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HomeMy WebLinkAboutAlpha Omega Christmas Trees, Inc., dba Bishop & Mathews II/Christmas Tree House - 2010-11-15k-'l Council/Agency Meeting Held: (1 Deferred/Continued to: ].App ved ❑ Conditionally Approved ❑ Denied c ' Cit � Ier ,'s SignatoVe Council Meeting Date: November 15, 2010 Department ID Number: ED 10-54 SUBMITTED TO: Honorable Chairman and Agency Members SUBMITTED BY: Fred A. Wilson, Executive Director PREPARED BY: Stanley Smalewitz, Deputy Executive Director/Director of Economic Development SUBJECT: Approve and authorize execution of a License Agreement with Alpha Omega Christmas Trees, Inc., dba Bishop & Mathews II/ Christmas Tree House, for Temporary Use of Vacant Agency Owned Property Statement of Issue: A License Agreement between the Agency and Alpha Omega Christmas Trees, Inc. is submitted for approval. This Agreement will grant Alpha Omega Christmas Trees, Inc. permission to operate a Christmas tree lot on Agency owned property. Financial Impact: This Agreement will generate eight thousand dollars ($8,000). Recommended Action: Motion to: A) Approve the "License Agreement By and Between the Redevelopment Agency of the City of Huntington Beach and Alpha Omega Christmas Trees, Inc. dba Bishop and Mathews II Christmas Tree House for Temporary Use of Agency Property;" and, B) Authorize the Chairperson, Executive Director, and Agency Secretary to sign all related documents. Alternative Action(s): Do not approve the License Agreement and/or direct staff accordingly. HB -209- Item 19. - 1 REQUEST FOR COUNCIL. ACTION MEETING DATE: 11/15/2010 DEPARTMENT ID NUMBER: ED 10-54 Analysis: Alpha Omega Christmas Trees, Inc. proposes to use the vacant Agency owned property located on the southwest corner of Edinger Avenue and Parkside Lane for the purpose of operating a retail/wholesale Christmas tree lot. The Agreement consists of the following terms: Rental Period: Maximum period of two (2) consecutive months from the date the license is executed. Permission: Agency will grant the Licensee permission to enter and use the property for the purpose of operating a retail/wholesale Christmas tree lot. Rent: Licensee shall pay Agency upon execution of this Agreement, as rent, the total sum of eight thousand dollars ($8,000.00) for the entire term. Insurance: Licensee shall meet/provide all City insurance requirements. The proposed temporary use of this property will not affect operations of the adjoining businesses nor future redevelopment of the property. Environmental Status: Not applicable Strategic Plan Goal: Maintain financial viability and our reserves Attachment(s): "License Agreement By and Between the Redevelopment Agency of the City of Huntington Beach and Alpha Omega Christmas Trees, Inc., dba Bishop & Mathews II/Christmas Tree House For Temporary Use of Agency Property" 2 1 Vicinity Map Item 19. - 2 HB -210- � ? a f i a _ s � r a `� — i � � l — — — — — LICENSE AGREEMENT BY AND BETWEEN THE REDEVELOPMENT AGENCY OF THE CITY OF HUNTINGTON BEACH AND ALPHA OMEGA CHRISTMAS TREES, INC., dba BISHOP & MATHEWS 1I CHRISTMAS TREE HOUSE FOR TEMPORARY USE OF AGENCY PROPERTY This License Agreement is made and entered into by and between the REDEVELOPMENT AGENCY OF THE CITY OF HUNTINGTON BEACH, a public body of the State of California, hereinafter referred to as "AGENCY," and the ALPHA OMEGA CHRISTMAS TREES, INC. dba, BISHOP & MATHEWS II CHRISTMAS TREE HOUSE, hereinafter referred to as "LICENSEE." WHEREAS, LICENSEE has applied to AGENCY for permission to use AGENCY -owned property, described as follows: APNs: 142-081-06, 142-081-09, 142-081-10, 142-081-11, 142-081-12. Location: Edinger Avenue and Parkside Lane, (hereinafter "the "Property") in the City of Huntington Beach for the purpose of operating a retail/wholesale Christmas tree lot on the Property; and AGENCY desires to allow such use as necessary for the purposes stated above in; and The proposed use of the Property is permitted per Section 230.90 of the Huntington Beach Zoning and Subdivision Ordinance, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. PERMISSION. Permission is hereby given to LICENSEE to enter upon and use the Property as depicted in the map attached hereto as Exhibit "A" for the purpose described above. 2. TERM. The term of this License shall be for a maximum period of two consecutive (2) months from the date this License is signed by the Chairman of the Agency. 10-2686/54231 Page 1 of 8 3. RENT. LICENSEE shall pay AGENCY, as rent, the total sum of Eight Thousand Dollars ($8,000.00) for the entire term. Rent shall be paid upon execution of this Agreement and shall be paid to AGENCY at P. O. Box 711, Huntington Beach, CA 92648-0711. In addition to Rent, LICENSEE shall pay to the entities entitled thereto all taxes, assessments, insurance premiums, maintenance charges and any other charges, costs and expenses against the Property which may be contemplated under any provision of this License. 4. INDEMNIFICATION, DEFENSE, HOLD HARMLESS. LICENSEE hereby agrees to protect, defend, indemnify and hold and save harmless AGENCY, its officers, and employees against any and all liability, claims, judgments, costs and demands, however caused, including those resulting from death or injury to LICENSEE'S employees and damage to LICENSEE'S property, arising directly or indirectly out of the grant of License herein contained, including those arising from the passive concurrent negligence of AGENCY, but save and except those which arise out of the active concurrent negligence, sole negligence, or the sole willful misconduct of AGENCY. LICENSEE will conduct all defense at its sole cost and expense. 5. 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 Property pursuant to this License. LICENSEE shall maintain such Workers' Compensation Insurance in an amount of not less than One Hundred Thousand Dollars ($100,000) bodily injury by accident, each occurrence, One Hundred Thousand Dollars ($100,000) bodily injury by disease, each employee, and Two Hundred Fifty Thousand Dollars ($250,000) bodily injury by disease, policy limit, at all times incident hereto, in forms and underwritten by insurance companies satisfactory to AGENCY. 10-2686/54231 Page 2 of 8 6. INSURANCE. LICENSEE shall carry at all times incident hereto, on all activities to be performed in the Property as contemplated herein, general liability insurance, including coverage for bodily injury, and property damage. All insurance shall be underwritten by insurance companies in forms satisfactory to AGENCY. Said insurance shall name the AGENCY, its officers, agents and employees and all public agencies as determined by the AGENCY 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. If coverage is provided under a form which includes a designated general aggregate limit, such limit shall be not less than One Million Dollars ($1,000,000). In the event of aggregate coverage, LICENSEE shall immediately notify AGENCY of any known depletion of limits. LICENSEE shall require its insurer to waive its subrogation rights against AGENCY and agrees to provide certificates evidencing the same. 7. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENT. Prior to the encroachment into the Property pursuant to this License, LICENSEE shall furnish to AGENCY 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 AGENCY. 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 AGENCY by LICENSEE under this Agreement. AGENCY or its representative shall at all times have the right to demand the original or a copy of all said policies 10-2686/54231 Page 3 of 8 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 AGENCY, its officers and employees as Additional Insureds shall be provided to the AGENCY counsel for approval prior to the encroachment into the Property pursuant to this License. 8. RELEASE. LICENSEE hereby releases and forever discharges AGENCY of and from any and all claims, demands, actions or causes of action whatsoever which LICENSEE may have, or may hereafter have, against the AGENCY specifically arising out of the matter of the entry of LICENSEE onto the Property. This is a complete and final release and shall be binding upon LICENSEE and the heirs, executors, administrators, successors and assigns of LICENSEE'S use of the Property. LICENSEE hereby expressly waives any rights under or benefit of any law of any jurisdiction whatsoever providing to the contrary. Neither the acceptance of this release nor any payment made hereunder shall constitute any admission of any liability of AGENCY. 9. WASTE. LICENSEE shall not alter, damage or commit any kind of waste upon the Property or any improvement, equipment or personal property thereon and shall not interfere in any manner with the operations or activities of AGENCY. LICENSEE shall make no change in the use of the Property nor shall the design of the Property be changed other than as authorized herein without prior written consent of AGENCY. LICENSEE shall not cause any workmen's or materialmen's liens to be placed upon the Property and agrees to indemnify and hold AGENCY harmless against any such liens including but not limited to the payment of attorneys' fees. 10. MAINTENANCE. LICENSEE agrees to care for and maintain the Property in good and satisfactory condition as acceptable to the AGENCY. Maintenance shall include daily cleaning 10-2686/54231 Page 4 of 8 of the Property area including but not limited to removal of all rubbish, food stuffs, paper, bottles, cans, gum, cigarettes, animal litter, dirt and sand. LICENSEE shall keep the Property area reasonably clean and free of debris during its use thereof, and shall restore the Property, as much as reasonably practicable, to its former condition. In the event LICENSEE does not maintain the Property in a satisfactory manner, LICENSEE authorizes AGENCY to perform such maintenance on LICENSEE'S behalf. All costs incurred performing said maintenance shall be assessed to and billed directly to the LICENSEE. LICENSEE agrees to pay such costs within thirty (30) days of billing. In the event any damage is caused to the Property, as a result of the use authorized hereunder, LICENSEE agrees to repair same at its own expense. 11. ACCESS a) Each party shall provide access to the Property to the other party, and its employees, agents, contractors and subcontractors, twenty-four (24) hours a day, seven (7) days a week or as designated in permit approvals. AGENCY represents and warrants that it has full rights of ingress and egress to and from the Property, and hereby grants such rights to Licensee to the extent required for authorized operations. LICENSEE'S exercise of such rights shall not cause undue inconvenience to AGENCY. All LICENSEE'S operations shall comply with all ordinances, regulations, and laws. b) LICENSEE shall, at its sole cost and expense, maintain and repair the Property and LICENSEE'S Facilities including, but not limited to, the removal of all trash, debris and graffiti. If LICENSEE causes any damage to the Property or to access roadways or other nearby facilities, it shall properly repair same as specified by AGENCY. 10-2686/54231 Page 5 of 8 c) Upon the expiration or termination of this Agreement, LICENSEE shall surrender the Property to AGENCY in good and clean condition, less ordinary wear and tear, and as approved in writing by AGENCY. 12. CONTROL OF EQUIPMENT. LICENSEE shall keep any equipment used or brought onto the Property under its absolute and complete control at all times and said equipment shall be used on the Property at the sole risk of LICENSEE. 13. INDEPENDENT CONTRACTOR. LICENSEE agrees that all work done or undertaken by it on the Property shall be for its sole account and not as an agent, servant or contractor for AGENCY. 14. HAZARDOUS SUBSTANCE. LICENSEE represents and warrants that its use of the Property herein will not generate any hazardous substance, and it will not store or dispose on the Property nor transport to or over the Property any hazardous substance. LICENSEE further agrees to clean-up and remediate any hazardous substance on the Property, and hold AGENCY harmless from and indemnify AGENCY against any release of any such hazardous substance and any damage, loss, or expense or liability resulting from such release including all attorneys' fees, costs and penalties incurred as a result thereof except any release caused by the negligence of AGENCY, its employees or agents. "Hazardous substance" shall be interpreted broadly to mean any substance or material defined or designated as hazardous or toxic waste, hazardous or toxic material, hazardous or toxic or radioactive substance, or other similar term by any federal, state or local environmental law, regulation or rule presently in effect or promulgated in the future, as such laws, regulations or rules may be amended from time to time; and it shall be interpreted to include, but not be limited to, any substance which after release into the environment will or may reasonably be anticipated to cause sickness, death or disease. 10-2686/54231 Page 6 of 8 15. NO ASSIGNMENT. LICENSEE agrees that the permission herein extended shall be personal to it and that it shall not assign or permit any third party to avail itself of any of the privileges granted hereunder, without the express written permission of AGENCY. 16. NO TITLE INTEREST. No title interest of any kind is hereby given and LICENSEE shall never assert any claim or title to the Property. 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 AGENCY at the respective addresses shown below: AGENCY: Redevelopment Agency of the City of Huntington Beach Attn: Real Estate Services Manager 2000 Main Street Huntington Beach, CA 92648 LICENSEE: Janelle Clark Christmas Tree House 14 Autumn Hill Lane Laguna Hills, CA 92653 18. NO DISCRIMINATION. LICENSEE agrees that in performance of this Agreement and in the use of the Property area authorized hereunder, it will not engage in, nor permit its officers, agents or employees to engage in, any discrimination or discriminatory practices against any person based on race, religion, creed, color, natural origin, ancestry, physical handicap, medical condition, marital status or gender. 19. ATTORNEY'S FEES. In the event suit is brought by either party to enforce the terms and provisions of this agreement or to secure the performance hereof, each party shall bear its own attorney's fees. The prevailing party shall not be entitled to recover its attorney's fees. 10-2686/5423 ( Page 7 of 8 20. ENTIRETY. This Agreement contains the entire agreement between the parties. This Agreement shall be modified only by a subsequent written amendment, as may be mutually agreed upon by the parties. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on No V /'.�, 2010. ALPHA OMEGA CHRISTMAS TREES, INC., dba BISHOP & MATHEWS IICHRISTMAS TREE HOUSE print name ITS: (circle one) Chairman/Presiden ice Presiders anaging Partner AND By: print name ITS: (circle one) Secretary/Chief Financial Officer sst. Secretary Treasurer/Managing Partner .� ;D ....• 9D W REDEVELOPMENT AGENCY OF THE CITY OF HUNTINGTON BEACH INITIATED AND APP OVED: i Deputy Execu e Director APPROVED AS TO FORM: Agency Counsel ; Y) v /D aq /D 10-2686/54231 Page 8 of 8 _CERTIFICATE OF V LIABILITY 10/27/2010 PRODUCER (503) 226-1422 FAX: (503) 226-2488 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keelson Partners ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES "NOT AMEND, EXTEND OR Attn: Mimi, Buslach, ext 108 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 707 SW Washington, Suite 625 Portland OR 97205-3536 INSURERS AFFORDING COVERAGE NAIC # -- — - -- - --------------- INSURED NSURER A: Great Northern Insurance Cc -. - - --- -.-..._..---- Bishop 6 Mathews II/Christmas Tree House, '1NSURER13: Alpha Omega Christmas Trees And Tin lrides P g Y g INSURER C: 14 Autumn Hill LaneIN%UtNSUR..------------------------...............__......_............,........._...-.....__..... --------....--.._....... ......._._.... ....----- .......,... ER D: Laguna Hills CA 92653 NSURER£ rnV9PArt;c 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 OFSUCH POLICIES" AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. insRl._aotU_._..-...... ..._....._.._.. -- - POLICYEFFEGTIVE'POLICYEXPIRATtON ...... ..............-_..._. ......... _._._-----.._.._........ ...... ,_...._._-- LTR f I RANCE POLICYNUMBER DATE ! D Y LIMI75 GENERAL LIABILITY EACH OC_CURII 01000 MMERCIALGENER_ALLIABILITY COMMERCIAL O I DAMAGE 70.131=WEED S 250 000 PREMISE$ Eaoacurro -- --- -( ---- ,_._.-•----.---------------.....t....._.._-- A 3 . CLAIMS MADE X� OCCUR,35766060 10/18/2010 9/1/2011 ; MEDEXP(Anyonaperson)._._. r'----.._ .._....... _S,_......__._BxCluded I_----... ......... _,...,..........., __PERSONAL & ADV INJURY___I $ ____._.1, O,OQ.,.000 t GENERAL AGGREGATE........._1.5_..._....__l.x 0001 000 GEN'LAGGREGATE LIMITAPPUESPER: I PRODUCTS-COMPIOPAGG $ 1.,000,000 X POLICY I PRO- - LOC ------------ ........................__.._.. ......._...._...........,_... AUTOMOBILE --"-- LIABILITY COMBINED SINGLE LIMIT S ANY AUTO (Ea accident) ....... ALL OWNED AUTOS SCHEDULED AUTOS /iJB!", ' .i + �) ,[ -+ " tZirt (j I BODILY INJURY (Perperson) S --_E ;._._. HIRED AUTOS NON -OWNED AUTOS +, r y' i +" City � mt, I .._.........-.................................-------- BODILY INJURY (Per accident) - - -....................i-.._.__......._........._..__.......,......... ------- ..._.....----------- ---------.._.... $ PROPERTY DAMAGE S (Per accident GARAGELIABILITY AUTO ONLY EA ACCIDENT $ �........- ANY AUTO FA ;OTHER THAN ..,......._ACC _.... .S. .............. ............ ........_........... i AUTO ONLY: AGG 5 EXCESS; UMBRELiAL{ABILITY i 'EACH OCCURRENCE $ OCCUR CLAIMS MADE I AGGREGATE ------- -----...._.............._....--------------" - S .._,... S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION wCSTA"ru- [orH- ORYR.___.__ ANDEMPLOYERS'LIABILITY Y/NI --- - _-" - " ................. ANY PROPRIETORWARTNEWEXECUTIVE E, L. EAGH ACCIDENT 5 OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NHI { E.L. DISEASE - EA EMPLOYE S UP s, describe under - ------.._..------------ .................. .....i.... ---------- ...._.,,... i SCIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT ¢ $ OTHER DESCRIPTION OF OPERATIONS, LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT, SPECIAL PROVISIONS The City, its officers, elected or appointed officials, employees, agents & volunteers are included as additional insured as respects liability arising out of action performed by the named insured 6 subject to policy terms, conditions, and exclusions with regard to location at: 7880 Edinger Avenue, Huntington Beach, CA 92647, CG2010 (1001) attached. CG2037 (0704) attached. CERTIFICATE HOLDER CANCELLATION luis.gomez@surfcity-hb.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANC£LLEOBEFORETHE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN The City Of Huntington Beach NOTICE TO THECERTIFICATE HOLDERNAMEDTO THE LEFT, BUT FAILURE TO DO SO SHALL 2000 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Huntington Beach, CA 92648 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Thomas Wilkins/MIMI ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved, INS025 (2009D1).01 The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 35766060 COMMERCIAL GENERAL LIABILITY Named Insured: Bishop & Mathews II/Christmas Tree CG 20 10 10 01 House, Alpha Omega Christmas Trees THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED O; CONTRACTORS!PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: The City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 Re: Operations of the Named Insured City of Huntington Beach, its elected or appointed officials, agents, officers, employees & volunteers (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations per- formed for that insured. S. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily in- jury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the addi- tional insured(s) at the site of the cov- ered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another con- tractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 0 ISO Properties, Inc., 2000 Page 1 of 1 13 POLICY NUMBER: 35766060 Named Insured: Bishop & Mathews II/Christmas Tree House, Alpha Omega Christmas Trees COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. v This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ izations : Location And Description Of Completed Opera - tions The City'of Huntington Beach 7880 Edinger Avenue 2000 Main Street Huntington Beach, CA 92647 Huntington Beach, CA 92648 Re: Operations of the Named Insured City of Huntington Beach, its elected or appointed officials, agents, officers employees & volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 13 CERTHOLDER COPY Sc P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-20-2010 CITY OF HUNTINGTON BEACH RISK MANAGEMENT 2000 MAIN ST HUNTINGTON BEACH CA 92648-2702 Sc GROUP: POLICY NUMBER: 1939592-2009 CERTIFICATE ID: 1 CERTIFICATE EXPIRES: 11-01-2010 11-26-2009/11-01-2010 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 that will expire or did expire as indicated above. This certificate of insurance is not an insurance policy and does not amend, extend or alter 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 all the terms, exclusions, and conditions, of such policy, ttor,zed Representative Interim President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - ANDREW TINGIRIDES PRIES - EXCLUDED. ENDORSEMENT #1600 - JANELLE CASANOVA CLARK TRES,VP - EXCLUDED. EMPLOYER ALPHA OMEGA CHRISTMAS TREES INC 14 AUTUMN HILL LN LAGUNA HILLS CA 92853 APP D el"}'ORtE 1 ER MIN, City tt ey� tt0 SC [CAH,CN] PRINTED : 10-20-2010 (REV.1-2010) POLICYHOLDER COPY SC P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-20-2010 CITY OF HUNTINGTON BEACH RISK MANAGEMENT 2000 MAIN ST HUNTINGTON BEACH CA 92648-2702 SC GROUP: POLICY NUMBER: 1939592-2009 CERTIFICATE ID: 1 CERTIFICATE EXPIRESI1-01-2010 11-26-2009/11-01-2010 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 that will expire or did expire as indicated above. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other docurnent 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 all the terms, exclusions, and conditions, of such policy. tth,nized Representative Interim President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT N1600 - ANDREW TINGIRIDES PRES - EXCLUDED. ENDORSEMENT #1600 - JANELLE CASANOVA CLARK TRES,VP - EXCLUDED. EMPLOYER ALPHA OMEGA CHRISTMAS TREES INC 14 AUTUMN HILL LN LAGUNA HILLS CA 92653 Sc ICAH,CNj MEV.1-2010) PRINTED : 10-20-2010 ATTACHMENT #2