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HomeMy WebLinkAboutBeach Promenade, LLC - 2011-06-20Council/Agency Meeting Held: b Deferred/Continued to: I� Appr ed ❑ Conditionally Approved ❑ Denied Inel y Cle s Sign t re Council Meeting Date: June 20, 2011 Department ID Number: ED 11-16 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Stanley Smalewitz, Director of Economic Development Travis B. Hopkins, Director of Public Works SUBJECT: Approve a Site License Agreement with Beach Promenade, LLC for use of a portion of public right-of-way on Atlanta Avenue Statement of Issue: The City Council is asked to approve the Site License Agreement with Beach Promenade, LLC for use of a portion of public right-of-way on Atlanta Avenue. Financial Impact: Under the license terms, Beach Promenade, LLC assumes all liability for maintenance and utility costs. Recommended Action: Motion to: Approve and authorize the Mayor and City Clerk to execute and record the "Site License Agreement Between the City of Huntington Beach and Beach Promenade, LLC for use of a Portion of Public Right -of -Way on Atlanta Avenue." Alternative Action(s): Do not approve the Site License Agreement. 1113 - l 9- Item 9. - I REQUEST FOR COUNCIL ACTION MEETING DATE: 6/20/2011 DEPARTMENT ID NUMBER: ED 11-16 Analysis: The City is the owner of a public right-of-way easement along Atlanta Avenue, just east of Beach Boulevard. The adjacent owner, Beach Promenade, LLC, has been using the area for landscaping for the last several years and staff is recommending a License Agreement with the adjacent owner in order for the City to retain insurance from the adjacent owner and be released from any future liability. Beach Promenade, LLC (Licensee) will be allowed to utilize approximately 390 square feet of public right-of-way area for the installation, repair, maintenance, and replacement of landscape improvements in accordance with the approved plans. The Licensee will be allowed to beautify and improve the area with landscaped planters as an extension to the outdoor patio area for their adjacent restaurant. The outdoor dining area was approved by the Planning Commission in _June 2010, and the boundary area in the proposed License Agreement is consistent with the approved plans. All improvements have or will require prior approval by the City's Department of Public Works and Planning and Building Department. No permanent structures will be allowed. The license will continue until such time as terminated by either party. The City, in its sole discretion, shall have the right to terminate the license 'af any time, upon 90 days advance written notice to the Licensee. Licensee has met all of the City's insurance requirements. City staff recommends that the City Council approve the Site License Agreement with Beach Promenade LLC. Environmental Status: This recommended action is a ministerial act, and is exempt from the requirements of the California Environmental Quality Act, pursuant to State CEQA Guidelines, California Administrative Code, Title 14, Chapter 3, Section 15268 (b). Strategic Plan Goal: Maintain, improve and obtain funding for infrastructure and equipment. AttachFnent(s): Item 9. - 2 11 B - 1_50- At This Document was electronically recorded by City of Huntington Beach RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO: City Clerk City of Huntington Beach 2000 Main Street Huntington Beach, CA 92647 Recorded in Official Records, Orange County Tom Daly, Clerk -Recorder 111111111111IIIIIIIIIIIIIIII111111111111111111111111111111111 NO FEE 2011000303314 12:19pm 06/22/11 66 406 Al2 9 0.00 0.00 0.00 0.00 24.00 0.00 0.00 0.00 (Space Above For Recorder's Use) [Government Code Sec. 6103 exempt] SITE LICENSE AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH, AND BEACH PROMENADE, LLC, FOR USE OF A PORTION OF PUBLIC RIGHT-OF-WAY ON ATLANTA AVENUE This agreement (the "Agreement") is made and entered as of the ;W rff day of - �j—Lk"JC—" , 20_LL_, by and between the CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California, herein called "City," and BEACH PROMENADE, LLC, a California limited liability company, herein called "Licensee." RECITALS WHEREAS, Licensee is the owner of certain real property,. generally located along Atlanta Avenue east of Beach Boulevard in the ,City of Huntington Beach, County of Orange, State of California legally described in the attached Exhibit "A" and hereafter referred to as the "Site;" and City is the owner of a certain public right-of-way easement over and across the portion of the Site depicted by hatching on the attached Exhibit "B" and hereinafter referred to as the "Improvement Area"; and The Improvements to be constructed and/or installed in the Improvement Area by Licensee described and depicted on the Landscape Plans shall be inspected and approved by City; and By this Agreement the parties hereto desire to clarify and specifically delineate their respective obligations with respect to the -landscaping and maintenance of the Improvements located within the Improvement Area; NOW, THEREFORE, the parties hereto agree as follows: 1. Grant of License. City hereby grants to Licensee a license to utilize the Improvement Area for the installation, repair, maintenance and replacement of the Improvements in - accordance with the Landscape Plans. The Improvement Area may be used for the following purposes only: a. Landscaped planters, planter boxes, and/or pottery, and if necessary, area drains. b. Extension of outdoor patio area with a curb or wall no higher than thirty inches (30") with tubular steel railings or glass panels no higher than forty inches (40") atop the curb or wall and pilasters no higher than seventy inches (70"). 10-2660.003/61066 C. Sidewalk and/or handicap access between the public sidewalk and patio. d. Utility lines. Only to serve improvements in the Improvement Area. C. Plans for any proposed improvements shall be submitted. A building permit and encroachment (construction) permit will be required by Planning & Building and Public Works Departments 2. Term. This License shall become effective upon execution by City and Licensee, and shall continue until such time as terminated by either party. The City in its sole discretion shall have the right to terminate this License at any time, upon 90 days advance written notice to Licensee. In the event City terminates this License, Licensee shall have no further maintenance or repair obligations after the Licensee has restored the Improvement Area to pre-existing conditions per Section 9 of this agreement 3. Reserved. 4. Maintenance Standards. During the term hereof, Licensee agrees to maintain the Improvements and the Improvement Area in good and satisfactory condition. (a) Maintenance. Maintenance of street trees and landscaping shall, include but not be limited to watering, repairing and/or adjusting irrigation systems when failures occur, fertilizing, performing general planting and trimming or other corrective maintenance, spraying with both insecticides and herbicides, and generally keeping the street trees and landscaping within the Improvement Area in a clean, safe and attractive condition, taking into consideration the normal growth and the continuation of the aesthetic quality of the Improvement Area. The growth of all street trees and other landscaping shall be controlled so that none protrude into street, bicycle or other public access areas so as to obstruct or hinder vehicular or pedestrian traffic. Water, soil or other materials shall not be allowed. to flow or spray across or into the public right-of-way between the edge of the curb/gutter to the center of the public right-of-way designated on Exhibit "B." The Improvement Area shall be free from weeds, debris and harmful insects at all times, to the extent reasonably possible and consistent with good landscaping practices to the standard required below. All such gardening and maintenance practices so performed by Licensee shall conform to the standards set forth in the City's arboricultural and landscape standards and specifications issued by the Department of Public Works. The improvements located within the Improvement Area must not be a necessary component in order to comply with the City's minimum code requirements and conditions. For example, if improvements are removed at a future date, this will not result in a non -conforming property. (b) Utilities. Licensee shall pay all utility costs associated with operating the irrigation systems (i.e., water and electrical) which may be required t the maintenance in accordance with Section 4(a) above. 2 10-2660.003/61066 5. Installation Damage. In the event any damage is caused to the curb, gutters, sidewalk, street or utilities within the Improvement Area as a result of the installation and/or maintenance of the Improvements within the Improvement Area by Licensee, Licensee shall promptly repair the same at Licensee's sole cost and own expense. 6. Repair by City. In the event damage is caused to any of the Improvements within the Improvement Area as a result of any installation, maintenance and/or repair work performed by City or its contractors or employees, City shall replace and restore asphalt, concrete, landscaping, and landscape irrigation facilities in the Improvement Area to the conditions that existed prior to performance of such work. Restoration of enhanced improvements such as decorative pavements, planters, curbs, walls, and pilasters shall remain the responsibility of the Licensee. 7. Cooperation. In the event both Licensee and City are required to repair damage to improvements within the Improvement Area, the parties shall cooperate with each other so as to minimize the costs incurred by each of them. To the extent maintenance of any of the Improvements requires access to any real property owned by the California Department of Transportation, as opposed to City, City shall cooperate with Licensee by contacting said department in order to obtain the necessary permits, approvals and/or agreements required to permit such access. 8. Failure to Maintain. In the event Licensee does not maintain the Improvements, City shall notify Licensee of City's intent to assume maintenance as described below. Licensee shall resume said maintenance within five (5) days of receiving such notice. If Licensee thereafter fails to maintain the Improvements, City may cause such maintenance to be performed and all costs thereby incurred shall be assessed to and billed directly to Licensee. If a condition exists that poses a health and safety situation, Licensee shall immediately correct the condition. If the Licensee does not respond within 24 hours, City will correct the condition and License will be responsible for all costs incurred. Payment shall be due within thirty (30) days of billing. If the Payment is not received by the City Treasurer by the I Oh of each month for which the Rent is being paid, or the next business day if the 10t' day falls on a weekend or holiday, Licensee shall pay the following late charge and penalty: (1) a late charge of ten percent (10%) shall be applied to any outstanding balance after any payment hereunder is due but unpaid; and (2) one and a half percent (1 %2%) penalty per month shall be added for each month the Payment is due but unpaid. With respect to any other payments required by Licensee, a one and a half percent (1 1/2%) penalty per month shall be added for each month such payment hereunder is due but unpaid. 9. Material Alterations. Licensee shall make no material change in the placement or type of street trees and other landscaping and other improvements utilized within the Improvement Area nor shall the design and materials of the Improvement Area be materially changed without the prior written consent of both City's Department of Public Works and Planning and Building Department. Licensee shall not construct any permanent structures within the Improvement Area other than the identified Improvements. Any other items will require an amendment to this License Agreement. Upon termination of this License Agreement, Licensee will restore the subject property original condition within ninety (90) days from notice of termination. 10-2660.003/61066 10. Assignment. Except as expressly provided below, this License may not be assigned by Licensee. Notwithstanding the foregoing, Licensee may assign its rights and delegate its duties hereunder to any successor -in -interest of Licensee as the owner of the Site. Upon such assignment, the assignor shall be automatically released from its obligations hereunder from -and after the date of such assignment. 11. Indemnification, Defense, Hold Harmless. Licensee hereby agrees to protect, defend, indemnify and hold and save harmless City, its officers, elected or appointed officials, employees, agents and volunteers from and against any and all claims, damages, losses, expenses, judgments, demands and defense costs (including, without limitation, costs and fees of litigation of every nature or liability of any kind or nature) arising out of or in connection with Licensee's (or Licensee's subcontractors, if any) negligent (or alleged negligent) performance of this Agreement or its failure to comply with any of its obligations contained in this Agreement by Licensee, its officers, agents or employees except such loss or damage which was caused by the sole negligence or willful misconduct of City. City shall be reimbursed by Licensee for all costs and attorney's fees incurred by CITY in enforcing this obligation. Licensee will conduct all defense at its sole cost and expense and the City shall approve selection of Licensee's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as limitation upon the amount of indemnification to be provided by Licensee. 12. Workers' Compensation Insurance. Pursuant to the California Labor Code Section 1861, Licensee acknowledges awareness of Section 3700 et seq. of said code, which requires every employer to be insured against liability for workers' compensation; Licensee covenants that it will comply with all such laws and provisions prior to the encroachment into the public right-of-way pursuant to this license. Licensee shall maintain such Workers' Compensation Insurance in an amount that meets State statutory limits of $250,000 bodily injury by disease, policy limit, and $100,000 bodily injury each employee for accident or disease per occurrence. If Licensee has no employees, Licensee must sign a Declaration of Non -employee Status form available from City. In lieu of a certificate of insurance, a certificate of consent to self -insure issued by the California Director of Industrial Relations is also acceptable. 13. Insurance. Licensee shall carry at all times incident hereto, on all activities to be performed in the Public Right of Way as contemplated herein, general liability insurance, including coverage for bodily injury, and properly damage. All insurance shall be underwritten by insurance companies in forms satisfactory to City. Said insurance shall name the City, its elected or appointed officials, agents, officers, employees, and volunteers as Additional Insureds. Licensee shall subscribe for and maintain said insurance policies in full force and effect during the life of this Agreement, in an amount of not less than One Million Dollars ($1,000,000) combined single limit coverage for bodily injury, personal injury and property damage. If coverage is provided under a form which includes a designated general aggregate limit, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. "Claims made" designation is only acceptable for professional or pollution liability insurance. Licensee shall immediately notify City of any known depletion of limits. Any deductibles, self-insurance retentions or similar forms of coverage limitations or modifications must be declared to and approved by City. Licensee shall require its insurer to waive its subrogati6n rights against City and agrees to provide certificates evidencing the same. 4 10-2660.003/61066 14. Additional Insurance. Licensee shall carry property insurance for the Improvements to be installed in the Improvement Area for full replacement cost with no coinsurance penalty provision. 15. Certificates of Insurance; Additional Insured Endorsement. Prior to the encroachment into the public right-of-way pursuant to this license, Licensee shall furnish to City certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; said certificates shall provide the name and policy number of each carrier and policy, and shall state that the policy is currently in force and shall promise to provide that such policies will not be canceled without thirty (30) days prior written notice to City. Licensee shall maintain the foregoing insurance coverages in force until this Agreement is terminated. The requirement for carrying the foregoing insurance shall not derogate from the provisions for indemnification of City by Licensee under this Agreement. City or its representative shall at all times have the right to demand the original or a copy of all said policies of insurance. Licensee shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. A separate copy of the additional insured endorsement to each of Licensee's insurance policies, naming the City, .its elected or appointed officials, agents, officers, employees, and volunteers as certificate holder and as additional insureds shall be provided to the City Attorney for approval prior to the encroachment into the public right-of-way pursuant to this License. The requirement for carrying the foregoing insurance shall not derogate from the provisions for indemnification of City by Licensee under this Agreement. City or its representative shall at all times have the right to demand the original or a copy of all said policies of insurance. Licensee shall pay, or cause to be paid, in a prompt and timely manner, the premiums on all insurance hereinabove required. 16. Independent Contractor. Licensee agrees that all work done or undertaken by it on the Site shall be for its sole account and not as an agent, servant or contractor for City. Licensee, agrees to indemnify and hold City harmless from and against all claims or liens of workers and material/suppliers. 17. Notices. All notices given hereunder shall be effective when personally delivered or if mailed, within 48 hours of the deposit of such notice in the U.S. Mail, postage prepaid, and certified with return receipt requested and addressed to Licensee or to City at the respective addresses shown below: CITY: City of Huntington Beach Attn: Real Estate Services 2000 Main Street Huntington Beach, CA 92648 LICENSEE: Beach Promenade, LLC Attn: Bijan Sassounian 21190 Beach Boulevard Huntington Beach, CA 92648 10-2660.003/61066 0 18. Non -Exclusivity. This License is nonexclusive, and the Improvement Area shall at all times be open to use by the general public. 19. Nondiscrimination. Licensee agrees that in the performance of this Agreement and use of the Improvement Area it will not engage in, or permit its agents to engage in, discrimination against any person because of race, religious creed, color, national origin; ancestry, physical handicap, medical condition, marital status or sex. 20. Recordation. This Agreement shall be recorded with the County Recorder of Orange County, California. 21. Successor and Assigns. This instrument shall bind and insure to the benefit of the owners of the Site and their respective successors, heirs, personal representatives and assigns. The parties desire to enter into this Agreement in accordance with Civil Code Section 1468 in order to establish provisions that shall run with the land and be binding upon and insure to the benefit of the parties hereto and their successive owners. 22. Entire Agreement. This instrument contains the entire agreement between the parties hereto relating to the rights herein granted and the obligations herein assumed. Any oral representations or modifications concerning this instrument shall be of no force or effect except a subsequent modification in writing, signed by the parties to be charged. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized offices the day, month and year first above written. BEACH PR MENADE, LLC CITY OAF HUNTINGTON BEACH, a ,� \ ,/ i rnunic al corporation of the State of r print name ITS: (circle on Chairm residentNice President/Member/Manager AN By: print name ITS: (circle one) Secretary/Chief Financial Officer/Asst. Secretary reasurer/Member/Manager REVIE)4j. APPROVED: IF Clerk INITMED AND APP VED. APPROVED AS TO FORM: City Attorney 'j(ZI'�ii 10-2660.003/61066 M STATE OF CALIFORNIA ) )ss. COUNTY OF ,P On Y av 4 before me, ^ �� , Notary Public, (here insert name antitle of the officer) personally appeared i,4�- Sirs Nu..- /d 4 4"* ' � t S v� "-,-� who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument, and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNE :mZd fficial seal. Signature STATE OF CALIFORNIA ) )ss. COUNTY OF U/U)fg ) -� JAM ES T. DUNCAN F C(:,M. #1788734 n 0 ' , i NOTARY PUBLIC - CALIFORNIA .. t ORANGE COUNTY 0 my Cor t..T,. Expires FE,,bruary 9, 2012 (SEAL) On 'AA dio! / , before me, T • L--• C,-s ph -A &4 , Notary Public, (here insert name and title of the officer) personally appeared 6944WO ,4, Z Io" L- P-MW who proved to me on the basis of satisfactory evidence to be the persono whose name( subscribed to the within instrument, and acknowledged to me that 4e7i ie ie executed the same in -lkei eir authorized capacity 1es and that by hi&41e thei signature on the instrument the person& or the entity upon behalf of which the personeacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS'5hl Kdicial sea Signature P. L. ESPARZA Commission #E 1857021 Notary Public - California Orange County 10-2660.001/61066 EXHIBIT "A" PARCELS 1 AND 2, AS SHOWN ON A MAP FILED IN BOOK 44, PAGE 40 OF PARCEL MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF ORANGE COUNTY, CALIFORNIA, AND AS CORRECTED BY THAT CERTAIN CERTIFICATE OF CORRECTION RECORDED JULY 15, 1974 IN BOOK 11195, PAGE 1532 OF OFFICIAL RECORDS OF SAID ORANGE COUNTY. (APN: 148-021-18) A3TLANTA AVE 33 LICENSE AREA ±390 SF. FT. - EXISTING CURB/GUTTER m EXISTING SIDEWALK Q - x 3 © L rr f -- --_ -_ --_ -_-- -__ - ---- -- _ .._-_ EXISTING RIGHT-OF-WAY EXISTING BUS SHELTER p —— � i III II w z x II, -------______ N_893TO6' E t108.6' RA0=7', L=5.2' z C, II! II, II DO-- N 87"39'39" E t97.0' U , "- o III Q Io s . o Io III SCALE IN FEET III 1 inch =t0 ft. III ;s��_� -._.--Q:��-�,�-�1�e"- 3 ATTACHMENT #2 11B - 1 6 1 - Item 9. - 13 A4CC1'R ®1 CERTIFICATE OF LIABILITY INSURANCE 04/0,/20„ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION is WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: ALLIANT INSURANCE SERVICES INC 701 B STREET 6TH FLOOR SAN DIEGO, CA 921018156 (888) 661-3938 a%CNNo EM : 888 661-3938 ac, No): 877 552-6091 E-MAIL ADDRESS: Service.center@travelers.com PRODUCER 22s BG6038 XY330 882 INSURER(S) AFFORDING COVERAGE NAIC # INSURED BREAKER CENTER, A PARTNERSHIP 21190 BEACH BLVD HUNTINGTON BEACH, CA 92648 INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: DATE (MM/DD/YYY17 COVERAGES CFRTIFIr`ATF MIIMRFR• Q1IAla7r1MA710Sin RFVISIOM NIIMRFR- 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR TR TYPE OF INSURANCE ADD INSR SUER POLICY NUMBER POLICY EFF M/DD POLICY EXP MM/DD LIMITS A GENERALLIAB11 Y X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X HIRED AUTO X 680-294Y8257-10 08/01/2010 08/01/2011 EACH OCCURRENCE $1 000 000 DAMA E T R E PREMISES Ea occurrence $300,000 MED EXP An one person)$5 000 PERSONAL & ADV INJURY $1,000,000 X NONOWNEDAUTO GENERAL AGGREGATE $2 000,000 PRODUCTS - COMP/OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- X POLICY JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS -='-' }CORM ///���,,,���� o / PROPERTY DAMAGE (Per accident) $ $ LIAB OCCUR .`'. ), Z EACH OCCURRENCE $ HUMBRELLA EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WA TORY LIMITS ER E.L. EACH ACCIDENT $ j ANY PROPRIETOWPARTNER/EXECUTIVE a OFFICENMEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ It es, describe under SPECIAL PROVISIONS_ below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) AS RESPECTS TO GENERAL LIABILITY, CERTIFICATE HOLDER IS ADDITIONAL INSURED - STATE OR POL SUBDIVISIONS -PERMITS, CG D2 69 . . w� r a. r rvr_vcn GAIVl1tLLA 11UN THE CITY OF HUNTINGTON BEACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY ADMINISTRATOR EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE 2000 MAINSTREET WITH THE POLICY PROVISIONS. HUNTINGTON BEACH, CA 92648jA(�J AUTHORIZED REPRESENTATIVE {./ � • / �� ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Item 9. - 14 1-1B - r 62- Applicant's Signature:' Title: Date. Signed: Telephone Number: { `` ,/r I1B -16 - Item 9. - 15 POLICY NUMBER: I-680-294Y8257-TIL-10 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 04-14-11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ.IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Political Subdivision: THE CITY OF HUNTINGTON BEACH AND AS PER CG T8 00 2000 MAINSTREET HUNTINGTON BEACH CA 92648 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II — Who Is An Insured is amended to include as an insured any state or political subdivision shown in the Schedule, subject to the following provi- sions: 1. This insurance applies only with respect to opera- tions performed by you or on your behalf for which the state or political subdivision has issued a permit. 2. This insurance does not apply to: a. "Bodily injury," "property damage", "personal injury" or "advertising injury" arising out of op- erations performed for the state or municipal- ity; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". CG D2 69 11 03 Copyright, The Travelers Indemnity Company, 2003 Page 1 of 1 Includes copyrighted material of Insurance Services Office Inc., with its permission Item 9. - 16 IIB -164- GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: BUILDING PAC ISSUE DATE: 04/14/11 THE ADDITIONAL INSURED STATE OR POL SUBDIVISIONS -PERMITS (CG D2 69), THE NAME OF THE PERSON OR ORGANIZATION IS AMENDED TO READ: THE CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS CG T8 00 08 10 PAGE 1 OF 1 I-680-294Y825-7-TIL-10 1113 - 65- Item 9. - 17