HomeMy Public PortalAboutC-21-004 - UCLA Health, Blood & Platelet Center Blood DriveAGREEMENT FOR USE OF CITY FACILITIES
FOR UCLA HEALTH BLOOD & PLATELET CENTER BLOOD DRIVE
This Agreement for Use of City Facilities for UCLA Health Blood & Platelet Center Blood
Drive ("Agreement") is entered into effective Jonvaru 20 , 2021 (the "Effective Date"), by
and between the City of Carson, a municipal corporation ("Licensor" or "City") and The Regents
of the University of California ("Licensee"). Licensor and Licensee may be referred to, individually
or collectively, as a "Party" or the "Parties."
RECITALS
WHEREAS, Licensee, and specifically its UCLA Blood & Platelet Center, seeks to use
Licensor's Community Center at 801 E. Carson Street, Carson, CA 90745 to conduct a blood drive
on January 20, 2021; and
WHEREAS, Licensor is agreeable to granting Licensee a license to use the aforementioned
facilities as reasonably necessary to conduct the blood drive, with no charge for use of Licensor's
facilities, on the terms and conditions set forth herein, and Licensee is also agreeable to such
arrangement; and
NOW, THEREFORE, 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. Licensor grants Licensee a license to use the City's Community Center
facilities specified below (the "Licensed Premises") to conduct a blood drive on the date
specified below at the times specified below (or such other dates and times as may be
agreed upon by and between Licensor's Contract Officer and Licensee's Contract
representative designated pursuant to Section 10) (collectively, the "Event"). The location
of the Licensed Premises is subject to change in the Contract Officer's discretion, provided
the Licensed Premises shall remain within the Community Center in a room or other area
sufficient to accommodate the Event.
Event:
Date: January 20, 2021
Time: 7:30 a.m. to 3:30 p.m.
Location: Community Center, Carson Dominguez Room
3. License Fee. Licensor will not charge a license fee for the license granted pursuant to
Section 2.
01007.0001/676338.5
4. Term. This Agreement shall be effective from January 1, 2021 through January 31, 2021
(the "Term").
5. Renewal. Any renewal of the license granted by this Agreement upon or after expiration
of the Term, whether such renewal is on the same or different terms as this Agreement,
shall require approval and execution of a written agreement by the Parties.
6. Event Size Limits. The number of Event participants present at the Licensed Premises at
any given time shall not exceed the maximum occupancy of the Licensed Premises.
Further, the number of Event participants present at the Licensed Premises at any given
time shall be limited to ensure proper social distancing in accordance with COVID-19
rules, regulations and guidance, as required by Section 8 below. Blood donors shall be
accommodated based on reserved timeslots to control the flow of Event participants into
and out of the Licensed Premises.
7. Set -Up and Take -Down. Licensee is solely responsible for set-up and take down of the
Event and for returning the Licensed Premises, upon completion of the Event (and upon
completion of each of the two installments that comprise the Event) to the condition they
were in prior to the Event having been conducted, including all costs related to same.
8. COVID-19 Precautions. Licensee represents, warrants and attests that it will comply with
and implement all applicable laws, rules, regulations, and all applicable policies,
guidelines and recommendations from federal, state and local public health authorities,
and Licensee's internal policies and protocols to the extent not conflicting with same,
related to preventing the spread of COVID-19 in connection with conducting the Event.
Without limitation as to the foregoing, Licensee shall require and ensure that all Event
participants (including Licensee's officers, employees, agents and volunteers) shall wear
a facial covering over the nose and mouth at all times (except as may be required to
comply with applicable provisions of the Americans with Disabilities Act or applicable
regulations thereunder) and shall practice social distancing of at least six feet whenever
possible. Licensee shall make hand sanitizer readily available for all Event participants.
9. Termination; Survival. Either Party may terminate this Agreement at any time, for any
reason or no reason, upon 10 days' written notice of termination to the other Party.
Sections 15, 16, 17, 18, 21, 23, and 31 shall survive any termination or expiration of this
Agreement.
10. Representative of Licensee. Noelle Lai, Community Liaison, is hereby designated as being
the representative of Licensee authorized to act on its behalf with respect to this
Agreement and all decisions in connection therewith. All employees or agents of Licensee
making use of the Licensed Premises for the Event ("Personnel") shall be under the
01007.0001/676338.5
exclusive direction of the representative of Licensee. Licensee shall notify City of the
identities of all of its Personnel upon execution of this Agreement, and Licensee shall
provide advance notice to City of any changes to its Personnel. Licensor may designate a
different representative pursuant to this Section upon 30 days' written notice to City.
11. Contract Officer. Adrian Reynosa, Community Center Manager, or such other person as
may be designated by the City Manager, is hereby designated as being the representative
authorized to act on Licensor's behalf with respect to this Agreement and all decisions in
connection therewith ("Contract Officer").
12. Independent Status.
a. Licensor and its agents and employees are, for all purposes, an independent party
from Licensee and shall not be deemed employees or agents of Licensee. Licensor 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 Licensee. While
Licensee may be required by this Agreement to carry Worker's Compensation
Insurance, in no event shall Licensor or its employees be entitled to unemployment
or workers' compensation benefits from Licensee.
b. Licensee is for all purposes an independent party from Licensor, and neither Licensee
nor any officer, employee or agent of Licensee, shall be deemed an officer, employee
or agent of the Licensor. Licensee and its employees and agents shall at all times act
in an independent capacity and not as officers, employees or agents of Licensor. While
Licensor may be required by this Agreement to carry Worker's Compensation
Insurance, in no event shall Licensee or its employees or agents be entitled to
unemployment or workers' compensation benefits from Licensor.
c. 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.
13. Furnishings; Utilities; Waste; Nuisance. Tables, chairs, and trash cans from Licensor's
existing inventory will be provided within the Licensed Premises by Licensor in the
amount reasonably necessary for Licensee to conduct the Event. Licensee shall be
responsible for setting up and arranging the tables, chairs and trash cans as needed to
conduct the Event. Licensor will set and maintain the air temperature within the Licensed
Premises at 68 degrees while the Event is taking place. Except as otherwise provided in
this Section 13, the Parties acknowledge and agree that no furnishings or utilities other
01007.0001/676338.5
than those normally supplied to the Licensed Premises at the dates and times of the Event
will be provided for the Event, and Licensee represents and warrants that no such special
furnishings or utilities will be needed for Licensee to conduct the Event. Licensee shall not
commit, suffer, or permit any waste or nuisance by Licensee or the Event participants in
or about the Licensed Premises in connection with Licensee's use thereof pursuant to this
Agreement. Licensee agrees not to use any of the facilities furnished by Licensor in a
wasteful, unreasonable, or hazardous manner.
14. Compliance with Laws, Rules and Regulations. Licensee agrees to comply with all
applicable federal, state and local law and regulations and all applicable City policies, rules
and regulations in connection with its use of the Licensed Premises. Licensee represents
and acknowledges that it has received, read and understands Licensor's Community
Center rules and regulations, and agrees that it will comply with said rules and regulations
in connection with its use of the Licensed Premises.
15. Release. Licensee hereby waives, releases and discharges Licensor, including its officers
(elected and appointed), agents and employees, from and against any and all claims or
liabilities to Licensee or any other person or entity, including but not limited to claims or
liabilities for bodily injury, illness, death, or property damage, arising from or related in
any way to Licensee's use of the Licensed Premises or Licensee's hosting of or
participation in the Event, including those involving negligence of Licensor or Event
participant(s), and Licensee, on behalf of itself and its officers, employees, agents and
volunteers, agrees to waive its rights to make any such claims through any action or
proceeding against the City. Licensee also understands that an inherent risk of exposure
to and spread of COVID-19 exists in any public space where people are present, including
with respect to the Event. Licensee acknowledges that COVID-19 is an extremely
contagious disease that can lead to severe illness and death. Licensee voluntarily assumes
all risks of exposure to or spread of COVID-19 related to Licensee's hosting, participation
and involvement in the Event, and Licensee assumes sole responsibility therefor and
agrees to hold harmless Licensor, its officers (elected and appointed), officer, agents and
employees in connection therewith. Licensee is voluntarily hosting and participating in
the Event notwithstanding these risks, and Licensee acknowledges that it must comply
with all applicable federal, state and local laws and guidelines related to preventing the
spread of COVID-19 in connection with the Event as set forth in Section 8, and further
acknowledges that even where Licensee is in full compliance with same, there is no
guarantee that any person who attends or participates in the Event will not become
infected with COVID-19. However, Licensee understands that this Section is not intended
to release any party from any act or omission of "gross negligence."
01007.0001/676338.5
16. Civil Code Section 1542 Waiver. In giving the release and waiver set forth in Section 15,
Licensee expressly waives any and all rights conferred upon it by the provisions of
California Civil Code Section 1542, which Licensee understands reads as follows:
"A general release does not extend to claims that the creditor or releasing party does not
know or suspect to exist in his or her favor at the time of executing the release and that,
if known by him or her, would have materially affected his or her settlement with the
debtor or released party."
This waiver shall be effective as a bar to any and all actions, fees, damages, losses, claims,
liabilities and demands of whatsoever character, nature and kind, that are known or
unknown, or suspected or unsuspected, that may arise from or relate in any way to
Licensee's hosting of, presence at, or participation in the Event.
Licensee's Initials
17. Indemnification. Neither Licensor nor any official (elected or appointed), employee, or
agent of Licensor shall be responsible for any damage or liability occurring by reason of
any acts or omissions on the part of Licensee or any of its officers, directors, employees,
agents, representatives, volunteers or invitees under or in connection with this
Agreement. Licensee shall fully indemnify, defend, and hold harmless Licensor and its
officers (elected and appointed), employees and agents from any claim, action,
proceeding, damage, injury, loss, cost, expense, fee (including litigation expenses and
attorneys' fees), penalty, obligation, forfeiture or liability, of every nature (including but
not limited to property damage, bodily injury, illness, or death) arising out of or resulting
from any act or omission of Licensee or any of its officers, directors, employees, agents,
or representatives, or any act or omission of those who attend or participate in the Event,
under or in connection with this Agreement, but only in proportion to and to the extent
that such claim or liability is caused by the acts or omissions of Licensee, its officers,
directors, employees, agents, representatives or invitees.
18. Insurance. Licensee, at its sole cost and expense, shall secure and maintain, throughout
the Term of this Agreement, the following policies of insurance (or self-insurance): (1)
commercial general liability and property damage insurance with a limit of no less than
One Million Dollars ($1,000,000) per occurrence and Two Million Dollars ($2,000,000) in
the aggregate; and (2) if Licensee has any employees, worker's compensation insurance
in such amount as will fully comply with the laws of the State of California and which shall
indemnify, insure and provide legal defense for Licensee against any loss, claim or damage
arising from any injuries or occupational diseases occurring to any worker employed by
or any persons retained by Licensee in the course of conducting the Event.
01007.0001/676338.5
Licensee's insurance shall: (1) name Licensor as an additional insured (such provision shall
apply only in proportion to and to the extent of the acts or omissions of Licensee, its
officers, directors, employees, agents, representatives or invitees); (2) contain a
severability of interest clause and a provision that such policy shall be primary and non-
contributing with respect to any policy carried by Licensor and that any coverage carried
by Licensor shall be in excess of and non-contributing unless the policy limit of Licensee's
insurance is exceeded; and (3) be written by companies rated "A" or better in the most
recent edition of Best's Insurance Guide and authorized to do business in California, and
only if they are of a financial category Class VII or better, unless such requirements are
waived by the Risk Manager of the City ("Risk Manager") due to unique circumstances.
The insurer is deemed hereof to waive all rights of subrogation and contribution it may
have against Licensor, its officers (elected and appointed), employees and agents and
their respective insurers. A Certificate of Insurance and endorsements documenting the
above insurance coverage must be supplied to Licensor PRIOR to Licensee's use of the
Licensed Premises pursuant to this Agreement. All insurance coverages required pursuant
to this Section shall be maintained for a minimum of two (2) years, notwithstanding any
termination or expiration of this Agreement.
19. 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
in their present condition.
20. 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.
21. Prevailing Party Attorneys' Fees. The prevailing party in action or proceeding initiated by
either Party pursuant to this Agreement, in addition to any other relief which may be
granted, shall be entitled to recovery of reasonable attorney's fees.
22. Notice. Any notice, demand, request, document, consent, approval, or communication
either Party desires or is required to give pursuant to this Agreement shall be in writing
and either served personally or sent by prepaid, first-class mail, addressed as follows:
To Licensor: City of Carson
Attn.: Adrian Reynosa, Community Center Manager
801 E. Carson Street
Carson, CA 90745
(310) 830-7600
01007.0001/676338.5
To Licensor: UCLA Health Blood & Platelet Center
Attn.: Noelle Lai, Community Liaison
1045 Gayley Ave., 2 d Floor
Los Angeles, CA 90024
Tel.: (310) 895-0282
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.
23. Legal Action. In addition to any other rights or remedies, and except as otherwise
provided in this Agreement, either Party may take legal action, in law or in equity, to cure,
correct or remedy any default, to recover damages for any default, to compel specific
performance of this Agreement, to obtain declaratory or injunctive relief, or to obtain any
other remedy consistent with the purposes of this Agreement.
24. Covenant Against Discrimination. Licensee covenants that, by and for itself, its heirs,
executors, assigns, and all persons claiming under or through them, that there shall be no
discrimination against or segregation of, any person or group of persons on account of
race, color, creed, religion, sex, gender, sexual orientation, marital status, national origin,
ancestry or other protected class in the performance of this Agreement.
25. Conflict of Interest. No official, officer or employee of Licensor 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.
26. 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, 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.
01007.0001/676338.5
Licensee's Authorized Initialii%'L
27. 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.
28. Integration; Amendment. This Agreement is the entire, complete and exclusive
expression of the understanding of the Parties. It is understood that there are no oral
agreements between the Parties affecting this Agreement and this Agreement
supersedes and cancels any and all previous negotiations, arrangements, agreements and
understandings, if any, between the Parties, and none shall be used to interpret this
Agreement. No amendment to or modification of this Agreement shall be valid unless
made in writing and approved by the Parties. The Parties agree that this requirement for
written modifications cannot be waived and that any attempted waiver shall be void.
29. Waiver. Waiver by any Party of any term, condition, or covenant of this Agreement shall
not constitute a waiver of any other term, condition, or covenant. Waiver by any Party of
any breach 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.
30. 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.
31. Governing Law. This Agreement shall be interpreted, construed and governed both as to
validity and to performance of the parties in accordance with 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.
32. 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.
01007.0001/676338.5
33. Counterparts; Electronic Signature. This Agreement may be executed in counterparts,
each of which shall be deemed to be an original, whether the signatures are originals,
facsimiles or electronic. All such counterparts shall constitute one and the same
instrument.
34. 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) the entering into this
Agreement does not violate any provision of any other agreement to which said Party is
bound.
[signatures on the following page]
01007.0001/676338.5
11N WITNESS WHEREOF, the Parties hereto have executed this Agreement on the date
and year first above w ritte n.
THE REGENTS OF THE UNIVERSITY'
OF CALIFORNIA
Name.- Matthew�e'ragiac�R'
Title: Associate Dkgct9"tLA Real Estate
Narne:
Title,
APPROVED AS TO FORM:
Aleshire & Wynder, LLP
Sunny K. Soltani, City Attorney
[bril
Two corporate officer signatures required when Licensee is a corporation} with one signature required from
each orthe following groups: 1) Chairman orthe Board, President or any Vice President; and 2) Secretary, any
Assistant Secretary, Chier Financial Officer or any Assistant Treasurer. LICENSEES SIGNATURES SHALL
BE DULY NOTARIZED, AND APPROPRIATE ATTESTATIONS SHALL BE INCLUDED AS MAY BE
REQUIRED BY THE BYLAWS, ARTICLES OF INCORPORATION, OR OTHER RULES OR
RECULATIONS APPLICAPLE'r'D LICENSEW6 BUSUNESS ENTITY.
01W70,101/6763385
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
CIVIL CODE § 1189
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 document.
State of California
County of SUS 0-117 ge L42 S
On t CJ% � �f1-z 0 a)% before me,
Date
personally appeared
Here Insert Name and Title of
Name(s) of Signer(s)
Officer
C,
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s),
or the entity upon behalf of which the person(s) acted, executed the instrument.
*my
PAM L. BALFE
Notary Public - California
Los Angeles CountyCommission # 2303265 Comm. Expires Sep 25, 2x23
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESSmy d and official seal.
I /W
Signature (Lk�
Signature of Notarj Public
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Number of Pages:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual CI Attorney in Fact
❑ Trustee [I Guardian or Conservator
❑ Other:
Signer Is Representing:
Signer's Name:
CI Corporate Officer — Title(s): _
1_-1 Partner — 1-1 Limited D General
Ll Individual I. I Attorney in Fact
Cl Trustee 1 Guardian or Conservator
❑ Other:
Signer Is Representing:
L4� �4��'e/ 'r/S�G�%i ✓4�4�4�.�`✓, �✓.''✓ '✓4�✓,A✓,4�✓,i✓4�4�✓,4�✓,4�U, 4�✓,4C✓4�4�4�4�%4�✓1
4�%4✓4"✓4'✓4��,4�✓,4�✓,4✓.�✓,4�4�✓.4"✓4�✓,4�✓,4�✓, 4�✓i
CERTIFICATE OF
Date: 11/17/2020
SELF-INSURANCE COVERAGE
PRODUCER/INSURED
The Regents of the University of California
This Certificate is issued as a matter of information only to authorized viewers for
University of California, Los Angeles
their internal use only and confers no rights upon any viewer of this Certificate.
Insurance and Risk Management
10920 Wilshire Blvd Suite 860
The Certificate does not amend, extend or alter the coverage described below.
9
Los Angeles CA 90024
This Certificate may only be copied, printed and distributed by an authorized
(310) 794-6948
viewer for its internal use. Any other use, duplication or distribution of the
Certificate without the written consent of the Regents of the University of California
is prohibited.
ENTITIES AFFORDING COVERAGE
PARTICIPATION
COMPANY LETTER A The Regents of the University of California 100%
COVERAGES
THIS IS TO CERTIFY THAT THE REGENTS OF THE UNIVERSITY OF CALIFORNIA IS A GOVERNMENTAL ENTITY THAT HAS A SELF-FUNDED
RETENTION FOR LIABILITIES DESCRIBED BELOW, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY WRITTEN
CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY PERTAIN. THIS SELF-FUNDED PROGRAM IS
SUBJECT TO ALL PROVISIONS OF THE BYLAWS AND STANDING ORDERS OF THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, WHICH
DOES NOT PERMIT ANY ASSUMPTION OF LIABILITY WHICH DOES NOT RESULT FROM THE NEGLIGENT ACTS OR OMISSIONS OF ITS
OFFICERS, AGENTS OR EMPLOYEES.
CO
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE DATE
POLICY EXPIRATION DATE
LIMITS
LTR
A
GENERAL LIABILITY
Self -Insured
07/01/2020
07/01/2021
GENERAL AGGREGATE
$ 2,000,000
X COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OPAGG
$ 1,000,000
CLAIMS MADEX❑OCCURRENCE
PERSONAL&ADV INJURY
$ 1,000,000
CONTRACTUAL LIABILITY
$ 1,000,000
EACH OCCURRENCE
$ 1,000,000
A
AUTOMOBILE
LIABILITY
Self -Insured
07/01/2020
07/01/2021
COMBINED SINGLE LIMIT
$ Not Applicable
ANY AUTO
X
ALL OWNED
BODILY INJURY
$ 1,000,000
AUTOS
(PER PERSON)
SCHEDULED
AUTOS
X
HIREDAUTOS
BODILY INJURY
$ 1,000,000
(PER ACCIDENT)
X
NON -OWNED
AUTOS
GARAGE LIABILITY
PROPERTY DAMAGE
$ 1,000,000
PROPERTY
EACH OCCURRENCE
$
FIRE & EXTENDED PERILS
AGGREGATE
$
A
WORKERS'COMPENSATION AND
Self -Insured
07/01/2020
07/01/2021
STATUTORY LIMITS
YES
EMPLOYERS LIABILITY
EACH ACCIDENT
$ As required by
DISEASE - POLICY LIMIT
$ As required by
DISEASE - EACH EMPLOYEE
$ As required by
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
City of Carson is named as Additional Insured but only in connection with blood drive on 12/14/20 & 1/20/21 at the City of Carson
Community Center
CERTIFICATE HOLDER
CANCELLATION
APPLICABLE PARTY AS REQUIRED BY WRITTEN CONTRACT
SHOULD THE REGENTS ELECT TO DISCONTINUE SELF-INSURING ITS
OR AGREEMENT
LIABILITIES, THE REGENTS WILL UPDATE PROOF OF SELF-INSURANCE ON ITS
City of Carson
WEBSITE. THE REGENTS SHALL NOT BE OBLIGATED TO PROVIDE INDIVIDUAL
801 E. Carson Street
NOTICE TO VENDORS OR OTHERS.
By:
Carson CA 90745
0114 1
Johanna Klohn