPECIAL ITEMS Special endorsements Y,o follow upon policy issue - Additional Insured and primary coverage wording per expiring. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- D1r. Theodore G Simon, City Engineer PIRATION. DATE THEREOF, THE ISSUING COMPANY WILL v(Qp,�7� MAIL j0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDE�G'fYf'fHE CITY OF SAN JUAN CAPISTRANO LEFT, ISTQ.Mtp I1.,S J ' 32400 Paseo Adelanto AUTHORIZED REPRESENT E Y San Juan Capistrano, California 92675 Sherall Gradi f San Juan Capistrano Communitv Redevelopment Agencv April 18, 1989 Mr. M. Robert Lewis Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, California 92714 Re: Renewal of Professional Liability Certificate of Insurance (Desi n Precise Alignments for Ortega Highway, El Camino Real, and Forster Street Gentlemen: The Professional Liability Certificate of Insurance, regarding the above-referenced project is due to expire on May 18, 1989. In accordance with your contract, the insurance certificate needs to be renewed for an additional period of one year. Please forward an updated certificate to the City, attention City Clerk's Department, before the May 18, 1989, expiration date. In addition, a letter was sent to you on March 8, 1989, requesting renewed certificates of insurance for General Liability, Automobile Liability and Excess Liability which expired on April 1, 1989. The certificates have not been received. If you have any questions, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. Thank you for your cooperation. Very truly yours, Mary Ann Hanover, CMC City Clerk MAH/dms cc: Brian Perry, Associate Civil Engineer 32400 Paseo Adelanto San Juan Capistrano California 92675 714-493-1171 San Juan Capistrano Conununir7 Redevelopment Agenr7 i r � March 8, 1989 Mr. M. Robert Lewis Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, California 92714 Re: Renewal of General Liabilit Automobile Liabilit and Excess Liabilit Certificates of Insurance Desi n revise Ali nments or Ortega Highway, 1aminio Real, and orsterstreet) Dear Mr. Lewis: The General Liability, Automobile Liability and Excess Liability Certificates of Insurance, regarding the above-referenced project, are due to expire on April 1, 1989. In accordance with your contract, the insurance certificate needs to be renewed for an additional period of one year. Additional Insured, 30-day Cancellation Notice and Primary Coverage endorsements are required as referenced on page 5 of your contract. Please forward the updated certificates and endorsements to the City, attention City Clerk's Department, before the April 1, 1989, expiration date. If you have any questions, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. Thank you for your cooperation. Very truly yours, Mary Ann Ianover, CMC Agency Secretary MAH/dms zf cc: Director of Public Works City Engineer 52400 Paseo Adelanto San loan Capistrano California 92675 � f 711-195-1171 MEMORANDUM TO: Brian Perry, Associate Civil Engineer FROM: Dawn Marie Schanderl, Records Coordinator DATE: April 17, 1989 SUBJECT: Van Dell and Associates Brian, as per our conversation of April 17, 1989, the insurance certificates for Van Dell and Associates regarding general liability, automobile liability, excess liability expired on April 1, 1989. Their Professional liability is due to expire on May 18, 1989. 1 have notified Administrative Services that there will be no payments made until insurance is updated. Thanks for your insight on this! cc: Cynthia Pendleton, Accounting Officer Kathleen Trepa, Management Assistant Bonnie Shires, Account Clerk C1COf _ _ iiSUE DATE(M'UDDffY) 9/13/88 PR:IDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFI:RMATION ONLY AND CC LIFERS NO RIGHTS UPON HE CERTIFICATE HOLDER.THIS CERTIFICA"!E DOES NOT A IAEND, • EXTEND OR ALTE-I THE COVERAGI!AFFORDED BY THE POUAES BELOW. Association Administrators & Consultants, Inc. COWANIES AFFORDING COVERAGE 19000 MacArthur Boulevard #500 COMPANY Irvine, California 92715 LETTER A Hartford Accident & Indemnity Co. 714/833-0673 OAAPANY INSJRED LETTER B Van Dell and Associates, Inc. O"�AY C 17801 Cartwright Road Irvine, California 92714 GJAdPANY D LETTER O:•APANY E LETTER THIS S TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REGUIREMENT,TEAM 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 S SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDF TIONS OF SUCH POLICIES. CO POLICY EI IECrnE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER DATE(WOO" DATE MADO YY) rDA�GE EACH DOCURRENCE AOGREGAIE GENERAL LIABILITY _ - COMPREHENSIVE FORM $ $ PREMISES/OPERATIONS UNDERGROUND EXPLOSION&COLLAPSE HAZARD $ $ PRODUCTSAAMPLETED OPERATIONS CONTRACTUAL $ $ INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY 80DI-Y ANY AUTO (PER PERSON $ ' ALL OWNED AUTOS(PRN. PASS.) BODILYkkJ : - `x ALL OWNED AUTOS OTHER THAN) REENip O NO $ PRN. PASS.1 HIRED AUTOS PROPERTY NON-OWNED AUTOS DAMAGE $ ' GARAGE LIABILITY ' BI&PD s' COMBINED $ EXCESS LIABILITY UMBRELLA TOM BI 8 PD COMBINED $ $ OTHER THAN UMBRELLA FORIA WORKM'COMIPENSATION Renewal of sTATuraY k $ EACH ACCIDENT) A Ara 72WJ402995W 9/01/88 9/01/89 $ EASE-POLCYLMm EMPLOYERS'uAeurrr '� FA $ DISEASE-EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATONSILOCATnJNSNEHICMS/SPECIAL ITEMS Mr. Theodore G. Simon, Cit Engineer UA LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEF 'Y ION DATE THEREOF, THE ISSUING COMPANY WILL M1Xbh'�i'bX CITY OF SAN JUAN CAPI STRANO 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 Paseo Adelanto X San Juan Capistrano, CA 92675 radias fo A nc. /s THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES Policy #: 72WJ402995W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/01/88. Effective hour is the same as stated in the Declarations of the policy. It is agreed and understood that coverage provided by the above referenced policy is primary and not contributing with any other insurance maintained by City of San Juan Capistrano and San Juan Capistrano Redevelopment Agency. AAC: sg Issue: 9/13/88 Sherall Grad as for AA&C Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute a valid countersignature of this endorsement. Form G-2240-3B C cord. 9SUE DATE(M17/DD/M �� - • I - ! 9!13/88 PR IOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INK FImATtO N ONLY AND CONFERS NO RIGHTS UPON'HE CERTIFICATE HOLDER.THIS CERTIFICAT E DOES NOT AMEND, EXTEND OR ALTEF7 THE COVERAGE:AFFORDED BY THE POLICIES BELOW. Association Administrators A C4,0sultants, Inc. COWANIES AFFORDING COVERAGE 19000 MacArthur Bouleva -d ON C(MPANV p eiartfard Accident 8 IDd•alit I) vine, California 927.15 LEER y Co. 714/833-0673 CCINIPANY INS IRED LE--ER B Van Dell and Associates , Inc. COMPANY' C 17801 Cartwright Road Irvine, California 927.14 UE�TER` D COMPANY E LE'TER '"MIS IS TO CERTIFY THAT POLICES OI"INSURANCE LISTED BELOW HAVE BEEN ISSUEOTOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. IIOTWTTHSTANDING ANY REGUIIEMEH T,TERM OR CONDITION OF ANY CONTRACT OR OTHEA DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY HE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLHAES DESCRIED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDI- I'IONS OF SUCH POLICES. CO TYPE OF INSURANCE POLICY NUMBER POLICY FR law PGMI EIPIMTM LIABILITY LIMITS IN THOUSANDS L DATE AIMIGI1'1T DATE (MWO%YI � EACH _ A, ='.'77? OCCURRENCE AGGREGATE GENERAL LIABILITY BODILY COMPREHENSIVE FOAM INJURY $ $` PREMSES�OPEMTEXIS ,P UMDERGROUND DAMAGE _ EXPLOSION A COLLAPSE HAZARD $ $ PRODUCISCOMPLETED OPERATM PD CONTRACTUAL ICI 8COMBBI _ NED $ $ INDEPENDENT CONTRACTORS BROAD RXTM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY HDBY; ANY AUTO IRI RSI $ ALL OWNED AUTOS(PRN. PASS.) 8MLY ■W 1 ALL OWNED AUTOS(OTHER PS) IRR AWANt $ PF9HIRED AUTOS _ PROPERTY - '; NON-OWNED AUTOS DAMAGE $ GARAGE LIABILITY BI 8 PD COMBINED $ EXCESS LIABILITY - UA I"" BI 6 PD COMBINED $ $ OTHER THAN IABHELU FORM STATUTORY WORKERS'COMPENSATION FEenewal of ,? $ nrVJEACH ACCIDENT) A AND 72UJ402995M 9/01/88 9/01/89 .' g DISEASE-POLICY LIMIT) EMPLOYERS'LIABILITY .? ; (DISEASE-EACH EMPLOYEE) O'T/ER DESCRIPTION OF OPERATMJN,SILOCATIONSIVEHICLES/SPECIAL ITEMS Mr. Theodore 6. Simon:, City Engineer SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- PIRATION DATE THEREOF, THE ISSUING COMPANY WILL WNW CITY OF SAN JUAN CAPISTRANO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLD TO THE 32400 Paseo Adelanto LEFT, San Juan Capistrano, CA 92675 AUT She radios fa AA nc. s THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES INC. Pol 72WJ402995W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/01/88. Effective hour is the same as stated in the Declarations of the policy. ADDITIONAL INSURED EMPLOYER ENDORSEMENT IT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THE POLICY UNDER INSURING AGREEMENT I ALSO APPLIES TO: CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS AND EMPLOYEES. 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 AS AN ADDITIONAL INSURED EMPLOYER BUT ONLY AS RESPECTS EMPLOYEES HIRED BY AND CARRIED ON THE PAYROLL OF THE EMPLOYER NAMED IN ITEM I OF THE DECLARATION OF THIS POLICY. AAC sg ISSUE: 9/13/88 , Sherall Gra ias for AA&C Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, countersignature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B d� RECEivE6 SHERALL GRADIASppqq � ACCOUNT EXECUTIVE `(f{p I BUSINESS INSURANCE DIVISION ✓1 CITU OF •��a�, FAk MAN GAPISI'RANO June 20, 1988 CALIFORNIA Cvirl�n.o Cyo S�/�t�5�yu �/P Mr. Theodore G. Simon, City Engineer CITY OF SAN JUAN CAPISTRANO 32400 Paseo Adelanto / San Juan Capistrano, California 92675 Dear Mr. Simon: RE: VAN DELL AND ASSOCIATES, INC. Enclosed please find special endorsements which should be attached to the Certificate of Insurance issued to the City on April 14, 1988. The endorsements attach to the general and auto liability coverages. The City has been named as an additional insured and will be provided thirty days notice of cancellation as requested. Should you have any questions at all, please do not hesitate to contact the undersigned. Sincerely, Sher Sherall Gra ias SG:jr Enclosures ASSOCIATION ADMINISTRATORS & CONSULTANTS, INC. 19000 MacArthur Blvd - Irvine.CA 92715 • Mailing address.P.O Box 19579 • Irvine.CA 92713 In Alaska,California and Hawaii telephone 714.833-0673 •All other slates 800/854-0491 1 (The Attaching Clause need be completed only when this endorsement is issued subsequent to preparation of the policy.) LIABILITY GL 20 09(Ed.O1 73) L 9452 G116 (Ed.1.73) ISO G116 ADDITIONAL INSURED Owners or Contractors) This endorsement modifies such insurance as is afforde by the provisions of the policy relating to the following: COMPREHENSIVE GENERAL LIABILITY INSURANCE MANUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE This endorsement, effective 4/01/M.01 A.M.,standard time) forms a part of policy No. AAW655030 issued to VAN DELL AND ASSOCIATES, INC. by AMERICAN EMPLOYERS' INSURANCE COMPANY (213 ' "AUth.risenGtive Sherall Gradias for AA&C, Inc. Schedule - Name of Person or Organization (Additional Insured) Location of Covered Operations CITY OF SAN JUAN CAPISTRANO AND SAN JUAN CAPISTRANO REDEVELOPMENT AGENCY, ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS AND EMPLOYEff&ium Bases Rates Advance Premium Bodily Injury Liability Cost $100 of cost $ Included Property Damage Liability Cost $100 of cost $ Total Advance Premium $ i It is agreed that: 1.The"Persons Insured" provision is amended to include as an insured the person or organization named above(hereinafter called "additional insured"), but only with respect to liability arising out of (1)operations performed for the additional insured by the named insured at the location designated above or (2)acts or omissions of the additional insured in connection with his general supervision of such operations. 2. None of the exclusions of the policy, except exclusions (a). (c), (f), (g), (i), (j) and (m), apply to this insurance. 3. Additional Exclusions This insurance does not apply: (a) to bodily injury or property damage occurring after (1)all work on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured at the site of the covered operations has been completed or (2)that portion of the named insured's 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; (b)to bodily injury or property damage arising out of any act or omission of the additional insured or any of his employees,other than general supervision of work performed for the additional insured by the named insured; (c) to property damage to (I) property owned or occupied by or rented to the additional insured, (2) property used by the additional insured, (3) property in the care, custody or control of the additional insured or as to which the additional insured is for any purpose exercising physical control, or (4) work performed for the additional insured by the named insured. 4. Additional Definition When used in reference to this insurance. "work" includes materials, parts and equipment furnished in connection therewith. (JauieeHrcj) AAC:sg Issue: 6/16/88 , Producer: AA&C Producer Code: 04-67396 This endorsement, effective 4/01/88 , forms a part of Policy No. AAW655030 issued to VAN DELL AND ASSOCIATES INC. by the insurance company indicated below by an "X". Commercial Union Insurance Co. X American Employers Ins Co The Employers Fire Ins. Co. _ The Northern Assurance Co. of America It is agreed and understood that the above referenced policy shall not be terminated, nor shall it be cancelled, nor the coverage reduced until thirty (30) days after written notice is given to City. It is also agreed and that the policy and coverage afforded to the City of San Juan Capistrano and the San Juan Capistrano Redevelopment Agency and its elected and appointed boards, officers, agents and employees shall be primary insurance and not contributing with any other insurance maintained by the City. AAs: sg Issue: 6/16/88 Authorized Representative Sherall Gradias for AA&C Producer: AA&C Producer Code: 04-67396 This endorsement, effective April 1, 1988 , forms a part of Policy No. CAAA12192 issued to Van Dell and Associates, Inc. by the insurance company indicated below by an "X" . X Commercial Union Insurance Co. _ American Employers Ins Co The Employers Fire Ins. Co. _ The Northern Assurance Co. of America It is agreed and understood that the above referenced policy shall not be terminated, nor shall it be cancelled, nor the coverage reduced, until thirty (30) days after written notice is given to City. It is also agreed that the policy and coverage afforded to the City of San Juan Capistrano and the San Juan Capistrano Redevelopment Agency and its elected and appointed boards, officers, agents and employees shall be primary insurance and not contributing with any other insurance maintained by the City. AAC: sg Issue: 6/15/88 L&_Q, �i Aut orized Representative Sherall Gradias for AA&C r Producer: AA&C Producer Code: 04-67396 This endorsement, effective April 1, 1988 forms a part of Policy No. CAAA12192 issued to Van Dell and Associates Inc by the insurance company indicated below by an "X" . XX Commercial Union Ins. Co. _ American Employers Ins. Co. The Employers Fire Ins. Co. _ The Northern Assurance Co. of America ADDITIONAL INSURED IT IS AGREED AND UNDERSTOOD THAT THE FOLLOWING IS NAMED AS ADDITIONAL INSURED WITH RESPECT TO WORK PERFORMED FOR THEM BY THE NAMED INSURED. The City of San Juan Capistrano and the San Juan Capistrano Community Redevelopment Agency and its elected and appointed boards, officers, agents and employees. Additional premium charged: None a ��ao (Authorized Rep esentative) Sherall Gradias for AA&C Inc. AAC: sg Issue: 6/15/88 O� >SUE DATE(M A/DD/YY) ® i 88 RODUCERJP T CERTIFlC -IS ISSUE AS P MATT OF INFIRM ION O Y AND CC 1FE NO RIGHTS UPON-EHE CE CATS:HOLDER.THIS :ERTIFICA E DES NOT)ME D ISSbCIATION ADMINISTRATORS & EXTEND OR ALTER THE COVERAC =AFFORDED BY THE POLI :IES BELOW. :ONSULTANTS, INC. �I 19000 MacArthur Boulevard, No. 500 COINPANIES A,FF fAfitbVERAGE Irvine, California 92715 C'-IMPANY A LITTER CONTINE C ffOMPAVN w` _ COMPANY INSURED LETTER B _ _ 1 _y ,,,gyprP COMPANY `, VAN DELL AND ASSOCIATES, INC. L='�R of 17801 Cartwright Road COMPANY D O� SANJUA"APISH j Irvine, California 92714 LETTER GAL'waNIA LCOMPA ETTERNY E THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTC THE INSURED NAMED ABOVE FO R THE POLICY PERIOD INC ICATED. NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT'ARTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE 1"ERMS,EXCLUSIONS,AND CONDI- TIONS OF SUCH POLICIES. tucr POLICY F�EECTIVE Pot 'Y DOPIPATION LIABILITY LIMITS IN THOUSANDS TYPE OF INSURANCE POLICY NUMBER DATE IN rNMNY) DOIE(MMNDA'11 EACH _ _ CX'CURRENCE AGGREGATE GENERAL LIABILITY BODILY COMPREHENSIVE FORM IN"Y $ SI PREMISESIOPERATIONS PaOPERTY UNDERGROUND DAMAGE $ EXPLOSION&COLLAPSE HAZARD PRODUCTS/COMPLETED OPERATIONS CONTRACTUAL Bi&PD mm COMBINED `P $ M'DEPENDENT CONTRACTORS _ BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY WDILY ULI" ANY AUTO (".R PERSON) $ _ ALL OWNED AUTOS(PRIV. PASS.) eOOILY - OTHER THAN INJJRY `> ALL OWNED AUTOS(PRN PASS I°Eq acDDENp $ HIRED AUTOS " PROPERTY .. NON-OWNED AUTOS DAMAGE $ , GARAGE LIABILITY Ell&PD QOMBINED $ EXCESS LIABILITY UMBRELLA FORM Di&PD m COMBINED $ $ OTHER THAN UMBRELLA FORM WORKERS'COMPENSATION STATUTORY AND (EACH ACCIDENT) EMPLOYERS'LIABILITY ';$ (DISEASE-POLICY LIMIp YK $ (DISEASE-EACH EMPLOYEE) OTHER A Engineers AAE4312468 5/18/88 5/18/89 Limit: $1,000 er claim and in ol . DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS aggregate Mr. Theodore G. Simon, City Engineer neer SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- Y 9 PIRATION DATE THEREOF, THE ISSUING COMPANY WILL 001WOtl[E M CITY OF SAN JUAN CAPISTRANO LEFT, 3Q DAYS WRITTEN N� OTJ_-E-7D,TNf CERTIFICATE HOLDER NAMED TO THE 32400 Paseo Adelanto BEK �N��I�EBIa�X San Juan Capistrano, CA 92675 AUTHORIZ TI s CCOfSUE DATE(M17/DD/1'Y) 1 ' I an!' 8, 1988 PRI TDUCEf# THIS CERTIFICATE IS ISSUED AS A NATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON l HE CERTIFICATE HOLDER.THIS CERTIFICAI"E DOES NOT AMEND, AS:t?CIATION ADMIMISTRATO t,S d EXTEND OR ALTEI= THE COVERAGE AFFORDED BY THE POLICIES BELOW. C%SULTANTS, INC. 1900 MacArthur 8oulevarl, No. SW COIAPANIES AFFORDING COVERAGE Irvine, California 9271 i CC MPANY A LETTER CONTINENTAL CASUALTY_ COMPANY _ CG NPANY INS )RED LETTER B CC'APANV VAN DELL AND ASSOCIATES, INC. LETER C 17531 Cartwright Road CCJPANY D Irvine, California 9271• LE TER CCIJPANY E LETTER 1 HIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUNIEMEN f,TERM OR CONDITION OF ANY C TNITRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY E E ISSUED OR MAY PERTAIN,THE INSI RANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDI- 1 IONS OF SUCH POLICIES. CO POLICY EFFiCTIVE PoLIC�EXPIRATION LIABILITY LIMITS XJ THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER DATE(MW-DtM DATE AMNDIYYI - EACH _ OCCURRENCE AGGREGATE GENERAL LIABILITY BODILY COMPREHENSIVE FORM INJURY $ $ PREMISES/OPERATIONS PROPERTY UNDERGROUND DAMAGE $ $ EXPLOSION&COLLAPSE HAZARD PRODUCTSICOMPLETED OPERATIONS CONTRACTUAL BIS PD _ COMBINED $ $ INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY BODI+ F NJURY ANY AUTO (PER KRSON) $ $J ALL OWNED AUTOS(PRN. PASS.) BODILY 3- ALL OWNED AUTOS OTHER THANPRN. PASS (PER(PE�P nCD0EN0 $ HIRED AUTOS NOWMED AUTOS PROPERTY DAMAGE $ � GARAGE LIABILITY COMBINED $ y, E KCESS LIABILITY UMBRELLA FORM BI a PD _ COMBINED $ $ OTHER THAN UMBRELLA FORM WORKERS'COMPENSATIONSrnrUTORY AND $ (EACH ACCIDENT) EMPLOYERS'LIABILITY $ (DISEASE-PoLICY LIMIT) $ (DISEASE-EACH EMPLOYEE) I gineers AU4312468 5/18/88 /18/89 Limits $1,WO mforataml IPTION F PERATIONS/ 1111 LOCATIO SIVEHICLES/SPECIAL ITEMS ate T 77•_7e ,L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- Mr. Theodore s. Sisals, City Engineer PIRATION DATE THEREOF, THE ISSUING COMPANY WILL �yQ� CITY OF SAN JUAN CAPIN•FFyaus� MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER�RAfIPi c SZSYFEi YiMn J I RnF�V LEFT, 324M Paseo Wanto San Juan Capistrano, CA 92675 A TI 10 SHERALL GRADIAS ACCOUNT EXECUTIVE BUSINESS INSURANCE DIVISION ` I October 5, 1987 , SpN'GPjfov'w PNu Mr. Theodore G. Simon, City Engineer CITY OF SAN JUAN CAPISTRANO n 32400 Paseo Adelanto San Juan Capistrano, California 92675 �;��a/ Dear Mr. Simon: RE: VAN DELL AND ASSOCIATES, INC. As a follow up to my letter dated September 17, 1987, copy attached, I have enclosed the various endorsements to Van Iel /C insurance policies as noted on the Certificates of Insurance. Should you have any questions at all, please do not hesitate to call me at 714/833-0673 . Sincerely, erall Gradias /s Enclosures cc: Ms. Robin Whyte, VDA ASSOCIATION ADMINISTRATORS & CONSULTANTS, INC. 19000 MacArthur Blvd •Irvine.CA 92715 •Ma9mg adaress PO Box 19570 • Irv,ne.CA 92]13 In Alaska,Cal Ifornia and Hawaii telephone 710'833-0673 -All other slates 800`854-0491 .• ,,. 5 1 ".' 7 9/17/87 N ASSOCIATION ADMINISTRATORS & ,CONSULTANTS, INC. 19000 MacArthur Blvd. #500 Irvine, CA 92715 COMMERCIAL UNION CONTINENTAL CASUALTY CO VAN DELL AND ASSOCIATES, INC. :. HARTFORD ACCIDENT £P NTY C 17801 Cartwright Road 'if � Irvine, CA 92714 uRa SF�a? i'. e: ITEC E !4 �',':. C�[ .+"$►�- ICD INDICA Y D, [1 l vtE,- t t )E rJNDI f M1 -- 1 T �I �',' r tt<.Y ,ER".FIC T AY F-(.�DED -CPOI C ice. __! 'H 9gr11 (1J IO"�� W eONDI 'I THOUSANDS k. -o, G- !c TAS I_ f•S r - - -_i$- 500— X AAW655030 4/01/87 4/01/88 r$ incl A -X� _ i S' $ X _. TGU— — —._ _ y. $ 1X- =ITA, £=.tracter-s�:-if--&ny -- -- - - — - $ AUTOMOBILE LIABILITY $ 500 CAD391552 4/01/87 4/01/88 -- .-.._ _FR FaSON,T$ H R;L AtlTO< RaDILv I%.URY -x NON_N*TAUT./, a —$ - _- P iDEAn — &,1 A6ELAdIL'I ROPeR;Y DAMAGE m P c� EXCESS LIABILITY ence ac¢aecn-F �cwaReNce AX CAD436122 4/01/87 1 4/01/888 ,;. $ $ OTHER HEP THAN UMBRELLA FORM1,000 1,000 - J-_ WORKERS'COMPENSATION -I, 1`ArUTOR, C AND 72WJ402995W 9/01/87 9/01/88 $ 100_ FLHAn:mFNI T EMPLOYERS LIABILITY $ 5OO TISEASE POEICY�iMI . $ O SEASF FPCH EMPLOYEE OTHER __-- — j:: B Engineers professionalLno 500 per claim aliability AAE4312468 5/18/87 5/18/88 yaggregate UDES LIMITED CONTRACTU DESCRI TION QF OP TI NSI OCATI N /VE C IRESTRI TION / P IA Per gection � 9. �i a_n_c� � o tFfie pro`�oseds �nt� � endorsements will be issued upon award of the contract DL C)y L11 PAO rAH D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX Mr. Theodore G. Simon, City Engineer ON DATE THEREOF, THE ISSUING COMPANY WILL 041110aoa�exxa CITY OF SAN JUAN CAPISTRANO 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 Paseo Adelanto BucwxutwKaxaxenwc9uae>�aorx�E>seoaowcpwe�azjcaapAwsxaorxmx San Juan Capistrano, CA 92675 coag 3awomaxmxxmx)compwWXD(�x(Xa/e ")QXx�eWMAP w XD(W I I PRES� L. �k-/Gradias for AA&C, Inc. THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC. Pol 72WJ402995W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 10/01/87 Effective hour is the same as stated in the Declarations of the policy. ADDITIONAL INSURED EMPLOYER ENDORSEMENT IT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THE POLICY UNDER INSURING AGREEMENT I ALSO APPLIES TO: CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS, AND EMPLOYEES. AS AN ADDITIONAL INSURED EMPLOYER BUT ONLY AS RESPECTS EMPLOYEES HIRED BY AND CARRIED ON THE PAYROLL OF THE EMPLOYER NAMED IN ITEM I OF THE DECLARATION OF THIS POLICY. AAC sg ISSUE: 10/05/87 1/j Atao Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, countersignature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC.Policy # 72WJ402995W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 10/01/87. Effective hour is the same as stated in the Declarations of the policy. It is agreed and understood that coverage provided by the above referenced policy is primary and not contributing with any other insurance maintained by City of San Juan Capistrano and San Juan Capistrano Redevelopment Agency. AAC: sg Issue: 10/05/87 Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute a valid countersignature of this endorsement. Form G-2240-3B THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC. POL: 72WJ402995 This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 10/01/87. Effective hour is the same as stated in the Declarations of the policy. IT IS AGREED THAT PART SIX OF CONDITION D OF THIS CONTRACT IS AMENDED TO READ "THIRTY" DAYS NOTICE IN LIEU OF THE "TEN" DAYS. THIS AMENDMENT DOES NOT APPLY TO NOTICE OF CANCELLATION FOR NON- PAYMENT OF PREMIUM. AAC: sg ISSUED: 10/05/87 Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B Producer: AA&C Producer Code: 04-67396 This endorsement, effective October 1, 1987 forms a part of Policy No. CAD391552 issued to VAN DELL AND ASSOCIATES, INC. by the insurance company indicated below by an "X" . X Commercial Union Ins. Co. _ American Employers Ins. Co. The Employers Fire Ins. Co. _ The Northern Assurance Co. of America ADDITIONAL INSURED IT IS AGREED AND UNDERSTOOD THAT THE FOLLOWING IS NAMED AS ADDITIONAL INSURED WITH RESPECT TO WORK PERFORMED FOR THEM BY THE NAMED INSURED. THE CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS, AND EMPLOYEES Additional premium charged: None (Authorized _ ) Aut orized Representative) Sherall Gradias for AA&C, INC AAC: sg Issue: 10/5/87 Producer: AA&C Producer Code: 04-67396 This endorsement, effective 10/01/87 , forms a part of Policy No. CAD391552 issued to VAN DELL AND ASSOCIATES, INC. by the insurance company indicated below by an "X" . X Commercial Union Insurance Co. _ American Employers Ins Co The Employers Fire Ins. Co. _ The Northern Assurance Co. of America It is agreed and understood that the above referenced policy shall not be terminated, nor shall it be cancelled, nor the coverage reduced, until thirty (30) days after written notice is given to City. It is also agreed that the policy and coverage afforded to the City of San Juan Capistrano and the San Juan Capistrano Redevelopment Agency and its elected and appointed boards, officers, agents and employees shall be primary insurance and not contributing with any other insurance maintained by City. AAs: sg 41-0�Issue: 10/5/87 Authorized Representative Sherall Gradias for AA&C Producer: AA&C Producer Code: 04-67396 This endorsement, effective 10/01/87 , forms a part of Policy No. AAW655030 issued to VAN DELL AND ASSOCIATES, INC. by the insurance company indicated below by an "X" . Commercial Union Insurance Co. X American Employers Ins Cc The Employers Fire Ins. Co. _ The Northern Assurance Co. of America It is agreed and understood that the above referenced policy shall not be terminated, nor shall it be cancelled, nor the coverage reduced, until thirty (30) days after written notice is given to City. It is also agreed that the policy and coverage afforded to the City of San Juan Capistrano and the San Juan Capistrano Redevelopment Agency and its elected and appointed boards, officers, agents and employees shall be primary insurance and not contributing with any other insurance maintained by City. AAC: sg Issue: 10/5/87 Authorized Representative Sherall Gradias for AA&C 2 p (The Attaching Clause need be completed only when this endorsement is Issued subsequent to preparation of the policy.) fY GL 20 09(Ed.01 73) L 9452 GI16 (Ed. 1-73) ISO G116 ADDITIONAL INSURED Owners or Contractors This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: " COMPREHENSIVE GENERAL LIABILITY INSURANCE - MANUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE This endorsement, effective 10/01/87 forms a part of policy No. AAW655030 (12:01 A.M.,standard time) issued to VAN DELL AND ASSOCIATES, INC. by AMERICAN EMPLOYERS' INSURANCE COMPANY ....... .. .. ... ..... ..... . ...... .C�"-'.............. Shera�°�x`�"r`eai�i as"` Schedule Name of Person or Organization (Additional Insured) Location of Covered Operations CITY OF SAN JUAN CAPISTRANO AND SAN JUAN CAPISTRANO REDEVELOPMENT AGENCY, ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS AND EMPLOYEES Premium bases Rates Advance Premium Bodily Injury Liability Cast $100 of cost $ 35.00 flat charge Property Damage Liability Cast $100 of cost $ 9 Total Advance Premium $ I It is agreed that: 1.The"Persons Insured" provision is amended to include as an insured the person or organization named above(hereinafter called "additional insured"), but only with respect to liability arising out of (1) operations performed for the additional insured by the named insured at the location designated above or(2) acts or omissions of the additional insured in connection with his general supervision of such operations. 2. None of the exclusions of the policy, except exclusions (a), (c), (p, (g), (i), (j) and (m), apply to this insurance. 3. Additional Exclusions This insurance does not apply: (a) to bodily injury or property damage occurring aftet (1)all work on the project(other than service, maialenance or repairs)to be performed by or on behalf of the additional insured at the site of the covered operations has been completed or (2)that portion of the named insured's 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; (b)to bodily injury or properly damage arising out of any act or omission of the additional insured or any of his employees,other than general supervision of work performed for the additional insured by the named insured; (c) to property damage to (1) property owned or occupied by or rented to the additional insured, (2) property used by the additional insured, (3) property in the care, custody or control of the additional insured or as to which the additional insured is for any purpose exercising physical control, or (4) work performed for the additional insured by the named insured. 4. Additional Definition When used in reference to this insurance, "work" includes materials, parts and equipment furnished in connection therewith. - (�A6THENTICil rt f tate of Insurance 1E ISTE II b!O✓, COMPANIES AFFORDING COVERAGES ASSOCIATION ADMINISTRATORS & -�- CONSULTANTS, INC. A COMMERCIAL UNION 19000 MacArthur Boulevard, No. 500 Irvine, California 92715 B Ci VAN DELL AND ASSOCIATES, INC. 17801 Cartwright Road Irvine, California 92714 E aD✓,. , n]•e.l•.] nC.lil .iNr:r..Icwtfst. „I,y Illy m enlroI,onnihof ,; ltrPn SSlY,—ItOiIrhP12,1, Cdann[y) L „-u T Limits of Liability in Thousan s I GENE Pk; UARIU'Y , i it 3 A X, Renewal of: AAW6W30 4/01/89 Inception: 4/01/88 ` f , (I X -X. '� 500 ` 500 X, .. - (-Y�i ia• I __� X; t 500 -- ---- - AOTOM091LE UA[EIEiTY j' 51001 ARenewal of: CAE0364323 14/01/89 Inception: 4/01/88 EXCESS LIAHILf[Y �-- - - - -- ' A A Renewal of: CAD410532 4/01/89 � t 5,000 ' 5,000 �I Inception: 4/01/88 l -- - — IK -, ' WORKER'S COMPENSG. ;`y EMPLOYER'S LIAatUTI b a,eai1 nt- OTHER I Special endorsements to follow upon policy issue- Notice of cancellation, addtional insured and primary coverage wording per expiring. Cancellation ``ho, 1. ., .I tY , d po Ir o s be cancelled before the expiration date thereof,the issuing company w10 ""xKWKXXxr _-30 days wl trc , notice to the below named certificate ho1de%jD)0XXkW)QECIO(Rtai1 xxxxxcaxlxx zxxlX Mzx7�7exxnroOt7Dxx9ixxx9@4xht<X)P1Cxxzc�ixAx+X�12xRIR9rA�xR�7aJc:t�R 7�1aRR�Fx9[�fR�'iFRR�Rkft�cx April 14, 1988 /s ' Mr. Theodore G. Simon, City Engineer - — CITY OF SAN JUAN CAPISTRANO 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Sherall Gradi s for AA&C, Inc. 3 i I. H:,, 11 - I San Juan Capistrano Qnnmuniq Redeselopment Agency s i d' October 2, 1987 Mr. M. Robert Lewis, Project Manager Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, California 92714 Re: Consultant Agreement - Precise Alignment Design of Ortega Highway, El Camino Real, and Forster Street Dear Mr. Lewis: The Board of Directors of the San Juan Capistrano Community Redevelopment Agency at its regular meeting held September 29, 1987, approved the Agreement for Consulting Services for the precise alignment design for Ortega Highway, El Camino Real, and Forster Street in the amount of $26,675. A fully-executed copy of the Agreement is enclosed for your records. Please take note of pages four and five of the agreement outlining insurance requirements. The City and the Agency need to be listed as additional insured, and we need an endorsement for professional errors and omissions insurance. If you have any questions regarding insurance requirements, please contact Dawn Schanderl of my staff. Thank you for your cooperation. If we can be of further assistance, please call. Very truly yours, Mary Ann Um8nover, CMC Agency Secretary MAH/mac Enclosure cc: Director of Public Works Dene Oliver, Oliver/Mcktillan/Collins 12400 Paseo Adelanto San Juan Capistrano California 92675 714-498-1171 r L 1_. MEMBERS OF THE CITY COUNCIL Q O ANTHONY L. BLAND 9 LAWRENCE F. BUCN NEIM mtloo... KENNETH E. FRIESS U.1.Vil 1961 GARY L. HAUSDORFER 176 PHILLIP R. SCHWARTZE • • CITY MANAGER STEPHCN B JULIAN September 28, 1987 Mr. M. Robert Lewis, Project Manager Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, CA 92714 Re: Consultant Services - Precise Alignment of Ortega Highway, El Camino Real and Forster Street Dear Mr. Lewis: After a thorough review of the submitted proposals, your firm has been selected to provide the above-noted service. Your proposal has met all the requirements of the RFP and it has been requested that you execute two copies and return the Consultant Services Agreement which includes Exhibits A and B. Please note that the agreement requires insurance prior to commencing work, so please stjbmit a Certificate of Insurance with the endorsements as noted. Upon receipt of necessary documents and approval of the City/Agency, you will be issued a Notice to Proceed. If you have any questions or require additional information, do not hesitate to contact me. I appreciate your interest and am looking forward to your working with the City/Agency. Very truly yours, Theodore G. Simon City Engineer TGS:kjs cc: W.D. Murphy City Clerk Nancy Erickson Brian Perry 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 • (714) 493-1171 - 1 MEMBERS Of THE CITU COUNCIL u ANTHONY L. BLAND LAWRENCE F. BUCHHEIM KENNETH E. FRIE55 GARY L HAUSOORFER 1776 PHIUIP R. SCHwARTZE �'�_ • CITU MANAGER STEPHEN B JULIAN September 28, 1987 Willdan Associates 290 South Anaheim Blvd., Suite 100 Anaheim, CA 92805 Attn: Mr. Robert Merrell, Division Manager Re: Consultant Services - Precise Alignment of Ortega Highway, El Camino Real and Forster Street Dear Mr. Merrell: After a thorough review of the submitted proposals, your firm was not selected for providing the subject consulting services. Though your firm met the requirements, the firm that was selected exceeded the requirements in their proposal. I appreciate the interest you extended the City of San Juan Capistrano in this matter and your firm will be considered in future requests. Very truly yours, Theodore G. Simon City Engineer TGS:kjs cc: Mr. Charles W. Lake, Vice President Willdan Associates L,6ity Clerk Brian Perry 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 0 (714) 493-1171 i F(ITY OM1 .0Iii^ f\PIflPANO� San Juan Capistrano Community Redevelopment Agency July 31, 1991 Mr. M. Robert Lewis Van Dell and Associates, inc. 17801 Cartwright Road Irvine, California 92714 Re: Renewal of Professional Liability and Workers' Com nationCertificates of Insurance (Design Precise Alignments for Ortega Highway, El Camino Real and Forster Street Dear Mr. Lewis: The Professional Liability Certificate of Insurance, regarding the above-referenced project, expired on May 18, 1991, and the Workers' Compensation Certificate of Insurance is due to expire on September 1, 1991. In accordance with your agreement, the insurance certificates need to be renewed for an additional period of one year. Please forward the updated certificates to the City, attention City Clerk's Office, before the September 1, 1991, expiration date. If you have any questions, please contact me at (714) 493-1171 extension 243. Thank you for your cooperation. Very truly yours, , Dawn M. Schanderl Records Coordinator cc: Cheryl Johnson, City Clerk Brian Perry, Senior Civil Engineer 32400 Paseo Adelanto San Juan Capistrano California 92675 714-493-1171 wNURn. CERTIFICATERJF INSURANCE 9 ISSUE DATE (MM=NY) 3/28/91 PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE ASSOCIATION ADMINISTRATORS POLICIES BELOW. & CONSULTANTS INC COMPANIES AFFORDING COVERAGE P O BOX 19570 IRVINE CA 92713 COMPANY A LETTER COMMERCIAL UNION COMPANY B INSURED LETTER COMMERCIAL UNION COMPANY C D LETTER +s VAN DELL AND ASSOCIATES COMPANY D mn 17801 CARTWRIGHT SER m IRVINE CA 92714 COMPANY NY E rT�n — n y=m w t COVERAGES . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A�E FOR THMOUCY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TQ WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT Td-Ah THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. TYPE OP SK/IIRAIICE POLICY NUMBER POLICY EFRECT7VE POLICY EXPIRATION DATE LTR DATE(MMMINYE) DATE(MMMNY) GKIIIIIIIIIAL LIABILITY FALB96825 4/01/91 4/01/92 BODILY INJURY Dec. i COMPREHENSIVE FORM BODILY INJURY AGG. j �I PI�R�IEMMppIIS�IEqSSpOPERATPONS PROPERTY DAMAGE OCC. $ EXOPLOSI A COLLAPSE HAZARD PROPERTY DAMAGE AGG. j PRODUCTSlCOMPLETEDOPER. BILFOCOMBINED DOC. $1, 000,000 CONTRACTUAL &L PD COMBINED AGO. j INDEPE14DEWT CONTRACTORS PERSONAL INJURY AGO. $1, 000, 000 , BROAD FORM PROPERTY DAMAGE PERSONAL SLJURY AIROMOBLE uABEnY CAAA09 3 54 4/01/91 4/01/92 BODILY INJURY j ANY AUTO (PK P. ) ALL OWNED AUTOS(PM.pm.) GODLY INJURY ALL OWNED AUTOS l__F,IY pw.) (Pw wcleNlq i HIRED AUTOS NON-0WNED AUTOS PROPERTY DAMAGE j GARAGE LIABILITY BODILY INJURY L PROPERTY D.UAAGE COMBINED 1, 000, 000 000000 EXCESS LUUl LTIY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE j OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS ALO EACH ACCIDE NT i EMPLOYERS'LMBLIfY DISEASE—POLICY LIMIT Is DISEASE-EACH EMPLOYEE is OWNERIN THE EVE T OF CANCELLATION FOR NOW PAYMENT 10 DAY 140TI E WILL BE GIVEN DESCRIPT10111 OF OPERATKWMLtC"TIOULNEVACLELIPUZAL ITEMS ALL ENGINEERING OPERATIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCHES BE CANCELLED BEFORE THE CITY OF SAN JUAN EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL CAPISTRANO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT SAN JUAN CAP CA 92675 DED ANNE CJ WEBBERL FOR AA&CW ACORD 25 (7'!90) CORD CORPORATION 1990 Producer: AA&C Producer Code: 04-67396 COPY This endorsement, effective 4/01/91 forms a part of Policy Number FALB96825 issued to VAN DELL AND ASSOCIATES by Employers Fire Insurance Company. ADDITIONAL INSURED ENDORSEMENT SECTION II - LIABILITY INSURANCE CLAUSE NAME OF ADDITIONAL DESCRIPTION OF NO. INSURED PREMISES 6 ANYONE ENTERING INTO A CONTRACTUAL AGREEMENT WITH THE NAMED INSURED WHICH REQUIRES THEY BE NAMED AS AN ADDITIONAL INSURED **SEE ATTACHED FORM G10411 (Ed. 9-83) ** PRIMARY CLAUSE ENDORSEMENT It is further agreed that such insurance as is afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only as respects any claim, loss or liability arising out of the Operations of the Named Insured and any insurance maintained by the Additional Insuredshall be none co1ntributing. [d " - I — CJ WEBBER Y for AA&C (Authorized Representative) AA&C: cjw Issued: 3/28/91 ADDIANAL INSURED ENDORSEMER SECTION 11 - LIABILITY INSURANCE THIS FORM IS PART OF YOUR POLICY. PLEASE READ IT CAREFULLY AND KEEP IT WITH YOUR POLICY JACKET. SCHEDULE CLAUSE NAME OF ADDITIONAL DESCRIPTION OF NO. INSURED PREMISES CLAUSE NO. 1 — PREMISES LEASED TO NAMED INSURED When"Clause No.1"is indicated in the schedule on this form,then the definition of"insured"in your policy is amended to include the additional insured described in the schedule. Coverage for such additional insured applies only to their bodily injury or property damage liability arising from the ownership,maintenance or use of the premises described in the schedule, which are leased to you. Insurance provided under this clause does not apply to: 1. Any occurrence which takes place after you cease to be a tenant in the described premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization described in the schedule. CLAUSE NO. 2— STATE OR POLITICAL SUBDIVISIONS (PERMITS) When"Clause No.2"is indicated in the schedule on this form,then the definition of"insured"in your policy is amended to includethe state or political subdivision listed in the schedule as additional insured,subject to the following: 1. Insurance provided underthis clause applies only to bodily injury or property damage liability arising out of (continued) G10411 (Ed.9-83) © Commercial Union Insurance Company 1983 operations performed by yu. or on your behalf for which the state o, jolitical subdivision has issued a permit. 2. Insurance provided under this clause does not apply to bodily injury or property damage: A. Arising out of operations performed for the state or municipality, or B. Included within the completed operations hazard. CLAUSE NO. 3— STATE OR POLITICAL SUBDIVISIONS (PERMITS RELATING TO PREMISES) When"Clause No.3"is indicated in the schedule on this form,then the definition of"insured"in your policy is amended to include the state or political subdivision listed in the schedule as additional insured. However, insurance provided under this clause applies only to bodily injury or property damage liability arising out of the following hazards for which the state or political subdivision has issued a permit in connection with premises owned by, rented to or controlled by you at which Bodily Injury Liability Coverage applies: 1. The existence, maintenance, repair, construction, erection, or removal of: (A) advertising signs, (B) awnings, (C) canopies, (D) cellar entrances, (E) coal holes, (F) driveways, (G) manholes, (H) marquees, ( I ) hoistway openings, (J) sidewalk vaults, (K) street banners or decorations, and (L) similar exposures. 2. The Construction, erection, or removal of elevators. 3. The ownership, maintenance, or use of elevators covered by this policy. CLAUSE NO. 4— ENGINEERS,ARCHITECTS OR SURVEYORS When"Clause No.4"is indicated in the schedule on this form,then the definition of"insured"in your policy is amended to include any architect,engineer or surveyor engaged by you,but only with respect to bodily injury or property damage liability arising out of the insured premises or operations performed by or for you. Insurance provided under this clause does not apply to bodily injury or property damage arising out of the rendering of or failure to render any professional services by or for you, including: 1. The preparation or approval of maps, plans, opinions, reports, surveys, designs or specifications. 2. Supervisory, inspection or engineering services. CLAUSE NO. 5— OWNERS OR LESSEES When"Clause No.5"is indicated in the schedule on this form,then the definition of"insured"in your policy is amended to include the additional insured described in the schedule, but only with respect to liability arising out of operations performed for such additional insured by or on behalf of you. 2. CLAUSE NO. 6— OWNERS OR CONTRACTORS When"Clause No.6"is indicated in the schedule on this form,then the definition of"insured"in your policy is amended to include the additional insured described in the schedule, but only with respect to bodily injury or property damage liability arising out of: 1. Operations performed for the additional insured by you at the premises listed in the schedule. 2. Acts or omissions of the additional insured in connection with his or her general supervision of your operations. As regards insurance provided under this clause, only the following exclusions under "B. WHAT IS NOT COVERED" of the Special Liability Form apply: 3. Bodily Injury To Employees. 4. Contracts. 7. Loss Of Use. 9. Mobile Equipment. 10. Nuclear Energy. 12. Pollution. 15. War. 17. Workers' Compensation. In addition to the above exclusions, insurance provided under this clause does not apply: 1. To bodily injury or property damage occurring after: A. All"work"on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured at the site of the covered operations has been completed. B. 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. 2. Tobodilyinjury or property damage arising out of any actor omission of theadditional insuredoranyof his or her employees, other than general supervision of "work" performed for the additional insured by you. 3. To property damage to: A. Property owned or occupied by or rented to the additional insured. B. Property used by the additional insured. C. Property in the care,custody or control of the additional insured oras to which the additional insured is for any purpose exercising physical control. D. "Work" performed for the additional insured by you. "Work", as used in this clause, includes materials, parts and equipment furnished in connection with such work. 3. v Producer: AA&C Producer Code: 04-67396 OUD This endorsement, effective 4/01/91 forms a part of Policy No. CAAA09354 issued to VAN DELL AND ASSOCIATES by the insurance company indicated below by an "X" . XX Commercial Union Ins. Co. _ American Employers Ins. Co. _ The Employers Fire Ins. Co. _ The Northern Assurance Co. of America ADDITIONAL INSURED IT IS AGREED AND UNDERSTOOD THAT THE FOLLOWING IS NAMED AS ADDITIONAL INSURED, BUT ONLY IN RESPECT TO THE OPERATIONS OF COVERED AUTOS BY THE NAMED INSURED: ANYONE ENTERING INTO A CONTRACTUAL AGREEMENT WITH THE NAMED INSURED WHICH REQUIRE THEY BE NAMED AS AN ADDITIONAL INSURED. PRIMARY CLAUSE ENDORSEMENT It is further agreed that such insurance as is afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only as respects any claim, loss or liability arising out of the Operations of the Named Iured and any insurance maintained by the Additional Insure hall be non-Go t ib ting. 61ULU CJ WEBBE �� Y for AA&C (Authorized Representative) AA&C: cjw Issued: 3/28/91 AICORD. CERTIFICAW OF INSURANCE ISSUE DATE ($) PRODUCER 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 ALTER THE COVERAGE AFFORDED BY THE ASSOCIATION ADMINISTRATORS POLICIES BELOW. & CONSULTANTS INC COMPANIES AFFORDING COVERAGE P 0 BOX 19570 IRVINE CA 92713 COMPANY A LETTER COMMERCIAL UNION COMPANY B BISORED LETTER COMMERCIAL UNION COMPANY C LETTER VAN DELL AND ASSOCIATES COMPANY D 17801 CARTWRIGHT LETTER IRVINE CA 92714 COMPANY E LETTER COVERAGES'- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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. CO TYPE OF INSURANCE tOIN;Y NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MMMDNY) DATE(MMMONY) GENERAL LIABILITY FALB9 6 8 2 5 4/01/91 4/01/92 BODILY INJURY OCC. i COMPREHENSIVE FORM BODILY INJURY AGG. t PREMISE&OPERATXNJB PROPERTY DAMAGE OCC. j UNDERf'roRN 8 COWPSE HAZARD PROPERTY DAMAGE AGG. i PRODUCT&COMPLETEDOPER. 01&PD COMBINED OCC. $1, 000, 000 CONTRACTUAL BI S PD COMBINED AGG. i INDEPENDENT CONTRACTORS PERSONAL INJURY AGG. f 1 O O O 0 0 0 BROAD PORM PROPERTY DAMAGE - - PERSONAL WURY AUTOMOBILE:LIABILITY CAAA09354 4/01/91 4/01/92 BODILY INJURY j ANY AUTO (PK P°'°O^) ALL OWNED AUTOS IPAY.pm.) ccc BODILY d#M)ALL OWNED AUTOS (Pdw ) (Por ^I) pa". HIRED AUTOS NOM-OWNED AUTOS O PROPERTY DAMAGE j GARAGE LIASAM BODILY INJURY& PROPERTY DAMAGE 9 COMBINFD 1, 000, 000 EXCESS LUMLJTV EACH OCCURRENCE 7 UMBRELLA FORM AGGREGATE j OTHER THAN UMBRELLA FORM WOR%EWS COMPENSATION STATUTORY LIMBS AND EACH ACCIDENT Is DISEASE-POLICY LIMB i EMPLOYERS'LIABILITY DISEASE-EACH EMPLOYEE 18 OTHER IN THE EVE JT CF C,'.,,:CELLATICN FOR NON- PAYMENT 10 DAY NOTICE WILLBE GIVEN DESCRIPTION OF OPERATIONSA.00A710N&NENICLESBPECIAL ITEMS ALL ENGINEERING OPERATIONS CERTIFICATE HOLDER - CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SAN JUAN EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL 6 CAPISTRANO MAIL 3 U DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT, SAN JUAN CAP CA 92675 A REPRESENTATIV�Ej CJ FR FOR AA&C W ACORD 25 (7100) ttt����� CACORD CORPORATION 1990 cor ® I - MIDD/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, WEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. AS WAAnO A111111101111SIM&IIIIIS * a NwTJane I». COMPANIES AFFORDING COVERAGE ftcArtkmr Udft brNO • �t�,,,, 4 CCMPANV A CN�;j�� IT e�rlrwaW �t Tilts 4lihrai� .,,� LEFTER �•wir�1 OCSAPANY INSI iRED LETTER s VA ML AM ASSICUM, INC- ITER Y C a Glu cwu rid � 1"d IrAlh CA1196 slia 9D;.4 COMPANY D COMPANY E LETTER T IIS IS TO CERTIFY THAT POLICIES OF rNSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N)TWITHSTANOING ANY REOUIREMEII TERM OR CONINTON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY B'ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED NEFIEIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDO T ONS OF SUCH POLICIES. CO POLICY ERECIIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMDOR'Y) DME IMMNDNYI E H OCCURRENCE AGGREGATE IJENERAL UABIJTY BODILY COMPREHENSIVE FORM INJURY $ $ PREMISESIOPERATIONS PROPERTY UNDERGROUND DROWN 8 COLLAPSE HAZARD DAMAGE $• $• PRODUCTS/COMPLETED OPERATIONS CONTRACTUAL BI 6 PD COMBINED $ $ INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY HOLY ANY AUTO Om kR RRmNI 1$ ALL OWNED AUTOS(PRIV. PASS.( GODLY ALL OWNED AUTOS OTHER THAN N:CDENfI $ UIRY PRIV. PASS. HIRED AUTOS PROPERTY NON-OWNED AUTOS DAMAGE $ GARAGE LIABILITY &a PO COMBINED $ EXCESS LIABILITY UMBRELLA FORM BI 6 PO COMBINED $ $ OTHER THAN UMBRELLA FORM WORKERS'COMPENSATION STATUTORY AND $ (EACH ACCIDENT) EMPLOYERS' LIABILITY $ (DISEASE POLICY LIMIT) $ (DISEASE-EACH EMPLOYEE) OTHER �„ da LIAKL .• AM DESCRIPTION OF OPERATIONSILOCATK)NSN'EHICLESfSPECIAL ITEMS CITY OF SAN JUAN CAPISTRANO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- 32400 Paseo Adelanto PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE San Juan Capistrano, California 92675 LEFT, FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPOIt THE COM ANY ITS AGENTS OR REPRESENTATIVES. H D REP N7 Fm ARM au"Am 3ft"Im •• E • Jaw* • MEMBERS OF THE CITY COUNCIL /f�IJ LAWRENCE F SUCHHEIM KENNETH E FRIESS OMf01q[ �7: - nununH GARY L HAUSOORFER ® InR1l6I OIL JONES 177676 JEFF YASGUEZ CITY MANAGER STEPHEN B JULIAN March 26, 1991 �� f Mr. M. Robert Lewis Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, California 92714 Re: Renewal of Generaia lity utomobile Liability and Professional Liability Certificates of Insurance (Design Precise Alignments for Ortega Highway, EI Camino Real and Forster Street Dear Mr. Lewis: The Professional Liability Certificate of Insurance, regarding the above-referenced project, that I have on file expired on May 18, 1990. The General Liability and Automobile Liability Certificates of Insurance are due to expire on April 1, 1991. In accordance with your agreement, the insurance certificates need to be renewed for an additional period of one year. The agreement requires a general liability endorsement form naming the City of San Juan Capistrano as an additional insured. Please forward the updated certificates and the endorsement form to the City, attention City Clerk's Office, by April 1st. If you have any questions, please contact me at (714) 493-1171 extension 243. Thank you for your cooperation. Very truly yours, I Dawn M. Schanderl Records Coordinator cc: Cheryl Johnson, City Clerk Brian Perry, Senior Civil Engineer 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 0 (714) 493-1171 iase„ MEMBERS OF THE CITY COUNCIL c LAWRENCE F. BUCHHEIM KENNETH E. FRIESS OR110{I![ �'� •Ime.ro..m GARY L. HAUSOORFER If 6ulutem 1961 GIL JONES 1776 JEFF VASQUEZ •'�_ • CITY MANAGER '�`('�•f��-Yr-wJ•/� STEPHEN B. JULIAN April 26, 1991 Mr. M. Robert Lewis Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, California 92714 Re: Professional Liability Certificate of Insurance Dear Mr. Lewis: Thank you for the Certificate of Insurance, which was received by the City on April 1, 1991. In accordance with your agreement, please be advised of the following: (1) The Professional Liability Certificate of Insurance has not been received. Please forward the certificate to the City of San Juan Capistrano, attention City Clerk's Office, immediately. If you have any questions, please contact me at (714) 493-1171 extension 243. Thank you for your cooperation. Very truly yours, IQ9 9b�"� Dawn M. Schanderl Records Coordinator cc: Cheryl Johnson, City Clerk Brian Perry, Senior Civil Engineer 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 • (714) 493-1171 DATE F (MMIUDI") 8/24/90 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE ASSOCIATION ADMINISTRATORS DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE & CONSULTANTS INC POLICIES BELOW. P 0 BOX 19570 —— ,; IRVINE CA 92713 COMPANIES AFFORDING COVERAGE 'F COMPANY SlC 11 l �e Cl LETTER A v COMPANY ASI INSURED LETTER S Ih, COMPANY ' VAN DELL AND ASSOCIATES LETTER C 17801 CARTWRIGHT COMPANY HARTFORD INS GROUP �> IRVINECA 92714 LETTER D COMPANY LETTER E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 2# 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 i(? SUCH POLICIES. W IT LIABILITY LIMITS IN THOUSANDS I' LO TYPE OF INSURANCE POLICY NUMBER Poucr EFFECTIVE POLICY EXPIRATION TO PO DATE(MMIDDIYY) DATE IMM)DD/YT1 EACH OCCURENCE AGGREGATE *' GENERAL LIABILITY BODILY COMPREHENSIVE FORM IWURY �'- PREMISES/OPERATIONS {�( PROPERTY UNDERGROUND DAMAGE I .. EXPLOSION A COLLAPSE HAZARD PRODl1CTSlGOMPLETED OPERATIONS CONTRACTUAL BI M PD BI COM&NEO INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY BOD�'.y. "p AUTOMOBILE LIABILITY INJURY Q,.'. (PER PERSON tI., BODILY ANY AUTO INJURY IPER ALL OWNED AUTOS ACCIDENT) HIRED AUTOS PROPERTY NON-OWNED AUTOS DAMAGE GARAGE UARUTY IN&PD COMBINED . + EXCESS LIABILITY PD UMBREUA FORM B1 A BI LOM&NEO OTHER THAN UMBRELLA FORM .1, 72WJC 14619W 9/01 /90 9/01 /91 STATUTORY WORKERS'COMPENSATION i 000 (EACH ACCIDENT) AND EMPLOYERS'LIABILITY SE-Poucr uMln 1 0 0 0 (DISEASE-EACH EMPLOYEE) " OTHI ED fi .3 10 ®AYNICY WiLi, :k : � il6 N. - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ALL ENGINEERING OPERATIONS FAUT ULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EXPIRATION DATE THEREOF, THE ISSUING COMPANY CITY OF SAN JUAN CAP I STRANO WILL BE ^ -^MAIL 30 DAYS WRITTEN NOTICE TO _ ATTN : THEODORE G. SIMON CERTIFICATE HOLD NAMED TO THE LEFT,BW* " "^E T^•"" ^'e 32400 PASEO ADELANTO SAN JUAN CAPISTRANO CA 92675 IZED REPRESEN ATIV / X WEBBERL U L i L' THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC. Pol #72WJCI4519W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/01/90 Effective hour is the same as stated in the Declarations of the policy. ADDITIONAL INSURED EMPLOYER ENDORSEMENT IT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THE POLICY UNDER INSURING AGREEMENT I ALSO APPLIES TO: CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS AND EMPLOYEES 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CALIFORNIA 92675 AS AN ADDITIONAL INSURED EMPLOYER BUT ONLY AS RESPECTS EMPLOYEES HIRED BY AND CARRIED ON THE PAYROLL OF THE EMPLOYER NAMED IN ITEM I OF THE DECLARATION OF THIS POLI AA&C cjw ISSUE: 8/24/90 CJ WEB LEY for XACF Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC. Pol #72WJCI4619W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/01/90 Effective hour is the same as stated in the Declarations of the policy. PRIMARY CLAUSE ENDORSEMENT It is agreed that such insurance as is afforded by this policy for the benefit of CITY OF SAN JUAN CAPISTRANO shall be primary insurance, but only as respects any claim, loss or liability arising out of the operations of the Named Insureds) and any insurance maintained by the CITY OF SAN JUAN CAPISTRANO shall be non-contributing. AA&C cjw ISSUE: 8/24/90 CJ WE BERLEY for AA&C Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B DATE 872490 R4511 , F O lei (MN100/w) PRODUCER 14W THIS CERTIFICATE IS ISSUED A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ASSOCIATION ADMINISTRATORS DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE & CONSULTANTS INC POLICIES BELOW. P 0 BOX 19670 COMPANIES AFFORDING COVERAGE IRVINE CA 92713 , COMPANY LETTER A COMPANY INSURED LETTER B COMPANY VAN DELL AND ASSOCIATES LETTER C 17801 CARTWR I GHT COMPANY HARTFORD INS GROUP IRVINE CA 92714 LETTER D COMPANY LETTER E 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, Co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATION LIABILITY LIMITS IN THOUSANDS LTR pATE(MM/0G/YYI DATE(MMIDO/Yl') - EACH AGGREGATE OGREOATE GENERAL LIABILITY aoolLr COMPREHENSIVE FORM INJURY PREMISES/OPERATIONS PROPERTY UNDERGROUND DAMAGE EXPLOSION 6 COLLAPSE HAZARD PRODUCTSICOMPLETED OPERATIONS CONTRACTUAL BI&PD COMBINED INDEPENDENT CONTRACTORS SADAO FORM PROPERTY DAMAGE PERSONALIWURV '1 PERSONAL INJURY t f_ AUTOMOBILE LIABILITY %. ILY INJURY (PER PER PERSON) /J BODILY ANY AUTO C/ IWURY PER ALL OWNED AUTOS // ACCIDENT) HIRED AUTOS PROPERTY NON-OWNEDAUTOS DAMAGE GARAGE LIABILITY BIS COMBINED EXCESS LIABILITY UMBRELLA FORM BI 6 PO COMBINED OTHER THAN UMBRELLA FORM 72WJC 14619W 9/01 /90 9/01 /91 STATUTORY WORKERS'COMPENSATION 1 000 (EACH ACCIDENT) AND EMPLOYERS'LIABILITY 11 . 000r IasEASE-Poucr LIMIT) 'y n.l,Y.,,.� - 5 — �' rL 1 1 000 (DISEASE-EACH EMPLOYEE) O y u - 10 DAYS OTICE WILL N. r DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ALL ENGINEERING OPERATIONS ' iJ SHOULD ANY'OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY CITY OF SAN JUAN CAP I STRANO WILLEH9£A#007"MAIL 30 DAYS WRITTEN NOTICE TO ATTN: THEODORE G. SIMON THE CERTIFICATE DERNAMED TO THE LEFT, 32400 PASEO ADELANTO SAN JUAN CAPISTRANO CA 92676 AUTHORIZED REP SE CJ WEBB &C �� W /� O� I:iSUE DATE(M4UDD/VV) ® 4/01/90 PRODUCER CHIS CERTIFICATE IS ISSUED AS A NATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON' HE CERTIFICATI:HOLDER.THIS C:FRTIFICAI E DOES NOT AMEND, RECEIVE EXTEND OR ALTO THE COVERAG AFFORDED BY'HE POLICIES BELOW. ASSOCIATION ADMINISTRATORS & CONSULTANTS, INC. jFR I IE 12 lUr 99 COLIPANIES AFFORDING COVERAGE 19000 MacArthur Blvd. #500 CC APANV Irvine, CA 92715 CITY CLEr TER A EMPLOYERS' FIRE INSURANCE COMPANY 714/833-0673 lCITY O htE CITY OE 5 FbC APANV INSURED JUAN CWTTFALK TER B COMMERCIAL UNION INSURANCE COMPANY CO LE CERNV C VAN DELL AND ASSOCIATES, INC. AMERICAN EMPLOYERS' INSURANCE COMPANY 17801 Cartwright Road CO IPANY D. Irvine, Caliofrnia 92714 LE'TER CO IPANY E LEI TER THIS IS TO CERTIFY THAT POLICIES OF NSURANCE LISTED BELOW HAVE 3EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT ,TERM OR CONDITION OF ANY C,MITRACT OR OTHE R DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSL RANCE AFFORDED BY THE POLIO ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDE TIONS OF SUCH POLICIES. CO POLICY FIFE,THE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS TYPE OF INSURANCE POLICY NUMBER LTR DATE(MMIDII(YYI DATE IAMOD" - OCCURRENCE AGGREGATE GENERAL LIABILITY BODILY A COMPREHENSIVE FORM IWURY $ $ FALB96105 4/01/90 4/01/91 PREMISES/OPERATIONS PROPERTY UNDERGROUND DAMAGE EXPLOSION&COLLAPSE HAZARD $ $ RWOMPLETED OPERATIONS coNrRAcruA BCIG&WNED $ 500 $ 500 INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ 500 AUTOMOBILE LIABILITY BOMLY ANY AUTO ruu" (PER RASWI $ ALL OWNED AUTOS(PRIV. PASS.) B CAAA09354 4/01/90 4/01/91 ALL OWNED AUTOS(OTHER THAN N_ PEBROC OE $ ? PRPASS. +` HIRED AUTOS w NON OWNED AUTOS PROPERTY $ DAMAGE GARAGE LIABILITY `Y } BI&PD COMBINED $ 500 x rETY RM BI&PD AAD510872 4/01/90 4/01/91 COMBINED $ 5,000 $ 5,000 UMBRELLA FORM e#ewiil there&,P� STATUTORY :�,: k'�COMPENSATION -�' ' AND $ (EACH ACCIDENT) $ (DISEASE-POLICY L11AT) RS'LIABILITY n $ (DISEASE-EACHEMPLOYEE) OTHER DESCRIPTION OF OPERATIONSILOCATIONSN EHICLESISPECIAL ITEMS ADDITIONAL INSURED WITH RESPECTS TO AUTO LIABILITY. SEE ATTACHED ENDORSEMENT FOR GENERAL LIABILITY. * 10 DAY NOTICE OF CANCELLATION FOR NON-PAYMENT CITY OF SAN JUAN CAP I STRAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- PIRATION DATE THEREOF, THE ISSUING COMPANY WILL Y3N007WA6MM ATTN: MR. THEODORE G. SIMON, CITY ENG. wuL*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFr1�l19R7t9cM�k �aa� lax IBNa333Lo►3cxxOcaEor aac�asw x SAN JUAN CAPISTRANO, CA 92675 AUTHORIZED REPRESENTATIVE C.J. Webberle for A& Producer: AA&C Producer Code: 04-67396 This endorsement, effective 4/1/90 forms a part of Policy Number FALB96105 issued to VAN DELL AND ASSOCIATES, INC, by Employers' Fire Insurance Company. ADDITIONAL INSURED ENDORSEMENT SECTION II - LIABILITY INSURANCE CLAUSE NAME OF ADDITIONAL DESCRIPTION OF NO. INSURED PREMISES 6 CITY OF SAN JUAN CAPISTRNAO All work performed 32400 PASEO ADELANTO, CITY ENG. for additional SAN JUAN CAPISTRANO, CA 92675 insured in ATT: MR. THEODORE G. SIMON, CITY California ENG. **SEE ATTACHED FORM G10411 (Ed. 9-83) ** PRIMARY CLAUSE ENDORSEMENT It is further agreed that such insurance as is afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only as respects any claim, loss or liability arising out of the operations of the Named Insured and any insurance maintained by the Additional Insured shall be non-contributing. non-contributing. e-.,, e) WjrG�`�'X CJ WEBBERLEY for AA&C (Authorized Representative) AA&C: sls Issued: 4/1/90 Sari Juan G:apistranu Coarnitulm Redevelopment Agency March 23, 1990 Mr. Robert Lewis Van Dell and Associates, Inc. 17801 Cartwright Road Irvine, California 92714 Re- Renewal of General Liability and Automobile Liability Certificates of InsuranceDesi n Precise Ali nments for Orte a Hi hwa El amino Real and Forster Street Dear Mr. Lewis- The General Liability and Automobile Liability Certificates of Insurance, regarding the above-referenced projects, are due to expire on April 1, 1990. In accordance with your agreement, the insurance certificate needs to be renewed for an additional period of one year. The agreement requires a general liability endorsement form naming the City of San Juan Capistrano and the San Juan Capistrano Community Redevelopment Agency as additional insureds. Please forward the updated certificates and the endorsement to the City, attention City Clerk's Department, by April 6, 1990. If you have any questions, please contact me at (714) 493-1171 extension 244. Thank you for your cooperation. Very truly yours, Dawn M. Schanderl Records Coordinator 82400 Paseo Adelanto San Juan Capistrano California 92675 714-493-1171 II:} DATE 13 NA wol jr,&-I InrlIMMIBDnr. 8/1 ,/89 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND ` CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ASSOCIATION ADMINISTRATORS DFIF3 NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE & CONSULTANTS INC POI laesBELOW. P 0 BOX 19570 COMPANIES AFFORDING COVERAGE IRVINE CA 92713 COMPANY LETTER A 2. ' COMPANY INSIIRen � Le-I-Ea B COMPANIY VAN DELL AND ASSOCIATES LETTER C 17801 CARTWR I GHT COMPANY LETTER D HARTFORD INS GROUP IRVINE CA 92714 I-------- -OMPANIY jLETTER E 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 GONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDITIONS OF SUCH POLICIES I LIABILITY LIMITS IN THOUSANDS JOS PUUCe EFFECTIVE POLICY EXPIRATION R T YEE OF INSURANCE POLICY NUMBER 7 DA TE;MM/DD/YL`) DATE IMM/DD!YYI EACH OCCURENCE AGGREGATE GENERAL LIABILITY —� BODRY COMPREHENSIVE FORM INJURY PR EMISES'OPERATIONS PROPERTY UNDERGROUND DAMAGE E%PLOSION A COLLAPSE HAZARD PRODUCTS/COMPLETED OPERATIONS CONTRACTUAL BIAPD COMBINED INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY 1 AUTOMOBILE LIABILITY — T- Bo ILY W URY (PER PERSON) ANY AUTO BODILY INJURY E ALL OWNED AUTOS I � APCCOIDENT) HIRED AUTOS- I PROPERTY NON OWNED AUTOS ` DAMAGE GARAGE LIABILITY I &APO COMBINED EXCESS LIABILITY - UMBRELLA FORM 018 PD OMBINED OTHER THAN UMBRELLA FORM ---� D — -- ---- i72WJCI4619W T9/01/89 9/01/90 STATUTORY WORKERS'COMPENSATION IEACH ACCIDENT, AND 11 1 EMPLOYERS'LIABILITY (DISEASE-Poucv LIMIT) -- 1 000 (DIBEA3EEACH EMPLOYEE) OTHER I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS v` SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Mr. Theodore G. Simon, City F!ggineer' THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY CITY OF SAN JUAN CAPISTRANO wILLYEr`� ICT DAYS WRITTEN NOTICE TO 32400 Paseo Adelanto ��Ty`+ECERTIFyyI��CA�TEHOLDxE�RE�N}AS�M DTOTH FT r g 3y _ San Juan Capistrano, CA. 92675 'fF3Cx �75xs 25# rf5r� YE# �rr�F�# AU EPRES E ALL 0 A A5 FOR AA&C L THE HARTFORD Named Insured: VAN DELL AND ASSOICATES, INC. Policy No: 72WJCI4619W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/01/89 Effective hour is the same as stated in the Declarations of the policy. ADDITIONAL INSURED EMPLOYER ENDORSEMENT IT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THE POLICY UNDER INSURING AGREEMENT I ALSO APPLIES TO: CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS AND EMPLOYEES. 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CALIFORNIA 92675 AS AN ADDITIONAL INSURED EMPLOYER BUT ONLY AS RESPECTS EMPLOYEES HIRED BY AND CARRIED ON THE PAYROLL OF THE EMPLOYER NAMED IN ITEM I OF THE DECLARATION OF THIS POLICY.. AA&C L7P ISSUE: 8/15/89 g�jj I� SHERALL GRA AS for AAC Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC. Policy No:72WJCI4619W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/1/89 Effective hour is the same as stated in the Declarations of the policy. It is agreed and understood that coverage provided by the above referenced policy is primary and not contributing with any other insurance maintained by the City of San Juan Capistrano and San Juan Capistrano Redevelopment Agency. AA&C ljp ISSUE: 8/15/89 { dka'L'� / y:. dtp-,4 udh'erall Gradilas for AAC Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B DT ® L Mumo1w) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ASSOCIATION ADMINISTRATORS DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE & CONS'ULTAN'TS INC POLICIES BELOW. P 0 BOX 19571 COMPANIES AFFORDING COVERAGE IRVINE CA 92713 COMPANY LETTER A COMPANY INSURED LEYTER B COMPANY VAN DELL AND ASSOCIATES LETTER C 17801 CARTWRIGHT COMPANY HARTFORD INS GROUP IRVINE CA 92714 ETER D COMPANY LETTER E • f THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDITIONS OF SUCH POLICIES. GD TYPE OF INSURANCE POLICY NUMBER PO UGY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS LTR DATE(MMIDDIYY) GATE(MMlODfYYI EACH OOOURENCE AGGREGATE _ GENERAL LIABILITY BODILY COMPREHENSIVE FORM IWURV PREMISES/OPERATIONS PROPERTY UNDERGROUND DAMAGE EXPLOSION&COLLAPSE HAZARD PRODUCTS/COMPLETED OPERATIONS CONTRACTUAL w&PD COMBINED INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONALINJURY PERSONAL INJURY AUTOMOBILE LIABILITY BODILY PW URY ER PERSON BODILY ANY AUTO IWURY PER ALL OWNED AUTOS ACCIDENT) HIRED AUTOS 1 PROPERTY NON-OWNED AUTOS DAMAGE GARAGE LIABILITY &6 PD COMBINED EXCESS LIABILITY UMBRELLA FORM BI&PD COMBINED OTHER THAN UMBRELLA FORM D 7' WJC14619W' 9/01/89 9/()1/90 STATUTORY WORKERS'COMPENSATIONLEACH AcdDENp AND t 1t 111 EMPLOYERS' LIABILITY I (DISEASE-POLICY 1 L1oo (dSEABE-EACH EMPLOYEE) L ERATIONS/LOCATIONS/VEHICLE$/SPECIAL ITEMS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Mr. Theodore G. Simon, City Engineer THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY CITY OF SAN JUAN CAPISTRANO WILIFYFF'E*XMWr4 G?� 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDyEy R�y��NAM TOT F a��5 %Fg�# �y 32400 Paseo Adelanto THS �ER ��3' o r'i�=ggWg5 San Juan Capistrano, CA. 92675 fl?IL�� AUTHO E TI SH ALL GRA IA 0 ' AA&C L THE HARTFORD Named Insured: VAN DELL AND ASSOICATES, INC. Policy No: 72WJCI4619W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/01/89 Effective hour is the same as stated in the Declarations of the policy. ADDITIONAL INSURED EMPLOYER ENDORSEMENT IT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THE POLICY UNDER INSURING AGREEMENT I ALSO APPLIES TO: CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS AND EMPLOYEES. 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CALIFORNIA 92675 AS AN ADDITIONAL INSURED EMPLOYER BUT ONLY AS RESPECTS EMPLOYEES HIRED BY AND CARRIED ON THE PAYROLL OF THE EMPLOYER NAMED IN ITEM I OF THE DECLARATION OF THIS POLICY. AA&C IJP ISSUE: 8/15/89 HERALL GRADIAS for AAC Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC. Policy No:72WJCI4619W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/1/89 Effective hour is the same as stated in the Declarations of the policy. It is agreed and understood that coverage provided by the above referenced policy is primary and not contributing with any other insurance maintained by the City of San Juan Capistrano and San Juan Capistrano Redevelopment Agency. AA&C ljp ISSUE: 8/15/89 S erall Gradi s for AAC Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B W June 13 , 1989 ';aysmutaMsraauo .auwaW Mr. Theodore G. Simon City Engineer City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, Ca. 92675 Re: Van Dell and Associates, Inc. Professional Liability Insurance CNA Policy No. AAE4312468 Dear Mr. Simon: In accordance with our letter of May 17 , 1989 , enclosed please find a Certificate of Insurance evidencing Professional Liability Insurance for the above referenced Insured. Please be advised that in lieu of any amending of the cancellation clause (which is no longer allowed by CNA) , we shall be ordering an endorsement from CNA providing you with a 30 day notice of cancellation. This shall be forthcoming under seperate cover. We trust you will find all in order. If you should have any questions at all , please feel free to contact our office. Sincerely, Laura J. Pr tt Business Insurance Division : ljp Enclosure cc: Van Dell and Associates, Inc. ASSOCIATION ADMINISTRATORS & CONSULTANTS, INC. 19000 MacArthur Blvd.•Spite 500•Irvine.CA 92715•Mailing address'P.O.Box 19570•Irvine.CA 92713 In Alaska,California and Hawaii telephone 7141833 0673•All other states 80018540491 FAX 7141752-1568 CC,410 OM. CERTIFICA* OF INSURANCE OP ISSUE DAIS (M .+►i 3/31/92 92 PRODUCER 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 ALTER THE COVERAGE AFFORDED BY THE ASSOCIATION ADMINISTRATORS POLICIES BELOW. & CONSULTANTS INC COMPANIES AFFORDING COVERAGE P 0 BOX 19570 IRVINE CA 92713 AN LEITCOMPERY A COMMERCIAL UNION_ LEITER Y B INCOMMERCIAL UNION COMPANY LEITER n VAN DELL AND ASSOCIATES COMPANY n'I=r 17801 CARTWRIGHT LETTER D isms IRVINE CA 92714 COMPANY LETTER E V COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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. co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MMIDONY) DATE(MM/DD/YY) GENERAL LIABILITY FALB9 68 2 5 4/01/92 4/01/93 BODILY INJURY OCC. S COMPREHENSIVE FORM BODILY INJURY AGG. $ {PIREMIpSpES/OPEpRATIONS PROPERTY DAMAGE OCG. S EXPLOSION 6 COLLAPSE HAZARD PROPERTY DAMAGE AGG. $ PRODUCT=OMPLLTED OPER. BI E PD COMBINED OCC. $1 000 000 CONTRACTUAL BI$PD COMBINED AGG. $ INDEPENDENT CONTRACTORS PERSONAL INJURY AGG. $1 000 000 BROAD FORM PROPERTY DAMAGE PERSONAL INJURY AUTOMOBILE UARLITY CAAA0 9 3 5 4 4/01/92 4/01/93 BODILY INJURY ANY AUTO (PK Pslsa^) $ All OWNED AUTOS(Ptiv,pus.) BODILY INJURY ALL OWNED AUTOS (per DaaI (Per accident) E pft�pass. HIRED AUTOS PROPERTY DAMAGE E NON-OWNED AUTOS GARAGE LIABILITY BODILY INJURY$ PROPERTY DAMAGE E COMBINED 1, 000,000 EXCESS uAsLITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT S AND DISEASE--POLICY LIMIT $ EMPLOYERS'LIABILITY DISEASE-EACH EMPLOYEE S OTNER DESCRIPTION OF OPERATIONMOunONSNEIICLEMPECML ITEMS IN THC 01- CANCELLATION FOR NON- ALL ENGINEERING OPERATIONS PAYMENT,A 10 DAY NOTICE WILL BE GIVEN CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SAN JUAN EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL CAPISTRANO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT, SAN JUAN CAP CA 92675 L p A Igo ALIVE • . CJ WEBBER FOR C W ACORD 25-(T/90) - ACORD CORPORATION 1990 _ > , Producer: AA&C Producer Code: 04-67396 This endorsement, effective 4/01/92 forms a part of Policy Number FALB96825 issued to VAN DELL AND ASSOCIATES, INC. by Employers ' Fire Insurance Company. ADDITIONAL INSURED ENDORSEMENT SECTION II - LIABILITY INSURANCE CLAUSE NAME OF ADDITIONAL DESCRIPTION OF NO. INSURED PREMISES 6 CITY OF SAN JUAN CAPISTRANO All work performed 32400 PASEO ADELANTO for additional SAN JUAN CAPISTRANO, CA 92675 insured in California **SEE ATTACHED FORM G10411 (Ed. 9-83 ) ** PRIMARY CLAUSE ENDORSEMENT It is further agreed that such insurance as is afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only as respects any claim, loss or liability arising out of the Operations of the Named Insured and any insurance maintained by the Additional Insured shall be non-contributing. ( �,d J� CJ WEBB RLEY for AA&C (Authorized Representative) AA&C: cjw Issued: 4/6/92 ADDITIONAL INSURED ENDORSEMENT SECTION 11 — LIABILITY INSURANCE THIS FORM IS PART OF YOUR POLICY, PLEASE READ ITCAREFULLYAND KEEP IT WITH YOUR POLICY JACKET. SCHEDULE CLAUSE NAME OF ADDITIONAL DESCRIPTION OF NO. INSURED PREMISES CLAUSE NO. 1 —PREMISES LEASED TO NAMED INSURED When"Clause No. 1"is Indicated in the schedule on this form,then the definition of"insured"In yourpolicy is amended to include the additional insured described in the schedule. Coverage for such additional insured applies only to their bodily Injury or property damage liability arising from the ownership,maintenance or use of the premises described In the schedule,which are leased to you. Insurance provided under this clause does not apply to: 1. Any occurrence which takes place after you cease to be a tenant in the described premises. 2. Structural alterations,new construction or demolition operations performed by or on behalf of the person or organization described in the schedule. CLAUSE NO.2—STATE OR POLITICAL SUBDIVISIONS(PERMITS) When"Clause No.2"is indicated in the schedule on this form,then the definition of Insured"In your policy is amended to include the state or political subdivision listed in the schedule as additional Insured,subjectto the following: 1. Insurance provided under this clause applies only to bodily injury or property damage liability arising out of (continued) 010411 (Ed.9-83) ® Commercial Union Insurance Company 1983 When"Clause No.5"is indicated in the schedule on this form,then the definition of Insured"in your pol icy is amended to include the additional insured described In the schedule,but only with respect to liability arising out of operations performed for such additional Insured by or on behalf of you. 2. operations performed by you or on your behalf for which the state or.political subdivision has Issued a permit. 2. Insurance provided under this clause does not apply to bodily injury or property damage: A. Arising out of operations performed for the state or municipality, or B. Included within the completed operations hazard. w. :LA Producer: AA&C Producer Code: 04-67396 This endorsement, effective 4/01/92 forms a part of Policy No. CAAA09354 issued to VAN DELL AND ASSOCIATES, INC. by the insurance company indicated below by an "XII . XX Commercial Union Ins. Co. _ American Employers Ins. Co. The Employers Fire Ins. Co. _ The Northern Assurance Co. of America ADDITIONAL INSURED IT IS AGREED AND UNDERSTOOD THAT THE FOLLOWING IS NAMED AS ADDITIONAL INSURED WITH RESPECT TO WORK PERFORMED FOR THEM BY THE NAMED INSURED. CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 PRIMARY CLAUSE ENDORSEMENT It is further agreed that such insurance as is afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only as respects any claim, loss or liability arising out of the Operations of the Named Insured and any insurance maintained by the Additional Insured s 1 be non-contributing. CJ WEBBERL for AA&C (Authorized Representative) AA&C: cjw Issued: 4/6/92 A/CAIlu® CERTIFIcAVE OF INSURANCE 40 ISSUE DATE 3 M,Do) /31/92 PRODUCER 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 ALTER THE COVERAGE AFFORDED BY THE ASSOCIATION ADMINISTRATORS POLICIES BELOW. & CONSULTANTS INC P O BOX 19570 COMPANIES AFFORDING COVERAGE IRVINE CA 92713 COMPANY A COMMERCIAL UNION COMPANY Y B �R� COMMERCIAL UNION LEETMTEER Y C VAN DELL AND ASSOCIATES COMPANY D 17801 CARTWRIGHT LETTER IRVINE CA 92714 COMPANY E EMP COVERAGES- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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. L p E PDAEFFECTIVE PTE��H LIMITS TYPE OF INSURANCPOLICY NUMBER TEIMY (M GENERAL L Mw rrY I FALB9 6 8 2 5 4/01/92 4/01/93 BODILY INJURY OCC. E COMPREHENSIVE FORM BODILY INJURY AGG. E PREMISES/OPERATIONS PROPERTY DAMAGE OCC. E {1NDERGROUNp EXPLOSION 8 COLLAPSE HAZARD PROPERTY DAMAGE AGG. i PRODUCTS/COMPLETED OPER, BI E PD COMBINED OCC. 181, 000, 000 CONTRACTUAL - BI E PO COMBINED AGG. E INDEPENDENT CONTRACTORS PERSONAL INJURY AGG. $1,000,000 BROAD FORM PROPERTY DAMAGE PERSONAL INJURY AUTOMOBILE LMBILRY I CAAA0 9 3 5 4 4/01/92 14/01/93 BODILY INJURY E ANY AUTO (PW pf a ) ALL OWNED AUTOS(Pdv.pbs.) BODILY INJURY ALL OWNED AUTOS (V&�) i IPW W.CIEP11q i HIRED AUTOS PROPERTY DAMAGE E NON-OWNED AUTOS GARAGE LIABILITY .'.'S 1 BODILY INJURY d PROPERTY DAMAGE E COMBINED 11000, 000 EXCE88=1 UUIL.RY - EACH OCCURRENCE E UMBRELLA FORM ` t' AGGREGATE 3 OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMBS AND EACH ACCIDENT E OISEASE-POLICY LIMB E EMPLOYERS'LIABILITY DISEASE-EACH EMPLOYEE E OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNE/ECLESAIPECIAL ITEMS _ ALL ENGINEERING OPERATIONS {N 1 h= t` �' �''�==LA•TiON FOR NON- PAYMEN`. A 10 DAY NOTICE WILL BE GIVEN CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SAN JUAN EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL fiNDGNRCFT%iO CAPISTRANO MAIL-1-0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT SAN JUAN CAP CA 92675 AUTHORM(!_!E,PPi1 CJ WEBBERLE FOR AA&C W ACORD.25 (7/00) CACORD CORPORATION IYYO MEMORANDUM April 1, 1992 TO: Brian Perry, Senior Civil Engineer FROM: Theodore G. Simon, City Engineer SUBJECT: Ortega Highway Realignment (CIP No. 129) According to the March 5, 1991 City Council action on the CIP budget, the plan of action was to complete the Record of Survey and precise alignment and defer design to future years. The revised budget for FY 90-91 was $12,000. Projects were agreed to be performed based on cash flow availability. Since there has been no other direction given to date, the agreement for the subject project between Van Dell and Associates and the CRA should not be terminated. TG S:ssg cc: William M. Huber Cassandra Walker b0a .4o MEMORANDUM March 18, 1992 TO: Ted Simon, City Engineer Cassandra Walker, Community Development Manager FROM: Brian Perry, Senior Civil Engineer SUBJECT: Ortega Highway Realignment In 1987, the CRA entered into an agreement with Van Dell & Associates to perform precise alignment studies for Ortega Highway, El Camino Real and Forster Street. The work progressed for a time but was never concluded nor terminated. The last correspondence, to my knowledge, was the attached letter, dated February 26, 1991, to which we received no response. Section 11 of the Agreement allows for termination of the Agreement by the Agency. Dawn Schanderl has asked if the contract should be terminated to end the City Clerk's requests for updated insurance certificates. Please let me know if this Agreement should be terminated, and I will proceed accordingly. BP:cly C ,a A 1 L MEMBERS OF THE CITY COUNCIL (JyJ ANTHONY L. BLAND LAWRENCE F. BUCHNEIM V u' '40,101.111 KENNETH E. FRIESS if IllAhupl 1961 GARY L. HAUSDORFER 1776 PHILLIP R. SCNWARTZE • CITY MANAGER STEPHEN B JULIAN February 26, 1991 Van Dell & Associates 17801 Cartwright Road Irvine, California 92714 Attention: Mr. Thomas E. Propst Re: Ortega Highway Realignment - Record of Survey Dear Mr. Propst: I have reviewed the following documents with reference to your letter of January 28, 1991, regarding the above subject Record of Survey: 1. The original Scope of Work. 2. Van Dell letter of November 23, 1987, from Kevin McHugh. 3. Van Dell letter of December 16, 1987, from Matt Hoglund. 4. City letter of January 18, 1988, from Ted Simon. i) Originally, a Record of Survey was envisaged for the project at a proposed cost of $782, for which you are now requesting $8,975. ii) Kevin McHugh's letter (2), Matt Hoglund's letter (3) and Ted Simon's letter (4), referred to and accepted sixteen (16) hours of boundary analysis for the preparation of a Parcel Map after all field conditions were known. As we are now referring to a Record of Survey again, I need to know why Van Dell requests forty (40) hours to perform what would appear to be less work? iii) Kevin McHugh's letter (2) referred to two (2) hours of office calculations and this was accepted in Ted Simon's letter (4), again, after all field conditions were known. I need to know why this time has increased from the original by much more than two (2) hours, to fifteen (15) hours? 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO. CALIFORNIA 92675 0 (714) 493-1171 Van Dell do Associates• • February 26, 1991 Page 2 iv) The original Scope called for eight (8) hours of drafting. Van Dell is now requesting thirty-five (35) hours. I need to know why there is over four times more drafting work as well as another fifteen (15) hours of preparation work? v) Finally, Van Dell is requesting ten (10) hours of coordination and review time. Please reconsider this in light of my previous comments. vi) In summary, I need to have some definite reasons why you propose that costs have risen from $782 to $8,975. Hopefully, the City and Van Dell can reach an agreement on this item of work to prepare a Record of Survey. There are, however, sections in the Consulting Services Agreement which provide for the settlement of disputes if no agreement can be reached. Very truly yours �n�� Brian Perry Senior Civil Engineer BP:ssg wIC®Ru. CERTIFICAQE OF INSURANCE ISSUE DATE (MMMONY) 9/09/91 PRODUCER 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 ALTER THE COVERAGE AFFORDED BY THE ASSOCIATION ADMINISTRATORS POLICIES BELOW. & CONSULTANTS INC COMPANIES AFFORDING COVERAGE P O BOX 19570 IRVINE CA 92713 COMPANY A LETTER COMPANY B INSURED LETTER COMPANY C LEITER VAN DELL AND ASSOCIATES COMPANY D 17801 CARTWRIGHT LETTER HARTFORD INS GROUP IRVINE CA 92714 LCOMPANY E COVERAGES - - - - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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. TYP[OP IEIIRANCE PM1CY NUMBER POLICY DAY EXPIRATION DTiTLMRB GENERAL LJABLNTY BODILY INJURY DCC. i COMPREHENSIVE FORM BODILY INJURY AGG. S IPIlRIJE�M�IpSpEpSpOPERATIONS PROPERTY DAMAGE OCC. i IXPI.OSKKJ i COLLAPSE HAZARD PROPERTY DAMAGE AGG. i PROPUCTSSAMPLETED OPER. BI 8 FO COMBWED OCC. i CONTRACTUAL BI i PO COMBINED AGO. i INDEPENDENT CONTRACTORS PERSONAL INJURY AGO. S BROAD FORM PROPERTY DAMAGE PERSONAL IMURV AUTOMOBILE LLASEJTY BODILY INJURY ANY AUTO IPM pl I ) i ALL OWNED AUTOS(PAv.MIr.) BODILY INJURY .oaaRA) + ALL OWNED AUTOS (P,Iy P. .) (PM HIRED AUTOS PROPERTY DAMAGE i NON-OWNED AUTOS GARAGE LIABILITY BODILY INJURY L PROPERTY DAMAGE i COMBINED FxCESS LIABILITY EACH OCCURRENCE i UMBRELLA FORM AGGREGATE i OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION 72WJCI4619W 9/01/91 9/01/92 AMD STAMORYLMRS EACH ACCIDENT +1 000 000 DISEASE—POLICY LIMIT +1 000 000 EMPLOYERS'LIABLm DISEASE—EACH EMPLOYEE +1 000 000 OTHER DESCRIPTION OF OPERATCNN.ODATWNLVEHO ESMPECML"EMS tri l f3 2'.:.VT(_)i-CAN;:ELIATION FOR NON- ALL ENGINEERING OPERATIONS PAYMENT,A'10 DAY NOTICE WILL BE GIVEN CERTIFICATE HOLDER CANCELLATION. - - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SAN JUAN EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL 5NDFAVORVO' CAPISTRANO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT, SAN JUAN CAP CA 92675 AUHIOIIIZfD REM �j/� ' CJ WEBS ACORD-25 (7/90). - 'NOACc CORPORATION-19Y0 THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC. Pol 72WJCI4619W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 09/01/91 Effective hour is the same as stated in the Declarations of the policy. ADDITIONAL INSURED EMPLOYER ENDORSEMENT IT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THE POLICY UNDER INSURING AGREEMENT I ALSO APPLIES TO: CITY OF SAN JUAN CAPISTRANO AND THE SAN JUAN CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS AND EMPLOYEES 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 AS AN ADDITIONAL INSURED EMPLOYER BUT ONLY AS RESPECTS EMPLOYEES HIRED BY AND CARRIED ON THE PAYROLL OF THE EMPLOYER NAMED IN ITEM I OF THE DECLARATION OF THIS POLICY. AA&C cjw ISSUE: 9/09/91 CJ WEBBERUY for AA Authorized" Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B U THE HARTFORD Named Insured: VAN DELL AND ASSOCIATES, INC. Pol 72WJCI4619W This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another effective date is stated herein. Effective date: 9/01/91 Effective hour is the same as stated in the Declarations of the policy. PRIMARY CLAUSE ENDORSEMENT It is agreed that such insurance as is afforded by this policy for the benefit of CITY OF SAN JUAN CAPISTRANO shall be primary insurance, but only as respects any claim, loss or liability arising out of the operations of the Named Insured(s) and any insurance maintained by above shall be non-contributing. AA&C cjw ISSUE: 9/09/91 GdWEBBERUEY for AA Authorized Agent Nothing herein contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or declarations of the policy other than as herein stated. This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of said policy and, at issue of said policy, forms a part thereof, counter- signature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. Form G-2240-3B AID01:10. CERTIFIC/SE OF INSURANCE 1 ISSUE DATE( OMmom) 1 PRODUCER - -- 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 ALTER THE COVERAGE AFFORDED BY THE ASSOCIATION ADMINISTRATORS POLICIES BELOW. & CONSULTANTS INC COMPANIES AFFORDING COVERAGE P O BOX 19570 IRVINE CA 92713 COMPANY A LETTER < COMPANY B INSUREDLETTER i COMPANY LETTER V c VAN DELL AND ASSOCIATES COMPANYD 1780,}' C,kRTWRIGHT LETTER HARTFORD INS GROUP IRVINE , CA 92714 COMPANY E COVERAGES" THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.'NOTIWTHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAX-BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AN4FONDr IONS OF SUCH POLICIES. co IV TYPE OF8ISURANCE POLICY NUMBER! POLICY EFFECTIVE POLICY EXPIRATION LTH TYPE (MM,DDNY) DATE(MMNDNY) LAM r GENERAL LIABILITY BODILY INJURY OCC. i COMPREHENSIVE FORM BODILY INJURY AGO. i PP�RRINEE�MpIISGCE�SIOPEpRATIONS PROPERTY DAMAGE OCC. i EXPLOSION 8 COLLAPSE HAZARD PROPERTY DAMAGE AGO. i PRODUCTS COMPLETED OPER. BI i PD COMBINED OCC. i CONTRACTUAL BI d PO COMBINED AGO. i INDEPENDENT CONTRACTORS PERSONAL INJURY AGO. S BROAD FORM PROPERTY DAMAGE PERSONAL INJURY \ AUTOMOBILE LI429ITY �. BODILY INJURY ANY AUTO "" (Pw Pw ) i ALL OWNED AUTOS(PIv.p.u.) BODILY ILIURY ALL OWNED AUTOS (�wIN) (Pw IoLNdMI i HIRED AUTOS PROPERTY DAMAGE i NONOWNED AUTOS GARAGE LIABILITY PPRROOPERTTYY DAMAGE i COMBINED EXCESS LIABBITY EACH OCCURRENCE i UMBREI IA FORM AGGREGATE i OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION 7 2 WJCI4 619 W 9/01/91 9/O-1/9 2 X STATUTORY LIMITS AND EACH ACCIDENT $1, 000.000 DISEASE-POLICY LIMrt 1:11, 000, 000 t 000, 000 EMPLOYERS'LIABILITY DISEASE-EACH EMPLOYEE it QQQ 000 OTHER DESCRIPTION OF OPERATION&LOCATIGwNEHICLEBIBPECIAL ITEMSL•'�.::`T CSF CAnCC'L.LATION FOR NOW ENGINEERING OPERATIONS PAYMENT, A'10 DAY NOTICE WILL BE GIVEN CERTIFICATE,HOLDER . .:.CANCELLATION -i. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SAN JUAN EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL 6RDEAV0R\,TW CAPISTRANO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT, BUr FAILURE T`O-XWI,SUC I-NOTIdL cHALL1MPosEtluo-G6lL GATlowoR SAN JUAN CAP CA 92675 "IUrLQF'A I UPON-THE COMPANY RS AGENTS ORREP..RESENTATNEB.., AUTNONDEDBE CJ WEBB � W ACORD 25 (7190):' 'OA D CORPORATIONIt" 6PROFESS AL LIABILITY CNA ARCHITEC S/ENGINEERS Far All the Commitm uYou Make INSURED: VAN DELL AND ASSOCIATES, INC. Policy AAE 00-431-24-68 MEMORANDUM OF INSURANCE ARCHITECTS AND ENGINEERS PROFESSIONAL LIABILITY This memorandum is issued Addressee : as a matter of information City of San Juan Capistrano only and confers no rights Attn: Mr. Theodore G. Simon upon the holder . By its City Engineer issuance the Company does 32400 Paseo Adelanto not alter, change, modify San Juan Capistrano, CA 92657 or extend the provisions of said policy and does not waive any of its Name and Address of Insured: rightz thereunder . Van Dell And Associates, Inc. 17801 Cartwright Road Irvine, California 92714 Policy Period: 5/18/91 to 5/18/92 $ 1000,000 Per Claim limit of liability (including claims expenses) $ 1,,000,000 Aggregate limit of liability (including claims expenses) The above policy has been issued by the Continental Casualty Company and is in force at the date indicated below: Dated at: San Francisco, California Date: August 9, 1991 In the event of the cancellation of the Insurance as shown herein, the Continental Casualty Company or its authorized representative will provide thrity (30 ) days prior written notice to the party to whom this certificate is addressed at the address stated herein. The mailing of such notice shall be sufficient proof of notice. VICTOR O . SCHINNERER & CO . J ^ } BY: o cr s su++.wwe.�Asra�nu _ iCAlx'�7lFJ?A Authorized Represe _. 1-41249-A