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Infotox, Inc.
. Amend #1 - Asbestos Survey
517 E. Vista Chino - CP98-05
AGREEMENT #3986
M06417, 6-2-99
AMENDMENT N0.1 TO AGREEMENT NO. 3986 for
ASBESTOS ABATEMENT AND DEMOLITION PROJECT
AT 517 E. VISTA CHINO
CITY PROJECT NO. 98-05
The following articles of Agreement No. 3986 are hereby amended to read as follows:
1. SECTION 2.1, Contract Sum, is hereby amended to provide a maximum
contract amount of$5,857.50, an increase of$3,057.50
2. SECTION 5.1, Term, is hereby amended to read:
Unless earlier terminated in accordance with Section 5.2 below, this
Agreement shall continue in full force and effect until October 31, 1999.
3. EXHIBIT "A", Scope of Services, is hereby amended by adding the following:
Contractor shall provide professional services to the City of Palm Springs for
Asbestos Abatement and Demolition project as follows:
A. Provide oversight services for removal of asbestos containing materials
from structures located at 517 E. Vista Chino, and compliance
monitoring in accordance with the project specifications (Section 02080).
The services shall include:
• Background air samples collection and analyses
• Compliance air samples collection and analyses during each separate
operation
• Clearance air samples collection and analyses, and final inspection.
Air samples shall be analyzed by Phase Contrast Microscopy.
B. Participate in, and provide assistance to the City at the pre-construction
activities (meetings, job walks, etc.) .
4. EXHIBIT "B", Schedule of Compensation, is hereby amended by adding the
following:
The Contractor's compensation for services described in Articles 3A and 3B of
Amendment No.1 for 517 E. Vista Chino, shall be on an hourly basis, in
accordance with Contractor's hourly rate schedule (attached), for an
amount not to exceed $3,282.50
1 of 2
The above fee is based upon the schedule provided for the project. Only the
actual number of hours and number of samples collected and analyzed
will be paid.
Contractor shall notify the City of any changes in the Scope of Services
prior to executing such change.
Except as specifically amended by this First Amendment, all terms and provisions of
Agreement No. 3986 approved by the City Manager on June 9, 1998, remain in full
force and effect.
DATED this � Day of _1 0Z 1999.
ATTEST: CI OP PALM SPRI GS
A municipal corporaf
City Clerk City Mat ger
APPROVED AS TQ FORM:
C( Attorney
CONTRACTOR:
fti'' itl; q t (a[l_nG l(t [i. Ch/ck one: _Individual Partnership
�/
Corporation
(Corporations require two signatures: By:,�4"Y'4�-""�.�;_•,>���_--;'--�%-^r'`:�
One from each of the following: A. Signatu-e (Notarized)
A. Chairman of Board, President, P,- 1-4 1 EL1�1-([_P. ICI
any Vice-President: AND B. Secretary, Print Nante & T1tIe
Assistant Secretary, Treasurer, Assistant nn
Treasurer, or Chief Financial Officer). By:
B. "Signature (Notarized)
State of California J. 1"9 t r=Lk UJ l—?, t-L 9:r f //r
County of San Bernardino Print Name & Title
Subscribed & SworB to(or affirmedl) �'" Mailing Address: 96 I Qi7��1 4��i/ ✓'
Before me thi �s t i Dayf of �>_IL19
Gj
!'f CA OA
/�
Notary Public
DELLA
COMM
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ORYPUNNE N
es-S1OC9AMC2LO6IIFUT2ON3HRT NY IA�aj
E'P Aup.8,2002
Infotox, Inc.
Asbestos Removal 517 E. Vist
• Chino CP98-05
AGREEMENT #3986
CM Signed, 6-9-98
CITY OF PALM SPRINGS - -- - -- - - --- -- - -
CONTRACT SERVICES AGREEMENT FOR
ASBESTOS MANAGEMENT AT
517 E. VISTA CHINO
CITY PROJECT NO. 98-05
THIS CONTRACT SERVICE$ AGREEMENT (herein "Agreement") is made
and entered into this i� day of C , 191;�L,
by and between the CITY OF PALM SPRI S, a municipal corporation
(herein "City") and Infotox, Inc. (herein "Contractor") . (The
term Contractor includes professionals performing in a consulting
capacity) .
NOW, THEREFORE, the parties hereto agree as follows:
1.0 SERVICES OF CONTRACTOR
1 . 1 Scope of Services. In compliance with all of the
terms and conditions of this Agreement, the Contractor shall
perform the work or services set forth in the Scope of Services
attached hereto as Exhibit "A" and incorporated herein by
reference. Contractor warrants that all work and services set
forth in the Scope of Services will be performed in a competent,
professional and satisfactory manner.
1 .2 Compliance With Law. All work and 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.
2.0 COMPENSATION
2. 1 Contract Sum. For the services rendered pursuant
to this Agreement, Contractor shall be compensated in accordance
with the "Schedule of Compensation" attached hereto as Exhibit "B"
and incorporated herein by this reference, but not exceeding the
maximum contract amount of Two Thousand Eight Hundred Dollars
($2,800.00) ("Contract Sum") .
FS2\276\099999-3000\2022693.2 mO8/22/95
• 0
2 .2 Method of Payment. Provided that Contractor is not
in default under the terms of this Agreement, Contractor shall be
paid in a lump sum, as determined on Exhibit B of this agreement.
3.0 COORDINATION OF' WORK
3. 1 Representative of Contractor. Michael A.
y/ 0ieuwlandt is hereby designated as being the principal and
representative of Contractor authorized to act in its behalf with
respect to the work and services specified herein and make all
decisions in connection therewith.
3.2 Contract Officer. Tom Cartwright is hereby
designated as being the representative the City authorized to act
in its behalf with respect to the work and 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.
3 . 3 Prohibition Against Subcontracting or Assignment.
Contractor shall not contract with any entity to perform in whole
or in part the work or 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.
3 .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.
4 .0 INSURANCE AND INDEMNIFICATION
4 . 1 Insurance. The Contractor shall procure and
maintain, at its sole cost and expense, in a form and content
satisfactory to City, during the entire term of this Agreement
including any extension thereof, the following policies of
insurance:
(a) Comprehensive General Liability Insurance. A
policy of comprehensive general liability insurance written on
a -per &e-- ence basis in an amount not less than either (i) a
(� combined single limit of g $500, 000. 00 or (ii) bodily injury
FS2\296\099999-3000\2022693.2 m00/22/95
-2-
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ter,
limits of $250, 000. 00 per person, $500, 000. 00
and $500, 000. 00 products and completed operations and property
damage limits of $100, 000 .00 and $100, 000. 00 in
the aggregate. 11P�/a
(b) Worker' s Compensation Insurance. A policy of
worker' s compensation insurance in such amount as will fully
comply with the laws of the State of California and which
shall indemnify, insure and provide legal defense for both the
Contractor and the City against any loss, claim or damage
arising from any injuries or occupational diseases occurring
to any worker employed by or any persons retained by the
Contractor in the course of carrying out the work or services
contemplated in this Agreement.
(c) Automotive Insurance. A policy of ,
O comprehensive automobile liability insurance written on a .PQ-r—V'
ecerrr-r-enee basis in an amount not less than either (i) bodily
injury liability limits of $250, 000. 00 per person and
$500, 000. 00 peia aeeu-3 Wand property damage liability
limits of $100, 000. 00 per occurrence and $250, 000 .00 in the
aggregate or (ii) combined single limit liability of
$500, 000. 00. Said policy shall include coverage for e ., ? . w
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, 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. In the event any of
said policies of insurance are canceled, the Contractor shall,
prior to the cancellation date, submit new evidence of insurance in
conformance with this Section 4.1 to the Contract Officer. No work
or services under this Agreement shall commence until the
Contractor 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 Contractor agrees that the provisions of this Section 5. 1
shall not be construed as limiting in any way the extent to which
the Contractor may be held responsible for the payment of damages
to any persons or property resulting from the Contractor' s
activities or the activities of any person or persons for which the
Contractor is otherwise responsible.
The insurance required by this Agreement shall be satisfactory
only if issued by companies qualified to do business in California,
FS2\276\099999-3000\2022693.2 m00/22/95
-3-
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 Director of Administrative Services
or designee of the City due to unique circumstances .
4.2 Indemnific:ation. Contractor agrees to indemnify
the City, its officers, agents and employees against, and will hold
and save them and each of them harmless from, any and all actions,
suits, claims, damages to persons or property, losses, costs,
penalties, obligations, errors, omissions or liabilities, including
paying any legal costs, attorneys fees, or paying any judgment
(herein "claims or liabilities") that may be asserted or claimed by
any person, firm or entity arising out of or in connection with the
negligent performance of the work or services of Contractor, its
agents, employees, subcontractors, or invitees, provided for
herein, or arising from the negligent acts or omissions of
Contractor hereunder, or arising from Contractor' s negligent
performance of or failure to perform any term, provision covenant
or condition of this Agreement, but excluding such claims or
liabilities to the extent caused by the negligence or willful
misconduct of the City.
5.0 TERM
5. 1 Term. Unless earlier terminated in accordance with
Section 5.3 below, this Agreement shall continue in full force and
effect until July 30, 1998.
5.2 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 City, 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.
FS2\296\099999-3000\2022693.2 m00/22/95
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6.0 MISCELLANEOUS
6. 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.
6.2 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 City 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.
6.3 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.
a
6.4 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 City, to the City Manager and
to the attention of the Contract Officer, 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.
6.5 Interpretation. The terms of this Agreement shall
be construed in accordance with the meaning of the language used
and shall not be construed for or against either party by reason of
the authorship of this Agreement or any other rule of construction
which might otherwise apply.
6. 6 Integration; Amendment. It is understood that
there are no oral agreements between the parties hereto affecting
this Agreement and this Agreement supersedes and cancels any and
all previous negotiations, arrangements, agreements and
FS2\276\099999-3000\2022693.2 m06/22/95
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• 10
understandings, if any, between the parties, and none shall be used
to interpret this Agreement. This Agreement may be amended at any
time by the mutual consent of the parties by an instrument in
writing.
6.7 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 hereunder unless the invalid provision is so material that
its invalidity deprives either party of the basic benefit of their
bargain or renders this Agreement meaningless.
6. 8 Waiver. No delay or omission in the exercise of
any right or remedy by a nondefaulting 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.
6. 9 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.
6. 10 Corporate 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 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.
F52\276\099999-3000\2022693.2 m00/22/95
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0
CITY:
CITY INGS,
municipal Corp a '
City pager
ATTEST:
Ci y Jerk
APPROVED AS TO FORM: A-,MOVEDB THE- MYAAANAGER
c*4 �e�l
City Att6 y
[SIGNATURES CONTINUED ON NEXT PAGE]
FS2\276\099999-3000\2022693.2 mOB/22/95
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Q
CONTRACTOR:
INFOTOX, INC.
By: /B ✓� ✓ CiS/i/ /�i��F
Name: Michael A. Nieuwlandt
Title: President
Address: 9251 Orco Parkway, Ste. J
Riverside, CA 92509-0906
[END OF SIGNATURES]
Exhibit `IC"
Special Requirements
If the Contractor satisfies sections 4 . 0, 4 . 1 & 4 . 2 with an
insurance policy that is a "claims made" policy, then the
r9auirement for sections 4 . 0, 4 . 1 6 4 . 2 are herebv extended
an additional six ( 6) months past the terms , so identified
in sections 5 , 0, 5 , 1 & 5 . 2 . This extension of the terra wi'_1
provide for an additional claim reporting period for the
discovery of any claims that occurred within the contract
term, yet were not discovered until after the expiration. of
he term of the contract. .
FS2\276\099999-3000\2022693.2 MOB/22/95
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EXHIBIT "A"
SCOPE OF SERVICES
Infotox, Inc. , Asbestos Management Services will collect bulk
samples of suspect asbestos-containing building materials from the
structures at 517 East Vista Chino Road, Palm Springs, using non-
destructive representative sampling protocols.
The asbestos survey will be performed in accordance with CAL/OSHA
and South Coast Air Quality Management District regulations.
Collected samples will be submitted to a NVLAP approved laboratory
for analysis by Polarized Light Microscopy (PLM) .
Upon receipt of the laboratory analysis report, Infotox, Inc. , will
prepare a confidential inspection report and submit one copy to the
above addressee. The report shall include specific recommendations
for the abatement of asbestos found.
The above described services will be provided for the following
fees:
-Inspection services, supplies, and report preparation $1, 000.00
-Laboratory analysis of bulk material samples $1, 000.00
(50 samples @ $20. 00 each)
-Project job-walk site visit $ 250. 00
-Specification review and modification $ 550. 00
(including one meeting with engineering
staff at City Hall)
Total Estimate Not to Exceed $2 , 800. 00
This estimate is based on the information that this structure is a
five unit apartment building. The cost will be adjusted to reflect
the hours expended and number of samples collected and analyzed.
One calendar day is estimated to complete the survey. The complete
report will be delivered within 5-7 working days following the
completion of the survey.
EXHIBIT "A"
� Q
EXHIBIT "B"
SCHEDULE OF COMPENSATION
Contractor' s compensation for work described on attached Exhibit A
will be $ 2,800.00 paid in a lump sum, upon satisfactory
completion of work.
EXHIBIT "B"
F52\276\099999-3000\2022693.2 m06/22/95
ACORD CERTIFI CPW OF LIABILITY IIJSU CE111p x� DATE(MM/DDIYY)
IIvFOT-1 07/27/98
PRODUCER THIS CERTIFICATE IS 'SUED AS A MATTER OF INFORMATION
VAN OPPEN & CO. INS. SERV. ,INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
LIC## OB10732 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2248 N State College Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fullerton CA 92831 COMPANIES AFFORDING COVERAGE
COMPANY
Phone No. 714-255-9800 F-ac No. 714-255-989']9 A United National Insurance Co.
INSURED RECEIVEb COMPANY 2
J2 9 199$ COMPANY
Infotox, Inc. C
9250 Orco Parkway, Ste. J
Riverside CA 92509-0906 CITY CL FPP POMPPANY
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED,NOTWITHSTANDING ANY REQUIREMEN F,TERM OR CONDITION OE ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
r'0 TYPE OF INSURANCE POLICY NUMBER ON EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MMIDD/YY) DATE(MMIDD/YY)
GENERAL LIABILITY GENERAL AGGREGATE $ $2,000,000
A X COMMERCIAL GENERAL LIABILITY L7121157 01/23/98 01/23/99 PRODUCTS-COMPIOPAGG $ INCLUDED
_CLAIMS MADE [—]OCCUR PERSONAL ADV II4JURY .$ $1,000,000
OWN ER'S&CONTRACTOR'S PRO EACH OCCURRENCE $ $1,000,000
X PROFESSIONAL FIRE DAMAGE(Any one ore) $ $50,000
LIABILITY MED EXP(Any one person) $ $1,000
AUTOMOBILE LIABILITY
-- COMBINED SINGLE LIMIT $ INCLUDED
A ANY AUTO
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AU FOS (Per person)
_X HIRED AUTOS L7121157 01/23/98 01/23/99 BODILY INJURY $
X NON-OWNED AUTOS Per accident)
— — PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACII OCCURRENCE $ _
UMBRELLA FORM AGGREGATE $
OTHER TI IAN UMBRELLA FORM S
WORKERS COMPENSATION AND WCSTATU- orIH
TORY LIMITS ER
EMPLOYERS'LIABILITY EL EACH ACCIDENT $
TI IE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $
PARTNERSIEXECUTIVE -- - -
OFFICERSARE: EXCL EL DISEASE-EA EMPLOYEE_ S
OTHER
DESCRIPI ION OF OPERAI'IONSILOCATIONSNEHICLES/SPECIAL ITEMS
Certificate Holder is added as Additional Insured to the General Liability
but only as respects all covered operations of the named insured.
CERTIFICATE HOLDER CANCELLATION
C/OPLMS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Palm Springs EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
City Clerk 30 DAYS WRITTEN NOTICE TO TI IE CERTIFICATE HOLDER NAMED TO TI IE LEFT,
ATTN: Judith Sumich
P.O. Box 2743 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATIONOR LIABILITY
Palm Springs CA 92263-2743 OF A YKJND UPON THE PGMVNY,ITS AGENTS OR REPRESENTATIVES.
AUTH IZE REPRESEN rIVE
ACORD 25.5(1/95) -� �ACI1RD CORPORATION '1988
qW
P O. BOX 420807,SAN FRANCISCO, CA 94142-0807
1, COMPENSATION;, '
-
F�N CERTIFICATE,OF WORKERS,,COMPENSATION,INSURANCE
MAR(l l nl i99J3 POLICY NUMBER 14^ck-c6H - 9F
�0ERTrlQkT1E-VPIRE3- _Q \\
CITY OF PALM SC�RINIaS
C7
ATTPJ h15 'JUDITY 5111h'CCM; C"I1-Y CI -RK
P 0 BOX 2743
PALM SPRINGS CA"92-863-2743
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon ten days'advance written notice to the employer.
We will also give you TEN days'advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with
respect to which tills certificate of insurance may be issuod..or may pertain,.-the insurance afforded by the policies
described herein is subject to all the terms,exclusions and conditions of such policies. '
��q L•yG��%Gr�i2'f7_P_�'�' �C'���%� (l'(�(/c..±Gl..
AUTHORIZED REPRESENTATIVE: - + "hri E&IDGNT
EMPLOYER'S LIABILITY LIMIT INCLUDING DF.F"ENSI~ COSTSt' +111f000l000 PER CICCORNENCE,
r
EMPLOYER '
J
INFOTOX INC
9250 ORCO PARKWAY fiTE J �f'I+� g�fli(
RIVERSIDE CA 92509
1..,T7 i �/
POLICYHOLDVI'S r9OPY
aCORD CERTIFICA OF LIABILITY INSUR I�ICEEPID TA DATE(MM/DD/YY) _
INFOT-1 03/10/99
PRDDUGER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
VAN OPPEN & CO. INS. SERV. ,INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
LIC# OB10732 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2248 N State College Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fullerton CA 92831
Phone: 714-255-9800 Fax:714-255-989 Pp�`SA,p INSURERS AFFORDING COVERAGE
INSURED _ URER A Comm'1 Cas.Ins. Co.of Ga/ECIC
11 p
6 WAR 2 IM HIRE
R B
In£otox, Inc. RECEIVED SURER C.
9250 Orco Parkwayy Ste. J 'INSURER D:
Riverside CA 92M-0906 C�CL�e�
INSURER E:
COVERAGES -
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM/DD LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ $1,000,000
A X COMMERCIAL GENERAL LIABILITY ACP201081-0 01/23/99 01/23/00 FIRE DAMAGE(Anyone fire) $ $5D,000
X1 CLAIMS MADE ❑OCCUR $
MED EXP(Any one person) $ 5r 000
PERSONAL&ADV INJURY $ $1,000,000
GENERAL AGGREGATE $ $-2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO $ $2,000,000
X POLICY PECT RO LOC
J
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $ $1,000,000
A ANY AUTO (Ea accident)
ALL OWNED AUTOS
BODILY $
SCHEDULED AUTOS (Perrperson)
)
X HIRED AUTOS ACP201081-0 01/23/99 01/23/00
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO f 1 �.
OTHERTHAN EA ACC $
1 _r AUTO ONLY AGO g
EXCESS LIABILITY 1A ( l r EACH OCCURRENCE $
OCCUR CLAIMS MADE , AGGREGATE $
DEDUCTIBLE l�
RETENTION $ -
WORKERS COMPENSATION AND TORY WO 8 ILATU
ER EMPLOYERS'LIABILITY P ��
E L.EACH ACCIDENT $
EL DISEASE-EA EMPLOYE $
EL DISEASE-POLICY LIMIT $
OTHER
A CLAIMS MADE PROF./ EA.CLAIM $1,000,000
POLLUTION LIAB ACP201081-0 01/23/99 01/23/00 ANN.AGG. $2,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The City of Palm Springs, its officers, employees and agents are added as
Additional Insured to the General Liability but only as respects all covered
operations of the named insured.Coverage is primary. The insurer waives all
rights of subrogation and contribution it may have against the city, its
officers, employees and agents and their respective insurers. *10 Day Notice Of Cancellation
CERTIFICATE HOLDER y A —NAL INSURED,INSURER LETTER A CANCELLATION
C/OPLMS SHOULD ANYOFTHEABOVE DE50RISED POLICIES BEOANCELLED BEFORETHE EXPIRATION
City of Palm Springs DATE THEREOF,THE ISSUING INSURER WIL*EI0Q0UM MAIL *30 DAYSWRITTEN
City Clerk
ATTN: Judith Sumi ch NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
P.O. Box 2743
Palm Springs CA 92263-2743
AU ORIZ REPRESENT IVE
ACORD 25-5(7/97) AC CORPORATION 1991
acoko CERTIFICA , OF LIABILITY INSURWICBIPID TA DATE(MM/DD/YY)
INFOT-1 03/10/99
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
VAN OPPEN & CO. INS. SERV. ,INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
LIC# OB10732 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2246 N State College Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Fullerton CA 92831
Phone: 714-255-9800 Fax:714-255-9899 Q�pA M`S INSURERS AFFORDING COVERAGE
INSURED F.. I ERA' Commrl CaS.Ins. Co.of Ga/ECIC
c> MAR 12 19% ER B
In£otox, Inc. RECEIVE INS RER C'
9250 Orco Parkwayy Ste. J GC USER
Riverside CA 92506-0906 �'CL��
I INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE MMIOO DATE MM/DO LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 500,000
A X COMMERCIAL GENERAL LIABILITY OGL360090-0 02/11/99 02/11/00 FIRE DAMAGE(Any one fire) $ 50,000
CLAIMS MADE FX-1 OCCUR MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 500,000
GENERALAGGREGATE $ 1,000,000
GEHL AGGREGATE LIMIT APPLIES PER' .......
/ — —�} PRODUCTS-COMP/OP AGE $ 1,000,000
POLICY X PRO-JEGT 7 LOC
_
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO L� �,i - __ (Ea accident)
ALL OWNED AUTOS
[, /�� BODILY INJURY $
SCHEDULEDAUTOS 1, (Par person)
HIRED AUTOS -
.} } BODILY INJURY
NON-OWNED AUTOS I✓ '`- _ ---LP1ccitact)
$
PROPERTY DAMAGE 5
(Per accident)
I
AGE LIABILITY _ - AUTO ONLY EAACCIDENT S
ANY AUTO
1 OTHER THAN EA ACC $
AUTO ONLY ADS $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE
RETENTION $ $
WORKERS COMPENSATION AND TORY' MITS ER
EMPLOYERS'LIABILITY
EL EACH ACCIDENT S
EL DISEASE-EA EMPLOYE $
EL DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The City of Palm Springs, its officers, employees and agents are added as
Additional Insured to the General Liability but only as respects all covered
operations of the named insured.Coverage is primary.The insurer waives all
rights of subrogation and contribution it may have against the city, its
officers, employees and agents and their respective insurers. *10 Day Notice Of Cancellation
CERTIFICATE HOLDER y I ADDITIONAL INSURED,INSURER LETTER A CANCELLATION
C/OPLMS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Palm Springs DATE THEREOF,THE ISSUING INSURER WILLXN)nV9Y,7(�VAIL *30 DAYSWRITTEN
City Clerk NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
ATTN: Judith Sumich
P.O. Box 2743 itORAX
Palm Springs CA 92263-2743
AUTH RIZED REPRESENT IVE
AAA
ACORD 25-S(7/97) —' C RD CORPORATION 1991
SK
STATE P.O. BOX 807, SA,N FRANCISCO,CA 94 1 0 1-0807
COMPENSATION
INS U R A N C E
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
POLICY NUMBER: 1424268 - 99 /
ISSUE DATE: 03-01-99 CERTIFICATE EXPIRES: 03-01-00 J
CITY OF PALM SPRINGS VED
ATTN MS JUDITY SUMICH CITY CLERK
P 0 BOX 2743
PALM SPRINGS CA 92263-2743
l.rt-rtg�.
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer.
We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terns, exclusions and conditions of such policies.
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
EMPLOYER LEGAL NAME
INFOTOX, INC. INFOTOX, INC.
9250 ORCO PARKWAY STE J
RIVERSIDE CA 92509
02-18-99
PRINTED: P0408
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