HomeMy WebLinkAboutFinal Tract Map 10449 - All of TT 10449 - G.F. Goeden Compan t
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OFFI
CE CF� 4 TH F C CITY. CLERK .
o ber •v ,,78
N �m 5 1
G. F. Goede'n & Co.
17931 Beach Blvd. , Suite G
Huntington Beach, CA.
Gentlemen:
The city council of Huntington Beach, at its regular
meeting held October 2, 1978 ,
approved the Subdivision Agreement for Tract No.10449 •
We are enclosing herewith a duly executed copy for your
riles. �
I
Sincerely,
Alicia M. Wentworth
city cler'.
i
A.MW:yr
Enclosure
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P P.;M M.
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P.O. 'BOX SOp CALIFORNIA U>ti41r
OFFICE OF THE CITY CLERK
November 14, 1978
Ti t'I a Insurance & Trust
800, N.. Main, Street
Santa Ana, CA.
Attention; Larry Williams
RE: Tract Map No. 10449
Gentlemen:
This is to inform you that all £eeu have been
paid and condition& -yet on the above named tract.
You are free to record same at your convenience.
Sincerely yours,
A/x
J/
Alicia M. Wentworth
City Clerk
AHW,-to
Received by '
Dace
11(fJ .LCE OIL 'COMPLETION WIT If CONDIZ IONS G1J TRACTS
.• � � r r 1 r TRACTS'
II
Au't'll( .ATION FOR I(I L1 ASE FUtt 1111. .DII C;
TO : CITY CLEI:K DATE. : 6
It 7
FROM: PUBLIC WORKS ; DEPARTMENT
Charles P. Spencer
TRACT NQ, j - t DEVELOPER �, M , i> .
....k �..._ _ �""("�
CONDITIONS : Date
De osit . of fees for water, sewer, drainage,
P I engineering and' inspection. . . . . . . . . . . . . . . .r
Bond for Improvement. . . . . . . . . . . . . . . . . . . . . . :
Signature of Agreement . . . . . . . . . . . . . . . . . . . . .
Certificate of Insurance . . . . . . . . . . . . . . . . . . :
Bondfor Monuments . . . . . . . . . . . . . . . . . . . . . . . . .
Approval. from County Surveyor. . . . . . . . . . . . . .
Labor & Material Bond . . . . . . . . . . . . . . . . . . . . . .
Other:
.V. jAL�
Signature
NOTICE OF COMPLIAICE WITH CONDITIO14S 014 TRACT
AUTHORIZATION FOR RELEASE FOIL RECORDING
TO : City Clerk Date // - 1- -7�
FROM: PLANNING DEPARTMENT
JE-mes W. Pali.i
'1TRAC1 NO. 0 4� q
RECREATION & PARKS FEES F AID J62-Z-3
Other:
(Signature)
Rc FOR' i-rYoNci ATiow
}
ohn he Y. DJ evlopm en Services
Suimitted'by James . W. Pal'in `DeparmanPlanning
}
Date Prepared October '20 , 1938 BicKup Material At#ached 0 Yes .0 Ao
j Subj1ect Firial Tract . 10449 - Bein all of Tentative Tract 10449
taP f .ej; north `f 116iner V u: .
City-Admini5trator's Comments
APPItOVED•I3Y CITY COLTS*GIL
Approve as recommended.
'CITY EXIC
Statement of Issue, Recoriunendati6h, Analysis, Funding Source,'Alternative Actions:
STATEMENT OF ISSUE
The Final Map of Tract 1044+9 , being all of Tentative Tract 10449 ,
has been submitted to the City for approval .
RECOMMENDATION:
1 . Approve Negative Declaration 78-65;
2 . Approvr the Final Map pursuant to the mandatory findings set
forth in Section 66474 of the Government Code;
3 . Accept the offer of dedication and improvement subject to
completion of the requirements as shown; and
4 . Instruct the City Clerk to .alpt-- affix her signature to the map
nor release it for preliminary processing by the County or for
recordation until the following conditions have been complied with:
(a) Deposit of fees for water, sewer, drainage , engineering,
and inspections .
i
(b) Certificate of insurance.
(c) Subdivision agreement.
(d) The final map shall be recorded prior to the expiration of
Tentative Tract 10449 on February 11 1980 .
(e) Park and Recreation Fees shall be paid prior to recordation of the
Final trap.
NO 3178
Re' quQst for . City. 'Council �Actzon
Final Tract 10449 (TT10449)
Page 2
ANALYSIS:
Subdivider: G. F . Goeden Co;
17931 Beach : Blyd. , #•G
Huntington Beach, CA 92647
Engineer: Hunsaker & Associates Inc .
3001 Red Hill , ,BIA - 'V�i #212
Costa Mesa , CA 92626
Location: West side oi: Graham, 902+ feet north of Warner Avenue
Lots : 13
Acreage: 2 . 982
Zone: Rl, Low Density Residential
General Plan: Low Density Residential
Discussion: This. ian has been examined and certified by the Director
of Public Works anid the Secretary to the Planning Commission as
being substantially in accordance with the tentative map as
filed with, amended and approved by the Planning 'Commission.
Environmental Status : Negative Declaration 78--65 was approved by
the Planning Commission on August 1, 1978 .
FUNDING SOURCE: Not Applicable
ALTERNATIVE .ACTIONS : None
ATTACHMENT: Area Map
Respectfully submitted,
JOHN BEHRENS, INTERIM DIRECTOR
EVELOPMEN ES
s W. Palitl
Acting Plannig Director
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, tm -- , - � _ __ WARNER AVENUE
,CASE IN FEET
FINAL TRACT 10449
TENTATIVE TRACT 10449 J1 '
HUNTIHGKYv aTA.CN
HUNT111GTOM BEACH PL AU14116G DEPT.
J CITY' ACT1CNREQU T C
Hart4e ;; . :,. Pub�l'ic -lWork;s
&.Ibm'itted by H.. E.. w Department
Septei't eir 20 , 7g ;...,
Date Pre ared 19 Backu Material Attached x Yes No
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Subject B6has and Agreements Tract 10449
I
City AAnl—'Iisf
• ny r
:IL9:
Approve ,as recommended.
CITY RIB '
Statement of Issue, Recommendation, Analysis, Funding Source, Alternative Actions:
:Statement of Issue
G. F. Goeden & Co, . Inc. has requested the City to accept bonds and
agreements for Traci: 10449 as provided for in Section 66499 of the
Subdivision Map Act.
'Recommendation
It is recommended that the City Council accept the following bonds and
two copies of the Subdivision Agreement: .
i
Monument Bond No. 8SM 550 299
Guarantee and Warranty Bond No. 8SM 550 300
Faithful Performance Bond No. 8SM 550 298
Labor and Material Bond No. 8SM 550 298
and instruct the City Clerk to file them wide City Treasurer. It
is further recommended that the City Council accept the Subdivision
Agreements and instruct the City Clerk to file one copy and return the
second copy to the subdivider.
Analysis
Subdivider: G. F. Goeden & Co, 17931 Beach Blvd. , Suite G, Huntington
Beach
Engineer: Hunsacker & Assoc. , 3001 Redhill , Bldg VI , Suite 212
Costa Mesa, CA. 92626
Location: W/s Graham, N/o Warner
Lots: 13
Acreage: 2 . 982
Zone: R1
All of the documents have been approved for amount by the Department
of Public Wor;;c and as to form by the City Attorney ' s office
HEH:BPC:mc
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` P.O. ®QX ISO CAL.!!+ ORNIA 924M
OFFICE OF THE CITY CLERK
October 3, 1978
G. F. Goeden Co.
17931 Beach Blvd. , Suite G
Huntington Beach, CA.
Gentlermn:
'the city council of tiwitington Beach, at its regular
meting held October 2, 1978
approved the Subdivision Agreement for Tract 14o. 10 ,_•
WQ are enclosing herewith a duly executud copy for your
files.
Sincerely,
Y �I �� �,r ++"- !•ilk .+���Gr��C Cam./
Alicia M. Wentworth
City Clerk
AMW:pr
Enclosure
THIS -AGREEMENT 'dated this 13•6h day c,f September �!
19 78 by and
BETWEEN
CITY ()Y IIIJNT1N(';TOiv' BEAGIi
a i1imilripal r.orporaLinn,
licrr:itia fter for convenience
rc�fc;rrc:cl to as
1f
fy:
1(
CITY
and G. F. Goeden & Co. , Inc .
hereinafter for convenience
referred to as 5
SUBDIVIDER
• WITNESSE THr
WHEREAS, Subdivider is the owner of a tract of land in the City of
Huntington Beach, California, which it is seeking to subdivide into lots and to
dedicate certain streets, alleyb, and other improvements therein to the public
une, and is about to file with said City a map of the Tract of land known as
Tract No. 10449 and
WHEREAS, as a condition to the approval of said subdivision map and
the acceptance of the dedication of the streets, alleys, and other improvements
in said subdivision, said subdivider is required to enter into an agreement with
the City 8 of Huntington Beach to do and verform the work hereinafter specified and
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to execute and deliver to the City of Huntington Reach, bonds for the faithful
performance of said agreement and or the payment of all labor and material in
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connection therewith, as required by Sections 66499 and 66499. 3 of the Government
Codo of the State of California and Article 997 of the Huntington Beach Ordinance
Code:
NOW THEREFORE, in consideration of the promises and agreements of
the parties as herein set forth, the parties agree as followq:
1. Subdivider does hereby agree to do and perform the following work,
.the cost of which has been estimated oy► the City Engineer to be the sum of
Six _y six '.'hoiisanrl and No1100 ( $66 , 000 . 00 )•
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F or the constr%icLi6n '6f sI rCeti-, � including c xt ay.-iLinn, pnvt*nl,, curhs,
f; .tLers, sidewalks, trees, la II I sCaping', ctic . , sewers, inchtrling c6n' htruc,ti6n
of main Iiites and lot latcrah; and structures; strr.trl. lights, slrtIvI sigtes; con-
s truction Iof d0�'rrlestic water syst,vnl iitcluclliik, tlic cotestruct ion cif water nia tis
I
lot laterals and installation of nielers; esngi6verhig ::osts; aorl'any miscr. 11ar.t.-ous t+l
requirements as 'may�m1 lie set. forth in Chapter 99, �i f L i! r l l et n t i n t: t „ n
1
Meath Ordinance rode, and all of which said work haII bt; do'lle and performed in '
accordance with P I
plans, specifications and profiles w1iich h7 :ve: been approved by
.
Lhe City Engineer and filed in the office of the City l-:ngin:!er and'all of which
work shall be done at the sole cast.- and expense "of the Stabdivider .end as' a
condition for the approval cif said nt.tp aitrl the ac:cc;phitice of file dedication of
said streets, alle sand other im >rctclements, and saiel work shall ;:e completed y p
on or before two (2) years from the dale horecif. and all labor and maieri.tl bills
shall be paid.
2. Subdivi.der agrees is c•otriNlete all Arterial Highway Improvement:,,
including perimeter walls and lali sc:apinc;, }prior to release or colinbction of
utilities for occupancy for .any lot in the Trttc•t.
r
�. Subdivider shall gitaratttee all work and nictlt_rial rt:duired try
fulfill his obligation as st.lLed herein for .a period of (,tw year following the elate:
of City Council acc eptanc:u of same.
4. Said Subdivider sl)all faidihilly perform all cat the, work agreed
herein to be dune by Subdivider and sltall fully indertlnif•., and harmless the:
City of Iduntington Beach from all. cost and damage which it may suffer by.
reason of failure so Lo do Inca shall fully reimburse and rc;pay the City ail outlay
and exponse which the City may incur in malting good any such default.
5. The Subclividc-r .tl;rees to furnish to the City and maintain to
force until the completion of the work herein agreed to be done: by Subdivider,
at Subdivider 's expe•tise, a protective liability pclicy in which Lhe City is named
.as :itt additional insured. The policy shall insure the CiLy, its officers and
employees while acting within the scope of their duties, against all claims arising
out of or ill connection with the work to be performed. The policy shall provide
z
�. for not: less than the fo'llowitig Aniounta:
Connbi'ned single limit bodily injury and/or property damage
incluili'ng products liability: $l, Q00 40Q, combined single
, 4
limit 'per occurrence, + :
Such 'policy small provido'coverage at least as ))road as that provided x
in the`Standard Form approved by the Nntianll Bureau of Casualty Underwriters .
together with such endorsements as are required to c over, the risks involved.
The Subdivider shall arrange for the policies 'to be so c4onditio-ned
as to cover the performance of extra or.unforeseen work should such -.work
become necessary..
Prior to the recordation of the Final Tract t-.iap, evidence of insurance
shall be furnished in a form satisfactory to the City. In addition, the Subdivider
�. II
shall furnish evidence of a commitment by the insurance company to notify the
i
City of the expiration or cancellation of any of the insurance poV.cies required' '
hereunder not less than 30 days before each expiration or cancellation is
effective.
��. That said City shalt not, nor shalt any officer or employee there-
of, be liable or responsible for and accident, loss or damage happening or
occurring to the works specified in this contract priar to the completion and
acceptanc:u of the same, nor shall said City nor any officer or employee thereof
be liable for any .persons or property injured by reason of the nature of.said work,
but all of said liabilities shall be assumed by sa ld Subdivider. Said Subdivider
further agrees to protect said City and the officers thereof from ;,.*Li liability
or claim because of, or arising out of, the use of any .patent or patented article
in the construction of said work.
7. 'That it is further agreed that said Subdivider will at all times
from the acceptance by City Council of the highways offered for dedication in
`said tract up to the completion and acceptance of said work or improvement by
said Cuuncil, give good and adequate warning to the traveling public of each and
every dangerous condition existent in said highways or any of them, and will
protect the traveling public from such defective or da-igerous conditions. That
it is i ndersl'�iod acid �h0ecd that'untiI the comjilelicii1'o'f;.1ll°llte i'inprev :tiic�its `
tier:*in a creed to he ' erforrned .each of 'said highways no. acc(�` ted as ini iroved
b P P 1, , .
ahall'be iinder t} ar ,e of said Sub'dividbr for the
f li purpos ois contract,
and sai&Sub'divider may close all or`a` portion `of any fitreet whenever it is
,t
necessary .tc `jorotect the traveling pchl1c 'durih6 the making of the improi%crnents ;
herein agreed, to �be made. And the Subdivider"he�rchy agrees to pay for such
inspection of highways as -inay he required by the City Engineer of the City
G: FIuntin,gton 'Beach.
$. That in the event suit is brought-by "the City to enforce the terms
and prnvisioas of this Agre:eme.nt or in any bond given to secure the performance
hereof, a reasonable attorneys, fee, to he fixed by the Court, shall be paid by
4 the Subdivider.
IN WITNESS WHEREOF, the parties have executed this Agreement.
SUBDIVIDER:
By:
B Y --cz�
CITY OF HUNTINGTON BEACH,
a municipal corporation,
By: . ,
Mayo F'Ro- TAM
AP rN107",, AS TO. FOPJA
C-J,Ht 14UTTON r.
city, ttnrney
ATTEST:
/U 17
aty C ,y Attorney
ity Clerk of the ity of Huntington Beach
-4-
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STA'f')' OF C;ALIl~'Oiti`J1A
COUNTY'OF 01'i.ANGE' ) `
J
Or, this day of _, 1 ') � _, lic;fora In(:, a
Notary Public in anti tar :Itkid Gounty aril Stati:, Personally appeared
s.
):..uown to me to be the Mayor and 625�,�vv 7,0�.
known to the to be the City Clerk of the City of f iuntingtun Beach, the'municipal
corporation thatexecuted, tlie 'within instrument, known to me to be the 'persons
who '_-xe:cuted the within i.nstrurrient• on behalf of said nfiinicipal corporation an'3
acknowledged to me that such -municipal corporation executed the same.
Iilli111111 Ito 111911211111:Ir11/711 III 1111111111111111111111,
OFFICIAL SEAL M
- Nota ry public
• CONNIE A.. BROCKWAY N
`C a v`.-'w NOTARY PUBLIC•CALIFORNIA
.�•�" • ORANGE COUNT';. mar; -
`N My Commission Expires Oc1.10,19U1
Itlt11till!Uli![!1.`illltll:Ililal1111111:I[111:1iI:a:aI1
STATE OF CALIFORNIA ) ss
COUN I'Y OF ORANGE )
197jL before me, Barbara J . SteI I a r
a Notary Public, in and for said County and State, personally appeared
1
Gerald F . Goeden and BettyJo Goeden
known to me to be the President and the
`Secretary of the corporation that executed the within
jinstrument; pursuant to its by-laws or a resolution of its Board of Directors.
aotar N y Public
LO0MCML SEAL
E3AReARA J. 51�tlAR My Commission expires:
NOTARY PUBLIC- CA7LIFWAMA
:air E _I•qY July 17 , 1981
I!r c�.nr,�, �xrita 1JL 11, INI
r OMi CIAL SEAL
BARBARA J. STELLAR
NOTARY PUBLIC• CALIFOnNIA
ru.NCE c:nurmr
Nr rimai, ac,:ires 1JL 17, 19JI
j .
ottirn e:ig Ina l and throe copies of . It
amploted certificato to:
:.�; ;
CERTIFICATE OF INSURANCE
City of Huntington Buach TO .+A
t s
Oapt. ,; ,CITY OF HUNTINGTON BEACH,CALIFORNIA �
P.d.Box 190
Huniington Boach,California .92648 A MUNICIPAL CORPORATION �•
This is to certify that the policies-of1ins.,rance as described below have been issued to the insured'fay'the under-
;icgne'd and are in force at this time. If these are cancelled or changed in inch a'istanner•that"will affect this certificate, the
insurance company,agrees to give 30 days prior written notice, by mail,to City.of Huntinnton Beach, P_'O. Box 190, Huntington.
beach, California 92648.
Nantc of l G . F . GOEDEN $' CO INC .
Addressof In u UN
red 717931 BEACH BLVD SUITE G 'NTINGTON BEACH CAL
Location of Insured Operations GRAHAM ST , HUNTINGTON BEACH
Description of Operations 13 SINGLE FAMILY RESIDENCES
POLICIES IN FORCE ..NUMBER EFFECTIVE EXPIRATION LIMITS OF LIABILITY
A, Worke�.Compensation 103-26— 6--22--78 TILL . Statutory
03 WC CANCELE 290001000
Employers' Liability S _
B. Public Liability: * $1,000,000 conibinetl single.
8adil In 156$ limit per occurrence.
Y IY=
Manufacturers and $ 5_2 2_ $ UNTIL
Contractors 12 71—. CANC . * Each Person
Q$-10
Comprehensive
General X S * Each Accident
(Including products completed
operations)
Property Damage " " " $ Each Accident
C. Automobile Liability:
Bodily Injury $ * Each Person
S * Each Accident
Property Damage S * Each Accident
Does policy cover:
All-owned automobiles (X ) Yes ( )No
.Non-owned automobiles ( X ) Yes ( ) No
Hired automobiles (X ) Yes ( ) No
i
D. Additional Insfired Endorsement:
The insurer agrees that the City of Huntington Beach City Council,and/oi all City Council appoiwed groups,Committees,
commissions, boards and any other City Council appointed body, and/or elective and appointive officers, Servants or
employees of the City of Huntington Beach, wh n acting as such a ,additional assureds hereunder.
E. Hrld Harmless Agreement By Insured:
The insured agrees to protect, defend, ind nify and save harmless the City of Huntington Beach against loss,damage or
expense by reason of any suits,claims, demands,judgements and causes of action caused by insured,his employees,a,ents
or any subcontractor arising out of or in consequence of,the performance of all or any operations covered by the certificate
of insurance,and such insurance shall be jrimary to any insurance of the city.
F. Minimum Limits Required: APPROVED ;�►S TO FORM:
Combined Single Limit Bodily Injury and/or Pton,:rcy Deimage including Products Liability: �6 OF*
combined single limit per occurrem.i:.
_ City tternoy
G. Remarks: PER ET-2 ATTACHED
— / Ur.�-tity tto ey
Date ,
REPRE± NTATIVEIBRtOKU
INSURANCE COMPANY
TRUCK INSURANCE EXCHANGE BY s` j
Namp. �I u ar e n
2021 E y TH 11061
Address Address '-
SANTA ANla, CALIF. _F
City _, _Telephone
Attach to yoqLpol.lcy with tho same policy number shown on this • dorsoment
• 'j
ENDORSEMENT
1568-57-70
5-22-78 1271--08-10
Effective pale _� ----
Policy Number
� of the Company detipnated
In the Declarations
ADDITIONAL INSURED ENDORSEMENT
1
IT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THE COVC-RAGES
INDICATED BY THE CERTIFICATE OF INSURANCE ATTACHED, ALSO APPLIES,
EFFEC T TVE THE DATE SHOWN TO THE PERSON OR ORGANIZATION NAMFO ON
SAID CERTIFICATE OF .INSURANCE] AS AN ADDITIONAL INSURED BUT ONLY
WITH RESPECT TO LIABILITY OF THE ADDITIONAL INSURED ARISING OUT
OF THE ACTS AND OMISSIONS OF THE NA1,1iED INSURED. THIS EXTENSION OF
COVERAGE DOES NOT APPLY TO THE LIABILITY OF THE ADDITIONAL INSURED
ARISING EITHER WHOLLY OR PARTLY OUT OF ( 1) t I I S OR ITS OWN NEGLIGENCE,
OR THAT OF ITS AGENTS OR EMPLOYEES (EXCEPT WHERE THE MAMED INSURED
IS AN AGENT OR EMPLOYEE OF THE ADDITIONAL INSURED), OR C1) ANY DEFECT i
OF MATERIAL, DESIGN, OR VIORI".MANSHIP IN ANYTHING OF WHICH HE OR IT IS
THE OWNER, LESSOR, MANUFACTURER, MORTGAGEE, OR BENEFICIARY .
THIS ENDORSEMENT SHALL NOT OPERATE TO INCREASE THE LIMITS OF THE
COMPANY ' S LIABILITY UNDER THE POLICY .
IT IS AGREED THAT UPON CANCELLATION OR TERIMINATION OF THIS POLICY
FOR ANY CAUSE THE COMPANY 1ILL MAIL NOTICE THEREOF IN WRITING TO
SAID ADDITIONAL INSURED TO THE ADDRESS SET FORTH IN THE CERTIFICATE
OF INSURANCE ATTACHED .
Effective (not prior to time applied lot) on the effective dale shown above this endorsement, when counteisigned, becomes part of the above numbered
policy issued by the Company designalcd in the Declarations, and supersedes acid controls anything in the policy contrary hereto but is olher dse subject
to the Declarations, Insuricut Agr Tanls, Exclusio nd Coodilions theraof.
Countersign
AUTNONIYEO R PnE6ENTATIVE
e6.0002 TACT-MZ) 3•721 11331 "X--7 . e2 r~�•'
•1 7 4 a/ T. ,s 3
}` �oturnoriginal and thred'caNies of F �;' il,
pletgd certificate to: `''
"CERTIFICATE'UF INSURANCE
City,of Huntington Beach TU =
, Gept.
CITY OF HUNTINGTON BEACH, CALIFORNIA �.
P:O.Box 19t) : ,. .. .. `'#
Huntington Beach,California 92648 A MUNICIPAL CORPORATION r
This Is to certify that the policies of insurance as described below havo'been'issuod to the insured by the under- �
signed and are in force at this time:If these po"Bries are cancelled or'changed in such'a,manner that will affect this certificate, the
insurance company agrees to give 30 days prior writteri notice, by mail,`to City of Huntington Beach, P.0. Box 190, Huntington
Beach, California 92648.
Name of Insured
Address of Insured Y 7`1'. 2 F3i=/1C1i fsL.Vl Stl7 TE r HUNT C N i i. N BEACF? CAL Y
Location of Insured Operations GPA'rIAl4 aT • i"ItJl`l 1 I t16TO,,q nEACH
Description of Operations
13 ' S iGLE �~a'1 IL.Y P' liSIDENCES
POLICIES IN FORCE POLICY LIMITS OF LIABILITY
NUMBER EFFECTIVE EXPIRATION
A. 'Workers Compensation Statutory
Employers' Liability $
B. Public Liability: * $1,000,00r) combined single Ilk
15I'13- lirrsit per occurrence.
Bodily Injury- r• 7-7 0
Manufacturers'and �l 5-21--79 . UNTIL
Contractors o 1 ;?71-- CANC $ Each Person
,• ll $--I �
Comprehensive
General $ Each Accident
(Including products completed
operations)
Property Damage 5 * Each Accident
C. Auiomobile Liability:
Bodily Injury S Each Person
$ Each Accident
Property Damage $ * Each Accident
Does policy cover:
`All owned automobiles ( �` ) Yes ( ) No
Non.owned automobiles ( :f ).Yes ( ) No
Hired automobiles ( X Yes ( ) No
D. Additional Insured Endorsement:'
The insurer agrees that the City of Huntington Beach 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, servants or
employees of the City of Huntington Beach, when acting as sucit'are additional assureds hereunder.
E. Hold Harmless Agreement: By Insured.� r`'r�- ."i . l,�f >,y�.'.
.
The insured agrees to protect, defend, ind imnify and save harmless the City of Huntington Beach against loss, damage or
expense by reason'of any suits, claims,demands,judgements and causes of action caused by insured, his employees, agents
or any subco* tractor arising nut of or in consequence of the performance of all or any operations covered by the certificate
of insurance, and such insurance shall be primcry to any insurance of the city.
F. Minimum Limits Required: APPROVED AS TO FORM:
Combined Single Limit.Bodily Injury vnd/or Property Damage including Products Liability:
combined single limit per occurrence.
_ City Attorney__
G. Remarks:
Deputy-City Attorney L II
Date,
FIE
PESE
NTATIVEXf0XC� 'INSURANCE COMPANY J ,"r'.M
By
Name. I y.;� 7 rl;., !o 17 r i 41 4 "nS ;"S*<"`i f'\ r Signature of Au6sifized Reprtnentative/A
'�i'�'!'i ►. �i t,7i� i I �'a/3 i , , r '
Address Address /
City .. Telephone
Attach to your pollLy wills 11110 snm13 policy slusnbor shown on this ndorsernent
, ENDORSEMENT
'�� 15 6 S•-5�-'�U
Effective Date _ �� 2 $
Policy Number
r of IN Company designated
In the Declarations
ADDITIONAL INSURED ENDORSEMENT
IT IS .AGREED THAT SUCH INSURANCE AS.- IS AFFORDED BY THE COVERAGES
INDICATED BY THE CERTIFICATE OF INSURANCE ATTACHED, ALSO' APPLIES,
EFFECTIVE THE DATE SHOWN, TO THE PERSON OR ORGANIZATION NAMED ON
SAID CERTIFICATE OF INSURANCE, AS AN ADDITIONAL INSURED 13UT ONLY
KITH RESPECT TO LIABILITY OF THE ADDITIONAL INSURED ARISING OUT
i OF THE ACTS AND 'OMISSIONS OF T14E NAMED INSURED. THIS EXTENSION OF
COVERAGE DOES NOT APPLY TO THE LIABILITY OF THE ADDITIONAL INSURED
ARISING EITHER WHOLLY OR PARTLY OUT OF (I) HIS OR ITS OWN NEGLIGE14CEIR
OR THAT OF ITS AGENTS OR EMPLOYEES (EXCEPT WHERE THE NAMED INSURED
IS AN AGENT OR EMPLOYEE OF THE ADDITIONAL INSURED, Ott ' (2) ANY DEFECT
OF MATERIAL, DESIGN, OR WORnMANSH I P IN ANYTHING OF WHICH HE OR IT 15
THE OWNER, LESSOR, MANUFACTURER, MORTGAGEE, OR BENEFICIARY .
THIS ENDORSEMENT SHALL NOT OPERATE TO INCREASE THE LIMITS OF THE
COMPANY 'S LIABILITY UNDER THE POLICY .
IT IS AGREED THAT UPON CANCF_LLATIOW OR TERMINATION OF THIS POLICY
FOR ANY CAUSE THE COMPANY WILL MAIL NOTICE THEREOF IN WRITINa TO 1
SAID ADDITIONAL INSURED TO THE ADDRESS SET FORTH IN THE CERTIFICATE
OF INSURANCE ATTACHED.
Effective (not prior to time applied for) on the effective dale shown above this endorsement, when countersigned, become: Fart of the above numbered
policy issued by the Company designated in the Declarations, and supersedes and controls anything in the policy contrary hereto but is otherwise subject
to the Declarations, Insurjqg Agreements, E lions and Conditions thereof.
K��?ef"
Countcrsigr} .� � ��••
AUTHO IICO R£PRES£NTATivr
Oo•0002 1 ACT•ET•21 3.7e 11551 at �*
M
t y
1
• s i
�c>
"riginal and threw copies of
i.cmplated certificate to: CERTIFICATE OF INSURANCE
Y_
City of Huntington Boa.h TO
Dept Box
P. pt Box t9C? CITY OF HUNTINGTON BEACH, CALIFORNIA
0.Huntington Beach,California 9264.3 A MUNICIPAL CORPORATION
f,
This is to certify 'hat the policies of insurance as described below have been issued to the insured by the under- �
signed and are in force at this time. If'these policies are cancelled ur changed in such a manner that will affect this certificate,.the i
insurance company agrees to give 30 days prior written notice, by mail, to City of Huntington Beach, P. 0. Box 190, Huntington
Beach, California 92648.
Name of Insured C . . tr�t:f)1:1, Ct")
Address of insured I7' 1 REACii P ! VD IT,,-* r: 1V ,'!TTW. ON fW"FA4- 1 C,'s.f_ ..
Location of Insured Operation. C R AI IA1,' 5 T
Description of Operations
POLICIES IN FORCE POLICY LIMITS OF LIABILITY .
NUMBER EFFECTIVE EXPIRATION
A. Workers Compensation Statutory
Employers' Liability S
B. Public Liability: T _ * $1,000,000 combined single r
t limit per occurrence.
Bodily Injury: ';7 7►1
Manufacturers and i; 12 81 UN T I L
Contractors ;, 1 ] {_- T,AN C y S " . Each Person
Comprehensive
%'General " Etch Accident
(including products completed
operations)
Property Damage S * Fach Accident
C. Automobile Liability:
.Bodily Injury. $„�, *. Each Person
$ Each Accident
Property Damage I $ Each Accident j
Does policy cover:
All owned automobiles Yes ( ) No
Non-owned automobiles ( r� ) Ye:, ( J Na
Hired automobiles ( ,', ) Yes ( ) No
D. Additional Insured Endorsement:
The insurer agrees that the City of Huntington Beach 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, servants or
employees of the City of Huntington Beach, when acting as such are additional ass+ireds hereunder.
E. Hold Harmless Agreement: By Insured:�'`'��f
The insured agrees to protect, defend, indemnify and save harmless the City of Huntington Beach against loss,damage or
expense by reason of any suits,nlaims,demands,judger. ants and causes of action caused by insured, his employees,agents
orany subcontractor arising out of or in consequence of the.performance of all or any operations covered by the certificate
of insurance,and sus;;insurance shsil ben primary to any insurance of the city.
F. Minimum Limits Required: APPROVED AS TO FORM:
Combined Single Limit Bodily Injury. and/or Property Damage including Products Liability: .
combined single limit per occurrence. City Attorney.
G. Rmttarks:
Pr:p, F`f 2 ATTAC1'iE-i7
B
,,Deputy'City At tor,ney
Da to
I I EPRESI~NTATIVEj13ROK
INSURANCE COMPANY
By
Noma '1"R"'CK Si rrl� ,1+r. h e
sti - ,
11 Jdress Address . .�►
City ;!Avmi, hr.r , 7.,1 T 17 Telephone
1M�
'1