The URL can be used to link to this page

Home My WebLink AboutKings Auto Body Shop, Inc. - 2022-11-01 SERVICE AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH AND KINGS AUTO BODY SHOP,INC. FOR FLEET VEHICLE REPAIR & MAINTENANCE THIS AGREEMENT("Agreement") is made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter called"City," and King's Auto Body Shop, Inc., a California Corporation, hereinafter referred to as "Contractor." Recitals A. The City desires to retain a Contractor having special skill and knowledge in the field of fleet vehicle repair and maintenance services. B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a comparable company or firm in the field. Contractor has been selected to perform these services pursuant to Huntington Beach Municipal Code Chapter 3.02. NOW, THEREFORE, it is agreed by City and Contractor as follows: 1. Scope of Services Contractor shall provide all services as described in Exhibit"A,"which is attached hereto and incorporated into this Agreement by this reference. These services shall sometimes hereinafter be referred to as the"Project." Contractor hereby designates Ayed Alnajjar, who shall represent it and be its sole contact and agent in all consultations with City during the performance of this Agreement. 2. City Staff Assistance City shall assign a staff coordinator to work directly with Contractor in the performance of this Agreement. 22-12006/294519 l 3. Compensation a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit"B." The total sum to be expended under this Agreement, shall not exceed Three Hundred Thousand Dollars($300,000.00) per year for any one year during the term of this Agreement. Additional services required by other divisions and/or departments shall not count towards the Public Works Maintenance Operations annual not to exceed amount. b. Payment by City shall be made within thirty(30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. c. Contractor shall be paid pursuant to the terms of Exhibit"B." 4. Term Time is of the essence of this Agreement. The services of Contractor are to commence November 1, 2022, or as soon as practicable after the execution of this Agreement by City (the "Commencement Date") and terminate five (5) years from Commencement Date, unless terminated earlier in accordance with the provisions of this Agreement. Contract may be extended for 2 additional two-year periods if mutually agreed to in writing by both parties. The time for performance of the tasks identified in Exhibit"A" are generally to be shown in Exhibit"A." This schedule and Term may be amended to benefit the Project if mutually agreed to in writing by City and Contractor. In the event the Commencement Date precedes the Effective Date, Contractor shall be bound by all terms and conditions as provided herein. 5. Extra Work In the event City requires additional services not included in Exhibit "A"or changes in the scope of services described in Exhibit"A," Contractor will undertake such work only after receiving written authorization from City. Additional compensation for such extra work shall be allowed only if the prior written approval of City is obtained. 6. Disposition of Plans,Estimates and Other Documents Contractor agrees that title to all materials prepared hereunder, including, without limitation, all original drawings, designs, reports, both field and office notices, calculations,computer code, language, date or programs, maps, memoranda, letters and other documents, shall belong to City, and Contractor shall turn these materials over to City upon expiration or termination of this Agreement or upon Project completion, whichever shall occur first. These materials may be used by City as it sees fit. 22-12006/294519 2 7. Hold Harmless Contractor hereby agrees to protect, defend, indemnify and hold harmless City, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all claims, damages, losses, expenses,judgments, demands and defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to Contractor's employees and damage to Contractor's property, arising directly or indirectly out of the obligations or operations herein undertaken by Contractor, caused in whole or in part by any negligent act or omission of the Contractor, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the City. Contractor will conduct all defense at its sole cost and expense and City shall approve selection of Contractor's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by Contractor. 8. Workers Compensation Insurance Pursuant to California Labor Code Section 1861, Contractor acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; Contractor covenants that it will comply with such provisions prior to commencing performance of the work hereunder. Contractor shall obtain and furnish to City workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. Contractor shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. Contractor shall furnish to City a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and Contractor shall similarly require all subcontractors to waive subrogation. 9. General Liability Insurance In addition to the workers' compensation and employer's liability insurance and Contractor's covenant to defend, hold harmless and indemnify City, Contractor shall obtain and furnish to City, a policy of general public liability insurance, including motor vehicle coverage covering the Project/Service. This policy shall indemnify Contractor, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out of or in connection with the Project/Service, and shall provide coverage in not less than the following amount: combined single limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, 22-12006/294519 3 the aggregate limit must be no less than One Million Dollars ($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 One Million Dollars ($1,000,000)for this Project/Service. This policy shall name City, its officers, elected or appointed officials, employees, agents, and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the Project/Service shall be deemed excess coverage and that Contractor's insurance shall be primary. Under no circumstances shall said above-mentioned insurance contain a self- insured retention, or a"deductible" or any other similar form of limitation on the required coverage. 10. Automobile Liability Insurance Contractor shall obtain and furnish to City an automotive liability insurance policy covering the work performed by it hereunder. This policy shall provide coverage for Contractor's automotive liability in an amount not less than One Million Dollars ($1,000,000.00)per occurrence and a separate"Additional Insured Endorsement"page listing both the policy number and naming the"City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers" as additional insured on the endorsement. The above-mentioned insurance shall not contain a self-insured retention, "deductible" or any similar form of limitation on the required coverage except with the express written consent of City. 11. Certificate of Insurance Prior to commencing performance of the work hereunder, Contractor shall furnish to City a certificate of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverage as required by this Agreement; the certificate shall: a. provide the name and policy number of each carrier and policy; b. state that the policy is currently in force; and c. promise that such policy shall not be suspended, voided or canceled by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice; however, ten (10) days' prior written notice in the event of cancellation for nonpayment of premium. Contractor shall maintain the foregoing insurance coverage in force until the work under this Agreement is fully completed and accepted by City. This requirement for carrying the foregoing insurance coverage shall not derogate from Contractor's defense,hold harmless and indemnification obligations as set forth in this Agreement. City or its representative shall at all times have the right to demand the original or a copy of the policy of insurance. Contractor shall pay, in a prompt and timely manner, the premiums on the insurance hereinabove required. 22-12006/294519 4 12. Independent Contractor Contractor is, and shall be, acting at all times in the performance of this Agreement as an independent contractor herein and not as an employee of City. Contractor shall secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for Contractor and its officers, agents and employees and all business licenses, if any, in connection with the Project and/or the services to be performed hereunder. 13. Conflict of Interest Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 14. Termination This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment,the Director may require Contractor to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor consents the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 15. Exclusivity and Amendment This Agreement represents the complete and exclusive statement between the City and Contractor, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Contractor. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to,the terms and conditions hereof, shall not bind or obligate Contractor or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein, 22-12006/294519 5 16. Assignment Inasmuch as to this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Contractors retained by City. 17. City Employees and Officials Contractor shall employ no City official nor any regular City employee in the work performed pursuant to this Agreement. No officer or employee of City shall have any financial interest in this Agreement in violation of the applicable provisions of the California Government Code. 18. Notices Any notices, certificates, or other communications hereunder shall be given either by personal delivery to Contractor's agent (as designated in Section 1 hereinabove) or to City as the situation shall warrant, or by enclosing the same in a sealed envelope,postage prepaid, and depositing the same in the United States Postal Service, to the addresses below. City and Contractor may designate different addresses to which subsequent notices, certificates or other communications will be sent by notifying the other party via personal delivery, a reputable overnight carrier or U.S. certified U.S. certified mail-return receipt requested: To City: Contractor: City of Huntington Beach Kings Auto Body Shop, Inc. Attn: Director of Public Works Attn: Ayed Alnajjar 2000 Main Street 5402 System Drive Huntington Beach, CA 92648 Huntington Beach, CA 92649 19. Consent When City's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be a consent/approval to any subsequent occurrence of the same or any other transactions or event. 20. Modification No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties. 22-12006/294519 6 21. Section Headings The titles, captions, section, paragraph and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of matters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 22. Interpretation of this Agreement The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement,the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 23. Duplicate Original The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 24. Immigration Contractor shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the United States Code regarding employment verification. 25. Legal Services Subcontracting Prohibited Contractor and City agree that City is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. Contractor understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for City; 22-12006/294519 7 and City shall not be liable for payment of any legal services expenses incurred by Contractor. 26. Confidentiality Contractor recognizes that in the performance of its duties under this Agreement, it must conduct its activities in a manner designed to protect information of a sensitive nature from improper use or disclosure. Contractor warrants that it will use reasonable efforts consistent with practices customary in the facilities management industry in recruiting,training and supervising employees and in otherwise performing its duties hereunder in order to achieve this result. In the furtherance of this, Contractor agrees, at the request of the City, to require its employees to execute written undertakings to comply with the foregoing confidentiality provision. 27. Discrimination Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 28. Jurisdiction—Venue This Agreement and all questions relating to its validity, interpretation, performance, and enforcement shall be government and construed in accordance with the laws of the State of California. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 29. Professional Licenses Contractor shall, through the term of this Agreement, maintain all necessary licenses, permits, approvals,waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Huntington Beach and all other governmental agencies. Contractor shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 22-12006/294519 8 30. Attorney's Fees In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees, such that the prevailing party shall not be entitled to recover its attorney's fees from the non-prevailing party. 31. Survival Terms and conditions of this Agreement,which by their sense and context survive the expiration or termination of this Agreement, shall so survive. 32. Governing Law This Agreement shall be governed and construed in accordance with the laws of the State of California. 33. Signatories Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully for any injuries or damages to City in the event that such authority or power is not, in fact,held by the signatory or is withdrawn. 34. Entirety (a) The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiation, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise,have been made by that party or anyone acting on that party's behalf,which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement warranty, fact or circumstance not expressly set forth in this Agreement. (b) All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 22-12006/294519 9 35. Effective Date IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers. This Agreement shall be effective on the date of its approval by the Mayor. This Agreement shall expire when terminated as provided herein. CONTRACTOR CITY OF HUNTINGTON BEACH, a KINGS AUTO BODY SHOP, INC. municipal corporation of the State of California I* • Mayor dieci dhe Pr t name QM'u4J& ITScircleonChairm. 'residen Vice President City Clerk *24' AND By: INITIA D AND APPROVED: Print name ITS: (circle one) Secretary/Chief Financial Officer/Asst. Secretary-Treasurer Director of Public W s APPROVED AS TO F RM: City Attorney VIE D AND APPROVED: City anager 22-12006/294519 10 EXHIBIT "A" A. STATEMENT OF WORK: (Narrative of work to be performed) Vehicle Repair and Maintenance Services as well as Shop/Equipment Installation, Repair and Maintenance Services. B. CONSULTANT'S DUTIES AND RESPONSIBILITIES: A. Vehicle Repair and Maintenance Services 1. Body collision repair services (brakes, engine,frame, suspension, etc.) 2. CNG vehicle tank inspections 3. Diagnosis 4. Dent and Bodywork 5. Glass Replacement 6. Transmission 7. Warranty inspections and repairs 8. Window Tint 9. Wheel alignment B. Shop /Equipment Installation, Repair and Maintenance Services 1. Shop equipment services (hose reels/shop machinery installation, repair and maintenance, etc.) 2. In-ground and above-ground vehicle lift installation, repair and maintenance 3. Materials removal (waste oil,waste coolant, filters, etc.) 4. Overhead crane installation, repair and maintenance 5. Uniform service 22-12006/294519 11 EXHIBIT "B" Payment Schedule (Hourly Payment) A. Hourly Rate CONSULTANT'S fees for such services shall be based upon the following hourly rate and cost schedule: "SEE ATTACHED EXHIBIT B" B. Travel Charges for time during travel are not reimbursable. C. Billing 1. All billing shall be done monthly in fifteen (15) minute increments and matched to an appropriate breakdown of the time that was taken to perform that work and who performed it. 2. Each month's bill should include a total to date. That total should provide, at a glance,the total fees and costs incurred to date for the project. 3. A copy of memoranda, letters, reports, calculations and other documentation prepared by CONSULTANT may be required to be submitted to CITY to demonstrate progress toward completion of tasks. In the event CITY rejects or has comments on any such product, CITY shall identify specific requirements for satisfactory completion. 4. CONSULTANT shall submit to CITY an invoice for each monthly payment due. Such invoice shall: A) Reference this Agreement; B) Describe the services performed; C) Show the total amount of the payment due; D) Include a certification by a principal member of CONSULTANT's firm that the work has been performed in accordance with the provisions of this Agreement; and E) For all payments include an estimate of the percentage of work completed. Upon submission of any such invoice, if CITY is satisfied that CONSULTANT is making satisfactory progress toward completion of tasks in accordance with this Agreement, CITY shall approve the invoice, in which event payment shall be made within thirty (30) days of receipt of the invoice by CITY. Such approval shall not be unreasonably withheld. If CITY does not approve an invoice, CITY shall notify CONSULTANT in writing of the reasons for non-approval and the schedule of performance set 22-12006/294519 12 forth in Exhibit "A" may at the option of CITY be suspended until the parties agree that past performance by CONSULTANT is in, or has been brought into compliance, or until this Agreement has expired or is terminated as provided herein. 5. Any billings for extra work or additional services authorized in advance and in writing by CITY shall be invoiced separately to CITY. Such invoice shall contain all of the information required above, and in addition shall list the hours expended and hourly rate charged for such time. Such invoices shall be approved by CITY if the work performed is in accordance with the extra work or additional services requested, and if CITY is satisfied that the statement of hours worked and costs incurred is accurate. Such approval shall not be unreasonably withheld. Any dispute between the parties concerning payment of such an invoice shall be treated as separate and apart from the ongoing performance of the remainder of this Agreement. 22-12006/294519 13 EXHIBIT B 0 Kings Auto Body Shop Rates DATE ITEM Bodywork $60/hour Paint $60/hour Paint Material $48/hour Frame $85/hour Mechanical $120/hour Electrical $120/hour ACORDTu CERTIFICATE OF LIABILITY INSURANCE 10 TE(MWDD//YYY) 6-2022 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Nhuy Insurance and financial agency LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2871 Mauricia Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Santa Clara,CA 95051 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Nationwide KINGS AUTO BODY INSURER B: ALNAJJAR,AYED-INDIVIDUAL Malting Address:5402 SYSTEM DR INSURER C: HUNTINGTON BEACH,CA INSURER D: 92649-1501 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. HER AOD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS 1TR NSRI?� TYPE OF INSURANCE DATEIMWDD/KY1 DATEIMM/DD/YYl GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Eaoccurence) $ 300,000 CLAIMS MADE OCCUR MED EXP(Anyone person) $ 5,000 ACP BPA 3039195813 2-11-2022 2-11-2023 PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GENt AGGREGATE LIMIT APPUES PER: PRODUCTS-COMP/OP AGG S 2,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accldenl) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) APP1OVED S TO FORM PROPERTY DAMAGE (Per accident) By; GARAGE LIABILITY M AEL E G g AUTO ONLY•EA ACCIDENT $ ANY AUTO CITY ATTORNEY OTHER THAN EA ACC $ CITY OF HUNTINGTON 6EACH AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ I OCCUR I I CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ S WORKERS COMPENSATION AND 1OCY LIMITS R T- E EMPLOYERS'LIABILITY TORY ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE•EA EMPLOYEE $ II yes,describe under SPECIAL PROVISIONS below E.L.DISEASE•POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Additional lnsuredi" City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION The DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL City of Huntington Beach,2000 Main Street, Huntington Beach,CA 92648 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENT ACORD 25(2001/08) 0 ACORD CORPORATION 19813 ACORDu CERTIFICATE OF LIABILITY INSURANCE 10 T2 20WDD/YYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Nhuy Insurance and financial agency LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2871 Mauricia Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Santa Clara,CA 95051 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Nationwide KINGS AUTO BODY INSURERS: ALNAJJAR,AYE°-INDIVIDUAL Melling Address:5402 SYSTEM DR INSURER C: HUNTINGTON BEACH,CA INSURER D: 92649-1601 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INN AOD'L POLICY EFFECTIVE POLICY EXPIRATION LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATEIMM/O0YYI DATE(MM/DD/YY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES{EaocCVrence) $ 300,000 CLAIMS MADE l I OCCUR MED EXP(Anyone person) $ 5,000 ACP BPA 3039195813 2-11-2022 2-11-2023 PERSONALSADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEM.AGGREGATE'Aar APPUESPER: PRODUCTS•COMP/OP AGO $ 2,000,000 POLICY I l JECT Ft LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AmJPOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON•OWNEDAUTOS (Per accident) APPrOVED S TO FORM PROPERTY DAMAGE $ (Per accident) By; GARAGE LIABILITY M' AEL E.GA S AUTO ONLY-EA ACCIDENT $ I ANYAUTO CITY ATTORNEY OTHER THAN FA ACC $ CITY or HUNTINGTON 6EAr H AUTO ONLY: AGO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 7 OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WC S H- WORK!RSCOMPENSATIONAND ORY TNT TORY LIMIT-S E EATA EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE $ II yes,describe under SPECIAL PROVISIONS below EL DISEASE-POLICY UMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Additional Insuredi" City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION The DATE THEREOF,THE ISSUING INSURER WILL ENOEAVOR TO MAIL DAYS WRITTEN City of Huntington Beach,2000 Main Street, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Huntington Beach,CA 92648 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENT ACORD 25(2001/08) aI ACORD CORPORATION 1988 A CERTIFICATE OF LIABILITY INSURANCE DATE 28/ 2 THIS CERTIFICATE IS 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(los)must 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 lieu of such endorsemont(s). PRODUCER COMTACY Ghiath Baker Nhuy insurance and financial agency LLC PHONE NAME---- --- — - FAX— �^ we No E:D• — 714-3t33-3317 INC Nol: 2871 Mauricia Avenue A oRless: Ghlathdaker@yahoo.com Santa Clara, CA 95051 INSURER(S)AFFORDING COVERAGE _ NAIC_N_ INSURERA; Sequoia Insurance Company INSURED KINGS AUTO BODY INSURER s: ALNAJJAR,AYED-INDIVIDUAL INSURER C Mailing Address:5402 SYSTEM OR INSURER D: HUNTINGTON BEACH,CA 92649-1501 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NS IR —AblfI4UDR _ POLICYEFF POLICYEXP Lift TYPE OF INSURANCE INSR WYO POLICY NUMBER IMM,DOIYYYYI IMMIDOIYYYW LIMITS GENERALUAOILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMUGE FO RENTED ._. PBfhIlS.E9(£u..acswtnusA)_._-...f_.-......._..._...................._..... ___ 1 MAIM/WADE �__J OCCUR MED EXP(Any one poison) S _ PERSONAL&ADV INJURY $ GENERAL AGGREGATE S GENT.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO S Nit —1 POLICY I-j I LOC AUTOMOBILE LIABILITY COMBINED SINGLELIMITlEa = ANY AUTO BODILY INJURY(PSI pe rson) $ — ALL OWNED SCHEDULED BODILY INJURY(Per occident) I AUTOS '—•AUTOS NON•OWNED PROPERTY DAMAGE HIRED AUTOS _ AUTOS _1EoL ddoJU $ UMBRELLA LIAO OCCUR EACH OCCURRENCE EXCESS LIAO CLAIMS-MADE AGGREGATE _ $..»... DEO El RETENTIONS i WORKERS COMPENSATION If WCSTATU• OTH. AND EMPLOYERS'LIABILITY �� ANY OFFICEO,PRIETOI ARTNERIE ECUTIVE (\/-I NIA E.L.EACH ACCIDENT $ 1,000,000 Mandatory In Nil) QWCi 193504 02-21-22 02-21-23 El.DISEASE•EA EMPLOYEE $ 1'000,000 DES(flIPTION(*OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(Attach ACORO 101,Additional Remarks Schedule,II more opus Is tequbad) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Huntington Beach, 2000 Main Street, ACCORDANCE WITH THE POLICY PROVISIONS. Huntington Beach, CA 92648 AUTHORIZED REPRESENTATIVE ACORD 25(2010105) ®1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Rcsalotion No.2008-63 ib CITY OF HUNTINGTON BEACH • Hun. J� 2000 Main Street Huntington Beach, CA 92648 DECLARATION OF PERMI t"1'liE I certify that no vehicles) will be used or operated in the performance of the task(s) or event(s) for which this permit is granted. - I authorize the City of Huntington Beach to immediately and retroactively revoke the license or permit issued in connection with or in the performance of said task(s) or event(s) if any vehicle(s)is used. • Signature of Permittee Print name 4yed 4) n a J)a" Company name(it'appiicabic) kihi i/t4i0 Undy SJ p Date signed /0 —27- 2P Z • 16407 EXHIBIT I Policy Number:ACP BPA 3039195813 BUSINESSOWNERS PB60030411 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MUNICIPALITIES OR PUBLIC AGENCY - INSURED PROVIDING PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM The following Is added to Section II.WHO IS AN INSURED: The municipality and/or public agency designated in the Schedule of this endorsement Is also an insured,but only with respect to liability lot'bodily Injury', "property damage"or'personal and advertising Injury"caused,In whole or In part,by your acts or omissions or the acts or omissions of those acting on your behalf in connection with your operations,other than the rendering of or the(allure to render professional services,advice of instruction, subject to the following additional exclusion: This insurance,Including any duly we have to defend"sults",does not apply to`bodily injury","property damage" or"personal and advertising injury"that arises out of,in whole or in part,or Is a result of,In whole or In part,the active or primary negligence of the municipality andlor public agency designated in the Schedule of this endorsement,whether or not such negligence has been assumed by you in a contract or agreement. All terms and conditions of this policy apply unless modified by this endorsement. SCHEDULE Municipality andlor Public Agency: Additional insured City of Huntington Beach, its officers, elected or appointed officials,employees, agents and volunteers PB 60 03 0411 Includes copyeieleed material of Instnmico Services Office,hie.,with Ns permission, Page 1 of 1 BUSINESSOWNERS PB 60 03 0411 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MUNICIPALITIES OR PUBLIC AGENCY - INSURED PROVIDING PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM The following is added to Section Ii.WHO IS AN professional services, advice of instruction,subject INSURED: to the following additional exclusion: The municipality and/or public agency designated in This insurance,including any duty we have to the Schedule of this endorsement is also an insured, defend"suits",does not apply to"bodily injury', but only with respect to liability for"bodily injury", "property damage"or"personal and advertising "property damage"or"personal and advertising injury that arises out of, in whole or in part,or is a injury"caused,in whole or In part,by your acts or result of, in whole or in pars,the active or primary omissions or the acts or omissions of those acting negligence of the municipality and/or public agency designated in the Schedule of this endorsement, on your behalf in connection with your operations, other than the rendering of or the failure to render whether or not such negligence has been assumed by you in a contract or agreement. All terms and conditions of this policy apply unless modified by this endorsement. SCHEDULE Municipality and/or Public Agency: CITY OF HUNTINGTON BEACH, ITS OFFICERS ELECTED OR APPOINTED OFFICIALS, EMPLOYEES, AGENTS; &VOLUNTEER 2000 MAIN STREET HUNTINGTON BEACH CA 92648 P8 60 03 04 11 Page 1 of 1 ACP SPA 3039195813 INSURED COPY 47 00884 Policy Number: ACP BPA 3039195813 BUSINESSOWNERS PBS0720711 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. AMENDMENT TO OTHER INSURANCE CLAUSE FOR ADDITIONAL INSUREDS - PRIMARY AND NON- CONTRIBUTORY WHEN REQUIRED IN A WRITTEN AGREEMENT OR CONTRACT WITH YOU This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS COMMON POLICY CONDITIONS Only with respect to any additional Insured,In the COMMON POLICY CONDITIONS,Iona PB 00 09,under condition H.OTHER INSURANCE,paragraph 2.a.is replaced by the following: H. OTHER INSURANCE 2, Under any liability coverage provided by this policy, a. If for Injury or loss we cover,there is other valid and collectible insurance available to any additional insured under another policy,our obligations are limited as follows: (1) Issued by another insurer,or if there Is sell insurance or similar risk retention that applies to a loss covered by this policy,then this insurance provided by us shall be excess over such other Insurance,unless you have agreed in a written contract or written agreement signed prior to the loss that this Insurance shall be printery: (a) Then this insurance is primary,II other insurance Is also primary.we will share with all that other insurance as described in d.below;and (h) The coverage nflorded by this insurance is noncontributory with the additional insured's own insurance. Paragraphs(a)and(b)do not apply to other insurance to which the additional insured has been added as an additional Insured Io any other person or organization's policy;or (2) issued by us or any of ow affiliate companies,that applies to a loss covered by tills policy,then only the highest applicable Limit of Insurance shall apply to such loss.This condition does not apply to any policy issued by us that is designed to provide Excess or Umbrella liability Insurance. All terms and conditions of this policy apply unless modified by this endorsement. Additional Insured City of Huntington Beach, Its officers,elected or appointed of ficials,employees, agents and volunteers PB 80 72 0711 Includes copyrighted material of insor ncu Servicos Office.Inc.,with its permission. Page 1 of 1 Policy Number:ACP BPA 3039195813 BUSINESSOWNERS PB 30 03 0411 THIS ENDORSEMENT CHANGES THE POLICY,PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - GARAGE OPERATIONS PERFORMED BY THE NAMED INSURED This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM A. The following is added to Section Ii.WHO IS AN INSURED: The person or organization designated In the Schedule of this endorsement Is also an Insured,but only with respect to liability for"bodily injury or"property damage'caused,In whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf in connection with"garage operations" performed by you pursuant to the terms of a written contract with such person or organization. B. ADDITIONAL EXCLUSIONS This insurance,including any duty we have to defend"sults",does not apply to: 1. Any"occurrence"which takes place after the contract or agreement between you and such person or organization concerning such"garage operations"has expired:or 2. "Bodily Injury"or"property damage"arising out of any active negligence of the person or organization designated In the Schedule of this endorsement. C. ADDITIONAL DEFINITIONS The following additional definitions apply only to coverage provided by this endorsement. 1. "Customer's auto"means a customers land motor vehicle,trailer or semitrailer while left with you for service,repair,storage or safekeeping,Customers include your"employees"and members of their households,but only It they pay or services performed, 2. "Garage operations"means the ownership,maintenance or use of premises for the purpose of a business of servicing,repairing,parking or storing"customers autos"."Garage operations"also Includes ell operations necessary or Incidental to the performance of garage operations. All terms and conditions of this policy apply unless modified by this endorsement. SCHEDULE Person or Organization as Additional Insured Additional insured City of Huntington Beach, its officers,elected or appointed officials, employees, agents and volunteers PB 30 03 0411 Includes copyrighted material or Insurance Services Office,Inc.,with its permission. Page 1 of 1 BUSINESSOWNERS PB 60 72 0711 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT TO OTHER INSURANCE CLAUSE FOR ADDITIONAL INSUREDS - PRIMARY AND NON- CONTRIBUTORY WHEN REQUIRED IN A WRITTEN AGREEMENT OR CONTRACT WITH YOU This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS COMMON POLICY CONDITIONS Only with respect to any additional insured,in the COMMON POLICY CONDITIONS, form PB 00 09, under condition H. OTHER INSURANCE, paragraph 2.a. Is replaced by the following: H. OTHER INSURANCE 2, Under any liability coverage provided by this policy, a. If for injury or loss we cover,there is other valid and collectible Insurance available to any additional insured under another policy,our obligations are limited as follows: (1) Issued by another insurer,or if there is self insurance or similar risk retention that applies to a loss covered by this policy,then this insurance provided by us shall be excess over such other insurance,unless you have agreed In a written contract or written agreement signed prior to the loss that this insurance shall be primary: (a) Then this insurance is primary.If other insurance is also primary,we will share with all that other insurance as described in d.below;and (b) The coverage afforded by this insurance is non-contributory with the additional insured's own insurance. Paragraphs(a)and(b)do not apply to other insurance to which the additional insured has been added as an additional insured to any other person or organization's policy.;or (2) Issued by us or any of our affiliate companies,that applies to a loss covered by this policy,then only the highest applicable Limit of Insurance shall apply to such loss.This condition does not apply to any policy issued by us that is designed to provide Excess or Umbrella liability insurance. All terms and conditions of this policy apply unless modified by this endorsement. PB 60 72 07 11 Includes copyrighted material of Insurance Services Office,Inc.,with Its permission. Page 1 of 1 ACP BPA 3039195813 INSURED COPY 47 01639 Nationwide Isoo your sw. AMCO INSURANCE COMPANY CHANGE OF DECLARATIONS ENDORSEMENT-PLEASE READ CAREFULLY. POLICY NUMBER ACP BPA 3039195813 PREMIER BUSINESSOWNERS POLICY NAMED INSURED:KINGS AUTO BODY ALNAJJAR,APED-INDIVIDUAL MAILING ADDRESS:5402 SYSTEM DR HUNTINGTON BEACH, CA 92649-1501 AGENT NAME: NHUY INSURANCE SERVICES 84 56429 NO CHARGE $ .00 AGENT ADDRESS:SAN JOSE CA 95129 234 POLICY PERIOD: FROM 02-11-22 TO 02-11-23 12:01 A.M. Standard Time EFFECTIVE DATE OF CHANGE: 10-14-22 12:01 A.M. Standard Time NOT A STATEMENT-YOUR BILLING WILL FOLLOW TOTAL PREMIUM $ .00 PREMIUM MMMMMMMMMMMMMMM191100000000E ADDITIONAL INSURED MMMMMMMMMMMMAMwMkA No. 001000 $ .00 CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED OR ADDED NAM CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED OR ADDED OLD ADDRESS APPOINTED OFFICIALS, EMPLOYEES, AGENTS & VOLUNTEER ADDED ADDRESS 2000 MAIN STREET ADDED CITY HUNTINGTON BEACH ADDED STATE CA ADDED ZIP CODE 92648 ADDED FORM NUMBER P86003 MUNICIPALITY CHANGE kkkkkNEk101kkkkkMkkMKNMKKMMNMMMM ENDORSEMENT MMMM101kkkwMMkwMwmkkkMwMMMMMmmkkk ADDED ENDORSEMENT FORM FORM P86003 EDITION DATE 0411 A COPY OF THIS FORM IS ATTACHED For your protection, California law required the following to appear on this forms Any person who knowingly presents false or fraudulent information to a obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinements in o state prison. A COPY OF THIS FORM IS ATTACHED DIRECT BILL LNTB 22293 INSURED COPY 320058425 47 00883 NIs on your skis ationwide AMCO INSURANCE COMPANY CHANGE OF DECLARATIONS ENDORSEMENT- PLEASE READ CAREFULLY. POLICY NUMBER ACP BPA 3039195813 PREMIER BUSINESSOWNERS POLICY NAMED INSURED: KINGS AUTO BODY ALNAJJAR,APED-INDIVIDUAL MAILING ADDRESS:5402 SYSTEM DR HUNTINGTON BEACH, CA 92649-1501 AGENT NAME: NHUY INSURANCE SERVICES 84 56429 ADDL PREMIUM $ 25.00 AGENT ADDRESS:SAN JOSE CA 95129 234 POLICY PERIOD: FROM 02-11-22 TO 02-11-23 12:01 A.M. Standard Time EFFECTIVE DATE OF CHANGE: 10-14-22 12:01 A.M. Standard Time NOT A STATEMENT-YOUR BILLING WILL FOLLOW TOTAL PREMIUM 2B.00 PREMIUM xxaaax EK10 01101tflEa;'calt;0001a09t ADDITIONAL INSURED Nakilaaaaa*MtaxKt!e0a NO. 003000 $ 9.00 THE CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED ADDED NAME THE CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED ADDED OLD ADDRESS SEE BLANK ENDORSEMENT PB2500 ADDED ADDRESS 2000 MAIN STREET ADDED CITY HUNTINGTON BEACH ADDED STATE CA ADDED ZIP CODE 926482702 ADDED FORM NUMBER PB3003 PREMIUM CHANGE MUNICIPALITY CHANGE NNNNNNNNNNNNNNNNNNNNNNNNNN ADDITIONAL INSURED NNNNNNNNNNNkNNNNNN NO. 004000 16.00 THE CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED ADDED NAME THE CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED ADDED OLD ADDRESS SEE BLANK ENDORSEMENT PB2800 ADDED ADDRESS 2000 MAIN STREET 4 ADDED CITY HUNTINGTON BEACH a DIRECT BILL LKNA 22299 INSURED COPY 320066426 47 01635 • Nationwide' Is on yourstd• AMCO INSURANCE COMPANY PREMIER BUSINESSOWNERS POLICY Policy Number:ACP BPA 3039195813 POLICY PERIOD: FROM 02-11-22 TO 02-11-23 12:01 A.M.Standard Time PREMIUM EFFECTIVE DATE OF CHANGE: 10-14-22 12:01 A.M. Standard Time ADDED STATE CA ADDED ZIP CODE 926482702 ADDED FORM NUMBER PH6072 PREMIUM CHANCE MUNICIPALITY CHANGE NIIMNANIMMMNNWIIMkNNKNKAeemiewes ENDORSEMENT KNMPOWNKNIMIENNIENKNNNNNNNNNNNNMM ADDED ENDORSEMENT FORM FORM P83003 EDITION DATE 0411 A COPY OF THIS FORM IS ATTACHED ADDED ENDORSEMENT FORM FORM PB6072 EDITION DATE 0711 A COPY OF THIS FORM IS ATTACHED ADDED ENDORSEMENT FORM FORM PB2500 EDITION DATE 0101 A COPY OF THIS FORM IS ATTACHED For your protection, California law required the following to appear on this form: Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim far the payment of a loss is guilty of a crime and may be subject to fines and confinements in @ state prison. A COPY OF THIS FORM IS ATTACHED 9 DIRECT BILL LKNA 22299 INSURED COPY 320056425 47 01636 BUSINESSOWNERS P8 30 03 04 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - GARAGE OPERATIONS PERFORMED BY THE NAMED INSURED This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM A. The following is added to Section II.WHO IS AN organization designated in the Schedule of INSURED: this endorsement. The person or organization designated in the C. ADDITIONAL DEFINITIONS Schedule of this endorsement is also an Insured, The following additional definitions apply only but only with respect to liability for"bodily injury" to coverage provided by this endorsement. or"property damage"caused,in whole or in part, 1. "Customer's auto"means a by your acts or omissions or the acts or customer's land motor vehicle,trailer or omissions of those acting on your behalf in semitrailer while left with you for service, connection with "garage operations"performed repair, storage or safekeeping. by you pursuant to the terms of a written contract Customers include your"employees" with such person or organization. and members of their households,but B. ADDITIONAL EXCLUSIONS only if they pay for services performed. This insurance,including any duty we have to 2. "Garage operations" means the defend"suits",does not apply to: ownership,maintenance or use of 1. Any"occurrence"which takes place after premises for the purpose of a business the contract or agreement between you and of servicing,repairing,parking or storing such person or organization concerning "customer's autos"."Garage operations" such"garage operations"has expired;or also includes all operations necessary or incidental to the performance of 2. "Bodily injury"or"property damage"arising garage operations. out of any active negligence of the person or All terms and conditions of this policy apply unless modified by this endorsement. SCHEDULE Person or Organization as Additional Insured THE CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED 2000 MAIN STREET HUNTINGTON BEACH CA 926482702 PB 30 03 04 11 Page 1 of 1 ACP BPA 3039195813 INSURED COPY 47 01838 EFFECTIVE DATE: 12:01 AM Standard Time, BUSINESSOWNERS (at your principal place of business) PB 25 00(01-01) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OFM001 COMPLETE NAMES &ADDRESSES OF ADDITIONAL INSUREDS RE: (PB3003, PB6072) THE CITY OF HUNTINGTON BEACH,ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS. 2000 MAIN STREET HUNTINGTON BEACH, CA,926482702 All terms and conditions of this policy apply unless modified by this endorsement. PB 25 00 (01-01) ACP BPA 3039195813 INSURED COPY 47 01837