HomeMy WebLinkAboutHoag Memorial Hospital Presbyterian - 2021-08-03 42MOVED 6- O- l
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City of Huntington Beach
File #: 21-499 MEETING DATE: 8/3/2021
REQUEST FOR CITY COUNCIL ACTION
SUBMITTED TO: Honorable Mayor and City Council Members
SUBMITTED BY: Oliver Chi, City Manager
PREPARED BY: Chris Slama, Director of Community & Library Services
Subject:
Approve and authorize execution of a Memorandum of Understanding (MOU) and License to
Utilize Certain Space between the City of Huntington Beach and Hoag Memorial Hospital
Presbyterian, including Acceptance and Authorization of an Annual Donation of $100,000 for
Five Consecutive Years
Statement of Issue:
Hoag Memorial Hospital Presbyterian (HOAG) and the City wish to continue the long-standing
partnership between the two entities by approving a new five-year MOU for services and programs at
the Senior Center in Central Park to enhance the quality of life for Huntington Beach residents.
Financial Impact:
There is no financial impact to the General Fund. Per the terms of the MOU, HOAG will provide an
annual donation of $100,000 for sponsorship of the HOAG Health and Wellness Pavilion for five
consecutive years, for a total donation of $500,000. Upon receipt of the annual donation, funds will
be appropriated to Donation Fund 103, account 10345507.
Recommended Action:
A) Approve and authorize the Mayor and City Clerk to execute the "Memorandum of Understanding
and License to Use Certain Space Between the City of Huntington Beach and Hoag Memorial
Hospital Presbyterian;" and.
B) Accept and authorize the appropriation of the annual donation of $100,000 from HOAG as
stipulated in the Memorandum of Understanding for five consecutive years.
Alternative Action(s):
Do not approve the Memorandum of Understanding with Hoag Memorial Hospital Presbyterian and
direct staff accordingly.
Analysis:
City of Hunbngton Beach Page 1 of 2 Pnnted on 7/282021
-'e'e}2s lea 5.3,
File #: 21-499 MEETING DATE: 8/3/2021
The City of Huntington Beach began collaborating with HOAG in 1999 to provide funding for the
City's "Seniors on the Go" transportation program. In 2014, in anticipation of the new Senior Center
in Central Park opening in July 2016, HOAG donated $2,000,000 for construction of the new center
with an additional $1,775,000 for ongoing human services programs, including $500,000 for Hoag
Health and Wellness Pavilion programs and services.
HOAG now wishes to continue their five-year partnership with the City of Huntington Beach and its
senior services wellness and fitness team. The proposed MOU will provide the City with a total of
$500,000 for another five years of programs and services associated with the Hoag Health and
Wellness Pavilion.
In return, the MOU provides HOAG a fitness suite and other areas as described in the MOU, as well
as staff to assist in the development and maintenance of a comprehensive contracted array of
exercise, fitness, and wellness offerings. The City will also continue to provide prominent signage
indicating the HOAG Health and Wellness Pavilion entry area, as well as signage in the fitness
center.
Approval of the MOU will memorialize and legally bind the City and HOAG with regard to its direct
support of the Hoag Health and Wellness Pavilion for another five years.
Environmental Status:
Not applicable.
Strategic Plan Goal:
Community Engagement
Attachment(§):
1 ) Memorandum of Understanding and License to Use Certain Space Between the City of
Huntington Beach and Hoag Memorial Hospital Presbyterian
City of Huntington Beach Page 2 of 2 Printed on 712812021
ywere729 Legistar'•
MEMORANDUM OF UNDERSTANDING
AND LICENSE TO USE CERTAIN SPACE
BETWEEN THE CITY OF HUNTINGTON BEACH
AND HOAG MEMORIAL HOSPITAL 13RES13YTERIAN
THIS MGlv40RANDU\q OF UNDERSTANDING AND LICENSE TO USE CERTAIN SPACE
(this "iMOU") is made and entered into on July 1, 2021. by and between the CITY 01'
HUNfINGTON BEACI-1, a municipal corporation of the State of Califomia (hereinafter referred
to as "City"), and HOAG Memorial Hospital Presbyterian, a California corporation (hereinafter
referred to as "HOAG"). The City and HOAG are sometimes each referred to herein as a `Party '
and collectiveh, as the "Parties."
WHEREAS. beginning in 1999, the City entered into various affiliations with HOAG. with
the goal of providing life enhancing programs and services to seniors who reside in the City or
who otherwise receive services from the City; and
WHEREAS. HOAG began serving the Citizens of 1-luntington Beach as a member of the
I IBCOA Board of Directors in 2004. to enhance quality of life for Huntington Beach Seniors:
WHEREAS, HOAG made a significant impact on the community with a 3.775 million
dollar donation towards the opening of the Senior Center in Central Park in 2016: and
WHEREAS. HOAG wishes to renew an agzreement with City to maintain their level of
support to the Huntington Beach Community: and
WHEREAS. HOAG has licensed the area of the Senior Center as the HOAG Health and
Wellness Pavilion since 2016 and wishes to continue this support; and
1
NOW, TFIFRF..FORE, FIOAG and the City of Huntington Beach agree as follows:
SECTION I . TERIM & TERMINATION
This MOU will become effective on the date it is approved by the City Council and shall
be for a term of five (5) years. Either party may terminate this Memorandum of Understanding,
with or without cause, by providing 120 days written notice.
SECTION 2. OBLIGATIONS OF CITY
I. The Citv will make available to FIOAG. a fitness suite and other areas as described
below and on Exhibit A, attached hereto and incorporated herein by this reference ("Licensed
Areas"). Subject to the terms of this MOU. the City hereby licenses to HOAG, and HOAG hereby
accepts the license from the City. the Licensed Areas. In addition to HOAG's right to use and
occupy the Licensed Areas as provided by the MOU. FIOAG shall also have non-exclusive rights
to all areas and facilities outside the Licensed Areas open to public use.
2. The City agrees to provide all maintenance,janitorial services, heating, ventilation, air
conditioning, reasonable amounts of electricity and other utilities for HOAG's intended uses, water
for reasonable and normal drinking and lavatory use in connection with HOAG's intended uses
for the Licensed Areas.
3. During the term of the MOU. the City will provide staff to assist in the development
and maintenance of a comprehensive contracted array of exercise, fitness and wellness offerings.
d. The City will work with HOAG to develop an "Annual Program Plan"that supports
HOAG's stratcgic objectives, including the exclusive right to provide clinical services. and to
provide and distribute clinical information and related HOAG services at the Licensed Areas. The
parties will also work together to develop and adopt a sustainability plan that will support these
programs for the long term.
5. The City shall provide prominent signage indicating the 'HOAG Health and
Wellness Pavilion' entry area and signage in the fitness center. HOAG shall approve this signage.
6. The Cilv acknowledges and agrees that it will use the Funding exclusively for the
purposes set forth in this MOU and that the City may not use any portion of the Funding for any
other use without the prior written approval of HOAG. in particular, the Funding and services
provided by HOAG shall be used in furtherance of charitable purposes within the meaning of
501(c)(3) of the Internal Revenue Code. as amended in and response to a community need. In
particular. the City, agrees to repay any portion of the Funding which is not used for the purposes
set forth in this \IOU and accordance with the terms of this \IOU.
7. The Citv agrees to provide annual or more frequently, if requested by HOAG.
written reports to HOAG accounting for the expenditure of the Funding and the progress made to
accomplishing the purposes set forth in this MOU. including demonstration that such Funding is
being used for charitable purposes in accordance with the provisions of 501(c)(3) of the Internal
Revenue Code. as amended and in furtherance of a community need. Further. the City agrees that
the I IOAG's representatives shall have the right to inspect and make copies of all other applicable
records relating to the Citys use of the Funding. upon written request and during normal business
hours.
3
8. SECTION 3. OBLIGATIONS OF HOAG
HOAG shall provide City with the following:
• Annual Donation of S100,000.00 to the City of Fluntington Beach for sponsorship of
the HOAG Health and Wellness Pavilion for five consecutive wars.
• Annual meeting with Senior Services Staff to determine program schedule.
SECTION 4. ACCESS TO CITY MARKS AND LOGOS
HOAG shall have the right to use the official Huntington Beach City logo, surfboard logo,
and City's "Surf City Fluntington Beach" trademark with the prior written approval of' Cit 's
Director of Community and Library Services before using any of these logos or trademark, which
approval shall be at the sole discretion of the Director. Note: The surfboard logo is not the property
ofthe City. Neither logo will be used by HOAG for commercial purposes.
SECTION 5. HOLD HARMLESS
HOAG shall protect, indemnify and hold harmless City, its officers, officials, employees,
and agents from and against any and all liability, loss, damage, expenses, costs (including without
limitation. costs and fees of litigation of every nature) arising out of or in connection with
performance of this MOU or its failure to comply with any of its obligations contained in this
MOU excCpt such loss or ciantag-c which was caused by the sole negligence or willful misconduct
of City and FIOAG shall similarly require all subcontractors to waive subrogation.
SECTION 6. GENERAL LIABILITY INSURANCE
In addition to the workers' compensation insurance and HOAG covenant to indemnify
City. HOAG shall obtain and furnish to City, a policy of general public liability insurance. Said
policy shall indemnify HOAG, its officers, agents and employees, while acting within the scope
of their duties, against any and all claims arising out of or in connection Nvith this Agreement, and
shall provide coverage in not less than the following amount: combined single limit bodily injury
4
and property damage, including products/completed operations liability and blanket contractual
liability, of' $1,000,000 per occurrence. If coverage is provided under a form which includes a
designated general aggregate limit, the aggregate limit must be no less than S1.000.000. Said
police shall name City, its agents. its officers, employees and volunteers as Additional Insured,
and shall specifically provide that any other insurance coverage which may be applicable shall be
deemed excess coverage and that Foundation'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.
SECTION 7. ASSIGNING AS BR17ACFI
Neither party shall encumber, assign, or otherwise transfer this MOU, or any right or
interest in this MOU. without the express written consent of the other party. A consent by a party
to one assignment or transfer to another person shall not be deemed to be a consent to am
subsequent assigmment or transfer to another person. Any encumbrance. assignment or transfer,
without the prior written consent of' the other party, whether it be voluntary or involuntary, by
operation of law or otherwise, is void and shall. at the option of' the other party, terminate this
MOU.
SUCTION S. TERMS BINDING ON SUCCESSORS
All the terms, covenants and conditions of this MOU shall inure to the benefit of and be
binding upon the parties and their successors and assigns. The provisions of this Section shall not
be deemed as a waiver of any of the conditions against assignment hereinbefore set forth.
SECTION 9. CONFLICT OF INTEREST
A Party shall not employ an official, director, or officer or employee of'the other Party in
the work performed pursuant to this MOU. No officer, director or employee of a Party shall have
5
any financial interest in this MOU in violation of the applicable provisions of the California
Governmew Code or FIOAG's conflict of interest policy.
SECTION 10. PHOTOGRAPHY
City may grant permits to persons engaged in the production of still and motion pictures,
television programs, advertising and related activities, to take photographs and/or motion pictures
of Senior Center activities. However, consistent with good safety practices-, Cite will endeavor to
give 24-hour advance notification of such activities to HOAG.
SECTION 11. NONDISCLOSURES/PRESS RELEASES
HOAG shall consult with City prior to issuing any press releases or otherwise making any
public statements with respect to this MOU, the transactions contemplated herein, or matters
arising herefrom.
SECTION 12. CUMULATIVE REMEDIES
The remedies given to the parties in this MOU shall not be exclusive but shall be
cumulative and in addition to all remedies now or hereafter allowed by law or elsewhere provided
in this MOU.
SECTION 13. WAIVER OF BREACH
The waiver by City of any breach by HOAG of any of the provisions of this MOU,
irrespective of the length oftime for which such failure continues. shall not constitute a waiver of
such breach or a waiver of any subsequent breach by HOAG either of the same or another provision
of this MOU.
SECTION 14. FORCE MAJEURE - UNAVOIDABLE DELAYS
Should the performance of any act required by this MOU to be performed by either City
or HOAG be prevented or delayed by reason of an act of God. strike. lockout, labor troubles.
inabilitv to secure materials, restrictive governmental laws or regulations, or any other cause
6
(except financial inability) not the fault of the party required to perform the act, the time for
performance of the act will be extended for a period equivalent to the period of delay and
perlormance ol'the act during the period of delay will be excused.
SECTION 15. NOTICE
Any written notice, given under the terms of this MOU. shall be either delivered personally or
mailed, certified mail, postage prepaid, addressed to the party concerned, as hollows:
Citv HOAG
Director of Community R Library Services Director Franchise [Marketing R Communications
Cityol'Huntington Beach HOAG Memorial Hospital Presbyterian
2000 Main Street, P.O. Box 190 510 Superior Avenue. Suite 290
Fluntington Beach, CA 92648 Newport Beach, CA 92663
Phone: (714) 536-5291 direct 949/764-8452 1 fax 949/764-5820
If party desires to change the address for notices set forth herein, said party will provide
30 days advance written notice to the other party of any such change.
SECTION 16. ATTORNEY'S FEES
In the event suit is brought by either party to enforce the terms and provisions of this MOU
or to secure the performance hereof, each party shall bear its own attorneys fees. The prevailing
party shall not be entitled to recover its attorney's fees from the non-prevailing party.
SECTION 17, CONTROLLING LAW AND VENUE
The rights and liabilities of the parties, and the interpretation and construction of this MOU,
shall be determined in accordance with the laws of the State of California. Any controversy arising
out of or tinder this MOU, if' litigated, shall be adjudicated in a court of competent jurisdiction in
Orange County, California.
7
SECTION 18. SECTION TITLES
The section titles in this MOU are inserted only as a matter of convenience and for reference,
and in no way del ine, limit or describe the scope of intent of this MOU or in any sway affect this
IvIOU.
SECTION 19. TIME OF L=SSENCE
Time is of the essence with respect to all provisions of this MOU in which a definite time for
performance is specified including, but not limited to, the expiration of this MOU.
SECTION 20. SURVIVAL OF INDEMNITIES
Termination of this MOU shall not affect the right of City to enforce any and all indemnities
given or made by HOAG under this MOU. nor shall it affect any provision of this MOU that expressly
states that the provision shall survive termination thereof.
SECTION 21. NONLIABILITY OF CITY OFFICIAL. EMPLOYEES OR AGENTS
No elective or appointed City or City affiliated board, commission or member thereof, or
officer, official. employee or agent of City shall be personaliv liable to HOAG, its successors and
assigns, of am default or breach by City under this MOU or for any amount which may become due
to HOAG. its successors and assigns, under this MOU or for any obligation of City raider this MOU.
SECTION 22, MOU IN WRITING
This NIOU contains and embraces the entire agreement between the parties hereto and neither
it nor any part of it may be changed, altered. modified. limited or extended orally or by any other
agreement between the parties unless such agreement be expressed in writing. signed and
acknowledged by City and HOAG. or their successors in interest.
SECTION 23. PARTIAL INVALIDITY
Should anv provision of this MOU be held by a court of competent jurisdiction to be either
invalid, void, or unenforceable, the remaining provisions of this f`4OU shall remain in full force and
8
effect unimpaired by the holding, so long as the reasonable expectations of the parties hereto are not
materially impaired.
SECTION 24. NO TITLE INTEREST
No title interest of any kind is hereby given and HOAG shall never assert any claim or title to
Senior Center in Central Park or any other public property. Any use of Senior Center in Central Park
by HOAG is non-exclusive.
SECTION 25. ENTIRETY
The foregoing sets forth the entire agreement between the parties.
IN WITNESS WHEREOF, the parties hereto have caused this MOU to be executed by and
through their authorized officers the day, month and year first above written.
HOAG MEMORIAL HOSPITAL CITY OF HUNTINGTON BEACH, a
PRESBYTERIAN. a nonprofit public benefit munici al corporation of the State of California
corporation: %
By: Mayor
print name ATTEST:
ITS:(circle one)Chairman/President(V ice President
AND
Ch ler
By:
print name
APPROVED AS ' RM:
ITS:(circle one)Secretary/Chief Financial Officer/Asst.
Secretary—Treasurer
' tdJJCity Attorney •
INITIATED AND APPROVED:
tRI E AN AWED:
Director of Community& Library Services
Manager COUNTERPART
9
effect unimpaired by the holding, so long as the reasonable expectations of the parties hereto are not
materially impaired.
SECTION 24. NO TITLE INTEREST
No title interest of any kind is hereby given and HOAG shall never assert any claim or title to
Senior Center in Central Park or any other public property. Any use of Senior Center in Central Park
by HOAG is non-exclusive.
SECTION 25. ENTIRETY
The foregoing sets forth the entire agreement between the parties.
IN WITNESS WHEREOF, the parties hereto have caused this MOU to be executed by and
through their authorized officers the day, month and year first above written.
HOAG MEMORIAL HOSPITAL CITY OF HUNTINGTON BEACH, a
PRESBYTERIAN, a nonprofit public benefit municipal corporation of the State of California
corporation:
B Nrdrnv R _ju wml% Mayor
y' - -- y
Andrew R. Guarni CFO
print time ATTEST:
ITS:(circle one)Chairman/President/Vice Pmidcni
AND
By:
Andrew R_ Cjurriu City Clerk
--
Andrew R. Guarni CFO
APPROVED AS TO FORM:
print name
ITS:(circle one)Secretary/Chief Financial OlTicer/Assi.
Secretary I rcasurer
Jul 6,2021
ul/JCiry Attorney
INITIATED AND APPROVED:
REVIEWED AND APPROVED:
Director of Community & Library Services
City Manager COUNTERPART
9
Gonzales, Carrie
From: Martinez, Kristin
Sent: Thursday, July 8, 2021 8:44 AM
To: Gonzales, Carrie
Cc: Pesqueira, Randy;Wysocki, Ashley
Subject: FW: HOAG MOU approved by City of HB legal
Attachments: Att 1 HOAG MOU_HoagSigned.pdf
Hi Carrie,
See attached!
From:Tensfeldt, Tricia <Tricia.Tensfeldt@Hoag.org>
Sent: Wednesday,July 7, 2021 5:54 PM
To: Pesqueira, Randy <rpesqueira@surfcity-hb.org>; Martinez, Kristin <kmartinez@surfcity-hb.org>
Subject: FW: HOAG MOU approved by City of HB legal
Hello,
Please see attached approved/signed by Hoag. Please have approved/signed on your end and provide the fully executed
document for our files. Happy we are able to partner with your team on the this important work for HB seniors!
Tricia Tensfeldt
Director I Franchise Marketing & Communications
Hoag Memorial Hospital Presbyterian
510 Superior Avenue, Suite 290, Newport Beach, CA 92663
direct 949/764-8452 1 fax 949/764-5820
Tricia.Tensfeldt@hoag.orQ I www.hoag.org
1
EXHIBIT A
LICENSED AREAS
The area licensed hereunder are described as a portion of the HOAG Health and Wellness
Pavilion, located in the Senior Center in Central Park.
a. One 100 sq. ft. office within the Pavilion which will be available for HOAG or an
affiliate to provide direct care to patients. Office will be used to provide for a variety ofclinical
services from preventative care and education to health services.
b. The City will operate space within the fitness area for City contracted classes, including
dance, exercise and strength training for groups or individuals. HOAG may also use this space to
provide its own classes not in conflict with the City's classes. The Consultation spaces for
personal training or the development of individualized fitness plans will be available for
contracted trainers and HOAG service providers or affiliates of l-IOAG. Further, during the
Term, the City will provide HOAG with the first refusal to provide any other health, fitness or
wellness services that are not in conflict with City contracted classes.
c. If available, the City will make available to educators and physicians of HOAG and
HOAG's affiliates, spaces within the Center equipped with audio and visual technology to enable
state-of-the-art teaching to improve health and wellbeing for large and small groups.
d. The City acknowledges and agrees that in the provision of health care services that
employees or agents of I-IOAG Nledical Group or another affiliate of HOAG will provide such
medical services, as may be required under applicable law, and that when such services are being
provided. HOAG or its affiliates shall have exclusive use ofthe applicable portion of the
Licensed Areas.
10
_ AU
A`�D® CERTIFICATE OF LIABILITY INSURANCE OATE(M141a03r2oz11Y
D7„
THIS CERTIFICATE M ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions Of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder In list of such endorsemenl(s).
PRODUCER NANE:C Leidy Rivera
Hays Companies Inc. (909)243-8200 AIC No
4200 Contours,Sidle 4350 AODR PHCNe Essy. Yrvera@haysccmpaNes.cum
INSURERS AFFORDING COVERAGE _ NAIC0
Ontam CA 91764 INSURER A: Hoag Memorial Hospital Self-Insured Program
INSURED INSURER B: Notional Union Fire Insurance Company of Pittsburgh,Pa. 19445
Haag Memorial Hospllal Presbyterian INSURER C: Liberty Insurance Corporation 42404
One Hoag Drive INSURER 0:
PO Box 6100 INSURER E:
Newport Beach CA 9265E INSURER F:
COVERAGES CERTIFICATE NUMBER: 20-21/21-22 Master REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD
INDICATED. NOTMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALLTHE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY WAVE BEEN REDUCED BY PAID CLAMS.
LTR TYPE OFINWRANCE FMICYNUMSER MNNlDI1'1'YY MMnGO LINITS
x COMMERCMI-GENERALUABILITY EACHOCCURRENCF $ 2,000,000
— -WQXrM707fV7TFIr—
CINNW, ACE ❑OCCUR PREN.rSES Ea omu,r n eI S 2.000.000
Professional Liability-Claims Made MED Era on. , s 2.000,000
A I Rollo Dale: 10/1/1966 Hoag Memorial Self-Insured 03/02J2021 03/022022 PERSONALSAGVINamv s 2,000,000
GEN L AGGREGATE OMIT APPLIES PER: GE.VERALAGGREGATE s 2,000,000
POUCY ❑PR6 LOC PRODUCTS-COMPIOP AGO S 2,000,000
OTHER s
AUIOMOBIMI-MEILJTY C 310NF.DSINGLE LIMIT s 1,000,OCO
H eWA.nl _
ANYAUO BOOLY WSURY(Per pwam) $
B OvmED SGIEOU.ED CA5630125 03/02/2021 03/02f=2 eooav w/uRY(wrwxeml 3
AUTOS ONLY AMOS
HIRED NON AUTOSONLY AUTOS ONLY PROPERTY O S
S
UMBRELLA CIAO OCCUR EACH OCCURRENCE S
EX CLWASAIAOE AGGREGATE $
DEO I I RETENTDN S S
WORNERSCOMPENSATION PFA TH' SIR:$1,000,000
AND EMPLOYERS LIABILITY STATUTE ER
N
C ANYCEFUME142ERE EXCLUDED?
❑ NIA EVV7.6 N-445515.010 09/01/2020 09/012021 EL FAp1 ACG0EHT 3 1,000,000
MandstUMEMBER E%CLUCEDI
It To,doryhn NH) E.L DISEASE EA EMPLOYEE 3 1,000,000
OEGCRI P I ONb.OF O 1,000,0DO
YEEN:RIPIION OF OPERATIONS blow E.L DISEASE POLICYUWr s
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101,A4oltlanM Remarks SchMuN,may 0e 4nache4 If mom epeu Is MgUIree)
Cory of Huntington Beach,its officers,elected or appointed officials,employees,agents and volunteers are included as Addibanal Insured on the Insured's
General Liability and Automobile LIablOty policies,Subject to the policies terms and conditions. Waiver of Subrogation applies as respects Insureds General
Llabillry,Automobile Uablllty enolor Worters'Compensallon policy(s)where required by the written contract or agreement with the Insured,subject to Me
o01ky terms and conditions.Policies are primary and nmconbibutory.30 day notice of cancellallon. APPROVED AS TO FORM
Byc —r
CERTIFICATE HOLDER CANCELLATION 4 f QU ATTORNEY
Cm OF H
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION CATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Huntington Beach ACCORDANCE WITH THE POLICY PROVISIONS.
2000 Main St
AUTHORIVIO REPRESENTATIVE
Hunl4lgion Beach CA 9264B
(D 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD
Nays
All.Tbgothar.Certoln.
July 13, 2021
City of Huntington Beach
2000 Main St
Huntington Beach,CA 92648
Hoag Memorial Hospital Presbyterian
Professional and General Liability(including Malpractice)
Term:3/2/2021 to 3/2/2022
To Whom It May Concern,
This is to confirm that Hoag Memorial Hospital maintains General Liability through the Hoag Memorial
Hospital Self-Insured Program.
Hospital Professional Liability:The Hospital Is self-insured for$2 Million with respects to Its Hospital
Professional Liability, Including Hospital General Liability Insurance Coverage.
General Liability:The Hospital self-Insured for$2 Million with respects to it General Liability Insurance
Coverage for non-hospital operations and exposures.
Hoag Memorial Hospital Presbyterian,as a self-insured entity for Its Hospital Professional and General
Liability exposures can elect to extend Additional Insured coverage to third parties by agreement,up to
$2 Million limit.The limit is above most agreements requirements of$5oo,000 or$1,000,000.
City of Huntington Beach, Its officers,elected or appointed officials, employees,agents and volunteers
Is hereby named Additional Insured as respects General Liability;Waiver of Subrogation and Primary
and Non-Contributory apply to General Liability.
For those Hospital Professional and Hospital General Liability agreements requiring higher than$2
Million,underwriting approval will be necessary.
Please contact our office if you have any questions.
Sincerely, Q5"�
0 Jo--
Kirk Aguilera
Executive Vice President
ENDORSEMENT
This endorsement, effective 12:01 A.M. 03/02/2021 forms a part of
policy No. CA 563-01 -25 issued to HOAG MEMORIAL HOSPITAL PRESBYTERIAN
I
by NATIONAL UNION FIRE INSURANCE COMPANY OF P I TTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SCHEDULE
ADDITIONAL INSURED:
Any person or organization for whom you are contractually bound to
provide Additional Insured status but only to the extent of such
person's or organization's ) lability arising out of the use of a
covered "auto" .
1. SECTION II - LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add:
d. Any person or organization, shown in the schedule above, to whom you become obligated
to include as an additional insured under this policy, as a result of any contract or agreement
you enter into which requires you to furnish insurance to that person or organization of the
type provided by this policy, but only with respect to liability arising out of use of a covered
"auto". However, the insurance provided will not exceed the lesser of:
(1) The coverage and/or limits of this policy, or
(2) The coverage and/or limits required by said contract or agreement.
W1=-::::
Auth rued Representative or
Countersignature (in States Where
Applicable)
87950 (1O/05) Page 1 of 1
POLICY NUMBER: CA 563-01-25 COMMERCIAL AUTO
CA 00 01 10 13
BUSINESS AUTO COVERAGE FORM
Various provisions in this policy restrict coverage. SECTION I — COVERED AUTOS
Read the entire policy carefully to determine rights, Item Two of the Declarations shows the "autos"
duties and what is and is not covered. that are covered "autos" for each of your cover-
Throughout this policy the words "you" and "your" ages. The following numerical symbols describe
refer to the Named Insured shown in the Declare- the "autos" that may be covered "autos". The
tions. The words "we", "us" and "our" refer to the symbols entered next to a coverage on the
company providing this insurance. Declarations designate the only "autos" that are
Other words and phrases that appear in quotation covered "autos".
marks have special meaning. Refer to Section V — A. Description Of Covered Auto Designation
Definitions, Symbols
Symbol Description Of Covered Auto Designation Symbols
1 Any "Auto"
2 Owned "Autos" Only those "autos" you own (and for Covered Autos Liability Coverage any
Only "trailers" you don't own while attached to power units you own). This
includes those "autos" you acquire ownership of after the policy begins.
3 Owned Private Only the private passenger "autos" you own. This includes those private
Passenger passsenger "autos" you acquire ownership of after the policy begins.
"Autos" Only
q Owned "Autos" Only those "autos" you own that are not of the private passenger type (and
Other Than Pri- for Covered Autos Liability Coverage any "trailers" you don't own while
vate Passenger attached to power units you own). This includes those "autos" not of the
"Autos" Only private passenger type you acquire ownership of after the policy begins.
5 Owned "Autos" Only those "autos" you own that are required to have no-fault benefits in the.
Subject To state where they are licensed or principally garaged. This includes those
No-fault "autos" you acquire ownership of after the policy begins provided they are
required to have no-fault benefits in the state where they are licensed or
principally garaged.
6 Owned "Autos" Only those 'autos' you own that because of the law in the state where they
Subject To A are licensed or principally garaged are required to have and cannot reject
Compulsory Uninsured Motorists Coverage. This includes those "autos" you acquire
Uninsured ownership of after the policy begins provided they are subject to the same
Motorists Law state uninsured motorists requirement.
7 Soecifically Only those "autos" described in Item Three of the Declarations for which a
Described premium charge is shown (and for Covered Autos Liability Coverage any
"Autos" "trailers" you don't own while attached to any power unit described in Item
Three).
B Hired "Autos" Only those "autos" you lease, hire, rent or borrow. This does not include any
Only "auto" you lease, hire, rent or borrow from any of your "employees",
partners (if you are a partnership), members (if you are a limited liability
company) or members of their households.
9 Non-owned Only those "autos" you do not own, lease, hire, rent or borrow that are used
"Autos" Only in connection with your business. This includes "autos" owned by your
"employees", partners (if you are a partnership), members Of you are a limited
liability company) or members of their households but only while used in your
business or your personal affairs.
i
i
CA 00 01 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 11 ❑
19 Mobile Equipment Only those "autos" that are land vehicles and that would Qualify under the
Subject To definition of "mobile equipment" under this policy if they were not subject
Compulsory Or to a compulsory or financial responsibility law or other motor vehicle
Financial insurance law where they are licensed or principally garaged.
Responsibility
Or Other Motor
Vehicle Insur-
ance Law Only
B. Owned Autos You Acquire After The Polley expense" to which this insurance applies,
Begins caused by an "accident" and resulting from the
1. If Symbols 1, 2, 3, 4, 5, 6 or 19 are entered ownership, maintenance or use of covered
next to a coverage in Item Two of the Decla- "autos". However, we will only pay for the
rations, then you have coverage for "autos" "covered pollution cost or expense if there is
that you acquire of the type described for either "bodily injury" or "property damage" to
the remainder of the policy period. which this insurance applies that is caused by
the same "accident".
2. But, if Symbol 7 is entered next to a
coverage in Item Two of the Declarations, We have the right and duty to defend any
an "auto" you acquire will be a covered "insured" against a "suit" asking for such
"auto" for that coverage only if: damages or a "covered pollution cost or
expense". However, we have no duty to defend
a. We already cover all "autos" that you any "insured" against a "suit" seeking damages
own for that coverage or it replaces an for "bodily injury" or "property damage" or a
"auto" you previously owned that had "covered pollution cost or expense" to which
that coverage; and this insurance does not apply. We may
b. You tell us within 30 days after you investigate and settle any claim or "suit" as we
acquire it that you want us to cover it for consider appropriate. Our duty to defend or
that coverage. settle ends when the Covered Autos Liability
C. Certain Trailers, Mobile Equipment And Coverage Limit of Insurance has been
Temporary Substitute Autos exhausted by payment o, judgments or
settlements.
If Covered Autos Liability Coverage is provided 1. Who Is An Insured
by this Coverage Form, the following types of
vehicles are also covered "autos" for Covered The following are. "insureds":
Autos Liability Coverage: a. You for any covered "auto".
1. "Trailers" with a load capacity of 2,000 b. Anyone else while using with your
pounds or less designed primarily for travel permission a covered "auto" you own,
on public roads. hire or borrow except:
2. "Mobile equipment" while being carried or (1) The owner or anyone else from
towed by a covered "auto". whom you hire or borrow a covered
3. Any "auto" you do not own while used with "auto".
the permission of its owner as a temporary This exception does not apply if the
substitute for a covered "auto" you own covered "auto" is a "trailer" connected to
that is out of service because of its: a covered "auto" you own.
a. Breakdown; (2) Your "employee" if the covered
b. Repair; 'auto" is owned by that "employee"
c. Servicing; or a member of his or her household.
d. "Loss"; or (3) Someone using a covered "auto"
while he or she is working in a busi-
e. Destruction. ness of selling, servicing, repairing,
SECTION II — COVERED AUTOS LIABILITY parking or storing "autos" unless that
COVERAGE business is yours.
A. Coverage (4) Anyone other than your "employ-
We will pay all sums an "insured" legally must ees", partners (if you are a partner-
pay as damages because of "bodily injury" or ship), members (if you are a limited
"property damage" to which this insurance liability company) or a lessee or
applies, caused by an "accident" and resulting borrower or any of their "em-
from the ownership, maintenance or use of a ployees", while moving property to or
covered "auto". from a covered "auto".
We will also pay all sums an "insured" legally (5) A partner (if you are a partnership) or
must pay as a "covered pollution cost or a member (if you are a limited liability
Page 2 of 11 0 Insurance Services Office, Inc., 2011 CA 00 01 10 13 ❑
company) for a covered "auto" owned We will not pay anyone more than once
by him or her or a member of his or for the same elements of loss because of
her household. these extensions.
c. Anyone liable for the conduct of an B. Exclusions
"insured" described above but only to the This insurance does not apply to any of the
extent of that liability. following:
2. Coverage Extensions 1. Expected Or Intended Injury
a. Supplementary Payments "Bodily injury" or "property damage" ex-
We will pay for the "insured": petted or intended from the standpoint of
the "insured".
(1) All expenses we incur. 2. Contractual
(2) Up to $2,000 for cost of bail bonds Liability assumed under any contract or
(including bonds for related traffic agreement.
law violations) required because of an'accident" we cover. We do not have But this exclusion does not apply to liability
to furnish these bonds. for damages:
(3) The cost of bonds to release attach- a. Assumed in a contract or agreement that
marts in any "suit" against the
is an "insured contract", provided the
"insured" we defend, but only for "bodily injury" or "property damage"
bond amounts within our Limit of occurs subsequent to the execution of
Insurance. the contract or agreement; or
(4) All reasonable expenses incurred by b. That the "insured" would have in the
the "insured" at our request, in- absence of the contract or agreement.
eluding actual loss of earnings up to 3. Workers' Compensation
$250 a day because of time off from Any obligation for which the "insured" or
work. the "insured's" insurer may be held liable
(5) All court costs taxed against the under any workers' compensation, disability
"insured" in any "suit" against the benefits or unemployment compensation law
"insured" we defend. However, these or any similar law.
payments do not include attorneys' 4. Employee Indemnification And Employer's
fees or attorneys' expenses taxed Liability
against the "insured".
(6) All interest on the full amount of any "Bodily injury" to:
judgment that accrues after entry of a. An "employee" of the "insured" arising
the judgment in any "suit" against out of and in the course of:
the "insured" we defend, but our (1) Employment by the "insured"; or
duty to pay interest ends when we
have paid, offered to pay or depos- (2) Performing the duties related to the
ited in court the part of the judgment conduct of the "insured's" business;
that is within our Limit of Insurance. or
These payments will not reduce the Limit b. The spouse, child, parent, brother or
of Insurance. sister of that "employee" as a conse-
b. Out-of-state Coverage Extensions quence of Paragraph a. above.
While a covered "auto" is away from the This exclusion applies:
state where it is licensed, we will: (1) Whether the "insured" may be liable
(1) Increase the Limit of Insurance for as an employer or in any other
Covered Autos Liability Coverage to capacity; and
meet the limits specified by a (2) To any obligation to share damages
compulsory or financial responsibility with or repay someone else who
law of the jurisdiction where the must pay damages because of the
covered "auto" is being used. This injury.
extension does not apply to the limit
or limits specified by any law But this exclusion does not apply to "bodily
governing motor carriers of injury" to domestic "employees" not entitled
passengers or property. to workers' compensation benefits or to
12) Provide the minimum amounts and liability assumed by the "insured" under an
types of other coverages, such as "insured contract". For the purposes of the
no-fault, required of out-of-state vehi- Coverage Form, a domestic "employee' is a
cles by the jurisdiction where the person engaged in household or domestic
covered "auto" is being used. work performed principally in connection
with a residence premises.
CA 00 01 10 13 O Insurance Services Office, Inc., 2011 Page 3 of 11 ❑
I
S. Fellow Employee rations made at any time with respect to the
"Bodily injury" to: fitness, quality, durability or performance of
any of the items included in Paragraph a. or
a. Any fellow "employee" of the "insured" b. above.
arising out of and in the course of the Your work will be deemed completed at the I
fellow "employee's" employment or earliest of the following times:
while performing duties related to the (1)When all of the work called for in your
conduct of your business; or contract has been completed;
b. The spouse, child, parent, brother or sis- 12)When all of the work to be done at
ter of that fellow "employee" as a conse- the, site has been completed if your
quence of Paragraph a. above. contract calls for work at more than
6. Care, Custody Or Control one site; or
"Property damage" to or "covered pollution (3)When that part of the work done at a
cost or expense" involving property owned job site has been put to its intended
or transported by the "insured" or in the use by any person or organization
"insured's" care, custody or control. But this other than another contractor or sub-
exclusion does not apply to liability assumed contractor working on the same
under a sidetrack agreement. project.
7. Handling Of Property Work that may need service, maintenance,
"Bodily injury" or "property damage" re- correction, repair or replacement, but which
sulting from the handling of property: is otherwise complete, will be treated as
completed.
a. Before it is moved from the place where 11. Pollution
it is accepted by the "insured" for
movement into or onto the covered 'Bodily injury" or "property damage" arising
"auto"; or out of the actual, alleged or threatened
b. After it is moved from the covered "auto" discharge, dispersal, seepage, migration, ve-
to the place where it is finally delivered lease or escape of "pollutants":
by the "insured". a. That are, or that are contained in any
8. Movement Of Property By Mechanical property that is:
Device {1) Being transported or towed by,
"Bodily injury" or "property damage` re- handled or handled for movement
sulting from the movement of property by a into, onto or from the covered 'au-
mechanical device (other than a hand truck) to";
unless the device is attached to the covered (2) Otherwise in the course of transit by
"auto". or on behalf of the "insured"; or
9. Operations 131 Being stored, disposed of, treated or
"Bodily injury" or "property damage" arising processed in or upon the covered
out of the operation of: auto";
a. Any equipment listed in Paragraphs 6.b. b. Before the "pollutants" or any property in
and 6.c. of the definition of "mobile which the "pollutants" are contained are
equipment"; or moved from the place where they are
accepted by the "insured" for movement
b. Machinery or equipment that is on, into or onto the covered "auto"; or
attached to or part of a land vehicle that c. After the "pollutants" or any property in
would qualify under the definition of which the "pollutants" are contained are
"mobile equipment" if it were not subject moved from the covered "auto" to the
to a compulsory or financial responsibility place where they are finally delivered,
law or other motor vehicle insurance law disposed of or abandoned by the "in-
where it is licensed or principally ga- sured".
raged.
10. Completed Operations Paragraph a. above does not apply to fuels,
lubricants, fluids, exhaust gases or other
"Bodily injury" or "property damage" arising similar "pollutants" that are needed for or
out of your work after that work has been result from the normal electrical, hydraulic or
completed or abandoned. mechanical functioning of the covered "au-
In this exclusion, your work means: to" or its parts if:
a. Work or operations performed by you or (1) The "pollutants" escape, seep, mi-
on your behalf; and grate or are discharged, dispersed or
b. Materials, parts or equipment furnished in released directly from an "auto" part
connection with such work or operations. designed by its manufacturer to hold,
store, receive or dispose of such "po-
Your work includes warranties or represen-
Page 4 of 11 0 Insurance Services Office, Inc., 2011 CA 00 01 10 13❑
Ilutants"; and under this Coverage Form and any Medical
(2) The "bodily injury", "property dam- Payments Coverage endorsement, Uninsured
age" or "covered pollution cost or Motorists Coverage endorsement or Under-
expense" does not arise out of the insured Motorists Coverage endorsement at-
operation of any equipment listed in tached to this Coverage Part.
Paragraphs 6.b. and 6.c. of the SECTION III — PHYSICAL DAMAGE COVERAGE
definition of 'mobile equipment". A, Coverage
Paragraphs b. and c. above of this exclusion 1. We will pay for "loss" to a covered "auto"
do not apply to "accidents" that occur away or its equipment under:
from premises owned by or rented to an
"insured" with respect to "pollutants" not in a. Comprehensive Coverage
or upon a covered "auto" if: From any cause except:
(a) The "pollutants" or any property in (1) The covered "auto's" collision with
which the "pollutants" are contained another object; or
are upset, overturned or damaged as (2) The covered "auto's" overturn.
a result of the maintenance or use of
a covered "auto"; and b. Specified Causes Of Loss Coverage
(b) The discharge, dispersal, seepage, Caused by:
migration, release or escape of the (1) Fire, lightning or explosion;
"pollutants" is caused directly by (2) Theft;
such upset, overturn or damage.
12.War l31 Windstorm, hail or earthquake;
"Bodily injury" or "property damage" arising (4) Flood;
directly or indirectly out of: (5) Mischief of vandalism; or
a. War, including undeclared or civil war; (6) The sinking, burning, collision or
b. Warlike action by a military force, derailment of any conveyance
transporting the covered "auto'.
including action in hindering or defending
against an actual or expected attack, by c. Collision Coverage
any government, sovereign or other au- Caused by:
thority using military personnel or other
agents; or 111 The covered "auto's" collision with
another object; or
c. Insurrection, rebellion, revolution,
usurped power or action taken by gov-
ernmental authority in hindering or de- 2. Towing
fending against any of these. We will pay up to the limit shown in the
13.Racing Declarations for towing and labor costs in-
Covered "autos" while used in any profes- curred each time a covered "auto" of the
sional or organized racing or demolition con- private passenger type is disabled. However,
test or stunting activity, or while practicing the labor must be performed at the place of
for such contest or activity. This insurance disablement.
also does not apply while that covered "au- 3. Glass Breakage — Hitting A Bird Or Animal —
to" is being prepared for such a contest or Falling Objects Or Missiles
activity. It you carry Comprehensive Coverage for the
C. Limit Of Insurance damaged covered "auto", we will pay for the
Regardless of the number of covered "autos", follcwing under Comprehensive Coverage:
"insureds", premiums paid, claims made or a. Glass breakage;
vehicles involved in the "accident", the most b. "Loss" caused by hitting a bird or animal;
we will pay for the total of all damages and and
"covered pollution cost or expense" combined c. "Less" caused by falling objects or
resulting from any one "accident" is the Limit missiles. '
Of Insurance for Covered Autos Liability !
Coverage shown in the Declarations. However, you have the option of having
glass breakage caused by a covered "au-
All "bodily injury", "property damage" and to's" collision or overturn considered a
"covered pollution cost or expense" resulting "loss" under Collision Coverage.
from continuous or repeated exposure to sub-
stantially the same conditions will be consid- 4. Coverage Extensions
ered as resulting from one "accident". a. Transportation Expenses
No one will be entitled to receive duplicate We will pay up to $20 per day, to a maximum of
payments for the same. elements of "loss"
$600, for temporary
CA 00 01 10 13 0 Insurance Services Office, Inc., 2011 Page 5 of 11 ❑
transportation expense incurred by you or defending against any of these.
because of the total theft of a covered 2. We will not pay for "loss" to any covered
"auto" of the private passenger type. We "auto" while used in any professional or
will pay only for those covered "autos" organized racing or demolition contest or
for which you carry either Compre- stunting activity, or while practicing for such
hensive or Specified Causes Of Loss contest or activity. We will also not pay for
Coverage. We will pay for temporary "loss" to any covered "auto" while that
transportation expenses incurred during covered "auto" is being prepared for such a
the period beginning 48 hours after the contest or activity.
theft and ending, regardless of the
policy's expiration, when the covered 3. We will not pay for "loss" due and confined
"auto" is returned to use or we pay for to:
its "loss". a. Wear and tear, freezing, mechanical or
b. Loss Of Use Expenses electrical breakdown.
For Hired Auto Physical Damage, we will b. Blowouts, punctures or other road dam-
pay expenses for which an "insured" age to tires.
becomes legally responsible to pay for This exclusion does not apply to such 'loss"
loss of use of a vehicle rented or hired resulting from the total theft of a covered
without a driver under a written rental "auto".
contract or agreement. We will pay for
loss of use expenses if caused by: 4. We will not pay for "loss" to any of the
(1) Other than collision only if the Dec- following:
larations indicates that Compre- a. Tapes, records, discs or other similar
hensive Coverage is provided for any audio, visual or data electronic devices
covered "auto"; designed for use with audio, visual or
data electronic equipment.
Declarations indicates that Specified
(2) Specified Causes Of Loss only the b. Any device designed or used to detect Causes Of Lass Coverage is provided speed-measuring equipment, such as
or any covered "auto"; or radar or laser detectors, and any jamming
(3) Collision onlyif the Declarations apparatus intended to elude or disrupt
speed-measuring equipment.
indicates that Collision Coverage is c. Any electronic equipment, without regard
provided for any covered "auto". to whether this equipment is permanently
However, the most we will pay for any installed, that reproduces, receives or
expenses for loss of use is $20 per day, transmits audio, visual or data signals.
to a maximum of $600.
d. Any accessories used with the electronic
B. Exclusions equipment described in Paragraph c.
1. We will not pay for "loss" caused by or above.
resulting from any of the following. Such 5. Exclusions 4.c. and 4.d. do not apply to
"loss" is excluded regardless of any other equipment designed to be operated solely by
cause or event that contributes concurrently use of the power from the "auto's' electrical
or in any sequence to the "loss". system that, at the time of "loss", is:
a. Nuclear Hazard a. Permanently installed in or upon the
(1) The explosion of any weapon covered "auto";
employing atomic fission or fusion; or b. Removable from a housing unit which is
(2) Nuclear reaction or radiation, or radi- permanently installed in or upon the
oactive contamination, however covered "auto";
caused. c. An integral part of the same unit housing
b. War Or Military Action any electronic equipment described in
(1) War, including undeclared or civil Paragraphs a. and b. above; or
war; d. Necessary for the normal operation of the
(2) Warlike action by a military force, covered "auto" or the monitoring of the
including action in hindering of de- covered "auto's" operating system.
fending against an actual or expected 6. We will not pay for "loss" to a covered
attack, by any government, sovereign "auto" due to "diminution in value".
or other authority using military per- C. Limits Of Insurance
sonnel or other agents; or
(3) Insurrection, rebellion, revolution, 1. The most we will pay for:
usurped power or action taken by a. "Loss" to any one covered "auto" is the
governmental authority in hindering lesser of:
Page 6 of 11 0 Insurance Services Office, Inc., 2011 CA 00 01 10 130
(11 The actual cash value of the damaged or 2. Duties In The Event Of Accident, Claim, Suit
stolen property as of the time of the Or Loss
"loss"; or We have no duty to provide coverage under
(2)The cost of repairing or replacing the this policy unless there has been full com-
darnaged or stolen property with other plianr-e with the following duties:
property of like kind and quality. a. In the event of "accident", claim, "suit"
b. All electronic, equipment that reproduces, or "loss", you must give us or our au-
receives or transmits audio, visual or data thorized representative prompt notice of
signals in any one "lass" is $1,000, if, at the "accident" or "loss". Include:
the time of "loss", such electronic equip- (1) Now, when and where the "accident"
ment is: or "loss" occurred;
(11Permanently installed in or upon the (2) The "insured's" name and address;
covered "auto" in a housing, opening or and
other location that is not normally used (3) To the extent possible, the names
by the "auto" manufacturer for the instal- and addresses of any injured persons
lation of such equipment; and witnesses.
(2)Removable from a permanently installed b. Additionally, you and any other involved
housing unit as described in Paragraph "insured" must:
b.0) above; or (1) Assume no obligation, make no
payment or incur no expense without
(3)An integral part of such equipment as
our consent, except at the "in-
described in Paragraphs b.(1) and b.(2) seed's" own cost.
above' f2) Immediately send us Cooies of any
2. An adjustment for depreciation and physical request, demand, order, notice, sum-
condition will be made in determining actual mons or legal paper received con-
cash value in the event of a total "loss". corning the claim or "suit".
3. If a repair or replacement results in better f3) Cooperate with us in the
than like kind or quality, we will not pay for investigation or settlement of the
the amount of the betterment. claim or defense against the "suit".
D. Deductible (4) Authorize us to obtain medical
For each covered "auto", our obligation to pay records or other pertinent informa-
for, repair, return or replace damaged or stolen tion.
property will be reduced by the applicable (5) Submit to examination, at our
deductible shown in the Declarations. Any expense, by physicians of our choice,
Comprehensive Coverage deductible shown in as often as we reasonably require.
the Declarations does not apply to "loss" c. If there is "loss" to a covered "auto" or
caused by fire or lightning. its equipment, you must also do the
SECTION IV — BUSINESS AUTO CONDITIONS following:
The following conditions apply in addition to the (1) Promptly notify the police if the cov-
Common Policy Conditions: ered "auto" or any of its equipment is
A. Loss Conditions stolen.
1. Appraisal For Physical Damage Loss (2) Take all reasonable steps to protect
the covered "auto" from further
If you and we disagree an the amount of damage. Also keep a record of your
"loss", either may demand an appraisal of expenses for consideration in the
the "loss". In this event, each party will settlement of the claim.
select a competent appraiser. The two ap- (3) Permit us to inspect the covered
praisers will select a competent and impartial "auto" and records proving the "loss"
umpire. The appraisers will state separately before its repair or disposition.
the actual cash value and amount of "lass".
If they fail to agree, they will submit their (4) Agree to examinations under oath at
differences to the umpire. A decision agreed our request and give us a signed
to by any two will be binding. Each party statement of your answers.
will: 3. Legal Action Against Us
a. Pay its chosen appraiser; and No one may bring a legal action against us
b. Bear the other expenses of the appraisal under this Coverage Form until:
and umpire equally. a. There has been full compliance with all the
If we submit to an appraisal, we will still terms of this Coverage Form; and
retain cur right to deny the claim.
CA 00 01 10 13 0 Insurance Services Office, Inc., 2011 Page 7 of 11 0
b. Under Covered Autos Liability Coverage, person or organization holding, storing or
we agree in writing that the "insured" transporting property for a fee regardless of
has an obligation to pay or until the any other provision of this Coverage Form.
amount of that obligation has finally been 5. Other Insurance
determined by judgment after trial. No
one has the right under this policy to a. For any covered "auto" you own, this
bring us into an action to determine the Coverage Form provides primary insur-
"insured's" liability. ance. For any covered "auto" you don't
own, the insurance provided by this Cov-
4. Loss Payment — Physical Damage Coverages
erage Form is excess over any other
At our option, we may: collectible insurance. However, while a
a. Pay for, repair or replace damaged or covered "auto" which is a "trailer" is
stolen property; connected to another vehicle, the
Covered Autos Liability Coverage this
b. Return the stolen property, at our ex-
Coverage Form provides for the "trailer"
pense. We will pay for any damage that is:
results to the "auto" from the theft; or
c. Take all or any part of the damaged or 11} motor m while it is connected to a
stolen property at an agreed or appraised motor vehicle you do not awn; or
value. (2) Primary while it is connected to a
If we pay for the "loss", our payment will covered "auto" you own,
include the applicable sales tax for the b. For Hired Auto Physical Damage
damaged or stolen property. Coverage, any covered "auto' you lease,
hire, rent or borrow is deemed to be a
5. Transfer Of Rights Of Recovery Against
Others To Us covered "auto' you own. However, any
"auto" that is leased, hired, rented or
If any person or organization to or for whom borrowed with a driver is not a covered
we make payment under this Coverage Form "auto".
has rights to recover damages from another, c. Regardless of the provisions of Paragraph
those rights are transferred to us. That a. above, this Coverage Form's Covered
person or organization must do everything Autos Liability Coverage is primary for
necessary to secure our rights and must do any liability assumed under an "insured
nothing after "accident" or "loss" to impair contract".
them.
B. General Conditions d. When this Coverage Form and any other
Coverage Form or policy covers on the
1. Bankruptcy same basis, either excess or primary, we
Bankruptcy or insolvency of the "insured" or will pay only our share. Our share is the
the "insured's" estate will net relieve us of proportion that the Limit of Insurance of
any obligations under this Coverage Form. our Coverage Form bears to the total of
the limits of all the Coverage Forms and
2. Concealment, Misrepresentation Or Fraud policies covering on the same basis.
This Coverage Form is void in any case of 6. Premium Audit
fraud by you at any time as it relates to this
Coverage Form. It is also void if you or any a. The estimated premium for this Coverage
other "insured", at any time, intentionally Form is based on the exposures you told
conceals or misrepresents a material fact us you would have when this policy
concerning; began. We will compute the final Are-
a. This Coverage Form; mium due when we determine your
b. The covered "auto"; actual exposures. The estimated total
premium will be credited against the final
c. Your interest in the covered "auto"; or premium due and the first Named Insured
d. A claim under this Coverage Farm. will be billed for the balance, if any. The
3. Liberalization due date for the final premium or
If we revise this Coverage Form to provide retrospective preinium is the date shown
more coverage without additional premium as the due date on the bill. If the
charge, your policy will automatically pro- estimated total premium exceeds the final
vide the additional coverage as of the day premium due, the first Named Insured
the revision is effective in your state. will get a refund.
4. No Benefit To Bailee — Physical Damage b. If this policy is issued for more than one year,
Coverages the premium for this Coverage Form will be
We will not recognize any assignment or computed annually based on our rates or premiums
grant any coverage for the benefit of any in effect at the
Page 8 of 11 0 Insurance Services Office, Inc., 2011 CA 00 01 10 13 0
7. Policy Period, Coverage Territory resulting from any of these.
Under this Coverage Form, we cover D. "Covered pollution cost or expense" means any
"accidents" and "losses" occurring: cost or expense arising out of:
a. During the policy period shown in the 1. Any request, demand, order or statutory or
Declarations; and regulatory requirement that any "insured" or
b. Within the coverage territory. others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
The coverage territory is: any way respond to, or assess the effects
(1) The United States of America; of, "pollutants"; or
(2)The territories and possessions of the 2. Any claim or "suit" by or on behalf of a
United States of America; governmental authority for damages because
of testing for, monitoring, cleaning up,
13) Puerto Rico; removing, containing, treating, detoxifying
(4) Canada; and or neutralizing, or in any way responding to,
(5)Anywhere in the world if a covered or assessing the effects of, "pollutants".
"auto" of the private passenger type "Covered pollution cost or expense" does not
is leased, hired, rented or borrowed include any cost or expense arising out of the
without a driver for e period of 30 actual, alleged or threatened discharge, disper-
sal, seepage, migration, release or escape of
days or less, "pollutants":
provided that the "insured's" responsibility a. That are, or that are contained in any
to pay damages is determined in a "suit" on property that is:
the merits, in the United States of America, (1) Being transported or towed by,
the territories and possessions of the United handled or handled for movement
States of America, Puerto Rico or Canada, into, onto or from the covered "au-
or in a settlement we agree to. to";
We also cover "loss" to, or "accidents" 12) Otherwise in the course of transit by
involving, a covered "auto" while being or on behalf of the "Insured"; or
transported between any of these places. (3) Being stored, disposed of, treated or
8. Two Or More Coverage Forms Or Policies processed in or upon the covered
Issued By Us 11 auto";
If this Coverage Form and any other b. Before the "pollutants" or any property in
Coverage Form or policy issued to you by us which the "pollutants" are contained are
or any company affiliated with us applies to moved from the place where they are
accepted by the "insured" for movement
the some "accident", the aggregate into or onto the covered "auto"; or
maximum Limit of Insurance under all the
Coverage Forms or policies shall not exceed c. After the "pollutants" or any prooerty in
the highest applicable Limit of Insurance which the "pollutants" are contained are
under any one Coverage Form or policy. This moved from the covered "auto" to the
condition does not apply to any Coverage place where thoy are finally delivered,
Form or policy issued by us or an affiliated disposed of or abandoned by the
company specifically to apply as excess "insured".
insurance over this Coverage Form. Paragraph a. above does not apply to fuels,
SECTION V — DEFINITIONS lubricants, fluids, exhaust gases or other
A. "Accident" includes continuous or repeated similar "pollutants" that are needed for or
exposure to the same conditions resulting in result from the normal electrical, hydraulic or
"bodilyinjury" or "property dame a". mechanical functioning of the covered "au-
to" or its parts, if:
B. "Auto" means: 11) The "pollutants" escape, seep, mig-
1. A land motor vehicle, "trailer" or semitrailer rate or are discharged, dispersed or
designed for travel on public roads; or
released directly from an "auto" part
2. Any other land vehicle that is subject to a designed by its manufacturer to held,
compulsory or financial responsibility law or store, receive or dispose of such
other motor vehicle insurance law where it is "pollutants"; and
licensed or principally garaged.
However, "auto" does not include "mobile (2)The "bodily injury", "property dam-
equipment". age" or "covered pollution cost or
C. "Bodily injury" means bodily injury, sickness or expense" does not arise out of the
disease sustained by a person, including death operation of any equipment listed in
CA 00 01 10 13 0 Insurance Services Office, Inc., 2011 Page 9 of 11 ❑
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Paragraph 6.b. or 6.c. of the defini- injury" or "property darnage" arising out
tion of "mobile equipment". of construction or demolition operations,
Paragraphs b. and c, above do not apply to within 50 feet of any railroad prooerty
"accidents" that occur away from premises and affecting any railroad bridge or
owned by or rented to an "insured" with trestle, tracks, roadbeds, tunnel,
respect to "pollutants" not in or upon a underpass or crossing;
covered "auto" if: b. That pertains to the loan, lease or rental
fa) The "pollutants" or any property in of an "auto" to you or any of your "em-
which the "pollutants" are contained ployees", if the 'auto" is loaned, leased
are upset, overturned or damaged as or rented with a driver; or
a result of the maintenance or use of c. That holds a person or organization
a covered "auto"; and engaged in the business of transporting
(b) The discharge, dispersal, seepage, property by "auto" for hire harmless for
migration, release or escape of the your use of a covered auto" over a
"pollutants" is caused directly by route or territory that person or organ-
such upset, overturn or damage. ization is authorized to serve by public
authority.
perceived loss
E. "Diminution in market value or resale value value" means the actual or I. "Leased worker" means a person leased to you
which results from a direct and accidental by a labor leasing firm under an agreement
"loss". between you and the labor leasing firm to
perform duties related to the conduct of your
F. "Employee" includes a "leased worker". "Em- business. "Leased worker" does not include a
ployee" does not include a "temporary worker". "temporary worker".
G. "Insured" means any person or organization J. "Loss" means direct and accidental loss or
qualifying as an insured in the Who Is An In- damage.
sured provision of the applicable coverage.
Except with respect to the Limit of Insurance, K. "Mobile equipment" means any of the following
the coverage afforded applies separately to types of land vehicles, including any attached
each insured who is seeking coverage or machinery or equipment:
against whom a claim or "suit" is brought. 1. Bulldozers, farm machinery, forklifts and
H. "Insured contract" means: other vehicles designed for use principally
1. A lease of premises; off public roads;
2. Vehicles maintained for use solely on or next
2. A sidetrack agreement; to premises you own or rent;
3. Any easement or license agreement. except 3. Vehicles that travel on crawler treads;
in connection with construction or dem-
olition operations on or within 50 feet of a 4. Vehicles, whether self-propelled or not,
railroad; maintained primarily to provide mobility to
4. An obligation, as required by ordinance, to Permanently mounted:
indemnify a municipality, except in connec- a. Power cranes, shovels, loaders, diggers
tion with work for a municipality; or drills; or
5. That part of any other contract or agreement b. Road construction or resurfacing equip-
pertaining to your business (including an ment such as graders, scrapers or rollers;
indemnification of a municipality in connection 5. Vehicles not described in Paragraph 1., 2.,
with work performed for a municipality) under 3. or 4. above that are not self-propelled and
which you assume the tort liability of another to are maintained primarily to provide mobility
pay for "bodily injury" or "property damage" to to permanently attached equipment of the
a third party or organization. Tort liability means following types:
a liability that would be imposed by law in the
absence of any contract or agreement; or a. Air compressors, pumps and generators,
6. That part of any contract or agreement entered including spraying, welding, building
into, as part of your business, pertaining to the cleaning, geophysical exploration, lighting
rental or lease, by you or any of your and well-servicing equipment; or
"employees", of any "auto". However, such b. Cherry pickers and similar devices used
contract or agreement shall not be considered to raise or lower workers; or
an "insured contract" to the extent that it 6. Vehicles not described in Paragraph 1., 2.,
obligates you or any of your "employees" to 3. or 4. above maintained primarily for pur-
pay for "property damage" to any "auto" rented poses other than the transportation of per-
or leased by you or any of your "employees
sons or cargo. However, self-propelled
An "insured contract" does not include that Part vehicles with the following types of
Of any contract or agreement: permanently attached equipment are not
a. That indemnifies a railroad for "bodily
Page 10 of 11 0 Insurance Services Office, Inc., 201 1 CA 00 01 10 13 G
"mobile equipment" but will be considered be recycled, reconditioned or reclaimed.
"autos": M. "Property damage' means damage to or loss of
a. Equipment designed primarily for: use of tangible property.
(1)Snow removal; N. "Suit" means a civil proceeding in which:
(2)Road maintenance, but not construc- 1. Damages because of "bodily injury" or
tion or resurfacing; or "property damage"; or
(3)Street cleaning; 2. A "covered pollution cost or expense";
b. Cherry pickers and similar devices to which this insurance applies, are alleged.
mounted on automobile or truck chassis "Suit" includes:
and used to raise or lower workers; and
a. An arbitration proceeding in which such
c. Air compressors, pumps and generators, es or damages "covered
including spraying, welding, building 9 pollution costs or
expenses" are claimed and to which the
cleaning, geophysical exploration, lighting
or well-servicing equipment. "insured" must submit or does submit
with our consent; or
However, "mobile equipment" does not include b. Any other alternative dispute resolution
land vehicles that are subject to a compulsory proceeding in which such damages or
or financial responsibility law or other motor "covered pollution costs or expenses" are
vehicle insurance law where it is licensed or claimed and to which the insured submits
principally garaged. Land vehicles subject to a with our consent.
compulsory or financial responsibility law or
other motor vehicle insurance law are consid- O. "Temporary worker" means a person who is
ered "autos". furnished to you to substitute for a permanent
"employee" on leave or to meet seasonal or
L. "Pollutants" means any solid, liquid, gaseous or short-term workload conditions.
thermal irritant or contaminant, including
smoke, vapor, soot, fumes, acids, alkalis, che- P. "Trailer" includes semitrailer.
micals andwaste. Waste includes materials to
CA 00 01 10 13 0 Insurance Services Office, Inc., 2011 Page 11 of 11 0
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ENDORSEMENT
This endorsement, effective 12:01 A.M. 03/02/2021 forms a part of
policy No. CA 563-01-25 Issued to HOAG MEMORIAL HOSPITAL PRESBYTERIAN
by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. j
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US j
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
Section IV - Business Auto Conditions, A. - Loss Conditions, 5. - Transfer of Rights of Recovery
Against Others to Us, is amended to add:
However, we will waive any right of recover we have against any person or organization with wham you have
entered into a contract or agreement because of payments we make under this Coverage Form arising out of
an 'accident" or"loss" if:
(1) The "accident' or "loss" Is due to operations undertaken In accordance with the contract existing
between you and such person or organization; and
(2) The contract or agreement was entered into prior to any "accident' or "loss".
No waiver of the right of recovery will directly or Indirectly apply to your employees or employees of the i
person or organization, and we reserve our rights or lien to be reimbursed from any recovery funds obtained
by any injured employee,
i
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/ /AUTl4ORIZED REPRESENTATIVE
62897 (6/95)
j
EXCESS INSURANCE POLICY FOR SELF INSURER OF
WORKERS COMPENSATION AND EMPLOYERS LIABILITY
WAIVER OF SUBROGATION - RECOVERY FROM OTHERS
We have the right to recover any payments which we have made to you from anyone liable for such loss. We will
not enforce our right against the person or organization named in the Schedule.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
Where required by contract or written agreement prior to loss
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Issued by Liberty Insurance Corporation
For attachment to Policy No.EW7-64N-445515-010 Effective Date Premium $
Issued to
GPO 4249 Page 1 of 1
Ed. 01/0111 9 9 2
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City of Huntington Beach
2000 Main Street ♦ Huntington Beach, CA 92648
(714) 536-5227 ♦ �NryNlv.huntingtonbeachca.gov
Office of the City Clerk
Robin Estanislau, City Clerk
August 9, 2021
Director Franchise Marketing & Communications
HOAG Memorial Hospital Presbyterian
510 Superior Avenue, Suite 290
Newport Beach, CA 92663
To Whom It May Concern:
Enclosed is a fully executed copy of the "Memorandum of Understanding and License
to Use Certain Space between the City of Huntington Beach and Hoag Memorial
Hospital Presbyterian" approved by the Huntington Beach City Council on August 3,
2021.
Sincerely,
Robin Estanislau, CMC
City Clerk
RE:ds
Enclosure
Sister Cities: Anjo, Japan . Waitakere, New Zealand