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HomeMy WebLinkAbout- - PSA Waste - 9/20/2011PROFESSIONAL SERVICES AGREEMENT FOR ADMINISTRATING AND MONITORING WASTE HAULER OPERATORS THIS AGREEMENT is made and entered into this i st day of October, 2011 ("Effective Date"), by and between the CITY OF COSTA MESA, a municipal corporation {"City"), and Michael Balliet, an individual ("Consultant"). WITNESSETH: A. WHEREAS, City proposes to have Consultant administer and monitor all waste hauler operators as it relates to the City's applicable ordinances, resolutions and elements as they relate to solid waste collection and Assembly Bill 939, as described herein below; and B. WHEREAS, Consultant represents that it has that degree of specialized expertise contemplated within California Government Code, Section 37103, and holds all necessary licenses to practice and perform the services herein contemplated; and C. WHEREAS, City and Consultant desire to contract for specific services in connection with the project described below (the "Project") and desire to set forth their rights, duties and liabilities in connection with the services to be performed; and D. WHEREAS, no official or employee of City has a financial interest, within the provisions of California Government Code, Sections 1090-1092, in the subject matter of this Agreement. NOW, THEREFORE, for and in consideration of the mutual covenants and conditions contained herein, the parties hereby agree as follows: 1.0® SERVICES PROVIDED BY CONSULTANT I.I. Scope of Services. Consultant shall provide the professional services described in the City's Request for Proposal ("RFP") attached hereto as Exhibit "A," and Consultant's Response to City's RFP (the "Response"). A copy of said Response is attached hereto as Exhibit "B" and incorporated herein by this reference. 1.2. Professional Practices. All professional services to be provided by Consultant pursuant to this Agreement shall be provided by personnel experienced in their respective fields and in a manner consistent with the standards of care, diligence and skill ordinarily exercised by professional consultants in similar fields and circumstances in accordance with sound professional practices. Consultant also warrants that it is familiar with all laws that may affect its performance of this Agreement and shall advise_ City of any changes in any laws that may affect Consultant's performance of this Agreement. 1.3. Warranty. Consultant warrants that it shall perform the services required by this Agreement in compliance with all applicable Federal and California employment laws including, but not limited to, those laws related to minimum hours and wages; occupational health and safety; fair employment and employment practices; workers' compensation insurance and safety in employment; and all other Federal, State and local laws and ordinances applicable to the services required under this Agreement. Consultant shall indemnify and hold harmless City from and against all claims, demands, payments, suits, actions, proceedings, and judgments of every nature and description including attorneys' fees and costs, presented, brought, or recovered against City for, or on account of any liability under any of the above-mentioned laws, which may be incurred by reason of Consultant's performance under this Agreement. 1.4. Non-discrimination. In performing this Agreement, Consultant shall not engage in, nor permit its agents to engage in, discrimination in employment of persons because of their race, religion, color, national origin, ancestry, age, physical handicap, medical condition, marital status, sexual gender or sexual orientation, except as permitted pursuant to Section 12940 of the Government Code. Violation of this provision may result in the imposition of penalties referred to in Labor Code, Section 1735. 1.5. Non -Exclusive Agreement. Consultant acknowledges that City may enter into agreements with other consultants for services similar to the services that are subject to this Agreement or may have its own employees perform services similar to those services contemplated by this Agreement. 1.6. Delegation and Assignment. This is a personal service contract, and the duties set forth herein shall not be delegated or assigned to any person or entity without the prior written consent of City. Consultant may engage a subcontractor(s) as permitted by law and may employ other personnel to perform services contemplated by this Agreement at Consultant's sole cost and expense. 1' 80' - i,► a► I{► ,, 2.1. Compensation. Consultant shall be paid in accordance with the fee schedule set forth in Exhibit "C," attached hereto and made a part of this Agreement (the "Fee Schedule"). Consultant's total compensation shall in no case exceed Thirty Three Thousand Five Hundred Dollars ($33,500.00). 2.2. Additional Services. Consultant shall not receive compensation for any services provided outside the scope of services specified in the Response unless the City or the Project Manager for this Project, prior to Consultant performing the additional services, approves such additional services in writing. It is specifically understood that oral requests and/or approvals of such additional services or additional compensation shall be barred and are unenforceable. 2.3. Method of Biilin . Consultant may submit invoices to City's Project Manager for approval on a progress basis, but no more often than monthly. Said invoice shall be based on the total of all Consultant's services which have been completed to City's sole satisfaction. City shall pay Consultant's invoice within forty-five (45) days from the date City receives said invoice. Each invoice shall describe in detail, the services performed and the associated time for completion. Any additional services approved and performed pursuant to this Agreement shall be designated as "Additional Services" and shall identify the number of the authorized change order, where applicable, on all invoices. 2.4. Records and. Audits. Records of Consultant's services relating to this Agreement shall be maintained in accordance with generally recognized accounting principles and shall be made available to City or its Project Manager for inspection and/or audit at mutually convenient times for a period of three (3) years from the Effective Date. 2 Michael Balliet PSA 11 1a910410p] ! a 0100, 3.1. Commencement and Completion of Work. The professional services to be performed pursuant to this Agreement shall commence within five (5) days from the Effective Date of this Agreement. 3.2. Excusable Delays. Neither party shall be responsible for delays or lack of performance resulting from acts beyond the reasonable control of the party or parties. Such acts shall include, but not be limited to, acts of God, fire, strikes, material shortages, compliance with laws or regulations, riots, acts of war, or any other conditions beyond the reasonable control of a ply. 1 �1. 1 -1 lIIiiliCt l 4.1.. Term. This Agreement shall commence on the Effective Date and continue for a period of one (1) year, ending on September 30, 2012, unless previously terminated as provided herein or as otherwise agreed to in writing by the parties. 4.2. Notice of Termination. The City reserves and has the right and privilege of canceling, suspending or abandoning the execution of all or any part of the work contemplated by this Agreement, with or without cause, at any time, by providing written notice to Consultant. The termination of this Agreement shall be deemed effective upon receipt of the notice of termination. In the event of such termination,. Consultant shall immediately stop rendering services under this Agreement unless directed otherwise by the City. 4.3. Compensation. In the event of termination, City shall pay Consultant for reasonable costs incurred and professional services satisfactorily performed up to and including the date of City's written notice of termination. Compensation for work in progress shall be prorated as to the percentage of work completed as of the effective date of termination in accordance with the fees set forth herein. In ascertaining the professional services actually rendered hereunder up to the effective date of termination of this Agreement, consideration shall be given to both completed work and work in progress, to complete and incomplete drawings, and to other documents pertaining to the services contemplated herein whether delivered to the City or in the possession of the Consultant. 4.4 Documents. In the event of termination of this Agreement, all documents prepared by Consultant in its performance of this Agreement including, but not limited to, finished or unfinished design, development and construction documents, data studies, drawings, maps and reports, shall be delivered to the City within ten (10) days of delivery of termination notice to Consultant, at no cost to City. Any use of uncompleted documents without specific written authorization from Consultant shall be at City's sole risk and without liability or legal expense to Consultant. 3 Michael Balliet PSA 11 5.0. INSURANCE 5.1. Minimum Scope and Limits of Insurance. Consultant shall obtain and maintain during the life of this Agreement all of the following insurance coverages: (a) Comprehensive general liability, including premises -operations, products/completed operations, broad form property damage, blanket contractual liability, independent contractors, personal injury with a policy limit of not less than One Million Dollars ($1,000,000.00), combined single limits, per occurrence and aggregate. (b) Automobile liability for owned vehicles, hired, and non -owned vehicles, with a policy limit of not less than One Million Dollars ($1,000,000.00), combined single limits, per occurrence and aggregate. (c) Workers' compensation insurance as required by the State of California. Consultant agrees to waive, and to obtain endorsements from its workers' compensation insurer waiving, subrogation rights under its - workers' compensation insurance policy against the. City and to require each of its subcontractors, if any, to do likewise under their workers' compensation insurance policies. (d) Professional errors and omissions C E&O") liability insurance with policy limits of not less than One Million Dollars ($1,000,000.00), combined single limits, per occurrence and aggregate. Consultant shall obtain and maintain, said E&O liability insurance during the life of this Agreement and for three years after completion of the work hereunder. 5.2. Endorsements. The comprehensive general liability insurance policy shall contain or be endorsed to contain the following provisions: (a) Additional insureds: "The City of Costa Mesa and its elected and appointed boards, officers, agents, and employees are additional insureds with respect to this subject project and contract with City." (b) Notice: "Said policy shall not terminate, nor shall it be cancelled, nor the coverage reduced, until thirty (30) days after written notice is given to City." (c) Other insurance: "Any other insurance maintained by the City of Costa Mesa shall be excess and not contributing with the insurance provided by this policy." 5.3. if any of such policies provide for a deductible or self-insured retention to provide such coverage, the amount of such deductible or self-insured retention shall be approved in advance by City. No policy of insurance issued as to which the City is an additional insured. shall contain a provision which requires that no insured except the named insured can satisfy any such deductible or self-insured retention. 4 Michael Balliet PSA 11 5.4. Certificates of Insurance. Consultant shall provide to City certificates of insurance showing the insurance coverages and required endorsements described above, in a form and content approved by City, prior to performing any services under this Agreement. 5.5. Non -limiting. Nothing in this Section shall be construed as limiting in any way, the indemnification provision contained in this Agreement, or the extent to which Consultant may be held responsible for payments of damages to persons or.property. 6.1. Entire Agreement. This Agreement constitutes the entire Agreement between the Parties with respect to any matter referenced herein and supersedes any and all other prior writings and oral negotiations. This Agreement may be modified only in writing, and signed by the parties in interest at the time of such modification. The terms of this Agreement shall prevail over any inconsistent provision in any other contract document appurtenant hereto, including exhibits to this Agreement. 6.2. Representatives. The City Manager or his designee shall be the representative of City for purposes of this Agreement and may issue all consents, approvals, directives and agreements on behalf of the City, called for by this Agreement, except as otherwise expressly provided in this Agreement. Consultant shall designate a representative for purposes of this Agreement who shall be authorized to issue all consents, approvals, directives and agreements on behalf of Consultant called for by this Agreement, except as otherwise expressly provided in this Agreement. 6.3. Project Managers. City shall designate a Project Manager to work directly with Consultant in the performance of this Agreement. Consultant shall designate a Project Manager who shall represent it and be its agent in all consultations with City during the term of this Agreement. Consultant or its Project Manager shall attend and assist in all coordination meetings called by City. 6.4. Notices. Any notices, documents, correspondence or other communications concerning this Agreement or the work hereunder may be provided by personal delivery, facsimile or snail and shall be addressed as set forth below. Such communication shall be deemed served or delivered: a) at the time of delivery if such communication is sent by personal delivery; b) at the time of transmission if such communication is sent by facsimile; and c) 48 hours after deposit in the U.S. Mail as reflected by the official U.S. postmark if such communication is sent through regular United States snail. IF TO CONSULTANT: Michael Balliet Consulting 26351 Tarrasa Lane Mission Viejo, CA 92691 IF TO CITY: City of Costa Mesa 77 Fair Drive Costa Mesa, CA 92626 5 Michael Balliet PSA 11 Tel: 949-837-3618 Fax: 949-837-3618 Attn: Michael Balliet Tel: 714-754-5024 Fax: 714-754-5040 Attn: Alma Reyes 6.5. Drug free Workplace Policy. Consultant shall provide a drug-free workplace by complying with all provisions set forth in City's Council Policy 100-5, attached hereto as Exhibit "C" and incorporated herein by reference. Consultant's failure to conform to the requirements set forth in Council Policy 100-5 shall constitute a material breach of this Agreement and shall be cause for immediate termination of this Agreement by City. 6.6. Attorneys' Fees. In the event that litigation is brought by any party in connection with this Agreement, the prevailing party shall be entitled to recover from the opposing party all costs and expenses, including reasonable attorneys' fees, incurred by the prevailing party in the exercise of any of its rights or remedies hereunder or the enforcement of any of the terms, conditions, or provisions hereof. 6.7. Governing Lave. This Agreement shall be governed by and construed under the laws of the State of California without giving effect to that body of laws pertaining to conflict of laws. In the event of any legal action to enforce or interpret this Agreement, the parties hereto agree that the sole and exclusive venue shall be a court of competent jurisdiction located in Orange County, California. 6.8. Assi ng meat. Consultant shall not voluntarily or by operation of law assign; transfer, sublet or encumber all or any part of Consultant's interest in this Agreement without City's prior written consent. Any attempted assignment, transfer, subletting or encumbrance shall be void and shall constitute a breach of this Agreement and cause for termination of this Agreement. Regardless of City's consent, no subletting or assignment shall release Consultant of Consultant's obligation to perform all other obligations to be performed by Consultant hereunder for the term of this Agreement. 6.9. Indemnification and Hold Harmless. Consultant shall protect, defend, indemnify and hold harmless City and its elected and appointed officials, officers, and employees from any and all claims, liabilities, expenses, including attorney fees, damage to property or injuries to or death of any person or persons or damages of any nature including, but not by way of limitation, all civil claims or workers' compensation claims arising out of or in any way connected with the intentional or negligent acts, error or omissions of Consultant, its employees, agents or subcontractors in the performance of this Agreement. 6.10. Independent Contractor. Consultant is and shall be acting at all times as an independent contractor and not as an employee of City. Consultant shall secure, at his expense, and be responsible for any and all payment of Income Tax, Social Security, State Disability Insurance Compensation, Unemployment Compensation, and other payroll deductions for Consultant and its officers, agents, and employees, and all business licenses, if any are required, in connection with the services to be performed hereunder. 6.11. Ownership of Documents. All findings, reports, documents, information and data including, but not limited to, computer tapes or discs, files and tapes furnished or prepared by Consultant or any of its subcontractors in the course of performance of this Agreement, shall be 6 Michael Balliet PSA 11 and remain the sole property of City. Consultant agrees that any such documents or information shall not be made available to any individual or organization without the prior consent of City. Any use of such documents for other projects not contemplated by this Agreement, and any use of incomplete documents, shall be at the sole risk of City and without liability or legal exposure to Consultant. City shall indemnify and hold harmless Consultant from all claims, damages, losses, and expenses, including attorneys' fees, arising out of or resulting from City's use of such documents for other projects not contemplated by this Agreement or use of incomplete documents furnished by Consultant. Consultant shall deliver to City any findings, reports, documents, information, data, in any form, including but not limited to, computer tapes, discs, files audio tapes or any other Project related items as requested by City or its authorized representative, at no additional cost to the City. 6.12. Public Records Act Disclosure. Consultant has been advised and is aware that all reports, documents, information and data including, but not limited to, computer tapes, discs or files furnished or prepared by Consultant, or any of its subcontractors, and provided to City may be subject to public disclosure as required by the California Public Records Act (California Government Code Section 6250 et. seq.). Exceptions to public ' disclosure may be those documents or information that qualify as trade secrets, as that term is defined in the California Government Code Section 6254.7, and of which Consultant informs City of such trade secret. The City will endeavor to maintain as confidential all information obtained by it that is designated as a trade secret. The City shall not, in any way, be liable or responsible for the disclosure of any trade secret including, without limitation, those records so marked if disclosure is deemed to be required by law or by order of the Court. 6.13. Responsibility for Errors. Consultant shall be responsible for its work and results under this Agreement. Consultant, when requested, shall furnish clarification and/or explanation as may be required by the City's representative, regarding any services rendered under this Agreement at no additional cost to City. In the event that an error or omission attributable to Consultant occurs, then Consultant shall, at no cost to City, provide all necessary design drawings, estimates and other Consultant professional services necessary to rectify and correct the matter to the sole satisfaction of City and to participate in any meeting required with regard to the correction. 6.14. Prohibited Employment. Consultant will not employ any regular employee of City while this Agreement is in effect. 6.15. Order of Precedence. In the event of an inconsistency in this Agreement and any of the attached Exhibits, the terms set forth in this Agreement shall prevail. If, and to the extent this Agreement incorporates by reference any provision of the RFP or the Response, such provision shall be"deemed a part of this Agreement. Nevertheless, if there is any conflict among the terms and conditions of this Agreement and those of any such provision or provisions so incorporated by reference, this Agreement shall govern over both the Response and the RFP and the Response shall govern over the RFP. 6.16. Costs. Each party shall bear its own costs and fees incurred in the preparation and negotiation of this Agreement and in the performance of its obligations hereunder except as expressly provided herein. 7 Michael Balliet PSA 11 6.17. No Third Pggy Beneficiary Rights. This Agreement is entered into for the sole benefit of City and Consultant and no other parties are intended to be direct or incidental beneficiaries of this Agreement and no third party shall have any right in, under or to this Agreement. 6.18. Headings. Paragraphs and subparagraph headings contained in this Agreement are included solely for convenience and are not intended to modify, explain or to be a full or accurate description of the content thereof and shall not in .any way affect the meaning or interpretation of this Agreement. 6.19. Construction. The parties have participated jointly in the negotiation and drafting of this Agreement. In the event an ambiguity or question of intent or interpretation arises with respect to this Agreement, this Agreement shall be construed as if drafted jointly by the parties and in accordance with its fair meaning. There shall be no presumption or burden of proof favoring or disfavoring any party by virtue of the authorship of any of the provisions of this Agreement. 6.20. Amendments. Only a writing executed by the parties hereto or their respective successors and assigns may amend this Agreement. 6.21. Waiver. The delay or failure of either party at any time to require performance or compliance by the other of any of its obligations or agreements shall in no way be deemed a waiver of those rights to require such performance or compliance. No waiver of any provision of this Agreement shall be effective unless in writing and signed by a duly authorized representative of the party against whom enforcement of a waiver is sought. The waiver of any right or remedy in respect to any occurrence or event shall not be deemed a waiver of any right or remedy in respect to any other occurrence or event, nor shall any waiver constitute a continuing waiver. 6.22. Severability. If any provision of this Agreement is determined by a court of competent jurisdiction to be unenforceable in any circumstance, such determination shall not affect the validity or enforceability of the remaining terms and provisions hereof or of the offending provision in any other circumstance. Notwithstanding the foregoing, if the value of this Agreement, based upon the substantial benefit of the bargain for any party is materially impaired, which determination as made by the presiding court or arbitrator of competent jurisdiction shall be binding, then both parties agree to substitute such provision(s) through good faith negotiations. 6.23. CounteMarts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original. All counterparts shall be construed together and shall constitute one agreement. 6.24. Corporate Authority. The persons executing this Agreement on behalf of the parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said parties and that by doing so, the parties hereto are formally bound to the provisions of this Agreement. 8 Michael Balliet PSA 3.1 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their respective authorized officers, as of the date first above written. CITY OF COSTA MESA, A municipal corporation Date: Mayor of the City of Costa Mesa CONSULTANT Date: Signature Name and Title Social Security or Taxpayer ID Number ATTEST: City Clerk and ex -officio Clerk of the City of Costa Mesa APPROVED AS TO FORM: Date: City Attorney APPROVED AS TOINSURANCE: �e /. Date: Is / Risld4anagement 9 Michael Balliet PSA 11 APPROVED AS TO CONTENT: Date: Project Mang er 10 Michael Balliet PSA 11 4i„ 11 Michael Balliet PSA 11 August 2, 2011 REQUEST FOR PROPOSALS TO ADMINISTER THE CITY OF COSTA MESA'S SOURCE REDUCTION AND RECYCLING ELEMENT . The City of Costa Mesa currently operates under Costa Mesa Municipal Code Title 8, Chapter IV, Article 1, which governs garbage, refuse and recyclable materials collection. The information is available on the City's website www.ci.costa-mesa.ca.us. This code section in conjunction with the City's Source Reduction and Recycling Element (SRRE) provides the City with the necessary documents to meet the requirements of AB 939, the California Integrated Waste Management Act of 1989. Currently 10 waste haulers operate within the City under the City franchise regulations. Each hauler is required by municipal code to meet certain minimum standards before a waste hauling permit, non-exclusive franchise and business license are issued. The City desires to hire a consulting firm to administer and monitor all waste hauler operators as it relates to the City's applicable ordinances, resolutions, elements, etc. as they relate to solid waste collection and AB 939. The City, with cooperation from the permitted waste haulers, has successfully achieved the 50 percent (50%) diversion rate for 2010 mandated by AB 939. Included in the City's Source Reduction and Recycling Element is a new scope of work relating. to the tracking of the disposal of solid waste from construction and demolition projects. The City recognizes that construction and demolition waste constitutes a substantial portion of the total volume of solid waste generated in the City, much of which is disposed of in solid waste landfills in Orange County. The waste materials generated through construction and demolition projects have potential of solid waste reduction, reuse, and recycling. The City's diversion rate requirement for construction and demolition waste generated by construction projects is 50 percent (50%), which City -Permitted Waste Haulers are required to meet. In order for the City to successfully achieve the required diversion rate the City has taken proper measures to establish and implement a tracking system for the disposal of solid waste generated by construction and demolition projects. On October 19, 2010, the City Council adopted Ordinance Number 10-11, amending Article 1 of Title 8 to make it unlawful for any person to use the services of an ccunpermitted" waste hauler in the City. Furthermore, on December 7, 2010, the City of Costa Mesa City Council adopted Resolution Number 10-79, establishing the City's penalties for violation of Costa Mesa Municipal Code Section 8-83 and amending the Civil Fines and Penalties Schedule pursuant to Costa Mesa Municipal Code Section 1- 40. Effective January 1, 2011, all construction and demolition projects with valuation of $10,000 or more is required to comply with the City's waste hauling requirements or face penalties of $1,000 or 3 percent (3%) of the total project value, which ever is greater. The City of Costa Mesa is soliciting proposals for the following services on an annual basis: I ANNUAL PERMIT PROCESS Cost/Year Review all annual waste hauling requests to perform waste hauling services within the City of Costa Mesa (currently 10 annual permits). $ 2. Verify all required information for the annual permits is submitted, and request in writing any additional information needed. $ 3. Review applicant's annual source reduction and recycling proposal for consistency with City's SRRE and all pertinent requirements of City Ordinances governing waste collection and recycling. $ 4. Recommend approval or denial of permit in writing to the City's project manager. If denial is recommended, detailed information will need to be provided to support the recommendation. $ 5. Compose approval or rejection letter to each applicant to be signed by City's project manager. $ 6. Send renewal letter yearly to each hauler for new waste hauling permit application. $ 7. Contact and initiate permit process for waste hauling companies found to be operating in the City without a permit. $ SUBTOTAL — PERMIT PROCESS $ 0 Cost/Year 1. Randomly check all hauler trucks for appropriate firm name on each truck. $ 2. Ensure permittees are in compliance with current or future Air Quality Management District rules pertaining to commercial waste hauling vehicles. $ 3. Spot check a minimum of 100 commercial/industrial areas per year to ensure containers have appropriate signage. Provide reports to the City Project Manager. $ 4. Notify those permittees that do not comply and enforce container requirements. $ 5. Spot check trucks from each permitted company on a bi-annual basis for proper State/local permits/ inspections. Provide reports to the City Project Manager. $ SUBTOTAL VEHICLE INSPECTIONS & EQUIPMENT REQUIREMENTS $ Ill SERVICE STANDARDS Cost/Year 1. Enforce hours of operation as set forth in Ordinance 92-31 and resolve complaints as they arise. $ 2. Check place of business and phone number of each hauler to assure compliance with Sec. 8-81(f) of Ordinance 92-31. $ 3. Check that each hauler has an appropriate tag identifying why refuse was not picked up. $ SUBTOTAL — SERVICE STANDARDS $ Cost/Year 1. Verify all haulers. have City -approved insurance and/or bonds. $ SUBTOTAL — INSURANCE AND BONDS $ V REGULATIONS Cost/Year 1. Verify that all special waste haulers have appropriate permits issued by the City, County, State or Federal Government as necessary. $ 2. Spot check vehicles of all haulers annually to verify. and enforce the no commingling requirement of Ordinance 92- 31. Provide reports to the City Project Manager. $ SUBTOTAL — REGULATIONS $ Cost/Year 1. Determine that all waste haulers have complied with all programs identified in the City's Source Reduction and Recycling Element. $ 2. Verify that all permitees have diversion rates through the year 2011. Determine that the total diversion rates outlined by each permittee will satisfy the State mandates of AB 939. $ 3. Review all annual Source Reduction and Recycling Plans submitted by each permittee and recommend approval or denial. Recommendations for denial must be supplemented With information to support the recommended action. $ 4. Receive all quarterly Source Reduction, Recycling and tonnage reports from each permittee. Compile all information and prepare reports on Citywide diversion issues with individual permittees. Prepare individual diversion rates. $ 5. Identify private recycling efforts Citywide. Verify progress and compliance with AB32 mandatory recycling requirements. $ 6. Prepare annual report to the California Integrated Waste Management Board. $ SUBTOTAL — SOURCE REDUCTION AND RECYCLING $ VII CONSTRUCTION AND DEMOLITION TRACKING SYSTEM Cost/Year 1. Enforcement of City of Costa Mesa Municipal Code Section 8-83(h) on all covered projects. Verify that all contractors and owner builders with projects with a valuation of $10,000.00 or more, comply with the City's waste hauling requirements. 2. Review all certification forms submitted. Requiring contractors and/or owner builders to provide waste hauling plan and ensure full cooperation. $ 3. Maintain a database of all covered projects. Tracking all disposal or diverted waste generated at project site. $ 4. Randomly visit construction sites for compliance of City's waste hauling requirements. $ 5. Recommend approval or denial of certification form for compliance City's waste hauling requirements. $ 6. Provide information regarding solid waste diversion for construction and demolition projects for AB 939 Annual Report. $ SUBTOTAL — CONSTRUCTION & DEMOLITION TRACKING $ • -� $ In addition to the above services, the City is requesting prices for services on the following list, which may or may not be implemented at the sole discretion of the City. VIII SPECIAL SERVICES Staff recycling booth at various community functions (May be weekday or weekend)- provide cost per day. 2. Coordination and attendance at City meetings with waste haulers as scheduled by the City -provide cost per meeting 3. Attendance at County Integrated Waste Management meetings as requested by the City -provide cost per meeting 4. Assist City Staff in preparation of reports to City Council if needed -provide cost per report. F $ SUBTOTAL — SPECIAL PROGRAMS TOTAL PROGRAM COSTS $ Your proposal should include all costs associated with this request for a period of one year. Each task must have an identified cost. The City reserves the right to 'implement each task as deemed necessary. Please be advised that the average annual consultant cost to the City for this service over the last 10 years has been approximately $35,000. Please provide your company's qualifications as it relates to this proposal, references from other cities, and knowledge of Public Resources Code Section 4000 et seq. The bidder must not be a waste hauler or an employee of a waste hauler in the City of Costa Mesa. The successful bidder must provide the following insurance: (1) errors and omissions, (2) liability, and (3) workers compensation insurance, acceptable to the City of Costa Mesa. All documents regarding this request for proposal are available in the Public Services Department at Costa Mesa City Hall, 77 Fair Drive, Costa Mesa, CA 92626. The deadline for submittal of this proposal is 5:00 p.m. August 25, 2011. Please mail 2 copies of your proposal to my attention at: City of Costa Mesa P.O. Box 1200 ' Costa Mesa, CA 92628-1200 You may hand deliver your proposal to the Public Services Department, 4t' floor of City Hall, 77 Fair Drive, Costa Mesa. Fax copies will not be accepted. Should you have any questions regarding this request, please contact Alma Reyes, Management Analyst at areyesOci.costa-mesa.ca.us or (714) 754-5024, Monday thru Friday 8:00 a.m. — 5:00 p.m. Thank you for your interest in providing service to the City of Costa Mesa. 10,14 111 i 12 Michael BalUet PSA 11 Michael Balliet Consulting August 23, 2011 Alma Reyes Management Analyst Public Services Department: City of Costa Mesa 77 Fair Drive P.O. Box 1200 Costa Mesa, CA 92628-1200 Ms. Reyes: I am pleased to submit this proposal to provide continued consulting services to the City of Costa Mesa. It has been my privilege to work with the City since 1993. on AB 939 compliance and waste hauler monitoring programs. In that time, the City of Costa Mesa has always maintained compliance with the diversion and program implementation requirements of the California Integrated Waste Management Board (CIWivM). I am confident that the required scope of services for 201112012 can be performed for $33,500. The proposed scope of work has expanded from previous years to include construction project hauling management. Listed below are the City required budget categories and related costs: Cost/Year 1. Review all annual waste hauling requests to perform waste hauling services within the City of Costa Mesa (currently 10 annual permits). $1,000.00 2. Verify all required information for the annual permits is submitted, and request in writing any additional information needed. $1,000.00 3. Review applicant's annual source reduction and recycling proposal for consistency with City's SRRE and all pertinent requirements of City Ordinances governing waste collection and recycling. $1,000.00 4. Recommend approval or denial of permit in writing to the City's project manager. If denial is recommended, detailed information will need to be provided to support the recommendation. $ 500.00 5. Compose approval or rejection letter to each applicant to be signed by City's project manager. $ 500.00 6. Send renewal letter yearly to each hauler for new waste hauling permit application. $ 300.00 7. Contact and initiate permit process for waste hauling companies found to be operating in the City without a permit. $1,000.00 SUBTOTAL — PERMIT PROCESS $5,300.00 11 VEHICLE INSPECTIONS/EQUIPMENT REQUIREMENTS CostlYear 1. Randomly check all hauler trucks for appropriate firm name on each truck. $ 500.00 2. Ensure permittees are in compliance with current or future Air Quality Management District rules pertaining to commercial waste hauling vehicles. $ 500.00 3. Spot check a minimum of 100 commeteialrndustrial areas per year to ensure containers have appropriate signage. Provide reports to the City Project Manager. $5,300.00 4. Notify those permittees that do not comply and enforce container requirements. $1,000.00 5. Spot check trucks from each permitted company on a bi-annual basis for proper State/local permits/ inspections. Provide reports to the City Project Manager. $1,000.00 SUBTOTAL VEHICLE INSPECTIONS & EQUIPMENT REQUIREMENTS $8,300.00 III SERVICE STANDARDS 1. Enforce hours of operation as set forth in Ordinance 92-31 and resolve complaints as they arise. 2. Check place of business and phone number of each hauler to assure compliance with Sec. 8-81(f) of Ordinance 92-31. 3. Check that each hauler has an appropriate tag identifying why refuse was not picked up. SUBTOTAL — SERVICE STANDARDS CostiYear $ 100.00 $ 200.00 $ 100.00 $ 500.00 IV INSURANCE AND BONDS Cost/Year 9. Verify all haulers have City -approved insurance and/or bonds. $ 400.00 SUBTOTAL -- INSURANCE AND BONDS $ 400.00 V REGULATIONS Cost/Year �. Verify that all special waste haulers have appropriate permits issued by the City, County, State or Federal Government as necessary. $ 300.00 2. Spot check vehicles of all haulers annually to verify and enforce the no commingling. requirement of Ordinance 92- 39. Provide reports to the City Project Manager. $9,700.00 SUBTOTAL -- REGULATIONS $2,000.00 VI SOURCE REDUCTION. AND RECYCLING Cost/Year 9. determine that all waste haulers have complied with all programs identified in the City's Source Reduction and Recycling Element. $ 500.00 2. Verify that all permitees have diversion rates through the year 2011. Determine that the total diversion rates outlined by each permittee will satisfy the State mandates of AB 939. $ 500.00 3. Review all annual Source Reduction and Recycling Plans submitted by each permittee and recommend approval or denial. Recommendations for denial must be supplemented with information to support the recommended action. $ 500.00 4. Receive all quarterly Source Reduction, Recycling and tonnage reports from each permittee. Compile all information and prepare reports on Citywide diversion issues with individual permittees. Prepare individual diversion rates. $6,000.00 5. Identify private recycling efforts Citywide. Verify progress and compliance with AB32 mandatory recycling requirements. $2,500.00 6. Prepare annual report to the California integrated Waste Management Board. $2,000.00 SUBTOTAL — SOURCE REDUCTION ARID RECYCLING $72,000.00 Vil CONSTRUCTION AND DEMOLITION TRACKING SYSTEM Cost/Year 1. Enforcement of City of Costa Mesa Municipal Code Section 8-83(h) on all covered projects. Verify that all contractors and owner builders with projects with a valuation of $10,000.00 or more, comply with the City's waste hauling requirements. $9,000.00 2. Review all certification forms submitted. Requiring contractors and/or owner builders to provide waste hauling plan and ensure full cooperation. $1,000.00 3. Maintain a database of all covered projects. Tracking all disposal or diverted waste generated at project site. $1,000.00 4. Randomly visit construction sites for compliance of City's waste hauling requirements. $ 500.00 5. Recommend approval or denial of certification form for compliance City's waste hauling requirements. $ 750.00 6. Provide information regarding solid waste diversion for construction and demolition projects for AB 939 Annual Report. $ 750.00 SUBTOTAL. — CONSTRUCTION. Eli DEMOLITION TRACKING $6,400.00 TOTAL. - SECTIONS I THROUGH VII $33,500.00 In addition to the above services, the City is requesting prices for services on the following list, which may or may not be implemented at the sole discretion of the City. Vill SPECIAL. SERVICES 1. Staff recycling booth at various community functions $1,000.00 (May be weekday or weekend)- provide cost per day. 2. Coordination and attendance at City meetings with waste haulers as scheduled by the City -provide cost per meeting. $ 300.00 3. Attendance at County Integrated Waste Management meetings as requested by the City -provide cost per meeting. $ 300.00 4. Assist City Staff in preparation of reports to City Council if needed -provide cost per report. $ 800.00 �. y ■ t 't n _�.. 1 y . ) # A �Jgmmmw a '. i l:.. Qualifications Having served as the City of Costa Mesa's AB939 consultant since 1992 I have submitted various qualifications listings at each 5 -year interval. Since the last list of qualifications was submitted I have performed new consulting services for the following clients: City of Costa Mesa — 2006 to present (5 years) Contact: Colleen O'Donoghue, Finance Director Phone: 714-754-5219 In 20051 helped the City transition from a hauler permit program to a non-exclusive franchise, increasing City revenues by -$1.2 million. Through consistent and effective hauler audits Mr. Balliet has ensured timely remittance of all funds due the City, reducing hauler reporting errors to less than 2%. Mr. Balliet performs there hauler audits annually under contract with the City's Finance Department. City of Laguna Woods — 2002 to present (9 years) Douglas C. Reilly, Public Works Director Phone: 949-639-0561 Mr. Balliet has worked with the City of Laguna Woods since shortly after their incorporation in 2001. He performed all required waste generation and waste composition studies and prepared the City's SRRE. Subsequently he assisted the City in implementing one of the most comprehensive solid and hazardous waste management programs in State. Mr. Balliet assisted the City in developing its municipal code and evolving these requirements through the City's maturation process. He transitioned the City from a group of County permitted haulers to an exclusive franchise system. In 2006 he developed a comprehensive construction waste management program that successfully tracks over 750 projects annually. He has obtained multiple competitive grant awards for the City that established door-to-door collection of HHW, door-to-door collection of E -Waste and U Waste, a used oil recycling program, a medical waste collection program, and a multi -family recycling program. Laguna Woods has exceeded State diversion requirements in every year since measurements began and has reached a 69% diversion rate. In addition to the long-term clients listed above we have performed a number of successful hauler performance and franchise fee audits. Listed below are the projects that are still active or have been completed within the past year: City of Newport Beach —1996,1999, 2005 to Present Hortensia Mato, City Auditor Phone: 949-644-3143 Since 1996 Mr. Balliet has performed two traditional franchise fee audits of the City's non- exclusive franchise system. Those audits recovered over $300,000 in revenue for the City. In 2008 the City elected to switch to our proprietary quarterly monitoring and audit program. This program effectively audits hauler franchise fee and tonnage reports at the date of submission rectifying any errors encountered and capturing revenues immediately rather than waiting for the traditional 3 -year audit term used by most jurisdictions. City of Santa Rosa — 2008-2010 Greg Scoles, Deputy City Manager 707-543-3021 Mr. Balliet has performed two franchise fee and performance audits for the largest municipality north of San Francisco. These audits resulted in over $500,000 in findings and helped the City identify and rectify a number of tonnage reporting errors. These efforts allowed the City to negotiate very favorable terms in their exclusive franchise extension. City of Placentia - 2009 Troy Butzlaff, City Manager 714-993-8117 Mr. Ballet conducted a performance audit and review rate increase requests from the City's exclusive franchised haulers. His review uncovered a myriad of compliance and rate increase issues over a 15 year term. This study resulted in payment to the City of over $3 million dollars by the hauler and a rate reduction, rather that the requested rate increase. City of Gardena - 2010 Mitch Lansdell, City Manager 310-217-9503 Mr. Balliet audited the City's current and past exclusive franchise haulers for both franchise fee submissions and compliance with their agreement. This audit resulted in findings of over $250,000. City of Pasadena - 2010 Carmen Rubio, Program Coordinator 626-744-7162 W. Balliet was retained to audit a random sampling of 13 haulers in the City's non-exclusive franchise system. Though these haulers have been audited annually for the past 5 years by other consultants we identified and recovered over $15,000 in franchise fees. In addition we identified over 5,000 tons in reporting errors and worked with haulers to revise landfill reporting issues. In addition to compliance consulting and hauler audits Waste Systems Management has a unique understanding of solid waste systems. We have performed a number of projects to assist both the public and private sectors to increase diversion while lowering associated costs. A sampling of these projects is provided below: Cal State Los Angeles — 2008 to Present - --- Kirby -Williams, Custodial Services Director 323-791-6875 Developed a waste management system for the University that reduced trash hauler fees by 50%. Established new recycling programs to increase diversion by over 30% and create a revenue stream from formerly discarded materials. Provide ongoing program monitoring services. Additional references are available upon request. Additional Information: Michael Balliet Consulting is still a sole proprietorship and my professional liability insurance is current and on -file with the Cityprovided by The Hartford insurance Company as is my general liability provider. American Specialty covers my automobiles. My current insurance information is on file with the City of Costa Mesa. I have enjoyed my tenure of service to the City and look forward to continuing my work with your department Thannks for the opportunity to present this proposal. Sincerely, alliet MBC *114 111 113 9 W4 I 1 3 Di Wei I 13 Micliael BaBiet PSA 11 I 14 Michael Balliet PSA 11 SUBJECT POLICY EFFECTIVE PAGE NUMBER DATE DRUG-FREE WORKPLACE 100-5 8-8-89 1 of 3 BACKGROUND Under the Federal Drug -Free Workplace Act of 1988, passed as part of omnibus drug legislation enacted November 18, 1988, contractors and grantees of Federal funds must certify that they will provide drug-free workplaces. At the present time, the City of Costa Mesa, as a sub -grantee of Federal funds under a variety of programs,. is required to abide by this Act. The City Council has expressed its support of the national effort to eradicate drug abuse through the creation of a Substance Abuse Committee, institution of a City-wide D.A.R.E. program in all local schools and other activities in support of a drug-free community. This policy is intended to extend that effort to contractors and grantees of the City of Costa Mesa in the elimination of dangerous drugs in the workplace. PURPOSE It is the purpose of this Policy to: 1. Clearly state the City of Costa Mesa's commitment to a drug-free society. 2. Set forth guidelines to ensure that public, private, and nonprofit organizations receiving funds from the City of Costa Mesa share the commitment to a drug-free workplace. t; The City Manager, under direction by the City Council, shall take the necessary steps to see that the following provisions are included in all contracts and agreements entered into by the City of Costa Mesa involving the disbursement of funds. 1. Contractor or Sub -grantee hereby certifies that it will provide a drug-free workplace by: a. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in Contractor's and/or sub -grantee's workplace, specifically the job site or location included in this contract, and specifying the actions that will be taken against the employees for violation of such prohibition; 15 Michael Balliet PSA 11 SUBJECT POLICY EFFECTIVE PAGE NUMBER DATE DRUG-FREE WORKPLACE T 1 H• 100-5 8-8-89 2 of 3 U. LOLavu suiug a thug -Mee i,,wareness rrograrn to inform employees about: 1. The dangers of drug abuse in the workplace; 2. Contractor's and/or sub -grantee's policy of maintaining a drug-free workplace; 3. Any available drug counseling, rehabilitation and employee assistance programs; and 4. The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c. Making it a requirement that each employee to be engaged in the performance of the contract be given a copy of the statement required by subparagraph A; d. Notifying the employee in the statement required by subparagraph 1 A that, as a condition of employment under the contract, the employee will: 1. Abide by the terms of the statement; and 2. Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five (5) days after such conviction; e. Notifying the City of Costa Mesa within ten (10) days after receiving notice under subparagraph 1 D 2 from an employee or otherwise receiving the actual notice of such conviction; f. Taking one of the following actions within thirty (30) days of receiving notice under subparagraph 1 D 2 with respect to an employee who is so convicted: 1. Taking appropriate personnel action against such an employee, up to and including termination; or 2. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health agency, law enforcement, or other appropriate agency; 16 Michael Balliet PSA 11 SUBJECT POLICY EFFECTIVE PAGE NUMBER DATE DRUG-FREE WORKPLACE 100-5 8-8-89 3 of 3 g. Making a good faith effort to maintain a drug-free workplace through implementation of subparagraphs 1 A through 1 F, inclusive. 2. Contractor and/or sub -grantee shall be deemed to be in violation of this Policy if the City of Costa Mesa determines that: a. Contractor and/or sub -grantee has made a false certification under paragraph 1 above; b. Contractor and/or sub -grantee has violated the certification by failing to carry out the requirements of subparagraphs 1 A through 1 G above; c. Such number of employees of Contractor and/or sub -grantee have been convicted of violations of criminal drug statutes for violations occurring in the workplace as to indicate that the contractor and/or sub -grantee has failed to make a good faith effort to provide a drug-free workplace. 3. Should any contractor and/or sub -grantee be deemed to be in violation of this Policy pursuant to the provisions of *2 A, B, and C, a suspension, termination or debarment proceeding subject to applicable Federal, State, and local laws shall be conducted. Upon issuance of any final decision under this section requiring debarment of a contractor and/or sub -grantee, the contractor and/or sub -grantee shall be ineligible for award of any contract, agreement or grant from the City of Costa Mesa for a period specified in the decision, not to exceed five (5) years. Upon issuance of any final decision recommending against debarment of the contractor and/or sub -grantee, the contractor and/or sub -grantee shall be eligible for compensation as provided by law. 17 Michael Ballet PSA 11 0 1 18 Michael Balliet PSA 11 EXEMPTION FROM WORKER'S COMPENSATION DECLARATION I certify that in the performance of the work under this agreement/for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I understand that if after making this declaration, I should become subject to the Workers' Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions. Date: J ' aO i Signature: CSI&,el L -II 'Lt (Print Name) WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENATIES ANIS CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN evn r..rcc 05/12/2011 11:32 FAX �J001 ("#ERTIFI ATE OF LIABILITY IN URANCEDA©5nz11NY) �>aRDDuoER A6il'Ity insurance Agency IIIc_ 2787 Bristol St # 210 Gosta Mesa, CA 9=13 Phone (714)96&9600 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONKERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fax (714)968-8001 INSURERS AFFORDING COVERAGE NAIL # INSURED Michael Balliiet Consul6n� 9ISURERA: Halliard Casualty Insurance Co. 26351 Tarrasa Lane c: MissionViejo, CA 92691- -_._ ...-__-- _..._ _._.___..___ _.._.__�—...__-.----.•-___----.-_...._. INSURER D: (949) 837-3618 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED 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 0 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDrrIONS OF SUCH POUC1ES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS. 8Rj ADD'L ---- POLICY EPpECTIVE POLICY EXPIRATION r12 IRAM TYPE OF INSURANCE - POLICY NUMBER DATH DmyY DATE IarruDDmYY LIMITS R 1 JG❑EWL SKIM RRL LIABILITY ly!) COMMERCIAL GENERAL LIABILITY nn CLAIMSMADE R OCCUR ❑ AGGREGATE LUT APPLIES PER: MED EXP (Arty one person) -- POLICY n PROJECT_ ❑ LOC $1,00G,000 GENERALACGnGATE AUTOMOBILE LIABILITY PRODUCTS - COMP/OP AGG $2.000,000 iI ANY AUTO ❑ ALL OWNED AUTOS ❑ ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NONOWNEDAUTO$ GARAGE LIABILITY n n ANY AUTO EXCF-88 I UMBRELLA LIABILITY l I ❑ OCCUR n CLANS MADE F1 DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YlN! ANY PROPRIETOR t PARTNER t EXECUTIVE OFFICER I MEMBER EXCLUDED? (Mandatory In NH) It yes, de=Ibe under SPECIAL PROVISIONS beloW 1092SC I 1012612010 1 10/26/2011 EACH OCCURRENCE $1,000,000 u ncs PREM SES O RENTED occurrence) $300,000 MED EXP (Arty one person) $10,000 PERSONAL 8 ADV INJURY $1,00G,000 GENERALACGnGATE $2,000,000 PRODUCTS - COMP/OP AGG $2.000,000 COMBINED SINGLE LINT BODILY INJURY (Per Person) BODILY INJURY (Par accident) PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT OTHER THAN -A ACC AUTO ONLY: AGG EACH OCCURRENCE _ AGGREGATE E -L EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT TION OF OPERATIONS I LOCATIONS f VEHICLES I EXCLUSIONS AODED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER The City of Costa Mesa 77 Fair Drive Costa Mesa, CA 92626 ACORD 26 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E{PiI9AT10N DATE TABREOP, TME ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTZE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AQENT$ OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 9°EE-2609 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 05/12/2011 11:33 FAX 16002 DATE (MMIDDIYY) CERTIFICATE OF LIABILITY INSURANCE v/12/11 �.-- _... THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER AbilkyInsUranoeAgmeyInc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2787 Bristol St- # 210 BOLDER. THIS CERTIFICATE DOES NOT AMEND, EX'T'END OR Costa Mesa, CA 92628 __ ..... �_ . _ _ ALTER THE COVERAGE AFFORDED BY THE POLICIES. BELOW. Phone (714)988-8600 Fax (714)988.8001 INSURERS AFFORDING COVERAGE I NAIC # INSURED Michael Balliet Consulting INSURER A: Lloyds.4f London __..-....._ .. INSURER B: — 26351 Tarrasa Lane INSURER C: Mission Viejo, CA 92691- INSuttERTJ_-_-- (949) 837-3618 ttrtSURErt E: COVERAGES THE POLICIES OF INSURANCE LISTED RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE4, 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 htREW 13 SUB.ECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF $UCHI POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR J L LTR INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFfEGTIVE POLICY EXPIRATION _ LIMIT8 ._... ,— DATE DIYYYY PATS MWDDIYYYY —.... .. ..._ _ GENERAL LIABILITY EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LMILITYD MPL1068477.10 0711912010 07/19/2011 PREMISES (Es occurr e-) __.._.. CJ CLAIMS MADE I..-1 OCCUR MED EXP (Any one person) APERSONAL&ADV INJURY $1,000,000 n Professional Liability ❑ – GENERAL AGGREGATE - PRODUCTS - CCMP/OP AGG GEN'L AGGREGATE LIMIT APPLIES PER: F.1 POLICY ❑ PROJECT [_j -LOC__ -- AUTOMOBILE LIABILITY ❑ ANY AUTO 1 ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS U NCN OWNED AUTOS GAiiAGYL L ANUTY iJ ANY AUTO EXCESS I UMBRELLA LIABILITY I OCCUR ❑ CLAIMS MADE ❑ _ LJ UtUU;.:I ItA r ❑ RETENTION $ WORKERS COMPENSATION AND -- I EMPLOYERS' LIABILITY ANY PROPRIETOR I PARTNER / EXECUTIVE Y!N OFFICER / MEMBER EXCLUDED? (Mandatory In NH) (ryes, describe under SPECIAL. PROVISIONS below COMBINED SINGLE LIMIT BODILY INJURY BODILY INJURY (Per accident) PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY; AC-G EACH OCCURRENCE AGGREGATE _ -�— U WC STATU- 0 OTH- _TORY LIMITS ER. Et._EACH ACCIDENT_ E -L. DISEASE - EA EMPLOYEE E.L_ DISEASE - POLICY LIMIT SCRIPTION OF OPERATION] ! L17CATIONS 1 VEHICLES 1 EXCLUSIONS ADDED t iY ENDORSEMENT f SPECIAL PROVISIONS DE Additonal Insured: City of Costa Mesa 77 Fair Drive Costa Mesa, CA 92626 CERTIFICATE HOLDER — City of Costa Mesa 77 Fair Drive Costa Mesa, CA 92626 ACORD 25 (2009/01) QF CANCELLATION SHOULD ANY OF THE ABOVE DESORIZED POLICIES BE CANCELLED BEFORE THE EXpWATM DATE THWeOF, THE 199UINC (USURER VALL ENDEAVOR TO MAIL 30 DAYS wRTrTEd NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Burr FAILURE TO DO $O SHALL IMPOSE NO OBLIGATION OR LIMLITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE " X71988-2005 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks or ACORD 6 4 X M E p � F,rstierican property G, Casualty t 444 .Insurance Company Customer Service 888-922-5343 / www-fapcig.com A California domiciled company NAMED INSURED: MICHAEL BALLIET 26351 Tarrasa #Lane MISSION VIEJO CA 92691 Personal Auto Policy Amended Policy Declarations POLICY NO: (714) 968 - 9600 AGENT: 001 -002835 - ABILITY INSURANCE AGENCY 2787 BRISTOL STREET SUITE 210 COSTA MESA CA 92626 Gaverage Is provided only where a premium or deductible are shown. Limits not displayed are shown on applicable coverage endorsement. Policy Period: 12 months From: 01/19/11 To: 01/19/12 at 12:01 a.m., STANDARD TIME +h .moi rt.�• �iF H f s xx , #ilNl53,xtc1+x i�iacp •S C . t1 TP '�1. i �'fi 3:+L 3 n' � . +baa SPENT (r'c f,l ttiti# BODILY INJURY 250,000/person $619 $361 $341 $284 500,000/accdnt PROPERTY DAMAGE 100,000/accdnt $382 $212 $210 $173 UNDERIUNINSURED BI 60,000/person $121 $84 $68 $65 60,000/accdnt COMPREHENSIVE $276 $500 $83 $500 $102 $1000 $99 $1000 COLLISION $1,266 $500 $353 $500 $434 $1000 $395 $1000 COLLISION DEDUCTIBLE WAIVER $10 $500 $8 $500 $15 $1000 TRANSPORTATION EXPENSE COV. $36 $29 $29 $29 Total Premium Per Vehicle 1$2,710 $1,130 1 $1,184 1$1,060 FRAUD PREVENTION SURCHARGE $1.80 j$1,80 I $1.80 j$1,80 Total Premium $6,093.00 A $5.00 per installment service charge applies Ifyou pay In Install- ments. Payment In full will avoid this service charge. 1 2000 JAG XK-Series PL SAJJA41 C9YNA04892 26361 Tarrasa #Lane MISSION VIEJO CA 92691 15000 2 1999 AUDI A6 PL WAUBA2460XN100347 26351 Tarrasa #Lane MISSION VIEJO CA 92691 11000 3 2008 HOND CIVIC EX COUPE 2D PL 2HGFG12878H501572 126351 Tarrasa #Lane MISSION VIEJO CA 92691 11000 4 2011 FORD Flex PL 2FMGK5DC7BB024277 26351 Tarrasa #Lang MISSION VIEJO CA 92691 11000 Remarks: DELETE 2005 CHRYSLER AND ADD 2011 FORD FLEX PER BROKER 04/12/11 Duo to the chil2yiq noted /it Remarks, covers a shown on this Declaration page;s e/i`ectnrt 04105/20 1 1 Dec 1 of 2 WEB ID:2147526710 Z %T 'aDVd l--- --_ ` 4/ Countersigned: April 12, 2011 Santa Ana, CA By: ��� I\ /11'Ylac _ Dirk R. McName , P&sident Authorized Representative First American Property & Casualty Insurance Company 112 East 5th St. Santa Ana CA 92701 BKR INSURED COPY 8T98L£86i76 TaE1401W 90 XSap auk. 1u0ag WV TZ:OT TT0Z'8T'A'2W Irl. a i " li CITY COUNCIL POLICY 100-5 Rev. 1/02 SUBJECT POLICY EFFECTIV PAGE NUMBER E DRUG-FREE WORKPLACE 100-5 DATE 1 of 3 8-8-89 BACKGROUND Under the Federal Drug -Free Workplace Act of 1988, passed as part of omnibus drug legislation enacted November 18, 1988, contractors and grantees of Federal funds must certify that they will provide drug-free workplaces. At the present time, the City of Costa Mesa, as a sub -grantee of Federal funds under a variety of programs, is required to abide by this Act. The City Council has expressed its support of the national effort to eradicate drug abuse through the creation of a Substance Abuse Committee, institution of a City-wide D.A.R.E. program in all local schools and other activities in support of a drug-free community. This policy is intended to extend that effort to contractors and grantees of the City of Costa Mesa in the elimination of dangerous drags in the workplace. PURPOSE It is the purpose of this Policy to: 1. Clearly state the. City of Costa Mesa's commitment to a drug-free society. 2. Set forth guidelines to ensure that public, private, and nonprofit organizations receiving funds from the City of Costa Mesa share the commitment to a drug-free workplace. POLICY The City Manager, under direction by the City Council, shall take the necessary steps to see that the following provisions are included in all contracts and agreements entered into by the City of Costa Mesa involving the disbursement of funds. 1. Contractor or Sub -grantee hereby certifies that it will provide a drug-free workplace by: a. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in Contractor's and/or sub -grantee's workplace, specifically the job site or location included in this contract, and specifying the actions that will be taken against the employees for violation of such prohibition; SUBJECT POLICY EFFECTIV PAGE NUMBER E DRUG-FREE WORKPLACE 100-5 DATE 2 of 3 8-8-89 b. Establishing a Drug -Free Awareness Program to inform employees about: 1. The dangers of drug abuse in the workplace; 2. Contractor's and/or sub -grantee's policy of maintaining a drug-free workplace; 3. Any available drug counseling, rehabilitation and employee assistance programs; and 4. The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c. Making it a requirement that each employee to be engaged in the performance of the contract be given a copy of the statement required by subparagraph A; d. Notifying the employee in the statement required by subparagraph 1 A that, as a condition of employment under the contract, the employee will: 1. Abide by the terms of the statement; and 2. Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five (5) days after such conviction; e. Notifying the City of Costa Mesa within ten (10) days after receiving notice under subparagraph 1 D 2 from an employee or otherwise receiving the actual notice of such conviction; f. Taking one of the following actions within thirty (30) days of receiving notice under subparagraph 1 D 2 with respect to an employee who is so convicted: 1. Taking appropriate personnel action against such an employee, up to and including termination; or 2. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health agency, law enforcement, or other appropriate agency; SUBJECT POLICY EFFECTIV PAGE NUMBER E DRUG-FREE WORKPLACE 100-5 DATE 3 of 3 8-8-89 g. Malting a good faith effort to maintain a drug-free workplace through implementation of subparagraphs 1 A through 1 F, inclusive. . 2. Contractor and/or sub -grantee shall be deemed to be in violation of this Policy if the City of Costa Mesa determines that: a. Contractor and/or sub -grantee has made a false certification under paragraph 1 above; b. Contractor and/or sub -grantee has violated the certification by failing to carry out the requirements of subparagraphs 1 A through 1 G above; c. Such number of employees of Contractor and/or sub -grantee have been convicted of violations of criminal drag statutes for violations occurring in the workplace as to indicate that the contractor and/or sub -grantee has failed to make a good faith effort to provide a drug-free workplace. Should any contractor and/or sub -grantee be deemed to be in violation of this Policy pursuant to the provisions of 2 A, B, and C, a suspension, termination or debarment proceeding subject to applicable Federal, State, and local laws shall be conducted. Upon issuance of any final decision under this section requiring debarment of a contractor and/or sub -grantee, the contractor and/or sub -grantee shall be ineligible for award of any contract, agreement or grant from the City of Costa Mesa for a period specified in the decision, not to exceed five (5) years. Upon issuance of any final decision recommending against debarment of the contractor and/or sub -grantee, the contractor and/or sub -grantee shall be eligible for compensation as provided by law. CERTIFICATE OF LIABILITYINSURANCE DA05/1211DIYY} 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. PRODUCER Ability insurance Agency Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 2787 Bristol St. # 210 Costa Mesa, CA 92626 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (714)968-9600 Fax (714)968-MOO1 INSURERS AFFORDING COVERAGE NAIG # INSURED Michael Baliiet Consulting INSURER A: Hartford Casualty Insurance Co_ INSURER B: 26351 Tarrasa Lane INSURER C: Mission Viejo, CA 92691- (949) 837-3618 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED 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 LTR ADUL INSRO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MI&MYYYY POLICY EXPIRATION DATE MMIDDtYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 y7 COMMERCIAL GENERAL LIABILITY 72SBAZB1092SC 10/26/2010 10/26/2011 DAMAGE TORENTED ( D- $300,000 PREMISES Ea occurrence) A U,77 . CLAIMS MADE rod; OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 - PRODUCTS - COMP/OP AGG $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: d; POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY j SCHEDULED AUTOS (Per person) HIRED AUTOS NON OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR 1 PARTNER; EXECUTIVE YIN OFFICER I MEMBER EXCLUDED? WC STATU- OTH -TORY LIMITS ER _ E.L. EACH ACCIDENT E -L. DISEASE - EA EMPLOYEE (Mandatory in NH) If yes, describe under S SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES t EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City of Costa Mesa and its elected and appointed boards, officers, agents and employees are additional insureds with respect to this project and contract with City. UtH I IEIGA I E HOLDER CANCELLATION sI tier C 1988-2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL The City of Costa Mesa 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 77 Fair Drive THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY Costa Mesa; CA 92626 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE - sI tier C 1988-2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Page 1 of 1 Fir -11411M 51" From: Michael Kosmerl [mike@abil4ins.com] Sent: Tuesday, May 24, 2011 11:49 AM To: YASUI, DEBRA Cc: 'Mike Balliet' Subject: Michael Balliet Consulting Attachments: IMG.pdf Debra, Attached is the certificate of insurance for Michael Balliet with the specific wording. I have requested the additional insured endorsement from The Hartford. I will send it to you once I receive it from them. Thank you, Michael Kosmerl Ability Insurance Agency 714/968-9600 714/968-8001 Fax www.abilityins.com 06/03/2011 POLICY NUMBER: 72 SBA 781092 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON -ORGANIZATION THE CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS 2000 MAIN ST HUTNTINGTON BEACH, CA 92648 ATTN: RISK MANAGEMENT THE CITY OF NEWPORT BEACH, THE CITY, ITS ELECTED OR APPOINTED 0 N o THE CITY OF NEWPORT BEACH, THE CITY, ITS ELECTED OR APPOINTED OFFICERS, OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS ARE TO BE N COVERED AS ADDITIONAL INSUREDS WITH RESPECT TO LIABILITY OUT OF N WORKPERFORMED BY OR ON ah -HALF OF THE CONSULTANT- N THE CITY OF COSTA MESA AND ITS ELECTED AND APPOINTED BOARDS, OFFICERS, AGENTS, AND EMPLOYEES 77 FAIR. DRIVE % COSTA MESA, CA 92526 Form IH 12 00 11 85 T SEQ. NO. 002 Printed in U.S.A. Page 001 Process Date: 10/08/10 Expiration Date: 10/26/11 UW COPY ?2 This Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any 1 o other Forms and Endorsements issued to be a part of the Policy. This insurance is provided by the stock ZB insurance company of The Hartford Insurance Group shown below. SBA INSURER: HARTFORD CASUALTY INSURANCE COMPANY HARTFORD PLAZA, HARTFORD, CT 06115 COMPANY CODE: 3 THE Policy Number: 72 SBA ZB1092 SC ARTFORD SPECTRUM POLICY DECLARATIONS COPY Named Insured and Mailing Address: MIKE BALLIET (No., Street, Town, State, Zip Code) 26351 TARRASA LN MISSION VIEJO CA 92691 Policy Period: From 10/26/10 To 10/26/11 1 YEAR 12:01 a.m., Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire. Name of Agent/Broker: SUPERIOR ACCESS INS SERVICES INC Code: 181839 Previous Policy Number: 57 SBA TX7689 Named Insured is: INDIVIDUAL Audit Period: NON -AUDITABLE Type of Property Coverage: SPECIAL Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy, we agree with you to provide insurance as stated in this policy. TOTAL ANNUAL PREMIUM IS: $973 Form SS 00 02 12 06 Process Date: 10/08/10 Countersigned by UN COPY Authorized Representative Page 001 (CONTINUED ON NEXT PAGE) Policy Expiration Date: 10/26/11 Date SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 SBA ZB1092 Location(s), Building(s), Business of Named Insured and Schedule of Coverages for Premises as designated by Number below. Location: 001 Building: 001 26351 TARRASA LN MISSION VIEJO CA 92691 Description of Business: CONSULTANT - NOC Deductible: $ 500 PER OCCURRENCE BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS OF INSURANCE BUILDING BUSINESS PERSONAL PROPERTY REPLACEMENT COST PERSONAL PROPERTY OF OTHERS REPLACEMENT COST MONEY AND SECURITIES INSIDE THE PREMISES OtTTSIDE THE PREMISES Form SS 00 02 12 06 Process Date: 10/08/10 NO COVERAGE $ 5,900 NO COVERAGE $ 10,000 $ 5,000 Page 002 (CONTINTJED ON NEXT PAGE) Policy Expiration Date: 10/26/11 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 SBA ZB1092 Location(s), Building(s), Business of Named Insured and Schedule of Coverages for Premises as designated by Number below. Location: 001 Building: 001 PROPERTY OPTIONAL COVERAGES APPLICABLE LIMITS OF INSURANCE TO THIS LOCATION STRETCH COVERAGES FORM: SS 04 08 THIS FORM INCLUDES MANY ADDITIONAL COVERAGES AND EXTENSIONS OF COVERAGES. A SUMMARY OF THE COVERAGE LIMITS IS ATTACHED. o LIMITED FUNGI, BACTERIA OR VIRUS ra COVERAGE: o FORM SS 40 93 THIS IS THE MAXIMUM AMOUNT OF N INSURANCE FOR THIS COVERAGE, V SUBJECT TO ALL PROPERTY LIMITS o FOUND ELSEWHERE ON THIS o DECLARATION. N INCLUDING BUSINESS INCOME AND EXTRA * EXPENSE COVERAGE FOR: Form SS 00 0212 06 Process Date: 10/08/10 $ c0,000 30 DAYS Page 003 (CONTINUED ON NEXT PAGE) Policy Expiration Date: 10/26/11 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 SBA ZB1092 Location(s), Building(s), Business of Named Insured and Schedule of Coverages for Premises as designated by Number below. Location: 002 Building: 001 18391 GOLDENWEST ST HUNTINGTON BEACH CA 92648 Description of Business: CONSULTANT - NOC Deductible: $ 500 PER OCCURRENCE BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS OF INSURANCE BUILDING BUSINESS PERSONAL PROPERTY REPLACEMENT COST PERSONAL PROPERTY OF OTHERS REPLACEMENT COST MONEY AND SECURITIES INSIDE THE PREMISES OUTSIDE THE PREMISES Form SS 00 02 12 06 Process Date: 10/08/10 NO COVERAGE $ 5,900 NO COVERAGE $ 10,000 $ 5,000 Page 004 (CONTINUED ON NEXT PAGE) Policy Expiration Date: 10/26/11 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 SBA ZE1092 Location(s), Building(s), Business of Named Insured and Schedule of Coverages for Premises as designated by Number below. Location: 002 Building: 001 PROPERTY OPTIONAL COVERAGES APPLICABLE LIMITS OF INSURANCE TO THIS LOCATION STRETCH COVERAGES + FORM: SS 04 08 m THIS FORM INCLUDES MANY ADDITIONAL COVERAGES AND EXTENSIONS OF COVERAGES. A SUMMARY OF THE COVERAGE LIMITS IS ATTACHED. o LIMITED FUNGI, BACTERIA OR VIRUS u COVERAGE: o FORM SS 40 93 THIS IS THE MAXIMUM AMOUNT OF N INSURANCE FOR THIS COVERAGE, r SUBJECT TO ALL PROPERTY LIMITS o FOUND ELSEWHERE ON THIS o DECLARATION. N INCLUDING BUSINESS INCOME AND EXTRA * EXPENSE COVERAGE FOR: Form SS 00 0212 06 Process Date: 10/08/10 $ 50,000 30 DAYS Page 005 (CONTINIt7ED ON NEXT PAGE) Policy Expiration Date: 10/26/11 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 SBA ZB1092 PROPERTY OPTIONAL COVERAGES APPLICABLE LIMITS OF INSURANCE TO ALL LOCATIONS BUSINESS INCOME AND EXTRA EXPENSE COVERAGE COVERAGE INCLUDES THE FOLLOWING COVERAGE EXTENSIONS: ACTION OF CIVIL AUTHORITY: EXTENDED BUSINESS INCOME: EQUIPMENT BREAKDOWN COVERAGE COVERAGE FOR DIRECT PHYSICAL LOSS DUE TO: MECHANICAL BREAKDOWN, ARTIFICIALLY GENERATED CURRENT AND STEAM EXPLOSION THIS ADDITIONAL COVERAGE INCLUDES THE FOLLOWING EXTENSIONS HAZARDOUS SUBSTANCES EXPEDITING EXPENSES MECHANICAL BREAKDOWN COVERAGE ONLY APPLIES WHEN BUILDING OR BUSINESS PERSONAL PROPERTY IS SELECTED ON THE POLICY IDENTITY RECOVERY COVERAGE FORM SS 41 12 Form SS 00 02 12 06 Process Date: 10/08/10 12 MONTHS ACTUAL LOSS SUSTAINED 30 DAYS 30 CONSECUTIVE DAYS $ 50,000 $ 50,000 $ 15,000 Page006 (CONTINUED ON NEXT PAGE) Policy Expiration Date: 10/26/11 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 72 SBA ZB1092 BUSINESS LIABILITY LIMITS OF INSURANCE LIABILITY AND MEDICAL EXPENSES $1,000,000 MEDICAL EXPENSES - ANY ONE PERSON $ 10,000 PERSONAL AND ADVERTISING INJURY $1,000,000 DAMAGES TO PREMISES RENTED TO YOU ANYONE PREMISES M AGGREGATE LIMITS PRODUCTS -COMPLETED OPERATIONS FORM SS 05 09 GENERAL AGGREGATE 0 N O r-1 W N N O O O f-1 N Form SS 00 02 12 06 Process Date: 10/08/10 $ 300,000 $2,000,000 $2,000,000 Page 007 (CONTINUED ON NEXT PAGE) Policy Expiration Date: 10/26/11