HomeMy Public PortalAboutC-20-012 - CSUDH Foundation Facility Use Agreement, Art ClassesFACILITY USE AGREEMENT BY AND BETWEEN THE CITY OF CARSON AND
THE CALIFORNIA STATE UNIVERSITY DOMINvUEZ HILLS FOUNDATION
FOR ART CLASSES CONDUCTED PURSUANT TO THE PRAXIS CITY ArtS PARKS PROGRAM
This License Agreement ("Agreement") is made and entered into effective the( -'day ofh�`i<
20_2P by and between the City of Carson, a municipal corporation ("CITY" OR "LICENSOR") and the
California State University, Dominguez Hills Foundation ("FOUNDATION" or "LICENSEE"), a California
nonprofit public benefit corporation and auxiliary organization organized under California Education
Code §89900 et seq. for the benefit of California State University, Dominguez Hills, including specifically
its Arts Department (City and Foundation collectively, the "Parties," and each, a "Party).
RECITALS
WHEREAS, the California State University, Dominguez Hills ("University") Arts Department
operates a program known as the PRAXIS art engagement program, which launched the PRAXIS -City ArtS
Parks Program ("Program") in City of Carson ("City") the fall of 2018 to expand narratives of South Los
Angeles with afterschooi art and mentoring programs in the City. The Program provides an artistic outlet
for youth and local communities to aspire and dream, while cultivating pride and specificity of place; and
WHEREAS, on or about May 22, 2019, pursuant to application of the Foundation, the California
Arts Council awarded the Foundation a Creative California Communities grant in the amount of
$135,000 for the benefit of the University's Arts Department to continue and expand the Program by
providing art workshops taught by working artists at three City parks over a two-year period (the
"Grant"); and
WHEREAS, the Parties acknowledge and recognize the mutual benefit to be derived from the
continuation and expansion of the Program in the City, which will further integrate the University's arts
programming into City communities; and
WHEREAS, the purpose of this Agreement is to implement the Program in three City parks by
facilitating the provision of quality art workshops and classes for children and families throughout the
City while also providing jobs and training for professional artists and undergraduate students attending
the University; and
WHEREAS, the professional artists working in the Program will be compensated by the
Foundation with Grant funds to teach the workshops, and will be assisted by University undergraduate
students eager to acquire skills in community engagement and youth mentorship, who will be paid a
stipend by the Foundation with Grant funds; and
WHEREAS, the Program's benefits are three -fold: (1) it provides job opportunities for working
artists; (2) it provides professional development opportunities for undergraduate students; and (3) it
provides cultural and critical thinking enrichment for Carson youth (K-6) participants in the classes.
01007.0001/608395 6
NOW THEREFORE, in consideration of the promises, covenants, and conditions herein contained
and for other good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties agree as follows:
OPERATIVE PROVISIONS
1. RECITALS. The foregoing recitals are true and correct, and are incorporated herein by this
reference.
2. GRANT OF LICENSE FOR FACILITY USE
a. Licensor hereby grants Licensee, for no fee, payment or cost of any kind, one room or
other area or facility, to be determined by the City's Contract Officer in his or her sole
discretion, sufficient to accommodate one Program art cuss or workshop of 12-15 students
(hereinafter "Class"), on the days and at the times specified in subsection (b) of this Section,
except as otherwise provided pursuant to subsection (c) of this Section, at each of the
following City parks:
i. Del Amo Park, 703 E Dei Amo Blvd, Carson, CA 90745.
ii. Carson Park, 21411 Orrick Ave, Carson, CA 90745.
iii. Dolphin Park, 21205 South Water Street, Carson, CA 90745.
(the "Licensed Premises").
b. The Licensed Premises shall be reserved for exclusive Program use on Tuesdays and
Thursdays of each week, from 3:30 p.m. to 4:30 p.m., and from 4:45 p.m. to 5:45 p.m.,
during the weeks and months that coincide with the academic terms or semesters of the
public schools in the City, as follows: (i) approximately 17 consecutive weeks from January
of 2020 through June of 2020; (ii) approximately 17 consecutive weeks from September of
2020 until late December of 2020; and (iii) from January of 2021 through May of 2021.
c. The dates and times set forth subsection (b) of this Section are subject to change by
agreement of City's Contract Officer and Foundation's Representative, provided the
modified dates and times are memorialized in writing prior to the change taking effect, and
provided the total amount of facility use granted, as modified, remains equal to the amount
of facility use authorized in subsection (b) of this Section.
3. CITY RESPONSIBILITIES. In addition to granting the license pursuant to Section 2, City shall:
a. Provide registration services as necessary to register a maximum of 12-15 participants
per Class. Children in the levels of kindergarten through sixth grade who are residents
of the City of Carson will be eligible to register for the Classes, through a parent or legal
guardian;
Oi007.W01/608395.6
b. Make reasonable efforts to market, promote or publicize the Program and/or the
Classes to members of the public within the City in a manner that is commensurate and
consistent with those efforts of the City pertaining to classes, events, or programs
offered by the City's Parks and Recreation Department or Recreation Services Division.
Such efforts may include, without limitation, and in City's sole discretion, referencing or
providing information relevant or related to the Classes in the City's quarterly
Community Services Guide, or preparing or disseminating flyers or feature recreation
guides regarding the Classes;
c. Subject to compliance with applicable employment-related or other laws, rules, and
regulations, endeavor to consider University students who hold or complete Teaching
Assistant positions pursuant to this Agreement for subsequent employment or retention
by City in analogous or comparable roles, in the event the City establishes a City
program for the purpose of continuing art programs or services similar to those
rendered pursuant to this Agreement or the Program; and
d. Provide "livescan" fingerprinting for all Teachers and Teaching Assistants (as those
terms are defined in Section 4) to facilitate criminal history background checks of such
persons in accordance with the requirements of California Education Code Section
45125.1 and other applicable law and the City's fingerprint policy, at no cost to the
Teachers or Teaching Assistants, prior to such Teachers or Teaching Assistants
commencing involvement in Classes under this Agreement.
4. FOUNDATION RESPONSIBILITIES. In exchange for the License granted pursuant to Section 2 and
the City's responsibilities pursuant to Section 3, Foundation shall:
a. Provide professional artist teaching staff, which will be employees of Foundation (the
"Teachers") to lead and instruct the Classes, and provide University -student teaching
assistants (the "Teaching Assistants") to assist in teaching the Classes. One Teacher and
two Teaching Assistants shall be present at each Class. All Teaching assistants shall be
supervised by a Teacher with respect to the Teaching Assistants' activities and
involvement in the Classes. Foundation shall notify City of the identities of all Teachers
and Teaching Assistants prior to such persons making use of the Licensed Premises
pursuant to this Agreement and sufficiently in advance to facilitate compliance with
Section 3(d), and shall provide advance notice to City of any changes to its Teachers or
Teaching Assistants sufficiently in advance to facilitate compliance with Section 3(d);
b. Using Grant funds, compensate all Teachers and Teaching Assistants for their respective
roles in teaching the Classes, in accordance with the terms and conditions of the Grant
and/or the Program and this Agreement. Foundation represents and warrants that it will
employ and compensate the Teachers with Grant funds, and that it will provide the
Teaching Assistants with a stipend using Grant Funds. The parties acknowledge and
03007.0001/608395.6
agree that all Teachers and Teaching Assistants constitute agents of the Foundation for
purposes of this Agreement;
c. Provide all required, necessary, and appropriate training for Teachers and Teaching
Assistants;
d. Provide all necessary supplies and materials for the Classes; and
e. Develop curriculum and set learning outcomes for the Classes.
5. EFFECTIVE DATE. This Agreement shall become effective on the date of full execution hereof
(the "Effective Date").
6. TERM. The Term of this Agreement shall commence on the Effective Date and continue through
June 30, 2021.
7. TERMINATION. Either Party may terminate this Agreement for any reason or no reason upon
ninety (90) days' written notice to the other Party.
8. INSURANCE . By signing this Agreement, the Parties certify they have current insurance policies
(or self-insurance) in the following types and amounts of coverage, and that they shall maintain
such insurance at all times throughout the term of this Agreement:
a. Comprehensive General Liability insurance with limits of not less than $1 million per
occurrence, and $2 million general aggregate.
b. Workers' Compensation and Employers Liability Insurance in a form and amount
compliant with the California Workers' Compensation Insurance and Safety Act and
other applicable law.
c. Automobile liability with a minimum of $1,000,000 combined single limit.
Notwithstanding any other provision of this Agreement, Licensee shall not commence using the
Licensed Premises until it has provided the City with the following, to the satisfaction of the
City's Risk Management Division: (1) Certificates of Insurance evidencing the above insurance
coverages; and (2) endorsements naming the City as an additional insured as to its General
Liability and Auto insurance.
9. INDEMNIFICATION. Pursuant to Government Code Section 895.4, Foundation shall indemnify,
defend and hold harmless City and its elected and appointed officers, employees, and agents
from and against all liability, including but not limited to demands, claims, actions, proceedings,
damages, fees (including attorney and expert witness fees), costs, expenses, errors, omissions,
01007.0001/608395 6
and forfeitures, arising from or connected with any acts or omissions by Foundation or its
officers, agents or employees (including Teachers and Teaching Assistants) under or in
connection with the performance of this Agreement, except for any claim or liability which was
caused by the negligence or willful misconduct of City. Foundation shall have no right of
contribution from City for payment of any judgment pursuant to Government Code Section
895.6. This provision shall survive termination of this Agreement.
10. RELEASE. Licensee hereby waives, releases and discharges City, including its officials, officers,
agents and employees, from and against any and all claims or liabilities accruing to Licensee or
any of its officers, agents or employees or any other person or entity, including but not limited
to claims or liabilities for bodily injury, death, or property damage, arising from or related in any
way to Licensee's use of the Licensed Premises pursuant to this Agreement, including those
involving negligence of the City, Teachers, Teaching Assistants, or Class participants, and
Licensee agrees to waive its rights to make any such claims through any action or proceeding
against the City. However, Licensee understands that this Section is not intended to release any
party from any act or omission of "gross negligence."
11. PHOTO/VIDEO RELEASE. Each Party, on behalf of itself and its officers, agents and employees
using the Licensed Premises pursuant to this Agreement ("P/V Releasing Party"), hereby grants
the other Party ("P/V Released Party") the right to photograph or video -record P/V Releasing
Party during or in connection with its use of the Licensed Premises pursuant to this Agreement,
and to use its photographed or video -recorded likeness, and any image, silhouette, or
reproduction of its voice or appearance taken during or in connection with its use of the
Licensed Premises pursuant to this Agreement ("Likeness") for any purpose, including publicity
and promotion of P/V Released Party and its events, and creation or production of materials in
any form for such purpose, with no claim of entitlement to any license fee or royalty of any kind
from P/V Released Party. Each Party hereby waives any right to the intellectual property of its
Likeness in connection herewith. The rights granted by the Parties hereunder shall not expire.
12. REPRESENTATIVE OF FOUNDATION. Michael Williams, Chief Financial Officer, or such other
person as may be designated by the Executive Director, is hereby designated as being the
representative of Foundation authorized to act on its behalf with respect to this Agreement and
all decisions in connection therewith (Foundation's "Representative"). Foundation may
designate a different Representative pursuant to this Section upon 30 days' written notice to
City.
13. CONTRACT OFFICER. Tim Grierson, Recreation Superintendent (or such other person as may be
designated by the City Manager), is hereby designated as being the representative authorized to
act on City's behalf with respect to this Agreement and all decisions in connection therewith
(sometimes referred to herein as the "Contract Officer").
01007.0001/608395.6
14. NOTICES. All notices or other communication provided pursuant to this Agreement shall be
given to the Parties addressed as follows:
TO: FOUNDATION TO: CITY
Cal. State University Dominguez Hills Foundation City of Carson
1000 E. Victoria Street, WH360 701 E. Carson St.
Carson, CA 90747 Carson, CA 90745
Attn: Jerome Groomes, Interim Executive Director Attn.: Tim Grierson
Either Party may change its address by notifying the other Party of the change of address in
writing. Notice shall be deemed communicated at the time personally delivered or in seventy-
two (72) hours from the time of mailing if mailed as provided in this Section.
15. GENERAL PROVISIONS
a. Compliance with Law. Foundation agrees that it will comply with all applicable laws and City
policies, rules and regulations in connection with the use of the Licensed Premises pursuant
to this Agreement.
b. Waste; Nuisance. Foundation shall not commit, suffer, or permit any waste or nuisance by
any of its officers, agents or employees or any Class participants in or about the Licensed
Premises pursuant to this Agreement. Foundation agrees not to use any of the utilities
furnished by City in a wasteful, unreasonable, or hazardous manner.
c. Condition of Premises. Licensee represents it has inspected the Licensed Premises and has
found the same to be satisfactory, and agrees to make use of the Licensed Premises "as is,"
in their present condition as of the effective date of this Agreement.
d. Further Cooperation. The Parties shall reasonably cooperate with one another, and may
take additional acts or approve and sign additional documents as may be necessary,
appropriate or convenient to effectuate the purposes of this Agreement. The Parties shall
work together during the Term of this Agreement to explore opportunities to continue the
provision of services substantially similar those offered by the Program as an independent
and continuing program in and/or of the City after the expiration of this Agreement, or
during the Term of this Agreement but separate and apart from this Agreement.
e. Independent Status.
City and its agents and employees are, for all purposes, an independent party from
Foundation and shall not be deemed employees or agents of Foundation. City and its
agents and employees, in the performance of this Agreement, shall act in an
independent capacity and not as officers, employees or agents of Foundation. While
01007.0001/608395.6
Foundation may be required by this Agreement to carry Worker's Compensation
Insurance, in no event shall City or its employees be entitled to unemployment or
workers' compensation benefits from Foundation.
ii. Foundation is for all purposes an independent party from City, and neither Foundation
nor any officer, employee or agent of Foundation (including any Teacher or Teaching
Assistant), shall be deemed an officer, employee or agent of the City. Foundation and its
employees and agents shall at all times act in an independent capacity and not as
officers, employees or agents of City. While City may be required by this Agreement to
carry Worker's Compensation Insurance, in no event shall Foundation or its employees
or agents (including any Teachers or Teaching Assistants) be entitled to unemployment
or workers' compensation benefits from City.
iii. Neither Party shall at any time or in any manner represent that it or any of its agents or
employees are agents or employees of the other Party, or that it is a member of a joint
enterprise with such Party. Neither Party shall in any way or for any purpose become or
be deemed to be a partner of the other Party in its business or otherwise or a joint
venturer or a member of any joint enterprise with such other Party.
f. Equal Employment Opportunity. The Parties covenant and agree, on behalf of themselves and
their successors and assigns, that there shall be no discrimination against any employee or
applicant for employment because of race, color, religious creed, national origin, ancestry,
marital status, sex, sexual orientation, age, disability, medical condition or other protected class
in connection with the performance of this Agreement.
g. Conflict of Interest. No official, officer or employee of either Party has or shall have any financial
interest, direct or indirect, in this Agreement, nor shall any such official, officer or employee
participate in any decision relating to this Agreement which affects his financial interest or the
financial interest of any corporation, partnership or association in which he is, directly or
indirectly, interested, in violation of any State statute or regulation. The determination of
"financial interest" shall be consistent with State law and shall not include interests found to be
"remote" or "noninterests" pursuant to Government Code Sections 1091 or 1091.5.
h. Representation and Warranty of Non -Collusion. Licensee represents and warrants that it has
not paid or given and will not pay or give any third party any money or other consideration for
obtaining this Agreement. Licensee further warrants and represents that it has not engaged in
any act(s), omission(s), or other conduct or collusion that would result in the payment of any
money, consideration, or other thing of value to any third party including, but not limited to, any
City official, officer, agent, or employee, as a result or consequence of obtaining any agreement.
Licensee is aware of and understands that any such act(s), omission(s) or other conduct resulting
in such payment of money, consideration, or other thing of value will render this Agreement
void and of no force or effect.
01007.0001/608395.6
i. Dispute Resolution. Any dispute arising under the terms of this Agreement which is not resolved
within a reasonable period of time by the Contract Officer and the Foundation's Representative
shall be brought to the attention of the City's City Manager (or designee) and the Foundation's
Executive Director (or designee) for joint resolution. At the request of either Party, Foundation
shall provide a forum for discussion of the disputed incidents, at which time said officials shall
meet and confer in a good faith effort to resolve the dispute. If resolution of the dispute
through these means is reasonably pursued without success, either party may seek resolution of
the dispute by employing whatever remedies exist in law or equity beyond this Agreement.
j. Non -liability of City Officers and Employees. No officer or employee of either Parry shall be
personally liable to the other Party, or any successor in interest, in the event of any default or
breach of this Agreement by such officer or employee's Party.
k. Transfer, Assignment. Neither Party may transfer or assign its interest in this Agreement, or any
part thereof, without the prior written approval of the other Party. Any transfer or assignment
without such approval shall be void and unenforceable.
Governing law. This Agreement shall be construed in accordance with and governed by the
laws of the State of California. Legal actions concerning any dispute, claim or matter arising out
of or in relation to this Agreement shall be instituted in the Superior Court of the County of Los
Angeles, State of California or the United States District Court, Central District of California, as
applicable.
m. Prevailing Party Attorneys' Fees. The prevailing party in any action or proceeding initiated by
either Parry pursuant to this Agreement, in addition to any other relief which may be granted,
shall be entitled to recovery of reasonable attorney's fees.
n. Waiver. Waiver by any Party of any provision of this Agreement shall not constitute a waiver of
any other provision. Waiver by any Party of any breach of any of the provisions of this
Agreement shall not constitute a waiver of any other provision or a waiver of any subsequent
breach or violation of any provision of this Agreement. No delay or omission in the exercise of
any right or remedy by a non -defaulting Party on any default shall impair such right or remedy
or be construed as a waiver. Any waiver by either Party of any default must be in writing and
shall not be a waiver of any other default concerning the same or any other provision of this
Agreement.
o. Interpretation. The terms of this Agreement shall be construed in accordance with the meaning
of the language used and shall not be construed for or against either Party by reason of the
authorship of this Agreement or any other rule of construction which might otherwise apply.
01047.0001/608395.6
p. Headings. The headings contained in this Agreement are for reference purposes only and shall
not affect in any way the meaning or interpretation of this Agreement.
q. Amendment. This Agreement may be amended only by mutual agreement in a writing duly
approved and executed by authorized representatives of each Party.
r. Entire Agreement. This Agreement is the entire agreement between the Parties. No other
agreements, oral or written, have been entered into with respect to the subject matter of this
Agreement.
s. Severability. Any term or condition of this Agreement that is deemed invalid or unenforceable
by a court of competent jurisdiction shall be severed from the remainder of this Agreement, and
the remaining terms and conditions hereof shall nevertheless remain in full force and effect, and
shall be construed so as to effectuate the intent of the Parties.
t. Counterparts. This Agreement may be executed in any number of counterparts, each of which
shall be deemed an original, but all such counterparts together shall constitute one and the
same instrument.
u. Authority. The persons executing this Agreement on behalf of the Parties warrant that (i) such
Party is duly organized and existing, (ii) they are duly authorized to execute and deliver this
Agreement on behalf of said Party, (iii) by so executing this Agreement, such Party is formally
bound to the provisions of this Agreement, and (iv) entering into this Agreement does not
violate any provision of any other agreement to which said Party is bound.
[signatures on the following page]
01007.0001/608395.6
IN WITNESS WHEREOF, the Parties hereto have executed this Agreement on the date
and year first above written.
LICENSEE
LICENSOR
CALIFORNIA STATE UNIVERSITY CITY OF CARSON, a municipal corporation
DOMINGUEZ HILLS FOUNDATION,
a California nonprofit public benefit corporation
Name: Jerome Groomes
Title: Interim Executive Director
-<Zn- Name: AtVwcl V3-Alu,nns
Title: Ck,-Q—� RAMI i,\
bent Robles, Mayor
Donesia Gause-Aldana, City Clerk
APPROVED AS TO FORM:
ntler, LLP
�rr'En�i
Two corporate officer signatures required for Licensee, with one signature required from each of the following
groups: 1) Chairman of the Board, President or any Vice President; and 2) Secretary, any Assistant Secretary, Chief
Financial Officer or any Assistant Treasurer. LICENSEE'S SIGNATURES SHALL BE DULY NOTARIZED, AND
APPROPRIATE ATTESTATIONS SHALL BE INCLUDED AS MAY BE REQUIRED BY THE ARTICLES OF INCORPORATION,
OPERATING AGREEMENT, OR OTHER RULES OR REGULATIONS APPLICABLE TO LICENSEE'S BUSINESS ENTITY.
01007.0001/508395.3
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
the document to which this certificate is attached, and not the truthfulness, accuracy or validity of that
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
On Yksactory,2019 before rne, sonally appeared r' roved to me on the
basis sa evidence to be the person whose namesJ�jis/ bscribed to the within instrument and
acknowledged to me th t he/gre/! g executed the same in his rlOx<r authorized capacity, and that by
his/ Ef/Eh signatur on the instrument the person(,; or the entity upon behalf of which the persop(<acted,
executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true
and correct.
WITNESS my hand and official seal.
MICHAEL SOM CABMEN
COMM. #2202948
Signature: a . Notary Public • California G
Los Angeles County
l—� Comm. es June 26. Z l
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could
prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE OR TYPE OF DOCUMENT
TITLES)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL NUMBER OF PAGES
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHERDATE OF DOCUMENT
SIGNER IS REPRESENTING:
(NAME OF PERSON(S) OR ENTITY(IES)) SIGNER(S) OTHER THAN NAMED ABOVE
01007.0001/608395.3
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
the document to which this certificate is attached, and not the truthfulness, accuracy or validity of that
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES ,,yy
On r 2019 before me,MM�ntk�'Jr�, ersonalIy appeared M1004 1#1 oved to me on
the basis satisfactory evidence to be the person whose names;%�`is/subscribed to the within instrument and
acknowledged to me tha he/she/they executed the same in hist/tom authorized capacit%peSf and that by
his/her/their signatur on the instrument the perso*1,1or the entity upon behalf of which the personKacted,
executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
1111 AEL SOIi CASAER
COMM. #2202948 z
Signature: 0 Notary Public • California e
x Los Angeles County
Comm. Wres Jum 26, 2021
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could
prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE OR TYPE OF DOCUMENT
TITLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL NUMBER OF PAGES
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER DATE OF DOCUMENT
SIGNER IS REPRESENTING:
(NAME OF PERSON(S) OR ENTITY(IES)) SIGNER(S) OTHER THAN NAMED ABOVE
01007.0001/608395.6
CERTIFICATE OF COVERAGE
DArPIP 6120Mr2019YY,
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER 0 VI NONLY AND CONFERIE5 NO RIGHTS
TYPE OF COVERAGE
UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR
Alliant Insurance Services, Inc
NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
MEMORANDUMS) OF COVERAGE BELOW.
100 Pine Street
THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
11tH Floor
ISSUING COVERAGE PROVIDER AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE
San Francisco CA 94111
CERTIFICATE HOLDER.
EACH OCCURRENCE
IMPORTANT: IF THE CERTIFICATE HOLDER IS AN ADDITIONAL COVERED PARTY, THE
MEMORANDUM OF COVERAGE MUST BE ENDORSED. A STATEMENT ON THIS CERTIFICATE
DOES NOT CONFER RIGHTS TO THE CERTIFICATE HOLDER IN LIEU OF SUCH
ENDORSEMENTS).
IMPORTANT: IF SUBROGATION 15 WAIVED, SUBJECT TO THE TERMS AND CONDITIONS OF THE
NAMED COVERED PARTY
CSU Dominguez Hills Foundation
1000 East Victoria Street
Carson CA 90746
MEMORANDUM(5) OF COVERAGE AN ENDORSEMENT MAY BE REQUIRED. A STATEMENT ON
THE CERTIFICATE DOES NOT CONFER RIGHTS TO THE CERTIFICATE HOLDER IN LIEU OF SUCH
ENDORSEMENT151.
PROGRAM AFFORDING COVERAGE
CLAIMS MADE 0 OCCUR
A: CSURMA AORMA
B: AORMA WC/Safety National Cas.
C:
$5000
COVERAGES
TH15 IS TO CERTIFY THAT THE COVERAGE 15 AFFORDED TO THE ABOVE NAMED MEMBER, AS PROVIDED BY THE MEMORANDUMIS) OF COVERAGE FOR THE PERIOD SHOWN BELOW NOT WITHSTANO NG ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE SSUED OR MAY PERTAIN THE COVERAGE AFFORDED BY THE PROGRAM
DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS. AND CONDITIONS OF SUCH MEMORANDUM(S) OF COVERAGE. THE FOLOWING COVERAGE IS IN EFFECT
JPA
LTR
TYPE OF COVERAGE
MEMORANDUM NUMBER
COVERAGE EFFECTIVE
DATE (MWDOIYYI
COVERAGE EXPIRATION
DATE (MMIODIYY}
LIMITS
A
GENERAL LIABILITY
AORMA-1920.01
7112019
7/1/2020
EACH OCCURRENCE
S 5 OOO,DOD
XCOMMERCIAL GENERAL LIABILITY
FIRE DAMAGE {Arty ane fire)
S 100,000
CLAIMS MADE 0 OCCUR
MED EXPENSE (Any one person
$5000
XP -1 I-Labifty
PERSONAL S ADV INJURY
S5.000000
X I Contractual flab
GENERAL AGGREGATE
S5.000000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS -COMPIOP AGG
S5.000000
X A',E,,,°j' r I PROJECT LOC
A
AUTOMOBILE LIABILITY
AORMA-1920-01
7/1/2019
7/1/2020
COMBINED SINGLE LIMIT
$5,060,000
X ANY AUTO
1Ea accident)
S
X ALL OWNED AUTOS
}( SCHEDULEDAUTOS
X HIREDAUTOS
X NMOWNEDAUTOS
a
WORKERS' COMPENSATION AND
EMPLOYERS LIABILITY
AORMA-VVC-1920
7/1/2019
7/1/2020
WTUTORY OTHER
LIMITS
ANY PROPRtETORIPARTNERI
EXECUTIVEIOFFICERIMEMBER
EL EACH ACCIDENT
55,000000
EXCLUDED?
IF YES, DESCRIBED UNDER SPECIAL
E L DISEASE- EA EMPL:iYEE
$5.000000
E L DISEASE - POLICY LIMIT
S5.000000
PROVISION BELOW
OTHER
OTHER
DESCRIPTION OF OPERATIONSPLOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORLSEMENTISPECIAUPROVISIONS
Note: Workers' Compensation Coverage is provided as evidence only.
Evidence of coverage only.
City of Carson/Carson Redevelopment Agency
Risk Management Division
PO Box 6234
Carson CA 90749
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUM(S) OF COVERAGE
BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE VVITH THE MEMORANDUM(S) OF COVERAGE
PROVISIONS
AUTHORIZED REPRESENTATIVE
64
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