HomeMy WebLinkAboutEbanks, Elon; 2021-04-15; PSALCA-22083CACity Attorney Approved Version 6/12/18 1
AGREEMENT FOR LOAN OF ARTWORK & ARTIST SERVICES ELON EBANKS
THIS AGREEMENT is made and entered into as of the ______________ day of
___________________, 2021, by and between the CITY OF CARLSBAD, a municipal corporation, ("City"), and Elon Ebanks, a Sole Proprietorship, ("Contractor”/”Lender”/”Artist”.) RECITALS City requires the professional services of an artist to loan artwork to the City for public display in the City of Carlsbad Sculpture Garden, 2955 Elmwood Street, Carlsbad, CA. Contractor has the ability to loan the Artwork and is available for various speaking engagements and/or instructional and outreach events, has submitted a proposal to City and has affirmed its willingness and ability to share their artwork and their artwork knowledge. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the
“Services”) that are defined in Exhibit “A” and loan of Artwork as specified in “Exhibit B”, attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement.
2. TERM This Agreement will be effective for a period of no more than fifteen (15) months from the date first above written. 3. COMPENSATION The total fee payable for the Services to be performed will be two thousand five hundred dollars ($2,500). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. 4. STATUS OF CONTRACTOR
Contractor will perform the Services as an independent contractor and in pursuit of Contractor’s independent calling, and not as an employee of City. Contractor will be under the control of City only as to the results to be accomplished.
5. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees
and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or
makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement.
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13Debbie Jo McCool Tonya Rodzach Richard SchultzDebbie Jo McCool Suzanne Smithson Ed Garbo
April
15th
City Attorney Approved Version 6/12/18 2
6. INSURANCE Contractor will obtain and maintain policies of commercial general liability insurance, automobile
liability insurance, a combined policy of workers' compensation, employers liability insurance, and professional liability insurance from an insurance company authorized to transact the business of insurance in the State of California which has a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report, in an amount of not less than one million dollars ($1,000,000) each, unless otherwise authorized and approved by the Risk Manager or the City Manager. Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. The insurance will be in force during the life of this Agreement and will not be canceled without thirty (30) days prior written notice to the City by certified mail. City will be named as an additional insured on General Liability which shall provide primary coverage to the City. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Contractor will furnish certificates of insurance to the Contract Department, with endorsements to City prior to City’s execution of this Agreement. 7. NOTICES
The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement.
For City For Contractor
Name Richard Schultz Name Elon Ebanks
Title Cultural Arts Manager Title Artist/Lender
Department Library & Cultural Arts Address 1204 Tylee Street
Vista, CA 92083
Address
City of Carlsbad
1775 Dove Lane Phone No. 760-840-1469
Carlsbad, CA 92011 Email Deepart@cox.net
Phone No. 760-602-2086
Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address.
8. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the
requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. Yes No 9. COMPLIANCE WITH LAWS Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment and will obtain and maintain a City of Carlsbad Business License for the term of this Agreement.
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10. TERMINATION City may terminate this Agreement at any time after a discussion, and written notice to the
Contractor. Contractor may terminate this Agreement any time before the artwork is placed for exhibition, after a discussion, and written notice to the City. City will pay Contractor's costs for services delivered up to the time of termination, if the services have been delivered in accordance
with the Agreement. 11. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees it may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. Contractor further acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to terminate this Agreement. 12. JURISDICTIONS AND VENUE Contractor agrees and stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Agreement is the State Superior Court, San Diego County, California.
13. ASSIGNMENT Contractor may assign neither this Agreement nor any part of it, nor any monies due or to become due under it, without the prior written consent of City.
14. AMENDMENTS This Agreement may be amended by mutual consent of City and Contractor. Any amendment will
be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. \\\ \\\ \\\ \\\
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15. AUTHORITY The individuals executing this Agreement and the instruments referenced in it on behalf of
Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement.
CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California
By: By:
(sign here) SUZANNE SMITHSON Library & Cultural Arts Director As Authorized by City Manager Elon Ebanks, Artist
(print name/title)
ATTEST:
By:
(sign here) For BARBARA ENGLESON
City Clerk
(print name/title)
If required by City, proper notarial acknowledgment of execution by contractor must be attached.
If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A. Group B. Chairman, Secretary, President, or Assistant Secretary,
Vice-President CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: For CELIA A. BREWER, City Attorney By: Deputy City Attorney
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13
City Attorney Approved Version 6/12/18 5
EXHIBIT “A” SCOPE OF SERVICES Lender will loan artwork to the City to be exhibited in the 25-Year Retrospective exhibition in the
outdoor City of Carlsbad Sculpture Garden, 2955 Elmwood Street, Carlsbad, CA, and provide additional services as described below. 1. CITY’S CONTACT INFORMATION
• Cultural Arts Manager, Richard Schultz, 760-602-2086, richard.schultz@carlsbadca.gov
• Community Arts Coordinator, Tonya Rodzach, 442-245-0502, tonya.rodzach@carlsbadca.gov
• Cultural Arts General Phone, 760-602-2090
*Throughout COVID-19 pandemic, staff may have adjusted hours and work locations. Email
may be the initial preferred method of reaching staff. 2. EXHIBIT LOCATION
City of Carlsbad Sculpture Garden, 2955 Elmwood Street, Carlsbad, CA, 92008 3. ARTWORK LOAN PERIODS
• Artwork loan period: April 26, 2021 to June 10, 2022
• Sculpture Garden exhibit period: May 3, 2021 to May 28, 2022
Lender agrees to loan the Artwork specified on the checklist attached as Exhibit "B." The
Artwork will remain in the City’s possession during the loan period but may be withdrawn from the exhibition at the City’s sole discretion. City will notify Lender when any Artwork is withdrawn from the exhibit. City and Lender may agree in writing to extend the duration of this Agreement.
Acceptance of the Artwork does not imply that the Artwork will be placed or maintained on public display for the Agreement's exhibit duration. Lender agrees to loan the Artwork specified on the checklist attached as Exhibit "B" of this Agreement to City. 4. TRANSPORTATION AND PACKING
Lender will transport and deliver Artwork and oversee the artwork installation at the City's Sculpture Garden. City will select and arrange for the artwork installer for the project. Lender certifies that the work to be loaned to the City under the terms and conditions of this Agreement is in good condition. The City shall inspect the Artwork and complete and sign the opening
condition report for each piece of Artwork, which will constitute the property's condition at the time of the receipt of the Artwork loan. Any discrepancies, losses, or evidence of damage to the Artwork noted at the time of inspection or at any time while in the City's custody will be reported immediately to the Lender. Lender will deliver Artwork to the City’s Sculpture Garden by loan start date, as described
above. At the end of the exhibition, Lender will be responsible for picking up Artwork within a predetermined date that is agreed upon by both parties and within ten (10) business days after the close of the exhibition, no later than the date described above, unless other written arrangements are made between City and Lender. All drop-off and pickup deliveries shall be coordinated with the City's Cultural Arts Manager or Designee.
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5. LENDER
Virtual Programming Lender will be available to participate in virtual exhibition programming such as virtual tours, audio, or on-camera interviews and any media opportunity. All virtual programming will be
coordinated in advance with the City's Cultural Arts Manager or Designee and shall constitute “work made for hire” under the United States Copyright Act of 1976 [17 U.S.C. §§ 101, et seq.] and any other applicable law.
CITY reserves the right to audio and/or video record and to reproduce and distribute any lecture, reading or speaking engagement, and musical concert or musical Performance
performed under this Agreement as virtual programming. City may retain the recording in its
files, may replay the recordings for its employees and the public, including the right to post, replay, or broadcast the recordings on the City’s YouTube channel, the City’s cable channel, the
City’s Library Facebook Live account, and other similar City internet-based platforms, and may make the recording available for non-circulation use at its library facilities. City shall not sell the recording. City shall provide a copy of the recording to the Artist, upon the Artist’s request. Press Kit
Upon execution of Agreement, the Lender agrees to provide a high-resolution image of self (headshot preferred) and written biography (up to 300 words) as well as four (4) to five (5) high-resolution images of Artwork. Images shall be delivered to the City's Cultural Arts Manager or
Designee in electronic form immediately upon the Agreement's execution. Warranty of Title Lender warrants that Lender is either the owner of the Artwork or the authorized agent of the lawful owner or artist of the Artwork and has the authority to enter into this Agreement and to grant the rights to City as set forth in this Agreement. Lender also warrants that the Artwork(s) is not now or will be subjected to claims of ownership, lien, encumbrance, copyright infringement, or trademark infringement under any state or federal law. Lender shall indemnify the City, its officers, and employees for all damages related to a claim asserting a violation or claim of violation of this Warranty of Title, including reasonable attorney fees and costs.
Artwork Withdrawals Lender agrees once Artwork is placed for exhibition, it cannot be withdrawn from an exhibition by the Lender for any reason.
Model Release For valuable consideration, receipt of which is hereby acknowledged, I hereby assign all rights
to my portrait, picture, videotape and sound recording (collectively “Images”) of me or in which I may be included intact or in part, composite or distorted in character or form, without restriction, to the City of Carlsbad, a municipal corporation, and I hereby authorize the reproduction, copyright, exhibition, broadcast, cablecast, Internet posting, and/or distribution through any and all media now or hereafter known of said Images without limitation for purpose of this use. I waive the right to any fees, royalties or control, now or in the future, and I grant full permission for the use of my Image including, without limitations, name, likeness, performance, voice and biography, for the purpose of publicizing, advertising or promoting any City of Carlsbad matter or program. I hereby relinquish any right that I may have to examine or approve the completed product or products or the advertising copy or printed matter that may be used in conjunction
therewith or the use to which it may be applied. ___________(Artist’s Initials)
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6. CITY
Artwork Installation City shall install and exhibit the Artwork. City reserves the right to make the final decision on which items will be included in the exhibition, and the arrangement of the exhibit. City shall take
reasonable steps to preserve the exhibited Artwork against adverse environmental conditions, deterioration, damage or theft.
Artwork Inspection Artwork will be visually inspected upon receipt, and any noticeable damage will be documented on the shipping receipt. Evidence of damage to Artwork while in the City’s custody will be reported immediately to the Lender. Artwork can be installed into a concrete pad or other identified surface with two to four points of connection. City may elect to display damaged Artwork if, in City’s sole determination, the displaying of the damaged Artwork will not exacerbate the preexisting damage. 7. REPRODUCTION RIGHTS, PUBLICITY AND PHOTOGRAPHY
Except as limited by this Agreement, Lender retains any or all copyright, licensing, and/or ownership rights to the Artwork available to him/her under state or federal law.
In accordance with Section 5 of the Scope of Work, Lender grants City the right to photograph, telecast, video production, social media coverage or make similar visual reproductions of the
Artwork covered by this Agreement for publicity and advertising purposes and other educational purposes and in catalogues or posters that it distributes.
City agrees to acknowledge the artist on all related print matter, exhibition announcements, publicity releases, invitations, posters, signs, or other promotional or educational materials relating to the Artwork. 8. HEALTH & SAFETY
During the COVID-19 health-related pandemic, all activities occurring at City facilities, all Parties must adhere to the guidance from the state, county, and local authorities on health and safety protocols. City staff will inform Lender what the current guidelines are prior to their arrival and entering any City facility. Safety protocols may include, but are not limited to, hand washing, temperature testing, requiring face covering, maintaining physical distancing of six (6) feet. The safety protocols may be modified at any time due to changing rules, regulations or
circumstances. 9. CONTRACTOR FEE / INVOICING
Fee. The total fee payable for the Services to be performed will be two thousand five hundred dollars ($2,500) in two payment installments.
Payment Schedule -
• 1st Payment $1,750 Upon Artwork delivery and completion of installation
• 2nd Payment $750 Upon de-installation and pick-up of Artwork Invoicing & Payment. Contractor will be responsible for submitting invoices for Payment to the City of Carlsbad's Cultural Arts Manager or Designee, as designated on the schedule above. All invoices shall be detailed to include related activities. Final invoices approval will be completed
by the Library & Cultural Arts Director or Designee.
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13
Audra Mahoney
Audra Mahoney
City Attorney Approved Version 6/12/18 8
EXHIBIT “B”
CITY OF CARLSBAD SCULPTURE GARDEN ARTWORK LOAN
1.LENDER’S CONTACT INFORMATION
Name: Elon Ebanks
Phone: 760-840-1469
Address: 1204 Tylee Street, Vista, CA 92083
Email: deepart@cox.net
2.ARTWORK SUMMARY
Total number of works: 1
Total insurance value: $100,000
3.ARTWORK DETAILS
Title: Peace Dove
Insurance value: $100,000
Dimensions: height 7’10” x width 6’7” Overall weight: 1,500 lbs
Media: ½” Milled steel
Year made: 2018
Description: Abstract sculpture
Credit line: Elon Ebanks
Image:
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13
WAIVER REQUEST FORM FACTORS IN SUPPORT OF REQUEST TO MODIFY INSURANCE REQUIREMENT(S) Generally, a modification to the coverage requirement will be accepting a lower limit of coverage or waiving the requirement(s).
Requested by: Tonya Rodzach, Community Coordinator, Library & Cultural Arts Dept. Feb. 18, 2021
(Name and Department) (Date)
Proposed modification(s) to the General Liability requirement(s) for ARTIST (Type of insurance) (Name of contract)
Reduce coverage to the amount of: $ . Waive coverage
Other:
FACTOR(S) IN SUPPORT OF MODIFICATION(S)
(check those that apply)
Significance of Contractor: Contractor has previous experience with the City that is important to the efficiency of completing the scope of work and the quality of the work-product. [explain]
Significance of Contractor: Contractor has unique skills and there are few if any alternatives. [explain:
include number of candidates RFP sent to and number responded if applicable]
Contract Amount/Term of Contract: $ . Work will be completed over a period of .
Professional Liability coverage is not available to this contractor or would increase the cost of the contract by
$ [explain].
Other (e.g. explain why exposures are minimal, how exposures are covered in another policy, exposure control mechanisms, and any other information pertinent to your request):
All onsite interviews on this Agreement are speaking engagement and/or instructional outreach events taking place at the Carlsbad Sculpture Garden, located at 2955 Elmwood Street, Carlsbad, 92008. Each event would have no audience and adherence to Health and Safety requirements provided by the city.
Approved by Risk Manager for this contract only: (Signature) (Date)
H:\WORD\Insurance\Admin Order #68.doc
06/15/2006 27
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13
4/6/2021
For Roadside Assistance: 800-531-8555
Report a claim, get coverage and deductible information, request a tow from the accident
scene, schedule an appraisal or reserve a rental car using:
usaa.com,B
USAA's Mobile App, orB
By calling 210-531-USAA (8722), our mobile phone shortcut number #8722 or
800-531-USAA.
B
California Evidence of Financial Responsibility
This ID card is evidence of liability insurance for your vehicle. The card is valid only as long as liability
insurance remains in force.Keep a copy of the ID card in your vehicle at all times.
You may be required to produce your identification card at vehicle registration or inspection, when
applying for a driver's license, following an accident, or upon a law enforcement officer's request.
FCA1 Re.v. 6-13 50781-0513_02
b a c k
CALIFORNIA EVIDENCE OF FINANCIAL RESPONSIBILITY
Name and Address of Insured NAIC
California Evidence of Financial Responsibility
Keep this card.
IMPORTANT: The California Financial Responsibility
Act (Section 16020) of the Vehicle Code requires every
owner or operator of a vehicle subject to the
requirements of the Financial Responsibility Act to carry
evidence of financial responsibility in the vehicle at all
times. Under vehicle code (Section 16028) every driver
involved in an accident must provide evidence of
financial responsibility at the scene. Failure to comply is
an infraction and shall be punishable by fines,
impoundment or license suspension.
fo
l
d
Insurance Company
Policy Number Effective Date Expiration Date Additional copies available at usaa.com
Vehicle Make/Vehicle Identification Number Year
This policy provides at least the minimum amounts of liability insurance
required by the CA VEH CODE SECTION 16056 for the specified vehicle and
named insureds and may provide coverage for other persons and other
vehicles as provided by the insurance policy.9800 Fredericksburg Road, San Antonio, Texas 78288
VISTA CA 92083-5664
04660 59 61G
2000
CYNTHIA SIOUX COLLIER
ELON LESTER EBANKS
OR 800-531-USAA
CONTACT US: 210-531-USAA(8722)WAUAH68D2YA173321
09/01/217101
USAA GENERAL INDEMNITY COMPANY
03/01/21
AUDI
18600
5
ELON L EBANKS
1204 TYLEE ST
CYNTHIA S COLLIER
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13
For Roadside Assistance: 800-531-8555
Report a claim, get coverage and deductible information, request a tow from the accident
scene, schedule an appraisal or reserve a rental car using:
usaa.com,B
USAA's Mobile App, orB
By calling 210-531-USAA (8722), our mobile phone shortcut number #8722 or
800-531-USAA.
B
California Evidence of Financial Responsibility
This ID card is evidence of liability insurance for your vehicle. The card is valid only as long as liability
insurance remains in force.Keep a copy of the ID card in your vehicle at all times.
You may be required to produce your identification card at vehicle registration or inspection, when
applying for a driver's license, following an accident, or upon a law enforcement officer's request.
FCA1 Re.v. 6-13 50781-0513_02
b a c k
CALIFORNIA EVIDENCE OF FINANCIAL RESPONSIBILITY
Name and Address of Insured NAIC
California Evidence of Financial Responsibility
Keep this card.
IMPORTANT: The California Financial Responsibility
Act (Section 16020) of the Vehicle Code requires every
owner or operator of a vehicle subject to the
requirements of the Financial Responsibility Act to carry
evidence of financial responsibility in the vehicle at all
times. Under vehicle code (Section 16028) every driver
involved in an accident must provide evidence of
financial responsibility at the scene. Failure to comply is
an infraction and shall be punishable by fines,
impoundment or license suspension.
fo
l
d
Insurance Company
Policy Number Effective Date Expiration Date Additional copies available at usaa.com
Vehicle Make/Vehicle Identification Number Year
This policy provides at least the minimum amounts of liability insurance
required by the CA VEH CODE SECTION 16056 for the specified vehicle and
named insureds and may provide coverage for other persons and other
vehicles as provided by the insurance policy.9800 Fredericksburg Road, San Antonio, Texas 78288
VISTA CA 92083-5664
04660 59 61G
1991
ELON LESTER EBANKS
OR 800-531-USAA
CONTACT US: 210-531-USAA(8722)2FTHF25H8MCB03984
09/01/217101
USAA GENERAL INDEMNITY COMPANY
03/01/21
FORD
18600
5
ELON L EBANKS
1204 TYLEE ST
CYNTHIA S COLLIER
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13
For Roadside Assistance: 800-531-8555
Report a claim, get coverage and deductible information, request a tow from the accident
scene, schedule an appraisal or reserve a rental car using:
usaa.com,B
USAA's Mobile App, orB
By calling 210-531-USAA (8722), our mobile phone shortcut number #8722 or
800-531-USAA.
B
California Evidence of Financial Responsibility
This ID card is evidence of liability insurance for your vehicle. The card is valid only as long as liability
insurance remains in force.Keep a copy of the ID card in your vehicle at all times.
You may be required to produce your identification card at vehicle registration or inspection, when
applying for a driver's license, following an accident, or upon a law enforcement officer's request.
FCA1 Re.v. 6-13 50781-0513_02
b a c k
CALIFORNIA EVIDENCE OF FINANCIAL RESPONSIBILITY
Name and Address of Insured NAIC
California Evidence of Financial Responsibility
Keep this card.
IMPORTANT: The California Financial Responsibility
Act (Section 16020) of the Vehicle Code requires every
owner or operator of a vehicle subject to the
requirements of the Financial Responsibility Act to carry
evidence of financial responsibility in the vehicle at all
times. Under vehicle code (Section 16028) every driver
involved in an accident must provide evidence of
financial responsibility at the scene. Failure to comply is
an infraction and shall be punishable by fines,
impoundment or license suspension.
fo
l
d
Insurance Company
Policy Number Effective Date Expiration Date Additional copies available at usaa.com
Vehicle Make/Vehicle Identification Number Year
This policy provides at least the minimum amounts of liability insurance
required by the CA VEH CODE SECTION 16056 for the specified vehicle and
named insureds and may provide coverage for other persons and other
vehicles as provided by the insurance policy.9800 Fredericksburg Road, San Antonio, Texas 78288
VISTA CA 92083-5664
04660 59 61G
1992
ELON LESTER EBANKS
OR 800-531-USAA
CONTACT US: 210-531-USAA(8722)SAJKY1743NC653333
09/01/217101
USAA GENERAL INDEMNITY COMPANY
03/01/21
JAGUAR
18600
5
ELON L EBANKS
1204 TYLEE ST
CYNTHIA S COLLIER
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13
For Roadside Assistance: 800-531-8555
Report a claim, get coverage and deductible information, request a tow from the accident
scene, schedule an appraisal or reserve a rental car using:
usaa.com,B
USAA's Mobile App, orB
By calling 210-531-USAA (8722), our mobile phone shortcut number #8722 or
800-531-USAA.
B
California Evidence of Financial Responsibility
This ID card is evidence of liability insurance for your vehicle. The card is valid only as long as liability
insurance remains in force.Keep a copy of the ID card in your vehicle at all times.
You may be required to produce your identification card at vehicle registration or inspection, when
applying for a driver's license, following an accident, or upon a law enforcement officer's request.
FCA1 Re.v. 6-13 50781-0513_02
b a c k
CALIFORNIA EVIDENCE OF FINANCIAL RESPONSIBILITY
Name and Address of Insured NAIC
California Evidence of Financial Responsibility
Keep this card.
IMPORTANT: The California Financial Responsibility
Act (Section 16020) of the Vehicle Code requires every
owner or operator of a vehicle subject to the
requirements of the Financial Responsibility Act to carry
evidence of financial responsibility in the vehicle at all
times. Under vehicle code (Section 16028) every driver
involved in an accident must provide evidence of
financial responsibility at the scene. Failure to comply is
an infraction and shall be punishable by fines,
impoundment or license suspension.
fo
l
d
Insurance Company
Policy Number Effective Date Expiration Date Additional copies available at usaa.com
Vehicle Make/Vehicle Identification Number Year
This policy provides at least the minimum amounts of liability insurance
required by the CA VEH CODE SECTION 16056 for the specified vehicle and
named insureds and may provide coverage for other persons and other
vehicles as provided by the insurance policy.9800 Fredericksburg Road, San Antonio, Texas 78288
VISTA CA 92083-5664
04660 59 61G
2008
CYNTHIA SIOUX COLLIER
OR 800-531-USAA
CONTACT US: 210-531-USAA(8722)1N4AL21E08N479221
09/01/217101
USAA GENERAL INDEMNITY COMPANY
03/01/21
NISSAN
18600
5
ELON L EBANKS
1204 TYLEE ST
CYNTHIA S COLLIER
DocuSign Envelope ID: 2FA195D5-FA5C-447A-B60F-C573A4502B13