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Home My WebLink AboutEDITH FANDEY - 1982-05-17CITY OF HUNTINGTON BEACH ►y` 2000 MAIN STREET CALIFORNIA 12648 OFFICE OF'fHE`CITY CLERK March 5, 193E Orange County Assessor's Office P. 0., Box 149' Santa Ana, CA 92702 Attn: Real Property Department Enclosed is a copy of a -letter from ii th Tandy, tenant of the Main Library in the City of Huntington Beach, stating her intent to terminate her lease on April 1, 1986.- If you have any questions, please call the Off.e of the City Clerk, 536-5227. Alicia M. Wentworth City Clerk AMW: b t Enclosure (Taly pt wae: 714-53fr 52Z7 ) EDITH DOROTHY FANDLY l 601 - 10th Street Huntington Bea :h, CA 92645 , Telepnone: (714� 960-=2705 February 26, 1980 CITY OF HUNTINGTON BEACH 2000 Main S creel Huntington Beach, CA 92648 Attention: Mr. Ron Hayden Acting Library Director RE: 30 day notice to terminate tenancy. Premises: west Wing Annex Main Street Library 525 Main Street Huntington Beach, CA 92648 Dear Sirs:; Over the Fast three years, I have enjoyed my association' with the City of Huntington Beach as a tenant at the Main Street Library. It i5 with much sadness that I must now notify you of my intention to vacate the premises described'; above, by April 1, 1986. This notice is intended tip be a 30'day notice to 'vacate the premises describedabove as, prescribed by the lease agreement under which I now hold possession. Please. accept .my sincere appreciation for the many kindnesses you have shod;^ me in the past. I'hope we may again share a common endeavor togE`,ner. Very trvily yours, Edith ,Dorithy Fandey` cc: Jan Halvorsen E fi CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92W OFFICE OF THE CITY CLERK June 7 1983 - 4 Edith D. Fandey 601 - .10th Street Huntington Beach, CA. 92648 The City Council of the City of Huntington Beach at its regular meeting held Monday, _June 6, 1983, approved a renewil agreement with wou for the rental of the rear wing of the Main Street Library.. Enclosed is a, duly executed copy of said agreement for your records. Alicia M. Wentl�,;ert31 City Clerbt, i AMW:CBbt t Enclosure CC: 0. C. Assessor's Office Vince Moorhouse, Community Services Director Judy John, Finance Dept. I Ta W p hon e l 718M53"227I 3 RE UE T FOR CITY C UALL ACTION Date March 15, 1983 Submitted to: Honorable Mayor and City Council _ _ _i;y G1 Submitted by: Charles W. Thompson, City Admin stratoY L9 Prepared by: Vincent G. Moorhouse, Director, Community Se ice olt Subject: RENTAL OF REAR WING OF MAIN STREET LIBRARY xTy rtFR Statement of Issue, Recommendation, Anplysis, Funding Source, Alternative Act'pns, Attachments: STATEMENT OF ISSUE: Mrs. Edith Fandey has been renting the old children's wing of the Main Street Library for the past year for use as an art studio. Mrs. Fandey has requested to renew her lease and continue to rent this same space during the coming year. RECOMMENDATION:' It is recommended that the lease be renewed for the coming year at the rate of $350.00 per month, and be continued on a month -to -month basis at the end of the year provided the conditions cont`.inue to be sati'sfartory for the City and Mrs. Fandey. ANALYSIS: Mrs.: Fandey has utilized the space as specified as an art studio during the past year and has been a reliable tenant.. Income generated for the year has been at the rate of $350.00 per month and it is recommended that this amount remain constant. This space is not currently needed for Library purposes. No c"her prospective tenants have -offered to rent this space during the past year. FUNDING SOURCE; None;. ALTERNATIVE ACTION: 1. City Council could refuse to renew this lease. 2. City Council could request that stafr renegotiate the terms of the lease. 3 City Council could request that staff obtain additional aids. CWT:VGM:W.` gf Att; Lease Agreement �:o Est IT'S' OF HUNTINGTON BEACH 2000 MAIN STREET CA UFORNIA':12648 OFFICE OF THE CITY CLERK May 19, 1982 Mrs. Edith Fandey 601 10th Street Huntington Beach, CA. c'j648 The City Council of the City of Hun,.ington Beach at 'its May 17, 1982, meeting approved an agreement with you for the rental of the west wing of the Main Street Library located at 525 Main Street for the purpose of, operating an art studio_. Enclosed is a copy of said agreement which you requested. If you have any questions, please call the Community; Services Director at 536-5292. Alicia M. Wentworth City Clerk AN: C8:bc Enclosure CC: Vince Moorhouse Community Services Director Judy John, Finance l Ted �,Iilloughby, Assessor's Office I Ifilaplwne: 714.536-5227) CITY OF HUNTINGTON BEACH 2000 MAIN STr '_E-ICALIFOR NIA -,92648 OFFICE OF THE CITY CLERK May 19, 1982 Ted Willoughby Oran9e County Assessor's Office P. 0. Box 149 Santa Ana, Ca. 92702 Attn: Real Property Dept. Inclosed s a copy of a rental agreement with Edith Fandey for City owned property located at 525 Main Street which ,gas approved by the ' City Council of the 'City of Huntington Beach on May'17, 1982. If you have any questions, please call the Office of the City: Clerk, 536-5227.' Ai i ci a M. Wentworth City Clerk A.MW: bt Enclosure r (Te l y p h o4 c. 714.E 36.6 227) VN j 14 . f'REQUE *PMzFz-F7411 Cl%�CIAACTIGN � May 6, ]: 952 Submitted to: Date ctmx rr,�rczc ,, �,. _ . Honorable Mayor anal City ,Council Submitted by: Charles W. Thompson, City Admin.istrat"o(AN, 4 Prepared by: Vincent'G. -Poorhouse, Director, Community Servicks Subject: RENTAL OF VACANT WING OF MAIN STREET Statement of Issue, Recommendation, Analysis, Funding Source, Aiternati a Actions, Attachments: STATEMENT OF ISSUE S,--ace is available in the old children's ring of the Main Street Library. Mr. and 'Mrs. Joseph Fandey have submitted a request to rent said space on a yearly basis ; cr the purpose of c.peratinj; an, art studio. RECOMMENDATION: City Council approve the rental of the vacant wing 1:f the Main Street Library fur the sum of $350.00 a month as an art studio. ANALYSIS: Evaluation has been made of the proposal submitted by Mr. and Mrs. Fandey. A ,previous -proposal submitted by an Orange County agency, which has situ sequently been withdrawn, was for $200.00 for two-thirds of the space. The price appears to be fair and equitable, The space is not being used regularly at the present time. FUNDING SOURCE: None. ALTERNATIVE ACTION: 1. City Council refuse to ren- said space. 2. City Council requests that staff renegotiate the amount 3 City Council requests that staff obtain additional bids. CjVT: VGA, ; WJ: gf At W: Lease a. reement pto 4/a7 LEASE AGREEMENT THIS LEASE is made between. CITY_ OF H'JNTINGTON BEACH, a municipal corporation, 2000 Main Street, Huntington -Beach, Cali- fornia, herein called "LESSOR," and FDITH_aDOROTHY FANDEY, of 601 Tenth Street, Huntington Beach', California, telephone (714) 536-4013, herein called "LESSEE. WHEREAS, LESSOR is the owner of the premises described below, and WHEREAS, LESSOR desires to lease said premises to LESSEE, NOW, THEREFORE, the parties agree ;as follows ?. DESCRIPTION LESSOR hereby leases to LESSEE and LESSEE hereby hires from SOR, the space as presently constituted, hereinafter called "PREMISES," consisting of thewestwing of the Main Street Library, located at 525 Mail Street, Huntington Beach, California. 2. TERM The term of this lease shall be for a period of one (1 ) year to commence on June 1, 1983, and to termina',e on May 31, 7984, or on sich earlier date as this lease may terminate upon thirty (30) days' written notice of either party. Thereafter, the term of this ;lease shall be on a month -to -month basis until :such time as a new lease agreement re,.tal fee shall be, negotiated. 3. PURPOSE a LESSEE shall use and occupy the PREMISESfor an art �tudio, and for no other purpose. LESSOR represents that e PREM18r.S may lawfully be used for such purpose. 0 �7 4. RENT The total monthly rent is the sum of three ,hundred fifty dollars ($350.00), which .'am is payable in advance on the first day of each calend it month 5. SECURITY DEPOSIT LESSEE has payed to CITY the sure of one hundred dollars ($100.00) as a security deposit plus the sum of three hundred .fifty dollars as the 'final months_rent under a previous lease of these -s^me PREMISES signed on May 17, 1982, by the present parties. Said suns shall be retained by CITY a,, a sacur=.ty deposit and for final wot;th's rent for this new lease. If at any time during the term hereof, LESSEE fails to perform any of theconditions of the lease o;, causes damage to the PREMISES or fails to leave the PREMISES in a reasonably clean condition upon, ter-mination, ther. LESSOR may appropriate and apply any portion of the security necessary to make the repairs or clean the PREMISES, - 6. MAINTENANCE The LESSEE will be responsible for cleaning un- PREMISES; unless LESSEE chooses for LESSOR to be responsible for cleaning for the additional sum of forty dollars ($40.00) per month,, on a one time a week basis. The exterior and grounds of the PREMISES will be maintained by LESSOR. It is understoo6 that the heating system is an in -floor hot water system, and no improvement is anticipated in the system 2 - by LESSOR until such time that the entire system is improved for the benefit of the entire facility at the discretion. of LESSOR. LESSEE shall not make any alterations or improvements without written consent of LESSOR, j. UTILITIES LESSOR shall be responsible for the payment of all utilities, excluding telephone service of LESSEE. 8. ADEMNIFICRTION During the term of this lease, LESSEE agrees to indem- nify, defend, and save LESSOR harmless from any and all claims arising from ;any act, omission or negligence of LESSEE or her agents or employu(,s arising from any accident, injury or damage whatsoever caused to any person or property occurring in, on or about the leased PREMISES, and from any and all cost, expense, or liability incurred in connection with any such cla.im or proceeding . 9. INS RANCE LESSEE agrees to furnish to LESSORand maintain in force until termination of this lease a general liability certificate of insurance in which LESSOR is named as an additional insured. Such certificate of insurance shall indicate insurance coverage for LESSEE against all claims ariAng out of or in connection with LESSEES'activities on or about the leased PREMISES. The policy shall provide for not less that-, the following amounts: Combined single limit bodi.1y Injury and/or property damage of $�00 000 per ozurrence i 3 - .t 10. LAWS LESSEE shallcomply with all state, county, city and federal laws relating to LESSEE'S activities_ 11. TAXES, LESSEE shall. he obligated ,to pay any federal, state, 'county or local, license tax, property taxes, promissory interest tax, or other taxes which ie.y be imposed. Executed at Huntington Beach, California, on I I i LESSEE: CITY OF HUNT NGTON BEACH, a municipal corporation Edith, Dorothy F ndey Mayo -ATTEST: APPROVED AS 0 FORM: Aly City Clerk ulty A�to hey s; APPROVE TO CONTENT, INITIATP AND ,iPPROVED , City Adminis,tz^ator +" Breeta of Comza�unity Services I TE, kV II I LICENSE AGREEMENT The CITY OF HLNTINGTON BEACH, a municipal corporation, herein called "City," and EDITH DOROTHY FANDEY, herein called "Fandey," agree as follows:, The parties have prepared a written lease which is subject to approval by the City Council of the City prior to its becoming effective. Pending approval or rejection of such lease by the City Council, the parties agree that Fandey shall have a license to use the premises described as the west wing of the library located at 525 Main Street, Huntington Beach, for the period of one month, upon the terms and conditions set forth in the draft lease, a copy of which is attached hereto and incorporated by reference herein. Prior to occupancy, Fandey shall pay the 8-.Am of $350 to City as license fee for the month of May, and security deposit of $1O0, plus the additional sum of $350, to be credited as deposi-,; for last`month's rent upon approval of the lease by the , City Council This license shall terminate automatically on May 31, 1932, in the event said lease is not approved by the City Council prior thereto. Dated: May_3, 1982. APPROVED: CITY O TINGTON BEACH Director of Community Services By (tia les Thor span APPROVED AS TO FORM: City Administrator GAIL HUTTON, City 'Attorney EDITH DOROTHY FANDEY iLA LEASE 1. PARTIES THIS LEASE is rude betKeen CITY OF HLifidTIPzG'-"0N BEACH, a muni- cipal corporation, 2000 Main Street, Huntington Lseach, California, herein called"LESSOR," and EDITH DOROTHY FANDEY, of` 601 Tenth Street, Huntington. Reach, California., telephone �'714) 5'A-4013, herein called ,I LESSEE. " 2. DESCRIPTION LESSOR hereby leases to LESSEE and LESSEE hereby hires from LESSOR, the space as presently constituted, hereinafter called the premises, consisting, of the west wing. of the Taro Street Library, Located at 525 Main Street, Tluntington Reach, Palifornla. 3. TIER The term of %h.is lease shall be for a period of onp (l) year to L"t3dtiP.-nee On.T!ine I , 19F2, and to terminate on Tla,r 31 ,' 1983, or on such earlier date as ,this lease +gay terminate upon thirty (301, days' written notice of either party. )..I. PURPOSE LESSEE shall use and occupy the 'pre.mises for an art studio, and for no other purpose. LESSOR repre6ents that the premiaes may lawfully be used for such purpose. 5. REST The total monthly rent is the sum of Three hundred Pilty Dollars ($350), which su:-n is payable in advance on the first clay of each `calendar rionth 1. Alk 6. SECURITY DEPOSIT f I LESSEE shall p-,y`the first and last months' rent upon e..ecu- 'ion of this lease. In addition thereto, LESSEE shall pxy the sun of One Hundred Dollars ($100) as a security deposit for the performance of the conditions of this lease. If at any time during the term! hereof, LESSEE fails to perform any of the con- ditions of the lease or causes damage to the premises or fails to leave the premises in a reasonably cle-.n conditica upon termina- tion, ;hen LESSOR may appropriate and apply any portion of the security necessary to make the repaira or clean the premises.- 7. MAINTENANCE. The LESSEE will be responsible for cleaning the premises, f unless LESSEE chooses for LESSOR co be responsible for cleaning for the additional sum of 'Forty Dollars ($SIC) per month, on a one time a week basis. The exterior and grounds of the prer^iues will be maintained by LESSOR. it is understood that the heating system is are in -floor hot water system and no improvement is anticipated in the system by LESSOR until such time that the --ntire system is improved for the benefit of the entire facility at the discretion of LESSOR. LESSEE shall not make any alterations or improvements without written consent of LESSOR. B. UTILITIES LESSOR shall be responsible for the pa.-ment of all utilities, excluding telephone service' of LESSEE. RP 9. INDEMNIFICATION During the term of this lease, LESSEE agrees to indemnify, defend,and save LESSOR harmless from any and all claims arising from any act, omission or negligence of LESSEE or her agents or employees arising from any accident, injury or damage whatsoever caused to an'" person or property occurring in, on or about the leased premises, and from any and all cost, expense, or liability incurred in connection with any such claim or proceeding. 10.. INSURANCE LESSEE agrees to Purr.. :i to LESSOR and maintain in force until termination of this lease a general liability certificate of insur— ance in which LESSOR is named as an additional insured. Such certificate of insurance shall indicate insurance coverage for LESSEE against all claims arising out of or in connection with LESSEE's activities on or about the leased premises. 'Ihe policy shall provide for not lens than the following tuioun .s : Combined single limit bodily injug:°y and/or property darage of $300,000 per occurrence. 11. LAMS LESSEE shall comply with all state, county, city and federal laves relating to LESSEE's activities: 12. FAXES LESSEE, shall be obligated to pay any federal., state, county or local, license_ tax, property taxes, promissory interest tax, or other taxes frhich may be imposed. ;pry Exemited at Hantingtan Peach, California, on /Z ATTEST:- APPROVED AS TO FORM City Clpr i fZ tU Attorney:�f, APPROVED A5 TO CONTENT: INITIATED AND APPROVED: Cat A f niara lY i ctcr a 'Community .services LFSS FE, r,dith T,)ta.°athy Fan e I! . 731 North Idarttilgale Road Schaumburg, Illinois 60196 Hided 'FD IN : (Number. P.O. Address, Su eet, Town, I consirl5a 'un of the premium, Insurance is the named County, State and Zip No.i Isured with respect to the described premises shown in Item 4 below JosephS. Fandey and Edith D. Fandey ndwith respect t :,hose coverages and kinds of property for which a P. 0, Box N aecific limit of liat.1.1ty is shown, subject to all A the terms of this ® Huntington Beach, Calif. 92648 /-T'u ulicy including form,, and endorsements me&- a part hereof: rip 72-11-88 �'-� M POLICY PERIOD:From: 4-7-83 To! �% N 12:01 A.M. ❑ 12 NOON (Standard Time at Location of Described Premises) THE NAMED INSURED IS; individual ❑ Corporation [�( ❑ Partnershi Joint Venture p ❑ ❑ DESCRIBED PREMISES: ❑ Additional buildinns or locations listed on supplemental declarations BUSINESS OPERATION I 00 00 Location 1 528 Nain Street, Huntingt" Bench, C41if. Office CA)Location 2 r 1t5 TU FOFId • GAIL tll.i ?, „ MORTGAGEE: Cit; • �',,.,.•:::iy Location 1 Location 2 LOCATION #f Duputy City #_W_ Mlo1aF INSURANCE COVERAGE A— BUILDINGS* 1 $ w 2 $ 4 COVERAGEB—BUSINESS PERSONAL PROPERTY T $ � �500 3 0: W 2 $ > Q COVERAGE C—LOSS OF EARNINGS AND ADDITIONAL EXPENSE Included U COVERAGE D-EMPLOYEE DISHONESTY $10,000 F COVERAGE £-MONEY AND SECURITH:S inside $10,000^ Outside $5,000 w COVERAGE F—EXTERIOR SIGNS' Replacement Cost a O COVERAGE G—EXTERIOR BUILDING GLASS Replacement Cost u d COVERAGE H—ACCOUNTS RECEIVABLE $100,000 I '. ECTION 1 DEDUCTIBLE $100 The following coverage is afforded under this policy when designated by an 0 [� in the box shown below. F- U COVERAGE I -BUILDING HEATING AND AIR At Loc (Included in Limit for Coverage A above or CONDITIONING EQUIPMENT Coverage e Limit it Coverage A is not provided) 1 r I 'The anwurtts of insurahce for Coverage A - Buildings shall be automatically increased by 3% at the end of each period of three It -months after the inception date of the policy, ��—COVERAGE A —BUSINESS $1,000,000'per occurrence COVERAGE C—MEDICAL S 5,000 per person I LIABILITY including: $1,000,000 aggregate PAYMENTS $ 25,000 per, accident Zin vi -COMPLETED OPERATIONS COVERAGE D—AUTOMOBILE —, OZ r -PRODUCTS NON -OWNERSHIP $1,000,000 per occurrence a —CONTRACTUAL LIABILITY y O— COVERAGE B COVERAGE E—FIRE $ 300,000 per occurrence PERSONAL INJURY $1.000,000 aggregate LEGAL LIABILITY —ADVERTISING INJURY S 100,000'aggregate TOTAL L ANNUAL IF PAYABLE IN INSTALLMENTS (40-30-30) PREMIUM IS DATE DUE' AMOUNT DATE DUE AMOUNT DATE DUE < AMOUNT 100.00 s S s FORMS ATTACHED TOTHIS POLICY 1' U-GP-173 (3-81) UISP-166 _J Apri T 8, 1903 Newport Beach. California ��c, � � COUNTERSIGNATURE DATE AGENCY AT _ JAY &- RE(' i I ti J`GE�T -' U�«1 B1 f2•St l BUSINESS OWNERS POLICY CHANGE ENDORSEMENT ^ THIS ENDORSEMENT FORMS A PART OF THE POLICY NUMBERED BELOW POLICY CHANGE rA IS AGREED THAT' ) THE POLICY IS AMENDED AS FOLLOWS: s B) WITH RESPECT TO THOSE COVER. GES AND KINDS OF PROPERTY FOR WHICH A SPECIFIC LIMIT OF LIABILITY l SHOWN THE LIMIT OF THE COMPANY'S LIABILITY SHALL BE CHANGED TO READ AS STATED IN THE LIMITS OF LIABILITY CbLUMNS r HEREIN. SUCH LIMITS ARE IN LIEU OFTHE LIMITS OF LIABILITY STATED IN THE POLICY AND NOT IN ADDITIOti ZHERETO.Z3 LIMITS OF LIABILITY OR PREM- BASIS PREKUM � Loc. Bldg. OLD NEW. �. No. No. RATE RATE TITLE PREVIOUS NEW Old Premium New Premium G Add'I 0 Return Building $ S 5 $ Business Personal Property ; S a y Building Hearing and Conditioning [Air Equipmer.t ; V ; ; ; 5 i C) , LOSS PAYA--_c ENDORSEMENT Loss, it ar./, shall be adjusted with you and shall be payable to you and 3 I as your interests may appear. D) COMPREHENSIVE BUSINESS LIABILITY ADDITIONAL INSURED ENDORSEMENT (Premises Leased to the Named Insured) The definition of "you" and "your" *includes as an insured the person or organization designated below, but only with respect to Iiabllity arising out of they ownership, maintenance or use of that part of the premises designated below leased to the named In- sured, and subject to the following additional exclusions: The insurance does not apply: 1. To any occurrence which takos place after the named Insured ceases to be a tenant in said premises; 2. To structural alterations, new construction or demolition operations peC.ormed;by or on behalf' of the person or organization designated below. SCHEDULE Designation of Premises Name of Person (Part Leased to or Organization Named Insured? (Additional Insured) 528 Main Street, City of Huntington Beach Huntington Beath, Calif, c/o Jan Halvorsen, Dept. Analyst, Huntington'' ,..�, Agency by Beach Library, 7111 Talbert, Huntinton Bch —92648 UGP"lm Jn irmp.r.cl cerrit,cata to: - RTIPtCATE OF INStJRAt4�E pprove as. to orris CnY �4 }{antrttgltan Ouch Gail HurtC, City Attorney TO P.O Rox 190 CITY On HUNTINGTON BEACH, CALiPOFINIA By.. E Huot,ngton B—ch• CA 92648 r r° d Copy to Rul. M.naq.t .rt.r PProral A MUNICMAL CORPORATION This is to certify that the policies of insurance as described below navn been Issued to the insured by the und-rslpned and art, in f.ircir At this time. 11 these policies are cancelled or changed In such a marine( that will affect this certificate, the insurance company agrees to give 1G days prior writtwn notice, by mail, to City of Huntington Beach P. O. Box 711, Huntington $each, California 92648 ALL ITEMS MUST HE COMPLETED, ANY DELE; ION. OR CHANGE IN THIS FORM SHALL BE SIGNED AND DATED BY AN AUTHORIZED REPRESENTATIVE OF THE INSURANCE COMPANY AND MUST BE APPROVED IN WRITING BY THE CITY ATTORNEY N Name of Insured Address of Insured 1° I `~< f T x'A Location of Work or Op itions to be performed Description of Work or Operations n A; c, s 1 a 1i 2Ci 5N ) POLICY OATES LIMITS OF LIABILITY NAME OF COMPANY POLICIES IN FORCE POLICY NO, Effective Expiration In Thousands (000) (iNs.l 1 GENERAL LIABILITY �i� ��LAttt_,Q. '4.k�. Ltis, r viL t. rs lXl COMPREHENSIVE FORM r"rt,}thy, Ii,i 2 1 PREMISES -OPERATIONS t Leal xt Each Oeeurance f t LL I Li EXPLOSION AND t" i:t.i. C COLLAP2,E HAZARD tFx 4LlC'+. UNDERGROUND HAZARD I ), PRODUCTS COMPLETED OPERATIONS HAZARD I 1 CONTRACTUAL I' BROAD FURM PROPERTY DAMAGE IND '.::.. INDENT CONTRACTORS I PERSONAL, INJURY' AUTOMOBILE LIABILITY :�. j COMPREHENSIVE FORM OWNED I. I HIRED CSL Each Oceurance I l NON -OWNED CXCESS LIABI LITY I UMBRELLA FC(RM j tl, HER THAN.. $ . UMBRELLA. FORM WORKERS' CIOMPENSATION and EMPLOYERS` LIABILITY Addittonal Insured Endorsement: The insurer agreesthatthe City of Huntington Beach and its City Council, and/or all City Council appointed groups, committees, commissions, boards and any other City, Council appointed body, and/or elective and appointive officers, seryants or employees of the City of Huntington Beach, when acting as such are additional insureds hereunder, for the acts of the insured, and such insurance shall be primary to any insurance of the City of Huntington Beach,. as their interest may appear. _r Dsta t i Lt s" AUTHORIZED REPRESENTATIVE OF INSURANCE COMPANY iNSURANCE COMPANY 4I. a. { ( BYI RAWALMSM s Iw r>h� u:. .: c INSURANCE AGI`N0V Name 3e1 F. I?I0RA00I Q Addrea AddrtroT NA .+ Cityt r City I,i1i14v''Ir7 td < lrri':�'" r Telephone L HOLD HARMLESS AGREEMENT (to be executed by insured) The insured ' J c_-5 J grees to protect, defend, ind9mnify, save, and hold harmless the City of Huntington Beach its officers, agents, and itrilptoyees agai st any liability, loss, damage, cost, or expense by reasons of any and all liability, suits, cla?ms, demands, judgments and causes of action caused by insured, his employees. agents or any subcontractor or by any third Harty arising out of or in consequence of the performance of U or any operbtions or activity for xvtiil h this certifitcata of insurance is furnished. III Sete i'rOPeistonship I#f Partrwrohlp (St a4pN?ratson ' "I4)then i�atal HOL4 HRRMLESS5IGNED: Y_ Insured: Title °* — tC�C ra. t" �1 Llcp $ 4 IAiI nernrt shall be Prineeci or typed, BY lnaulud: Below oacq srprnlure,) Title dti h• i.t�l It Carporfltic;,, TW0 Officats must sign, or' present evidence of zuthorization to bind Corporation,