HomeMy WebLinkAboutA6621 - PALM SPRINGS PLUMBING COMPANY INC - LOW FLOW TOILET PROGRAM �aF pALM fA�i2 City of Pafm Springs
Office of Sustainability and
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cgll FO RN�P 3200 E rahquitz-Canyon Way •Palm Springs, Califomia 92262
August 2, 2016
Gregg Mandinach
Palm Springs Plumbing Company, Inc. (r]
3800 E Vista Chino Ste 4
Palm Springs CA 92262
Mr. Mandinach,
This is to inform you that the Contract Services Agreement # 6621 dated September 25,
2014 and City of Palm Springs Purchase Order # 16-0480:0 are hereby canceled. No further
payments will be issued on this contract services agreement or purchase order.
The following changes are to the Contract Services Agreement per Section 3.4 as follows:
➢ Section 3.4 Appropriations. This Agreement is subject to and contingent
upon funds being appropriated by the City Council of City for each fiscal year
covered by the Agreement. If such appropriations are not made, this Agreement
shall automatically terminate without penalty to City.
➢ As funding for this Agreement was not appropriated by the City Council for the
2016-17 Fiscal Year, this Agreement is terminated as of June 30, 2016.
We thank you for your services and look forward to working with you in the future should the
occasion arise. Please feel free to contact us with any questions at 760-323-8214 or 760-
323-8248. You may also email me at michele.micianapalmspringsca.gov
Sinc
Michele Mician
Manager, Office of Sustainability
City of Palm Springs
cc: James Thompson, City Clerk
CITY OF PALM SPRINGS
CONTRACT SERVICES AGREEMENT FOR
PLUMBING SERVICES FOR PALM SPRINGS PLUMBING COMPANY, INC.
THIS CONTRACT SERVICES AGREEMENT (herein "Agreement") is made and entered into
this 25th day of September, 2014, by and between the City Of Palm Springs, a municipal
corporation ("City"), acting by and through its City Manager, or his designee, a Contract Officer
of the City ("City") and Palm Springs Plumbing Company, Inc., a plumbing contractor,
("Contractor").
NOW, THEREFORE, the parties hereto agree as follows:
City requires the services of a plumbing contractor for the Low-Flow Toilet Program ("Project').
Contractor has submitted to City a proposal to provide plumbing service to City pursuant to the
terms of this Agreement.
Based on its experience, education, training, and reputation, Contractor is qualified to provide
the necessary services to City for the Project and desires to provide such services.
City desires to retain the services of Contractor for the Project.
NOW, THEREFORE, in consideration of the promises and mutual agreements contained
herein, City agrees to retain and does hereby retain Contractor and Contractor agrees to
provide services to the City as follows:
AGREEMENT
1.0 CONTRACTOR SERVICES
1.1 Scope of Services. In compliance with all of the terms and conditions of this
Agreement, the Contractor shall perform the services set forth in the Scope of Services attached
hereto as Exhibit "A" and incorporated herein by reference which includes the agreed upon
schedule of performance and the schedule of fees. Contractor warrants that all services set
forth in the Scope of Services will be performed in a competent, professional and satisfactory
manner.
1.2 Compliance With Law. All services rendered hereunder shall be provided in
accordance with all ordinances, resolutions, statutes, rules, and regulations of the City and any
federal, state or local governmental agency of competent jurisdiction.
1.3 Licenses, Permits, Fees and Assessments. Contractor 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.
1.4. Familiarity With Work. By executing this Agreement, Contractor warrants that it
has carefully considered how the services should be performed and fully understands the
facilities, difficulties, and restrictions attending performance of the work under this Agreement.
2.0 TIME FOR COMPLETION
The time for completion of the services to be performed by Contractor is an essential
condition of this Agreement. Contractor shall prosecute regularly and diligently the services of
this Agreement according to the agreed upon schedule of performance set forth in Exhibit "A."
Contractor shall not be accountable for delays in the progress of its work caused by any
condition beyond its control and without the fault or negligence of Contractor. Delays shall not
entitle Contractor to any additional compensation regardless of the party responsible for the
delay.
3.0 CONTRACTOR COMPENSATION
3.1 Contract Sum. For the services rendered pursuant to this Agreement,
Contractor shall be compensated and reimbursed, in accordance with the schedule of fees set
forth in Exhibit "A," which amount shall not exceed Two Thousand Eight Hundred Dollars
($2,800.00).
3.2 Method of Payment. In any month in which Contractor wishes to receive
payment, Contractor shall submit to City an invoice for services rendered. City shall pay
Contractor for all expenses stated thereon which are approved by City consistent with this
Agreement, within thirty(30) days of receipt of Contractor's invoice.
3.3 Changes. In the event any change or changes in the Scope of services is
requested by City, the parties hereto shall execute a written amendment to this Agreement,
setting forth with particularity all terms of such amendment, including, but not limited to, any
additional fees. An amendment may be entered into:
To provide for revisions or modifications to documents or other services when
documents or other service is required by the enactment or revision of law subsequent to the
preparation of any documents, or service;
To provide for additional services not included in this Agreement or not customarily
furnished in accordance with generally accepted practice in Contractor's profession.
3.4 Appropriations. This Agreement is subject to and contingent upon funds being
appropriated by the City Council of City for each fiscal year covered by the Agreement. If such
appropriations are not made, this Agreement shall automatically terminate without penalty to
City.
4.0 COORDINATION OF WORK
4.1 Contract Officer. The Manager of Sustainability is hereby designated as being
the representative the City authorized to act in its behalf with respect to the services specified
herein and make all decisions in connection therewith ("Contract Officer"). The City Manager of
City shall have the right to designate another Contract Officer by providing written notice to
Contractor.
4.2 Representative of Contractor. The following principal of Contractor is hereby
designated as being the principal and representative Contractor authorized to act in its behalf
Plumbing Services Contractor Agreement Page 2
Low Flow Toilet Program September 25, 2014
with respect to the services and make decisions in connection therewith: Gregg Mandinach,
President. It is expressly understood that the experience, knowledge, education, capability and
reputation of the foregoing principal is a substantial inducement for City to enter into this
Agreement. Therefore, the foregoing principal shall be responsible during the term of this
Agreement for directing all activities of Contractor. The foregoing principal may not be changed
by Contractor without prior written approval of the Contract Officer.
4.3 Prohibition Against Subcontracting or Assignment. Contractor shall not
contract with any entity to perform in whole or in part the services required hereunder without
the express written approval of the City. Neither this Agreement nor any interest herein may be
assigned or transferred, voluntarily or by operation of law, without the prior written approval of
City. Any such prohibited assignment or transfer shall be void.
4.4 Independent Contractor. Neither the City nor any of its employees shall have
any control over the manner, mode or means by which Contractor, its agents or employees,
perform the services required herein, except as otherwise set forth. Contractor shall perform all
services required herein as an independent contractor of City and shall remain under only such
obligations as are consistent with that role. Contractor shall not at any time or in any manner
represent that it or any of its agents or employees are agents or employees of City.
5.0 INSURANCE
Contractor shall procure and maintain, at its sole cost and expense, policies of insurance
as set forth in Exhibit "B," which is attached hereto and is incorporated herein by reference.
6.0 TERM
6.1 Term. Unless earlier terminated, this Agreement shall continue in full force until
June 30, 2016,
6.2 Termination Prior to Expiration of Term. Either party may terminate this
Agreement at any time, with or without cause, upon thirty (30) days' written notice to the other
party. Upon receipt of the notice of termination, the Contractor shall immediately cease all work
or services hereunder except as may be specifically approved by the Contract Officer. In the
event of termination by the Agency, Contractor shall be entitled to compensation for all services
rendered prior to the effectiveness of the notice of termination and for such additional services
specifically authorized by the Contract Officer and City shall be entitled to reimbursement for
any compensation paid in excess of the services rendered.
7.0 INDEMNIFICATION
To the fullest extent permitted by law, Contractor shall defend (at Contractor's sole cost
and expense), indemnify, protect, and hold harmless City, its elected officials, officers,
employees, agents, and volunteers (collectively the "Indemnified Parties"), from and against any
settlements, damages, demands, orders, penalties, and expenses including legal costs and
attorney fees (collectively"Claims"), including but not limited to Claims arising from injuries to or
death of persons (Contractor's employees included), for damage to property, including property
owned by City, from any violation of any federal, state, or local law or ordinance, and from errors
and omissions committed by Contractor, its officers, employees, representatives, and agents,
which Claims arise out of or are related to Contractor's performance under this Agreement, but
Plumbing Services Contractor Agreement Page 3
Low Flow Toilet Program September 25, 2014
excluding such Claims arising from the negligence or willful misconduct of the City, its elected
officials, officers, employees, agents and volunteers. Under no circumstances shall the
insurance requirements and limits set for in Exhibit "B" be construed to limit Contractor's
indemnification obligation or other liability hereunder.
8.0 RECORDS AND REPORTS
8.1 Reports. Contractor shall periodically prepare and submit to the Contract Officer
such reports concerning the performance of the services required by this Agreement as the
Contract Officer shall require.
8.2 Records. Contractor shall keep such books and records as shall be necessary
to properly perform the services required by this Agreement and enable the Contract Officer to
evaluate the performance of such services. The Contract Officer shall have full free access to
such books and records at all reasonable times, including the right to inspect, copy, audit and
make records and transcripts from such records.
8.3 Cost Records. Contractor shall maintain all books, documents, papers,
employee time sheets, account records, and other evidence pertaining to costs incurred.
9.0 AGREEMENT ENFORCEMENT
9.1 California Law. This Agreement shall be construed and interpreted both as to
validity and to performance of the parties in accordance with the laws of the State of California.
Legal actions concerning any dispute, claim, or matter arising out of or in relation to this
Agreement shall be instituted in the Superior Court of the County of Riverside, State of
California, or any other appropriate court in such county, and Contractor covenants and agrees
to submit to the personal jurisdiction of such court in the event of such action.
9.2 Waiver. No delay or omission in the exercise of any right or remedy by a non-
defaulting party on any default shall impair such right or remedy or be construed as a waiver. A
party's consent to or approval of any act by the other party requiring the party's consent or
approval shall not be deemed to waive or render unnecessary the other party's consent to or
approval of any subsequent act. Any waiver by either party of any default must be in writing and
shall not be a waiver of any other default concerning the same or any other provision of this
Agreement.
9.3 Rights and Remedies are Cumulative. Except with respect to rights and
remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the
parties are cumulative and the exercise by either party of one or more of such rights or
remedies shall not preclude the exercise by it, at the same or different times, of any other rights
remedies for the same default or any other default by the other party.
9.4 Legal Action. In addition to any other rights or remedies, either party may take
legal action, in law or in equity, to cure, correct, or remedy any default, to recover damages for
any default, to compel specific performance of this Agreement, to obtain injunctive relief, a
declaratory judgment, or any other remedy consistent with the purposes of this Agreement.
Plumbing Services Contractor Agreement Page 4
Low Flow Toilet Program September 25, 2014
10.0 City Officers And Employees; Non Discrimination.
10.1 Covenant Against Discrimination. Contractor 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. Contractor shall take affirmative action to ensure 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.
10.2 Non-liability of City Officers and Employees. No officer or employee of the
City shall be personally liable to the Contractor, or any successor in interest, in the event of any
default or breach by the Agency or for any amount which may become due to the Contractor or
to its successor, or for breach of any obligation of the terms of this Agreement.
11.0 Miscellaneous Provisions
11.1 Notice. Any notice, demand, request, document, consent, approval, or
communication either party desires or is required to give to the other party or any other person
shall be in writing and either served personally or sent by prepaid, first-class mail, in the case of
the Agency, to the City Manager and to the attention of the Contract Officer, COMMUNITY
REDEVELOPMENT AGENCY OF THE CITY OF PALM SPRINGS, P.O. Box 2743, Palm
Springs, California 92263, and in the case of the Contractor, to the person at the address
designated on the execution page of this Agreement.
11.2 Conflict of Interest. No officer or employee of the City shall have any financial
interest, direct or indirect, in this Agreement nor shall any such officer or employee participate in
any decision relating to the Agreement which effects his financial interest or the financial interest
of any corporation, partnership or association in which he is, directly or indirectly, interested, in
violation of any State statute or
regulation. The Contractor 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.
11.3 Amendment. This Agreement may be amended at any time by the mutual
consent of the parties by an instrument in writing.
11.4 Severability. In the event that part of this Agreement shall be declared invalid or
unenforceable by a valid judgment or decree of a court of competent jurisdiction, such invalidity
or unenforceability shall not affect any of the remaining portions of this Agreement which are
hereby declared as severable and shall be interpreted to carry out the intent of the parties.
11.5 Attorneys' Fees. If either party to this Agreement is required to initiate or defend
or made a party to any action or proceeding in any way connected with this Agreement, the
prevailing party in such action or proceeding, in addition to any other relief which may be
granted, whether legal or equitable, shall be entitled to reasonable attorney's fees, whether or
not the matter proceeds to judgment.
11.6 Authority. The persons executing this Agreement on behalf of the parties hereto
warrant that (i) such party is duly organized and existing, (ii) they are duly authorized to execute
Plumbing Services Contractor Agreement Page 5
Low Flow Toilet Program September 25, 2014
and deliver this Agreement on behalf of said party, (iii) by so executing this Agreement, such
party is formally bound to the provisions of this Agreement, and (iv) the entering into this
Agreement does not violate any provision of any other Agreement to which said party is bound.
IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as
of the date first written above.
CITY OF PALM SPRINGS
i ( � I �� a p 'c body, core and politic
Date: I PC((I�
i Michel C. Mician, Manager
J-H C Leat— a (/ Office of Sustainability
CONTRACTOR: Check one: Individual=Partnership_C`� orporation
Corporations require two notarized signatures: One from each of the following: A. Chairman of
Board, President, or any Vice President: AND B. Secretary, Assistant Secretary, Treasurer,
Assistant Treasurer, or Chief Financial Officer).
Name: Name:
- -%T L
Title: Title:
[END OF SIGNATURES]
Plumbing Services Contractor Agreement Page 6
Low Flow Toilet Program September 25, 2014
EXHIBIT "A"
SCHEDULE OF FEES AND SCOPE OF WORK
The Contractor shall be paid $110.00 for each toilet installation not to exceed $2,800.00.
The Schedule of Work shall include removal and discard of existing conventional toilet and
replaced with high-efficiency toilet with parts package provided by manufacturer. Flex line to be
provided by Contractor.
If repair or replacement of existing shut-off valve is necessary, it must be approved by the City
prior to work and billed separately.
Plumbing Services Contractor Agreement Page 7
Low Flow Toilet Program September 25, 2014
SCHEDULE B
INSURANCE PROVISIONS
Including
Verification of Coverage,
Sufficiently of Insurers,
Minimum Scope of Insurance,
Deductibles and Self-Insured Retentions, and
Severability of Interests (Separation of Insureds).
Plumbing Services Contractor Agreement Page 8
Low Flow Toilet Program September 25, 2014
INSURANCE
1. Procurement and Maintenance of Insurance. Consultant shall procure and
maintain public liability and property damage insurance against all claims for injuries against
persons or damages to property resulting from Consultant's performance under this Agreement.
Consultant shall procure and maintain all insurance at its sole cost and expense, in a form and
content satisfactory to the City, and submit concurrently with its execution of this Agreement.
Consultant shall also carry workers' compensation insurance in accordance with California
workers' compensation laws. Such insurance shall be kept in full force and effect during the
term of this Agreement, including any extensions. Such insurance shall not be cancelable
without thirty (30) days advance written notice to City of any proposed cancellation. Certificates
of insurance evidencing the foregoing and designating the City, its elected officials, officers,
employees, agents, and volunteers as additional named insureds by original endorsement shall
be delivered to and approved by City prior to commencement of services. The procuring of
such insurance and the delivery of policies, certificates, and endorsements evidencing the same
shall not be construed as a limitation of Consultant's obligation to indemnify City, its elected
officials, officers, agents, employees, and volunteers.
2. Minimum Scope of Insurance. The minimum amount of insurance required under this
Agreement shall be as follows:
2.1 Comprehensive general liability and personal injury with limits of at least one
million dollars ($1,000,000.00) combined single limit coverage per occurrence and two million
dollars ($2,000,000)general aggregate;
2.2 Automobile liability insurance with limits of at least one million dollars
($1,000,000.00) per occurrence;
2.3 Professional liability (errors and omissions) insurance with limits of at least one
million dollars ($1,000,000.00) per occurrence; and;
2.4 Workers' Compensation insurance in the statutory amount as required by the
State of California and Employer's Liability Insurance with limits of at least one million dollars $1
million per occurrence. If Consultant has no employees, Consultant shall complete the City's
Request for Waiver of Workers' Compensation Insurance Requirement form.
2.5 Primary Insurance. For any claims related to this Agreement, Consultant's
insurance coverage shall be primary with respect to the City and its respective elected officials,
officers, employees, agents, and volunteers. Any insurance or self-insurance maintained by
City and its respective elected officials, officers, employees, agents, and volunteers shall be in
excess of Consultant's insurance and shall not contribute with it. For Workers' Compensation
and Employer's Liability Insurance only, the insurer shall waive all rights of subrogation and
contribution it may have against City, its elected officials, officers, employees, agents, and
volunteers.
3. Errors and Omissions Coverage. If Errors & Omissions Insurance is required, and if
Consultant provides claims made professional liability insurance, Consultant shall also agree in
writing either (1) to purchase tail insurance in the amount required by this Agreement to cover
claims made within three years of the completion of Consultant's services under this
Plumbing Services Contractor Agreement Page 9
Low Flow Toilet Program September 25, 2014
Agreement, or (2) to maintain professional liability insurance coverage with the same carrier in
the amount required by this Agreement for at least three years after completion of Consultant's
services under this Agreement. Consultant shall also be required to provide evidence to City of
the purchase of the required tail insurance or continuation of the professional liability policy.
4. Sufficiency of Insurers. Insurance required in this Agreement shall be provided by
authorized insurers in good standing with the State of California. Coverage shall be provided by
insurers admitted in the State of California with an A.M. Best's Key Rating of B++, Class VII, or
better, unless otherwise acceptable to the City.
5. Verification of Coverage. Consultant shall furnish City with both certificates of
insurance and endorsements, including additional insured endorsements, effecting all of the
coverages required by this Agreement. The certificates and endorsements are to be signed by
a person authorized by that insurer to bind coverage on its behalf. All proof of insurance is to be
received and approved by the City before work commences. City reserves the right to require
Consultant's insurers to provide complete, certified copies of all required insurance policies at
any time. Additional insured endorsements are not required for Errors and Omissions and
Workers' Compensation policies. Verification of Insurance coverage may be provided by: (1) an
approved General and/or Auto Liability Endorsement Form for the City of Palm Springs or(2) an
acceptable Certificate of Liability Insurance Coverage with an approved Additional Insured
Endorsement with the following endorsements stated on the certificate:
"The City of Palm Springs, its officials, employees, and agents are named as an
additional insured..." ("as respects City of Palm Springs Plumbing Services Contract" or"for any
and all work performed with the City" may be included in this statement).
"This insurance is primary and non-contributory over any insurance or self-insurance the
City may have..." ("as respects City of Palm Springs Plumbing Services Contract" or "for any
and all work performed with the City" may be included in this statement).
"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 named."
Language such as, "endeavor to" mail and "but failure to mail such notice shall impose no
obligation or liability of any kind upon the company, its agents or representative" is not
acceptable and must be crossed out.
Both the Workers' Compensation and Employers' Liability policies shall contain the
insurer's waiver of subrogation in favor of City, its elected officials, officers, employees, agents,
and volunteers.
In addition to the endorsements listed above, the City of Palm Springs shall be named
the certificate holder on the policies.
All certificates of insurance and endorsements are to be received and approved by the
City before work commences. All certificates of insurance must be authorized by a person with
authority to bind coverage, whether that is the authorized agent/broker or insurance underwriter.
Failure to obtain the required documents prior to the commencement of work shall not waive the
Consultant's obligation to provide them.
Plumbing Services Contractor Agreement Page 10
Low Flow Toilet Program September 25, 2014
6. Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions
must be declared to and approved by the City prior to commencing any work or services under
this Agreement. At the option of the City, either (1) the insurer shall reduce or eliminate such
deductibles or self-insured retentions with respect to the City, its elected officials, officers,
employees, agents, and volunteers; or (2) Consultant shall procure a bond guaranteeing
payment of losses and related investigations, claim administration, and defense expenses.
Certificates of Insurance must include evidence of the amount of any deductible or self-insured
retention under the policy. Consultant guarantees payment of all deductibles and self-insured
retentions.
7. Severability of Interests (Separation of Insureds). This insurance applies separately
to each insured against whom claim is made or suit is brought except with respect to the limits
of the insurer's liability.
Plumbing Services Contractor Agreement Page 11
Low Flow Toilet Program September 25, 2014
California Automobile Insurance Company b 4
P.O. BOX 10730 MERCURY
SANTA ANA, CA 92711-0730 I N S U R A N C E
Customer Service: (800) 503-3724
BUSINESS AUTO POLICY RECEIVED
ADDITIONAL INSURED Renewal Declarations NOV 28 2022
Effective Date:01/24/2023 'ffleeofthe City Clerk
NAMED INSURED: AGENT:
PALM SPRINGS PLUMBING INC SAINT MOORE INS AGCY
3800 E VISTA CHINO STE 1 34045 YUCAIPA BLVD STE 107
PALM SPRINGS, CA 92262-4010 YUCAIPA, CA 923992440
(909)797-1141
SCHEDULE
Insurance Company:
California Automobile Insurance Company
Policy Number:
BA040000042021
Policy Period:
From: 01/24/2023 to 01/24/2024 at 12:01 AM Standard Time at your mailing
address
Additional Insured:
CITY OF PALM SPRINGS
Address:
3200 E Tahquitz Canyon Way, Palm Springs CA 92262
Endorsements Attached:
CA 20 48 10 13 - Designated Insured
AUTOMOBILE LIABILITY PROVIDED
Covered Autos:
Symbol 1- Any "Auto"
Limits of Insurance:
$1,000,000 CSL
M DS 9107 11 Page 1 of 1
California Automobile Insurance Company A (e d
P.O. BOX 10730 M E R C U RY
SANTA ANA, CA 92711-0730 INSURANCE
Customer Service: (800) 503-3724
BUSINESS AUTO POLICY
ADDITIONAL INSURED Renewal Declarations
Effective Date: 01/24/2023
NAMED INSURED:
AGENT:
PALM SPRINGS PLUMBING INC
SAINT MOORE INS AGCY
3800 E VISTA CHINO STE 1
34045 YUCAIPA BLVD STE 107
PALM SPRINGS, CA 92262-4010
YUCAIPA,CA 923992440
(909)797-1141
0-1
SCHEDULE
Insurance Company:
California Automobile Insurance Company
Policy Number:
BA040000042021
Policy Period:
From: 01/24/2023 to 01/24/2024 at 12:01 AM Standard Time at your mailing
address
Additional Insured:
CITY OF PALM SPRINGS
Address:
3200 E Tahquitz Canyon Way, Palm Springs CA 92262
Endorsements Attached:
CA 20 481013 - Designated Insured
AUTOMOBILE LIABILITY PROVIDED
Covered Autos:
Symbol 1- Any "Auto"
Limits of Insurance:
$1,000,000 CSL
RECEIVED
'AN 2 4 2023
City Hall
ReceDtion Desk
M DS 9107 11 Page 1 of 1
W020090008802 INIIIIIIII III IIII IIN1II111111111II
RECEIVED Iq 6 b '-� I
JAN 3 0 2023 /- MERCURY
Confirmation of Your Requstfor Cancellation
YOUR INSURANCE COVERAGE WILL TERMINATE ON JANUARY 19, 2023 AT 12:01 AM PT
Named Insured: PALM SPRINGS PLUMBING INC Your Agent: SAINT MOORE INS AGCY
(909) 797-1141
Policy Number: BA040000042021 Policy Issued By: CALIFORNIA AUTOMOBILE
INSURANCE COMPANY
Date Mailed: January 25, 2023 Mailed From: Brea, CA
Reason for Termination
INSURED'S REQUEST
Important Message
This notice does not extend or reinstate this policy. If cancellation has been requested by the Named Insured prior to
the termination date above, said cancellation will be effective on the date requested.
This is notice that your interest in this policy has been terminated.
Policy Number: BA040000042021
This is not a bill. Please kc
for your records.
CITY OF PALM SPRINGS
3200 E Tahquitz Canyon Way
Palm Springs CA 92262-6959
A MERCURY
INSURANCE
Contact Information
HOnline
www.mercuryinsurance.com
IPhone
(800)503-3724
= Mail
Check or Money Order
U Your Agent
SAINT MOORE INS AGCY
(909)797-1141
U-61 T 1012013
California Automobile Insurance Company
P.O. BOX 10730 MERCURY
SANTA ANA, CA 92711-0730 INSURANCE
Customer Service: (800) 503-3724
BUSINESS AUTO POLICY
ADDITIONAL INSURED Renewal Declarations
Effective Date: 01 /24/2023
NAMED INSURED:
AGENT:
PALM SPRINGS PLUMBING INC
SAINT MOORE INS AGCY
3800 E VISTA CHINO STE 1
34045 YUCAIPA BLVD STE 107
PALM SPRINGS, CA 92262-4010
YUCAIPA, CA 923992440
(909)797-1141
SCHEDULE
Insurance Company:
California Automobile Insurance Company
Policy Number:
BA040000042021
Policy Period:
From: 01/24/2023 to 01/24/2024 at 12:01 AM Standard Time at your mailing
address
Additional Insured:
CITY OF PALM SPRINGS
Address:
3200 E Tahquitz Canyon Way, Palm Springs CA 92262
Endorsements Attached:
CA 20 48 10 13 - Designated Insured
AUTOMOBILE LIABILITY PROVIDED
Covered Autos:
Symbol 1- Any "Auto"
Limits of Insurance:
I
$1,000,000 CSL
I
RECEIVED
DEC 2 0 2022
City Hall
Reception Desk
M Ds 9107 11 Page 1 of 1
111111111111111 lill I IN I III III INI IIII ZO6Z000606ZOW