Loading...
HomeMy WebLinkAbout05024 - CROSSWALK CAFE GWEN MORRIS 370 NPC APN 513-081-021 Page 1 of 1 Cindy Berardi From: Cindy Berardi Sent: Wednesday, December 31, 2008 11:52 AM To: Felipe Primera Subject: Status of 1 Encroachment Lic./1 Encroachment Agr. Follow Up Flag: Follow up Flag Status: Red Hi Felipe, Agreement#4652 is attached and as far as I can tell the ownership has changed twice since the Encroachment License was issued. I can't Find where we've issued a new license to a subsequent owner and I'm wondering what the procedure is to pursue the current owner. I've also attached agreement#5024 which is an Outdoor Dining Encroachment Agreement and, according to Carl in business license, he has no current licensee at the address indicated in the agreement. Would someone in Engineering do a field check on it or maybe someone in Code Enforcement I'm not sure what the procedure is but, I need to get to the bottom of the current status on both of these contracts with the City. Thank you for your assistance. 09 Cindy 5crar& pcputy cityClcrk Office of tine City Clcrk CJJ City of Palm Springs P. O. Box 2743 Palm Springs, CA 92262 (760) 322-8355 Cind .Berardi@palmsorinasca.gov 12/31/2008 DOC N 2004-100330E 12/17/2004 08:00A Fee:NC Page 1 of 12 Recorded in Official Records County of Riverside Gary L. Orso FAEE RECORDING REQUESTED BY Assessor, County Clerk d Recorder CITY � M SPRINGS IP MAIL TO. Y I I IIIIII IIIIII IIIIII IIII IIIII IIII IIIIIII III IIIII IIII IIII PO Box 2743 Patin Springs, CA 92263-2743 M S U PAGE SIZE DA POOR NOCOR SMF MISC. Attn: Engineering Division City Clerk A R L COPY LONG REFUND N.HHG VE C (For Recorder's Use Only) EP Filing Fee Exempt Per Government Code 6103 Crosswalk CafeGwen Morris Outdoor Dining Encroachment OUTDOOR DINING ENCROACHMENT AGREED AGREEMENT#5024 THIS ENCROACHMENT AGREEMENT ("Agreement") is entered into this � day of ter--Mmcrx- 2004,by and between Gwen M.Morris ("Applicant"),whose address is 2353 Silver Oak Circle, Palm Springs, Ca 92264 and the CITY OF PALM SPRINGS, a municipal corporation ("City"), whose address is P.O. Box 2743, 3200 E. Tahquitz Canyon Way, Palm Springs, CA 92263. RECITALS: A. Applicant is the owner of that certain real property located in the City of Palm Springs, Comity of Riverside, State of California commonlyknown as 370 N.Palm Canyon Drive,Palm Springs, California 92262, (APN a portion of 513-081-021), more particularly described on Exhibit "A" attached hereto and incorporated herein by reference ("Applicant Property"). City is the owner of certain fee and/or easement interests in that certain real property located in the City of Palm Springs, County of Riverside, State of California adjacent to the Applicant Property and encroachment is more particularly depicted in Exhibit "B" hereto ("City Property"). B. Applicant desires to construct or maintain 10 chairs and 3 tables and 36" high wrought iron fence to be placed in a portion of the public right-of-way hereto on the City property ("Encroachment"). City has agreed to grant to Applicant an encroachment permit ("Permit") for the Encroachment in accordance with Chapter 14.16 of the City of Palm Springs_ Municipal Code on the condition that Applicant executes this Agreement. NOW THEREFORE, the parties hereto agree as follows: 1.0 License. The City hereby grants to Applicant a license revocable or relocatable with or without cause at any time by the City to construct and/or maintain the Encroachment upon all of the terms and conditions of the Permit and this Agreement("License"). 1 2.0 Covenants. 2.1 In General. Applicant hereby agrees to construct,maintain,relocate and remove the Encroachment in accordance with Chapter 14.16 of the City of Palm Springs Municipal Code, as amended from time to time. 2.2 Maintenance. Applicant shall maintain, repair and replace the Encroachment and the City Property so as to keep the Encroachment and such area in a neat, clean,first class condition and in good order and repair, free of weeds, trash and debris at all times. All tables, chairs, or other items shall be kept in a clean, safe condition, and shall not be placed in a manner that impedes or prevents pedestrian traffic. In the event Applicant does not maintain the Encroachment and the City Property as required herein,the City may terminate the License as more particularly provided in Section 3.0. 2.3 Indemnity. Applicant hereby agrees to indemnify and defend the City, its officers, agents and employees against and to hold and save each of them harmless from, any and all actions, suits, claims, damages to persons or property, losses, costs, penalties, obligations, errors, omissions or liabilities (collectively "claims or liabilities") that may be asserted or claimed by any person, firm or entity arising out of or in connection with the location, construction, maintenance, relocation or removal of the Encroachment,but excluding such claims or liabilities arising from the sole negligence or willful misconduct of the City, its officers, agents or employees, who are directly responsible to City, and in connection therewith: (a) Applicant will defend any action or actions filed in connection with any of said claims or liabilities and will pay all costs and expenses, including legal costs and attorneys' fees incurred in connection therewith; (b) Applicant will promptly pay any judgment rendered against the City, its officers, agents or employees for any such claims or liabilities and Applicant agrees to save and hold the City, its officers, agents and employees harmless therefrom; (c) In the event the City, its officers, agents or employees is made a party to any action or proceeding filed or prosecuted against Applicant for such damages or other claims arising out of the location, construction, maintenance, relocation or removal of the Encroachment,Applicant agrees to pay the City, its officers, agents or employees, any and all costs and expenses incurred by the City,its officers,agents or employees in such action or proceeding, including,but not limited to, legal costs and attorneys fees. 2.4 Covenants Running With the Land. The covenants and restrictions by Applicant set forth in this Agreement: (a) are made for the direct benefit of the City Property; (b) will constitute covenants running with the land and equitable servitudes; (c) will bind Applicant and every person having any fee,leasehold or other interest in any portion of the Applicant Property at anytime or from time to time; and(d)will inure to the benefit of the City and every person having any fee, leasehold or other interest in the City Property at any time or from time to time. 2 IIIIIIIIiIIIIIIIII IIIIIII IIIIIIIII IIIIIIIIIIIIIII 1: Ia/2 000 i2�00R 3. Insurance. 3.1 Insurance Requirement. During the entire term of this License, Licensee shall procure and maintain public liability and property damage insurance, at its sole expense, in an amount not less than ONE MILLION DOLLARS ($1,000,000) combined single limit, insuring against all liability of Licensee and its authorized representatives arising out of and in connection with the Encroachment or Licensee's use of the Encroachment. Such public liability and property damage insurance shall also provide for and protect the Licensor against incurring any legal cost in defending claims for alleged loss. 3,2 Primary Policy; Additional Insured. All such insurance as required by this Section 6 shall be primary insurance and shall name the City as additional insured. 33 Insurance Increase. Not more frequently than one(1)time every three(3)years,if, in the opinion of the City Manager or the City's insurance broker, the amount of public liability and property damage insurance coverage at that time is not adequate, the City Manager may require modifications to this coverage. 3.4 Insurance Company. All insurance required under this Section 8 shall be issued by an insurance company authorized to do business in the State California,with a financial rating of at least A-3A status as rated in the most recent edition of Best's Insurance Reports or such comparable report should Best's Insurance Reports no longer be available. 3.5 Modification or Cancellation of Policy. All insurance required pursuant to this Section 8 shall contain an endorsement requiring thirty (30) days written notice from the insurance company to both parties before cancellation or change in the coverage, scope, or amount of any policy. Each policy, or a certificate of the policy, together with evidence of the payment of premiums, shall be deposited by Licensee with the City at the commencement of the term, and on a renewal policy not less than twenty(20) days before expiration of the term of the policy. 4.0 Termination. The License is terminable with or without cause by the City at any time. Applicant shall remove the Encroachment and restore the City Property to its former condition, at Applicant's sole cost and expense,within thirty(30) days of written notice from the City. In the event Applicant fails to remove the Encroachment and restore the City Property within said time period, the City shall have the right to do so without notice. Applicant shall immediately reimburse the City for all out of pocket expenses expended to remove the Encroachment and restore the Property, Said amounts shall accrue interest from the date expended by the City at the maximum non-usurious interest rate permitted by law. 3 (IIIII IIII I I II III IIIII I I IIIII III IIII III IIII 12117/2 AAA 3 of412�00R 5.0 Miscellaneous. 5.1 Notices. 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 prepaid,first-class mail to the addresses listed on the first page of this Agreement. Either party may change its address by notifying the other party of the change of address in writing. Notice shall be deemed communicated at the time personally delivered or in seventy two (72) hours from the time of mailing if mailed pursuant to this Section 4.1. 5.2 Attorneys Fees. In any action between the parties hereto seeking enforcement of this Agreement,or in connection with the License or the Permit,the prevailing party in such action shall be entitled to have and to recover from the other party its reasonable attorneys'fees and other reasonable expenses in connection with such action or proceeding in addition to its recoverable court costs. 5.3 Amendment or Modification. This Agreement may not be modified or amended except by written agreement executed by the then-owner of the Applicant Property and the City Property and recorded in the Office of the County Recorder, County of Riverside, California. 5.4 Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of California. 5.5 Severability. The invalidity or unenforceability of any provision of this Agreement with respect to a particular party or set of circumstances shall not in any way affect the validity and enforceability of any other provision hereof or the same provision when applied to another party or to a different set of circumstances. 5.6 Recordation. This License shall be recorded in the Office of the County Recorder, Riverside County, California, and it shall serve as notice to all parties succeeding to the interest of Licensee or the city that their use of the Licensee Property and the City Property shall be benefited and/or restricted in the manner herein described. 4 IIIII IIII I I I II IIII IIIII IIII IIIIIII III III I IIII IIII 12 2AA44 of 12@60R IN WITNESS WHEREOF,the parties have executed this Agreement as of the date first set forth above. crn ' ro-p-� Gwen M. Morris "Applicant" (APPLICANT MUST HAVE SIGNATURE NOTARIZED) CITY OF PALM SPRINGS, a Municipal Corporation By: '�K City Engineer paved �". �ara�C�an "City" (CITY ENGINEER MUST HAVE SIGNATURE NOTARIZED) APPROVED AS TO OWNERSHIP & LEGAL DES C .IPTION By:� J (NOTARY STATEMENTS ON FOLLOWING PAGE) 5 1111 IN iz2©©s of 12�eeR STATE OF CALIFORNIA) SS. COUNT"Y,�O"""F"""" 'RIVE RSIDE) � OnL �djZ46�beforMe, I/,Qb4/td� CLLet4 DatePersonally appeared ❑ personally known to me OR roved to me on the basis of satisfactory evidence to be the person whose_name is subscribed to the within instrument and acknowledged to me that>Te executed the same in othorized capacity,and that bytes ggnature on the instrument the person,or the entity upon behalf of which the person acted,executed the instrument. (SEAL) rF. Witness /my/hand and official lsseal. MARINA KAAA5 � �idlld� �I1 Comm.#1368429 1e N NOTARY PUBLIC-CALIFORNIA N Signature of Notary Riverside County My Comm.Expires Mvy26,2006 STATE OF CALIFORNIA) SS. COUNTY OF RIVERSIDE) n on1� .CP rklp,rq aooLl beforeme, Carr e Rouvlet�) 1Vt7+ark PL)1O��C Late Personally appeared r)e�vl Cll, J, _&rL1_k LCt h XI personally known to me OR ❑ ptvwd to nxe•ea-th®-basis of saGofaulwy evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity,and that by his signature on the instrument the person,or the entity upon behalf of which the person acted,executed the instrument. (SEAL) Witness my hand and official seal. � Q ����i C_ Signahue o 9t ry CARRIE ROVNEY COPnln4*n#134E457 Nokuy M t:-Ociftmics RN*mM County 10MYCMMERPIP101MCN26,2006t 6 III I IIIIii II III II II III IIIIIII III IIIII II I IIII tz 2006 of 12 eaR EXHIBIT "A" LEGAL DESCRIPTION OF OWNER/APPLICANT PROPERTY A PORTION OF LOT 6, IN BLOCK 24 OF PALM SPRINGS, AS SHOWN BY MAP ON FILE IN BOOK 9, PAGE 432 OF MAPS, RECORDS OF SAN DIEGO COUNTY, CALIFORNIA, DESCRIBED AS FOLLOWS; BEGINNING AT THE NORTHWEST CORNER OF SAID LOT; THENCE SOUTHERLY ON THE WEST LINE OF SAID LOT, 75 FEET; THENCE AT RIGHT ANGLES EASTERLY AND PARALLEL WITH THE NORTHERLY LINE OF SAID LOT, 145.50 FEET; THENCE AT RIGHT ANGLES NORTHERLY AND PARALLEL WITH THE WESTERLY LINE OF SAID LOT, 75 FEET TO THE NORTHERLY LINE OF SAID LOT; THENCE WESTERLY ON TFIE NORTHLY LINE OF SAID LOT, 145.50 FEET TO THE POINT OF BEGINNING. 1111111 IN 7 of 22�aR - " o � 0 oo e N I O Janitorial 11 - Storage i Station wm Area _ O6 m e�aaan� YI qo M O Office ----------------- 03 Area Dishawashing I 12 Area 06 +r•sr• re aration re o e 6 � � N 16 20 Hallway Service Area 2a xs v�a r• r '. 26 NF° •^[{��uI�IL//(/^~I Countertop level at 36"AFF E 20� Unisex Countertop Reatroom eahaust9n Restroero Dining level at 32"AFF Connecte4h.11,1hssvtch Area L 4 4 Seats SeatsSeatsTable Dining Iryandicap I Dining Handma 3Px48"Areag L°-'4J Area L__-J Area 2 Seats I I Tables Table Proje,en loot above y Scats a Tablc Scats Tablc N O nm Metal fence 66'height 2 Seats cable O _ y� Metal fence 36'height 6i_7u Planter Side Walk III�II I�II�I�IIIII IIII IIII IIII 111111111111111 IIII 1111 9 of 12006R EXHIBIT "C" Applicant's Signature Permit Center Signature Date Account# 1211& 011-32204 o� PALM Sad' City of Palm Springs Department of Planning &Zoning 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 eats poRN�* (760) 323-8245—direct (760) 322-8360—facsimile LAND USE PERMIT #04-22 CONDITIONS OF APPROVAL DATE: August 9, 2004 REQUEST: To operate a restaurant within the CBD (Central Business District)zone. There will be seating for 36 patrons(26 interior seats and 10 patio seats). The patio seating along North Palm Canyon Drive street frontage is located outside of the public right-of-way. The hours of operation will be 8:00 am. -6:00 pm, Monday through Sunday. No outdoor seating within the public right of way is proposed as part of this application. Live entertainment is not proposed under this permit. APPLICANT: Gwen Morris LOCATION: Crosswalk Cafe 370 North Palm Canyon Drive Before final acceptance of the project, all conditions listed below shall be completed to the satisfaction of the City Engineer, the Director of Planning and Zoning, the Chief of Police, the Fire Chief, or their designee, depending on which department recommended the condition(s). Any agreements, easements or covenants required to be entered into shall be in a form approved by the City Attorney, 1. The proposed development of the premises shall conform to all applicable regulations of the Palm Springs Zoning Ordinance, Municipal Code, or any other City Codes, ordinances and resolutions which supplement the zoning district regulations. 2. The owner shall defend, indemnify, and hold harmless the City of Palm Springs, its agents, officers, and employees from any claim, action, or proceeding against the City of Palm Springs or its agents, officers or employees to attach, set aside, void or annul, an approval of the City of Palm Springs, its legislative body, advisory agencies, or administrative officers concerning this Land Use Permit application. The City of Palm Springs will promptly notify the applicant of any such claim, action, or proceeding against the City of Palm Springs and the applicant will either undertake defense of the matter and pay the City's 41IIIII I{Ill{IIIIII III IIIII III IIIIIII III III I IIII IIII 12 1�0 9 o0'0 2�00R O� lALM gf+ " • N City of Palm Springs Department of Planning &Zoning Land Use Permit #04-22 Applicant Mailing Address Phone pp 9 Gwen Morris 2353 Silver Oak Circle, P.S. CA 92264 (760) 409-1496 Business Name I Site Address Crosswalk Cafe 370 North Palm Canyon Drive, P.S. CA 92262 PROCEDURE: An application for a land use permit shall be submitted to the Department of Planning & Zoning, and shall be accompanied by the following: 1. A Processing fee of$605 2. A floor plan and/or site plan displaying the layout of the proposal. Outdoor seating that encroaches into the public right-of-way will require an encroachment agreement or license, subject to the approval of the Director of Planning &Zoning. 3. Such other information as the Director of Planning &Zoning may require, including, but not limited to: adjacent uses, photographs, building elevations, landscape plans, design studies, furniture information, etc. STATEMENT OF ACTIVITY: Applicant shall submit a statement of the use, expected size, volume, hours, and length of operations; information relating to sanitation, noise, air pollution, vehicle parking, traffic circulation, and any other information of the proposed project. To operate a restaurant within the CBD(Central Business District)zone. There will be seating for 36 patrons(26 interior seats and 10 patio seats). The patio seating along North Palm Canyon Drive street frontage is located outside of the public right-of-way. The hours of operation will be 8:00 am. -6:00 pm, Monday through Sunday. No outdoor seating within the public right of way is proposed as part of this application. Live entertainment is not proposed under this permit. CONDITIONS: See attached. TRANSFER: Transfer of Land Use Permit to another applicant is subject to review and approval by the Director of Planning &Zoning. REVOCATION: The Director of Planning &Zoning may revoke any Land Use Permit that does not meet or comply with conditions and requirements of this permit. IIIIII IIIIII IIIIII IIII IIIiI IIII IIIIIII III IIIIII III IN12 200 100 @0 12 8000R r Gwen Morris-- Crosswalk Cafe 370 North Palm Canyon Drive Land Use Permit#04-22 July 26, 2004 Page 3 of 4 associated legal costs or will advance funds to pay for defense of the matter by the City Attorney. If the City of Palm Springs fails to promptly notify the applicant of any such claim, action or proceeding or fails to cooperate fully in the defense, the applicant shall not, thereafter, be responsible to defend, indemnify, or hold harmless the City of Palm Springs. Notwithstanding the foregoing, the City retains the right to settle or abandon the matter without the applicant's consent but should it do so, the City shall waive the indemnification herein, except, the City's decision to settle or abandon a matter following an adverse judgement or failure to appeal, shall not cause a waiver of the indemnification rights herein. 3. This application does not include approval of live or musical entertainment and/or dancing. 4. Daily cleaning and wash down of sidewalks for the outdoor seating will be required. Contact Scott Mikesell at 323-8281 for information regarding the proper method of cleaning of sidewalks and pavers within the public rights-of-way. 5. Any exterior signage, including menu boards, shall require separate permit and approval by the Planning Department. Menu boards shall not be permitted within the City right-of-way and violations will result in issuance of citations and revocation of all permits and agreements. 6. Compliance with the approved site and seating diagram shall be required at all times. The restaurant is approved for seating for maximum interior seating for twenty-six (26) patrons, patio outdoor seating for ten (10) with three table located within the public right of way. Any additional expansion of said seating will require a modification to this Land Use Permit. To accommodate fire exiting purposes from the front (main) restaurant entrance and adjoining businesses into the building, the applicant shall maintain the minimum clearance as specified by the Fire Department between the entrances and the outdoor tables and chairs. 7. Trash receptacles shall be strategically located to accommodate the outdoor service area and shall be submitted to the Director of Downtown Development and the Director of Planning and Zoning, for review and approval prior to installation. All trash receptacles on or adjacent to the subject property shall be emptied and cleaned on a regular basis. This includes public trash receptacles in rights-of-way, which are used by business patrons. & The use of umbrellas shall be subject to review by the Director of Downtown Development and the Department of Planning and Zoning. If umbrellas are proposed for use, they shall be 6.5 to 7 feet in height to the bottom of the umbrella as measured from the top of curb or sidewalk, and shall be properly secured to the ground and anchored as per approval from the Building Division. 9, This Land Use Permit does not permit outdoor heaters within the public right-of-way. Submit outdoor heater plan and specifications if they are proposed, Placement of outdoor heaters in the public right-of- way may result in immediate abatement (removal) by the City due to a safety hazard. 10. In an effort to have flexible but yet consistent aesthetic concept for all restaurants in the Central Business District, green, tan and terra cotta colors shall be considered for all outdoor furniture. Outdoor tables, chairs, and trash receptacles shall be designed as an integral part of the business and shall be custom IIIIII IIIIII IIIIIIIIIIIIIIIIIIIIIIIIiIIII IIIIIIIIIIII 122AA2i6f 12GOR Gwen Morris-- Crosswalk Cafe 370 North Palm Canyon Drive Land Use Permit#04-22 July 26, 2004 Page 4 of 4 decorative materials. Colored exhibits of the revised chairs, tables, and trash receptacles shall be submitted for review and approval by the Director of Planning and Zoning, and shall have written verification of approval by the property owner. 11. This Land Use Permit shall be displayed on-site at all times and made available to City officials upon request. 12. Failure to comply with Municipal Codes, Ordinances, and the conditions of this land use permit may result in revocation of this permit. Director of Planning Services Signature: ( �� fI Date: Z O / Applicant's Signature: Date: HAUSERSWLAMLUP 04-22,370NPCD,Crosswalk Cafe.wpd I IIIIII IIII I III II IIII IIII I III I II II II III f ari00120 of 00ei 10a0 AC-ORD. INSURANCE BINDER CSR PS os/17/o4 THIS BINDER IS A TEMPORARY INSURANCE CONTRACT,SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PRODUCER :INC,No,E>zl: 323-936-1010 COMPANY� I BINDER 5620 323-935-41Z1 Allied Insurance Companv hFFhCINE EYPIRATION B. HROOX RANDALL 46 SONS, INC. DATE TIME DATE TIME 4751 WILSHIRE BOULEVARD X AM X 12:01AM LOS ANGELES CA 90010 08/17/04 12p,01 PM 10/16/04 NOON Patricia Sullivan THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CODE: I SUBCODE: PEREXPIRINGPOLJCYA ACP7801631908 AG'ENSTOMGYER IO:" CROSS-1 DESCRIPTIONOFOPERATIDNSNENICLEVMPVXTYQMIudiIIBL000tlon) CU � ' INSURED Gwen Morris DBA: Crosswalk Cafe 370 N. Palm Canyon Drive Palm Springs CA 92262 I COVERAGES LIMITS TYPR OP INSURANCE COVERAGWFORMS DEDUCTIBLE COINS% AMOUNT PROPERTY CAUSES OF LOSS Business Personal Property 1000 25,0'00 BASIC 7 BROAD,a] SPEC Loss of Income/Actual/12 mth GENERALLIAUIUTY EACH OCCURRENCE e1,000,000 �^COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any.&.) S300,000 CLAIMSMADE FAI OCCUR MEDEXP("-EpgG ) $5,000 PERSONALSADVINJURY S1,000,000 GENERAL AGGREGATE $2,000,000 RETRO DATE FOR CWMS MADE PRODUCTS-COMPIOPAGG $1,00.0,000 AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT S1,000,000 ANV AVTO BODILY INJURY(PC,pw ) S ALLOWNEO AUTOS OVODILY INJURY(P¢I aWCeni) S SCHEDULEOAUYOS PROPERTY DAMAGB S X HAEDAUTOS MEDICAL PAYMENTS $ R NON OWNED AUTOS PERSONAL INJURY PROT $ -_J- UNINSURED MOTORIST S $ . AUTO PHYSICALDAMAGE DEDUCTIBLE ALLVEXICLES a SCHEDULEDVEHICLES AOTLIALOASHVALUE 71 COLLISION: STATED AMOUNT $ OTHER THAN COL:_ _ OTHER GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANY AUTO OTHERTHAN AUTO ONLY. EACH ACCIDENT S AGGREGATE $ - 04CESSLIABILITY EACH OCCURRENCE S UMBRELLAFORM -AGGREGATE S OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE; SELF-INSURED RETENTION S I WC STATUTORY LIMITS WORRER'S COMPENSATION E,L EACH ACCIDENT S AND EMPLOYER'S LIABILITY E,L.DISEASE•EA EMPLOYEE S EL DISEASE-POLICY LIMIT S SPSgA4 - FEES $ CONDITIONS! "- OTHER TAXER S COVERAGES ESTIMATED TOTAL PREMIUM $ NAME&ADDRESS MORTGAGEE X ADDITIONAL INSURED LOSS PAYEE H CITYOEP LOANP '— City Of Palm Springs All 0 RESL _ P1, -,oi ACORD 75-S(1198) - NOTE:IMPORTANT STATE IN OR Id - REVERSE51br ©ACORD CORPORATION 1993 Z0019 aS0'ON SZ£9zz£09LTG F '9NI `SNOS S -nbC[NHa XOOaH'3 T£101 b0a8/LT/80