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HomeMy WebLinkAboutZambelli Fireworks Manufacturing Company, Inc. - 2009-03-27CONTRACTS SUBMITTAL TO CITY CLERK'S OFFICE To: JOAN FLYNN, City Clerk Name of Contractor: Zambelli Fireworks Manufacturing Company, Inc. Purpose of Contract: For Example: Audit Services or Water Quality Testing Huntington Lake —Huntington Central Park Fireworks Display on the Fourth of July Amount of Contract: $50,000.00 Copy of contract distributed to: The original insurance certificate/waiver distributed ❑ Initiating Dept. ❑ to Risk Management Finance Dept. ❑ ORIGINAL bonds sent to Treasurer ❑ �kqo '6&14 Date: % C� Warnxte ion City Attorney's Office G:AttyMisc/Contract Forms/City Clerk Transmittal MAR/12/2009/THU 06:19 AM Zambelli Fireworks FAX No.724 658 8318 P.002 l SERVICES CONTRACT BETWEEN TBX CITY OF HUNTINGTON BEACH AND ZAIVIBELLI FIREWORKS MANUFACTURING COMPANY, INC. FOR ' FIREWORKS DISPLAY ON THE FOURTH OF R L'Y THIS AGREEMENT ("Agreement") is made -and entered into by and between the CITY OF HUNTINGTON BEACH, a California municipal corporation, hereinafter referred to as "CITY," and ZAMBELLI FIREWORKS MANUI~A"CTLMINO COMPANY, INC., a �Gtdffb7ffa C corporation, hereinafter referred to as "CONTRACTOR." WHEREAS, CITY desires to engage the services of a contractor to produce and display Ereworks for the 2009 Fourth of July on the Huntington Beach Municipal Pier, in the City of H=tington Beach; and The provisions of HBMC Chapter 3.02 relating to procurement of services contracts has been complied with; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, it is agreed by CZ'f`St' and CONTRACTOR as follows: 1. WORK STATEMENT CONTRACTOR shall, provide all services as described in herein for the Fourth of July, 2009 Fireworks display. The display is scheduled for approximately 9.00 p.m. and will last a mm; dxnum of twenty-five (25) minutes in duration, amd shall consist of the following: 09-1966/3ol77 1 MAR/12/2009/THU 06:19 AM Zambelli Fireworks AE OQ Fanfare Three Inch Finale Shells 120 Pour Inch Finale Shells 36 Five Inch Finale Shells 20 Six Inch Finale Shells 20 :.. Four Inch Display Shells 234 Five Inch Display Shells 195 Six Inch Display Shells 156 Eight Inch Display Shells 45 Finale Three Inch Display Shells 160 Four Inch Display Shells 312 Five Inch Display Shells 75 Six larch Display Shells 60 Eight Inch Display Shells 2 FAX No.724 658 8318 P. 003 The program will fire at a rate of 28 (or more) shells per minute. This ensures that the sky will not be "black" unless called for in the choreography. Shells will open to overlap previous shells to beep the action continuous - The display shall be accompanied by a musical soundtrack appropriate for the 40, of July and the show will be Bxed electrically. CONTRACTOR's services shall also include, without limitation, the provision of a licensed pyrotechnic operator, lull electronic Paring of the fireworks display, show choreography and design, insurance coverage, sales tax and delivery and the processing of the necessary permit applications_ These services shall somefim:s hereinafter be referred to as "PROJECT." 2. DESIGNATED CONTACTS CITY shall assign a staff coordinator to work directly with CONTRACTOR. in the performance of this Agreement. CONTRACTOR hereby designates Irving Perry, who shall represent it and be its point of contact in all consultations with CITY during the performance of this Agreement. 094966(30177 2 MAR/12/2009/THU 06.19 AM Zambelli Fireworks FAX No.724 858 8318 P.004 3. TIME O ERFORMANCE Time is of the essence of this Agreement. The services of CONTRACTOR are to commence as soon as practicable after the execution of this Agreement to ensure that the fireworks show occurs at the agreed upon time on the Fourth of, July. This schedule may be amended to benefit the PROJECT if mutually agreed by CITY and CONTRACTOR. 4. COMPENSATION In consideration of the performance of the services described herein, CITY agrees to pay CONTRACTORz, a fee of Fifty Thousand Dollars ($50,000.00). CITY agrees that the full and final payment for CONTRACTOR's services is due within ten (10) calendar days after the Fourth of July or by July 14, 5. SPECIAL PROVISIONS A. CONTRACTOR will provide a fireworks show that is a ni't i um of twenty-five (25) minutes in length on July 4, 2009. The fireworks shall be launched off of the Huntington Beach Pier, beginning at approximately 9:00 P.M. B. CONTRACTOR will provide a California licensed pyrotechnic operator (Jeffrey Eidemiller) and crew including sufficient qualified technicians and laborers to execute the event The assigned employee of contractor (Eidemiller) will be available for up to three on - site, pre -event meetings with the 4"' of July Board and CITY staff. If, in the event that Mr. Eidemiller's service cannot be provided, CONTRACTOR will provide a pyrotechnic operator with similar credentials and experience. C. CONTRACTOR will obtain all applicable federal, state, county and CITY permits. All CITY permit paperwork must be submitted and fees for CITY permits will be waived. CONTRACTOR is responsible for the processing of other permits. 09-1955/30177 3 MAR/12/2009/THU 06,19 AM Zambelli Fireworks FAX No,724 658 8318 P,005 D. CONTRACTOR will meet or exceed all provisions of the Huntington Beach Fire Code Article 78 and Cali£omia Code of Regulations, Title 19-Public Safety, Chapter 6, Articles 1 through 15. In the event of a conflict in standards between the codes, the more stringent shall prevail. E. Alternate materials and methods must be submitted by CONTRACTOR and may be approved by the Fire Chief provided that the Fire Chief funds that the proposed design, use or operation satisfactorily complies with the intent of Article 78 or other recognized national standards acceptable to the CITY. )Furthermore, the method of work performed or operation, shall be for the purpose intended, and at least equivalent to that prescribed in the code in quality, strength, effectiveness, fire resistance, durability and safety. F. CONTRACTOR is responsiblc to provide all necessary pyrotecxuuic equipment_ (3, CONTRACTOR is responsible for the removal of unexploded fireworks and event equipment. A plan detailing the route and destination of unexploded fireworks must be submitted to the authorities having jurisdiction as required. R CONTRACTOR must submit a fire protection plan, subject to the review and approval of CITY's Fire Chief to provide for the protection. of Ruby's restaurant at the end of the Pier from fire or other damage. L CONTRACTOR will provide a musical score that corresponds with the fireworks display. Operator will work with the evenfs radio partner and the Fourth of July Board to coordinate the live radio broadcast of the event. CITY will provide sound equipment. J. CITY will permit an accessible location to launch fireworks. 09-1966130177 4 MAR/12/2009/THU 06:19 AM Zambelli Fireworks FAX No,724 658 8318 P. A6 K. CITY will provide for barricades, police and security to clear the public from the set-up area and to maintain, the necessary safety zone throughout the set-up, the event and the takQ down. L. CITY will provide sand, including delivery and pick up. Vl. CITY and CONTRACTOR will work together and mutually agree on a timeline for fireworks delivery, set up and access to the Pier. N. If either party deems conditions unsafe, the fireworks display will be delayed or postponed until conditions are -corrected. If conditions are not corrected, either party may cancel the display without further liability to either party. O. CITY shall have the option to unilaterally cancel this display prior to the date of the display. If CITY exercises this option, CITY agrees to pay to CONTRACTOR, as liquidated damages, the following percentages of the agreed contact price: I) twenty-five percent (25%) if cancellation is three (3) or more days prior to the scheduled day of the display; 2) fifty percent (50%) if cancellation occurs within two (2) days of the actual date set for the display-, 3) seventy-five percent (75%) if cancellation occurs on, the date set for the display but prior to the time physical set-up of the display actually begins; 4) one hundred percent (I00%) thereafter. If cancellation occurs prior to the date set for the display, CITY agrees to pay CONTRACTOR in addition to the above percentages, the value associated with any specific custom work performed by CONTRACTOR or its agents including but not limited to music/narration tape productioix and/or sponsors' logos. P. Liquidated Damaggs/Delays: It is agreed by the parties hereto that in case CONTRACTOR fails to perform the fireworks show referenced herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of 09-196680177 5 NEAR/12/2009/,THU 06:19 AM Zambel l i Fireworks FAX No. 724 658 8318 P. 007 CONTRACTOR'S failure to perform. It is therefore agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of Fifty Thousand Dollars ($50,000.00), which represents a reasonable endeavor by the parties hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of CONTRACTOR'S failure to perform the fireworks show; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. As used herein, the phrase "failure to perform" does not refer to issues concerning the quality or completeness of the display. Q. Upon mutual written agreement of the parties, the terra of this Agreement may be extended for a period not to exceed three (3) years. In the event CITY requires additional services not included herein or changes in the scope of services described herein CONTRACTOR, will undertake such work only upon tpurW written agreement of CONTRACTOR and CITY, Additional compensation for such extra work shall be allowed only if the prior written approval of CITY is obtained. 7. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR shall defend, indemnify and save and hold harmless CITY", its officers, offirials, employees and agents from and against any and all liability, loss, damage, expenses, costs (including without limitation, costs and fees of litigation) arising out of the performance of this Agreement by CONTRACTOR, its officers, agents or ennplayees except such loss or damage which was caused by the negligence or willful misconduct of CITY or any other person. CONTRACTOR will conduct such defense at its sole costs and expense. CITY 09-19600177 6 MAR/12/2009/THU 06:20 AM Zambelli Fireworks FAX No.724 658 8318 PA08 shall be reimbursed by CONTRACTOR for all costs and attorney's fees necessarily incurred by CITY in successfully enforcing this obligation. S. WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of said Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder; and shall indemnify, defend and hold barmiess CITY from and against all claims, demands, payments, suit, actions, proceedings, and judgments of every nature and description, including attorney's fees and costs presented, brought or recovered against CITY, for or on account of any liability wader any of said acts which may be incurred by reason of any work to be performed by CONTRACTOR under this Agreement. CONTRACTOR shall maintain workers' compensation and employers' liability insurance in amounts not less than the State statutory limits - CONTRACTOR shall cover all subcontractors or require such subcontractors to provide such workers' compensation and employers' liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation uudex the terms of the workers' compensation and employers' liability insurances and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 9. lNSY7RANC�E In addition to the workers' compensation and employers' liability insurances, CONTRACTOR sW obtain and furnish to CITY, a policy of commercial general liability insurance covering the PROJECT, and a policy of automobile bodily injury and property damage 09-1966/30177 7 MAR/12/2009/THU 06:20 AM Zambelli Fireworks FAX No,724 658 8318 P,109 insurance covering all automobiles owned or operated by CONTRACTOR. The policies shall cover CONTRACTOR, its officers, agents and employees, while acting within the scope of their duties, against claims arising out of or in connection with the PROJECT, and shall provide coverage in not less than the following amount- - combined single limit bodily injury and property damage, including products/oompieted operations liability and blanket contractual liability, of Two Million Dollars ($2,000,000.00) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than Four Million Dollars ($4,000,000,00) for this PROJECT. The policies shall name CITY, its agents, its officers, employees and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary. Under no circumstances shall the above -mentioned insurance contain a self - insured retention, or a "deductible" or any other similar form of limitation on the required coverage in excess of Two Thousand Five Hundred Dollars ($2,500.00). 10, CERTIFICATES OF INSLIAN'CE Nor to commencing performance of the work hereunder, CONTRACTOR shall famish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: A. provide the name and policy number of each carrier and policy; B. shall state that the policy is currently in. force; and C. shall promise that such, policies shall not be suspended, voided or canceled by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice, 09-I966/30I77 & MAR/12/2009/THU 06:20 AM Zambelli Fireworks FAX No,724 658 8318 P,010 CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is frilly completed and accepted by CITY. The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand a copy of all said policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the pxemiums on all insurance hereinabove required. 11. INDEPENDENT CONTRACTOR CONTRACTOR is, and shall be, acting at all times in the performance of this Agreement as an independent contractor and not as an employee of CITY. CONTRACTOR shall secure at its expense, and be responsible for any and all payments of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the services to be performed hereunder. 12. ASSIGNMENT AND SUBCONTRACTING This Agreement is a personal service contract and the supervisory work hereunder shall not be delegated or subcontracted by CONTRACTOR to any other person or entity without the prior written consent of CITY. 13, CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any fmancial baterest in this Agreement in violation of the applicable provisions of the California Government Code. 09-1966130177 9 MAR/12/2009/THU 06:20 AM Zambelli Fireworks FAX No,724 658 8318 P,011 14. NOTICES Any notices or special instructions required to be given in writing under this Agreement shall be given either by personal delivery to CONTRACTOR's or to CITY'S Director of Community Services, as the situation shall warrant, or by enclosing the same in a sealed envelope, first class postage prepaid, and depositing the same in the United. States Postal Services, addressed as follows: TO CITY: City of Huntington Beach Attn: Director of Community Services 2000 Mainz Street Huntington Beach, CA 92648 TO CONTRACTOR: Izving Perry Zambelli Fireworks Manufacturing Corp. Inc. P. O. Box 986 Shaffer, CA 93263 Notice shall be deemed effective when delivered or three (3) business days after deposit in the mail. 15. DiDAIGRATION CONTRACTOR shall be responsible for full compliance with the inlrnigration and naturalization laves of the United States and shall, in particular, comply with the provisions of the United States Code regarding employment verification. 16, LEGAL SERVICES SUBC0NTRACTTNG 1?R0UlBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter § 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 09-1966/30177 10 MAR/12/2009/THU 06:20 AM Zambelli Fireworks FAX No,724 658 83H P,012 17. MODIFICATION No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties. 13. SECTION HEADINGS The titles, captions, section, paxagraph, subject headings and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of matters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parries or affect the construction or interpretation of any provision of this Agreement. 19, INTERPR.ETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable; void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 09-19600177 11 MAR/12/2009/,THU 06:20 AM Zambelli Fireworks FAX No,724 858 8318 P. J 13 20. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in countmparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each of the parties hereto shall retain an originally signed copy hereof. Each duplicate original shall be deemed an original instrument as against any part who has signed it, 21. ATTORNEY' S FEES In the event suit is brought by either party to enforce the terms and/or provisions of this agreement or to secure the performance hereof, each party shall bear its own attorney's fees. 22. GOVERN'ING LAW This Agreement shall be govertted and construed in, accordance with the laws of the State of California. REST OF RAGE NOT USED 09-1966130177 12 MAR/12•/2009/THU 06:21 AM Zambelli Fireworks FAX No.724 658 8318 P.014 23, ENTIRETY The Agreement contains the entire agreement between the parties respecting the subject matter of this Agreement and supercedes all prior understanding and agreements whether oral or in writing between the parties respecting to subject matter hereof. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on. f%��_ �_ C�C/� � / ; , 2009. ZAMBELLr FrREwORTCS NiANUFACTuRYNG COMPANY, INC. print name ITS: (circle one) ChairmmuPres' ent/Vice President AND By: Print namr ITS: (circle one) Secretary/Chief Financial Offic Secretary — Treasurer CITY OF HUNTINGTON BEACH, a munici rpor 'ou oftYle State of Cali£arnia Finance Di' a (Pursuant to HB Chapter 3.02) INITIATED AND APPR VED: Directo o Community Servi es er/Asst. APPROVED AS TO FORM: i City Attorney M.V 09-1966130177 13 AC®I D, CERTIFICATE OF LIABILITY INSURANCE 3 DATE(MMIDDIYYYY) 25 2009 PRODUCER Phone: 440-248-4711 Fax: 440-248-5406 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Britton -Gallagher and Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6240 SOM Center Rd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Cleveland OH 44139 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA:Granite State Insurance Co. 23809 Zambelli Fireworks Mfg. Co., Inc. PO Box 1463 INsuRERB:Arch Sipecialty Ins Co New Castle PA 16103-1463 INSURER c:Lexington Insurance Co INSURER D: INSURER E: rnVFRAnPA THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD'L NSR POLICY NUMBER POLICY EFFECTIVE DATE M DD Y POLICY EXPIRATION DATE MM DD LIMITS C GENERAL LIABILITY 1619 3 91- 01 2/l/2009 2/ 1/ 2 010 EACH OCCURRENCE $ 1 0 0 0 0 0 0 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurence $ 5 0 0 0 0 CLAIMS MADE K] OCCUR MED EXP (Any one person) $ PERSONAL& ADV INJURY $ 1 000 000 GENERALAGGREGATE $ 2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2 0 0 0 0 0 0 POLICY PRO LOC X JEC A AUTOMOBILE X LIABILITY ANY AUTO CA93488081 2/l/2009 2/1/2010 COMBINED SINGLE LIMIT (Ea accident)ALLOWNEDAUTOS $ 1, 000, 000 BODILY INJURY (Per person) $ SCHEDULED AUTOS WPVEDAST,0F0M ell BODILY INJURY (Per accident) $ X X HIRED AUTOS NON -OWNED AUTOS 13 AYAC(3 " C1'� PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EAACCIDENT $ OTHERTHAN EAACC $ ANYAUTO $ AUTOONLY: AGG B EXCESS/UMBRELLA LIABILITY UFP0024525 2/l/2009 2/1/2010 EACH OCCURRENCE $ 9 000 000 X OCCUR CLAIMS MADE AGGREGATE $ 9 0 0 0 0 0 0 $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC OTH- LIMIT TORY LIMITS ER E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ A OTHER Hired Car Physical Damage CA93488081 2/1/2009 2/1/2010 $150,000 limit $500 Comp Deductible $500 Collision Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Display Date: 7/4/09 or alternate date as per contract. The following are named as Additional Insureds as respects Commercial General Liability Insurance pertaining to the operations of the Named Insured only. The City of Huntington Beach, its officers, elected or appointed officals, employees, agents and volunteers, The Redevelopment of The City of Huntington Beach, California. Form CG2026, Additional Insured - Designated Person or Organization is attached hereto. CERTIFICATE HOLDER CANCELLATION Ms. Naida Osline City of Huntington Beach 2000 Main Street Huntington Beach CA 92648 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) POLICY NUMBER: 1619391-01 10141ftP114091"11Wr7ti+I4cl_1;lII10-I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION < r.. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. [•�a.1��71j� Name of Person or Organization: The City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers The Redevelopment Agency of The City of Huntington Beach, California Location: 2000 Main Street, Huntington Beach, CA 92648 With respects to the insureds operations on 07/04/2009 only (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. CG 20 26 11 85 Copyright, Insurance Services Office, Inc., 1984 Page i of 1 0 03/2V 2009 13:22 6617462844 ZAMBELLI WEST PAGE 01/02 POLICYHOLDER COPY NT STATE P.O. BOX 420807, SAN FRANCISCO,CA 94 142-0807 COMPENSATION INS U R A N C E FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 06-05-2008 GROUP: POLICY NUMBER: 0802299-2009 CERTIFICATE ID! 390 CERTIFICATE EXPIRES: 06-05-2009 06-OS-2008/06-05-2009 4TH OF JULY EXEC BOARD 2000 MAIN STREET HUNTINGTON BEACH CA 92648 NT JOD:HUNTINGTDN OCACH, CA This is to Certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This Certificate of insurance is not an insurance policy and does not amend, extend or after the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to ail the terms, exclusions, and conditions, of such policy. trHORIZU0 REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE~ COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - CONNIE ZAMBELLI, VP - EXCLUDED. ENDORSrEMENT #2O65 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 06-05-1990 IS -ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER ZAMBELLI FIREWORKS MFG CO., INC. PO BOX 1463 NEW CASTLE PA 16103 NT M0410 (FIEv.2-05) PRINTED : 05-16-2008 _?/0