HomeMy WebLinkAbout04606 - JEFFREY FOWLER SCULPTURE EXHIBITION Page: 1
Report: Expired Contracts: Oldest Date= I I and XREF=PUBLIC ARTS -Summary January e, 2004
Contract Number Description Approval Date Expiration Date Closed Date
A4266 Purchase Public Art - 08/02/2000 08/01/2003 < V
Contractor:Chihuly, Inc. Insurance Status: INACTIVE
\V XREF: PUBLIC ARTS
Service: In File
A4606 Jeffrey A. Fowler 12/11/2002 12/01/2003 /4�2/1 / L- ' i
/ Contractor :Jeffrey A. Fowler✓ Insurance Status: t `mJe�QL�
V` XREF: PUBLIC ARTS
\ Service: In File
* * * * * * END OFREPORT * ** * * *
t
Jeffrey A. Fowler
Sculpture Exhibit
AGREEMENT #4606 Amend 1
M07417, 12-29-03
FIRST AMENDMENT TO TEMPORARY PUBLIu— - - - -
EXHIBITION OF SCULPTURE AGREEMENT
This First Amendment to the Temporary Public Exhibition of Sculpture Agreement#A4606 is
made effective as of December 8, 2003, by and between the City of Palm Springs, a municipal
corporation ("City") and Jeffrey A. Fowler("Artist").
1.) On Recitals made on December 2, 2002, the Artist created a sculpture entitled
"Chairman of the Links" which was approved for temporary exhibition by the City's Public
Arts Commission. The sculpture is located on a pad site next to the Welwood Murray
Library, downtown Palm Springs.
2.) The Artist loaned the Sculpture to the City for an Exhibition Period of one year ending
December 1, 2003.
3.) All costs are the sole responsibility of the Artist, except that the City will pay the Artist the
expense of the insurance cost which shall not exceed $1,000.00.
NOW THEREFORE for good and valuable consideration,the sufficiency of which is hereby
acknowledged, the parties hereto agree as follows:
1.) Exhibition Period. The Artists hereby consents to continuous display of the Sculpture at
the Site for an additional six months ending, June 30, 2004. The Artist acknowledges
that such consent is given freely and knowingly, and that no attempt will be made by the
Artist to remove the work prior to the expiration of this period without the written consent
of the City. The City reserves the right to decline or terminate the Sculpture's exhibition
prior to the expiation of the period described above.
2.) Insurance Compensation. The Artist shall maintain the General Liability Insurance Policy
currently in place, during the entire term of this agreement. The City agrees to pay the
cost to renew the insurance policy in the amount of$892.97 for the extended term of the
exhibition period.
All other terms of the Agreement remain in full force and effect.
IN WITNESS WHEREOF,the parties have executed and entered into this First Amendment as
of the date first written above.
Artist: ,
_. „ .. . .v . Jeffrey A. Fowler/
A T: City of Palm Springs
a municipal corporation _
CityClerk 0•ajCity Manager _
a� ���
Jeffrey A. Fowler
Sculpture Exhibition
AGREEMENT #4606
Director signed 12-11-02
AGREEMENT FOR TEMPORARY PUBLIC EXHIBITION OF SCULPTURE
THIS AGREEMENT is entered into this 2nd day of December, 2002 by and between the CITY OF
PALM SPRINGS, a municipal corporation ("City") and Jeffrey A. Fowler("Artist").
RECITALS:
WHEREAS,The Artist has created a sculpture entitled"Chairman of the Links"("Sculpture").
Photo of Sculpture attached hereto as Exhibit"A" and incorporated herein by this reference.
WHEREAS,the City's Public Arts Commission has approved a temporary exhibition of the
Sculpture in a public place on South Palm Canyon in the City. The specific location where the
Sculpture will be exhibited is designated as the "Site" which is attached hereto as Exhibit "B" and
incorporated herein by this reference.
NOW, THEREFORE,the City and the Artist, under the conditions hereinafter set forth, and
as specified in the Artist's Proposal, ("Proposal") attached hereto as Exhibit"C" and incorporated
herein by this reference, agree to placement of a sculpture for a period, as stated herein, subject
to the following terms and conditions of this Agreement:
1. City Representative. The City of Palm Springs Public Arts Commission, an agency of the
City of Palm Springs, (the"Commission") shall be the City's designated representative with respect
to this Agreement unless such designation shall be withdrawn by the City Council. The Commission
shall have the authority to give any approvals or consents required hereunder and to otherwise act
on behalf of the City for purposes of this Agreement.
2. Ownership. Except as provided in Section 4 below, the Artist will remain at all times the
owner of the Sculpture. However, the Artist will relinquish possession of the Sculpture to the City
for the duration of the exhibition period described below.
3. Compensation. All costs shall be the responsibility of the Artist for any part of this
Agreement except for those expenses for insurance which the City will pay to the Artist in the
amount of ONE THOUSAND AND 00/100 DOLLARS ($1,000.00) as specified in Exhibit "D"
("Compensation") attached and incorporated herein by this reference
4. Sale of Sculpture. The Sculpture may be sold with assignment of rights under this
Agreement. However, sale of the Sculpture does not terminate this Agreement. The Artist shall
notify the City immediately upon sale of the Sculpture and/or assignment of rights under this
Agreement.
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5. Reproduction Rights. The Artist hereby grants to the City the right to photograph,firm and
videotape the Sculpture at any time during the exhibition period described below. The Artist also
grants the City a right in perpetuity to use such reproductions for any purposes, commercial or
otherwise, provided that the City gives artistic credit to the Artist.
6. Exhibition Period. The Artist hereby consents to continuous display of the Sculpture at
the Site of a period of one (1) year, beginning on December 9, 2002 and ending on December 1,
2003. The Artist acknowledges that such consent is given freely and knowingly, and that no
attempt will be made by the Artist to remove the work prior to the expiration of this period without
the written consent of the City. However, the City reserves the right to decline or terminate the
Sculpture's exhibition prior to expiration of the period described above.
7. Transportation, Installation, Maintenance and Removal. The Artist or its authorized
agents will be responsible for all transportation, installation, repair, insurance and removal of the
Sculpture. On or about December 9, 2002,the Artist will deliver the Sculpture to the Site. The Artist
shall make all appropriate arrangements for crating and transporting the Sculpture to the Site. The
Artist shall pay any crating and transportation costs.
The Artist shall place the Sculpture, at is sole cost and obligation, on the existing cement
slab on South Palm Canyon at the southwest comer of the Welwood Murray Library pursuant to the
"Site" attached hereto as Exhibit'V.
During the term of the Agreement, the Artist shall be responsible for the maintenance of the
Sculpture. The Sculpture shall be maintained in an appropriate condition to be deemed as a quality
work of art temporarily made part of the City's Public Art Collection. Should the piece need upkeep
or repair, the City will notify the Artist immediately of the need for maintenance.
On or about December 1, 2003, or at such earlier date as the City shall decide at its sole
discretion, the Artist shall remove the Sculpture and return the Site to its original condition, within
fourteen days of Sculpture removal, as it was prior to installation of the Sculpture.
8. Insurance. The Artist shall procure and maintain, in a form consistent with industry
standards, with an insurer qualified to do business in California and rated "A" or better in the most
recent edition of Best Rating Guide with a financial class category of Class VI or better, during the
entire term of this Agreement, the following policies of insurance:
(8.1) Comprehensive General Liability Insurance. A policy of comprehensive
general liability insurance together with a Broad Form CGL Endorsement insuring against
contractually assumed liability which shall specifically insure the Artist's obligation under
Section 8 above. The policy shall have a combined single limit liability of ONE MILLION
AND 00/100 DOLLARS ($1,000,000.00)
(8.2) Workers' Compensation Insurance. A policy of compensation insurance in an
amount as would fully comply with the laws of the State of California and which shall
indemnify, insure and provide legal defense for both the Artist and the City against any loss,
claim or damage arising from any injuries or occupational hazards or diseases occurring to
any worker employed by or any person retained by the Artist in the course of carrying out
the obligations of this Agreement.
2
(8.3) Fine Arts Insurance. The City shall place the Sculpture on the City's list of all-
risk property upon acceptance that the Sculpture is installed to the satisfaction of the
contract administrator and for the duration of the Agreement.The Artist shall be responsible
for damage and loss of the Artwork during transit and installation and removal of the
Sculpture from the Site. Artist states that the Sculpture is valued at FIFTY THOUSAND
AND 00/100 DOLLARS($50,000) which the parties agree is the replacement value of the
Sculpture.
(8.4) Automotive Insurance. A policy of comprehensive automobile liability
insurance written on a per occurrence basis in an amount not less than either(i) bodily injury
liability limits of TWO HUNDRED FIFTY THOUSAND DOLLARS ($250,000.00) per person
and FIVE HUNDRED THOUSAND DOLLARS ($500,000.00) per occurrence and property
damage liability limits of ONE HUNDRED THOUSAND DOLLARS ($100,000.00) per
occurrence and TWO HUNDRED FIFTY THOUSAND DOLLARS ($250,000.00) in the
aggregate, (ii) combined single limit liability of FIVE HUNDRED THOUSAND DOLLARS
($500,000.00), or (III) limits as set by the City Risk Manager. Said policy shall include
coverage for owned, non-owned, leased and hired cars.
All of the above policies of insurance shall be primary insurance and shall name the City,
its officers, employees and agents as additional insureds. The insurer shall waive all rights of
subrogation and contribution it may have against the City, its officers, representatives, employees
and agents and their respective insurers. All of said policies of insurance shall provide that said
insurance may not be amended or canceled without providing thirty (30) days prior written notice
by registered mail to the City. The cancellation clause shall read "SHOULD ANY OF THE ABOVE
DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF, THE
ISSUING COMPANY WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
NAME TO THE LEFT'. In the event any of said policies of insurance are canceled,the Artist shall,
prior to the cancellation date, submit new evidence of insurance in conformance with this Section
to the Commission. No work or services under this Agreement shall commence until the Artist has
provided the City with Certificates of Insurance or appropriate insurance binders evidencing the
above insurance coverages and said Certificates of Insurance or binders are approved by the City.
The policies of insurance required by this Agreement shall be satisfactory only if issued by
companies qualified to do business in California, rated "A" or better in the most recent edition of
Best Rating Guide, The Key Rating Guide or in the Federal Register, and only if they are of a
financial category Class VII or better, unless such requirements are waived by the-City Risk
Manager due to unique circumstances.
It is expressly agreed that due to changes in law and conditions prevailing in the insurance
market,-the need may arise to change insurance coverage during the life of this Agreement. In the
event the City Risk Manager determines that the Work or services to be performed under this
Agreement creates an increased or decreased risk of loss to the City, the Artist agrees that the
minimum limits of the insurance policies required by this Section may be changed Artist shall have
the right to appeal a determination of increased coverage by the City Risk Manager to the City
3
Council of City within ten (10) days of receipt of notice from the City Risk Manager.
9. Indemnification. The Artist hereby agrees to indemnify and hold harmless the City, its
officers, agents and employees from and against any and all actions, suits, claims, damages,
losses,costs,penalties,obligations,errors,omissions or liabilities(collectively"Claims or Liabilities")
arising out of or in any way connected with any act, omission or negligence of the Artist, its agents,
employees or contractors, or from the existence of the Artwork at the Site or related to this
Agreement, including, without limitation, bodily injury to or death of persons, injury or damage to
Property and attomeys'fees, but excluding such Claims or Liabilities resulting solely from the willful
misconduct of the City, its officers, agents or employees who are directly responsible to the City.
10. Conflict of Interest. No officer, representative or employee of the City shall have any
financial interest, direct or indirect, in this Agreement nor shall any such officer, representative or
employee participate in any decision relating to the Agreement which effects his or her financial
interest or the financial interest of any corporation, limited liability company, partnership or
association in which he or she is, directly or indirectly, interested, in violation of any Federal or
California statute or regulation. The Artist warrants that it has not paid or given and will not pay or
give any third party any money or other consideration for obtaining this Agreement.
11. Covenant Against Discrimination. Artist covenants that, by and for itself, its heirs,
executors, assigns, and all persons claiming under or through them, that there shall be no
discrimination against or segregation of, any person or group of persons on account of race, color,
creed, religion, sex, marital status, national origin, or ancestry in the performance of this
Agreement. Artist shall take affirmative action to insure that applicants are employed and that
employees are treated during employment without regard to their race, color, creed, religion, sex,
marital status, national origin, or ancestry.
1Z Integration; Amendments. This Agreement contains all of the agreements of the
parties and cannot be modified, terminated or rescinded, in whole or in part, unless written and
signed by authorized representatives of the parties hereto. No prior oral or written understanding
shall be of any force with respect to those matters covered in this Agreement.
13. Governing Law. This Agreement and all matters pertaining thereto shall be construed
according to the laws of the State of California.
14. Licenses, Pen-nits and Fees. Artist shall obtain at its sole cost and expense such
licenses, permits and approvals as may be required by law for the performance of the services
required by this Agreement. Except as specified below, Artist shall have the sole obligation to pay
for any fees, assessments and taxes, plus applicable penalties and interest,which may be imposed
by law and arise from or are necessary for the Artist's performance of the services required by this
Agreement, and shall indemnify, defend and hold harmless City against any such fees,
assessments,taxes, penalties or interest levied, assessed or imposed against City hereunder. Any
permits required for landscaping and installation of Work on City property shall be obtained by the
City at the City's sole cost and expense, and Artist shall provide any information necessary to obtain
such permits.
4
15. Further Responsibilities of the Parties. Both parties agree to use reasonable care
and diligence to perform their respective obligations under this Agreement. Both parties agree to
act in good faith to execute all instruments, prepare all documents and take all actions as may be
reasonably necessary to carry out the purposes of this Agreement. Unless hereafter specified,
neither party shall be responsible for the services of the other.
16. Notices. Any notice which either party may desire to give to the other party under
this Agreement must be in writing and may be given by personal delivery or by mailing the same
by registered or certified mail, return receipt requested, to the party to whom the notice is directed
at the address of such party hereinafter set forth, or such other address and to such other persons
as the parties may hereafter designate:
To Artist: Jeffrey A. Fowler
2560 Golf Club Drive
Palm Springs, CA 92264
Phone 760 321-6900
FAX 760 321-2111
To Commission: City of Palm Springs
Public Arts Commission
P.O. Box 2743
Palm Springs, CA 92263-2743
Attn: Ms. Diane Morgan
(760) 778-8408 office
(760) 322-8325 FAX
Copy to: Burke, Williams and Sorensen
18301 Von Karman Ave.
Irvine, CA 92612
Attn: David J. Aleshire, Esq.
A change in the designation of the person or address to which submittals, requests, notices or
reports shall be delivered is effective when the other party has received notice of the change by
certified mail.
16. Execution in Counterpart. This Agreement may be executed in several counterparts, and
all so executed shall constitute one agreement binding on all parties hereto, notwithstanding that
all parties are not signatories to the original on the same counterpart.
5
IN WITNESS WHEREOF, the parties have entered into this Agreement as of the date first
above written.
Artist:
/Je(fre' .'Fow er/
/ (Social Security Number)
(Check One: 'individual,
_partnership,_corporation
ATTEST: CITY OF PALM SPRINGS
a municipal corporation
�P
City Clerk irector of Comn u ty and Economic Development
APPROVED AS TO FORM: _
APPWWd BY I*MtlMENf HEAD
End of Signatures
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EXHIBIT T"
PROPOSAL
Jefficy Alden Fowler
2560 Golf Club Drive
Palm Springs,CA 92264
Phone: (760)321-6900
7
V,V
Date: November 4,2002
To: City of Palm Springs Art in Public Places
From: Jeffrey Alden Fowler
:submittingI, sal
this letter to The City of Palm Springs to describe my intent
on loan to the city,for a period of(1)year,"Me Chairman of the
a life size 6'4"cast bronze sculpture,Number I of 9,Dated 2000,
signed "Jeffrey A.Fowie,
e valuq of the sculpture is$50,000.00,insurance and liability(covering
The City 6f aim
. :P Springs, The Artist,The Sculpture and otherwise)is to be
covered by Me City of Palm Springs,
The Sculpture
Will be installed at the Welwood Murray Library on the
existing cylindrical pedestal,facing South palm Canyon with(3)y4"x 8-
lengths of steel"threvA secured internally to the concrete pedestal via
bored holes and epoxy cement.
Signed
y
FowlerFowler.&on
9 9
EXHIBIT M"
COMPENSATION
1. Fee. The Artist's total fee for services rendered hereunder, including all
applicable taxes and all expenses realting thereto, whether or not identified in this
Agreement shall be ONE THOUSAND AND 00/100 DOLLARS ($1,000.00).
2. Payments. The City shall make payments to the Artist as follows:
2.1 Upon execution of the Agreement aM receipt by City of evidence of
all insurance requirement .
2.2 All paymen shall be made payable to Jeffrey A. Fowler.
2.3 City a ees to pay all amounts within thirty (30)days of the satisfaction
of the conditions t erefor.
All
10
Date: 12/12/2002 Time: 2 : 36 PM To : Morgan, Diane 6 91(760) 322-8325
Page: 001-002
ACORD CERTIFICATE OF LIABILITY INSURANCE 121121 o 2
PRODUCER (909)793-2373 FAX (909)798-6983 THISCERTIFICATEISIS§UED ASA MATTER OF INFORMATION
Davis & Graeber Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
470 E. Highland Ave. ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW.
P.O. Box 40
Redlands, CA 92373 INSURERS AFFORDING COVERAGE
INSURED Jeffrey Fowler INSURERA Northfield Ins. Co.
2560 Golf Club Drive NSURERB: ,., I P '2
Palm Springs, CA 92264 INSURER C.
INSURERD: Y
INSURERE:
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 SUBIECTTO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR La DATE OF INSURANCE POJCYNUMBER POLICYEDATE M D DATE(MM)DOrM LIMITS
GENERALUABIUTY CP445099 12/11/2002 12/21/2003 EACH OCCURRENCE $ 1,000,000
X COMMERCIALGENERALUABWTY FIRE DAMAGE("One fire) $ 100'()00
CLAIMS MADEFXJ OCCUR MEDEXP(Anymepersm) $ 5,060
A PERSONAL KADV INJURY $ 1,000,000
GENERAL AGGREGATE S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPACP AGG $ 1,O00,000
POLICY PRO
PRO- n LOG
AUTOMOBILE LIABILITY
CCMeINED SINGLE LIMIT S
ANY AUTO (Ea accicknt)
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) S
HIREDAUTOS
BODILY INJURY S
NON OWNEDAUTOS Per awcere)
PROPERTY DAMAGE S
(Per eccmen[)
GpRAGELIABILITY AUTO ONLY-FA ACCIDENT S
ANY AUTO OTHER THAN EAACC S
AUTO ONLY. AGO S
EXCESSUABILITY EACH OCCURRENCE S
OCCUR ❑CLAIMS MADE AGGREGATE S
S
DEDUCTIBLE S
RETENTION $ S
WORKERS COMPENSATION AND TV
CHY LIMITS ER
EMPLOYERS LIABILITY
E.L.EACH ACCDENT S
EL.DISEASE-EA EMPLOYE S
EL.DISEASE-POUCY UMIT S
OTHER
DESCRIPTION OF OPERATIONS)LOCAMONS)VEHICLESIEXCLUBIONS ADDED BY ENDORSEMENTrSPECIAL PROVISIONS
e: Operations of the named insured.
Certificate Holder is an additional insured per endorsement on file with company.
0 days notice of cancellation for non-payment of premium.
CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THERE OF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
City of Palm Springs 30 DAYSWRITTEN NOTICE TO THE CERTIRCATE HOLDER NAMED TOTES LEFT,
Attn: Diane Morgan BUT FAILURETO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
3200 E. Tahquitz OF ANY HIND UPON THE COMPANY,ITSAGENTS OR REPRESENTATIVES.
Palm Springs, CA 92263 AUTHORIZED REPRESENTATIVE
Ross ]ones/GLD a
ACORD 2"(7 FAX: (760)322-8325 Z=RUM Iff F=WdTi9138
ALLSTATE INSURANCE COMPANY ® HOME OFFICE CERTIFICATE OF INSURANCE
ALLSTATE INDEMNITY COMPANY ❑ NORTHBROOK, ILLINOIS DATE OF
hereby certifies that the following automobile insurance is in JEFFREY FOWLER force: CERTIFICATE December 9, 2002
Name of Insured EFFR
Policy Number POLICY PERIOD: This policy is effective Address 2560 GOLF CLUB DR 11-16-200205-16-2003
PALM SPRINGS, CA 92264
Description of 1993 SUBERBAN
the Automobile VIN #02550 12:01 A.M.Standard Time
For Office
use only
The person or organization designated below is described In the policy as:
❑ LIENHOLDER (Loss Payable Clause)
❑ ADDITIONAL
INTERESTED PARTY AGENT RON NAYFACK
❑ OTHER PRODUCER OF RECORD
NAME OF BROKER
COVERAGES AND LIMITS INDICATED BELOW BY AN"X" IN THE INCLUDED COLUMN IS AFFORDED FOR ABOVE DESCRIBED VEHICLE
COVERAGES LIMITS OF INCLUDED COVERAGES LIMITS OF INCLUDED
LIABILITY I LIABILITY
A/AA BODILY INJURY LIABILITY
Each Person $ 250,0010 ® VA PERSONAL INJURY
Each Occurrence $ 500,000 PROTECTION
B/BB PROPERTY DAMAGE LIABILITY
Each Occurrence $ 100,000 ® SUPPLEMENTAL
STATUTORY COVERAGE
D/DD AUTOMOBILE COLLISION A.C.V. less 500 ® Uninsured BI JEJA
❑ Dim. Ded SS$ Underinsured Motorists
H ❑A,C.V. PD
®
R RR AUTOMOBILE COMPREHENSIVE ❑A.C.V. less El
500
The Loss Payable Clause=fsuch policy provides: The Additional Interest Endorsement of such policy, in part,provides:
"The company reserves the right to cancel such policy at any time as provided "...such insurance as is afforded by the policy"for automobile liability insurance
by its terms,but in such case the company shall notify the Lienholder when not appliesh so t
applies also to the person or organization named as Additional Interest Party. "As respects
less than ten days thereafter such cancellation shall be effective as to the such...interest, no cancellation...and no endorsement...adversely affecting such additional
interest of said Lienholder therein and the company shall have the right,on like interest,shall be effective until ten(10)days following the mailing of written notice(to the
notice,to cancel this agreement." person or organization)of such cancellation or endorsement..."
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy referred to above.
Jeffrey Alden Fowler
2560 Golf Club Drive
Palm Springs,CA 92264 [
Phone (760' 321-6900
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Date: December 11,2002
To: The City of Pahn Springs
Palm Springs,. CA
r
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Jry
Tp,yVhom It May Concern,
If Jtirey A.Fowler,am a sole proprietor and have no employees within the
„t r+, >,•, "" diysc of my business,
; 1lcere4ow
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Jeffrey J
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Date: 12/16/2003 Time: 12 : 12 PM To: B 917603228325
Page: C 002
DATE(MM/DDM9H)
QC -RQ, CERTIFICAT OF LIABILITY INSURAN 12/16/2003
PRODUCER (909)793-2373 FAX (909)798-6983 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Davis & Graeber Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
470 E. Highland and Ave. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 40
Redlands, CA 92373 ;. a , INSURERS AFFORDING COVERAGE NAIC#
INSURED Jeffrey Fowler INSURERA Northfield Ins. Co.
2560 Golf Club Drive INSURER A
Palm Springs, CA 92264 �9 INsuRERc
rir 6„)�tn ,G�V INSURER
R V i� f5 ,/�" INSURER E (G
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDIP
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 SUCI
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSRADD' TypE OFINSURANCE POLICY NUMBER POUCYEFFECTIVE POLICYEXPIRATION LIMITS
LTR NSR DATE MMIDWYY ATE MMIDOM'
GENERAL LIABILITY CP4450991 12/I1/2003 12/I1/2004 EACH OCCURRENCE $ 1 000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000
CLAIMS MADE j OCCUR MED EXP(Any one person) $ 5,000
A X PERSONAL&AOV INJURY $ 1,000.000
GENERAL AGGREGATE $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 1,000,000
POLICY JECT LOG
AUTOMODILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per Person) $
HIRED AUTOS
BODILY accident)
$
NON-OWNED AUTOS (Per acadenl)
PROPERTY DAMAGE $
(Perecodenl)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGO $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMSMADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND TWO START OTH-
EMPLOYERS'LIABILITY TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE $
If yes,describe under
SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERAT10NS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
e: Operations of the named insured.
Certificate Holder is an additional insured per endorsement on file with company.
0 days notice of cancellation for non-payment of premium.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVORTO MAIL
City of Palm Springs 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn: Cathy Van Horn BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
3200 E. Tahquitz OF ANY KIND UPON THE INSURER,TTS AGENTS OR REPRESENTATIVES.
Palm Springs, CA 92263 AUTHORIZED REPRESENTATME
Ross Jones/KDKa
ACORD 25(2001108) FAX: (760)322-8325 OACORD CORPORATION 196E