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HomeMy WebLinkAboutItalian Revolution LLC dba Notorious Burgers; 2019-06-20;1.0 PARTIES AGREEMENT BETWEEN THE CITY OF CARLSBAD AND ITALIAN REVOLUTION LLC DBA NOTORIOUS BURGERS REGARDING FOOD SERVICES AT TGIF CONCERTS IN THE PARKS THIS AGREEMENT ("AGREEMENT"), dated bu..Y\SZ, ~ I.LJ ('1'("Effective Date") is made and entered into between the City of Carlsbad, a Cilifo~7Municipal Corporation, hereinafter referred to as the "CITY" and, ITALIAN REVOLUTION LLC DBA NOTORIOUS BURGERS, hereinafter referred to as the "VENDOR." 2.0 RECITALS WHEREAS, the CITY is the presenter of TGIF Concerts in the Parks, a series of nine concert events, and holds fee title to portions of real property on which the concerts are performed; and WHEREAS, the CITY provides TGIF Concerts in the Parks, a special event series, and all related activities and services to MORE THAN 30,000 patrons annually; and WHEREAS, the site of TGIF Concerts in the Parks includes approximately 1,000 square feet of space (the "Premises") located adjacent to patrons attending the events and the CITY exercises control over the same Premises designed to be utilized for purposes compatible with, and supportive of, the mission of special events offered for the enjoyment of the public; and WHEREAS, subject to certain terms and conditions, the CITY desires to allow the use of the Premises by VENDOR for the sale of food items and beverages; NOW, THEREFORE, for good and valuable consideration, the CITY and VENDOR enter into this Agreement for use of the Premises subject to the following terms and conditions. 3.0 TERMS 3.1 Authorization for Use. Subject to the terms and conditions set forth below, CITY authorizes VENDOR non-exclusive use of the Premises during hours of operation, as defined in Section 3.3 below. A site plan of the Premises is shown in Exhibit "A" attached hereto and hereby incorporated by this reference. 3.2. Term. The term of this AGREEMENT shall be for the duration of the TGIF Concerts in the Parks 2019 season, commencing on June 21, 2019 and ending on August 16, 2019. The parties may renew this AGREEMENT by mutual consent and in writing for two (2) additional TGIF Concerts in the Parks concert seasons, as those dates may be defined (i.e. 2020 season and 2021 season), by giving written notice of such renewal to the other party no sooner than one hundred eighty (180) days following the end date of the current AGREEMENT, requesting an additional season term period. 3.3 Hours of Operation. The CITY shall allow the VENDOR use of the Premises for a period of six (6) hours, from 3:00 p.m. until 9:00 p.m., on the dates of 2019 TGIF Concerts in the Parks events. These dates are the nine (9) consecutive Fridays from June 21, 2019 through August 16, 2019. The Page 1 of 13 VENDOR shall remove all related equipment, materials and vehicles belonging to VENDOR by 9:00 p.m. on these dates. 4.0 AGREEMENT CONSIDERATION 4.1 Constderation Subfect to the Provisions of Section 11.0. VENDOR shalt pay the CITY a flat fee of $85 per concert for each of the nine concerts comprising the 20.19 TGIF Concerts in the Parks season, amounting to a totar of $765. Payment shall be in one installment, receivable and in accordance with the following payment schedule: Payment in full will be due on Friday, June 14 by 5 p.m. by check, either mailed or hand delivered to: library & Cultural Arts Administration 1775 Oovelaoe Carlsbad, CA 92011 City reserves the right to not renew or enter into future contracts with vendors who do not adhere to the above annual payment schedule. 5.0 OBUGATIONS 5.1 Obhgations of the CITY 5.1.1 The CITY shall maintain the Premises, including grounds, parking lots and access ways to the VENDOR's site of operation. 5.1.2 The CITY shall provide access to the onsite trash receptacles and recycle receptacles. The CITY shall provide removal service of trash and recycle materials. 5.2 Obligati.ons of tile VENDOR 5.2.1 The VENDOR shall provide mobile food services to the general public as submitted in its proposal of food and beverage menu and prices for the 2019 TGIF Concerts in the Parks. A copy of Vendor's proposal is attached hereto as Exhibit B and incorporated herein. 5.2.2 VENDOR agrees to maintain the hours as set forth in Section 3.3. that best serve the community at TGIF Concerts in the Parks events during the period of use of the Premises set forth in thts AGREEMENT. 5.2.3 VENDOR shall provide CITY with a copy of the Articles of Incorporation if vendor is a corporation, or any other document deemed by CITY to be valid proof the signatory(s) of the AGREEMENT have the legal authority to contractually bind VENDOR. 6.0 COMPLIANCE 6.1 VENDOR shall cornp.ly w~th all federal, state, county .and local laws, statues, ordinances, rules, and regulations and the orders and decrees of any courts or administrative bodies in any manner affecting performances of activities conducted on the Premises. VENDOR shall display in a prominent location of his/her food truck or booth all required permits and licenses. Page 2 of 13 7.0 ASSIGNMENT OF CONTRACT/NON-POSSESSORY INTEREST 7.1 Assignment of Agreement. VENDOR shall not assign this AGREEMENT or any part thereof without the prior written consent of the CITY. 7.2 Non-Possessory Interest. VENDOR sharr have no permanent or possessory interest in the Premises based upon this AGREEMENT or any activrties that VENDOR may conduct on the Premises. 8.0 ASSUMPTION OF RISKS 8.1 VENDOR assumes all loss or damage to VENDOR's property within the Premises, except damage or loss through the sole negligence or intentional misconduct of the CITY. The CITY shall not be liable to VENDOR, or those claiming through the CITY, for injury, death, or property damage occurring at the Premises and arising out of the conduct of VENDOR. 9.0 INDEMNIFICATION 9.1 VENDOR agrees to indemnify, defend, and hold the CITY and CITY's elected officials, officers, employees and agents harmless from and against any and all claims, demands, causes of action, losses, damages, and costs, including all costs of arising out of, or in any manner connected directly or indirectly with any actions or omi.ssions or operations of VENDOR or the VENDOR's agents, employees, contractors, offidah, offke-rs, patrons, invitees or representatives on the Premises. With respect to the indemnity and hold harmless provisions of this section, VENDOR shall, upon demand and at its own expense, defend the CITY and its officials, officers, employees and agents, with legal counsel acceptable to the CITY, from and against any and all claims, demands, causes of action, losses, damages, and costs. 10.0 INSURANCE 10.1 VEN DOR shall obtain, and during the term of this AGREEMENT sh.all maintain policies of general liability and property damage insurance (for structure and contents) from an insurance company authorized to do business in the State of California, in an amount not less than two million dollars ($2,000,000), for each occurrence in a form satisfactory to the CITY's Risk Manager. The insurance policy shall provide that the policies shall not be cancelled, terminated, or allowed to expire without thirty (30) day prior written notice to the CITY from the insurance company. VENDOR shall provide certificate of insurance and additional insured endorsement for insurance required pursuant to this section to the satisfaction of the CITY no later than the Effective Date of this AGREEMENT. The CITY shall be named as additionally insured by endorsement on these policies and provided proof of insurance by way of a certificate of insurance with additional insurance endorsement. 10.2 VENDOR shall procure a policy of Worker's Compensation Insurance as required by Labor Code of the State of California, if VENDOR has employees. 11.0 TERMlNATION 11.1 If VENDOR is in default in the performance of this AGREEMENT or materially breaches any of its provisions, the CITY at its sole option may terminate this AGREEMENT by giving written Page 3 of 13 notice to VENDOR. On receipt of said notice, VENDOR shall cease immediately all sale operations taking place on the Premises under the Terms of this AGREEMENT. 11.2 If the CITY defaults in the performance of the AGREEMENT, or materially breaches any of its provisions, VENDOR at its sole option may terminate this AGREEMENT by giving written notice to the City of Carlsbad. 11.3 Either party may terminate this AGREEMENT, for convenience, without cause, upon sixty (60) days prior written notice to the other party. 12.0 ENTIRE AGREEMENT 12.1 This writing constitutes the entire AGREEMENT between the parties relating to the terms and £onditions hereunder. No modification of this AGREEMENT sh-ttl be effective unless and until such modification rs evidenced by writing signed by all parties. 13.0 GOVERNING LAW; VENUE 13.1 The existence, validity, construction, operation and effect of this AGREEMENT shall be determined in accordance with laws of the State of California. Venue shall be established in the County of San Diego in the event of a dispute between parties. 14.0 NOTICES 14.1 Notices and requests to CITY or VENDOR shall be delivered at the following address served upon CITY or VENDOR or any person hereafter authorized to either in writing and may be delivered personally or by U.S. Postal Service or other delivery services. CfTV: CITY Contact: VENDOR: VENDOR Contact: City of Carisbad 1775 Dove lane Carlsbad CA 92011 Megan E. Gilby Community Arts Coordinator Phone:760-602-2081 Email: megan.gitby@cartsbadca.gov NOTORIOUS BURGERS Brian Gruber 3444 Filoli Circle Carlsbad, CA 92009 brian@notoriuosburgers.com 760431-2929 Page 4 of 13 15.0 AUTHORITY The individual on his/her own behalf or the representative for each party signing on behalf of a corporation, partnership, joint venture or governmental entity hereby declares that authority has been obtained to sign on behalf of the corporation, partnership, joint venture, or entity and agrees to hold the other party or parties hereto harmless, if it is. later determined-that 5WCh authority does, not exist. Vendor: ~·-:-7:S--;/ --;;/ ~~ Vendor's Signature Name printed: Brian Gruber Address: 3444 Filoli Cirlce Carlsbad, CA 92009 Email: brian@notoriuosburgers.com Phone: (w): 760-431-2929 Fal<:N/A Cell: Approved as to Form: CELIA A. BREWER, City Attorney By:_~_L_ Assistant Oty Attorney Date City: Library & Cultural Arts Director Signature Date fl>~ HEATHER PIZZUTO City of Carlsbad, 1200 Carlsbad Village Dr. Carlsbad CA 92008 Email: heather.pizzuto@carlsbadca.gov Phone (w) 760-602-2011 Fal<: 760-602-1941 Cell: N/A ATTEST: BARBARA ENGLESON City Clerk rl\- { Page 5 of 13 EXHIBIT A Food Vendor locations as determined by City for all TGIF Concerts in the Parks 2019 events. Maps subject to change. Stagecoach Community Park June 21, 28 & July 5, 2019 LEGEND: ll'AS!E MMIAG!IIENT CARS CARNOl,1,tJ -; : ~ ~~fcJ~~:tRS -POflTAlETS -STAGf -STCRII DRA!HS OJ FGOO 1-ENOORS r.;] FRi[NDS CF THE ARTS t:J IIERC>IANDl5i 0 FAJl:I..YCJ'i,~ ST.JDIOS (!] ElEC7!lrOTr IT] f/1/ST AID. l'/FO ,t 5iCIJRflY l!J SOONG ENC.ME// II] FRff 51'£ECH ZOii[ I!] err, f/001)1 ____ ..- _ __....----~----- TGIF CONCERTS IN THE PARKS STAGECOACH PARK 2019 Page 6 of 13 EXHIBIT A (cont.) Poinsettia Park July 12 & 19, 2019 LEGEND: -WASJ!" ",J,NAC("[NT CA~ CARS I, 2 de J _ J lllAS/1 DVIIPS1£1/S -; _ 2 RECYC(C OUIIPS7£/IS -PORTALCTS -STAC( -STORM OR,t,J.~S [I] fOOi) \t;','OORS (I] f~f/l~i~ARTS 0 FAll<t y OPE.N SRIO/OS r., £LECT11IC1TY [TI P.RST AID, INFO de SECUR1TY [!] SCtJND CNCINWI I!] O[Flll/1>,LAll)/1 5Hf;O [!] FREC SPfCCH ZONf [I) QTY BOOTH Page 7 of 13 EXHIBIT A (cont.) Calavera Hills Community Park July 26 & Aug. 2, 2019 LEGEND: 'otl.SiE ,ll/.,!/ACf.11£NT c~s Cl.RS 1. l It J - A -J i,l~Sr DUIIPSiERS 8 -2 RfCYCLf DUl.fPSicRS -PCflT~E7'5 • sr~c-c • srtM• o•u11, CT] FOOD WOO'IS 0 FR,fNlJS OF r,.. ARTS f ,"\ "AYH C.,_"I S1'lllYOS \.:_) l,lfRC~M,OISE_ III :J.ECTT!!CITf rn F71<5r AID, i,'fFO k 5£CURir'r U) SOJ>j!) !:.'IC..',E=. CT] fRff. SPf.!.CH ZO'.:! [l) CffY (IOO;"r, TGIF CONCERTS IN THE PARKS CALAVERA HILLS PARK 2019 Page 8 of 13 EXHIBIT A (cont.) Alga Norte Community Park Aug. 9 & 16, 2019 AOUAncs CENTER CLOS~S AT 5 1•./A, LEGEND: WASTE MANAG£MENT CARS CAR NO. 1, 2, 4c J A -J TRASH DUMPSTERS -8 -2 RfCYCLE DUMPSTERS -PORTALETS -STAGE -STORM DRAINS OJ rooo .-ENDORS r,;-, F'R1£NOS OF TH£ ARTS LL-.! /J£RCHANOIS£ QJ FMAtL r OP£N sruo,os G) EL£CT1?1CITY [fil F'IRST AID, INFO cl SECURITY [fil SOUND ENCINffR (Z] F'REE SPEECH ZONE [ID Cl TY BOO TH UIIIIIIIIII IIIIIIIII U ACCESS/8 f 4< Q!jUIUllllllllll:9 1111111111111 - TGJF PASS PARKING NQ THRU AFTER J P.M. DOG PARK CLOSES AT J P.IA. x-'f-' o,~s ? TGIF CONCERTS IN THE PARKS ALGA NOR'TE PARK 2019 Page 9 of 13 EXHIBITB IIOlO\t!!n~ B\11\Gllo ,u,11l1s&a1u• Notorious Burgers Summary Serving south Carlsbad for 6 years, we are experienced in preparing high quality food and a fast pace. We have serviced large events such as school carnivals, tasting events, weddings, and standard catering events. We are able to push out over 250 burgers per hour on a regular basis, and could do more if needed. We are a staple in the Carlsbad community. People know we only serve the best to our customers. We use all recyclable products at our events and are fully self sustainable. Our owner and owners family have resided in Carlsbad since J 980, and been attending concerts in the park since its inception. We give back to the community every chance we get and feel that we are deeply entrenched with the people here. We would be very excited to be a vendor at these events, as will the people attending. Vendor information dba Notorious Burgers , Italian Revolution, Inc. Hamburgers, Cheeseburgers, chicken wings, hot dogs, french fries Legal Status Corporation 6955 El Camino Real Suite 107 Carlsbad, Ca 92009 y.ww.NotoriousBurgers.com Providing service to the Carlsbad Community for 6.5 years Owner- Brian Gruber 3444 Filoli Circle Carlsbad, CA 92009 brianra.,,notoriousburg.:r~.com Page lOof 13 Menu Hamburger $7 Cheeseburger $8 Hot Dog $4 Chicken Wings 6 for $9 Fries $3 La Costa Meadows School (760) 290-2121 6889 El Fuerte Street Carlsbad, CA 92009 Served as a vendor in the halloween carnival for the past 3 years. 1500-2000 people in attendance. St. Johns (760) 753-6254 1001 Encinitas Blvd Encintas, CA 92024 Served as a vendor for .Halloween carnival 1000 people in attendance. Taste of Bressi 760-683-5106 Bressi Boys & Girls 2730 Bressi Ranch Way Carlsbad, CA 92009 Served as a vendor for the past 3 years 500-750 people in attendance Page 11 of 13 EXHIBITC TGIF FOOD VENDOR SCOPE OF WORK CITY shall provide food service access restricted to five (5) or less selected food vendors at nine (9) TGIF Concerts in the Parks 2019 for the purpose of providing concertgoers with onsite commercial food services; dates of services are presented in Exhibit D, TGIF Concerts in the Parks Schedule. • Notorious Burgers , VENDOR shall conduct commercial food service business at all nine (9) TGIF Concerts in the Parks at each concert's specific locations, with dates from June 21 through August 16, 2019 as presented in Exhibit D. • VENDOR shall use the site specifically designated for VENDOR at each concert location. • Food service will consist of a menu of hamburgers. cheeseburgers. chicken wings. hot dogs. French fries , menu and price as negotiated with the CITY and presented in Exhibit E. • VENDOR will arrive on-site by 3:15 p.m. on each event date. VENDOR may commence sales at 4 p.m., and must begin sales by 5 p.m. and must conclude all operations by 8 p.m. VENDOR shall vacate concert premises by 9 p.m. • If VENDOR is conducting service from vehicle (i.e. food truck), VENDOR must be on site and placed by event staff by 3:00 p.m. • VENDOR shall operate the commercial food service business from a self-contained truck, trailer, cart or mobile booth provided by the VENDOR. VENDOR is responsible for all food service staffing needs to support sales and distribution. • VENDOR is responsible for all operational costs, including, but not limited to, inventory costs, sale/delivery of products, labor, paper products, cleaning supplies, permits and additional miscellaneous expenses. • VENDOR shall have self-sufficient means of power and water adequate to any on-site food preparation requirements. VENDOR shall not dispose of any grease, oil or other materials related to food service on any city property. • VENDOR shall maintain and conduct all requirements with regard to taxes, licenses, insurance and fees applicable for food service operations in the City of Carlsbad. • VENDOR shall obtain and display all health permits and certifications applicable to food service operations as required by the San Diego County Department of Environmental Health. VENDOR shall adhere to all additional regulations regarding mobile food service operations required by the San Diego County Department of Environmental Health. • CITY shall provide VENDOR with trash and recycling receptacles and services during each TGIF event. • CITY shall provide VENDOR on-site parking permit for one (1) vehicle per VENDOR for transportation of equipment. Parking permits are for business purposes only and cannot be transferred to non-vendor staff. Page 12 of 13 EXHIBIT D TGIF CONCERTS IN THE PARKS SCHEDULE 2019 STAGECOACH COMMUNITY PARK 3420 Camino de las Caches, Carlsbad CA 92009 June 21 June 28 July 5 POINSETTIA COMMUNITY PARK 6600 Hidden Valley Road, Carlsbad CA 92011 July 12 July 19 CALAVERA HILLS COMMUNITY PARK 2997 Glasgow Drive, Carlsbad CA 92010 July 26 August 2 ALGA NORTE COMMUNITY PARK 6565 Alicante Road, Carlsbad CA 92009 August 9 August 16 Page 13 of 13 CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/00/YYVY) 05/24/2019 THIS CERTIRCATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENO,EXTENOORALTERTHECOll'ERAGEAFFORDEOBYTHEPOUCIESBEI.OW. THISCERTIFICATEOFINSURANCEOOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, ANO THE CERTIFICATE HOU>ER. 1--------------------------------------------------------- i IMPORTANT: If the aortll'lcate holder Is an ADDITIONAL INSURED, the pollcy(le:s) must have ADDITIONAL INSURED provisions or be endoned. If SUBROGATION IS WAIVED, subject to the terms and conditions of the pollcy, certain pollcles 11111y require an endorsement. A statement on t1ds certificate does not confer ri!lhtl to the certlflcat-e holder In lieu of such endonement(s). PRODUCER CONTACT Kelly Hamllton(9956G8X) 5752 Oberlin Dr Ste 108 San Diego INSURED CA 92121-1747 ITALIAN REVOLUTION LLC DBA: NOTORIOUS BURGERS 6955 EL CAMINO REAL #8106 & 8 107 CARLSBAD CA 92009 COVERAGES CERTIFICATE NUMBER: NAME: Kelly Hamilton PHONE (A/C,NO,EXT): 858-332-1655 I FAX (A/C, NO): 858-332-1654 E-MAIL ADDRESS: khami1ton1@rarmersagent.com INSURER(S)AFFORDINGCOVERAGE INSURERA: Truck Insurance Exchange INSURER B: Farmers Insurance Exchange "'5URERC: Mid Century Insurance Company INSURERD: INSURERE: INSURERF: REVISION NUMBER: NAie• 21709 21652 21687 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED m THE INSURED NAME ABOVE FOR THE POUCYPERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSR lYPE OF INSURANCE ADOTI. SUBR POLICY NUMBER I POUCYEFF POUCYEXP LTR INSD wvo , {MM/00/YYVY) (MM/DD/YYVY) ~ COMMERCIAi. GENERAL UA81lflY ~ ~ __J CLAIMS-MADE X OCCUR >-- A y N 605420631 11/19/2018 11/19/2019 GEN'L AGGREGATE LIMIT APPLIES PER: fZl POLICY □ PROJECT □ LOC OTHER: AUTOMOBILE LIABILITY f--- ANY AUTO -- A OWNED AUTOS SCHEDULED ONLY AUlOS 605420631 11/19/2018 11/19/2019 --~ HIRED AUTOS X NON-OWNED ONLY AUTOSONLY ---- K UMBRELLA UA8 OCCUR -B EXCESSLIAB CLAIMS-MADE 606662381 11/1912016 11/19/2019 OED I I RETENTION$ WORKERS COMPENSATION ANO EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OfACER/MEMBER C N/A F.XCllJDEO?(.._,~ln NH) If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION Of OPERATIONS/1.0CATIONS/VEHlctES (ACORD 101, Addltlonal Remarks Schedule, may be attached If more space Is n,qulred) 6955 EL CAMINO REAL# 81068107, CARLSBAD, CA 92009 Certificate Holder is hereby named as additional Insured: City of Garlsbad Attn: Library & Cultural Arts Dept. CERTIFICATE HOLDER o a Attn: Library & Cultural Arts Dept. 1635 Faraday Ave 1635 Faraday Ave Carlsbad. CA 92008 CANCEUATION LIMITS EACH OCCURRENCE $ DAMAGE TO RENTED $ PREMISES (Ea Occurrence) MED fXP (Any one pet'SO!l) s PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS-COMP/OPAGG $ $ COMBINED SINGLE LIMIT $ (Ea accident) BODllY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (PeuccidenQ $ EACH OCCURRENCE $ AGGREGATE $ $ I ::TUTE I I OTHER $ E.l. EACH ACCIDENT $ E.l. DISEASE· EA EMPLOYEE E.L DISEASE • POLICY LIMIT $ 2,000,00C 250,00C 5nntl 2,000,000 400000!1 4,000,00C 2,000,00C 5,000,000 ACORD 25 (2016/03) 31-1769 11.15 ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD ✓ Policy Change Summary I:\ FARMERS ., INSURANCE Farmers Insurance Group of Companies Business Name: ITALIAN REVOLUTION LLC Policy #: 605420631 Page 1 of2 Insured ITALIAN REVOLUTION LLC Name: , Effective ~~:~y s 05/24/2019 Date Of 05/24/2019 e. Change: Add ss· 6955 EL CAMINO REAL # re · B106B107 Agent 99-56-GSX Number: CARLSBAD , CA 92009 Kelly Agent: Hamilton Agent Phone #: 858-332- 1655 Policy Change Summary I Change Type II Change Description ~dditional Insured ~BP04480197 Designated Person or Organization City of Carlsbad Add Additional Interest ~ttn: Library & Cultural Arts 1635 Faraday Ave Carlsbad, CA 92008 Location : 6955 EL CAMINO REAL# B106B107 CARLSBAD, CA 92009 I "This is only a proposal for insurance, and is not an insurance policy, or part of or incorporated into an insurance policy. The coverages summarized in this quote proposal are based on information received through the prospective insured and may not include all available coverages. Coverage descriptions are abbreviated and do not indicate in force coverage. The need for any additional or optional coverages should https://bie.farmersinsurance.com/prweb/PRServletLDAP l/8g YJ4... 5/24/2019 POLICY NUMBER: 60542-06-31 BUSINESSOWNERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY SCHEDULE• Name Of Person Or Organization: CITY OF CARLSBAD *SEE J7105 AMEND TO ADDNL INS • Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations. The following is added to Paragraph C. Who Is An Insured In the Businessowners Liability Coverage Form: 4. Any person or organization shown in the Sched- ule is also an insured, but only with respect to liability arising out of your ongoing operations or premises owned by or rented to you. BP 04 48 01 97 Copyright, Insurance Services Qffice, Inc .• 1997 Page 1 of 1 D POLICY NUMBER: 60542-06-31 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ~ -FARMERS INSURANCE AMENDMENT OF ADDITIONAL INSURED This endorsement modifies insurance provided under the: BUSINESSOWNERS COVERAGE FORM BUSINESSOWNERS LIABILITY COVERAGE FORM APARTMENT OWNERS LIABILITY COVERAGE FORM CONDOMINIUM LIABILITY COVERAGE FORM SCHEDULE Name(s) or Addltlonal Insured Persons(s) or Organlzatlon(s): CITY OF CARLSBAD ATTN: LIBRARY & CUL TURALARTS DEPT. J7105-ED2 03-16 93-7105 lndudes copyrighted material of Insurance Services Office, Inc., with its permission. 17105 2nd Edition Page 1 of2 J7105201 Pohcy Changes Endorsement Description ADD ADDITIONAL INTEREST ADDITIONAL INSURED-BP04480197 DESIGNATED PERSON OR ORGANIZATION CITY OF CARLSBAD ATTN: LIBRARY&CULTURALARTS 1635 FARADAY AVE CARLSBAD, CA 92008 LOCATION: 6955 EL CAMINO REAL# BI06B107 CARLSBAD, CA 92009 Removal Permit If Covered Property is removed to a new location that is dacribed on this Policy Change, you may extend this insurance to include that Covered Property at each location during the removal. Coverage at t2eh location will apply in the proportion that die value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change: after that, this insurance does not apply at the previous location. 91-4277 lSTEDmON 7-112 E4277-1Dl lndullas u,,riglf• ,_,"'81, l111unm Sonios Ollb, loc, wth ls p,rnmiln mm02 PAGE 2 Of 2 CERTIFICATE OF EXEMPTION WORKERS' COMPENSATION/EMPLOYERS' LIABILITY INSURANCE L --~,,_',c-;..-,_,_~_-'--',--C,,,,..r=-""_.b_P _______ , am the () V"'e"' [ insert name] [ ti tie] of /t/2 ftv, ~ S ~ ,,7e,, 1 f ~v I hereby certify that /l/o~ ~t 6v(7?-( {._~ [ name of company] [ name of company] has no employees and is not required by law to maintain workers· compensation or employers' liability insurance. Should /'-(iJ4n ~r glN'flh;J' (P.t1e-r employ any person [name of company] during the term of the Agreement with the City of Carlsbad for __ V~~~J_,~,,_~~ ,.,._~l=o_n_c.~"=v+-if{ __ ,~ ~ [ description of project or work that is being contracted] then workers· compensation and employers' liability insurance will be obtained. (Name]