HomeMy WebLinkAbout6/26/2018 - AGREEMENTS FIRST AMENDMENT TO CONSULTING SERVICES AGREEMENT
DeAztlan Consulting (Agreement No. A7156)
THIS FIRST AMENDMENT to the Consulting Services Agreement No. A7156 for
Districting Initiative and Boards and Commissions Diversity Outreach Project is made and
entered into to be effective on the 20th day of September, 2018 by and between the City of
Palm Springs, a California charter city and municipal corporation (hereinafter referred to as
the City), and DeAztlan Consulting a single member LLC. City and Consultant are
individually referred to as "Party" and are collectively referred to as the "Parties".
RECITALS
A. City and Consultant previously entered into a consulting services agreement for
Districting and Boards and Commissions Diversity Outreach Project which was
made and entered into on June 26, 2018 (the "Agreement") in the amount not to
exceed $24,500.
B. City and Consultant desire to amend the Agreement to extend the term of the
contract and to modify to scope of services to include outreach regarding the City's
leaf blower ordinance.
NOW, THEREFORE, in consideration of the mutual promises and covenants contained
herein, the Parties agree as follows:
1 . Scope of Services. In compliance with all terms and conditions of the Agreement,
Consultant shall provide consulting services to the City as described in the Scope of
Services/Work attached to this Amendment as Exhibit "A" and incorporated by
reference (the "services" or"work"). Exhibit"A" includes the agreed upon schedule
of performance and the schedule of fees. Consultant warrants that all services and
work shall be performed in a competent, professional, and satisfactory manner
consistent with prevailing industry standards. In the event of any inconsistency
between the terms contained in the Scope of Services/Work and the terms setforth
in this Amendment, the terms set forth in this Amendment shall govern.
2. Compensation of Consultant. Consultant shall be compensated for the services
rendered under this Agreement in accordance with the schedule of fees set forth in
Exhibit"A".The total amount of Compensation shall not exceed $39,650(thirty nine
thousand six hundred fifty dollars).
3. Term. Unless earlier terminated in accordance with Section 4.5 of the Agreement,
this Agreement shall continue in full force and effect until December 31, 2018,
unless extended by mutual agreement of the parties.
[SIGNATURES ON NEXT PAGE]
OFUGWAl81D
ANDIORAGREEMENT
IN WITNESS WHEREOF, the parties have executed this Amendment as of the dates
stated below.
ATTEST: "CITY"
CITY OF PALM SPRINGS, CA.
77
By: By.
hony M jia, erk David H. Ready, City M ger
Date: tu,l �4(UiV6 Date: /Ulllll�
APPROVED AS TO FORM:
J
Edward Z. Kotkin, C ty Aft rn y
Date:
"CONSULTANT"
' pPRovEDBY CITY COUNCIL DeAztlan Consulting
tz q l`6 IAA Sao
By: 7� Q
Date:
2
EXHIBIT "A"
SCOPE OF SERVICESNVORK
SCHEDULE OF FEES
DeAztlan Consulting will deliver the following services, but not limited to, for the City of Palm
Springs:
• Spanish Language Media Outreach and Communications
• General Strategy
• Community Outreach and Engagement
• Culturally Appropriate Message Development
• Translation
• Meeting Attendance
Schedule of Fees:
• Monthly retainer of$4,000 for up to 20 hours of directed work.
• Consultant to provide report of hourly service when 20 hours are met in one billing cycle.
• Additional hours over 20 in anyone billing cycle will be billed at $150 per hour and will
not be performed without written approval by staff.
DEAZTLAN CONSULTING outreach support staff time and any travel expense incurred will
remain the responsibility of DEAZTLAN CONSULTING.
3
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
E4277
Policy Number: 60550-47-48 1st Edition
POLICY CHANGES
Effective Date of Change: 12/14/18 Expiration Date: 12/14/19
Change Endorsement No.: 002 Agent: 99-68-358
Named Insured: DEAZTLAN CONSULTING LLC
78115 CALLE ESTADO#206
LA QUINTA CA 92253
The following item(s):
Insured's Name Insured's Mailing Address
Policy Number Company
Effective/Expiration Date Insured's Legal Status / Business of Insured
Payment Plan Premium Determination
Additional Interested Parties Coverage Forms and Endorsements
X Limits /Exposures Deductibles
Covered Property/ Location Description Classification/Class Codes
Rates Underlying Insurance
is (are)changed to read {See Additional Page(s)}:
The above amendments result in a change in the premium as follows:
No Changes To Be Adjusted At Audit Additional Premium Return Premium
$ 1,008.00 $
Authorized Representative Signature:
FARMERS
INSURANCE
914277 15TEOIIION 7-02 Indud"CoMigltod Rnbriul,ImumnSonim ONko,lnc,wilhdspormvm. 14277101 PAGE I OF 2
E4277{GI
Policy Changes Endorsement Description
CHANGE POLICY LEVEL INFORMATION
CHANGE: LIABILITY LIMIT FROM$100,000/$300,000/$50,000 TO
$1,000,000
Removal If Covered Property is removed to a new location that is described on this Policy
Permit Change, you may extend this insurance to include that Covered Property at each
location during the removal. Coverage at each location will apply in the proportion
that the value at each location beats to the value of all Covered Property being
removed. This permit applies up to 10 days after the effective date of this Policy
Change: after that, this insurance does not apply at the previous location.
91A277 MUM 7-02 I duk CoMighled Mahrial, mmow Seniors Office,Inc,dlh is Pmuam. E4271102 PAGE 2 OF 2
142774DI
Farmers Insurance Exchange(A Reciprocal Insurer)
'FARM E R 9 Member Of The Farmers Insurance Group Of Companies®
INSURANCE Home Office:6301 Owensmouth Ave.,Woodland Hills,CA91367
COMMON POLICY DECLARATIONS
Named DEAZTLAN CONSULTING LLC F002569959-001-00001
Insured Account No. Prod.Count
78115 CALLE ESTADO#206 99-68-358 60550-47-48
Mailing Address LA QUINTA,CA 92253 Agent No- Policy Number
Form of ❑Individual ❑joint Venture ❑X Limited Liability Co. Business Description:
Business El Corporation ❑Partnership ❑Other Organization
Policy From 12-14-2018 (not prior to time applied for)
Period To 12-14-2019 12:01 A.M.Standard time at your mailing address shown above.
If this policy replaces other coverage that ends at noon standard time of the same day this policy begins,this policy will not take effect
until the other coverage ends. This policy will continue for successive policy periods as follows: If we elect to continue this
insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our
premiums,rules and forms then in effect.
This policy consists of the following coverage parts listed below and fo r wh is h a premium is indicated.This premium may be subject to
change.
Coverage Parts Premium After Discount And Modification
Business Auto $5,261.00
Total(See Additional Fee Information Below) $5,261.00
56-2406 1-17 C2406201 Page 1 of 3
56-2406-ED2
Policy Number: 60550-47-48 Effective Date: 12-14-2018
Forms Applicable To
All Coverage Parts:
YourAgent
Felipe Alvarez
81730 Us Hwy 111 #12
Indio,CA 92201
(760)698-8120
Countersigned(Date) By Authorized Representative
56-2406 1-17 C2406202 Page 2 of 3
Policy Number:60550-47-48 Effective Date:12-14-2018
Additional Fee Information
The following additional fees apply on an account,not a per-policy, basis.
• A service fee will be assessed on every installment invoice and will be included in the minimum amount due.
However, if you choose to pay the entire account balance in full upon receipt of the first installment, the fee will be
waived. In addition,foraccounts fully enrolled in online billing and scheduled for recurring Electronic Funds Transfer
(EFT)payments the fee will be waived.
State Installment Fee
All states except Alaska,Florida,Maryland,NewJersey And West Virginia $6.00
Alaska and Maryland Not applicable
Florida $3.00
NewJersey $7.00
West Virginia $5.00
• Areturned paymentfee applies per check,electronic transaction or other remittance which is not honored by your
financial institution for any reason including but not limited to insufficient funds or a closed account. NOTE:if the
returned payment is in response to a Notice of Cancellation,coverage still cancels on the cancellation effective
dateset forth W the notice.
State NSF Fee
All States Except Alaska, Florida, Indiana, Maine, Nebraska, New Jersey, $30.00
North Dakota,Oklahoma,Virginia And West Virginia
North Dakota And Oklahoma $25.00
Nebraska And Indiana $20.00
Florida And West Virginia $15.00
Maine $10.00
Alaska,New Jersey And Virginia Not applicable
• A late fee will be assessed on each Notice of Cancellation that is issued and will be included in the minimum amount
due.
State Late Fee
All States Except Alaska, Florida, Maryland, Missouri, Nebraska, New $20.00
Jersey,Rhode Island,Virginia,South Carolina And West Virginia
Nebraska,Rhode Island And South Carolina $10.00
Alaska,Florida,Maryland,Missouri,NewJersey,Virginia And West Virginia Not applicable
The following applies on a per-policy basis.
• A reinstatement fee of$25.00 will be assessed if the policy is reinstated over 30 days but under 6 months from the
cancellation date. This fee does not applyto Florida,Indiana&Maryland or to Workers Compensation policies.
One or more of the fees or charges described above maybe deemed apart of premium under applicable state law.
56-24061-17 C2406203 Page 3 of 3
OWN
Farmers Insurance Exchange(A Reciprocal Insurer)
F A R M E R A Part Of The Farmers Insurance Group Of Companies®
INSURANCE Home Office:6301 Owensmouth Ave.,Woodland Hills,CA 91367
POLICY DECLARATIONS
BUSINESS AUTO
vo1.00
ITEM ONE
Named DEAZTLAN CONSULTING LLC
Insured
Mailing 78115 CALLE ESTADO#206
Address LA QUINTA,CA92253
Policy Number 60550-47-48
Policy From 12-14-2018
Period To 12-14-2019 12:01 A.M.Standard time at your mailing address shown above.
In return for the payment of premium and subject to all the terms of this policy, we agree with you to provide insurance as
stated in this policy. We provide insurance only for those Coverages described and for which a specific limit of insurance is
shown.
Your Agent Felipe Alvarez
81730 Us Hwy 111 #12
Indio,CA 92201
(760)698-8120
Email:falvarez@farmersagent.com
License#:Og24325
56-619015TEDITION 06-16 C6190101
566190-EDI Page 1 of 6
Policy Number: 60550-47-48 Effective Date: 12-14-2018
ITEM TWO-SCHEDULE OF COVERAGES AND COVERED AUTOS
"This policy provides only those coverages where a charge is shown in the premium column below. Each of these
coverages will apply only to those"autos" shown as covered "autos". "Autos" are shown as covered "autos"for a
particular coverage by the entry of one or more of the symbols from the COVERED AUTO Section of the Business Auto
Coverage Form next to the name of the coverage.
*Covered Auto
Coverage =Designation Umit Of insurance Premium
Symbols
Liability 7 $1,000,000 $3,662
Medical Payments 7 See ITEM THREE $69
Uninsured Motorist 7 See ITEM THREE $176
Underinsured Motorist 7 See ITEM THREE Included
Uninsured Motorist 7 See ITEM THREE Included
Property Damage
Comprehensive 7 Actual Cash Value or Cost of Repair,whichever is $336
less,minus applicable deductible for each covered
auto.But no deductible applies to loss caused by
Fire or Lightning.See ITEM FOUR for hired or
borrowed"Autos".
Collision 7 Actual Cash Value or Cost of Repair,whichever is $974
less,minus applicable deductible for each covered
auto.See ITEM FOUR for hired or borrowed"Autos".
"Premium for Other Coverages and Endorsements $44
Total Premium $5,261
"For details of"Other Coverages",see ITEM FOUR,ITEM FIVE,and POLICY FORMS AND ENDORSEMENTS.
56-61901STEDITION 06-16 C6190102
566190-EIB Page 2 of 6
Policy Number: 60550-47-48 Effective Date: 12-14-2018
ITEM THREE-SCHEDULE OF COVERED AUTOS YOU OWN (DETAIL)
Covered Auto No. -001 I'. VIN: 5TFRM5F18AX013533
Description: 2010:TOYOTATUNDRA DOU Garaging Zip: 92203
Coverage Limit Of Insurance Or Deductible Premium
Liability $1,000,000 $1,844
Medical Payments $500 $54
Uninsured Motorist $100,000 $77
Underinsured Motorist Included Included
Uninsured Motorist Property Damage $3,500 Included
Vehicle Total Premium $1,975
Covered AutoNo.: 003 V1N: WBAJA5C5XJWA56984
Description: 2018--BMW 5301 Garaging.Ztpt 92203.
Coverage Limit Of Insurance or Deductible Premium
Liability $1,000,000 $1,818
Medical Payments $500 $15
Uninsured Motorist $100,000 $99
Underinsured Motorist Included Included
Comprehensive $1,000 Deductible $336
Collision $1,000 Deductible $974
Rental Reimbursement $30 per day,30 days $44
Vehicle Total Premium $3,286
56-61901STEDITION 06-16 C6190104
566190-E1D Page 3 of 6
Policy Number: 60550-47-48 Effective Date: 12-14-2018
ITEM FOUR-HIRED OR BORROWED COVERED AUTO
Cost of hire means the total amount you incur for the hire of"autos"you don't own(not including"autos"you borrow or rent
from your employees or their family members). Cost of hire does not include charges for services performed by motor carriers
of property or passengers.
Liability Coverage Rating Basis,CostOf Hire
stare Estimated Annual Cost Of Hire Premium
For Each State
Subtotal
Physical Damage Coverage
Limit Of Insurance Estimated Annual
Coverage ;Premium
And Deductible Cost OfHire
Subtotal
ITEM FIVE-NON-OWNERSHIP LIABILITY
Non-Ownership Liability covers bodily injury or property damage arising out of the maintenance or use of a non-owned
automobile in the business byany person other than the insured.
Named insured's Business hating Basis Number Premium
Other than a Number of Employees
Social Service Agency N umber of Partners
Social Service Agency Numberof Employees
Number of Volunteers
Subtotal
56-61901STEDITION 06-16 C6190105
566190-ElE Page 4 of 6
Policy Number: 60550-47-48 Effective Date: 12-14-2018
POLICY FORMS AND ENDORSEMENTS
Number Title
25-2984ED2 Ins Dept Address-Customer Letter
25-9200 Farmers Privacy Notice
25-9230ED3 Reminder-Review Your Coverages
CA00010310 Business Auto Policy
CA00381202 WarFxclusion
CA01430517 California Changes
CA03050297 Calif Chgs-Waiver Of Collision D
CA20480299 Addllnsd-Designated Insured
CA21540909 California Uninsrd Mtr-Bodily In
CA21550909 California Um Cov-Property Damag
CA23840106 Exclusion Of Terrorism
CA23940306 Silica Or Silica-Related Dust Ex
CA99230310 Rental Reimbursement Coverage
E0207-ED1 Punitive Or Exemplary Damages Ex
E2015-ED2 Family Exclusion Form
E2016-ED1 Auto Medical Payment Coverage
E3027-ED1 No Covg-Cert Computer Rel Losses
E3153-ED1 Waiver Of Subrogation
E4277-ED1 Policy Changes
IL00030498 Calculation Of Premium
IL00171198 Common Policy Conditions
IL00210498 Nuclear Energy Liab Excl
IL02700811 California Changes-Canc&Nonren
J6738-ED1 Two Or More Coverage Forms
J7118-ED1 Auto Rideshare Exclusion
J7119-ED3 Ded For Unlisted Employee Driver
J7153-ED1 Additional Benefits And Services
LOSS PAYEES
Countersigned(Date) By Authorized Representative
56-61901STEDITION 06-16 C6190106
566190-EIF Page 5 of 6
Policy Number: 60550-47-48 Effective Date: 12-14-2018
DRIVERS THAT ARE LISTED UNDER THIS POLICY
First Name Last Name License Driver License#
state
Roberto Deaztlan CA XXXXXX6521
Excluded drivers will be listed in the Excluded Driver Endorsement or Restriction Endorsement,if attached.
56-61901STEDITION 06-16 C6190108
566190-EIH Page 6 of 6
FIRST AMENDMENT TO,CONSULTING SERVICES AGREEMENT
DeAztlan Consulting (Agreement No. A7156)
THIS FIRST AMENDMENT to the Consulting Services Agreement No. A7156 for
Districting Initiative and Boards and Commissions Diversity Outreach Project is made and
entered into to be effective.on the 20th day of September, 2018 by and between the City of
Palm.Springs, a California charter city and municipal corporation (hereinafter referred to as
the City), and DeAztlan Consulting a single member LLC.. City and Consultant are
individually referred to as "Party" and are collectively referred to as the "Parties".
RECITALS ,
A. City and Consultant previously entered into a consulting services agreement for .
Districting and Boards and Commissions Diversity Outreach Project which was.
made and entered into on June 26, 2018 (the "Agreement") in the amount not to
exceed $24,500.
B. City and Consultant desire. to amend .the Agreement to' extend the term of the
contract and to modify to scope of services to include outreach regarding the City's
leaf blower ordinance.
NOW, THEREFORE, in consideration of the mutual promises and covenants contained
herein, the Parties agree as follows:
1, Scope of Services. In compliance with all terms and conditions of the Agreement,
Consultant shall provide consulting services to the City as described in the Scope of
Services/Work attached to this Amendment as Exhibit "A" and incorporated by "
reference (the"services" or."work"). Exhibit"A" includes the agreed upon schedule
of performance and the schedule of fees. Consultant warrants that all services and
work shall be performed in a competent, professional, and satisfactory manner
consistent with. prevailing industry standards. In the event of any inconsistency
between the terms contained:in the Scope of Services/Work and the terms set forth
in this Amendment, the terms set forth in this Amendment shall govern.
2. Compensation of Consultant. Consultant shall be compensated for the services
rendered under this Agreement in accordance with the schedule of fees set forth in -
Exhibit"A".The total amount of Compensation shall not exceed $39,650(thirty nine
thousand six hundred fifty dollars).
3. Term. Unless earlier terminated in accordance with Section 4.5 of the Agreement,
this Agreement shall continue in full force and effect until December 31, 2018,
.unless extended by mutual agreement of the parties. .
[SIGNATURES ON NEXT PAGE]
ORIGINAL BID
1 AND/OR AGREEMENT
IN WITNESS WHEREOF, the parties have executed this Amendment as of the dates
stated below.
ATTEST_ : "CITY"
CITY OF PALM SPRINGS, CA.
By: By.
)knffiony M jia, bire erk David H. Ready, City M ger
Date: I Iiadaelf Date:
T
APPROVED AS TO FORM:
s
Edward Z. Kotkin, C ty Aft trAy
Date: A� �
"CONSULTANT"
'APPROVED BY CITY COUNCIL DeAztlan Consulting
By:
Date: (%
2
0
a
FELIPE ALVAREZ
81730 US HWY 111 #12
INDIO CA 92201
FARMERS
INSURANCE
N
CL9
C1
aC
CITY OF PALM SPRINGS
3200 E TAHQUITZ CANYON WAY
PALM SPRINGS CA 922626959
E
0
a
COMMERCIAL AUTO MORTGAGEE
This section is for policy: 60550-47-48
Assembled-on Date: 10104118
Assembled-on Time: 01:33:56
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
E4277
Policy Number: 60550-47-48 Isl EERfisn
POLICY CHANGES
Effective Date of Change: 10/03/18 Expiration Date: 12/14/18
Change Endorsement No.: 009 Agent: 99-68-358
Named Insured: DEAZTLAN CONSULTING LLC
78115 CALLE ESTADO n206
LA QUINTA CA 92253
The following item(s):
Insured's Name Insured's Mailing Address
Policy Number Company
Effective/ Expiration Date Insured's Legal Status / Business of Insured
Payment Plan Premium Determination
Additional Interested Parties Coverage Forms and Endorsements
X Limits/Exposures Deductibles
Covered Property/ Location Description Classification/Class Codes
Rates Underlying Insurance
is (are) changed to read {See Additional Page(s)):
The above amendments result in a change in the premium as follows:
No Changes To Be Adjusted At Audit Additional Premium Return Premium
$ 181.00 $
Authorized Representative Signature:
AM FARMERS
INSURANCE
914177 ISTEDINON 7-01 Indudestopyrighled Nalrtial Dcmuna samm OFfia,Inc,rhh As Prn"w. E4277101 PAGE I OF 1
141774DI
Policy Changes Endorsement Description
CHANGE POLICY LEVEL INFORMATION
CHANGE:LIABILITY LIMIT FROM$100,000/$300,000/$50,000 TO
$1,000,000
Removal If Covered Property is removed to a new location that is described on this Policy
Permit Change, you may extend this insurance to include that Covered Property at each
location during the removal. Coverage at each location will apply in the proportion
that the value at each location bears to the value of all Covered Property being
removed. This permit applies up to 10 days after the effective date of this Policy
Change: after that, this insurance does not apply at the previous location.
914277 1STE0IIION 7-02 Indud�UM1916yd Molnioi,Imwone Snricn OENa,Inc,r0h 15 peraMm E4277102 PAGE 2 OF 2
E4277{O1
Farmers Insurance Exchange(A Reciprocal Insurer)
FARMERS" Member Of The Farmers Insurance Group Of Companies®
INSURANCE Home Office:6301 Owensmouth Ave.,Woodland Hills,CA91367
COMMON POLICY DECLARATIONS
Named DEAZTLAN CONSULTING LLC F002569959-001-00001
Insured Account No. Prod.Count
78115 CALLE ESTADO#206 99-68-358 60550-47-48
Mailing Address LA QUINTA,CA92253 Agent No. Policy Number
Form of ❑Individual ❑joint Venture ❑X Limited Liability Co. Business Description:
Business El Corporation ❑Partnership Other Organization
Policy From 10-03-2018 (not prior to time applied for)
Period To 12-14-2018 12:01 A.M.Standard time at your mailing address shown above.
If this policy replaces other coverage that ends at noon standard time of the same day this policy begins,this policy will not take effect
until the other coverage ends. This policy will continue for successive policy periods as follows: If we elect to continue this
insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our
premiums,rules and forms then in effect.
This policy consists of the following coverage parts listed below and for which a premium is indicated.This premium may be subject to
change.
Coverage Parts Premium After Discount And Modification
Business Auto $4,257.00
Total(See Additional Fee Information Below) $4,257.00
56-2406 1-17 C2406201 Page 1 of 3
56-2406-ED2
Policy Number: 60550-47-48 Effective Date: 10-03-2018
Forms Applicable To
All Coverage Parts:
YourAgent
Felipe Alvarez
81730 Us Hwy 111 #12
Indio,CA92201
(760)698-8120
Countersigned (Date) By Authorized Representative
56-2406 1-17 C2406202 Page 2 of 3
EXHIBIT "A"
SCOPE OF SERVICES/WORK
SCHEDULE OF FEES
-DeAztlan Consulting will deliver the following services, but not limited to,for the City of Palm
Springs:
• Spanish Language Media Outreach and Communications
• General Strategy
• Community Outreach and Engagement
• Culturally Appropriate Message Development
• Translation
• Meeting Attendance
Schedule of Fees:
• Monthly retainer of$4,000 for up to 20 hours of directed work.
• Consultant to provide report of hourly service when 20 hours are met in one billing cycle.
• Additional hours over 20 in any one billing cycle will be billed at$150 per hour and will
not be performed without written approval by staff.
DEAZTLAN CONSULTING outreach support staff time and any travel expense incurred will
remain the responsibility of DEAZTLAN CONSULTING.
3 .
Ac R CERTIFICATE OF LIABILITY INSURANCE °A1o042018'"`'
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THECERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELYOR NEGATIVELY
AMEND,EXTEND OR ALTERTHE COVERAGE AFFORDED BYTHE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE ACONTRACT BETWEEN THE ISSUING INSU RER(S),
AUTHORIZED REPRESENTATIVE OR PRODUCER,ANDTHE CERTIFICATE HOLDER.
IMPORTANT:Ifthe certificate holder Is an ADDMONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.USUBROGATION IS WAIVED,subJectto the terms and
conditions of the policy,certain pollcles mayrequire an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME: Farmers Business Insurance
Farmers Insurance Group Of Companies(99683fd PHONE FAX
81730 Us Highway 111 Ste 12 (A/c,No,EXr):760-698-8120 (A/C.NO):760-598-8121
E-MAIL
Indio CA 92201-5441 ADDRESS: falvarez@farmersagent.com
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED iNSURERA: Truck Insurance Exchange 21709
INSURER B: Farmers Insurance Exchange 21652
DEAZTLAN CONSULTING LLC INSURERC: Mid Century Insurance Company 21687
78115 CALLS ESTADO#206 INSURERD:
INSURER E:
LA QUINTA CA 92253
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTOTHE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY
REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE I NSURANCEAFFOR05D BYTHE
POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHETERMS,EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPEOFINSURANCE ADDTL SUER POLICYNUMBER POLICY EFF POLICYEXP LIMITS
LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S
CLAIMS-MADE F
OCCUR DAMAGETO PREMISES(E(ERENTED S
a Occurrence)
I MED EXP(Anyone person) S
PERSONAL&ADVINJURY $
GEN'L AGGREGATE LIMITAPPLIESPER: GENERAL AGGREGATE S
POLICY F PROJECT LOC PRODUCTS-COMP/OPAGG S
OTHER: S
AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT S 1,000,000
(Ea accident)
ANYAUTO BODILY INJURY(Per person) S
B OWNEDAUTOS X SCHEDULED BODILY INJURY(Per accident)S
ONLY AUTOS Y Y 1605504748 12/14/2017 12/14/2018
HIREDAUTOS NON-OWNED PROPERTY DAMAGE $
I ONLY AUTOSONLY (Peraccident)
S
UMBRELLALIAB OCCUR EACH OCCURRENCE S
r EXCFSSLIAB i CLAIMS-MADE AGGREGATE S
DED RkTENTI0N5 S
WORKERS COMPENSATION PER OTHER S
AND EMPLOYERS'LIABILITY STATUTE
ANY PROPRIETOR/PARTNER/ Y/N N/A E.L EACH ACCIDENT S
EXECUTIVE OFFICER/MEMBER
CXCLUDEW(Mandatoryin NH) E.L.DISEASE-EA EMPLOYEE
Ifyes,describe under DESCRIPTION OF
OPERATIONSbelow E.L.DISEASE-POLICY LIMIT S
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
'This Insurance is primary and non-contributory over any insurance or self insurance the City may have for any and all worked performed with the City."Should
any of the above described policies be canceled before the expiration date thereof,the issuing company will mail a 30:pm written notice to the certificate holder
names herein."ITS UNDERSTOOD AND AGREED THAT COMPANY WAIVES THE RIGHT OFSUBROGATION AGAINST THE ABOVE ADDITIONAL
INSURED,SUTONLY AS RESPECVTS THE JOB OR PREMISES DESCRIBED IN THE CERTIFICATE ATTACHED HERETO."
CERTIFICATE HOLDER CANCELLATION
CITY OF PALM SPRINGS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION
3200 E TAHQUITZ CANYON WAY DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
PGI
00
ACORD 25(2016/03) 01988-2015 ACORD CORPORATION.All Rights Reserved
31-1769 11-15 The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: 60550-47-48 COMMERCIAL AUTO
CA 20 48 02 99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless
modified by this endorsement.
This endorsement identifies person(s)or organization(s)who are"insureds"under the Who Is An Insured Provi-
sion of the Coverage Form.This endorsement does not alter coverage provided in the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is indi-
cated below.
Endorsement Effective: Countersigned By:
08
Namedmed Ins Insured: 01
DEAZTLAN CONSULTING LLC Authorized Representative)
SCHEDULE
Name of Person(s)or Organization(s):
CITY OF PALM SPRINGS
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to the endorsement.)
Each person or organization shown in the Schedule is an"insured"for Liability Coverage,but only to the extent
that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained
in Section II of the Coverage Form.
CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
FARM E RS E3153
INSURANCE 1st Edition
CHANGES IN TRANSFER OF
RIGHTS OF RECOVERY AGAINST OTHERS TO US
(WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following.
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Endorsement Effective: Countersigned By:
06/07/18
Named Insured: - a-4—
DEAZTLAN CONSULTING LLC �thorRepresentadvc)
SCHEDULE
Name Of Person(s)Or Organization(s):
CITY OF PALM SPRINGS
Additional Premium 1 $
(If no entry appears above,information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the parson(s) or
organization(s) shown in the Schedule. We will retain the additional premium shown above, regardless of any
early termination of this endorsement or the policy.
This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise
subject to all the terms of the policy.
913153 1STEDMON 646 E3153101 Page 1 of 1
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