HomeMy WebLinkAboutC-7577-1 - Revocable License Agreement for Temporary Use of Public Right of Wayr
f" AMENDMENT NO. ONE TO
REVOCABLE LICENSE AGREEMENT
BETWEEN THE CITY OF NEWPORT BEACH
AND ADVANCED MEDICAL PROPERTIES, LLC FOR
TEMPORARY USE OF PUBLIC RIGHT OF WAY
THIS AMENDMENT NO. ONE TO REVOCABLE LICENSE AGREEMENT
("Amendment No. One") is made and entered into as of this 1st day of January, 2019
("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California
municipal corporation and charter city ("City"), and ADVANCED MEDICAL
PROPERTIES, LLC, a California limited liability company ("Licensee"), and is made with
reference to the following:
RECITALS
A. On July 9, 2018, City and Consultant entered into a Revocable License Agreement
("Agreement") for the temporary use of public right of way between the street
known as Old Newport Boulevard and the real property located at 330 Old Newport
Boulevard in the City of Newport Beach, County of Orange, State of California
("Premises").
B. The parties desire to enter into this Amendment No. One to extend the term of the
Agreement to April 9, 2019.
NOW, THEREFORE, it is mutually agreed by and between the undersigned parties
as follows:
1. TERM
Section 1 of the Agreement is amended in its entirety and replaced with the
following: "The term of this Agreement shall commence on the Effective Date, and shall
terminate on April 9, 2019, unless terminated earlier as set forth herein."
2. INSURANCE
Section 12 of the Agreement is amended in its entirety and replaced with the
following: "Without limiting Licensee's indemnification of City, and prior to
commencement of work, Licensee and its subcontractors shall obtain, provide and
maintain at their own expense during the term of this Agreement or for other periods as
specified in this Agreement, policies of insurance of the type, amounts, terms and
conditions described in the Insurance Requirements attached hereto as exhibit C,
including any amendments thereto, and incorporated herein by reference."
3. INTEGRATED CONTRACT
Except as expressly modified herein, all other provisions, terms, and covenants
set forth in the Agreement shall remain unchanged and shall be in full force and effect.
[SIGNATURES ON NEXT PAGE]
IN WITNESS WHEREOF, the parties have caused this Amendment No. One to be
executed on the dates written below.
APPROVED AS TO FORM:
CITY ATTORNEY'S OFFICE
Date:
By:
Aaron C. Harp 1z Lo �8
City Attorney
ATTEST:
Date: ,
§-�ItNO, Of1
City Clerk
CITY OF NEWPORT BEACH,
a California municipal corporation
Date:
By:
Grq6eA.Leung
Cit tanager
LICENSEE: ADVANCED MEDICAL
PROPERTIES, LLC, a California limited
liability company
Date:
0
Signed in Counterpart
Emanuel Shaoulian
Managing Member
[END OF SIGNATURES]
Advanced Medical Properties, LLC Page 2
IN WITNESS WHEREOF, the parties have caused this Amendment No. One to be
executed on the dates written below.
APPROVED AS TO FORM:
CITY ATTORNEY'S OFFICE
Date: 1 21/=,/ Z,-.) ( 8
By: �� 4NL62eG
FOI.Aaron C. Harp AwiL'10'iQ
City Attorney
CITY OF NEWPORT BEACH,
a California municipal corporation
Date:
By:
Grace K. Leung
City Manager
ATTEST: LICENSEE: ADVANCED MEDICAL
Date: PROPERTIES, LLC, a California limited
liability company
Date:
By: By:
rvo'ff
Leilani I. Brown Emanuel a uftarr'
City Clerk Managing Member
(END OF SIGNATURES]
Advanced Medical Properties, LLC Page 2
r
r
Jr) REVOCABLE LICENSE AGREEMENT
r BETWEEN THE CITY OF NEWPORT BEACH
v AND ADVANCED MEDICAL PROPERTIES, LLC FOR
TEMPORARY USE OF PUBLIC RIGHT OF WAY
THIS REVOCABLE LICENSE AGREEMENT FOR TEMPORARY USE OF
PUBLIC RIGHT OF WAY ("Agreement") is made and entered into as of this 9th day of
July, 2018 ("Effective Date"), by and between the CITY OF NEWPORT BEACH, a
California municipal corporation and charter city ("City") and ADVANCED MEDICAL
PROPERTIES, LLC, a California limited liability company ("Licensee"), and is made with
reference to the following:
RECITALS
A. City is a municipal corporation duly organized and validly existing under the laws
of the State of California with the power to carry on its business as it is now being
conducted under the statutes of the State of California and the Charter of the City.
B. City is the owner of the public right of way between the street known as Old
Newport Boulevard and the real property located at 330 Old Newport Boulevard in
the City of Newport Beach, County of Orange, State of California and further
depicted in Exhibit "A" ("Premises"),
C. Licensee is the owner of the real property at 330 Old Newport Boulevard in the
City of Newport Beach, County of Orange, State of California, which is adjacent to
the Premises.
D. Licensee has requested that it be allowed to use a portion of the Premises depicted
in Exhibit "B" ("License Area") for temporary staging of construction equipment and
related appurtenances ("Project").
E. Pursuant to the terms and conditions of this Agreement and the Encroachment
permit issued by the City on July 6, 2018 (N2018-0349) ("Encroachment Permit"),
City authorizes Licensee's use of the License Area for the Project for the "Term"
(as defined in section 4 hereof) of this Agreement.
F. City Council Policy F-7 provides that the City may allow its property to generate
revenue and as a means to provide otherwise unfeasible uses and facilities to
benefit the community.
G. City would like to assist Licensee complete the Project in a timely manner and with
little disruption to the pedestrian and traffic circulation in the area. City and
Licensee, therefore, desire to enter into this Agreement to allow Licensee to use
the License Area on a non-exclusive basis, subject to the covenants and conditions
set forth in this Agreement in order to facilitate the Project.
H. In consideration of the mutual promises and obligations contained in this
Agreement, the receipt and sufficiency of which is hereby acknowledged, City
hereby grants to Licensee the revocable right to temporarily occupy and use the
License Area, and Licensee accepts the same on the following terms and
conditions.
NOW, THEREFORE, it is mutually agreed by and between the undersigned parties
as follows:
1. LICENSE
City grants a non-exclusive license ("License") to Licensee for the term of this
Agreement for Licensee to use the License Area, which is approximately six thousand
four hundred (6,400) square feet in size, to facilitate the Project. The License granted
herein is subject to the terms, covenants and conditions hereinafter set forth, and
Licensee covenants, as a material part of the consideration for this License, to keep and
perform each and every term, covenant and condition of this Agreement.
2. USE OF THE LICENSE AREA
Licensee's use of the License Area shall be limited to the terms of this Agreement.
3. PERMITS AND LICENSES
Licensee, at its sole expense, shall obtain and maintain during the term of this
Agreement, all appropriate permits, licenses and certificates that may be required by any
governmental agency including Licensor.
4. TERM
The term of this Agreement shall commence on the Effective Date, and continue
for ninety (90) days unless terminated earlier as set forth herein.
5. RENEWAL
The City Manager or designee may renew this Agreement for additional ninety (90)
day terms if it is determined that (i) that the terms of the Agreement have been met; and
(ii) the use by Licensee is not causing any negative impact on pedestrian or traffic
circulation, parking, or surrounding properties and uses. Any renewals approved
pursuant to this Section 5 must be in writing and approved as to form by the City Attorney
for the City.
6. LICENSE FEE
Licensee shall pay the City Six Thousand Three Hundred Dollars and 00/100
($6,300.00) per month ("License Fee") which amount shall be due and payable on the
Effective Date and each month thereafter (each, a "Due Date"). If Licensee fails to pay
the License Fee within thirty (30) days of any Due Date, Licensee shall pay a late charge
Advanced Medical Properties, LLC 2
in an amount equal to ten percent (10%) of the amount that was not timely paid by the
Licensee.
7. THE PURPOSE OF THE LICENSE
7.1 The purpose of this Agreement is to provide for the temporary use of the
License Area within the Premises. Use of area outside the License Area will not be
allowed unless prior permission is given in writing by the City. Licensee agrees to use
the License Area only for the activities described herein, and not to use or permit the use
of the License Area for any other purpose without first obtaining the prior written consent
of City, which consent may be withheld in City's sole discretion. Acceptable activities
include:
7. 1.1 Placement of a commercial office trailer and portable restroom facility;
7.1.2 The temporary parking of vehicles and equipment;
7.1.3 Installation of k -rail and fencing consisting of a 6 -foot -high chain link fence
and installation of a gate to provide City access to the Premises;
7.1.4 Storage of Project materials including storm water protection materials,
piping, traffic control devices, steel plates, crew trucks, and construction materials; and
7.1.5 Licensee must comply with all conditions for the Encroachment Permit.
8. CONDITIONS OF LICENSE
8.1 Licensee shall comply with the following conditions prior to the
commencement of use of the License Area:
8.1.1 The Licensed Area shall be temporarily fenced and screened on all sides
for the duration of the Project. The height of fence shall be six (6) feet, and fence material
shall be chain link metal fence overlaid on the exterior with an opaque vinyl screen, or
other equivalent fencing and screening material as approved by the City's Building
Official.
8.1.2 Prohibited Activities: storage of construction materials is expressly
prohibited outside of the fenced area. No improvements to the License Area are
permitted.
8.1.3 Maintenance: Licensee shall be responsible for maintenance of the License
Area including, but not limited to, the routine removal of foreign material, waste, and
debris. Licensee's obligation to maintain the License Area shall include a regular
preventative maintenance program, together with routine repairs caused by normal wear
and tear, to be provided by a licensed service company acceptable to City. Licensee
shall obtain all required Building permits necessary for such repair.
Advanced Medical Properties, LLC 3
8.1.3.1 City shall be entitled, with a Licensee representative, to
inspect the License Area for compliance with the terms of this Agreement, and with all
applicable Federal, State and local (including those of the City) government regulations.
8.1.4 Licensee shall work in a manner to minimize public inconvenience and
possible hazard, to restore other work areas to their original condition and former
usefulness as soon as possible, and to protect public and private property. Licensee shall
perform work to complete the Project to limit impacts to pedestrian and traffic circulation
during the Project. Licensee shall be liable for any private or public property damaged
during the performance of the Project.
8.1.5 Licensee shall provide traffic control and access in accordance with Section
7-10 of the State Standard Specifications and the latest edition of the Work Area Traffic
Control Handbook (WATCH), as published by Building News, Inc.
8.1.6 Traffic control and detours shall at a minimum meet the following
requirements:
8.7.1.1 Emergency vehicle access shall be maintained at all times.
8.7.1.2 The locations and wordings of all barricades, signs,
delineators, lights, warning devices, parking restrictions, and any other required details
shall ensure that all pedestrian and vehicular traffic will be handled in a safe manner with
a minimum of inconvenience to the public.
8.7.1.3 All advanced warning sign installations shall be reflectorized
and/or lighted.
8.7.1.4 Traffic signal system shutdown or planned "red flash" shall be
limited to 4 -hour periods between the hours of 9:00 a.m. and 3:00 p.m. on weekdays
(Monday through Thursday), except as authorized by the Project Administrator. 6 8.7.5
"STOP AHEAD" and "STOP" signs shall be furnished by the Contractor and shall conform
to the provisions in Section 12-3.06, "Construction Area Signs," of the State Standard
Specifications except that the base material for the signs shall not be plywood. Two
"STOP AHEAD" signs and two "STOP" signs shall be placed for each direction of traffic.
Locations of the signs shall be per the WATCH manual.
9. TERMINATION OF LICENSE
9.1 Notwithstanding the term of this Agreement, this Agreement may be
terminated during the term or any extended term in the following manner:
9. 1.1 By Licensee: At anytime, without cause, upon the giving of thirty (30) days
written notice of termination to City;
9.1.2 By City: At any time, without cause, upon the giving of thirty (30) days
written notice of termination to Licensee; or
Advanced Medical Properties, LLC 4
9.1.3 If, after written notice of default by City to Licensee of any of the terms or
conditions of this Agreement, Licensee fails to cure or correct the default within forty-eight
(48) hours of receipt of written notice, City may immediately terminate the License.
10. ADMINISTRATION
This Agreement will be administered by the Public Works Department. City's
Public Works Director, or designee, shall have the authority to act for City under this
Agreement. The License Administrator or their authorized representative shall represent
City in all matters pertaining to this Agreement.
11. INDEMNITY AND LIABILITY FOR DAMAGES
11.1 To the fullest extent permitted by law, Licensee shall indemnify, defend and
hold harmless City, its City Council, boards and commissions, officers, agents,
volunteers, employees and any person or entity owning or otherwise in legal control of
the property upon which Licensee performs the Project contemplated by this Agreement
(collectively, the "Indemnified Parties") from and against any and all claims (including,
without limitation, claims for bodily injury, death or damage to property), demands,
obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties,
liabilities, costs and expenses (including, without limitation, attorney's fees,
disbursements and court costs) of every kind and nature whatsoever (individually, a
Claim; collectively, "Claims"), and which may arise from or in any manner relate (directly
or indirectly) to any breach of the terms and conditions of this Agreement, any work
performed or services provided under this Agreement including, without limitation, defects
in workmanship or materials or Licensee's presence or activities conducted that relate in
any way to this Agreement (including the negligent and/or willful acts, errors and/or
omissions of Licensee, employees, vendors, suppliers, and anyone employed directly or
indirectly by any of them or for whose acts they may be liable or any or all of them).
Notwithstanding the foregoing, nothing herein shall be construed to require Licensee to
indemnify the Indemnified Parties from any Claim arising from the sole negligence or
willful misconduct of the Indemnified Parties. Nothing in this indemnity shall be construed
as authorizing any award of attorney's fees in any action on or to enforce the terms of this
Agreement. This indemnity shall apply to all claims and liability regardless of whether
any insurance policies are applicable. The policy limits do not act as a limitation upon the
amount of indemnification to be provided by the Licensee.
11.2 Licensee shall be liable and responsible for the security, repair and
maintenance of the License Area to the extent necessitated by Licensee's use of the
License Area under this Agreement, for such time as this Agreement is in effect. Licensee
shall use care to protect the License Area and restore it to its original condition to the
satisfaction of the City when the License Area is not in use by Licensee.
12. INSURANCE
Without limiting Licensee's indemnification of City, and prior to commencement of
work, Licensee shall obtain, provide and maintain at its own expense during the term of
Advanced Medical Properties, LLC 5
this Agreement or for other periods as specified in this Agreement, policies of insurance
of the type, amounts, terms and conditions described in the Insurance Requirements
attached hereto as Exhibit C, and incorporated herein by reference.
13. PROHIBITION AGAINST ASSIGNMENT AND TRANSFER
This Agreement shall not be assigned or transferred without the prior written
approval of City which approval may be withheld in the City's sole discretion.
14. CONFLICT OF INTEREST
The Licensee or its employees may be subject to the provisions of the California
Political Reform Act of 1974 ("Act"), which (a) requires such persons to disclose any
financial interest that may foreseeably be materially affected by the work performed under
this Agreement, and (b) prohibits such persons from making, or participating in making,
decisions that will foreseeably financially affect such interest. If subject to the Act,
Licensee shall conform to all requirements of the Act. Notwithstanding Section 9.1.3,
failure to conform to the requirements of the Act constitutes a material breach and is
grounds for immediate termination of this Agreement by City. Licensee shall indemnify
and hold harmless City for any and all claims for damages resulting from Licensee's
violation of this Section.
15. NOTICE
All notices, demands, requests or approvals to be given under the terms of this
Agreement shall be given in writing, and conclusively shall be deemed served when
delivered personally, or on the third business day after the deposit thereof in the United
States mail, postage prepaid, first-class mail, addressed as hereinafter provided. All
notices, demands, requests or approvals from Licensee to City shall be addressed to City
at:
Public Works Department
City of Newport Beach
Attn: Public Works Director
100 Civic Center Drive
PO Box 1768
Newport Beach, CA 92658
15.1 All notices, demands, requests or approvals from City to Licensee shall be
addressed to Licensee at:
Advanced Medical Properties, LLC
Attn: Emanuel Shaoulian
P. O. Box 3227
Newport Beach, CA 92659
Advanced Medical Properties, LLC 6
16. STANDARD PROVISIONS
16.1 Recitals. City and Licensee acknowledge that the above Recitals are true
and correct and are hereby incorporated by reference into this Agreement.
16.2 Compliance with all Laws. Licensee shall at its own cost and expense
comply with all statutes, ordinances, regulations and requirements of all governmental
entities, including federal, state, county or municipal, whether now in force or hereinafter
enacted. In addition, all work prepared by Licensee shall conform to applicable City,
county, state and federal laws, rules, regulations and permit requirements and be subject
to approval of the Project Administrator.
16.3 Waiver. A waiver by either party of any breach, of any term, covenant or
condition contained herein shall not be deemed to be a waiver of any subsequent breach
of the same or any other term, covenant or condition contained herein, whether of the
same or a different character.
16.4 Integrated Agreement. This Agreement represents the full and complete
understanding of every kind or nature whatsoever between the parties hereto, and all
preliminary negotiations and agreements of whatsoever kind or nature are merged herein.
No verbal agreement or implied covenant shall be held to vary the provisions herein.
16.5 Interpretation. The terms of this Agreement shall be construed in
accordance with the meaning of the language used and shall not be construed for or
against either party by reason of the authorship of the License or any other rule of
construction which might otherwise apply.
16.6 Amendments. This Agreement may be modified or amended only by a
written document executed by both Licensee and City and approved as to form by the
City Attorney.
16.7 Severability. If any term or portion of this Agreement is held to be invalid,
illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining
provisions of this Agreement shall continue in full force and effect.
16.8 Controlling Law and Venue. The laws of the State of California shall govern
this Agreement and all matters relating to it and any action brought relating to this
Agreement shall be adjudicated in a court of competent jurisdiction in the County of
Orange.
16.9 Taxes. Licensee acknowledges that the License granted herein may be
subject to possessory interest taxes. Licensee shall have the sole obligation to pay any
taxes, fees and assessments, plus applicable penalties and interest, which may be
imposed by law and arise out of Licensee's License hereunder. Licensee shall indemnify,
defend and hold harmless City against any and all such taxes, fees, penalties or interest
assessed, or imposed against City hereunder.
Advanced Medical Properties, LLC 7
16.10 No Third Party Rights. The Parties do not intend to create rights in or grant
remedies to, any third party as a beneficiary of this Agreement, or of any duty, covenant,
obligation or undertaking established herein.
16.11 No Attorneys' Fees. In the event of any dispute under the terms of this
Agreement the prevailing party shall not be entitled to attorneys' fees.
16.12 Counterparts. This Agreement may be executed in two (2) or more
counterparts, each of which shall be deemed an original and all of which together shall
constitute one and the same instrument.
(SIGNATURES ON NEXT PAGE]
Advanced Medical Properties, LLC 8
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed
on the dates written below.
APPROVED AS TO FORM: CITY OF NEWPORT BEACH,
CITY ATTORNEY'S OFFICE A California municipal corporation
Date: %/Q/!g Date: Dl lea 1G
By: �/��� By:
Aaron C. Harp o-io9 %s Dave
City Attorney City Manager
ATTEST: �r LICENSEE: ADVANCED MEDICAL
Date: b • PROPERTIES, LLC, a California limited
liability company
Date:
By: 4" NmfK-- By:
Leilani 1. Brown
:!l.7iFC.nII .
City Clerlk
Attachments:
Exhibit A:
Exhibit B:
Exhibit C:
Managing Member
[END OF SIGNATURES]
Depiction of Premises
Depiction of License Area
Insurance Requirements
Advanced Medical Properties, LLC 9
EXHIBIT "A"
DEPICTION OF PREMISES
Advanced Medical Properties, LLC Page A-1
EXHIBIT "B"
DEPICTION OF LICENSE AREA
Advanced Medical Properties, LLC B_1
EXHIBIT "C"
INSURANCE REQUIREMENTS
1. Provision of Insurance. Without limiting Licensee's indemnification of City, and
prior to commencement of work, Licensee shall obtain, provide and maintain at its
own expense during the term of this Agreement, policies of insurance of the type
and amounts described below and in a form satisfactory to City. Licensee agrees
to provide insurance in accordance with requirements set forth here. If Licensee
uses existing coverage to comply and that coverage does not meet these
requirements, Licensee agrees to amend, supplement or endorse the existing
coverage.
2. Acceptable Insurers. All insurance policies shall be issued by an insurance
company currently authorized by the Insurance Commissioner to transact
business of insurance in the State of California, with an assigned policyholders'
Rating of A- (or higher) and Financial Size Category Class VII (or larger) in
accordance with the latest edition of Best's Key Rating Guide, unless otherwise
approved by the City's Risk Manager.
3. Coverage Requirements
A. Workers' Compensation Insurance. Licensee shall maintain Workers'
Compensation Insurance, statutory limits, and Employer's Liability
Insurance with limits of at least one million dollars ($1,000,000) each
accident for bodily injury by accident and each employee for bodily injury by
disease in accordance with the laws of the State of California, Section 3700
of the Labor Code.
Licensee shall submit to City, along with the certificate of insurance, a
Waiver of Subrogation endorsement in favor of City, its City Council, boards
and commissions, officers, agents, volunteers, employees and any person
or entity owning or otherwise in legal control of the property upon which
Licensee performs the Project contemplated by this Agreement
B. General Liability Insurance. Licensee shall maintain commercial general
liability insurance, and if necessary umbrella liability insurance, with
coverage at least as broad as provided by Insurance Services Office form
CG 00 01, in an amount not less than one million dollars ($1,000,000) per
occurrence, one million dollars ($1,000,000) general aggregate. The policy
shall cover liability arising from premises, operations, personal and
advertising injury, and liability assumed under an insured contract (including
the tort liability of another assumed in a business contract) with no
endorsement or modification limiting the scope of coverage for liability
assumed under a contract.
C. Automobile Liability Insurance. Licensee shall maintain automobile
insurance at least as broad as Insurance Services Office form CA 00 01
Advanced Medical Properties, LLC Page C-1
covering bodily injury and property damage for all activities of Licensee
arising out of or in connection with work to be performed under this
Agreement, including coverage for any owned, hired, non -owned or rented
vehicles, in an amount not less than one million dollars ($1,000,000)
combined single limit each accident.
4. Other Insurance Requirements. The policies are to contain, or be endorsed to
contain, the following provisions:
A. Waiver of Subrogation. All insurance coverage maintained or procured
pursuant to this Agreement shall be endorsed to waive subrogation against
City, its City Council, boards and commissions, officers, agents, volunteers,
employees and any person or entity owning or otherwise in legal control of
the property upon which Licensee performs the Project contemplated by
this Agreement or shall specifically allow Licensee or others providing
insurance evidence in compliance with these requirements to waive their
right of recovery prior to a loss. Licensee hereby waives its own right of
recovery against City, and shall require similar written express waivers from
each of its subcontractors.
B. Additional Insured Status. All liability policies including general liability,
excess liability, pollution liability, and automobile liability, if required, but not
including professional liability, shall provide or be endorsed to provide that
City, its City Council, boards and commissions, officers, agents, volunteers,
employees and any person or entity owning or otherwise in legal control of
the property upon which Licensee performs the Project contemplated by
this Agreement shall be included as insureds under such policies.
C. Primary and Non Contributory. All liability coverage shall apply on a primary
basis and shall not require contribution from any insurance or self-insurance
maintained by City.
D. Notice of Cancellation. All policies shall provide City with thirty (30)
calendar days notice of cancellation (except for nonpayment for which ten
(10) calendar days notice is required) or nonrenewal of coverage for each
required coverage.
5. Additional Agreements Between the Parties. The parties hereby agree to the
following:
A. Evidence of Insurance. Licensee shall provide certificates of insurance to
City as evidence of the insurance coverage required herein, along with a
waiver of subrogation endorsement for workers' compensation and other
endorsements as specified herein for each coverage. Insurance certificates
and endorsement must be approved by City's Risk Manager prior to
commencement of performance. Current certification of insurance shall be
kept on file with City at all times during the term of this Agreement. City
Advanced Medical Properties, LLC Page C-2
reserves the right to require complete, certified copies of all required
insurance policies, at any time.
B. City's Right to Revise Requirements. City reserves the right at any time
during the term of the Agreement to change the amounts and types of
insurance required by giving Licensee sixty (60) calendar days advance
written notice of such change.
C. Enforcement of Agreement Provisions. Licensee acknowledges and
agrees that any actual or alleged failure on the part of City to inform
Licensee of non-compliance with any requirement imposes no additional
obligations on City nor does it waive any rights hereunder.
D. Requirements not Limiting. Requirements of specific coverage features or
limits contained in this Section are not intended as a limitation on coverage,
limits or other requirements, or a waiver of any coverage normally provided
by any insurance. Specific reference to a given coverage feature is for
purposes of clarification only as it pertains to a given issue and is not
intended by any party or insured to be all inclusive, or to the exclusion of
other coverage, or a waiver of any type.
E. Self-insured Retentions. Any self-insured retentions must be declared to
and approved by City. City reserves the right to require that self-insured
retentions be eliminated, lowered, or replaced by a deductible. Self-
insurance will not be considered to comply with these requirements unless
approved by City.
F. City Remedies for Non -Compliance. If Licensee or any subcontractor fails
to provide and maintain insurance as required herein, then City shall have
the right but not the obligation, to purchase such insurance, to terminate this
Agreement, or to suspend Licensee's right to proceed until proper evidence
of insurance is provided.
G. Timely Notice of Claims. Contractor shall give City prompt and timely notice
of claims made or suits instituted that arise out of or result from Contractor's
performance under this Contract, and that involve or may involve coverage
under any of the required liability policies. City assumes no obligation or
liability by such notice, but has the right (but not the duty) to monitor the
handling of any such claim or claims if they are likely to involve City.
H. Licensee's Insurance. Licensee shall also procure and maintain, at its own
cost and expense, any additional kinds of insurance, which in its own
judgment may be necessary for its proper protection and prosecution of the
work.
Advanced Medical Properties, LLC Page C-3
CERTIFICATE OF INSURANCE
CHECKLIST
City of Newport Beach
This checklist is comprised of requirements as outlined by the City of Newport Beach. "
Date Received: 8/04/18 Dept./Contact Received From: Raymund
Date Completed: 12/18/18 Sent to: Raymund By: Alicia / Jan
Company/Person required to have certificate: Advanced Medical Properties, LLC
Type of contract: Public Works
I. GENERAL LIABILITY
® N/A
EFFECTIVE/EXPIRATION DATE: 6/30/17 - 6/30/19
❑ No
A.
INSURANCE COMPANY: Colony Insurance Company
❑ Yes
B.
AM BEST RATING (A-: VII or greater): A: XIII
❑ N/A
C.
ADMITTED Company (Must be California Admitted):
Is Company admitted in California?
❑ Yes [D No
D.
LIMITS (Must be $1M or greater): What is limit provided?
1M/2M
E.
ADDITIONAL INSURED ENDORSEMENT — please attach
® Yes ❑ No
F.
PRODUCTS AND COMPLETED OPERATIONS (Must
include): Is it included? (completed Operations status does
not apply to Waste Haulers or Recreation)
❑ Yes ❑ No
G.
ADDITIONAL INSURED FOR PRODUCTS AND
COMPLETED OPERATIONS ENDORSEMENT (completed
Operations status does not apply to Waste Haulers)
❑ Yes ❑ No
H.
ADDITIONAL INSURED WORDING TO INCLUDE (The City
its officers, officials, employees and volunteers): Is it
included?
® Yes ❑ No
I.
PRIMARY & NON-CONTRIBUTORY WORDING (Must be
included): Is it included?
® Yes ❑ No
J.
CAUTION! (Confirm that loss or liability of the named insured
is not limited solely by their negligence) Does endorsement
include "solely by negligence' wording?
❑ Yes ®No
K.
ELECTED SCMAF COVERAGE (RECREATION ONLY):
® N/A ❑ Yes ❑ No
L.
NOTICE OF CANCELLATION:
❑ N/A ® Yes ❑ No
Il. AUTOMOBILE LIABILITY
EFFECTIVE/EXPIRATION DATE: Waived by Risk Management
A. INSURANCE COMPANY:
B. AM BEST RATING (A-: VII or greater)
C. ADMITTED COMPANY (Must be California Admitted):
Is Company admitted in California?
D. LIMITS - If Employees (Must be $1M min. BI & PD and $500,000
UM, $21M min for Waste Haulers): What is limits provided?
E LIMITS Waiver of Auto Insurance / Proof of coverage (if individual)
(What is limits provided?)
F. PRIMARY & NON-CONTRIBUTORY WORDING (For Waste
N/A
❑ Yes ❑ No
Haulers only):
® N/A
❑ Yes
❑ No
G. HIRED AND NON -OWNED AUTO ONLY:
❑ N/A
❑ Yes
❑ No
H. NOTICE OF CANCELLATION:
❑ N/A
0 Yes
❑ No
III. WORKERS' COMPENSATION
EFFECTIVE/EXPIRATION DATE: Waived by Risk Management
A. INSURANCE COMPANY:
B. AM BEST RATING (A-: VII or greater):
C. ADMITTED Company (Must be California Admitted):
D. WORKERS' COMPENSATION LIMIT: Statutory
E. EMPLOYERS' LIABILITY LIMIT (Must be $1 M or greater)
F. WAIVER OF SUBROGATION (To include): Is it included?
G. SIGNED WORKERS' COMPENSATION EXEMPTION FORM:
H. NOTICE OF CANCELLATION:
ADDITIONAL COVERAGE'S THAT MAYBE REQUIRED
IV. PROFESSIONAL LIABILITY
V POLLUTION LIABILITY
V BUILDERS RISK
HAVE ALL ABOVE REQUIREMENTS BEEN MET?
IF NO, WHICH ITEMS NEED TO BE COMPLETED?
12/18/18
Agent of Alliant Insurance Services
Broker of record for the City of Newport Beach
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
® N/A ❑ Yes ❑ No
❑ N/A ® Yes ❑ No
® N/A ❑ Yes ❑ No
® N/A ❑ Yes ❑ No
® N/A ❑ Yes ❑ No
® Yes ❑ No
RISK MANAGEMENT APPROVAL REQUIRED (Non -admitted carrier rated less than _
Self Insured Retention or Deductible greater than $ ) ❑ N/A ❑ Yes ❑ No
Reason for Risk Management approval/exception/waiver:
Risk Management approval needed due to GL carrier being non -admitted Also need sign off to waive Auto
Liability and Workers Compensation requirement (exposure being picked up by General Contractor) 12/2/18
Risk Management signed off on Auto Liability & Workers Compensation in favor of GC
Approved:
Risk Management
* Subject to the terms of the contract.
CERTIFICATE OF INSURANCE
CHECKLIST
City of Newport Beach
This checklist is comprised of requirements as outlined by the City of Newport Beach. *
Date Received: 12/1/18
Dept./Contact Received From: Raymund
Date Completed: 12/7/18 Sent to: Raymund By: Jan
Company/Person required to have certificate: Driver SPG, LLC (330 Old Newport Blvd)
Type of contract: Other
I. GENERAL LIABILITY
EFFECTIVE/EXPIRATION DATE: 10/31/18 —10/31/19
A.
INSURANCE COMPANY: Old Republic General Insurance Corporation
B.
AM BEST RATING (A-: VII or greater): A / X
INSURANCE COMPANY: Old Republic General Insurance Corporation
C.
ADMITTED Company (Must be California Admitted):
B.
Is Company admitted in California?
® Yes ❑ No
D.
LIMITS (Must be $1M or greater): What is limit provided?
$1M/$2M
E.
ADDITIONAL INSURED ENDORSEMENT—please attach
N Yes ❑ No
F.
PRODUCTS AND COMPLETED OPERATIONS (Must
Is Company admitted in California?
include): Is it included? (completed Operations status does
❑ No
D.
not apply to Waste Haulers or Recreation)
® Yes ❑ No
G.
ADDITIONAL INSURED FOR PRODUCTS AND
UM, $2M min for Waste Haulers): What is limits provided?
$1,000,000
COMPLETED OPERATIONS ENDORSEMENT (completed
E
LIMITS Waiver of Auto Insurance / Proof of coverage (if individual)
Operations status does not apply to Waste Haulers)
N Yes ❑ No
H.
ADDITIONAL INSURED WORDING TO INCLUDE (The City
N/A
its officers, officials, employees and volunteers): Is it
F.
ADDITIONAL INSURED WORDING:
included?
N Yes ❑ No
I.
PRIMARY & NON-CONTRIBUTORY WORDING (Must be
PRIMARY & NON-CONTRIBUTORY WORDING:
❑ N/A
included): Is it included?
N Yes ❑ No
J.
CAUTION! (Confirm that loss or liability of the named insured
N N/A
❑ Yes
is not limited solely by their negligence) Does endorsement
I.
NOTICE OF CANCELLATION:
include "solely by negligence' wording?
❑ Yes N No
K.
ELECTED SCMAF COVERAGE (RECREATION ONLY):
N N/A ❑ Yes ❑ No
L.
NOTICE OF CANCELLATION:
❑ N/A ® Yes ❑ No
11. AUTOMOBILE LIABILITY
EFFECTIVE/EXPIRATION DATE: 10/31/18 —10/31/19
A.
INSURANCE COMPANY: Old Republic General Insurance Corporation
B.
AM BEST RATING (A-: VII or greater) A / X
C.
ADMITTED COMPANY (Must be California Admitted):
Is Company admitted in California?
N Yes
❑ No
D.
LIMITS - If Employees (Must be $1M min. BI & PD and $500,000
UM, $2M min for Waste Haulers): What is limits provided?
$1,000,000
E
LIMITS Waiver of Auto Insurance / Proof of coverage (if individual)
(What is limits provided?)
N/A
F.
ADDITIONAL INSURED WORDING:
❑ N/A
N Yes
❑ No
G.
PRIMARY & NON-CONTRIBUTORY WORDING:
❑ N/A
N Yes
❑ No
H.
HIRED AND NON -OWNED AUTO ONLY:
N N/A
❑ Yes
❑ No
I.
NOTICE OF CANCELLATION:
❑ N/A
0 Yes
❑ No
III. WORKERS' COMPENSATION
EFFECTIVE/EXPIRATION DATE: 10/31/18 —10/31/19
A.
INSURANCE COMPANY: Old Republic General Insurance Corporation
B.
AM BEST RATING (A-: VII or greater): A / X
C.
ADMITTED Company (Must be California Admitted):
® Yes
❑ No
D.
WORKERS' COMPENSATION LIMIT: Statutory
® Yes
❑ No
E.
EMPLOYERS' LIABILITY LIMIT (Must be $1M or greater)
$1,000,000
F.
WAIVER OF SUBROGATION (To include): Is it included?
® Yes
❑ No
G.
SIGNED WORKERS' COMPENSATION EXEMPTION FORM:
® N/A ❑ Yes
❑ No
H.
NOTICE OF CANCELLATION:
❑ N/A E Yes
❑ No
ADDITIONAL COVERAGE'S THAT MAYBE REQUIRED
IV. PROFESSIONAL LIABILITY
® N/A ❑ Yes ❑ No
V POLLUTION LIABILITY
® N/A ❑ Yes ❑ No
VI BUILDERS RISK
® N/A ❑ Yes ❑ No
HAVE ALL ABOVE REQUIREMENTS BEEN MET? ® Yes ❑ No
IF NO, WHICH ITEMS NEED TO BE COMPLETED?
Broker of record for the City of Newport Beach
RISK MANAGEMENT APPROVAL REQUIRED (Non -admitted carrier rated less than _
Self Insured Retention or Deductible greater than $ ) ❑ N/A ❑ Yes ❑ No
Reason for Risk Management approval/exception/waiver:
Approved:
Risk Management
" Subject to the terms of the contract.
Date