HomeMy WebLinkAboutC-6244 - Revocable License Agreement for Temporary Use of City Property REVOCABLE LICENSE AGREEMENT
V BETWEEN THE CITY OF NEWPORT BEACH
AND T.E. ROBERTS, INC. FOR
TEMPORARY USE OF CITY PROPERTY
THIS REVOCABLE LICENSE AGREEMENT FOR TEMPORARY USE OF CITY
PROPERTY ("License") is made and entered into as of this 10th day of August, 2015
("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California
municipal corporation and charter city ("City" or "Licensor"), and T.E. ROBERTS, INC., a
California corporation ("Licensee"), whose address is 306 W. Katella Avenue, Unit B,
Orange, California 92867 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 real property in the City of Newport Beach located at 3204
Marcus Avenue in the City of Newport Beach, County of Orange, State of
California [A.P.N. 423-382-05] and further depicted in Exhibit "A" ("License
Area").
C. Licensee is T.E. Roberts, Inc., a California corporation. Licensee has been
retained by the City to complete the Newport Boulevard Water Main
Rehabilitation Project [C-5481] ("Project"), which is a major water infrastructure
rehabilitation project in the vicinity of the License Area.
D. Licensee has requested that it be allowed to use the License Area as a staging
and storage area for vehicles, equipment and materials during the course of the
Project.
E. On May 12, 2015, Council approved, the project plans and specifications, and
awarded Contract No. 5481 to T.E. Roberts, Inc. of Orange, California.
F. City Council Policy F-7 provides that the City may allow its unused property to
generate revenue and as a means to provide otherwise unfeasible uses and
facilities to benefit the community. Further, City Council Policy F-7 recognizes
that Licensee's use of the License Area for the Project eliminates the expense of
securing a staging area elsewhere.
G. City would like to assist Licensee to complete this major water infrastructure
rehabilitation project in a timely manner and with little disruption to the 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
eight hundred square feet (6,800 sq. ft.) in size, for a construction staging and storage
area. 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 License shall commence on August 10, 2015, and continue to
February 10, 2016, unless terminated earlier as set forth herein.
5. RENEWAL
The City Manager may renew this License for additional ninety (90) day terms if it
is determined that (i) the terms of the agreement have been met, and (ii) the use by
Licensee is not causing any negative impact on 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.
T.E. ROBERTS, INC. Page 2
6. LICENSE FEE
The fee for the License Area shall be waived because the City finds that the
License Area provides an essential and unique service to the community that might not
otherwise be provided if full market value were required. This is due to the fact that any
amount charged to Licensee would necessarily be charged back to the City through the
Project administration.
7. THE PURPOSE OF THIS LICENSE
7.1 The purpose of this License is to provide for the temporary use of the
License Area. 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 fencing consisting of a 6-foot-high chain link fence and
installation of a gate to provide secure access to the License Area.
7.1.4 Storage of Project materials including storm water protection materials,
temporary asphalt, piping, traffic control devices, steel plates, trailer mounted pumps,
generators, crew trucks, and street sweepers.
8. CONDITIONS OF LICENSE
Licensee shall comply with the following conditions prior to the commencement
of use of the License Area.
8.1 The Licensed Area shall be temporarily fenced and screened on all sides
for the duration of the construction 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
Public Works Director or his or her designee.
8.1.1 Licensee must comply with all special conditions, which are attached
hereto as Exhibit "B" and are all incorporated herein by this reference.
8.2 Prohibited Activities: storage of construction materials is expressly
prohibited outside of the fenced area. No improvements to the License Area are
permitted.
8.3 Maintenance: Licensee shall be responsible for maintenance of the
License Area including, but not limited to, the routine removal of foreign material, waste,
T.E. ROBERTS, INC. Page 3
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.
8.4 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.
9. TERMINATION OF LICENSE
9.1 Notwithstanding the term of this License, this License may be terminated
during the term or any extended term in the following manner:
9.1.1 By Licensee: At any time, 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
9.1.3 If, after written notice of default to Licensee of any of the terms or
conditions of this License, Licensee fails to cure or correct the default within ten (10)
business days of receipt of written notice, City may immediately terminate the License.
10. ADMINISTRATION
This License shall be administered by the Community Development Department
and the Public Works Department. The Community Development Director and the
Director of Public Works and shall have the authority to act for City under this License,
and their authorized representatives shall represent City in all matters pertaining to this
License.
11. INDEMNITY AND LIABILITY FOR DAMAGES
11.1 Licensee shall indemnify, defend and hold harmless City, its City Council,
boards and commissions, officers, agents, volunteers, and employees (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'), which
may arise from or in any manner relate (directly or indirectly) to any breach of the terms
and conditions of this License, any work performed or services provided under this
License including, without limitation, defects in workmanship or materials or Licensee's
presence or activities conducted that relate in any way to this License (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
T.E. ROBERTS, INC. Page 4
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 License. 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 License, for such time as this License 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
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 License 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 License, 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 License 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
License 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:
T.E. ROBERTS, INC. Page 5
Community Development Department
City of Newport Beach
Attn: Real Property Administrator
100 Civic Center Drive
PO Box 1768
Newport Beach, CA 92658
And to:
Public Works Department
City of Newport Beach
Attn: Public Works Director
100 Civic Center Drive
P.O. Box: 1768
Newport Beach, CA 92658
15.1 All notices, demands, requests or approvals from City to Licensee shall be
addressed to Licensee at:
Timothy Roberts, President
T.E. ROBERTS, INC.
306 W. Katella Ave, Unit B
Orange, CA 92867
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 City.
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 License 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.
T.E. ROBERTS, INC. Page 6
16.5 Interpretation. The terms of this License 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 License 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 License is held to be invalid,
illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining
provisions of this License shall continue in full force and effect.
16.8 Controlling Law and Venue. The laws of the State of California shall
govern this License and all matters relating to it and any action brought relating to this
License 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.
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 License, 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
License 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]
T.E. ROBERTS, INC. Page 7
IN WITNESS WHEREOF, the parties have caused this License Agreement to be
executed on the dates written below.
APPROVED AS TO FORM:
CITY ATT RN Y'S OFFICE
Date:
By:
Aaron C. Harp cAM
City Attorney
ATTEST:
Date: 0 1
By: A)Qw�- , e'k �
M*"
Leilani I. Brown
City Clerk
Attachments
SFW
Exhibit A.-
Exhibit
:Exhibit B:
Exhibit C:
CITY OF NEWPORT BEACH,
A California municipal corporation
Date: $) it ) I t�,
Dave Ki
City Manager
LICENSEE: T.E. ROBERTS, INC., a
California corporation
Date:
By:
Name: imothy Roberts
Title: President
Date:
By -
Na Luke Roberts
Title: Secretary
[END OF SIGNATURES]
License Area
Special Conditions
Insurance Requirements
T.E. ROBERTS, INC. Page 8
EXHIBIT A
LICENSE AREA
Access Gate
71-
T.E. ROBERTS, INC. Page A-1
EXHIBIT B
SPECIAL CONDITIONS
T.E. Roberts, Inc. has requested a staging area for the Newport Boulevard Water Main
Replacement — Via Oporto to 28th Street and 26th Street to 19th Street Project at 3204
Marcus Avenue. The yard is approximately 6,800 square feet in area and will be secured
by a 6-foot-high chain link fence. The fencing will have one gate for access and a green
fabric screening material will be attached to the fencing. The yard will primarily be used as
a staging and storage area for vehicles, equipment and materials. A commercial office
trailer and portable restroom facility may be located within the fenced area.
The proposed field office and contractor yard is in support of the Newport Boulevard
Water Main Replacement—Via Oporto to 28th Street and 26th Street to 19" Street Project.
Newport Boulevard (Via Oporto to 28th Street)
The work necessary for the completion of this contract consists of: the abandonment of
the 20-inch/16-inch diameter cast iron water transmission main; the construction of a
24- inch water transmission main replacement including all appurtenances, fittings, and
connections within Newport Boulevard within this stretch of the street; the abandonment
of several adjacent smaller size cast iron distribution mains; and the construction of the
6-inch/8-inch/10-inch and 12-inch replacement distribution water mains.
Newport Boulevard (26th Street to 19th Street)
The work necessary for the completion of this contract consists of: the abandonment of
the 16-inch diameter cast iron water transmission main; and the construction of a 16-
inch water transmission main replacement including all appurtenances, fittings,
services, and connections within Newport Boulevard within this stretch of the street.
Sewer Replacement/Repair
The work necessary for the completion of this contract consists of: the spot repair of
portions of several existing sewer mains; the reconstruction of existing sewer from
manhole to manhole in Finley Ave. (West); and the reconstruction of existing sewer
from manhole to just outside of an existing OCSD manhole in Newport Blvd.
Work will take place Monday to Friday, from 7:00 a.m. to 4:30 p.m., and Sunday to
Thursday, 9:00 p.m. to 6:00 a.m. for night work.
Special Conditions:
1. The contractor yard will be enclosed by a 6-foot-high chain link fence with gates
installed with screening materials. All activities will occur within the proposed
yard. Gates will open inward and not block the abutting driveway. The applicant
will install "No Parking or Stopping" signs along the public driveway and maintain
open access.
2. The site will serve as a storage and staging area for equipment and materials.
Access to the yard will be provided by an existing public driveway from 32nd
T.E. ROBERTS, INC. Page B-1
Street. Licensee has the option of placing a commercial office trailer and portable
restroom facility in the License Area.
3. The yard shall be enclosed with a 6-foot-high chain link and security fence installed
with a green screening fabric that provides screening of the activities within the
fenced area to the satisfaction of the Community Development Director or her
designee. Gates shall not swing out across the abutting public alley way. Post
shall be no bigger than 3-inches in diameter and no deeper than 12-inches. Fence
and posts shall be removed at completion of use. Post holes shall be filled with
compacted sand to subgrade and surface restoration shall be 1-inches more of
either concrete or asphalt depending on where post is placed.
4. The Licensee shall not allow the abutting alley way to be blocked for any reason at
any time. The alley way shall remain unobstructed at all times for public and
emergency access. The Licensee shall post two or more conspicuous signs
indicating "No Stopping or Parking" on the outside of the fence along the abutting
driveway to the east.
5. The Licensee shall post a conspicuous sign on the outside of the fenced area
indicating the following; "For information regarding this temporary facility, contact
Timothy Roberts, Project Manager at (714) 669-0072.
6. All activities, with the exception of ingress and egress of vehicles and pedestrians,
shall be confined within the approved fenced area. Parking of vehicles or the
storage of equipment or materials shall be confined to the approved fenced area.
7. Due to the close proximity of neighboring residents, Licensee shall not generate
any noise at the License Area during night hours up until 8:00 AM every day.
8. The applicant shall control dust and dirt in and around the yard, and on all streets
and driveways to and from the yard by any means necessary including watering
active construction areas or materials and the use of street sweepers.
9. The applicant shall allow access to the yard to the City and authorized agents for
the purpose of inspection, testing, or other investigatory work associated with
redevelopment of the site.
T.E. ROBERTS, INC. Page B-2
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 officers, agents,
employees and volunteers.
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
covering bodily injury and property damage for all activities of Licensee
arising out of or in connection with work to be performed under this
T.E. ROBERTS, INC. Page C-1
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 Reguirements. 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 elected or appointed officers, agents, officials, employees
and volunteers 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 and its officers, officials, employees, and agents 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 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.
T.E. ROBERTS, INC. Page C-2
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.
T.E. ROBERTS, INC. 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: 8/11/15 Dept./Contact Received From: Raymund
Date Completed: 8/11/15 Sent to: Raymund By: Chris
Company/Person required to have certificate: TE Roberts Inc.
Type of contract: License Agreement 3204 Marcus
I. GENERAL LIABILITY
EFFECTIVE/EXPIRATION DATE: 9/1/14 to 9/1/15
A. INSURANCE COMPANY: Valley Forge Insurance Company
B. AM BEST RATING (A- : VII or greater): A;XV
C. ADMITTED Company(Must be California Admitted):
Is Company admitted in California? R Yes ❑ No
D. LIMITS(Must be$1M or greater): What is limit provided? 1,000,000/2,000,000
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) R 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? R 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 R No
K. ELECTED SCMAF COVERAGE(RECREATION ONLY): R N/A ❑ Yes ❑ No
L. NOTICE OF CANCELLATION: ❑ N/A R Yes ❑ No
II. AUTOMOBILE LIABILITY
EFFECTIVE/EXPIRATION DATE: 9/1/14 to 9/1/15
A. INSURANCE COMPANY: Continental Casualty Company
B. AM BEST RATING(A-: VII or greater) A;XV
C. ADMITTED COMPANY(Must be California Admitted):
Is Company admitted in California? R Yes ❑ No
D. LIMITS- If Employees(Must be$11M 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. PRIMARY& NON-CONTRIBUTORY WORDING (For Waste
Haulers only): R N/A ❑ Yes ❑ No
G. HIRED AND NON-OWNED AUTO ONLY: ❑ N/A R Yes ❑ No
H. NOTICE OF CANCELLATION: ❑ N/A R Yes ❑ No